OBJECTIVETo evaluate the efficacy and safety of intravesical instillation with gemcitabine after first-line intravesical chemotherapy failure, including mitomycin (MMC), epirubicin (EPB) and camptothecin (CPT), in the treatment of non-muscle-invasive bladder cancer (NMIBC).

METHODSFrom June 2007 to October 2008, 72 patients with NMIBC, who had tumor recurrence within one year of first-line intravesical chemotherapy, were assigned to 3 groups (24 cases each). Group A received intravesical gemcitabine in a dose of 1000 mg, Group B received 2000 mg gemcitabine, and Group C received original intravesical chemotherapy. The time of reccurrence and adverse effects were recorded.

RESULTSThe 2-year tumor free survival rates of the 3 groups were 66.7%, 75.0% and 45.8%, respectively. The 2-year TFS rate of the patients who received gemcitabine was 70.8%, significantly higher than 45.8% of the patients treated by original chemotherapy. There was one case with renal function impairement in the groups A and B, respectively. There was no significant difference between the rates of low urinary tract symptoms in the 3 groups. No severe hematological side effects were observed in this study.

CONCLUSIONThe intravescal chemotherapy with gemcitabine in patients with recurrent bladder tumor after first-line intravesical chemotherapy is effective and well tolerated, however, renal function should be routinely assessed.

Administration, Intravesical ; Adult ; Aged ; Antibiotics, Antineoplastic ; therapeutic use ; Antimetabolites, Antineoplastic ; administration & dosage ; adverse effects ; therapeutic use ; Antineoplastic Agents, Phytogenic ; therapeutic use ; Camptothecin ; therapeutic use ; Deoxycytidine ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Disease-Free Survival ; Dose-Response Relationship, Drug ; Epirubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mitomycin ; therapeutic use ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Urinary Bladder Neoplasms ; drug therapy ; pathology

AIMTo investigate the mechanism of EA improving the obstruction of inner ear microcirculation and the effect on the vestibulo-ocular reflex (VOR) by comparing the effects of electroacupuncture (EA) with sibelium (flunarizine hydrochloride) on vertebrobasilar insufficiency(VBI).

METHODSInjected with sclerosant-775 injection into the solt tissue on the left side of cervical vertebral transverse processes of rabbits to set up the vertebral artery type of cervical spondylosis (VCS) models. Electronystagmography (ENG) induced by linear acceleration (LA) and horizontal rotation (HR), the transcranial Doppler (TCD), laser Doppler flowmetry (LDF) and hemorheology were used to measure changes of the frequencies of nystagmus, the hemodynamics in the basilar artery (BA), inner ear blood flow(IEBF) and blood viscosity in VBI rabbits.

RESULTSThe frequencies of ENG, the velocity of blood flow in BA and IEBF decreased obviously, and whole blood middle where viscosity, whole blood lower where viscosity and erythrocyte distortion index ( EDI) increased significantly in the model group. Sibelium could reduce whole blood viscosity and EDI, and increased the systolic phase velocity (Vs) of blood flow in BA, but had no effect on diastolic phase velocity (Vd) and mean velocity (Vm). EA could not reduce the viscosity of blood and EDI, but had more significant effects on improving IEBF and ENG induced by LA than those of sibelium,and had the tendency of increasing Vs, Vd and Vm. EA and sibelium had no effect on improving ENG induced by HR.

CONCLUSIONInner ear microcirculation obstruction caused by VBI can induce dysfunctions of vestibule cyst macula and horizontal semicircular canals. EA may depend upon the neurohumoral regulation to improve VBI, and ameliorate inner ear blood supply obstruction by enhancing mechanism of local adjusting for microcirculation in the inner ear to recover vestibular cyst macula irritability for LA chiefly. There exist complicated mechanism that EA adjusts blood flow distribution and vestibular signal transduction in vestibular organ in VBI model likely, and remain to be researched deeply.

Animals ; Blood Flow Velocity ; Ear, Inner ; blood supply ; Electroacupuncture ; Female ; Male ; Microcirculation ; Rabbits ; Reflex, Vestibulo-Ocular ; Vertebrobasilar Insufficiency ; physiopathology ; therapy

OBJECTIVETo identify the HBV genotype-specific tag sequence.

METHODSThe large S region sequences from 930 HBV genomes were aligned to identify the genotype-specific tag sequences. PCR was used to check the genotyping effect of these tags.

RESULTSTwo tag sequences, sequence between 149-169 and sequence between 461-483, were identified in the large S region. Using primers specific to these tag sequences, the genotype of HBV can be specifically identified.

CONCLUSIONThese tag sequences can be used for HBV genotyping.

Base Sequence ; DNA Primers ; Gene Library ; Genes, Viral ; Genotype ; Hepatitis B virus ; classification ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Molecular Sequence Data ; Polymerase Chain Reaction ; methods ; Protein Precursors ; genetics ; Sequence Analysis, DNA

OBJECTIVETo explore the factors influencing cognitive functions in patients with childhood and adolescence-onset schizophrenia.

