Objective To investigate the safety of thalidomide in the treatment of immune-related bowel diseases for providing clinical reference.Methods Thirty-five patients with immune-related bowel diseases (31 Crohn's disease,2 ulcerative colitis and 2 Behcet's disease) treated with thalidomide were enrolled in this study.The incidence,type,severity,duration of thalidomide related adverse drug reaction (ADR) and the dose-effect relationship of neurotoxicity were analyzed.Results All the patients were treated with a mean dose of thalidomide (109.29 ± 30.37) mg/d for (18.8 ± 12.4) months,and 33 occurred ADR.The three most frequent ADR were numbness [51.4％ (18/35)],somnolence [48.6％ (17/35)] and dermatitis [37.1％ (13/35)].The median time to development of these three ADR were 6.50,0.25,and 1.00 months,respectively.Severe ADR leading to withdrawal accounted for 20.0％ (7/35),including reasons of peripheral neuritis (3/7),dermatitis (2/7) and myelosuppression (2/7).The incidence of peripheral neuritis was not significantly related to the maximal and initial dose of thalidomide (P ＞ 0.05).Conclusions Although the incidence of ADR was relatively high during the treatment of thalidomide,most of them were mild and well tolerated.Thalidomide can be safely used in patients with immune-related bowel diseases under close monitoring.

· AIM: To report a rare case of mesenchymalchondrosarcoma in the orbit and to explore its clinicmanifestations, pathologic characters, management andprognosis. · METHODS: We report a case of mesenchymalchondrosarcoma of the orbit. The clinical materials,including ophthalmological examination, computed tomo-graphy scan of the orbit, histopathology and immunohis-tochemistry of the biopsy specimen was reported, and itspertinent literatures were reviewed.· RESULTS: A 36-year-old female was seen with proptosisand decreased vision. Histopathology demonstrated anadmixture of undifferentiated mesenchymal cells andislands of mature hyaline cartilage. Immunohistochemicalstudies revealed positivity for vimentin and S-100, whichwas consistent with the diagnosis of mesenchymalchondrosarcoma.· CONCLUSION: Mesenchymal chondrosarcoma in theorbit is extremely rare malignant tumor. Multi-modalitytreatments (surgery, chemotherapy and radiotherapy)may lead to long-term survival.

· AIM: To investigate whether heat shock protein 27 (HSP27) is induced in retinal ganglion cells (RGCs) in experimental rat glaucoma and whether the induction of HSP27 by intraocular pressure (IOP) elevation can increase serum autoantibody to HSP27 in the model.IOP elevation、Sham and normal groups by SPSS12.0. IOP was raised by electrocoagulating at least 3 episcleral veins and limbal veins on the right eye of each rat in IOP elevation group and its contralateral eye was used as controls. Immunohistochemical staining for HSP27 was performed in RGCs and retinal nerve fiber layer (RNFL) and serum immunoreactivity against HSP27 was detected by means of enzyme-linked immunosorbent assay (ELISA) in three groups.RNFL of the eyes with IOP elevation, while it was expressed weakly in untreated control eyes. Compared with sham and normal groups, serum autoantibody to HSP27 was slightly high at 1wk (P ＞0.05) and significantly increased at 2, 3, 4 and 8wk (P＜0.05) in IOP elevation group.enhanced expression of the endogenous HSP27 might play an important role in glaucomatous optic neuropathy.

AIM: To study the experimental method of inducing the chronic intraocular hypertension in rat eyes.METHODS: Twenty Wistar rats were randomly divided into ocular hypertension and Sham control groups. Intraocular pressure (IOP) was raised by electrocoagulating at least 3 episcleral and limbal veins on the right eye of each rat in ocular hypertension group and its contralateral eye was used as control. At 1, 2, 3, 4 and 8wk after the electrocoagulation of the veins, IOP were measured. RESULTS: The treatment of electrocoagulation caused a significant IOP increase of the right eyes over the baseline, over the contralateral eyes, and over the sham control eyes (repeated measures ANOVA, P＜0.001). At 1wk,IOP was (30.12± 5.L8 ) mmHg (1kPa=7.5mmHg), and maintained the high IOP up to 8wk.CONCLUSION: The chronic intraocular hypertension model could be successfully created by electrocoagulating three or more episcleral and limbal veins.

