Objective To analyze the treatment results of intracavitary hyperfractionated brachytherapy for nasopharyngeal carcinoma and to determine the optimal dose of external radiation. Methods From February 1996 to June 1998, 128 patients with T1 2 nasopharyngeal carcinoma were treated with external radiotherapy followed by intracavitary brachytherapy. The majority of them had residual tumor less than 10 mm after external radiotherapy. The external radiation doses were divided into 3 groups: 56 Gy, 60 Gy and 66 Gy. Brachytherapy was delivered with 2.5 3.0 Gy per fraction, 2 fractions a day with an interval of 6 hours. The total doses ranged from 12 to 24 Gy with a median of 18 Gy. Results The disease free survival rates at 3 and 4 years for all patients were 84.2% and 74.9%, respectively. The corresponding local relapse free survival rates were 97.1% and 92.7%, respectively. The 3 year disease free survival rates and local relapse free survival rates were 83.6% and 100% for 56 Gy group, 88.4% and 90.9% for 60 Gy group, and 84.6% and 93.3% for 66 Gy group, respectively,all with differences in significant. Radiation complications were rare. Conclusions We suggest that patients with residual tumor less than 10 mm after external radiotherapy should receive intracavitary brachytherapy as a boost. The dose of external radiotherapy for T1 2 stage NPC can be decreased to 56 Gy.

Objective To study the results of external beam radiotherapy plus 192 Ir hyperfractionated high dose rate interstitial brachytherapy (HHDR-IBT) for cancer of the oral cavity and oropharynx. Methods Fourty-eight patients with cancer of the oral cavity and oropharynx were treated by external beam radiotherapy (T 1,T 2 30～50 Gy,T 3,T 4 50～60 Gy) followed by 192 Ir HHDR-IBT delivering 15～35 Gy (30～35 Gy for T 1,T 2 and 15～30 Gy for T 3,T 4 in 250～350 cGy per fraction,two fractions per day). Over 3～5 days. Results The complete response rates at 3 months were T 1100% (5/5),T 2 85%(23/27),T 3 46%(6/13),T 4 0%(0/3) and the partial reponse rates:T 2 15% (4/27), T 3 54%(7/13), T 4 100%(3/3). The 3-year survival and disease-free survival rates were 79.4% and 55.8%,respectively.Multivariate analysis showed that TNM stage and pathalogic type were prognostic factors.Conclusions Carcinoma of the oral cavity and oropharynx treated with external beam radiotherapy combined with 192 Ir hyperfractionated high dose rate interstitial brachytherapy ia able to give a good local control for T 1,T 2 lesions with good functional preservation. For T 3,T 4 lesions,this method is able to offer a high palliation.

OBJECTIVE:To analyze the ADRs caused by Chinese prepared medicines.METHODS:638ADRs were col?lected from medical journals of2001～2002in consideration of sex,age,administration route,the time of the occurrence and clinical manifestations.RESULTS:There were638ADR cases involving76kinds of Chinese prepared medicines reported in256articles.Of them,shuanghuanglian injection was the most common preparation(87cases).The commonest clinical manifesta?tions were allergic reactions(157cases),followed with the liver and kidney injury.The ages of patients were mostly above60years,the time of the occurrence was mostly within30minutes after administration and about92%of the patients recovered within24hours.CONCLUSION:The occurrence of ADRs of Chinese prepared medicines is related to the route of administra?tion,dosage form of drug,quality of drug,patient’s age and constitution.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chemical and Drug Induced Liver Injury ; etiology ; Child ; Child, Preschool ; Drug Eruptions ; etiology ; Drug Hypersensitivity ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Infant ; Kidney Diseases ; chemically induced ; Male ; Middle Aged

Humans ; Water ; Rivers ; Skull/anatomy & histology* ; Brain/diagnostic imaging* ; Forensic Medicine ; Forensic Anthropology

To provide insights into the mechanism for the attenuate-synergistic effect of Zuota to Tibetan medicine Renqing Mangjue, a contrasted study was carried out on the pharmacokinetics of brucine and strychnine in mice plasm, which are active and toxicant ingredient in the Tibetan medicine Renqing Mangjue. LC-MS/MS was used to detect simultaneously the concentrations of brucine and strychnine in mice plasm at-different time intervals after administration parallelly and randomly, and the pharmacokinetic software Kinetica 5. 0 was selected to non-compartmental analysis (NCA) for data, and statistical analysis software SPSS 19. 0 was used for significance test on the pharmacokinetic parameters. A reliable LC-MS/MS method was established for the determination of brucine and strychnine in blood plasma, which are consistent with the requirements of the preclinical pharmacokinetic study confirmed by the methodology. The linear concentration ranges of brucine and strychnine were 0.301-104.4 µg · L(-1) (r = 0.999 5) and 0.305-106 µg · L(-1) (r = 0.999 7), respectively; The intra-day and inter-day variable coefficients were both less than 10.0% with good precision; The average extraction recoveries of brucine and strychnine were 116.23% and 112.82%, and RSD were 3.2% and 2.3% separately;The average matrix effects of brucine and strychnine were 122.48% and 116.36%, and RSD were 7.7% and 4.4%, respectively. The pharmacokinetic results showed that AUCtot of brucine and strychnine in Zuota group were both increased remarkably (P < 0.05), and the Cmax of brucine in Zuota group was about 5.25-fold higher than that of brucine in non-Zuota group (P < 0.05). The Tmax of brucine and strychnine reduced to one-eighth and one-quarter respectively compared with those in Non-Zuota group. In addition, the eliminations of brucine and strychnine in vivo were accelerated after the compatibility of Zuota. A significant difference (P < 0.05) occurred at the MRT0-t, of brucine, while the MRT0-∞ and Lz of strychnine were statistically significant upon the inspection level α = 0.1. It was found that the absorption degree of brucine and strychnine in Zuota group increased in the range of the safe dose (or concentration), while their elimination rates were accelerated, which may be one of the mechanisms for attenuate-synergistic effect of Zuota to Tibetan medicine Renqing Mangjue.
Animals ; Female ; Male ; Medicine, Tibetan Traditional ; Mice ; Strychnine ; analogs & derivatives ; pharmacokinetics

