Objective To evaluate the hematological adverse events of sunitinib in treatment of advanced renal cell carcinoma.Methods Forty-four male patients and 18 female patients were included in this study.They were all with metastatic renal cell carcinoma and received sunitinib treatment at the dose of 50 mg daily in repeated 6 weeks cycle (4 weeks on and 2 weeks off).Toxicity was assessed every cycle with tumor assessments every 2 cycles via CT or PET-CT.Results Fifty patients (80.6％) had experienced treatment-related hematotoxicity,including leucocytopenia,anemia and thrombocytopenia.Severe hematological adverse events ( grade 3 -4 ) occured in 18 patients ( 29.0％ ) and slight events ( grade 1 - 2 ) in others (51.6％).Most of the hematological adverse events were manageable and reversible and treatment-changes (dose reduction,interruption) were necessary in severe cases.Almost half of the dose reduction (9/21,42.9％ ) were owing to hematotoxicity.Conclusions Sunitinib of 50 mg dose on schedule 4/2 is effective and well-tolerated in advanced renal carcinoma patients.Hematological adverse events are frequent in Chinese patients and can be controlled well.

OBJECTIVETo investigate the etiologic value of diarrheagenic E. coil harboring genomic O island 28(OI-28) containing five putative virulence genes (Z0608, Z0609, Z0615, Z0634 and Z0635), which were related to RTX (Repeat in toxin) toxin family isolated from children with diarrheal disease in Taiyuan.

METHODSIn the study, 257 fecal samples from children with diarrheal disease collected in Shanxi Children's Hospital. Diarrheagenic E. coli and enteropathogenic bacteria were isolated and identified by conventional bacterial culture and typing specific diarrheagenic E. coli (EPEC, EIEC, ETEC and EHEC) diagnostic serum, while diarrheagenic E. coli harboring genomic 01-28 containing five putative virulence genes (Z0608, Z0609, Z0615, Z0634 and Z0635) were detected by PCR and DNA southern blot hybridization.

RESULTS206 strains (80.16%) of enteropathogenic bacteria were detected from 257 children with diarrhea disease, containing 149 strains (57.98%) of diarrheagenic E. coli and 57 strains(22.18%) of other entero-pathogenic bacteria. Among 3 strains (2.01%) of EPEC, 2 strains (1.34%) of ETEC, 2 strains (1.34%) EHEC were detected by typing specific serum, while all of the 142 strains (95.30%) isolated were suspected to be diarrheagenic E. coli. 21 strains (14.09%) of diarrheagenic E. coil harboring genomic O1-28 containing five putative virulence genes (Z0608, Z0609, Z0615, Z0634 and Z0635) were detected by polymerase chain reaction and DNA southen blot hybridization, 8 strains (5.37%) of diarrheagenic E. coli containing only one genomic OI-28 virulence gene, 2 strains (1.34%) of diarrheagenic E. coli containing two genomic OI-28 virulence gene. 21 children with diarrhea diseases caused OI-28-harboring E. coli containing five important putative virulence genes were among 0 to 3 years old (80.95%). These children correlating with OI-28-harboring E. coli did not present special clinical symptoms or signs.

CONCLUSIONThe diarrheagenic E. coil harboring genomic OI-28 was one of the important etiology for children with diarrheal disease in summer season.

Child ; China ; Diarrhea ; microbiology ; Escherichia coli ; genetics ; pathogenicity ; Escherichia coli Infections ; complications ; Genes, Bacterial ; Humans ; Virulence

