It have been known that many epigenetic alterations palyed an important role in development of myelodysplastic syndromes (MDS). In contrast to genetic alterations, epigenetic alterations could be in principle pharmacologically reversed. Application of epigenetic drugs can reactivate inactivated suppressor genes. Epigenetic drugs mainly include demethylating agents and histone deacylase (HDAC) inhibitors, which are available in treatment. 5-AZA and decitabine as DNA demethylation agents have been approved by FDAof treatment in intermediate or high risk MDS, especially those old patients who are resistant to chemotherapy.HDAC inhibitors such as valproic acid are mostly employed in phase I trial, probably effective in treating low risk MDS, but treatment schedules and curative effects still have to be evaluated. The combination of demethylation agents and HDAC inhibitors may result in synergistic activity, but its therapeutic effect seems not to be superior to monotherapy of demethylation agents in current clinical trials, and it still need new clinical trials containing more cases and rational treatment schedules to identify safety and effect of combination.

Objective To evaluate the efficacy and safety of diacerhein in the treatment of patients with knee osteoarthritis.Methods The efficacy and safety of diacerhein was randomly investigated in 42 pa- tients with knee osteoarthritis using parallel group methodology and a double-dummy technique to ensure dou- ble blind status with respect to diacerhein and control drugs diclofenac.Results Significant changes were ob- served in 20 meters walk pain,knee joint tenderness scale,WOMAC index scale,5F-36 health survey,knee joint swelling scale,compared with baseline(P＞0.05)in both diacerhein and diclofenac group respectively.No difference was found between diacerhein group and diclofenae group.The patient global assessment and physi- cian's global assessment were similar in diacerhein group and diclofenac group(P＞0.05).The side effect was similar in two groups.All of these side effects in gastrointestinal tract appeared to be transient.Conclusion Diacerhein can effectively relieve pain and swelling of knee osteoarthritis,and provides us a new effective and safe approach for treating knee osteoarthritis.

Adult ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Nose ; surgery ; Orbit ; surgery ; Orbital Neoplasms ; surgery

An investigation and analysis on the effect of current bilingual teaching has been done among the 2002rd seven-year program students by using questionnaire.The result can provide basic foundation for improving the quality of bilingual teaching.

Humans ; Macrophage Activation Syndrome ; etiology ; Rheumatic Diseases ; complications

BackgroundThe neutrophils infiltration and vascular endothelium damage are found in the patients with diabetic retinopathy (DR).Calprotectin existes in the cytosol outside lysoome.It is thought to be a marker of inflammation.The effect of calprotectin in the development of DR is still in the study. Objective This study was to investigate the contents of plasma calprotectin in different stages of DR in patients with type 2 diabetes mellitus. Methods This was a case-control study.Sixty consecutive patients with type 2 diabetes mellitus were enrolled in this study.The patients were assigned to non-DR (NDR) group,non-proliferative DR (NPDR) group and proliferative DR (PDR)group according to fundus appearance and fundus fluorescein angiography(FFA) manifestation and 20 patients for each group.Twenty healthy subjects matched in gender,age and blood biochemical indicators were collected as the normal control group.The periphery blood samples were collected from the subjects for the detection of plasma calprotectin by ELISA.The plasma calprotectin levels were compared among different stages of DR and normal subjects.All subjects had signed informed consents.Results The contents of plasma calprotectin were (57.70±12.29 ),( 72.07± 10.14 ),( 87.70 ± 10.37 ),( 94.36 ± 9.40 ) ng/L in the normal control group,NDR group,NPDR group,PDR group respectively,with a statistically significant difference among 4 groups (F =73.09,P＜0.001 ).The content of calprotectin in PDR group showed a highest value in comparison with normal control group,NDR group and PDR group(q =20.157,10.648,4.497,P＜0.01 ).The content of calprotectin in NPDR group was significantly higher than that in NDR group( q=6.216,P＜0.01 ). ConclusionsPlasma calprotectin may play a role during the development of DR in type 2 diabetes mellitus patient.

Objective To evaluate the diagnostic value of 99mTc-EC dynamic renography for renal scars in children with urinary tract infection. Methods The 99mTc-EC and 99mTc-DMSA renographic results of 67 children diagnosed with urinary tract infection were retrospectively studied. In comparison with 99mTc-DMSA cortical images, the value of 99mTc-EC dynamic renogra-phy for the diagnosis of urinary tract infection, hydronephrosis and renal scars was analyzed. Results The sensitivity and speci-ficity of the initial 2 minutes summed images in the 99mTc-EC images for the diagnosis of renal scars was 80.28%and 88.89%re-spectively, and the likelihood ratio was 7.23. Renal scars were more likely to be formed in patients with obstructed upper urinary tracts, as compared with patients with unobstructed upper urinary tracts and unsmooth upper urinary tracts (P<0.05). The inci-dence of renal scar formation was not significantly different among groups with hydronephrosis of varying degrees (P>0.05). Conclusions For children with urinary tract infection, the diagnostic sensitivity and specificity of the initial summed images of 99mTc-EC dynamic renography are high. Furthermore, the excretion of upper urinary tract showed by 99mTc-EC dynamic renogra-phy is valuable for the diagnosis of renal scars.