Objective To detect the signaling pathways involved in aldosterone (ALDO)induced mesangial cell (MC) proliferation. Methods The incorporation of 3H-thymidine (3H-TdR)and cell count were used as the measure of mesangial cell (MC) proliferation. Reactive oxygen species (ROS) production was determined by DCFDA fluorescence. Epidermal growth factor receptor (EGFR) activation was assayed by Western blotting. Results ALDO induced MC proliferation.When incubation with 100 nmol/L ALDO for 24 h, the 3H-TdR incorporation and cell number increased by 2.63- and 2.15-fold, respectively. Mineralocorticoid receptor (MR) antagonist EPLE almost completely blocked ALDO-induced MC proliferation (P<0.01), however, glucocorticoid receptor (GR) antagonist RU-486 had no effect on MC proliferation. ALDO increased intracellular ROS production in cultured human MCs. When incubation with ALDO (100 nmol/L) for 60 min,ROS production increased by 2.14-fold. ALDO-induced ROS generation was completely blocked by EPLE as well as mitochondrial complex Ⅰ inhibitor rotenone (P<0.01=, NADPH oxidase inhibitors diphenyleneiodonium sulfate (DPI) and apocynin inhibited ALDO-induced ROS production by 30%to 35% (P<0.05=. In contrast, inhibitors of other oxidant-producing enzymes, including allopurinol,indomethacin, nordihydroguiaretic acid, ketoconazole and G-nitro-L-arginine methyl ester (L-NAME)had no effect on ALDO-induced ROS production. Antioxidant N-acetyl-L-cysteine (NAC) and ROT inhibited ALDO-induced MC proliferation by 75% to 80%, whereas the inhibition of NADPH oxidase inhibitor apocynin and DPI on ALDO-induced MC proliferation was 25% to 30%. ALDO induced EGFR transactivation. When incubation with 100 nmol/L ALDO for 60 min, EGFR phosphorylation was increased by 4.95-fold, which was completely inhibited by EPLE and antioxidant NAC (P<0.01=. NAC and EGFR antagonist AG1478 significantly blocked ALDO-induced MC proliferation (P<0.01=. Conclusions ALDO-induced MC proliferation is mediated by ROS-dependent EGFR transactivation. ALDO-stimulated ROS is mainly generated by mitochondria.

Female ; Heart Septal Defects, Atrial ; complications ; Humans ; Levocardia ; complications ; Situs Inversus ; complications ; Young Adult

Objective To explore the clinical characteristics of monochorionic or dichorionic twin pregnancy and the high-risk factors for selective intrauterine growth restriction.Methods 460 women with twin pregnancy were divided into a monochorionic group and a dichorion group.The related clinical features were compared between the two groups.Logistic regression was used to analyze the high-risk factors for selective intrauterine growth restriction.Results The maternal age,conception way,and mode of delivery differed significantly between the two groups (P ＜ 0.05).There were significant differences in the rates of selective intrauterine growth restriction and preterm premature rupture of membranes (P ＜ 0.05).The neonatal weight (large or small) and the rate of neonatal transfer differed significantly (P ＜ 0.05).Logistic regression showed that gestational age and birth weight were the risk factors.Conclusions The chorionic nature plays an important role in the process and outcomes of maternal pregnancy.Monochorionic pregnancy is a high risk factor for selective intrauterine growth restriction,meaning the major cause of selective intrauterine growth restriction may originate from the placenta,with should be a placenta-derived disease.

Objective To compare blood pressure control in community hypertensive patients with different management methods.Methods Two neighborhood committees in a community of Pudong were selected as study area using cluster sampling method.A total of 5 166 residents aged ≥35 y were screened for blood pressure; the subjects with high blood pressure and had antihypertensive medication in last 6 months were included,and patients with secondary hypertension was excluded.The patients who entered community hypertension management program and got medication from community were included in community group; those who did not enter in community management program and/or not get medication from community were included in non-community group.Self-designed questionnaire was used for investigation.The medication compliance,awareness of hypertension risk factors and high blood pressure control were compared between two groups.Results Among 5 166 residents 4 763 were surveyed for hypertension with a response rate of 92.2％ and hypertension prevalence rate of 23.2％ (1 105/4 763).Among 1 012 patients with drug treatment for more than 6 months,there were 878 cases in community (86.8％) and 134 cases (13.2％) in non-community group.There were no significant differences in gender,age,education,working condition between community group and non-community group (P ＞ 0.05).44.3％ (389/878) patients in community group had a history of high blood pressure ＞ 10 y and that was 56.7％ (76/134) in non-community group (P =0.011) ; 28.6％ (251/878) patients in community group were at high risk for risk stratification and that in non-community group was 47.8％ (64/134) (P ＜0.001).The awareness of hypertension risk factors in community group and non-community group was 83.9％ and 95.5％,respectively (P ＜ 0.001).The medication compliance and blood pressure control rates in two groups were 93.2 ％ and 84.3 ％ (P ＜ 0.001),68.6％ and 51.5 ％,respectively (P ＜ 0.001).Conclusion The outcomes of hypertension management in terms of medication compliance and blood pressure control in community group are better than those in non-community group.