Background and purpose: Locoregional infusion chemotherapy such as hepatic artery, or hepaticportal vein infusion is one of the most important treatments for hepatocelluar carcinoma. This study was aimed to investigate the distribution of fluorouracil(5-FU) in rat hepatoma, liver tissue and plasma after administrated by caudal vein or locoregional routes of hepatic artery, hepaticportal vein, and hepaticportal vein with ligated hepatic artery. Methods:Twenty-four tumor-bearing rats were divided into 4 groups randomly, and they were infused with 5-FU through peripheral vein(caudal vein), hepatic artery, hepaticportal vein or hepaticportal vein with ligated hepatic artery, which dose was 20 mg/kg. High performance liquid chromatography was adopted to measure the content of 5-FU in hepatoma, liver tissue and plasma, and the drug penetration rate among them were calculated. Results:The group of hepaticportal vein with ligated hepatic artery reached the highest concentrations of 5-FU in live tissue and hepatoma, which concentrations were (22.1±9.5)μg/g and (16.4±7.2)μg/g. Then was the hepatic artery group, and the concentration of the hepaticportal vein group in the hepatoma focus was much smaller than the former 2 groups, which was (8.9±3.7)μg/g. The peripheral vein group got the lowest concentrations both in the liver tissue and hepatoma, which were (9.4±3.7) and (4.3±2.2)μg/g. The concentrations of 5-FU in the plasma in the peripheral vein group, the hepatic artery group, the group of hepaticportal vein with ligated hepatic artery and the hepaticportal vein group were (26.8±12.5), (16.4±9.7), (15.9±10.1) and (14.9±8.5)μg/mL, which indicated that the drug concentrations of the latter 3 groups were much lower than the former group. The hepatoma/plasma penetration rate of 5-FU in the group of hepaticportal vein with ligated hepatic artery, the hepatic artery group, the hepaticportal vein group and the peripheral vein group were 103.47%, 92.94%, 59.58% and 16.08%. Conclusion: Compared to the peripheral venous bolus injection, locoregional infusion could significantly increase the concentrations of chemotherapy agent in hepatoma focus and liver tissue, and decrease the drug distributions in peripheral blood. And the infusion through hepaticportal vein with ligated hepatic artery and through hepatic artery reaches higher concentrations in the hepatoma focuses, which indicate that they are 2 practical and promising routes for the locoregional chemotherapy of hepatoma.

Objective To study biliary excretion of ceftriaxone sodium in humans. Methods Twelve biliary calculi patients were infused with a single dose of 2.0g ceftriaxone half an hour before operation and the common bile duct bile and gallbladder bile samples were coUected in the operations. The bile drug concentrations were assayed by HPLC. Results The results of clinical study on the bile drug showed that the concentrations (C) of ceftriaxone in common bile duct and gallbladder were (264.43±166.46) μg/ml and (85.39 ±48.16) μg/ml, respectively. Conclusion Ceftriaxone reaches high concentrations in humans' bile, and it could be chosen as a good antibiotics for the treament of biliary infection.

Objective To investigate the prognostic value of AKT3 expression in gastric cancer. Methods AKT3 expression data in The Cancer Genome Atlas(TCGA)datasets and its clinical information were downloaded. Statistically assessed was performed for relationship with clinicopatho?logical factors and prognosis. Gene set enrichment analysis(GSEA)was used to predict the gene sets modulated by AKT3. Results The expres?sion of AKT3 was associated with T stage(P=0.001),TNM stage(P=0.049)and differentiation(P<0.001).High level of AKT3 expression indi?cates poor prognosis(P=0.001). AKT3 could regulate gene sets involving cell adhesion molecule,cytoskeleton regulation,focal adhesion and TGF?βsignaling pathway. Conclusion AKT3 could be used as a potential prognostic marker and a therapeutic target in gastric cancer.

Objective To establish a function model to modulate the tube current according to the chest circumference at Coronary CTA scan,and to evaluate the feasibility of using the function model individually.Methods Sixty-eight consecutive patients who underwent thoracic scan with automatic current modulation were studied to establish a function model of tube current and chest circumference.The other 64 consecutive patients underwent coronary CTA scan using the new function model.The image quality was scored,and the noise,tube current and radiation dose were recorded and statistically evaluated.Results The POW function model was the best one to adjust tuber current to the chest circumference (R2 =0.691,P ＜ 0.05).The mean image quality score,noise,tube current,radiation dose (CTDIvol) and dose-length product (DLP) were (3.38±0.72) scores,(31.02 ±3.97) HU,(390.63± 89.30) mA,(34.83±10.72) mGy,(751.67 ±175.16) mGy·cm,respectively.Conclusions Tube current modulation based on the chest circumference would be feasible to reduce the radiation dose individually in coronary CT angiography.

