Acute Disease ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Stroke ; drug therapy

OBJECTIVETo observe the clinical effect of Yufeng Capsule (YFC), a Chinese herbal preparation with function of clearing Heat-toxin in treating premonitory symptoms of apoplexy in middle and old aged patients.

METHODSOne hundred and fourteen patients with premonitory symptoms of apoplexy were treated with YFC and compared with 57 patients treated with Venoruton for control. The changes of clinical symptoms, anti-oxidation capability, blood lipid, blood sugar and hemorrheological parameters were observed.

RESULTS(1) The therapeutic effect in the YFC group was cured in 42 cases (36.84%), markedly effective in 38 (33.33%), effective in 28 (24.58%) and the total effective rate was 94.74%, while in the control group, the corresponding numbers were 9 (15.79%), 8(14.04%), 20(35.09%) and 64.91% respectively, the difference between the two groups in cure rate, markedly effective rate and total effective rate was significant (P < 0.05); (2) The whole blood viscosity, plasma viscosity, hemagglutination index and red blood cell deformity index in the YFC group were significantly improved after treatment (P < 0.01) and the improvement was better than those in the control group (P < 0.05 or P < 0.01); (3) Levels of serum malonyldialdehyde (MDA), superoxide dismutase (SOD), blood lipids and glucose were markedly improved in the YFC group (P < 0.05) after treatment, and showed a significant difference to those in the control group (P < 0.05).

CONCLUSIONYFC has obvious effect in treating premonitory symptoms of apoplexy patients, it could markedly improve the hemorrheologic parameters, regulate blood lipids and blood glucose metabolism, and strengthen the anti-oxidation capability of patients.

Aged ; Blood Viscosity ; drug effects ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Erythrocyte Deformability ; drug effects ; Female ; Humans ; Ischemic Attack, Transient ; blood ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Superoxide Dismutase ; blood

Objective To explore the clinical application of percutaneous endoscopic gastrostomy in gastroin- testinal nutrition among critically ill patients.Methods Twenty-two patients were undertaken percutaneous endo- scopic gastrostomy under the lead of gastroscope.The puncturatio site was located in anterior wall of stomach.Results All the procedures were performed successfully for one time.Intraoperational blood pressure was very steady.At the same time,intraoperational SpO_2 of the patients all exceeced 97%.The bleeding amount and operation time were respectively (3.8?1.9) ml and (15.5?2.3) min.Severe complications such as gastrostoma,gastrocolic fistula, pneumoperitoneum,refluxing or aspiration of gastric juice,inhalant pneumonia didn't occur after the operation.Con- clusion Percutaneous endoscopic gastrostomy was safe and feasible among critically ill patients who needed gastroin- testinal nutrition because of its slight injury,little bleeding and shorter operational time.

In this study the effects of red orpiment on NB4 and HL-60 cells were tried to determine. Semi-quantitative RT-PCR to determine the PML mRNA expression, immuno-fluorcscence study, together with the fluorescence stain and morphological observations were used. The results showed that: (1) red orpiment induces apoptosis morphologically in NB4 and HL-60 cells, the morphology of typical apoptosis can be seen in NB4 and HL-60 cells after 12 hours of treatment with red orpiment. Through the Wright's stain, we can see the extensive membrane blebbing, condensation of heterochromatin, and cell fragmentation, apoptotic body appearing. Many dead cells can be found on the second day. (2) in NB4 cells, red orpiment is shown to induce the PML-RARalpha chimera disappearance and to reorganize then to degradation of PML nuclear bodies which also seen in HL-60 cells, indirect immunofluorescence staining of PML with a specific monoclonal antibody was performed in control and treated cells. In NB4 cells, the control was diffusely microspeckled pattern of immunoreactivity. Upon red orpiment treatment, the microspeckled pattern disappeared, PML protein reversed into normal location. and the the size and the brightness of the particles were increased obviously. The normal nuclear distribution of PML protein was seen in untreated HL-60 cells. After treatment with red orpiment, in the nuclei of HL-60 cells, the size and the brightness of the particles were also increased. After two days of treatment with red orpiment, the immunofluorescent particles in cells almost disappeared. (3) the expression of PML mRNA is not changed in red orpiment-treated cells, RT-PCR to determine the PML mRNA expression in NB4 and HL-60 cells treated with red orpiment, the expression results are similar to the controls, that to say, the PML mRNA lever is unaffected. It was concluded that, red orpiment induced PML to play the effects of induce apoptosis in leukemia cells at the translational level and inhibited the proliferation of leukemia cells.