OBJECTIVEPrimary nephrotic syndrome (PNS) is one of the common renal diseases in children, the pathogenesis of which is unclear. Evidences suggested that the proteinuria of NS is associated with the increased expression of the interleukin-8 (IL-8) genes. The purpose of the study was to evaluate the serum concentration and mRNA expression of IL-8 before and after the methylprednisolone pulse therapy (MPT) in PNS.

METHODThirty children with PNS diagnosed from December 2000 to October 2001 were enrolled in this study (patients group). They were not treated with glucocorticoid at least within the recent 3 months. The children aged from 1.5 to 14 years (mean 8.5 years), and included 24 boys and 6 girls. Eighteen healthy children were selected as control group after physical examination. The children in control group aged from 2 to 14 years (mean 8 years) and included 13 boys and 5 girls. All patients were treated with MPT intravenously (30 mg/kg) for successive 3 days followed by oral prednisone. The serum protein level of IL-8 was measured by ELISA according to the manufacturer's instructions. Human IL-8 ELISA kit was purchased from Jingmei corporation Shenzhen, China. And the concentration was obtained after drawing the standard curve. The expression of IL-8 gene was detected with RT-PCR method. The important reverse transcription reagent kit and Trizol reagent were all bought from GIBCO BRL, USA. Statistical analysis of rank sum test was adopted for data processing.

RESULTSComparison of the serum IL-8 level in the same patient before and after the therapy showed significant difference [29.59 (7.14-352.08) ng/L vs. 10.80 (4.27-77.86) ng/L, u = 4.26, P < 0.01]. The serum level in patient group before the therapy increased obviously in comparison to the level of the control group [10.37 (5.46-33.31) ng/L, u = 4.53 P < 0.01]. The serum level of IL-8 in patient group after the therapy also showed significant difference compared to the control group (u = 2.73 P < 0.01). The mRNA expression of IL-8 in the same patient before and after therapy showed significant difference [0.862 (0.776-0.95) vs. 0 (0-0.754), u = 3.902 P < 0.01].

CONCLUSIONIL-8 may be involved in the pathogenesis of PNS because of the significant increase of the serum IL-8 level and PBMC IL-8 mRNA expression in nephrotic syndrome children. Methylprednisolone pulse therapy in PNS was able to inhibit the protein production and PBMC mRNA expression of IL-8, so the therapeutic mechanism of MPT in PNS might be associated with the inhibition of IL-8 expression.

Adolescent ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Gene Expression ; drug effects ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Infusions, Intravenous ; Interleukin-8 ; blood ; genetics ; Male ; Methylprednisolone ; administration & dosage ; therapeutic use ; Nephrotic Syndrome ; drug therapy ; Pulse Therapy, Drug ; RNA, Messenger ; drug effects ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Treatment Outcome

OBJECTIVETo assess the efficiency of the PDL in the treatment of PWS in Chinese patients with skin type III-IV.

METHODS252 patients with PWS at different anatomical sites were retrospectively studied. A flashlamp-pumped pulsed dye laser was used. The differences in therapeutic effect of laser were analyzed in the following ways: (1) by dermatomal distribution of face and neck; (2) by anatomical subdivision of face; (3) by the size of the lesion. The therapeutic effect was graded as 0 < or = poor < 25%, 25% < or = fair < 50%, 50% < or = good < 75%, 75% < or = excellent < or = 100%.

RESULTSIt revealed that the lesions at neck had the best response. The dermatome II zone showed the least response to PDL. Among the anatomical subdivision of face, the frontal area had the highest clearance, while the zygoma and cheek had the lowest clearance. Patients with PWS on the extremities respond less favorably with the fair lightening effect. Furthermore, the mean lightening was decreased as the size of PWS was increased.

