Adult ; Aged ; Female ; Humans ; Infection ; Infection Control ; instrumentation ; methods ; Intubation, Intratracheal ; instrumentation ; methods ; Male ; Middle Aged ; Suction ; Tracheostomy ; adverse effects ; Young Adult

Purpose Brain complications severely threaten the treatment and survival of children with leukemia. This paper aims to investigate the MRI manifestations and differences of brain complications in leukemia before and after chemotherapy for a clinical guidance.Materials and Methods The clinical data and MRI findings of 37 children with leukemia and brain complications were retrospectively analyzed. Thirty-four of them underwent MRI scan twice or more, among whom 28 received contrast-enhanced MRI scan.Results Twenty-two patients were discovered with brain complications before chemotherapy, 2 of whom were with two kinds of complications. Meningopathy was found in 7 patients who showed widespread or localized meningeal thickening. Among them, 5 patients'' lesions reduced or disappeared after chemotherapy. Intracerebral multiple small and micro bleed was found in these 7 patients, 2 of them combined with hematoma. Three patients were found with intracranial tumor which all proved to be temporal bone tumor, 1 of whom combined with temporal lobe tumor and 1 had tumor disappeared after chemotherapy. The other complications before chemotherapy included leukoencephalopathy (n=2), subdural collection of fluid (n=2), meninges and parenchymal infiltration of leukemia (n=1), fungal infection (n=1) and cerebral infarction (n=1). On the contrary, 17 patients were discovered with brain complications after chemotherapy, 8 of whom were with two or more complications. Two patients had different kinds of complications before and after chemotherapy. Brain atrophy was observed in 13 patients. Leukoenphalopathy was found in 9 patients who presented high signal in white matter of double periventricular and/or semi-oval center on T2WI; the lesions of 4 patients were reduced or disappeared after withdrawal. Infectious diseases were diagnosed in 3 patients, including viral encephalitis in 2 cases, tuberculous meningitis combined with tuberculoma in 1 case. The other complications included intracranial tumor (n=2), sinus thrombosis (n=1), posterior reversible encephalopathy syndrome (n=1) after chemotherapy. Conclusion The MRI findings of brain complications in childhood leukemia are various and demonstrate significantly different features before and after chemotherapy. The major complications before treatment include meningopathy and intra-cerebral hemorrhage;while after chemotherapy the main complications are brain atrophy, leukoencephalopathy and infectious diseases. MRI proves to be a valuable method to detect, observe and follow up these complications.

Objective To investigate the effects of caffeine citrate and aminophylline in treatment of primary apnea of premature infants and its related complications. Methods A total of 152 preterm infants who were diagnosed primary apnea within 10 days after birth were randomly divided into caffeine citrate group(n=77) and aminophylline group(n =75). The changes in the time of the apnea disappeared after treating,needing oxygen,non-invasive and invasive mechanical ventilation,and the incidence of bronchopul-monary dysplasia ( BPD ) , necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus (PDA),intercranial hemorrhage(ICH)were compared between the two groups. Results The time of the apnea disappeared after treating[(47. 4 ± 5. 3) h],needing oxygen[(20. 5 ± 7. 6) d],non-invasive mechani-cal ventilation[(8. 7 ± 4. 2) d] and invasive mechanical ventilation[(1. 0 ± 1. 3) d] in the caffeine citrate group were significantly lower than those in the aminophylline group [ ( 54. 8 ± 6. 2 ) h, ( 24. 4 ± 8. 5 ) d, (10.4±5.3)d,(10.4±5.3)d,respectively](P<0.05).TheincidenceofBPD[16.9%(13/77)],PDA [13. 0%(10/77)] and ICH[16. 9%(13/77)] in the caffeine citrate group were significantly lower than those in the aminophylline group[33.3%(25/75),26.7%(20/75),22.7%(17/75),respectively](P <0. 05),but there were no differences between the two group about the incidence of necrotizing enterocolitis [caffeine group 7. 8%(6/77),aminophylline group 9. 3%(7/75)] and retinopathy of prematurity[caffeine group 6. 5%(5/77),aminophylline group 9. 3%(7/75)](P>0. 05). Conclusion The caffeine citrate has a better efficacy in the treating primary apnea of preterm infants than aminophylline. It can also decrease the incidence of BPD,PDA and ICH in premature infants.