In order to explore the security and feasibility of double autologous peripheral blood stem cell transplantation (APBSCT) for treatment of multiple myeloma, a 49 years old female patient with multiple myeloma was therapied with double APBSCT. The first peripheral blood stem cell (PBSC) mobilization regimen included CTX 2 g/m(2) x 1d and G-CSF [10 microg/(kgxd)] x 5 d. The conditioning regimen was given melphalan 200 mg/m(2). The transplanted number of mononuclear cells was 6.1 x 10(8)/kg and that of CD34(+) cells was 4.7 x 10(6)/kg. The second APBSCT was performed six months later. PBSC mobilization regimen was G-CSF [10 microg/(kgxd)] x 5 d. The conditioning regimen was melphalan 200 mg/m(2). The transplanted number of mononuclear cells was 10.2 x 10(8)/kg and that of CD34(+) cells was 5.9 x 10(6)/kg. The results showed that the absolute neutrophil count (ANC) rose to above 0.5 x 10(9)/L on day 17 and platelet count exceeded 20 x 10(9)/L on day 15 after first transplantation. After second transplantation ANC rose to above 0.5 x 10(9)/L on day 22 and platelet count exceeded 20 x 10(9)/L on day 13. There were neither obvious adverse reaction nor severe complication during the double transplantations. The patient's ostealgia and anemia were healed through above therapy. In the follow-up of 7 months, the patient's general status was good and she remained in complete remission phase. It is concluded that double APBSCT is safe, effective and feasible for the treatment of multiple myeloma.
Female ; Humans ; Middle Aged ; Multiple Myeloma ; therapy ; Peripheral Blood Stem Cell Transplantation ; methods ; Transplantation, Autologous

OBJECTIVETo observe the changes of heart rate variability (HRV), adrenomedullin (ADM) and B-type natriuretic peptide (BNP) before and after transcatheter closure in children with patent ductus arteriosus.

METHODSHRV spectral values (TF, VLF, LF, HF, LF/HF) were detected by 24 dynamic electrocardiogram and the concentrations of plasma ADM and BNP were measured in 55 children with patent ductus arteriosus (Group PDA, n = 55) before and 3(rd) day, 3(rd) month after transcatheter closure therapy, and in 60 normal children (Group C).

RESULTS(1) Compared with Group C, the HRV spectral values (TF, VLF, HF) were significantly lower (all P < 0.01), LF/HF and the concentrations of plasma ADM, BNP were significantly higher in patients with PDA before transcatheter closure (all P < 0.01). (2) Compared with the values before transcatheter closure values, plasma ADM were significantly reduced at 3(rd) day and 3(rd) month after transcatheter closure (P < 0.01), the HRV spectral values (TF, VLF, HF) were significantly increased while LF/HF and plasma BNP were significantly decreased at 3(rd) month after transcatheter closure (P < 0.01 or P < 0.05).

CONCLUSIONSHRV and plasma ADM, BNP improved significantly post transcatheter closure in children with patent ductus arteriosus.

Adolescent ; Adrenomedullin ; blood ; Cardiac Catheterization ; Child ; Ductus Arteriosus, Patent ; blood ; physiopathology ; therapy ; Female ; Heart Rate ; Humans ; Male ; Natriuretic Peptide, Brain ; blood ; Young Adult

OBJECTIVETo examine HIV prevalence and its associated factors among men who have sex with men (MSM) and provide the evidence for the intervention program among MSM.

METHODSA face-to-face questionnaire interview was conducted among MSM recruited by snowball sampling method in Yuzhong, Jiulongpo and Shapingba district of Chongqing from July to September, 2007. Totally, 1044 MSM were recruited. Associated factors with HIV prevalence were analyzed using forward stepwise logistic regression that HIV status was the dependent variable and demographics, AIDS awareness, sexual behaviors and the status of the intervention were independent variables.

RESULTSA total of 1044 MSM were surveyed. The rate of AIDS awareness was 89.5% among MSM. The rate of unprotected anal sex during the past 6 months was 63.8%. The prevalence of HIV and syphilis was 8.5% (89/1044) and 12.5% (131/1044) respectively. The multivariate analysis identified that the older MSM (OR = 1.69, 95% CI: 1.13 - 2.52), junior school education (OR = 1.89, 95% CI: 1.17 - 3.05), younger than 18 years old of the first sex (OR = 3.11, 95% CI: 1.20 - 8.02), more than 10 sexual partners (OR = 2.24, 95% CI: 1.24 - 4.02), the history of having sex with women (OR = 2.40, 95% CI: 1.64 - 3.51) and syphilis infection (OR = 4.52, 95% CI: 2.77 - 7.38) were independent risk factors associated with HIV infection.

