Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

Brain Abscess ; etiology ; Female ; Humans ; Leuconostoc ; pathogenicity ; Male ; Sepsis ; complications ; microbiology

Objective To construct a stable expression plasmids miR-218,to lay the experimental foundation for the expression and mechanism of miR-218 in human renal cell carcinoma.Methods The primers were designed by Has-miR-218 and the miR-218 fragment were amplified by PCR,and then which was connected with the carrier pcDNA3.1 (+) to build a stable expression plasmids.The recombinant plasmids were trasfected into renal cell carcinoma cell line 769-P,and the expression of miR-218 in these cells were detected.Results The plasmids were constructat successfully,which was determind by enzyme digestion and sequencing results.The constructed expression plasmids pcDNA3.1-miR-218 transfection of human renal cell carcinoma cell line 769-P,miR-218 cxpression level of cells was significantly increased after trasfected by recombinant plasmids carrying miR-218 gene (relative expression quantity was 1.64).Conclusion The miR-218 expression plasmids pcDNA3.1-miR-218 were successfully constructed,the plasmids can be applied to the study of miR-218 function and mechanism in renal cell carcinoma.

Objective To evaluate the safety and efficacy of epirubicin (EPI) and gemcitabine (GEM) alternating sequential intravesical chemotherapy after transurethral resection in the treatment of non-muscle invasive bladder cancer.Methods 240 patients with primary non-muscle invasive bladder urothelial carcinoma were randomly divided into 2 groups.There were 120 cases for each group,EPI group was given EPI 50 mg (once a week),bladder perfusion,while the EPI+GEM group was given EPI 50 mg (once every other week),GEM 1000 mg (once every other week),alternating sequential perfusion.The follow-up time ranged from 6 to 24 months when the time of tumor recurrence and adverse reactions of chemotherapy were observed and recorded.Results The 2-year tumor free survival rate for EPI group recurrence was 60.0 ％ (72/120),and 75.0 ％ (90/120) for EPI+GEM group.There were statistical significance between the differences of the 2 groups (x2 =5.489,P ＜ 0.05).3 cases in EPI group and 2 cases in EPI+GEM group progressed to muscle invasive bladder cancer,and there was no statistical significance between the differences of bladder cancer progression rates for the 2 groups (2.5 ％ and 1.7 ％) (x2 =0.000,P ＜ 0.05).The main adverse reaction during the treatment was gastrointestinal discomfort (15 cases and 6 cases respectively),no serious haematological toxicity and other adverse reactions were frequent urination,urgency,dysuria and hematuria.The differences between the occurrence rates of adverse reactions for the 2 groups were 25.0 ％ and 11.7 ％,which were statistically significant (x2 =6.252,P ＜ 0.05).Conclusion For non-muscle invasive urothelial bladder carcinoma,the curative effect is better to use EPI and GEM sequential intravesical chemotherapy than to use EPI alone,which can not only reduce the 2 years recurrence rate after the operation,but also reduce the incidence rate of adverse reactions.Yet,this method cannot change the progress of bladder cancer.

Brain ; Dyspepsia ; therapy ; Gastritis ; Humans ; Medicine, Chinese Traditional ; Research Design ; Syndrome

OBJECTIVETo explore the effect of auricular point sticking before operation for postoperative complications of external excision and internal ligation on mixed hemorrhoid.

METHODSEighty patients with mixed hemorrhoid were randomly divided into an observation group and a control group, 40 cases in each group. In the control group, paracetamol and dihydrocodeine tartrate tablets were applied with oral administration 1 h after operation, 510 mg each time, twice a day; at the same time, diosmin tablets were treated with oral administration, 0.9 g each time, twice a day. Three days' treatments were required successively. In the observation group, auricular point sticking was used before operation based on the treatment in the control group. The auricular points of Shen (Co10), Pangguang (CO9), Shenmen (TF4), Pizhixia (AT4), Jiaogan (AH6a) and Gangmen (HX5) were selected. The patients were asked to press the points 3-6 times per day, 3-5 min each time, 3 days' treatment in total. The scores of the postoperative complications in the 1st and the 2nd days were compared between the two groups such as pain, edema, hematochezia, retention of urine, etc.