Objective To investigate the clinical therapeutic effects of endovascular repair for patients with DeBakey Ⅲ aortic dissection.Methods From December 2002 to June 2007,endovascular TALENT stent-graft exclusion was performed in 75(65 males,mean age 54.4±12.6 years)patients with DeBakey Ⅲ aortic dissection(1 young woman due to Ehlers-Danlos syndrome,2 young men due to primary aldosteronism and trauma respectively).All patients were diagnosed by contrast enhanced computed tomography(CT)or MRI.Stent-grafts were deployed via femoral artery to exclude the tear of dissection.Aortic angiography was performed immediately after procedure.Results Eighty-one stent-grafts were installed in 75 patients successfully without operation related dissection.Endoleakage immediately after stent-graft deploying was evidenced in 25 patients and disappeared after stent placements(n=6)or balloon dilation (n=19).Two patients died from aortic rupture within 2 days after procedure.Iliac artery was torn in a female patient with Ehlers-Danlos syndrome,this patient developed hemorrhagic shock after stent-graft placement and recovered after anti-shock treatments and iliac artery replacement with synthetic artery.During the follow-up of 1-24 months,2 patients(including the woman with Ehlers-Danlos syndrome)suddenly died half a year after procedure.The remaining patients were alive and well.Repeat CT during follow up showed that reduced lumen size and thrombosis in the false lumen.There was no aortic rupture,endoleak and stent migration during the follow-up period except descending aortic dissection distal of the stent-graft in 1 patient 1 year after procedure and the patient were successfully treated surgically without complication.Conclusions Endovasular repair is a safe and effective treatment for patients with DeBakey Ⅲ aortic dissection,suitable for old patients with high risk of surgery.Ehlers-Danlos syndrome should be considered in young DeBakey Ⅲ aortic dissection patients without hypertension.Further studies are warranted on endovasular repair therapy for artery complication of Ehlers-Danlos syndrome.

OBJECTIVETo investigate if CYP3A5 is involved in drug resistances mechanisms of acute leukemia.

METHODSBy using RT-PCR, immunohistochemistry and MTT assay, CYP3A5 mRNA and protein were detected in leukemia cell lines and acute leukemia patients, meanwhile transcriptional regulation of CYP3A5 induced by daunorubicin was observed. A pcDNA3-CYP3A5 reconstituted plasmid and its stably transfected cell line HL-60/CYP3A5 were both established.

RESULTSCYP3A5 mRNA was detected in K562 and U937 cells, whose IC(50) values of daunorubicin were 2.1-fold higher than those of NB4 and HL-60 cells. Bone marrow CYP3A5 positive blast cell percentage at the time of diagnosis in primary drug resistance group (17.2%) was significantly higher than that of continuous complete remission (CCR) group (0.4%) and secondary drug resistance group (5.4%). In their first complete remission of the early relapsed group, the positive rate had been 23.9% as compared with that of CCR group (1.3%). Daunorubicin increased CYP3A5 mRNA level in K562/A02 and activated its transcription in HL-60/ADR. HL-60/CYP3A5 cell was significantly resistant to daunorubicin and vincristine than HL-60 cells did (3.0 and 4.0 times, respectively).

CONCLUSIONCYP3A5 expressed in leukemia cells may cause in situ metabolization of many kinds of anticancer drugs, thus led to drug resistance.

Cytochrome P-450 CYP3A ; Cytochrome P-450 Enzyme System ; genetics ; physiology ; Daunorubicin ; pharmacology ; Drug Resistance, Neoplasm ; Humans ; Leukemia ; drug therapy ; enzymology ; RNA, Messenger ; analysis ; Tumor Cells, Cultured

OBJECTIVETo investigate COX-2 expression in patients with gastric cancer and its relationship with angiogenesis and clinicopathologic features of gastric cancer.

METHODSCOX-2 expression and CD34-stained microvessel density (MVD) were detected by immunohistochemical methods in specimens from 96 patients with gastric cancer. The correlations among COX-2 expression, MVD and clinicopathologic features were analyzed.

RESULTSThe COX-2 positive rate and MVD in gastric cancer were significantly higher than those in the normal gastric mucosa (80.2% vs. 13.3%; 32.5+/- 8.3 vs. 13.1+/- 2.4, all P< 0.01). The COX-2 positive rate and MVD in the patients with stage III and IV were significantly higher (91.4% and 34.9+/- 8.7 respectively, P< 0.01), than that in the patients with stage I and II. The COX-2 positive rate and MVD in the cases with lymph node metastasis were 87.9% and (35.0+/- 8.5) respectively, higher than those in the cases without lymph node metastasis (P< 0.05). The Spearman rank correlation test showed a significant correlation between COX-2 expression and tumor MVD (r=0.311, P< 0.01).

