Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response due to infection, and it can further develop into septic shock.Currently, sepsis is still a leading cause of death in children all over the world.Therefore, early assessment of the severity and prognosis of sepsis is of great significance.However, there are no indexes with high sensitivity and specificity for evaluating the severity and prognosis of sepsis at present.In recent years, a large number of studies have revealed the essential role of platelets in sepsis.It has been reported that the platelet count is an independent factor affecting the severity and prognosis of sepsis patients.Up to now, the specific mechanism of sepsis-induced thrombocytopenia has not been fully clarified.In this review, the value of thrombocytopenia in predicting the severity and prognosis of sepsis patients was elaborated.

Objective To study the reasonable doses, efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration(CVVH) in children. Methods There were 66 patients hospi-ta-lized in Pediatric Intensive Care Unit of Zhujiang Hospital,Southern Medical University treated with RCA-CVVH that were recruited in the study from October 2012 to July 2014. The patients were divided into 4 groups according to their weight:≤10 kg( group Ⅰ) ,20 kg≥weight>10 kg( group Ⅱ) ,30 kg≥weight>20 kg( group Ⅲ) ,>30 kg( groupⅣ),and each group randomly received 2 different doses of anticoagulant acid citrate dextrose formula A(ACD-A):ACD-A(mL/h)=0. 75×blood flow rate(BFR)(mL/min)(A dose) and ACD-A=1. 5×BFR(B dose). Data of hemo-filter duration, activated partial thromboplastin time( APTT) ( systemic and circuit) , ionized calcium( Ca2+) ( systemic and circuit), blood urea nitrogen(BUN), serum creatinine(Cr), alanine aminotransferase(ALT), aspartate amin-otransferase(AST), blood pH, sodium ion(Na+), bicarbonate ion(HCO3-) were collected and analyzed. Results There was no significant difference in BUN,Cr,ALT,AST and APTT of 2 different doses of ACD-A among the groups (all P>0.05);pH of B dose of ACD-A in group Ⅰwas significantly higher than that in A dose(F=7.384,P=0. 015);pH of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 492,P=0. 046),HCO3-of B dose of ACD-A in groupⅠwas significantly higher than that in A dose(F=7. 735,P=0. 013);HCO3-of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 644,P=0. 042);hemofilter duration of B dose of ACD-A in group Ⅲ was significantly higher than that in A dose(t=-3. 147,P=0. 016);hemofilter duration of B dose of ACD-A in groupⅣwas significantly higher than that in A dose(t=-6. 342,P=0. 000). Conclusions RCA-CVVH is effective and safe for critical children,and different doses of ACD-A for children with different weight can re-duce metabolic alkalosis and enhance regional anticoagulation.

Objective To investigated the efficacy and toxic effects of combined chemotherapy of vinorelbine plus cisplatin or carboplatin in patients aged ≥ 70 years and with non-small cell lung cancer (NSCLC).Methods One hundred patients with lung cancer aged ≥70 years were enrolled in the study.Fifty patients in chemotherapy group were assigned to receive vinorelbine 25 mg/m2 at the first day and the fifth day plus cisplatin 60-70 mg/m2 or carboplatin 250 mg/m2 at the second day.All treatments were repeated every 3 or 4 weeks.Another fifty patients aged ≥ 70 years were taken as control group, not receiving treatment.The primary endpoint was survival.Results Forty-five patients were evaluable for response and the partial remission rate was 35.6% (16/45).One year survival rate was 37.8% and median survival time was 9.75 months in chemotherapy group.The median survival time was 4.0 months for patients in control group.All 50 patients in chemotherapy group were evaluable for toxic side effects.WHO grade Ⅲ incidences of leucopoenia, neutropenia and anemia were 38.0%, 52.0% and 2.2%, respectively.Grade IV incidence of neutropenia was 35.5%.WHO grade Ⅲ incidences of fatigue, constipation and vomit were 22.0%, 8.0% and 14.8%,respectively.Five patients failed to complete the treatment due to side effects.Conclusions Combined chemotherapy of vinorelbine plus platinum drugs is effective and tolerated in patients aged over 70 years with advanced NSCLC.Even patients with stable clinical effects shows benefit of survival time.