METHODSThe clinical data of 78 patients with childhood and adolescence-onset schizophrenia who met with the criteria of ICD-10 for schizophrenia were retrospectively reviewed. The cognitive functions were evaluated by the Chinese Wechsler Intelligence Scale for Children (C-WISC), the Wisconsin Card Sorting Test (WCST), digit span backward and P300. The clinical symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS).

RESULTSThe patients with a lower education level or earlier onset of age had a longer P3 latency at the P300Fz area. The patients with a higher parental education level had higher scores of full intelligence quotient (FIQ), verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), conceptual level and completed categories of WCST and backward numeric order reciting. The patients with higher PANSS negative subscale scores had lower scores of FIQ, VIQ, PIQ, completed categories and conceptual level of WCST and backward numeric order reciting. The patients with a longer stabilization time had higher backward numeric order reciting scores.

CONCLUSIONSThe severity of negative symptoms of the patients and the educational level of their parents are major factors influencing cognitive functions in patients with childhood and adolescence-onset schizophrenia.

Adolescent ; Adult ; Age of Onset ; Child ; Cognition ; Educational Status ; Female ; Humans ; Intelligence ; Logistic Models ; Male ; Schizophrenia ; Schizophrenic Psychology

OBJECTIVETo discuss clinical effects of headless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture.

METHODSFrom January 2010 to June 2016, 7 patients with old metatarsal intra-articular fracture treated by open reduction headless compression screw internal fixation by local application PRP, including 5 males and 2 females, aged from 21 to 52 years old, 5 patients injured by falling down and 2 patients caused by crushing, the time from injury to operation ranged from 3 to 6 weeks. Preoperative anteroposterior, lateral and oblique X-ray film and three-dimensional CT reconstruction were examined, and the results showed 2 patients on the second metatarsal, 2 patients on the third metatarsal, 3 patients on the fourth metatarsal. Regular X-ray as postoperative examination was observed, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle scoring system at the final follow-up was evaluated.

RESULTSSeven patients were followed up from 6 to 17 months. All incisions healed at stage I without joint stiffness, traumatic arthritis and related complications. Imaging examination showed fracture reached bone healing, healing time ranged from 3 to 6 months. No joint stiffness and traumatic arthritis occurred. One of seven patients occurred stiffness of metatarsophalangeal joints. AOFAS score increased from 40.5±4.2 before operation to 85.0±10.5 at 12 months after operation, and 4 patients got excellent results, 2 moderate and 1 poor. The active motion of metatarsophalangeal joint showed dorsal flexion ranged from 35° to 40°, plantar flexion ranged from 25° to 35°.

CONCLUSIONSHeadless pressure screw with local complication of PRP in treating old metatarsal intra-articular fracture could recover articular surface of metatarsal head, improve metatarsophalangeal joints activity, which do not need the second operation, and could receive good clinical results with early exercise.

OBJECTIVETo investigate the clinical effect of a new bundle-to-bundle suturing method for acute Achilles tendon rupture.

METHODSFrom April 2013 to January 2015, 15 patients with acute Achilles tendon rupture were treated with a new bundle-to-bundle suturing method including 12 males and 3 females with an average age of 37.5 years old ranging from 27 to 56 years old. All of them were immobilized by cast for 6 weeks on the underlying limbs, and were educated for a rehabilitation training during the follow-up.

RESULTSAll the patients were followed up for 9 to 17.5 months with an average of 13.5 months. According to the American Ankle Surgery Association (AOFAS), ankle and foot score was 93.3±3.5 at 6 months after operation. All patients got incomplete weight-bearing at 1.6 months on average after the operation, and back to primary work position 4.7 months later on average. All the wounds got primary healing. No incisional infection, necrosis of incisional marginal necrosis, rupture of the Achilles tendon, and gastrocnemius injury occurred.

CONCLUSIONSThe surgical treatment of acute Achilles tendon rupture with bundle-to-bundle suturing method has advantages of mini-invasion, a low rate of incision problems and quick function recovery, and was valuable spread in clinic.

OBJECTIVEThe aim of this study was to compare the safety and efficacy profiles of R-CHOP and R-fCHOP regimes in the treatment of primary gastric diffuse large B cell lymphoma (PG-DLBCL).

METHODSData of PG-DLBCL patients admitted in our hospital from March 2010 to March 2014 were collected retrospectively. Differences in gastrointestinal bleeding and perforation between the R-CHOP group and R-fCHOP group were compared. The influence of the gastrointestinal complication on subsequent treatment was also analyzed. Treatment outcome of the two groups was also compared.

RESULTSA total of 50 patients were included in this retrospective study. Forty of them were in the R-CHOP group, another ten were in the R-fCHOP group. Patients in the R-fCHOP group had a higher rate of Lugano late stage disease, and a relatively high rate of a deeper/larger ulcer. Fence occult blood test (FOBT) was positive in one (10.0%) patient in the R-fCHOP group, and 11 (31.4%) patients in the R-CHOP group, among them one had hematemesis and had to give up the subsequent chemotherapy. No perforation was observed in both groups. The response rate (RR) was 92.5% in the R-CHOP group and 90.0% in the R-fCHOP group (P > 0.05). The PFS was also comparable between the two groups (P > 0.05).

