Objective To study the CT and MRI findings of hemorrhagic and necrotic nasal polyps. Methods The imaging data of 17 cases with hemorrhagic and necrotic nasal polyps confirmed by surgery and pathology were analyzed retrospectively. CT was performed in 14 cases, MRI in 16 cases, of which 15 also underwent contrast-enhanced MRI. Results All 17 lesions with well-circumscribed margin originated in the areas of maxillary sinus ostia and extended into adjacent nasal cavity and maxillary sinus. The lesions appeared as lobular shape in 16 cases and oval shape in 1 case. On non-enhanced CT, 14 lesions showed heterogenous soft tissue density masses, the hyperdense strip and nodule were detected on the periphery and in the center of 2 lesions respectively. All the involved bony walls were compressed and remodeled with focal defect,especially in the medial wall of maxillary sinus. On MRI, all 16 lesions revealed inhomogenous signal. The central region of the lesions appeared hypointense signal on T_1WI compared to gray matter and hyperintense signal on T_2WI with line-like hypointense signal septa in 14 cases, the irregular hypointense signal rims were also found on the periphery of 15 lesions on T_2WI, postcontrast MR imaging showed strongly inhomogenous enhancing masses with non-enhancing hypointense rim, the appearances of enhancement showed multiple nodules in 10 cases, patches in 4 cases and leaf-like in 1 case. The typical simple polyps were present in the ipsilateral nasal cavity of the lesions in 4 cases, extending into nasal vestibule anteriorly and choana posteriorly. On dynamic contrast-enhanced MRI in 11 cases, the timeintensity curves (TIC) showed increasing enhancement type in 7 cases and rapid enhancement and slow wash-out type in 4 cases. Conclusion The inhomogenous hyperintensity surrounded by the peripheral hypointense rim on MR T_2WI and marked nodular and patchy enhancement appearance are typical features of hemorrhagic and necrotic nasal polyps. CT is helpful to judge the nature of lesions, but difficultly confirms the diagnosis, while MRI should be the imaging modality of first choice for hemorrhagic and necrotic nasal polyps.

OBJECTIVE: To explore the expression level of class I integrase (intI 1) mRNA in Acinetobacter baumannii from biofilm cells and planktonic cultured cells ,and to analyze the drug-resistance of Class I integron positive strains. METHODS: Acinetobacter baumannii were collected from hospitals,and Class I integron strains were screened by gene amplification. Total RNA of Class I integron positive strains was extracted, and the intI1 mRNA expression in the bioflim cells and planktonic cultured cells was measured by RT-PCR. Susceptibilities to antibiotics of Class I integron positive strains were also examined. RESULTS: The intI1 gene mRNA was expressed under 2 conditions, and the mRNA expressed in the biofilm cells was about 4 times higher than that in the planktonic cultured cells. Among the 64 strains of Acinetobacter baumannii, 46 strains were Class I integron positive strains. The antibiotic resistance of intI1 gene cassette-positive strains was higher than that of gene cassette-negative strains. CONCLUSION The intI1 gene mRNA can be up-regulated in Acinetobacter baumannii biofilm cells.Class I integron plays an important role in drug resistance. It is much easier to capture gene cassettes for bacteria under biofilm condition.
Acinetobacter Infections ; microbiology ; Acinetobacter baumannii ; genetics ; isolation & purification ; Base Sequence ; Biofilms ; Drug Resistance, Multiple ; genetics ; Humans ; Integrases ; biosynthesis ; genetics ; Molecular Sequence Data ; RNA, Messenger ; biosynthesis ; genetics

OBJECTIVETo investigate oxidative DNA damage in pharmacy technicians preparing antineoplastic drugs at the PIVAS (Pharmacy Intravenous Admixture Service) in two Chinese hospitals.

METHODSUrinary 8-OHdG served as a biomarker. 5-Fluorouracil (5-FU) concentrations in air, masks and gloves were determined. The spill exposure of each PIVAS technician to antineoplastic drugs was investigated. Eighty subjects were divided into exposed group I, II, and control group I, II.

RESULTS5-FU concentration ratios for gloves and masks in exposed group I were significantly higher than those in exposed group II (P<0.05 or P<0.01). The average urinary 8-OHdG concentrations in exposed group I, control group I, exposed group II, and control group II were 14.69±0.93, 10.68±1.07, 10.57±0.55, and 11.96±0.73 ng/mg Cr, respectively. Urinary 8-OHdG concentration in exposed group I was significantly higher than that in control group I or that in exposed group II (P<0.01). There was a significant correlation between urinary 8-OHdG concentrations and spill frequencies per technician (P<0.01).

