Objective To find out nutrient support drug utilization in cancer patients in our hospital. Methods An analysis was made by means of drug utilization research into the structure and rationality of nutrient support drug utilization in our hospital through an investigation into the detailed records of the dispensary from 1999 to 2002 and into 1 014 medical records from 2002. Results The variety, quantity, and cost of nutrient support drug utilization in the four years rose respectively by 58.82%, 71.66% and 28.16%. 49.30% of the cancer patients whose medical records were surveyed used such drugs. The quantity and person time ratio of PN and EN drug utilization was respectively 14∶1 and 13∶1, with malnourished patients accounting for 19.80%. Of the PN drugs whose DDD value could be determined, most had a DUI value that was greater than 1 whereas most of the EN drugs had a DUI value which was smaller than 1. Conclusion The variety, quantity, and cost of nutrient support drug utilization in the four years rose rapidly. The quantity and person time of PN drug utilization were much higher than those of EN drug utilization. Doubts could be cast in the handling of indications for nutrient support drug utilization in some patients and the doses of some nutrient support drugs prescribed were not so rational. Further explorations need to be made into the rational application of nutrient support treatment.

OBJECTIVE:To promote the adjustment of National Essential Drug List and implementation of Essential Drug List. METHODS:National Essential Drug List was compared with Essential Drug List issued by WHO. Retrieved from statistical results conducted by State Food and Drug Administration, the problem that there were large number of drug in China while little category were included in National Essential Drug List was analyzed, according to practice in China. RESULTS & CONCLUSION: Drug enterprises increased the dosage form and category of preparation blindly because of huge raw drug market, various dosage forms and weak administration to drug enterprises. The characteristics of drug were cheap, high quality, acceptance by state, which decided that the category of drug in Essential Drug List should not be too much. It is necessary to adjust Essential Drug List as the change of situation so as to meet the requirement of public health.

Objective To explore the effect of surgical treatment of bronchioloalveolar carcinoma (BAC). Methods Data were collected from 94 patients with BAC (including 67 cases with pure bronchioloalveolar carcinoma, 16 cases with BAC by local infiltration and 11 cases with adenocarcinoma having BAC character). All patients were proved pathologically bronchioloalveolar carcinoma from January 1989 to December 2003. Clinical features, characteristics of radiology, methods of treatment and survival status were studied retrospectively. Surgical treatment and efficacy approaches according to different TNM stages and clinical patterns were also analyzed. Results Ninety-eight patients underwent complete resection and 4 underwent palliative operation and 2 underwent exploratory thoractomy. The 1-, 3-, 5-year survival rates were 75.5 %, 53.2 %, 41.5 %. According to international staging system of lung cancer, there were marked difference in stage Ⅰ group, stage Ⅱ group and stage Ⅲ group (P <0.01). According to pathological classification, there were marked difference in pure bronchioloalveolar carcinoma, BAC with local infiltration and adenocarcinoma having BAC character (P <0.01). Conclusion Bronchioalveoar carcinoma is a special form of lung cancer. It has its own characteristics on biology,radiology,clinic or pathology. Lobectomy is performed commonly in patients with bronchioloalveolar carcinoma. It may be concluded that the early diagnosis, early therapy are the key points for improving the survival rate of BAC.

