Objective To observe the efficacy and adverse reaction of Durogesic (thansdermal fenfanul) for analgesia in patients with malignant tumors, who occur moderate or severe pain from mucosal response during radiochemotherapy. Methods 50 patients were divided into two groups randomly. The treatment group received Durogesic and normal therapy, the contrast group received normal therapy. The analgesic effects, the quality of life and the side effects after medicine were observed. Results The pain remission rates of treatment group and control group were 100 % (25/25) and 52 % (13/25), respectively (χ2 =15.78, P ＜ 0.01)[(9.66±0.35), (10.01±0.34) min]and[(18.12±0.46), (14.68±0.19) min].The quality of life in treatment group was improved significantly (t = 8.11, P ＜0.01).The main adverse reactions of Durogesic included constipation, itch of skin, drowsiness, nausea, vomiting and so on. All of adverse reactions were tolerable. Conclusion Durogesic for analgesia have high curative effect and slight adverse effects in pain of oral cavity and laryngeal pharynx in patients with malignant tumors during radiochemotherapy which make patients complete radiochemotherapy successfully.

Objective To investigate the causes and risk factors of postpartum hemorrhage (PPH) in hepatitis B virus (HBV) infected parturient.Methods Retrospective analysis was performed on the 1021 HBV infected parturient from Shanghai Public Health Clinical Center from July 2005 to June 2011.The comparisons were done by chi-square test.Results Among 1021 cases of HBV infected parturient,868 (85.01％) were asymptomatic and the PPH rate was 2.76％ (24/868) ;the remaining 153 cases (14.99％) were chronic active hepatitis B and the PPH rate was 16.99％(26/153).The difference between two groups was statistically significant (x2 =56.541,P＜0.01).The total incidence rate of PPH was 4.89％ (50/1021) and 17 cases (34.00％) were postpartum hemorrhage＞1000mL.The causes of PPH included uterine inertia (30/50,60.00％),abnormal placenta (11/50,22.00％),dysfunction of coagulation (5/50,10.00％) and lesion of birth canal (4/50,8.00％).The risk factors of PPH included delivery mode (x2 =6.528,P=0.038),abortion times (x2 =16.269,P=0.000),delivery times (x2 =6.990,P=0.008),ALT levels (x2=56.541,P=0.000) and HBV DNA (x2 =64.706,P=0.000).Conclusions The main causes of PPH in HBV infected parturient include uterine inertia,abnormal placenta,lesion of birth canal and dysfunction of blood coagulation.PPH is correlated with abortion times,delivery times,delivery mode,liver function and HBV DNA.The incidence of PPH in parturient with chronic active hepatitis B is higher than asymptomatic parturient.

Background and purpose: Increasing evidence has indicated that polymorphisms in the microRNA (miRNA, miR) binding site of target gene can alter the ability of miRNA and modulate the risk of cancer. We aimed to investigate the association between a miR-520a binding site single nucleotide polymorphism (SNP) rs141178472 in the PIK3CA 3’UTR and the risk of colorectal cancer in a Chinese Han population. Methods:The polymorphism rs141178472 was analyzed in a case-control study, including 386 colorectal cancer patients and 394 age-and sex-matched controls. The relationship between the polymorphism and the risk of colorectal cancer was examined by statistical methods. Results:Individuals carrying the rs141178472 CC genotype or C allele had an increased risk of developing colorectal cancer (CC vs TT, OR=1.716, 95%CI:1.084-2.716, P=0.022;C vs T, OR=1.258, 95%CI:1.021-1.551, P=0.033). Furthermore, the expression of PIK3CA was detected in the peripheral blood mononucleated cell of colorectal cancer patients, suggesting that mRNA levels of PIK3CA might be associated with SNP rs141178472. Conclusion:These ifndings provide evidence that a miR-520a binding site polymorphism rs141178472 in the PIK3CA 3’UTR may play crucial roles in the etiology of colorectal cancer.