Objective To explore the influence of tea polyphenols (TP)on the apoptosis of human colon cancer cell line Caco-2 and RhoA protein activity.Methods The passage human colon cancer cell line Caco-2 cells were divided into experimental group and control group.The experimental was added with different concentrations of TP (25,50,100 and 200 μmol /L),while the control group was added with equal amount of culture fluid RPMI-1640.Inhibition of Caco-2 proliferation,ap-optosis indexes and RhoA protein activity within human colon cancer cell line Caco-2 cells were re-spectively detected by methyl thiazolyl tetrazolium (MTT),flow cytometry (FCM)and Pull-down method.Results Different concentrations of TP showed significant inhibitory effects on human colon cancer cell line Caco-2.Pull-down test results showed that TP could reduce the activity of RhoA pro-tein in human colon cancer cell line Caco-2 cells,and with the increasing of concentration,its protein activity decreased.Conclusion TP can promote the apoptosis of human colon cancer cell line Caco-2, which may be achieved by reducing the activity of RhoA protein.

Objective To explore the influence of tea polyphenols (TP)on the apoptosis of human colon cancer cell line Caco-2 and RhoA protein activity.Methods The passage human colon cancer cell line Caco-2 cells were divided into experimental group and control group.The experimental was added with different concentrations of TP (25,50,100 and 200 μmol /L),while the control group was added with equal amount of culture fluid RPMI-1640.Inhibition of Caco-2 proliferation,ap-optosis indexes and RhoA protein activity within human colon cancer cell line Caco-2 cells were re-spectively detected by methyl thiazolyl tetrazolium (MTT),flow cytometry (FCM)and Pull-down method.Results Different concentrations of TP showed significant inhibitory effects on human colon cancer cell line Caco-2.Pull-down test results showed that TP could reduce the activity of RhoA pro-tein in human colon cancer cell line Caco-2 cells,and with the increasing of concentration,its protein activity decreased.Conclusion TP can promote the apoptosis of human colon cancer cell line Caco-2, which may be achieved by reducing the activity of RhoA protein.

To investigate effects of collagen matrices by covalent incorporation of heparin and loading with huangqi injection (HI) on anagenetic capillaries, we established the chick chorioallantois model. The collagen matrices by covalent incorporation of heparin and loading with HI were placed and then the eggs were continuously incubated for 3 days. The number of capillaries in the vicinity of samples, the hemoglobin content inside the samples, the dry weight and the macroscopic observation were evaluated. We found the heparinized matrices had comparable angiogenic effects. The number of capillaries, the hemoglobin content, the expression of CD34 increased remarkably (P < 0.01). So we concluded that HI might be considered as an alternative or addition agent to promote the acidification of capillaries.
Animals ; Blood Vessels ; drug effects ; physiology ; Capillaries ; drug effects ; metabolism ; Chick Embryo ; Collagen ; administration & dosage ; chemistry ; pharmacology ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; Heparin ; administration & dosage ; chemistry ; pharmacology ; Humans ; Injections

BACKGROUNDTo evaluate the activity and toxicity of paclitaxel as second-line treatment for advanced non-small cell lung cancer (NSCLC).

METHODSForty patients with recurrent advanced NSCLC were enrolled. Thirty-six patients were managed with regular regimen. Paclitaxel 135 mg/m², 3 h, on day 1; DDP 75 mg/m² or carboplatin 300-350 mg/m² on day 2. Four patients were managed with weekly regimen. Paclitaxel 60 mg/m²,3 h, on days 1,8,15; DDP 75 mg/m² on day 2. It was repeated every three or four weeks, up to two to four cycles.

RESULTSThirty-six cases were evaluated for response and 27 for survival. The objective response rate was 13.9% (5/36). At least one tumor-related symptom relief was observed in 21 patients (58.3%). The median survival duration was 26.4 weeks and 1-year survival rate was 8% (4/36). The main toxicities included myelosuppression, fatigue and myalgia-arthralgia neuropathy.

CONCLUSIONSPaclitaxel has advantage to be well-tolerated and improve tumor-related symptom. Further studies with standardization of dose and regimen will be needed to clarify its role in the second-line treatment.

OBJECTIVETo evaluate the efficacy and toxicity of Serratia marcescens (S311) vaccine in the treatment of malignant pleural effusion.

METHODSThirty-four patients with malignant pleural effusion were given S311 as intrapleural injection with a dose of 10(9) U (0.32 mg) on D 1, 8 and 15, and observed for four weeks.