CONCLUSIONThere was detectable oxidative DNA damage in PIVAS technicians exposed to antineoplastic drugs. This oxidative DNA damage may be associated with their spill exposure experience and contamination of their personal protective equipment.

Adult ; Air ; analysis ; Antineoplastic Agents ; analysis ; toxicity ; Case-Control Studies ; China ; DNA Damage ; Deoxyguanosine ; analogs & derivatives ; urine ; Female ; Fluorouracil ; analysis ; toxicity ; Gloves, Protective ; Health Personnel ; statistics & numerical data ; Hospitals ; statistics & numerical data ; Humans ; Male ; Masks ; Occupational Exposure ; statistics & numerical data ; Oxidative Stress ; Young Adult

OBJECTIVETo develop a colon-specific prodrug of Indomethacin microbially triggered, carry out in vitro/in vivo evaluation of drug release, and appraise its inhibitory effect on liver metastasis from colon cancer.

METHODSIndomethacin prodrugs were synthesized and characterized by FTIR and NMR, and dissolution test simulating gastrointestinal tract was employed to screen the colon-specific prodrug. Then, the pharmacokinetic profile of portal vein and peripheral blood in Sprague-Dawley rats was studied. Lastly, the inhibitory effect on liver metastasis from colon cancer in nude mice was observed.

RESULTSThe chemical structure characterized by FTIR and NMR demonstrated that six kinds of indomethacin-block-amylose with different drug loading (IDM-AM-1-6) were synthesized, among which IDM-AM-3 was degraded 1.3%, 9.3% and 95.3%, respectively, in simulated gastric fluid for 4 h, small intestine for 6 h, and colon for 36 h. The pharmacokinetic test of IDM-AM-3 showed that absorption was delayed significantly (P < 0.01), peak time [(11.35 + or - 2.45) h], elimination half-life [(16.74 + or - 4.04) h] and mean residence time [(22.27 + or - 0.52) h] were significantly prolonged (P < 0.01), as well as peak serum concentrations [(9.69 + or - 2.40) mg/L] and AUC(0-t) [(236.7 + or - 13.1) mg x L(-1) x h] were decreased markedly (P < 0.01) as compared with those of IDM regarding to portal vein. Additionally, its AUC(0-t) in peripheral blood was remarkably lower than that in Portal vein (P < 0.01). The tumor suppression observation showed that it could remarkably reduce the number of liver metastases in contrast to IDM (P < 0.05).

CONCLUSIONColon-specific IDM-AM-3 possesses advantage of sustained release in portal vein providing some experimental basis for colon-specific delivery system applied to sustained release in the portal vein.

Amylose ; administration & dosage ; chemical synthesis ; pharmacokinetics ; therapeutic use ; Animals ; Colon ; metabolism ; Colonic Neoplasms ; pathology ; Delayed-Action Preparations ; Drug Delivery Systems ; HT29 Cells ; Humans ; Indomethacin ; administration & dosage ; chemical synthesis ; pharmacokinetics ; therapeutic use ; Liver Neoplasms ; prevention & control ; secondary ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Prodrugs ; administration & dosage ; chemical synthesis ; pharmacokinetics ; therapeutic use ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVESTo investigate role of hypoxia inducible factor 1 (HIF-1) in the transcriptional activation of heat shock protein 70-2 (HSP70-2) in hepatocellular carcinoma (HCC) cells under hypoxic conditions.

METHODSHCC cells were exposed to reduced oxygen atmosphere (1% O2), or treated with YC-1 or HIF-1 alpha siRNA, the expression of HIF-1 alpha and HSP70-2 were detected by Western blot analysis. Serial deletions of the HSPA2 promoter were cloned in the reporter pGL3-Basic plasmid. These reporter plasmids were co-transfected with HIF-1 alpha siRNA, and the promoter activities were detected with the dual luciferase assay.

RESULTSWestern blot analysis showed that both HIF-1 alpha and HSP70-2 proteins were strongly increased after HCC cells were exposed to hypoxic conditions (1% O2) for 6 h, and the expression level of HSP70-2 was increased in a time-dependent manner. Treatment of HepG2 cells with YC-1 or HIF-1 alpha siRNA significantly inhibited the expression of HIF-1 alpha and HSP70-2. In silico analysis of the HSP70-2 promoter using the Gene2 Promoter software revealed the presence of two putative hypoxic response element (HRE) consensus at -446bp (HRE1) and -238bp (HRE2). Depletion of promoter sequence between -653 and -385 led to a dramatic reduction of promoter activity, whereas further deletion to position -201 did not reduce the activity further. These data suggested that HRE1 plays an important role in hypoxia-induced activation of the HSPA2 promoter. Site-directed mutagenesis further confirmed these results. Mutation of HRE1 but not of HRE2 abrogated the sensitivity of the HSP70-2 promoter to hypoxia.