CONCLUSIONSCOX-2 plays an important role in gastric cancer angiogenesis. COX-2 and angiogenesis induced by COX-2 contribute to tumor invasion and lymph node metastasis.

Adult ; Aged ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Neoplasm Staging ; Neovascularization, Pathologic ; metabolism ; pathology ; Stomach Neoplasms ; metabolism ; pathology

BACKGROUNDLive attenuated hepatitis A vaccine (H2 strain) is widely applied in prevention of hepatitis A epidemic in China and other countries now. It is essential to observe and confirm the vaccine immune efficacy, population antibody level and its persistent efficacy after mass immunization.

METHODSA total of 220 children with negative anti-HAV antibody (aged 1 - 3 years) were taken for follow-up assay to observe seroconversion and geometric mean titre (GMT) level 2 months, 12 months, 6 years, and 10 years after inoculation. Another survey sampled from subjects of different age groups (3, 6, 9, 15, 18, 25 and 35 years) to compare anti-HA antibody positive rate before and after inoculation performed 10 years previously. Epidemiological observations were taken for 10 years to evaluate the relationship between vaccine coverage and hepatitis A morbidity. Serum antibody to HAV was detected by enzyme linked immunoassay (ELISA, calibrated by WHO international reference) and ABBOTT Axsym HAVAB microparticle enzyme immunoassay.

RESULTSSeroconversion in follow-up assay 2 months and 10 years after inoculation was 98.6% and 80.2% respectively. For children, the vaccination anti-HA antibody positive rates were significantly different before and after 10 years, 7.69% cf 70.45% (aged 3 years) and 52.58% cf 71.78% (aged 18 years). When vaccine coverage rose from 57% to 74%, there were no any HA epidemics. When vaccine coverage reached 85%, there were no any HA cases. With vaccine coverage between 85% and 91%, there were no any HA cases in cohorts from the age of 1 year to 15 years during the 10 years.

CONCLUSIONSLive attenuated hepatitis A vaccine has an obvious long-term effectiveness in prevention and control of HA epidemics through mass vaccination.

Adolescent ; Adult ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Hepatitis A ; prevention & control ; Hepatitis A Vaccines ; immunology ; Hepatitis Antibodies ; blood ; Humans ; Immunoglobulin G ; blood ; Mass Vaccination ; Vaccines, Attenuated ; immunology

Objective To evaluate the long-term immunogencity and effectiveness of live attenuated hepatitis A (HA) vaccine (H2 strain) after one dose injection, through a 15 years' follow up observation. Methods A total of 220 children with negative anti-HAV antibody (aged 1-3 y)were involved and followed up in Jiaojiang district, Taizhou city, Zhejiang province. Indicators would include seroconversion and geometric meantiter(GMT) levels after inoculation the vaccine with single dose at 2 m, 12 m, 6 years, 10 years and 15 years. Epidemiological observation was carried out within the 15 years to evaluate the relationship between vaccine coverage, the incidence of HA and the overall effectiveness. In the studied population, serum was tested by ELISA(calibrated by WHO international reference) and ABBOTT Axsym HAVAB mEIA. Results Seroconversion rates were found to be 98.6% and 81.3% after 2 months and 15 years of inoculation and slowly decreased. GMT level was 128 mIU/ml after 15 years, significantly higher than the required protective level of 20 mIU/ml,recommended by WHO experts. Effectiveness through the 15-year follow up program showed a significant correlation between vaccine coverage and incidence of HA in 1-15 years aged group (Kendall-Rank test, t =-0.931, P＜0.01). There was no HA case seen among the observed accumulated 236 413 person-year vaccines, compared to 4 HA cases discovered in the 27 206 personyear of the non-vaccinees. The overall protective rate reached 100%. Through a mass vaccination program on children, the whole population established an immune-defence to enable the incidence of HA decreased by 96.7%. Conclusion The long-term immunogencity and effectiveness of live attenuated hepatitis A vaccine (H2 strain) after one dose injection could last as long as 15 years.

[Objective]To discuss the CT diagnosis and differential diagnosis of solid pseudopapillary tumor of the pancreas (SPTP).[Methods]The CT findings of 20 patients with SPTP proved by surgically pathology were retrospectively analyzed and summa?rized.[Results]SPTP were composed of solid and cystic components with surrounding capsule resulting to clear demarcation between tumor and normal pancreas without dilation of pancreatic duct. The tumor parenchyma was slightly hyperenhancement on arterial phase and showed gradual enhancement on venous and delayed phase.[Conclusions]The CT findings of SPTP have relative specifici?ty and can contribute to early diagnosis and differential diagnosis of SPTP.