RESULTSAfter operation, the scores of pain, edema, hematochezia, retention of urine in the 2nd day were all decreased obviously than those in the 1st day in the two groups (all P<0.05); and the scores of pain, edema, hematochezia, retention of urine in the 1st and the 2nd days of the observation group were lower than those in the control group (all P<0.05).

CONCLUSIONAuricular point sticking before operation combined with conventional western medicine with oral administration for preventing and treating postoperative complications of external excision and internal ligation on mixed hemorrhoid achieves positive and reliable efficacy.

Acetaminophen ; administration & dosage ; Acupuncture Points ; Acupuncture, Ear ; Adult ; Codeine ; administration & dosage ; analogs & derivatives ; Combined Modality Therapy ; Female ; Hemorrhoids ; surgery ; Humans ; Ligation ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; prevention & control ; therapy

Objective To investigate whether the laparoscopic portoenterostomy is superior to open surgery in the treatment of biliary atresia.Methods A total of 26 children with type Ⅲ biliary atresia underwent laparoscopic portoenterostomy from August 2003 to September 2005(Laparoscopic Group).The operation was performed under 4-port laparoscopy.The hepatic portal was fully exposed and mobilized and the gallbladder was removed.The cut end of the duct was widened by incising along the anterior wall of the hepatic duct following the excision of the narrow segment.By using intraoperative bile duct endoscopy,the optimal level of resection of the common hepatic duct was determined without endangering the orifices of the hepatic ducts or leaving any redundant duct.The Roux-en-Y jejunal loop was fashioned extracorporeally by exteriorizing the jejunum for 40 cm in length distally through the umbilical incision and passed up retrocolically followed by an end-to-side hepaticojejunostomy.They were compared with other group of 34 children,with the same age range and diagnosis,who underwent open portoenterostomy(Open Group) in the same period,in respect of the operative time,the blood loss,the liver functions,complications,the length of hospital stay,the hospitalization expenditure,and the short-term outcomes. Results As compared with the Open Group,the Laparoscopic Group presented a less blood loss(15.4?5.0 ml vs 33.8?19.4 ml;t=-4.709,P=0.000) and a higher hospitalization expenditure(19 153.9?619.5 yuan vs 15 116.7?898.4 yuan;(t=19.607),P=0.000).There were no significant differences between the two groups in the operative time and the length of hospital stay.The serum levels of total bilirubin,direct bilirubin,ALT,and AST were deceased more significantly in the Laparoscopic Group than in the Open Group.Complications happened in 1 case in the Laparoscopic Group(incisional hernia) and in 4 cases in the Open Group(1 case of acute hepatic failure,1 case of incision rupture,and 2 cases of wound infection),the incidence of complications being not significant(?~2=0.395,P=0.530).Follow-up observations at 4 postoperative month found the jaundice had subsided in 13 cases in the Laparoscopic Group(50%) and in 18 cases in the Open Group(53%). Conclusions Laparoscopic portoenterostomy is a minimally invasive,safe,and effective procedure for the treatment of pediatric biliary atresia.

Objective To explore the categories and precautions of complications after laparoscopic total cyst excision with Roux-en-Y hepatoenterostomy for congenital choledochal cyst in children. Methods Laparoscopic cyst excision with Roux-en-Y hepatoenterostomy was performed in 66 cases of congenital choledochal cyst from July 2001 to June 2006. Their median age was 3.8 years (range, 2 months ~ 28 years). The choledochal cyst was classified as cystic type in 61 cases, with a diameter ranged 2.5~18 cm, and fusiform type in 5 cases, with a diameter ranged 1.2~2.2 cm. Nine cases were associated with hepatic ductal stenosis; they underwent a laparoscopic excision of the cyst with a ductoplasty. Results The laparoscopic operation was successfully completed in all the 66 patients, with a mean operation time of 3.8 h (2.6~9.5 h) and a mean hospital stay of 4.5 d (3~8 d). Early complications included 2 cases of bile leakage (spontaneous recovery in 1 case, and an open surgery required in 1 case because of obstructed drainage, with anastomotic leakage identified and re-anastomosis performed during the operation), 1 case of hyperkalemia (10.8 mmol/L at 7 h after operation, resulting in heart failure and cardiopulmonary resuscitation, and died of renal failure on the 3rd postoperative day), and 2 cases of stress ulcer (spontaneously relieved). There were no infections of the abdominal cavity or the wound. Long-term complications included 1 case of intestinal obstruction (open exploration showed intestinal adhesion and necrosis, and an enterectomy with enteroanastomosis was given). No anastomotic stenosis and postoperative cholangitis were encountered.Follow-up observations for 6~56 months (median, 21 months) were conducted in 65 survived cases, B-ultrasonography found no bilestone, and liver functions were in normal limits. Conclusions Laparoscopic total cyst excision with Roux-en-Y hepatoenterostomy is a complicated operation with high risks. Some complications are similar to those after conventional operations, such as bile leakage, stress ulcer, and intestinal obstruction. Hyperkalemia is perhaps the most serious one, which maybe related to carbon dioxide pneumoperitoneum. It is essential to monitoring hyperkalemia in postoperative period.