CONCLUSIONSHSP70-2 expression is up-regulated in response to hypoxia and a HIF-1 binding site (HRE1) in the HSP70-2 promoter is involved in this response.

Base Sequence ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Cell Hypoxia ; Gene Expression Regulation, Neoplastic ; HSP70 Heat-Shock Proteins ; genetics ; metabolism ; Hep G2 Cells ; Humans ; Hypoxia-Inducible Factor 1 ; genetics ; metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; antagonists & inhibitors ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Molecular Sequence Data ; Plasmids ; genetics ; Promoter Regions, Genetic ; RNA, Small Interfering ; genetics ; Transfection ; Up-Regulation

Recent studies have shown that astrocytes play important roles in ATP degradation and adenosine (a well known analgesic molecule) generation, which are closely related to pain signaling pathway. The aim of this study was to investigate whether morphine, a well known analgesic drug, could affect the speeds of ATP enzymolysis and adenosine generation in rat astrocytes. Intracellular calcium concentration ([Ca(2+)](i)) of astrocyte was measured by flow cytometry, and the time points that morphine exerted notable effects were determined for subsequent experiments. Cultured astrocytes were pre-incubated with morphine (1 μmol/L) and then were incubated with substrates, ATP and AMP, for 30 min. The speeds of ATP enzymolysis and adenosine generation were measured by high performance liquid chromatography (HPLC). The results showed that both 1.5 and 48 h of morphine pre-incubation induced maximal ATP enzymolysis speed in astrocytes among all the time points, and there was no statistical difference of ATP enzymolysis speed between morphine treatments for 1.5 and 48 h. As to adenosine, morphine pre-incubation for 1.5 h statistically increased adenosine generation, which was degraded from AMP, in cultured astrocytes compared with control group. However, no difference of adenosine generation was observed after 48 h of morphine pre-incubation. These results indicate that treatment of morphine in vitro dynamically changes the concentrations of ATP and adenosine in extracellular milieu of astrocytic cells. In addition, astrocyte can be regarded as at least one of the target cells of morphine to induce changes of ATP and adenosine levels in central nervous system.
Adenosine ; biosynthesis ; Adenosine Triphosphate ; metabolism ; Analgesics, Opioid ; pharmacology ; Animals ; Animals, Newborn ; Astrocytes ; cytology ; drug effects ; metabolism ; Calcium ; analysis ; metabolism ; Cells, Cultured ; Cerebral Cortex ; cytology ; Morphine ; pharmacology ; Rats ; Rats, Sprague-Dawley

BACKGROUNDDisease recurrence is a main challenge in treatment of hepatocellular carcinoma (HCC). There is no generally accepted method for preventing recurrence of HCC after resection.

OBJECTIVETo compare the efficacy of a traditional herbal medicine (THM) regimen and transarterial chemoembolization (TACE) in preventing recurrence in post-resection patients with small HCC.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONSThis is a multicenter, open-label, randomized, controlled study, which was undertaken in five centers of China. A total of 379 patients who met the eligibility criteria and underwent randomization were enrolled in this trial. One hundred and eighty-eight patients were assigned to the THM group and received Cinobufacini injection and Jiedu Granule, and the other 191 patients were assigned to the TACE group and received one single course of TACE.

MAIN OUTCOME MEASURESPrimary outcome measures were the annual recurrence rate and the time to recurrence. Incidence of adverse events was regarded as the secondary outcome measure.

RESULTSAmong the 364 patients who were included in the intention-to-treat analysis, 67 patients of the THM group and 87 of the TACE group had recurrence, with a hazard ratio of 0.695 (P = 0.048). Median recurrence-free survival of the patients in the THM and TACE groups was 46.89 and 34.49 months, respectively. Recurrence rates at 1, 2 and 3 years were 17.7%, 33.0% and 43.5% for the THM group, and 28.8%, 42.5% and 54.0% for the TACE group, respectively (P = 0.026). Multivariate analysis indicated that the THM regimen had a big advantage for prolonging the recurrence-free survival. Adverse events were mild and abnormality of laboratory indices of the two groups were similar.