RESULTSThe overall response rate (CR + PR) was 97.1% (CR in 12 patients and PR in 21 patients). The systemic toxicity was mild, including fever (82.4%), pleuritic pain (50.7%), nansea (26.5%), dyspnea (17.5%) and chills (5.9%).

CONCLUSIONSerratia marcescens vaccine is effective for malignant pleural effusion, with tolerable toxic effects. Further study is warranted.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Vaccines ; adverse effects ; immunology ; therapeutic use ; Chest Pain ; chemically induced ; Dose-Response Relationship, Drug ; Female ; Fever ; chemically induced ; Humans ; Male ; Middle Aged ; Pleural Effusion ; drug therapy ; immunology ; Serratia marcescens ; immunology ; Time Factors ; Treatment Outcome

BACKGROUNDGefitinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor which is used to treat advanced non-small cell lung cancer, especially adenocarcinoma. The aim of this study is to evaluate the efficacy, side effects and prognostic factors of gefitinib in adenocarcinoma of the lung.

METHODSA total of 26 patients with advanced adenocarcinoma of the lung were enrolled in the study. Gefitinib was orally administered 250mg once daily until disease progression or the occurrence of intolerable toxicity. They were evaluated regularly and their survival was analyzed.

RESULTSIn 26 patients, there was 1 with complete regression (3.8%), 11 with partial response (42.3%), 9 with stable disease (34.6%) and 5 with progression of disease (19.2%). The objective response rate was 46.2% and the disease control rate was 80.8%. The median progression-free survival time was 8.2 months and the median overall survival time was 10.4 months. The 1-year survival rate was 31.6%. Age ( < 70 years old), skin rash and CEA decrease were significantly related to longer survival, however, times of prior chemotherapy and gefitinib treatment stage did not influence the survival. Mean PS (ECOG) was 3.0 before treatment, and 1.8 after treatment. Mean symptom relief time was 5.2 days.

CONCLUSIONSGefitinib is an effective target drug with slight side effect. It can significantly improve quality of life of patients with adenocarcinoma. It can be used as first-line therapy to patients who are not suitable for chemotherapy.

Objective To investigate the safety and efficacy of rescue stenting after failure of endovascular treatment for acute cerebral large artery occlusive infarction, and compare the differences of safety and efficacy between bridged treatment and direct endovascular treatment in acute cerebral large artery occlusive infarction. Methods The clinical data of 60 patients with acute cerebral large artery occlusive infarction who underwent rescue stenting after failure of endovascular treatment in our hospital form March 2015 to March 2018 were retrospectively analyzed; 26 patients underwent bridged treatment+rescue stenting (bridged treatment group), while 34 patients underwent direct endovascular treatment+rescue stenting (direct treatment group). The recanalization degree immediately after the treatment was evaluated by Modified Thrombolysis in Cerebral Infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was performed 24 h and 5-7 d after the treatment, and modified Rankin Scale (mRS) was applied 90 d after treatment to evaluate the neurological functions. In addition, incidences of intracranial hemorrhage and symptomatic intracranial hemorrhage (SICH) and postoperative mortality within 90 d of treatment were calculated. Results (1) Among the 60 patients, 55 patients (91.7％) had revascularization (mTICI 2b-3) immediately after the rescue stenting. NIHSS scores before rescue stenting and NIHSS scores 24 h after rescue stenting (17.50 [15.00, 24.00) vs. 12.00 [8.25, 19.00]) showed statistically significant differences (P<0.05). Twenty-nine patients (48.3％) obtained satisfactory prognosis 90 d after rescue stenting (mRS scores≤2), 9 patients (15.0％) suffered SICH after rescue stenting, and 9 patients died (15.0％). (2) The immediate revascularization rate (92.3％ vs. 91.2％), NIHSS scores 24 h and 5-7 d after surgery (12.00 [7.75, 18.00] vs. 14.50 [10.00, 22.00] and 8.00 [3.00, 12.50] vs. 10.50 [6.75, 16.75]), good prognosis rate 90 d after treatment (57.7％ vs. 41.2％), postoperative SICH incidence (19.2％ vs. 11.8％), and mortality (11.5％ vs. 17.7％) in the bridged treatment group and direct treatment group were not significantly different (P>0.05). Conclusion Rescue stenting is safe and effective for patients with acute cerebral large artery occlusive infarction, no matter it is by bridged treatment or direct intravascular treatment; and the two methods show no significant differences in safety and efficacy