CONCLUSIONSR-fCHOP regimen has a good safety profile in patients with Lugano late stage and deep/large ulcers, who are of high risk of gastrointestinal bleeding or perforation, and also has a comparable efficacy profile when compared with the R-CHOP regimen in short-term follow-up.

Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; Doxorubicin ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; Lymphoma, Non-Hodgkin ; Male ; Middle Aged ; Prednisone ; Retrospective Studies ; Rituximab ; Stomach Neoplasms ; Treatment Outcome ; Vincristine

OBJECTIVETo study the efficacy of gene therapy with human vascular endothelial growth factor-c (VEGF-C) on obstructive lymphedema.

METHODSTwo animal models of lymphedema were created: one in the right hind limb of adult New Zealand white rabbits and the other in SD mouse tail. Each model was randomly divided into two groups to receive intradermal injection of either VEGF-C gene (experimental group), or saline(control group). In rabbit model, the volume change of affected limb was measured. In mouse model, biopsy was performed after 3 weeks treatment to detect the expression of VEGF-C mRNA and proteins. The lymphagenesis was evaluated by immunohistochemical examination with lymphatic endothelium hyaluronan receptor antibody.

RESULTSThe volume of the affect rabbit limb decreased by (24.40 +/- 1.08) ml in experimental group, compared with (5.80 +/- 1.92) ml in control group (P = 0.0001). The expression of VEGF-C mRNA and protein increased markedly in experiment group, but not in controls. More lymphatic vessels with large caliber were seen in experiment group (P = 0.0004).

CONCLUSIONSVEGF-C gene therapy may alleviate or treat lymphedema by inducing lyphmangiogenesis.

Animals ; Disease Models, Animal ; Gene Transfer Techniques ; Genetic Therapy ; Humans ; Lymphedema ; therapy ; RNA, Messenger ; genetics ; Rabbits ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor C ; genetics

BACKGROUNDCurrent randomized trials have demonstrated the effects of short-term rosuvastatin therapy in preventing contrast-induced acute kidney injury (CIAKI). However, the consistency of these effects on patients administered different volumes of contrast media is unknown.

METHODSIn the TRACK-D trial, 2998 patients with type 2 diabetes and concomitant chronic kidney disease (CKD) who underwent coronary/peripheral arterial angiography with or without percutaneous intervention were randomized to short-term (2 days before and 3 days after procedure) rosuvastatin therapy or standard-of-care. This prespecified analysis compared the effects of rosuvastatin versus standard therapy in patients exposed to (moderate contrast volume [MCV], 200-300 ml, n = 712) or (high contrast volume [HCV], ≥ 300 ml, n = 220). The primary outcome was the incidence of CIAKI. The secondary outcome was a composite of death, dialysis/hemofiltration or worsened heart failure at 30 days.

RESULTSRosuvastatin treatment was associated with a significant reduction in CIAKI compared with the controls (2.1% vs. 4.4%, P = 0.050) in the overall cohort and in patients with MCV (1.7% vs. 4.5%, P = 0.029), whereas no benefit was observed in patients with HCV (3.4% vs. 3.9%, P = 0.834). The incidence of secondary outcomes was significantly lower in the rosuvastatin group compared with control group (2.7% vs. 5.3%, P = 0.049) in the overall cohort, but it was similar between the patients with MCV (2.0% vs. 4.2%, P = 0.081) or HCV (5.1% vs. 8.8%, P = 0.273).

CONCLUSIONSPeriprocedural short-term rosuvastatin treatment is effective in reducing CIAKI and adverse clinical events for patients with diabetes and CKD after their exposure to a moderate volume of contrast medium.

Acute Kidney Injury ; chemically induced ; prevention & control ; Aged ; Contrast Media ; adverse effects ; Female ; Fluorobenzenes ; therapeutic use ; Humans ; Male ; Middle Aged ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use ; Treatment Outcome

Objective To design a mobile intelligent inventory system for medical equipment to solve the problems of medical equipment management in efficiency and accuracy due to manual inventory.Methods A mobile intelligent inventory system for medical equipment was designed with radio frequency identification(RFID)technology,optical character recognition technology and wireless network technology,which was composed of a photo acquisition device,an inventory workstation,a wireless router,a mobile cart,a RFID barcode printer and a mobile power source.The photo acquisition device realized equipment image collection with a photography App in the cell phone or tablet computer;the inventory workstation consisted of an offline inventory system and an equipment nameplate recognition system,which built inventory tasks with Tomcat Web service and identified equipment nameplate information through feature-based learning algorithms;the RFID barcode printer controlled label printing by an offline inventory system embedded into its driver.Results The system developed executed medical equipment inventory and labeling simultaneously,which established electronic file for each piece of equipment to realize accounts corresponding to the equipment accurately.Conclusion The inventory system developed enhances the efficiency of medical equipment inventory,standardizes the flow of medical equipment ledger management and provides support for life-cycle management of medical equipment.[Chinese Medical Equipment Journal,2023,44(11):45-49]