Objective To evaluate the possibility and curative effect of total en bloc spondylectomy (TES) for the treatment of primary tumors of the lumbar spine. MethodsBetween June 2005 and July 2009,nine cases of primary tumor of the lumbar spine were treated with total en bloc spondylectomy through a single posterior approach performed in seven cases(L1 giant cell tumor, L1 osteosarcoma, L2 giant cell tumor,L2 solitary plasmacytoma, L2 chondrosarcoma, L2 chordoma, and L3 histiocytic sarcoma), and two cases through a single stage anterior and posterior combined approach (L4 giant cell tumor with paraspinal mass and L4 fibrosarcoma). They were performed a single stage reconstruction after removing tumors of vertebra. Neurofunction was evaluated perioperatively and recurrence of tumor was tracked for all cases.ResultsThe follow up was obtained for 3-49 months (averaging 19 months). All patients attained significant clinical improvement after surgery without any severe complications. There was no local recurrence and distal metastasis in shortterm follow-up. ConclusionThe treatment by TES to remove tumors and reconstruction of spine are reliable for primary tumors of the lumbar spine. The curative effect of short-term follow-up is satisfactory. However, the long-term curative effect remain to be further follow-up.

Objective:To explore the differences between emergency healthcare-associated pneumonia (HCAP) and community-acquired pneumonia (CAP), to analyze whether HCAP is a relatively independent type pneumonia in the emergency department in China.Methods:Clinical data of HCAP and CAP patients admitted to the emergency department of Beijing Tiantan Hospital, Beijing Chaoyang Hospital of Capital Medical University and Huilongguan Hospital from September 2018 to May 2019 were retrospectively analyzed. General information of the patients, types of basic diseases, laboratory examination within 24 h of admission, etiological examination results, empirical anti-infection treatment plan, mechanical ventilation and clinical outcome were collected. The pneumonia severity index (PSI) was used to assess the pneumonia severity. The measurement data were expressed as mean ± standard deviation for t test, and the counting data were performed by χ 2 test. A P<0.05 indicated statistical difference. Results:One hundred and five HCAP patients and 105 CAP patients were collected. The number of HCAP combined with two or more basic diseases was higher than that of the CAP group. There were statistically significant differences between the two groups in white blood cell count, mean hemoglobin and blood lactic acid level.The PSI score of the HCAP group was higher than that of the CAP group (134.0±26.3 vs 113.0±16.34). The PSI score grade IV of the HCAP group was lower than that of the CAP group, while the PSI score grade V of the HCAP group was higher than that of the CAP group, with statistically significant differences ( P<0.05). In the HCAP group, 73 strains (69.52%) and 55 strains (52.38%) of multi-drug resistant strains were isolated. Acinetobacter baumannii and Streptococcus pneumoniae, Klebsiella pneumoniae and Escherichia coli in the HCAP group were more than those in the CAP group. The drug resistance rate of pseudomonas aeruginosa to imipenem in the HCAP group was higher than that in the CAP group (22.2% vs 10.0%); the drug resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was lower than that in the CAP group (27.3% vs 54.5%); the drug resistance rate of Pseudomonas aeruginosa to Meropenem was lower than that in the CAP group (45.5% vs 72.7%). The proportion of carbapenems in the initial empirical anti-infection treatment in the HCAP group was higher than that in the CAP group (21.00% vs 10.48%), and the difference was statistically significant. The ratio of invasive mechanical ventilation and the fatality rate in the HCAP group were higher than those in the CAP group (21.00% vs 7.62%, 21.00% vs 8.57%; both P<0.05). Conclusions:HCAP patients in emergency department are complicated with a variety of basic diseases, high drug resistance rate of pathogenic bacteria, and more advanced drugs are required for initial empirical anti-infection treatment, high proportion of mechanical ventilation, and high fatality rate. HCAP is a relatively independent category of pneumonia in emergency in China.

Objective To explore expression of hypoxia inducible factor-1?(HIF-1?)in kidney cells during hypoxia/reoxygenation injury,and to study the effect of Danshen on prevention of the hypoxia/reoxygenation injury to cells.Methods Human renal proximal tubular cells(HK-2)were used as the target cell.There were 3 groups:control group,model group,Danshen group.hypoxia/reoxygenation models after neonatal asphyxia were established with liquid paraffin covering method.Expression of HIF-1? were detected with strcp avidin biotin complex(SABC)immunohistochemistry at following different time points:hypoxia 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia;and hypoxia/reoxygenation 1,4,8,12,24 h,which means 1,4,8,12,24 h respectively after hypoxia/reoxygenation.Results HIF-1? was expressed mainly in HK-2's nucleus.There had low expression of HIF-1? in HK-2 cells under the normal culture,and its expression level kept rising quickly during hypoxic/reoxygenatic culture,until 4 h after the beginning of reoxygenation.Compared with the study group,the expression level of HIF-1? in HK-2 cells of the Danshen group were significantly lower at different time points(Pa

