Objective:To compare efficacy of percutaneous vertebroplasty (PVP) with radiotherapy and radiotherapy alone for bone me-tastasis pain. Methods:A total of 247 bone metastasis patients with pain were analyzed. The radiotherapy group comprised 158 cases, whereas the combination group comprised 89 cases. We mainly observed the effect of pain treatment, behavioral states, and im-proved emotional condition. The side effects and complications were also investigated. Daily medicine consumption of background pain treatment was observed between the two groups. Analysis was done by SPSS 17.0 statistical software. Numerical variables were analyzed using t test and comparisons between groups used chi-square test. Results:The VAS scores of radiotherapy group decreased from 8.12±1.45 to 3.06±1.68 after treatment (P<0.05), and combination group VAS scores from 8.46±1.73 to 2.45±1.47 (P<0.05). The time to pain relief following PVP and radiotherapy were 1.63±0.81 and 8.56±2.87 days, respectively (P<0.001). The breakthrough pain frequency was 4.56 ± 1.98 times/day, which decreased to 1.57 ± 0.98 times/day after PVP (P<0.05). By contrast, the breakthrough pain frequency was 4.73±2.24 times/day before treatment, which decreased to 3.56±1.56 times/day after radiotherapy. No serious compli-cations were observed in the two groups. The depression and anxiety mood in the combination group improved after treatment. Daily medicine consumption in radiotherapy group increased after therapy. However, daily medicine consumption in combination group was reduced after therapy. Conclusion:PVP with radiotherapy can effectively relieve bone metastasis pain and improve patients' quality of life and it is worthy of promotion in clinical practice.

OBJECTIVETo assess the long-term clinical effectiveness of Chinese herbal medicines for benefiting qi and activating blood circulation (CHMBQABC) plus routine Western medical intervention in treating unstable angina (UA) patients of qi deficiency blood stasis syndrome (QDBSS) after percutaneous coronary intervention (PCI) based on Markov model.

METHODSA Markov model was established based on prognosis and sequelae of UA patients after PCI treated by CHMBQABC plus routine Western medical intervention or by routine Western medical intervention. According to the transition probabilities of 40 Markov cycles and quality-adjusted life years (QALYs) averagely gained, we assessed the therapeutic advantage of CHMBQABC plus routine Western medical intervention.

RESULTSBy the prediction of Markov model for 20 years, the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke, and all-cause death in the CHMBQABC plus routine Western medical intervention group was 56.65%, 6.53%, 5.16%, and 31.66%, respectively, and the QALYs averagely gained was 12.95; while the transition probabilities of revascularization, non-fatal myocardial infarction, non-fatal stroke, and all-cause death in the Western medical intervention group was 55.31%, 6.87%, 5.25%, and 32.57%, respectively, and the QALYs averagely gained was 12.84. Compared with the Western medical intervention group, the QALYs averagely gained was 0.11 in the CHMBQABC plus routine Western medical intervention group.

CONCLUSIONBased on predicted results of the Markov model, CHMBQABC plus routine Western medical intervention got better efficacy in treating UA patients after PCI, indicating CHMBQABC plus routine Western medical intervention could improve the long-term clinical effectiveness for UA patients of QDBSS after PCI.

Aged ; Angina, Unstable ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Markov Chains ; Middle Aged ; Models, Theoretical ; Phytotherapy ; Treatment Outcome

Objective To investigate effects of hyperbaric oxygen (HBO) therapy on C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) levels in patients with moderate or severe traumatic brain injury (TBI)and to analyze its therapeutic efficacy. Methods One hundred and eight patients with moderate or severe TBI were randomly divided into a control group (54 cases) and an HBO adjunctive therapy group (HBO group, 54 cases).Both groups received essential neurosurgical treatment and conventional drug treatment, and the HBO group was given one session of HBO therapy in addition. Serum CRP and TNF-α were detected, and the scores on the Glasgow coma scale (GCS) were measured before and after treatment. CRP was detected by turbidimetric immunoassay and TNF-α using ELISA. Glasgow outcome scale (GOS) scores were evaluated in a follow-up 6 months after injury. Results Average CRP, TNF-α and GCS measurements showed no statistically significant difference between the groups before treatment. After treatment, CRP and TNF-α were significantly lower and GCS scores significantly better in both groups, but patients in the HBO group were, on average, significantly better than the controls on all three measures.Six months later, GOS evaluation gave a significantly larger number of patients with a better prognosis in the HBO group compared with the controls. Conclusion HBO therapy can significantly decrease serum CRP and TNF-α after severe TBI, thus enhancing therapeutic efficacy.