CONCLUSIONSThe response difference of PWS to PDL was not only related to the anatomical region, but also related to the lesion size. It is imperative to give the patients rational treatment suggestion and normal expectation.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Laser Therapy ; Lasers, Dye ; therapeutic use ; Male ; Middle Aged ; Port-Wine Stain ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVEEpidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) such as gefitinib and erlotinib are used as standard 2(nd)/3(rd) line therapy in previously treated advanced non-small cell lung cancer (NSCLC). However, the optimal treatment for patients who experienced disease progression after chemotherapy and EGFR-TKI is unclear. The aim of this study was to explore the efficacy and safety of a salvage chemotherapy in advanced NSCLC patients who failed the previous treatment of platinum-based chemotherapy and EGFR-TKI.

METHODSClinicopathological data of 55 cases of advanced NSCLC patients who failure of first-line platinum-based chemotherapy and subsequent treatment with TKI were collected and analyzed. The patients were of PS = 0-2, and with normal vital organ function. Patients received salvage chemotherapy until disease progression or unacceptable toxicity or the patient refused to continue receiving treatment. A chart review assessed the key outcomes including the objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS).

RESULTSFifty-five patients were enrolled in this study from march 2007 to october 2009. The median age of patients was 55 years (range: 34 - 72), 60.0% were males, PS 0-1 patients were 65.5%, stage IV patients were 100%; 34.5% had a TKI treatment duration ≥ 6 months. Twenty-four patients received pemetrexed as salvage chemotherapy, 21 received docetaxal and 10 had other chemotherapy. All patients were evaluable for efficacy. Among them, 7 (12.7%) patients achieved PR, 21 (38.2%) patients SD, and 27 (49.1%) patients PD, with ORR of 12.7% and DCR of 50.9%. The median follow-up duration was 5.5 months, and the median PFS was 2.0 months. The ORR and PFS were not significantly related with gender, PS and chemotherapy regimens (all P > 0.05), but patients with EGFR-TKI treatment ≥ 6 months achieved a significantly better ORR and DCR than those < 6 months (ORR: 21.1% vs. 8.3%, P = 0.012; DCR: 73.3% vs. 38.9%, P = 0.017), mPFS was significant longer in the patients received ≥ 6 months of EGFR-TKI (4.5 vs. 2.0 months, P = 0.008). The toxicity was acceptable and there were no treatment-related deaths.

CONCLUSIONAdvanced NSCLC patients failed with the previous treatment of first-line platinum-based chemotherapy and EGFR-TKI may benefit from salvage chemotherapy, especially in patients who received ≥ 6 months of EGFR-TKI. The toxicity of the salvage chemotherapy is acceptable.

Adult ; Aged ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Disease-Free Survival ; Erlotinib Hydrochloride ; Female ; Follow-Up Studies ; Glutamates ; adverse effects ; therapeutic use ; Guanine ; adverse effects ; analogs & derivatives ; therapeutic use ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Neoplasm Staging ; Neutropenia ; chemically induced ; Pemetrexed ; Platinum ; administration & dosage ; Protein Kinase Inhibitors ; therapeutic use ; Quinazolines ; therapeutic use ; Receptor, Epidermal Growth Factor ; antagonists & inhibitors ; therapeutic use ; Remission Induction ; Salvage Therapy ; Taxoids ; adverse effects ; therapeutic use ; Treatment Failure