Multiple myeloma is a neoplasm of mature and immature plasma cells, it remains an incurable disease using conventional chemotherapy and increasing aggressive approaches. In recent years, due to the better understanding of myeloma biology, genetics and tumor formation, there are lots of new active drugs or combinational chemotherapy regimens having been developed, such as proteasome inhibitors, immunomodulatory agents etc, they are more effective than conventional chemotherapy. This article summarizes the recent advances with the new options for the treatment of multiple myeloma.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Combined Modality Therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Multiple Myeloma ; drug therapy ; Oligopeptides ; therapeutic use

To enhance the quality and efficiency of ozagrel by investigating the differences between the ozagrel polymorphs in bioavailability. Solid ozagrel in different polymorph forms were orally administered to SD rats. An HPLC method was established to determinate plasma level of ozagrel. The bioavailabilities of two polymorph forms were calculated and compared. The pharmacokinetic parameters of ozagrel, were as follows: Cmax was 32.72 ± 17.04 and 34.01 ± 19.13 mg · L(-1), respectively; AUC0-t was 61.14 ± 14.76 and 85.56 ± 18.08 mg · L(-1) · h, respectively; t½ was 1.53 ± 0.51 and 4.73 ± 3.00 h, respectively. There was no significant difference in pharmacokinetic parameters between form I and II polymorphs of ozagrel while the t½ of form II is longer, which indicates that the use of form II polymorph as pharmaceutical product may prolong the effective action time in clinics. This would help the polymorph quality control in drug production.
Animals ; Biological Availability ; Chromatography, High Pressure Liquid ; Methacrylates ; chemistry ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley

Objective To observe the effect of recombinant human mannose-binding lectin ( rhMBL) on apoptosis of intestinal epithelial cells. Methods Fourteen C57 mice were randomly divided into two groups. The LPS mice received intra-peritoneal injection of LPS for indu-cing acute intestinal barrier injury. The expression of MBL protein and mRNA were observed by immuno-histochemisty and RT-PCR respec-tively. The apoptosis of intestinal epithelial cells was detected by tunel staining. In vitro, the Caco-2 cells were treated with 0、 5、10、20 μg/mLrhMBL, flow cytometry was used to detect the apoptosis rate of Caco-2 cells. The Bax and Bcl-2 protein and mRNA were detected by Western blotting and Real-Time PCR methods between various groups. MAPK signal proteins were detected by Western blotting method. Results The MBL and TUNEL staining were apparently increased under LPS condition. The apoptotic rates of Caco-2 cells which were trea-ted by different rhMBL concentrations after 48 h were increased in 20μg/mL rhMBL when compared with other groups. The apoptotic rates of Caco-2 cells which were treated by 20 μg/mL rhMBL after different time were increased in time-dependent manner. The results of Western blotting and Real-Time PCR assay showed that levels of Bax/Bcl-2 was increased in Caco-2 cells which were treated by 20μg/mL rhMBL af-ter 48h. Meanwhile, the phosphorylation of P38 and ERK were obviously increased in Caco-2 cells. The inhibitory effect of ERK and P38 in-hibitors were studied by Western blotting. Our current study showed that a block in P38 MAPK dependent cell death might contribute to the decrease in 20μg/mL MBL-mediated Caco-2 apoptosis. Conclusion High concentration of rhMBL may play an important role in the intesti-nal epithelial cell apoptosis, and P38 pathway may be involved in this regulation.

Objective To investigate the effect of S-Nitrosoglutathione (GSNO)on acute ischemia reperfusion (I/R)induced in-testinal barrier function lesion in a mouse model.Methods Twenty-four 6-8-year-old C57BL/6 mice were divided into 3 groups,8 for each:(1)the sham group;(2)the I/R group;(3)the I/R+GSNO group.The mouse intestine I/R model was established by the occlusion of the superior mesenteric artery temporarily followed by reperfusion for 6 h.Histological changes in the small intestine were observed after HE staining;the expression of claudin-1 protein in the intestine epithelium was assessed by immunohistochem-istry staining as well as western blot analysis.Results Both HE staining and immunohistochemistry results showed the integrate intestinal villi with the continuous Claudin-1 expression alone the villi in the sham group;the intestinal villi of the I/R group partial-ly detached,thickened,crooked and fractured,with the obvious disconnection of Claudin-1 staining alone the top of the villi;while the intestinal villi of the I/R+GSNO group were neatly arranged and damage to intestinal mucosa was much alleviated,accompanied with the marked restoration of the continuity of claudin-1 staining.Compared to the sham group,claudin-1 protein level of for the I/R group and the I/R+GSNO group decreased by 32.5% and 13.8% respectively (P <0.05);and compared to the I/R group,clau-din-1 protein level of the I/R+GSNO group increased by 27.8% (P <0.05).Conclusion Protein level of claudin-1 would decrea-ses after I/R,and pretreatment with GSNO can effectively relieve the damage of intestinal mucosal structure as well as intestinal tight junction barrier through upregulating the expression of claudin-1 protein.