Objective:To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up.Methods:In the study,299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included.The patients were divided into AKI group with AKI and control group without AKI after operation.The data during perioperative stage were compared,and multivariable Logistic regression modeling was used to identify the risk factors of AKI.The complications were compared after surgery and the patients were followed up for 3 years to observe the difference of MACCE between the two groups.Results:AKI occurred in 37.1％ patients (111/299).The elevated serum creatinine levels (Wald =9.276,P =0.002,95 ％ CI 1.006-1.028),chronic obstructive pulmonary disease(COPD) (Wald =3.469,P =0.063,95％ CI 0.950-7.630),decreased left ventricular ejection fraction (LVEF) (Wald =4.414,P =0.036,95 ％ CI 0.965-0.999),and implantation of intraaortic balloon pump (IABP) before or after operation(Wald =6.745,P =0.009,95％ CI 1.336-7.925)were risk factors of AKI in multivariable logistic regression modeling.More complications occurred in AKI group,such as the duration of mechanic ventilation,the time of ICU and the length of stay post operation,reintubation,pulmonary infection,stroke,hemorrhage of digestive tract,the volume of blood transfusion (plasma and red blood cell) and renal replacement therapy(P ＜ 0.05).The difference of mortality rate had no statistical significance between the AKI group and the control group,but two patients died in the AKI group.The difference of MACCE between the two groups had no statistical significance after 3 years' follow-up either.Conclusion:The incidence of AKI was high (37.1％) after off-pump CABG.The elevated serum creatinine levels,COPD,decreased LVEF,and implantation IABP before or after operation were independent risk factors of AKI in multivariable Logistic regression modeling.More complications occurred in AKI group during perioperative period,but the difference of MACCE between the two groups after 3 years' follow-up had no statistical significance.

Objective To compare fentanyl and sufentanil in total intravenous anesthesia for liver resection. Methods 100 patients undergoing liver resection were randomly received either sufentanil (group S, n = 50) anesthesia or fentanyl (group C, n = 50). Hemodynamic variables, time to spontaneous eye opening and extubation were recorded. VAS-scale was used to assess postoperative pain. The incidence of nausea & vomiting, agitation and respiratory depression was recorded and compared. Results Patients in group S had a more stable hemodynamic variables, and the incidence of postoperative pain (VAS: group S 4. 2± 1.1, group C 6. 1 ± 1.2), agitation (group S 2 cases, group C 11 cases) and respiratory depression (group S 1 case, group C 5 cases)was lower. Conclusions Both sufentanil and fentanyl were safe and efficacious in total intravenous anesthesia for liver resection. Compared with fentanyl, Sufentanil had higher hemodynamic stability, and lower incidence of postoperative pain, respiratory depression and agitation.

Objective: To investigate the peri-operative incidence of depression and anxiety symptoms of coronary artery bypass grafting (CABG). Methods: 73 patients,who underwent scheduled consecutive CABG between July 2005 and May 2006,were assessed with self-rating depression scale( SDS) and self-rating anxiety scale(SAS)before operation and before leaving hospital.Results: 21 patients (28.8%) had depression and/or anxiety symptoms before CABG, including 11 patients with depression, 7 patients with both depression and anxiety and the other 3 patients had anxiety symptoms. 34 patients (46.6%) had depression and/or anxiety symptoms after CABG, including 18 patients who had depression, 13 patients had both depression and anxiety symptoms and the other 3 patients had anxiety symptoms. The SDS score(47.9?10.0)after surgery was significantly higher than that before surgery(43.7?10) ,t=3.55, P=0.001. The SAS score after surgery (41.6?8.5) was significantly higher than that before surgery (39.3?7.4),t=2.20, P=0.031. Patients with bad mood before operation had lower educational levels (8?3/10?3,t=2.18,P=0.032). Four patients had multiple myocardial infarctions, all of them were in the anxiety-depression group postoperatively (4/34 vs 0/39,P=0.043). There was no difference in post-operative length of hospital stay between the two groups.Conclusions: The peri-operative incidence of depression and anxiety of CABG patients was very high and even higher after surgery. Less education is a risk factor for preoperative depression and anxiety states, multiple infarctions is a risk factor of post operative anxiety and depression.