CONCLUSIONThe rate of unprotected anal sex was high, so were the prevalence of HIV and syphilis among MSM. It should be urgent to conduct the intervention to stop AIDS rapid transmission among MSM.

China ; epidemiology ; HIV Infections ; epidemiology ; Homosexuality, Male ; Humans ; Male ; Prevalence ; Risk Factors ; Risk-Taking ; Surveys and Questionnaires ; Syphilis ; epidemiology ; Unsafe Sex

Objective To study the outcomes of AIDS intervention programs and to provide scientific evidence for developing pertinent strategy on intervention among men who have sex with men (MSM).Methods MSM were recruited through snowballing and investigated by face to face interview in 2006 and 2007 respectively.SPSS 12.0 was used to compare the change of cognition about AIDS,sexual behavior,prevalence rates of HIV and Syphilis before and after the intervention program among the population under study.Results The cognition about AIDS among MSM was obviously improved after the intervention with the rate increased from 74.3% to 82.4% (P=0.01).The rate of last time condom use among MSM increased from 56.4% to 65.5% (P=0.00).The rate of consistent condom use during six months among MSM increased from 31.8% to 41.9% (P=0.00).The rates of both condom use during commercial sex with men and with women did not change much among MSM.The prevalence rates of HIV in 2006 and 2007 were 10.4% and 10.8% and of syphilis in 2006 and 2007 were 9.3% and 7.3% respectively which were not significantly different between before and after the intervention.Conclusion The cognition about AIDS among MSM was improved obviously.However,the rate of consistent condom use was still low,reflecting the segregation phenomenon between their behavior and cognition.All our findings implied that it was crucial to carry out AIDS prevention and control programs.

OBJECTIVETo evaluate the accuracy and value of the placement of metallic clips during colonoscopy in the localization of colorectal cancer and incision selection.

METHODSA total of 30 patients received metallic clip placement by colonoscopy before operation. Abdominal plain film (supine and upright position) was taken and incision was determined by the projection of clips on the abdominal wall.

RESULTSThe inaccuracy rate of localization by colonoscopy was 30%(9/30). Colonoscopy combined with the placement of metallic clips achieved an accurate incision rate of 100% (30/30).

CONCLUSIONSThere is a considerable rate of inaccuracy for localization in colonic cancer by colonoscopy. Colonoscopy combined with placement of metallic clips should be considered in order to select a reasonable incision.

Adult ; Aged ; Aged, 80 and over ; Colon ; surgery ; Colonic Neoplasms ; surgery ; Colonoscopy ; Female ; Humans ; Male ; Middle Aged ; Surgical Instruments

To examine if polyprotein gene (VP2/VP4/VP3) of Infectious Bursal Disease Virus (IBDV) could be delivered into mammalian cells and expressed using attenuated Salmonella typhimurium as vector. The IBDV polyprotein gene was amplified by RT-PCR and inserted in to pCI, an eukaryotic expression plasmid. The resulting recombinant pCI-VP2/VP4/VP3 was transformed by electroporation into attenuated Salmonella typhimurium strain ZJ111 (dam- and phoP-), which was then use to transfect the Vero cells. Gene specific RT-PCR revealed that VP2/VP4/VP3 was transcribed into mRNA in the Vero cells. Indirect immunofluorscence assay, SDS-PAGE and Western-blot analysis showed that VP2/VP4/VP3 was expressed and the product was immuno-reactive with anti-IBDV serum. This work provides essential precondition for developing a new oral DNA vaccine against IBDV.
Animals ; Cercopithecus aethiops ; Electroporation ; Genetic Vectors ; genetics ; Infectious bursal disease virus ; genetics ; metabolism ; Polyproteins ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Salmonella typhimurium ; genetics ; metabolism ; Transfection ; Vero Cells ; Viral Proteins ; genetics

OBJECTIVETo compare the therapeutic effect of recombinant human brain natriuretic peptide (rhBNP) and nitroglycerin on acute decompensated heart failure (ADHF).