Objective To study the characteristics of inhibition on hemozoin formation by chloroquine under in vitro condition.Methods Under different concentrations(0.5-2 mol/L) of sodium acetate(NaAc) and at the pH range of 4.0-5.0, chloroquine was tested for inhibition of ?-hematin(hemozion) formation by using the HPIA(heme polymerization inhibitory activity) assay.The morphology of ?-hematin crystals was determined by light microscopy.Ultraviolet spectrophotometry was employed to measure ?-hematin content, and the size of ?-hematin crystal was analyzed by X-ray diffraction(XRD) .Results Chloroquine exhibited varied effect on ?-hematin formation, depending on pH value and Na+ concentration.When the NaAc concentration increased from 0.5 mol/L(pH 4.2) to 2 mol/L(pH 4.8), the chloroquine inhibitory effect also increased.Results suggested that there exists a threshold pH, below which the ?-hematin formation escalates and chloroquine inhibition declines, and at or above which chloroquine exerts a stronger inhibitory effect on ?-hematin formation.With the increase of pH from 4.4 to 4.8, the crystallinity and the size of crystal changed from 6.93% and 357  to 6.32% and 264 , respectively.When pH reached to 5, no more ?-hematin formed.Chloroquine could reduce the crystallinity and crystal size of ?-hematin at same pH value.Morphology analysis on the samples was consistent with the above results.Conclusion Chloroquine inhibits hemozoin formation only when the pH value is at or above threshold pH.

Objective To investigate the diagnostic value of combined detection of procalcitonin (PCT), C-reactive protein (CRP), white blood cell (WBC), and neutrophil percentage (NEU%) in bloodstream infection with gram-positive coccus(G+), gram-negative bacillus (G-)and fungus.Methods Detection results of positive blood culture of 389 patients in a hospital between January 2014 and December 2015 were analyzed retrospectively, according to the results of blood culture, patients were divided into G+ coccus, G-bacillus and fungal bloodstream infection groups, inflammatory indicators of different groups of patients were compared.Results Mann-Whitney U test revealed that PCT level of G-infection group was higher than that of G+ and fungal infection group (comparison between G-infection group and G+ infection group : Z=-2.68,P<0.01;comparison between G-infection group and fungal infection group: Z=-2.46,P<0.05).If PCT≥0.5 ng/mL, CRP≥5.0 mg/L, NEU%≥70% and WBC≥10×109/L were as the cut-off point, statistical analysis revealed the positive rate of PCT in G-infection group was higher than that in G+ and fungal infection group(comparison between G-infection group and G+ infection group:χ2=5.94,P<0.05;comparison between G-infection group and fungal infection group:χ2=7.721,P<0.01);the positive rate of CRP in G-infection group was higher than that in G+ infection group (χ2=5.03,P<0.05).Binary logistic regression was adopted to analyze the efficacy of four indicators for the differentiation of bloodstream infection caused by G+ coccus, G-bacillus, and fungus, only PCT had significant difference in the identification of bloodstream infection caused by G-bacillus, G+ coccus and fungus(P<0.01).Conclusion PCT has high accuracy in differentiating G-bacillus, G+ coccus, and fungus of blood culture, dynamic monitoring of PCT combined with detection results of CRP, WBC, and NEU%, patient's condition can be judged rapidly, and antimicrobial agents can be used rationally, so the mortality of patients with bloodstream infection can be reduced.