OBJECTIVE: To investigate the clinical application and efficacy of ¹²⁵Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy. METHODS: From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation only and 18 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects. RESULTS: The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%. CONCLUSION ¹²⁵Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.
Brachytherapy/adverse effects* ; Humans ; Iodine Radioisotopes/therapeutic use* ; Neoplasm Recurrence, Local/radiotherapy* ; Salivary Gland Neoplasms/radiotherapy* ; Salivary Glands

OBJECTIVETo explore the correlation between serum levels of growth differentiation factor-15 (GDF-15) and Thrombolysis in Myocardial Infarction (TIMI) risk scores in patients with unstable angina pectoris (UA).

METHODSThe serum levels of GDF-15 in 97 patients with UA and 30 healthy volunteers were measured using enzyme-linked immunosorbent assay (ELISA) and compared between 3 patient groups with different TIMI scores to analyze relationship between serum GDF-15 levels and TIMI risk scores.

RESULTSThe serum levels of GDF-15 in UA patients were significantly higher than those in the healthy volunteers (P<0.01). GDF-15 levels also differed significantly between patients with different TIMI scores (P<0.01), and showed a significant positive correlation to TIMI risk scores.

CONCLUSIONSerum levels of GDF-15 can be used as an index for evaluating the severity of UA.

Aged ; Angina, Unstable ; blood ; drug therapy ; Female ; Growth Differentiation Factor 15 ; blood ; Humans ; Male ; Middle Aged ; Risk Assessment ; Severity of Illness Index ; Thrombolytic Therapy ; adverse effects

Objective To observe the perioperative myocardial protection of high-dose atorvastatin to acute coronary syndrome(ACS) patients during percutaneous coronary artery interventional therapy(PCI).Methods One hundred and twenty patients with ACS undergoing elective PCI were divided into group A and group B with different oral dose of atorvastatin ( 80 mg/d and 20 mg/d ) for 3 days before operation by random digits table. Troponin I (cTnI), creatine kinase isozyme MB (CK-MB), high sensitive C-reactive protein (hs-CRP), interleukin (IL)-6 levels were measured before operation, 6 hours, 12 hours after operation and total cholesterol (TC), triglyeride (TG), low desity lipeprotein cholesterol (LDL-C), high density lipeprotein cholesterol (HDL-C) levels were measured before operation and 3 days after operation.Results cTnI,CK-MB,hs-CRP and IL-6 levels in the two groups were increased significandy 6 hours and 12 hours after operation (P <0.05). Six hours after operation, cTnI and CK-MB levels in group A were significantly lower than those in group B [(0.35±0. 18 ) μg/L vs. (0.48±0. 16 ) μg/L, ( 3.78±0.45 )μg/Lvs. (4.56±0.55 )μg/L] (P < 0.05 ). Twelve hours after operation , hs-CRP and IL-6 levels in group A were significantly lower than those in group B [(4.53±0.98 ) mg/L vs. (7.03±0.88 ) mg/L, ( 30.6±11.2) ng/L vs.(43.8±12.1) ng/L] (P <0.05). TC, TG, LDL-C, HDL-C levels in the two groups did not change significantly before and after operation (P >0.05). Conclusions Myocardial protective effects of ACS patients treated with atorvastatin 80 mg/d for 3 days are better than those treated with oral atorvastatin 20 mg/d. High-dose atorvastatin can produce more beneficial effects.

OBJECTIVE Liver cancer is one of the most common causes of cancer related deaths worldwide, specially, in China. Hinesol, extracted from Atractylodeslance a(Thunb.) DC. has been proved that has anti-cancer effect in leukemia in vitro and in vivo.However,it has been not well under-stood in liver cancer cells.METHODS Cell proliferation,apoptosis,cell cycle and invasion were performed to investigate the anti-liver cancer effect of hinesol in SMMC-7721 and LM3 by MTT assay,flow cytometry and scratch assay.Western blot was used to research the potential mechanism.RESULTS We revealed that hinesol suppresses cell proliferation and invasion,prompts population of G1 phase,induces apop-tosis in dose-dependent manner in SMMC-7721 and LM3 cells.Western blot data showed that hinesol could inhibits the expression of cyclin-D1, Bcl-2 and Bax, and inhibited phosphorylation of MEK and ERK, down-regulated the expressions of NF-κB p65 and phosphor-p65 in nucleus. The results indicated that hinesol reduces cell proliferation via arresting cell cycle at G1 phase and induces apoptosis.Further-more,western blot showed that hinesol inhibited phosphorylation of MEK and ERK,down-regulated the expressions of NF-κB p65 and phosphor-p65 in nucleus.CONCLUSION Our results demonstrate that hinesolreduces cell proliferation via arresting cell cycle at G1 phase and induces apoptosis, it has potent anti-cancer effect against liver cancer cells via down-regulation of MEK/ERK and NF-κB pathway,and indicate that hinesol is a potential liver cancer drug for further research.