For screening the potential drugs as anti-liver fibrosis candidates, we established a high- throughput drug screening cell model based on COL1A1 promoter. The activity of COL1A1 promoter and luciferase reporter gene can be elevated by TGF-β1, and inhibited by candidate drugs. We constructed a recombined plasmid with COL1A1 promoter and luciferase reporter gene pGL4.17, the activity of COL1A1 promoter was reflected by fluorescence intensity. COL1A1 promoter activity was detected by Dual-Luciferase Reporter Assay System, it came that the relative luciferase activity of COL1A1 promoter was 15.98 times higher than that of control group induced by TGF-β1, showing the recombined plasmid could be used in cell model. The recombined plasmid was transfected into human hepatic stellate cells LX2, detected the effect of potential drugs, and obtained a stable expression system through stable transfection and monoclonal cell culture. A sample which could reduce COL1A1 promoter activity signally by our cell model, decreased collagen I mRNA and protein expression detected by real-time RT-PCR and Western blotting. It indicates this novel cell model can be used in high-throughput drug screening of potential anti-liver fibrosis drugs.
Collagen Type I ; genetics ; Drug Evaluation, Preclinical ; methods ; Genes, Reporter ; Hepatic Stellate Cells ; High-Throughput Screening Assays ; Humans ; Liver Cirrhosis ; drug therapy ; Luciferases ; Plasmids ; Promoter Regions, Genetic ; RNA, Messenger ; Transfection ; Transforming Growth Factor beta1 ; pharmacology

Objective To discuss the method,safety and effect of malignant pancreas tumor treated by CT guided percutaneous embedding of~(125)I. Methods 32 cases of malignant pancreas tumor with CT scan and contrast enhancement were retrospectively analysed.All the cases had been confirmed pathologically be- fore CT guided therapy.The number of~(125)I particle was 12～46,The distance between particles was 0.～1.2 cm. The number of puncture point was 1～2.The number of puncture direction was 2-5 times.Results Regarding 32 cases for 1 month,the size of the tumor reduced in 11 cases,no change in 20 cases,and increased in 1 case.As for 31 cases for 2 months,the size reduced in 16 cases,no change in 13 cases,and enlarged in 3 cases.Regarding 30 cases for 3 months,the size reduced in 18 cases,no change in 11 cases,and increased in 3 cases. Regarding 28 cases for 6 months, he size reduced in 10 cases, no change in 5 cases, and in- creased in 13 cases.Regarding 22 cases for 1 year,12 cases had been done the second therapy,the size of the tumor reduced in 16 cases,no change in 3 cases,and increased in 3 cases.Conclusion The size of pancreas tumors were reduced obviously,the symptoms were relieved after the treatment.The method turned out to be safe and accurate.

Objective:To explore the metabolic regulations of different Traditional Chinese Medicine (TCM) syndromes in the diabetic patients with high risk for foot ulceration.Methods:Based on gas chromatography-mass spectrometer and multi-dimensional data processing methods, the metabolomics analysis was used to compare the serum metabolites profile of healthy people (32 cases) and the high-risk foot patients in Cold and Blood Stagnation syndrome (44 cases), Heat-toxin hurting Yin syndrome (54 cases), and Qi-Blood deficiency syndrome (33 cases), who were hospitalized at Shanghai TCM-Integrated Hospital from Apirl to December, 2018.Results:This study suggested that compared with healthy people, the diabetic patients with high risk for foot ulceration showed significantly lower serum level of urea [(2.41 ± 1.57)×10 5vs. (3.32 ± 2.10)×10 5], L-leucine [(4.94 ± 3.15)×10 5vs. (6.39 ± 3.57)×10 5], aspartic acid [(3.94 ± 4.48)×10 5vs. (9.62 ± 6.93)×10 5], 9H-purine [(1.74 ± 1.95)×10 5vs. (3.34 ± 2.23)×10 5] ( P<0.05 or P<0.01), while higher level of d-Glucose [(3.72 ± 1.71)×10 5vs. (2.21 ± 1.32)×10 5] and d-glucopyranose [(3.32 ± 2.10)×10 5vs. (1.35 ± 1.43)×10 5] ( P<0.01). Energy metabolism, amino acid metabolism and sugar metabolism were mainly involved. the content of L-tyrosine in the group of patients with Cold and Blood Stagnation syndromewas significantly higher than that in healthy people. The urea, purine, leucine, aspartic acidcontent in patients of Heat-toxin hurting Yin syndrome were significantly lower than that in healthy people. The purine content in patients of Qi and Blood Deficiency Syndrome was significantly lower than that in healthy people. Compared with the syndrome of Heat-toxin hurting Yin syndrome, patients in Cold and Blood Stagnation syndrome showed a significantly higher content of beta-1-galactopyranoside and butanoic acid. Compared to the Qi-Blood deficiency syndrome, serum urea level in patients of Heat-toxin hurting Yin syndrome was significantly higher than those in the patients of other two TCM syndromes. Conclusions:The serum metabolomics profiling differentiate three TCM-syndrome in high-risk DF patients, which can provide objective basis for clinical TCM syndrome differentiation and treatment of high-risk diabetic foot patients.