Humans ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; genetics ; metabolism ; Protein Isoforms ; genetics ; metabolism ; Stomach Neoplasms ; genetics ; metabolism ; Tumor Cells, Cultured

Objective To evaluate the efifcacy and safety of hemostatics of injected gelatin matrix (HIGM) under the guidance of contrast-enhanced ultrasound (CEUS) for treating splenic trauma in canine model. Methods A total of 24 commercial hybrid dogs underwent celiotomy with creation of uniformly blunt splenic trauma lesion of 4.0 cm×4.0 cm×2.5 cm (length, width and depth, respectively) by hemostatic clamp. Subjects were prospectively randomized into two groups. The treatment group was treated with HIGM under the guidance of CEUS and the positive control group received thrombin solution. Conventional ultrasound and CEUS were performed to record the ascites and the splenic lesion areas at 1st, 3rd, 7th, 14th and 21st day. The ifne needle biopsy and splenectomy were performed for histopathologic examination. The weight, free intraperitoneal lfuid and injury site were compared with t test between HIGM and postive group. Results All animals in two groups survived. All dogs stopped hemorrhage after injection of HIGM under CEUS guidance. The area of injury site was (12.91±0.89) cm2, (4.45±0.75) cm2 and (1.38±0.23) cm2 at 1st, 3rd and 7th day and splenic lesions were not found at 14th and 21st day in all dogs (n=12) of HIGM group. The splenic lesion was (16.74±0.91) cm2, (11.26±0.99) cm2, (8.02±0.82) cm2 and (1.58±0.36) cm2 in the postive group at 1st, 3rd, 7th and 14th day and splenic lesions were not found at 21st day in all dogs (n=12). At 7th and 14th day post-injection, lesion areas were statistically significant between two groups (t=27.162, P=0.008;t=15.129, P=0.001). Free intraperitoneal lfuid was (0.91±0.05) cm at 1st day detected by conventional ultrasound and free intraperitoneal fluid was not found at 3rd, 7th, 14th and 21st day in all dogs (n=12) of HIGM group. The free intraperitoneal fluid in thepositive group was (1.96±0.17) cm, (1.30±0.11) cm and (0.81±0.12) cm at 1st, 3rd and 7th day and free intraperitoneal lfuid was not found at 14th and 21st day in all dogs (n=12). At 1st, 3rd and 7th day post-injection, free intraperatitoneal lfuid was statistically significant between two groups (t=20.934, P=0.003; t=41.310, P=0.000; t=22.520, P=0.000). Histopathological examination showed that there was no foreign body and foreign body granuloma and the structure of red pulp was recovered at 7th, 14th and 21st day. Gross anatomy showed that the splenic injury site was recovered completely without complications. Conclusion This study explored the value of HIGM for splenic trauma and provided a preliminary experimental evidence for clinical treatment.

Objective To explore the application effect of ultrasound in rapid position detection of central venous catheterization.Methods Totals of 218 patients received central venous catheterization were randomly divided into experimental group ( 114 cases) and control group ( 104 cases).The experimental group accepted ultrasonic testing before PICC catheter was fixed and examined by X-ray.The control group accepted traditional examination after catheter was fixed.The accuracy of catheterization position,patients' satisfaction,catheterization time,catheter detective costs,and ratio of catheter-adjusting related complications among both groups were collected and analysed.Results The rate of correct catheter positioning in the first time in experimental group was 96.49％ higher than control group which was 76.92％,and the difference was statistically significant ( x2 =18.603,P ＜0.01 ).Patients satisfaction score of experimental group was(4.717 ±0.524) higher than control group that was (4.096 ± 1.296 ).Catheterization time of experimental group was (21.455 ± 3.923 )min lower than control group (24.123 ± 7.184 )min,and the difference was statistically significant ( t =4.728,- 4.603,respectively; P ＜ 0.05 ).The rate of catheter-adjusting-related complications of experimental group was 18.421％ lower than 30.769％ in control group,and the difference was statistically significant ( x2 =4.507,P ＜ 0.05 ). There was no significantly difference between two groups in catheter detective costs.Conclusions Application of ultrasound in rapid position detection of central venous catheterization can increase the accuracy of catheterization,save catheterization time,reduce the ratio of catheteradjusting related complications,effectively improve the quality of PICC without increase catheterization costs.