Objective To explore the predictive value of soluble growth STimulation expressed gene 2(sST2) on major adverse cardiovascular events(MACE) of acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods The study included 148 patients with first episode of AMI admitted from January 2015 to May 2016 in the heart center of the First Hospital of Lanzhou University.Serum sST2 level before PCI was tested and all patients were followed up clinically for 6 months after PCI.Results 1.MACEs were found in 23 patients during follow up.The sST2 leveles were significantly higher in patients with MACEs than the non-MACE group [(44.50 ±5.32) ng/ml vs.(23.59±1.15) ng/ml, P=0.001].Pearson correlation analysis showed that serum sST2 were positively correlated with MACE and type Ⅲ procollagen amine terminal peptide (PⅢNP) but was not correlated with NT-proBNP.2.Serum sST2 found to be correlated with the body mass index, blood pressure, triglycerides, aspartate aminotransferase, left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF).3.The area under the ROC curve of sST2 to predict the occurrence of MACE after PCI was 0.787 which was higher than that of NT-proBNP.The area under curve of sST2 combined with NT-proBNP was 0.820.4.The survival rate of patients with serum sST2 level ≤29 ng/ml was higher than patients with sST2>29 ng/ml in 6 months after PCI.Conclusions sST2 is affected by a variety of factors.sST2 combined with NT-proBNP can improve the predictive value of MACE after PCI, and higher the level of sST2, higher the mortality rate in 6 months after PCI.

Objective To summarize the experience in management of main hepatic vein injury due to hepatectomy for hepatic neoplasm of segment Ⅷ. Methods Clinical data of 64 patients suffering from main hepatic vein injury due to hepatectomy of hepatic neoplasm of segment Ⅷ in our hospital from October 1996 to October 2008 were retrospectively analyzed. Results Both the main trunks of the middle and right hepatic vein were injured in 34 patients, single right hepatic vein in 13 and middle hepatic vein in 17. In these patients with hepatic vein injury, the main trunk of the hepatic vein was repaired in 39, vessels ligated in 12 and direct liver wound surfaces sutured in 12. The hepatectomy and hemostasis were successfully performed during operation in all patients. After operation, 3 patients had active bleeding and 2 patients were reoperated on to sew up the bleeding points by wadding with the gelatin sponge and discharged after rehabilitation. One patient gave up treatment and was discharged automatically. Conclusion Main hepatic vein injury in hepatectomy of hepatic neoplasm of segment Ⅷ can be managed effectively by hepatic vein repair, hepatic vein ligation and suture of the liver section that can be chosen to control the bleeding of hepatic vein injury according to the actual conditions.

OBJECTIVETo study the concentrations and pharmacokinetics of 6 different kinds of antibiotics in rabbit bile, and evaluate their microbicidal potential.

METHODSThirty-six health rabbits were randomly divided into 6 groups, and each group was 6 rabbits. After anaesthesia, the common bile duct of rabbit was isolated and cumulated with a silicone tube. The rabbits were administered intravenously with the equal-effect dose of antibiotics. Bile (1.5 ml) was collected at different time points after administration, and the concentration of antibiotics of bile was assayed by high performance liquid chromatography. The bile drug concentration-time data were processed by software to figure out the pharmacokinetic parameters such as maximum concentration (C(max)), peak time (T(max)), half-life time (T(1/2)), clearance (CL) and apparent volume of distribution (VD). The bile antibiotics concentration contrasted to the minimum inhibitory concentration (MIC), and attained the bactericidal index (C(max)/MIC) and the time when the drug concentration exceeded the MIC (T(>MIC)).

RESULTSThe C(max) and T1/2 of each antibiotic were as the followings: piperacillin (7 950 ± 3 023) mg/L and (1.97 ± 1.23) h, ceftriaxone (1 104 ± 248) mg/L and (3.14 ± 0.57) h, cefoperazone (5 215 ± 2 225) mg/L and (0.89 ± 0.13) h, meropenem (31.97 ± 12.44) mg/L and (0.36 ± 0.11) h, levofloxacin (66.3 ± 36.9) mg/L and (3.32 ± 2.57) h, metronidazole (28.2 ± 10.2) mg/L and (0.81 ± 0.33) h, respectively. Piperacillin/tazobactam and cefoperazone/sulbactam had the largest bactericidal index and the longest T(>MIC), and their bactericidal indexes were (62.1 ± 23.6) - (993.8 ± 377.9) and (164.8 ± 69.0) - (659.3 ± 275.9), their T(>MIC) were (6.00 ± 2.53) - (8.00 ± 0.00) h and (6.33 ± 1.97) - (8.00 ± 0.00) h. The bactericidal index and T(>MIC) of levofloxacin were the smallest, which were (2.1 ± 1.2) - (8.3 ± 4.6) and (0.54 ± 0.25) - (2.67 ± 1.03) h . Ceftriaxone and meropenem were as the medium, and their bactericidal indexes and T(>MIC) were (4.3 ± 1.0) - (69.2 ± 15.5) , (1.42 ± 0.65) - (8.00 ± 0.00) h and (2.0 ± 0.8) - (1 031.3 ± 401.4) , (0.29 ± 0.10) - (1.83 ± 0.26) h. The bactericidal index of metronidazole to anaerobic ranged from 7.4 to 294.9, and the T(>MIC) ranged from 1.88 to 5.00 h.