BACKGROUND:When immunological rejection occurs following liver transplantation,liver cells are destroyed by infiltrated T lymphocytes,leading to progressive deterioration of hepatic function owing to reduction of liver cells.Induction of immunological tolerance of liver transplantation remains a challenge.OBJECTIVE:To observe the influences of pretransplant intraportal infusion of recipient blood into donor on the apoptosis of hepatic allograft-infiltrating T lymphocytes in rats.DESIGN,TIME AND SETTING:A randomized,controlled,animal experiment was performed at the Organ Transplant Unit,China University between May 2002 and May 2004.MATERIALS:Inbred rats were developed into models of orthotopic liver transplantation.Twenty-four female ACI rats(RT1a)served as donors,and an additional twenty-four male LEW rats(RT11)served as recipients.METHODS:A modification of cuff method was employed for orthotopic liver transplantation in rats.Twenty-four recipient rats recipient blood was infused into each donor rat via the portal vein.All blood infusions were performed 7 days prior to liver transplantation.MAIN OUTCOME MEASURES:Rat survival time,serum content of γ- interferon,histological changes of hepatic allograft,number of dendritic cells in the hepatic allograft,and T lymphocyte apoptosis following liver transplantation.RESULTS:Rat survival time was significantly longer in the intraportal infusion of non-recipient blood group than in the control group(P＜0.01).At 3 and 5 days after liver transplantation,the intraportal infusion of non-recipient blood group exhibited significantly higher serum content of y- interferon than the control group(P＜0.05).No significant differences in rat survival time and serum content of γ- interferon were found between intraportal infusion of non-recipient blood and intraportal infusion of non-recipient blood groups and control group(P＞0.05).In the intraportal infusion of non-recipient blood group,infiltrated T lymphocytes in the hepatic allograft were significantly reduced,and a large number of donor-sourced dendritic cells were detected.The number of apoptotic cells per square millimeter of hepatic tissue was significantly higher in the intraportal infusion of non-recipient blood group than in the control group(P＜0.01).CONCLUSION:Pretransplant intraportal infusion of recipient blood into donor can prolong the survival time of hepatic allograft and promote the apoptosis of hepatic allograft-infiltrating T lymphocytes.

To explore the status of cancer pain management among hospitalized elderly patients.Pain intensity,use of analgesic drugs and incidence of adverse reactions were surveyed for 620 cancer pain patients.And 218 of them were aged over 65 years.The proportions of mild,moderate and severe pain were 29.8％,36.2％ and 34.0％ respectively.And the corresponding rates in young and middle-aged patients were 28.4％,34.8％ and 36.8％ respectively (P ＞ 0.05).In elders with cancer pain,28％ used no analgesic.For severe pain patients,only 71.6％ received potent opioids and 5.4％ nonsteroidal antiinflammatory drugs.And the corresponding rates in young and middle-aged patients were 26.1％,73.0％ and 4.7％ respectively (P ＞ 0.05).The rates of constipation,dysuria and delirium in elderly patient group were higher than young and middle-aged patient group (P ＜ 0.05).Pain management is unsatisfactory and rational uses of analgesic drugs should be strengthened for preventing the relevant adverse reactions.

Objective To assess the value of contrast-enhanced ultrasound (CEUS) on quantitative analysis of re?nal cortex perfusion in hypertensive rabbits model. Methods Hypertensive rabbit modal (n=10) were established by inject?ing N-nitro-L-arginin methylester (L-NAME). CEUS and Cystatin C (CysC) serum level analysis were performed at differ?ent time points:before and the 2nd, 4th, 6th and 8th week after injecting L-NAME. Time-intensity curve and area under curve (AUC) were analyzed quantatively while correlation of AUC and CysC were also analyzed. Results Serum level of Cys C in?creased significantly at the 6th week after L-NAME administration which is earlier than the increase of serum levels of Scr and BUN. AUC decreased at first then increased after L-NAME administration. Upon addition of L-NAME, rise time (RT) and peak intensity (PI) decreased while mean transit time (MTT), time from peak to one half (HPT) and time to peak (TTP) in?creased. Our study confirmed a positive correlation between AUC and Cys C (r=0.950, P<0.001). Conclusion Setting up rabbits model by L-NAME is convenient and reproducible, which is an useful tool in experimental study of preclinical and clinical phase of hypertensive renal injury. CEUS combining with CysC serum level analysis is considered as an effective technology for evaluating renal function in hypertensive patients.

Highly Active Anti-Retroviral Therapy (HAART) has effectively inhibited the prevalence of HIV-1 and reduced the death rate caused by AIDS. In recent years,the emergence of resistance-conferring RT gene mutations in HIV-1 strains has become the major reason for HAART failure. The detection of drug resistance is important for the HAART regimen choice and novel drug development. A novel assay for the detection of HIV-1 RT drug resistance mutations was developed. HIV-1 drug resistance and wild strains in B subtypes were investigated using Two-Step Mutagenically-Separated PCR (MS-PCR),and point mutations including M41L,K70R,K103N,Y181C,T215F were detected. A longer mutant type primer was designed,using microplates hybridization and ELISA technique to detect several point mutations within a mixed mutant-wild type population. The results indicate that the Two-Step MS-PCR is as sensitive and specific as that in the traditional MS-PCR and MS-PCR combined with ELISA can give a good P/N quotient with better sensitivity,low cost,relatively less time consumption and high-throughput screening. It will be used in clinic usage for the detection of HIV-1 drug resistance mutations as well as other point mutations.