Objective To investigate the clinical characteristics of patients with idiopathic pulmonary arterial hypertension (IPAH) in China.Methods A total of 161 patients diagnosed as IPAH in Shanghai Pulmonary Hospital from June 2008 to June 2010 were retrospective analyzed.Results The mean diagnostic age was (33 ± 15 ) years old and 70.2％ patients were female. The median duration from symptoms onset to diagnostic right heart catheterization was 12 months.Incidence of NYHA class Ⅲ to Ⅳ was 56.5％ at diagnosis and the mean six minutes walk distance was limited to (398 ± 108) meters.Incidence of mild obstructive,restrictive and diffusing impairment in pulmonary function test was 7.8％,42.2％ and 82.2％ patients with IPAH,respectively. Right heart catheterization demonstrated severe elevated mean pulmonary arterial pressure [ ( 63 ± 17 ) mm Hg ( 1 mm Hg =0.133 kPa) ] and pulmonary vascular resistance index [ ( 25 ± 12 ) Wood U/m2 ] in this patient cohort.The response rate of acute pulmonary vasoreactivity testing was 8.7％ in this cohort. Compared with non-responders,responders to acute pulmonary vasoreactivity testing were younger and with less severe pulmonary hypertension. Among non-responders,89％ patients were treated by one specific anti-pulmonary arterial hypertension drug and 27％ patients received combined anti-pulmonary arterial hypertension medications.Conclusions Young female was predominantly involved in patients with IPAH in China.The diagnosis of IPAH is often made at advanced disease stage and majority patients with IPAH received specific anti-pulmonary arterial hypertension therapies in this patient cohort.

To investigate the protection effect of DNA vaccine in mammalian and avian systems, the DNA vaccine was inoculated in both BALB/c mice and SPF chickens immunized with DNA vaccines encoding hemagglutinin (HA) from A/Goose/GuangDong/1/96 (H5N1) virus. The mice and chickens were immunized twice, 3 weeks apart, by electroporation into muscles or intramuscular injection. Two weeks after the second immunization, the mice and chickens were challenged with a lethal dose of homologous virus. The mice and chickens immunized by electroporation obtained completely protection against the virus, and could effectively inhibited viruses to replicating in mouse lung and chicken cloaca. At the same time, these protections were companied by high levels specific antibody to H5N1 AIV, while the blank plasmid controls experience 100 percent mortality following challenge. Furthermore, in the experiment of mice by eletroporation,stronger obviously CTL activity were observed after challenge. Thus, the cellular immune responses of the mice immunized by electroporation were exhibited. These results strongly demonstrate that HA DNA vaccines provide effective protection against influenza virus infection in mammalian and avian, and suggest that electroporation is one of the efficient gene delivery systems for the transfer of influenza DNA vaccine in both humoral immunity and cellular immunity.

Objective To report the clinical effect of free transplanting for soft tissue defects pedieled with high site cutaneous branches of the transverse branch of lateral cirumflex femoral artery.Methods Cu- taneous branches of the descending branch of lateral circumflex femoral artery were found small or abscent in 7 patients.The anterolateral femoral skin flap was pedicled with high site cutaneous branches of the transverse branch to repair the soft tissue defects of the arm,hand,leg and foot,rather than with the descending ones. The size of the flap ranged from 15 cm?6 cm to 28 cm?13 cm,with part muscle valve,iliotibal tract and lat- eral femoral cutaneous nerve.The fractures were performed with internal or external fixation.Results All of the anterolateral femoral skin flap survived well postoperatively in the 7 cases and had good appearance and sensation at one stage.The function of the repaired extremities recovered well.Conclusion The anterolat- eral femoral skin flap pedicled with high site cutaneous branches of the transuvrse branch of lateral circumflex femoral artery has many advantages of good blood supply and large size.The flap was secluding,and can be taken with some muscle and lateral femoral cutaneous nerve.When cutaneous branches of the descending branch of lateral circumflex femoral artery is small or abscent,the anterolateral femoral skin flap with high site cutaneous branches of the transverse branch of lateral circumflex femoral artery is an optimal alternative.