METHODSFifty ADHF patients were randomly divided into rhBNP group and nitroglycerin group. In all the patients, dyspnea and global clinical status were assessed before and at 30 min, 6 h and 24 h after drug administration, and the volume of fluid intake and urine along with hemodynamic parameters was recorded 24 h after drug administration. In the nitroglycerin group, the patients received an initial nitroglycerin dose of 5 microg/min, with subsequent dose increment of 5 microg/min every 3 to 5 min; the dose was adjusted individually according to the hemodynamics of the patients. The patients in rhBNP group were given rhBNP at the initial dose of 1.5 microg/kg by with an intravenous bolus injection followed by infusion at the rate of 0.0075 microg.kg(-1).min(-1) for 72 h.

RESULTSAt 30 min and 6 h after drug administration, the patients in the rhBNP group showed significant greater improvement of dyspnea (P=0.042 and 0.019) and global clinical status (P=0.018 and 0.044) than those in the nitroglycerin group, but 24 h after drug administration, no significant difference was noted between the two groups (P=0.192 and 0.179). Twenty-four hours after drug administration, the mean urine volume was significantly greater in rhBNP group than in nitroglycerin group (1513.8-/+242.9 vs 1341.2-/+239.7 ml, P=0.015), and the ejection fraction increased and pulmonary arterial pressure and systolic blood pressure decreased at greater amplitude in the former group (P=0.001,0.000 and 0.002, respectively). At 72 h, the numbers of premature ventricular contraction and couplets premature beats and onset of paroxysmal ventricular tachycardia were significantly reduced in rhBNP group as compared with the nitroglycerin group (P=0, 0.001 and 0.002, respectively).

CONCLUSIONRhBNP promotes urine excretion, decreases pulmonary arterial pressure and increases left ventricular ejection fraction to improve dyspnea and global clinical status and reduce the onset of ventricular arrhythmia in ADHF patients.

Aged ; Aged, 80 and over ; Blood Pressure ; drug effects ; Female ; Heart Failure ; drug therapy ; pathology ; physiopathology ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; administration & dosage ; genetics ; therapeutic use ; Nitric Oxide Donors ; administration & dosage ; therapeutic use ; Nitroglycerin ; administration & dosage ; therapeutic use ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Treatment Outcome

OBJECTIVETo observe and investigate the risk factors and pathogen diversification of nosocomial lower respiratory infections in patients with hematological malignancy after chemotherapy.

METHODSRespiratory tract microbial population of fifty patients with different kinds of hematological malignancy and para-prepared to chemotherapy was quantitatively analyzed before and after chemotherapy at an arranged time from April, 2004 to December, 2005. Susceptibility test was determined for bacterium of nosocomial infection, and the homology of the same species of the bacteria was analyzed by a pulsed field gel electrophoresis (PFGE).

RESULTSIncidence rate of lower respiratory infections in patients with the hematological malignant after chemotherapy was 16%. The major nosocomial infectious pathogens were Acinetobacter spp; Escherichia coil and Fungus. Among them, Acinetobacter spp, were highly resistant to cephalosporins, quinolones, aminoglycosides, carbapenems and antibiotic with enzyme inhibitor, respectively but susceptible to Cefoperazone/Sulbactam belonging to antibiotic with enzyme inhibitor. And it was shown that there were two clones by the pulsed field gel electrophoresis (PFGE).

CONCLUSIONFollowing-up of nosocomial lower respiratory infection in patients with hematological malignancy after chemotherapy might offer theoretical evidence for the rational use of antibiotics and the control of nosocomial infections.

Acinetobacter baumannii ; drug effects ; isolation & purification ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Cross Infection ; epidemiology ; Escherichia ; drug effects ; isolation & purification ; Female ; Follow-Up Studies ; Hematologic Neoplasms ; drug therapy ; immunology ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Opportunistic Infections ; epidemiology ; Respiratory Tract Infections ; epidemiology