CONCLUSIONSThe bile concentrations of six antibiotics all exceed their effective bactericidal concentrations. The concentration-time curves of piperacillin, cefoperazone, meropenem and metronidazole conformed to one-compartment model, and ceftriaxone and levofloxacin are conformed to two-compartment model. Piperacillin/tazobactam and cefoperazone/sulbactam have the largest bactericidal index and the longest T(>MIC), so they can be chosen as the first choice for the therapy of hepatobiliary infection.For the anaerobic, the microbicidal potential of metronidazole is high.

Animals ; Anti-Bacterial Agents ; analysis ; pharmacokinetics ; Bile ; chemistry ; drug effects ; Cefoperazone ; analysis ; pharmacokinetics ; Drug Combinations ; Metronidazole ; analysis ; pharmacokinetics ; Microbial Sensitivity Tests ; Penicillanic Acid ; analogs & derivatives ; analysis ; pharmacokinetics ; Piperacillin ; analysis ; pharmacokinetics ; Rabbits ; Random Allocation ; Sulbactam ; analysis ; pharmacokinetics ; Thienamycins ; analysis ; pharmacokinetics

Objective:To investigate the feasibility of reducing radiation dose in coronary CT angiography for patients with arrhythmia with absolute phase and narrow window in prospective electrocardiogram-gating.Methods:200 patients with arrhythmia underwent coronary CT angiography procedure with prospective electrocardiogram-gating adaptive sequence in dual source CT were randomly divided into 2 groups according to the scan mode. Group A was scanned with absolute phase and narrow window(250-450 ms) and group B uesd relative phase and wide window (30%-75%). The other parameters and injection protocol of contrast media were the same in 2 groups. Both image quality and radiation dose of the 2 groups were analyzed.Results:No significant difference of image quality was found between the 2 groups. CTDI vol, DLP, E of group A were all lower than those in group B [CTDI vol : (16.71±8.35) vs.(29.35±17.90)mGy , DLP: (231.04±114.86) vs.(398.27±238.40)mGy·cm , E: (3.23±1.60) vs.(5.57±3.33)mSv, t=-6.40, -6.32、-6.32, P<0.05] . The patients with repeat scan cycles in group A and group B were 81 vs. 22 for 0 cycle , 17 vs. 62 for 1 cycle, 2 vs. 10 for 2 cycles, 0 vs. 6 for 3 cycles( χ2=70.76, P<0.05). Conclusions:The prospective electrocardiogram-gating adaptive CCTA sequence with absolute phase and narrow window can reduce radiation dose while the image quality meets the requirementsfor patients with arrhythmia.

The goal of this study was to identify MSX1 gene variants in multiple Chinese families with nonsyndromic oligodontia and analyse the functional influence of these variants. Whole-exome sequencing (WES) and Sanger sequencing were performed to identify the causal gene variants in five families with nonsyndromic oligodontia, and a series of bioinformatics databases were used for variant confirmation and functional prediction. Phenotypic characterization of the members of these families was described, and an in vitro analysis was performed for functional evaluation. Five novel MSX1 heterozygous variants were identified: three missense variants [c.662A>C (p.Q221P), c.670C>T (p.R224C), and c.809C>T (p.S270L)], one nonsense variant [c.364G>T (p.G122*)], and one frameshift variant [c.277delG (p.A93Rfs*67)]. Preliminary in vitro studies demonstrated that the subcellular localization of MSX1 was abnormal with the p.Q221P, p.R224C, p.G122*, and p.A93Rfs*67 variants compared to the wild type. Three variants (p.Q221P, p.G122*, and p.A93Rfs*67) were classified as pathogenic or likely pathogenic, while p.S270L and p.R224C were of uncertain significance in the current data. Moreover, we summarized and analysed the MSX1-related tooth agenesis positions and found that the type and variant locus were not related to the severity of tooth loss. Our results expand the variant spectrum of nonsyndromic oligodontia and provide valuable information for genetic counselling.
Anodontia/genetics* ; Humans ; MSX1 Transcription Factor/genetics* ; Pedigree ; Whole Exome Sequencing