CONCLUSIONIn comparison with TACE therapy, the THM regimen was associated with diminished risk of recurrence of small-sized HCC after resection, with comparable adverse events. TRIAL REGISTRTION IDENTIFIER: This trial was registered in the Chinese Clinical Trial Registry with the identifier ChiCTR-TRC-07000033.

Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; prevention & control ; surgery ; Chemoembolization, Therapeutic ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; prevention & control ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate ; Young Adult

Objective:To investigate the effect of jugular tubercle thickness on pathogenesis of hemifacial spasm (HFS) and its curative efficacy by microvascular decompression (MVD).Methods:One hundred and thirty-five HFS patients accepted MVD in our hospital from June 2017 to May 2018 were enrolled in this study. The thickness of the jugular tubercle was measured on preoperative magnetic resonance imaging (MRI) with steady state acquisition (FIESTA) sequence. The differences of jugular tubercle thickness and arterial flow rate from the jugular tubercle to the brainstem between the healthy side and symptomatic side in these patients were compared. These patients were divided into immediate symptom-relief group ( n=112) and symptom residual group ( n=23) according to the symptom relief one d after MVD; the difference of jugular tubercle thickness between the two groups were compared. Results:No significant difference in the jugular tubercle thickness was noted between the healthy side and the symptomatic side in all 135 patients ( t=0.787, P=0.432). The arterial flow rate from the jugular tubercle to the brainstem in the symptomatic side (95.6%) was significantly higher than that in the healthy side (57.0%, P<0.05). The jugular tubercle thickness in the symptomatic residual group ([5.13±2.19] mm) was significantly higher than that in the immediate symptom-relief group ([4.03±1.16] mm, t=2.114, P=0.0396). Conclusion:The thickness of jugular tubercle is not associated with HFS onset, but may affect the immediate outcome of MVD.

OBJECTIVE: To establish a method for detecting tin in human blood by microwave digestion-atomic fluorescence spectrometry. METHODS: The microwave digestion instrument was used to digest 1. 00 mL blood sample with 4. 00 mL concentrated nitric acid( mass fraction 65. 00%) and 1. 00 mL perchloric acid( mass fraction 68. 00%). After 1. 00 mL of thiocarbamide-ascorbic acid( mass fraction 10. 00%) was added,hydrochloric acid( concentration 1. 5 mol / L) was added to a total constant volume of 10. 00 mL. Then 5. 00 mL of the sample was collected and detected by atomic fluorescence spectrophotometry. RESULTS: The good linear relationship was shown in the range of 0. 00-60. 00 μg / L,and the correlation coefficient was 0. 999 5. The limit of detection was 0. 01 μg / L. The average recovery rate was 98. 80%-103. 30%. The relative standard deviation( RSD) of within-run precision was 3. 74%-5. 26%,and the RSD of betweenrun precision was 1. 23%-4. 45%. The samples can be stored for at least 7 days under the temperature of 4 ℃.CONCLUSION: This method has the advantages of low detection limit,good precision and high sensitivity,which is suitable for the determination of tin in human blood.

【Objective】 To analyze the causes of staff burnout and various errors during group blood donation in blood centers, and to explore the significance of overall planning to improve above problems. 【Methods】 Various errors occurred during group blood donation from January 2016 to December 2020 in a blood center were selected as the research object. Job burnout related survey data including emotional exhaustion (MBI-EE), work attitude (MBI-DP), sense of achievement (MBI-PA) etc. were collected. The influence of six variables, including blood collection quantity, staff, order control, plan compliance, overload blood collection and over-stock blood collection, on the occurrence of errors was analyzed, and an ordered logistic regression model was established. After optimizing overall planning measures, the occurrence of errors and the improvement of burnout were compared. 【Results】 In addition to the volume of blood collected (P>0.05), the other five variables had significant influence on the occurrence of errors (P<0.05), and all included in the final Logistic regression model, with the OR values as 6.178, 6.143, 4.768, 3.435 and 1.957, respectively. There were significant differences in the three aspects of job burnout index between the two groups (P<0.05). After the intervention of inventory management and blood collection planning assessment, the overall collection planning had been significantly improved, MBI-EE in job burnout index also significantly improved, and the incidence of errors significantly decreased (P<0.05), but MBI-DP and MBI-PA had no significant difference (P>0.05). 【Conclusion】 Scientific inventory management and effective blood collection assessment measures are helpful to improve work quality, and the ordered Logistic regression model has a good fitting degree for error rectification. Analyzing the occurrence of errors during blood collection and supply from the influencing factors is conducive to formulate corrective and preventive measures and promote the continuous improvement of work quality.