Objective To evaluate the association of apM1 gene single nucleotide polymorphisms (SNP) with type 2 diabetes mellitus in Chinese population. Methods Odds ratios (OR) of apM1 gene SNP distribution were analyzed. The Meta-analysis software (RevMan 4.3.1) was employed for summarizing the studies,calculating the pooled OR and its 95% CI and testing the overall effects. Egger's test and fail-safe number for P=0.05 (Nfs<,0.05>) were performed for evaluating the publication bias. The sensitivity analysis by different effect models and sample sizes were employed for the reliability of Meta-analysis. Results Nine literatures were obtained, apM1 gene SNP45 showed remarkable heterogeneity among the studies (P<0.10). Sub-group analysis revealed that the discrepancy based on southern Chinese individuals was the main source of the total heterogeneity.The distribution frequencies of apM1 gene SNP45G, SNP45GG, SNP276G and SNP276GG were significantly higher in Chinese type 2 diabetes mellitus group than those in NGT group (P<0.05). Their pooled OR and 95% C/were 1.50[1.12,2.02], 2.15[1.53, 3.02],1.23[1.03, 1.46] and 1.26[1.00,1.59], respectively (all P<0.05). The distribution of apM1 gene SNP45TG and SNP276GT between type 2 diabetes mellitus and normal glucose tolerance group revealed no difference among these studies. The results of publication bias diagnostics and sensitivity analysis accounted for the reliability and stability of this Meta-analysis. Conclusion apM1 gene SNPs are strongly associated with type 2 diabetes mellitus in Chinese population. SNP45G and SNP276G seem to be risk factors for type 2 diabetes mellitus.

Objective:To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's pre-operative management and improving the efficiency of medical resources as well as the patient's satisfaction.Methods: The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital,from cases of knee and hip arthroplasty that were suspended before the scheduled operation time.Acquisition data from the collected cases including the patients' gender,age and the surgical procedure.At the same time,the suspension reasons were recorded and analyzed.All the decisions of suspension was made by the surgeons and the anesthesiologists according to the abnormal result of preoperative examinations,after communicating with the patients and their families and obtaining their understandings.Results: In the collecting period,our department scheduled 1 146 cases of knee and hip arthroplasty,among which 1 003 were completed,143 suspended (12.5％ suspension rate).Among the causes of suspension,the top four common causes were cardiovascular disease (44/143,31％),other infections (20/143,14％),bacteriuria (18/143,13％) and inappropriate surgical indication (16/143,11％).Other causes include surgeon's reason,Blood system abnormalities,high inflammatory index,deep vein thrombosis,other diseases uncontrolled,abnormal liver function and poor diabetes mellitus control,etc.For the rate of suspension,there was no significant difference between the patients with different genders (male: 15.0％,and female: 11.7％,P=0.149),or age (≤50 years: 13.0％;51-65 years: 11.6％;66-80 years 13.3％;>80 years 11.1％;P=0.864).However compared with knee arthroplasty,hip arthroplasty had a higher suspension rate (knee arthroplasry 11.1％,hip arthroplasry 16.1％,P=0.021).Conclusion: It is important to educate and manage the patients before their knee and hip arthroplasty.Through clear diagnosis,detailed medical history analysis careful physical examination,and targeted outpatient examinations and tests for which priority was focused on cardiovascular or other system diseases we could minimize the occurrence of operative suspension post hospitalization,therefore improving the efficiency of the use of medical resources.

Objective To optimize the shaping process of Biyuan dropping pills.Methods With the hardness,tailing degree,spherical degree and coefficient of heavy variation of the dropping pills as the scoring indexes,the proportion of extract and matrix,temperature of extract and refrigerant liquid,internal diameter of the dropper,dropping speed were observed.Orthogonal design was applied to optimize the proportion of extract and matrix,temperature of extract and refrigerant liquid,drops distance on the basis of the preliminary experiments.Results The optimal conditions were: semi-synthesized fatty acid ester and extract at the proportion of 4 ∶1 were heated in a water bath and were completely stirred for melting;the pills were dropped into the 65 %alcohol (10 ℃) at temperature 40 ℃at the constant rate of 60 drops per minute;the diameter (internal)of the dropping tip is 2.0 mm .Conclusion The experimental results provide evidences for shaping process of Biyuan dropping pills in the manufacturing scale.