Objective To investigate the clinical effects of laparoscopic sleeve gastrectomy with duodenaljejunal bypass (LSG + DJB) for the treatment of type 2 diabetes mellitus.Methods The clinical data of 17 patients with type 2 diabetes mellitus who underwent LSG + DJB at the Xijing Hospital of the Fourth Military Medical University from March 2013 to February 2014 were retrospectively analyzed.The fasting blood glucose,postprandial 2-hour blood glucose,glycosylated hemoglobin (HbA1c) and body mass index (BMI) in 17 patients before operation were (9.2 ± 0.6) mmol/L,(14.4 ± 2.2) mmol/L,8.3％ ± 1.2％ and (29.4 ± 2.2) kg/m2,respectively.All the patients received LSG + DJB and were followed up by outpatient examination up to March 2015.The pre-and post-operative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1 c and BMI in 17 patients were compared.Measurement data with normal distribution were presented as-x ± s and analyzed by the t test.Results All the 17 patients received successful laparoscopic LSG + DJB without conversion to open surgery.The operation time,volume of intraoperative blood loss and recovery time of postoperative gastrointestinal function were (141 ±53)minutes,40 mL and 2.5 days.Of 3 patients with postoperative complications,1 patient with anastomotic leakage at postoperative day 5 received reoperation by laparoscopic Roux-en-Y gastric bypass,1 patient with digestive tract obstruction at postoperative day 10 released obstruction by reoperation and 1 patient with left subphrenic abscess and leakage at the upper of the stomach at postoperative week 2 was cured by the symptomatic treatment.The duration of hospital stay was 5.2 days.All the patients were followed up for a median time of 16 months (range,13-24 months).The postoperative 12-month fasting blood glucose,postprandial 2-hour blood glucose,HbA1c and BMI in 17 patients were (5.5 ± 0.7)mmol/L,(8.8 ± 1.7)mmol/L,5.1％ ± 0.7％ and (24.7 ± 2.3)kg/m2,which were significantly different from preoperative indicators (t =19.96,10.52,12.06,31.99,P ＜ 0.05).During the follow-up,no anastomotic ulcer and stenosis,dumping syndrome and severe malnutrition were occurred.Conclusion LSG + DJB is safe and feasible for the treatment of type 2 diabetes mellitus,with a good short-term hypoglycemic effect.

Objective To construct bispecific antibody BsAb1/17 against both IL-1β and IL-17A,express and purify the biologically active BsAbl/17 protein in prokaryotic system for further studies and applications. Methods VH1VL17-CL and VL1VH17-CH1 gene segments were constructed by overlap-PCR.Restriction enzyme sites Nco Ⅰ and BamH Ⅰ were designed at the 5'and 3' end primers respectively. The products of overlap-PCR were ligated to the Nco Ⅰ/BamH Ⅰ -prepared pET-27b vector. The recombinant plasmids pET-27b-VH1 VL17-CL(petA) and pET-27b-VL1 VH17-CH1 ( petB ) were transformed into E. coliRosetta separately. The expressing products were analyzed by SDS-PAGE and Western blot. Neutralization activity of the bispecific antibody for blocking the induction of IL-18 expression by IL-1β in human T cells was determined by real-time PCR. Neutralization activity of the bispecific antibody for blocking the induction of IL-6 expression by IL-17A in HeLa cells was determined by ELISA assay. Results The structure of the plasmids pET-27b-VH1 VL17-CL(petA) and pET-27b-VL1 VH17-CH1 (petB)was confirmed by DNA sequencing. After induction, the fusion proteins were expressed mainly as inclusion bodies. The purity of the both proteins exceeded 90%. SDS-PAGE analysis suggests the relative molecular mass of both products expressed by petA and petB were approximately 38× 103, which is in accordance with the theoretical value. The results of Western blot and ELISA test demonstrated that BsAb1/17 molecule had binding ability to both IL-1β and IL-17A. The BsAb1/17 could block IL-1β to stimulate human T cell to express IL-18 and block IL-17A to stimulate HeLa cell to express IL-6. Conclusion We successfully constructed a novel bispecific antibody BsAb1/17 against both IL-1 β and IL-17A, and expressed biologically active BsAb1/17 protein in prokaryotic system.

OBJECTIVETo introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example.

METHODSA clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice.

RESULTSThe treatment was effective and the patient achieved disease remission.

CONCLUSIONEvidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.

Evidence-Based Medicine ; Humans ; Male ; Orchiectomy ; Prostatic Neoplasms, Castration-Resistant ; therapy