OBJECTIVE: To evaluate the therapeutic effects of intraarticular injection of ligustrazine on knee osteoarthritis (OA). METHODS: Seventy-one cases of knee osteoarthritis (82 knees) were randomly divided into ligustrazine (LI) group and sodium hyaluronate (SH) group. The patients were intraarticularly injected ligustrazine or sodium hyaluronate once a week for 5 consecutive weeks, and were followed-up for 3 months. Lequesneos protocol for the evaluation of OA severity and activity was used. The therapeutic effects and changes of Lequesneos index were observed after the treatment. RESULTS: There was significant decrease in Lequesneos index in SH group after the treatment (P<0.01), but not in LI group (P>0.05). Three weeks later, there was significant decrease in Lequesneos index in both groups after the treatment (P<0.01), with no significant difference between SH and LI group (P>0.05). After the 5-week treatment, the efficacy rate of the LI group was 82.1%, and that of the SH group was 87.2%. No serious toxic or side effect was observed during the treatment and the follow-up. CONCLUSION Intraarticular injection of ligustrazine has a therapeutic effect on knee OA. No adverse effect is observed, but it needs long time to take effect.
Anti-Inflammatory Agents, Non-Steroidal ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Injections, Intra-Articular ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Pyrazines ; administration & dosage

OBJECTIVETo study the pattern of blood-brain barrier (BBB) permeability changes during whole brain radiotherapy (WBRT) for metastatic brain tumor.

METHODSTwenty patients with metastatic brain tumors receiving WBRT by 6 MV X-ray underwent (99)mTc-DTPA brain SPECT before and during WBRT (20, 40 Gy) and at 2 weeks after the end of irradiation. A frame of transverse (99)mTc-DTPA brain SPECT image that best displayed the brain metastasis was chosen, and the regions of interest (ROI) were defined in the tumor foci (T), the contralateral normal brain tissue (N) and the background outside the soft tissues around the cranium (B). The radioactive counts of every ROI were measured and the ratios of the total counts (T/B and N/B) before and during WBRT (20 Gy, 40 Gy) and at 2 weeks after the irradiation were calculated.

RESULTSThe average T/B and N/B in the 20 patients with 30 brain metastases was 142.2-/+51.1 and 82.6-/+42.3 before WBRT, 260.3-/+121.5 and 150.7-/+72.5 during 20 Gy WBRT, 251.6-/+118.3 and 161.8-/+68.4 during 40 Gy WBRT, and 250.3-/+117.2 and 158.6-/+73.5 at 2 weeks after the irradiation, respectively. The measurements during WBRT (20 and 40 Gy) and at 2 weeks after the irradiation group underwent no significant variations (P>0.05), but showed significant differences from those before WBRT (P<0.05).

CONCLUSIONSIrradiation causes direct damage of the BBB function, and the permeability of the BBB increases significantly during and within 2 weeks following 20 and 40 Gy WBRT, which provides the optimal time window for interventions with chemotherapy.

Adult ; Aged ; Blood-Brain Barrier ; diagnostic imaging ; physiopathology ; Brain Neoplasms ; diagnostic imaging ; radiotherapy ; secondary ; Capillary Permeability ; physiology ; Cranial Irradiation ; Female ; Humans ; Male ; Middle Aged ; Sodium Pertechnetate Tc 99m ; Tomography, Emission-Computed, Single-Photon

BACKGROUNDCholedochal cyst excision and biliary enteric reconstruction constitute the best therapy for choledochal cyst. And laparoscopy is currently used to cure this disease now.

METHODSWe retrospectively analyzed the clinical data of 34 cases of total laparoscopic choledochal cyst excision between January 2007 and August 2011. All patients underwent in vitro Roux-en-Y hepatoenterostomy.

RESULTSAll 34 patients underwent successful total laparoscopic choledochal cyst excision. The operation time was 200 - 360 minutes. The duration of hospital stay was 3 - 7 days. Follow-up observations lasted 1 - 56 months. One patient developed an anastomotic stoma stricture, but no other cases had postoperative complications. No patients died.

CONCLUSIONTotal laparoscopic choledochal cyst excision is safe and feasible.

Adult ; Choledochal Cyst ; surgery ; Female ; Humans ; Laparoscopy ; adverse effects ; methods ; Male ; Postoperative Complications ; Retrospective Studies ; Young Adult