OBJECTIVETo study the inhibitory effect and reasons of liposomes survivin antisense oligonucleotides (ASODN) on growth of human gastric carcinoma transplanted subcutaneously in nude mice.

METHODSHuman gastric carcinoma transplanted subcutaneously in nude mice model was established, and subsequently was divided randomly into six groups: control group, liposome group, sense oligonucleotide (SODN) group, 100, 200 and 400 nmol/L ASODN group. Different treatments were given respectively. The weight and volume of subcutaneous tumors were measured, and tumor growth inhibitory rate and decreased rate was calculated. The morphological changes of transplanted tumor cells were observed under light microscope. The expression of survivin was detected by immunohistology (SP). Changes of survivin gene transcription and protein expression were determined by western blot and RT-PCR.

RESULTSGrowth of the tumors was significantly inhibited in all ASODN groups as compared with that in the control, liposome and SODN group. The highest growth inhibitory rate in the 400 nmol/L group is 93%. The number of apoptotic cells of ASODN group increased and expression of survivin became weaken under the microscope. Liquified necrosis regions could be seen in 6 cases (6/12) of tumor tissues. The content of survivin mRNA and protein decreased in all survivin ASODN groups. The survivin protein expression of 400 nmol/L group was about 36.8% of the control group.

CONCLUSIONSSurvivin gene ASODN can inhibit the growth of human gastric carcinoma in nude mice by inducing cells apoptosis and decreasing the expression of survivin mRNA and protein.

Animals ; Antineoplastic Agents ; pharmacology ; Apoptosis ; drug effects ; Humans ; Inhibitor of Apoptosis Proteins ; Liposomes ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Microtubule-Associated Proteins ; biosynthesis ; genetics ; Neoplasm Proteins ; biosynthesis ; genetics ; Neoplasm Transplantation ; Oligonucleotides, Antisense ; genetics ; pharmacology ; RNA, Messenger ; genetics ; Stomach Neoplasms ; metabolism ; pathology ; therapy

Coronary artery disease (CAD) is a multifactorial disease in which inflammation plays a central role.This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio (NLR),the Global Registry of Acute Coronary Events (GRACE) score with in-hospital mortality of elderly patients with acute myocardial infarction (AMI) in an attempt to explore the prognostic value of these indices for elderly AMI patients.One thousand consecutive CAD patients were divided into two groups based on age 60.The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records.The NLR and GRACE score were calculated.In the elderly (≥60 years),patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) had significantly higher NLR than did those with unstable angina (UA) and stable angina pectoris (SAP) (P＜0.01).The NLR was considerably elevated in older AMI patients compared with their younger counterparts (＜60 years) (P＜0.05).In elderly AMI patients,the NLR was considerably higher in the high-risk group than in both the low-risk and medium-risk groups based on the GRACE score (P＜0.05 and P＜0.01,respectively),and the NLR was positively correlated with the GRACE score (r=0.322,P＜0.001).Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group (P＜0.05).By curve receiver operator characteristic curve (ROC) analysis,the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve (AUC) 0.771 and 0.787,respectively,P＜0.001].It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

Background: Percutaneous radiofrequency ablation (RFA) is a first-line treatment for very-early-stage hepatocellular carcinoma (HCC), whereas the efficacy of percutaneous microwave ablation (MWA) for very-early-stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very-early-stage HCC. Methods: Clinical data of 460 patients who were diagnosed with very-early-stage HCC and treated with percutane-ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili-tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival (OS), recurrence-free survival (RFS), local tumor progression (LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed. Results: No significant differences were observed between the two groups in terms of the 1-, 3-, or 5-year OS rates (99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively;P= 0.331). Furthermore, no signif-icant differences were observed between the two groups in terms of the corresponding RFS rates (94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively;P= 0.309), the LTP rates (9.6% vs. 10.1%,P= 0.883), the complete ablation rates (98.3% vs. 98.1%,P= 0.860), or the occurrence rates of major complications (0.7% vs. 0.6%,P= 0.691). By multivariate analysis, LTP, antiviral therapy, and treatment of recurrence were independent risk fac-tors for OS (P < 0.001), and the alpha-fetoprotein level was an independent prognostic factor for RFS (P= 0.002). Conclusions: MWA is as safe and effective as RFA in treating very-early-stage HCC, supporting MWA as a first-line treatment option for this disease.