Objective:To explore the safety and efficacy of Castor branched stent-graft exclusion in the treatment of aortic dissection and aneurysm involving left subclavian artery.Methods:The clinical and imaging data of 88 patients with aortic dissection or aneurysm involving left subclavian artery diagnosed by CTA or DSA in our hospital from December 2017 to December 2019 were collected retrospectively, including 67 aorta dissections, 7 thoracic aortic aneurysms and 14 aorta penetrating ulcer. All patients were treated with branched stent-graft under the guidance of DSA. The postoperative curative effect and complications were observed. The paired t test was used to compare the maximum aortic diameter of the lesion before and 6 months after the operation. Results:Eighty-eight patients were successfully treated with integrated stent, the success rate of operation was 100%, and the disease-related symptoms of all patients were basically or completely relieved. The mortality rate within 1 month after the operation was 2.7% (2/88). The two deaths were complicated with other serious diseases before the operation, and the cause of death was not related the operation. All patients were followed up except 4 patients who lost contact after discharge. During the follow-up, there were 1 case of retrograde type A dissection, 1 case of new aneurysm of aortic arch, 2 cases of in-stent stenosis of left subclavian artery branch, 3 cases of mild stroke, no persistent endoleak and no death or other serious complications. The mean maximum aortic diameter at 6 months after operation [(34±4)mm] was significantly lower than that before operation [(38±6 mm)] ( t=6.63, P<0.05). Conclusion:Castor branched stent-graft is simple, mini-invasive and effective in the treatment of aortic dissection and aneurysms involving the left subclavian artery.

OBJECTIVETo investigate the relation between endothelial nitric oxide synthase (eNOS) gene polymorphism and IgA nephropathy (IgAN).

METHODSThe variable number of tandem repeats (VNTR) polymorphism of eNOS gene was analyzed with PCR in 296 Chinese Han patients with IgAN groups and 310 healthy Han subjects from Beijing, Tianjin and Hebei Province, and the gene frequency and allele frequency were compared between the two groups.

RESULTSIn these Chinese Han subjects involved in this study, VNTR of eNOS gene showed 3 genetypes, namely eNOS4a, eNOS4b and eNOS4a/4b. No significant difference was found in the gene frequency between IgAN group and the healthy subjects.

CONCLUSIONSIgAN is not associated with VNTR polymorphism of eNOS gene, and no sufficient evidence has been obtained to establish the relation of eNOS VNTR polymorphism with the genetic factors of IgAN. The role of eNOS gene polymorphism in IgAN can be heterogeneous in regard to different races or areas.

Adolescent ; Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; China ; Female ; Gene Frequency ; Genotype ; Glomerulonephritis, IGA ; ethnology ; genetics ; Humans ; Male ; Middle Aged ; Minisatellite Repeats ; genetics ; Molecular Sequence Data ; Nitric Oxide Synthase Type III ; genetics ; Polymorphism, Genetic

OBJECTIVETo study a family affected with osteogenesis imperfecta for potential mutations in COL1A1 gene.

METHODSClinical data of an affected family was collected. Potential mutation of the COL1A1 gene was screened using polymerase chain reaction and direct sequencing. Suspected mutation was detected in 20 unaffected relatives and 200 unrelated healthy controls.

RESULTSAnalysis of RNA splicing has revealed a c.3208G/A mutation, which created a new splice sites and led to a frameshift mutation. The same mutation was not detected in the unaffected relatives or the 200 healthy controls.

CONCLUSIONMutations of the COL1A1 gene are one of the major causes of osteogenesis imperfecta in Chinese population. Our finding has enriched the mutation spectrum of type I collagen genes.

Adult ; Child, Preschool ; Collagen Type I ; genetics ; Female ; Humans ; Male ; Mutation ; Osteogenesis Imperfecta ; genetics ; RNA Splicing

Though all the marketed drugs of dipeptidyl peptidase IV inhibitors are structurally different, their inherent correlation is worthy of further investigation. Herein we rapidly discovered a novel DPP-IV inhibitor 8g (IC50 = 4.9 nmol.L-1) which exhibits as good activity and selectivity as the market drugs through scaffold hopping and drug splicing strategies based on alogliptin and linagliptin. This study demonstrated that the employment of classic medicinal chemistry strategy to the marketed drugs with specific target is an efficient approach to discover novel bioactive molecules.
Dipeptidyl-Peptidase IV Inhibitors ; chemical synthesis ; chemistry ; Drug Design ; Drug Discovery ; methods ; Humans ; Hypoglycemic Agents ; chemical synthesis ; chemistry ; Linagliptin ; chemical synthesis ; chemistry ; Molecular Structure ; Piperidines ; chemical synthesis ; chemistry ; Structure-Activity Relationship ; Uracil ; analogs & derivatives ; chemical synthesis ; chemistry