Objective To evaluate the therapeutic effect of 5-aminolevulinic acid mediated photody-namic therapy(ALA-PDT)in combination with recombinant human interferon alpha 2b ointment on superficial basal cell carcinoma(BCC)in elderly.Methods A total of 143 elderly patients with superficial BCC was ran-domly divided into PDT group(n=72 cases)and the surgical group(n=71 cases).The patients in the two groups were given the ALA-PDT in combination with IFN-α2b and routine surgical treatment respectively .The effica-cy after treatment was observed according to surgical wound area , lesion area , recurrence and security during 1 year follow-up.Results The results displayed the complete remission rate of lesion in the PDT group was sig-nificantly higher than that in the surgical group (81.94%vs.57.75%,P<0.05)after treatment,and the total ef-fective rate of BCC was also higher than that in the surgical group ,but no significant difference was identified in the two groups(91.66%vs.81.73%,P>0.05).During 1 year follow-up after treatment,the results showed the rate of recurrence in the PDT group was significantly lower than that in the surgical group (9.72% vs.22. 54%,P<0.05).Moreover,the mean wound area,the lesion area in the PDT group after treatment were also sig-nificantly smaller than that in the surgical group (P<0.05).Conclusion ALA-PDT in combination with IFN is an effective method with lower recurrence and minor trauma in the treatment of superficial basal cell carcino -ma.

Objective To study the effect of dexmedetomidine on perioperative stress reaction and postoperative cellular immunity of patients with breast cancer radical surgery.Methods We selected 108 cases of breast cancer patients undergoing elective radical surgery under general anesthesia in our hospital from Janu-ary 2012 to June 2015.These patients were divided into dexmedetomidine group (group D)and the control group (group C)by random number table method,54 cases in each group.Patients in group D were given dexmedetomidine 1.0 μg/kg by intravenous drip within 15 min before anesthesia and maintained 0.5 μg.kg -1 .h -1 after anesthesia induction intubation until operation finish.Patients in group C were given the same capacity of normal saline instead of dexmedetomidine,and the rest of the anesthesia was same as group D.The plasma norepinephrine (NE)and epinephrine (E)and cortisol (COR),serum interleukin-6 and T lymphocyte subsets (CD3 +,CD4 +,CD8 +,CD4 +/CD8 +)and NK cells levels were determined before anes-thesia (T0 ),postoperative 4 h (T1 ),1 d (T2 ),3 d (T3 ),and 7 d (T4 ).Results The level of plasma NE, E,COR and serum IL-6 of the D group in different time had no statistical significance compared with T0 time (P ﹥ 0.05).The plasma level of E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the C group were increased significantly (P ﹤ 0.05).The level of plasma E and NE in T1 -T3 ,plasma COR in T2-T3 and serum IL-6 in T2-T4 of the D group were decreased significantly compared with C group (P ﹤ 0.05).The level of CD3 + and NK cells in T1 -T3 of the two groups decreased significantly compared with T0 (P ﹤ 0.05).The level of NK and CD3 + in T1 -T3 and CD4 +,CD4 +/CD8 + in T2-T3 of group D increased significantly com-pared with group C (P ﹤ 0.05).Conclusion Dexmedetomidine of intravenous drip during general anesthesia can effectively reduce stress reaction in perioperative period of breast cancer patients,and improve patients immune status.

Objective To investigate the relationship between CRP, plasminogen activator inhibitor type 1 (PAI-1) levels, PAI-1 gene promoter 4G/5G polymorphism and the type of acute myocardial infarction (ST elevation myocardial infarction, STEMI vs the non-ST elevation Myocardial infarction, NSTEMI). Methods One hundred seventy-six consecutive patients with AMI were included for the study, of whom 60 had STEMI and 56 had NSTEMI, and 60 adults without cardiovascular and cerebrovascular disease were selected as controls. Blood samples were obtained from patients within 6 h of AMI and the plasma PAI-1, CRP, and the gene polymorphism were measured. Results Plasma levels of PAI-1 and CRP were higher in AMI groups, compared those in the control group, and plasma levels of PAI-1 were significantly higher in patients with STEMI compared to those with NSTEMI (80.12ng/ml VS.73.01ng/ml, P <0.01), while CRP levels were not significantly different between patient with STEMI and NSTEMI (3.87±0.79 mg/ml VS.4.01±0.69mg/ml, P>0.05). PAI-1 levels presented a significant correlation with CRP levels in the NSTEMI subjects. However, PAI-1 and CRP levels could explain the lack of a significant relationship between them in control and STEMI subjects.The frequencies of 4G/4G genotype in the AMI group were higher than those in the control group and higher in patient with STEMI than in patient with NSTEMI. Plasma levels of PAI-1 in subjects with 4G/4G genotype were significantly increased as compared to those in subjects with 4G/5G and 5G/5G genotype. Conclusions Plasma PAI-1 levels were associated with different myocardial infarction type, and PAI-1 promoter 4G/5G polymorphisms and CRP may be related to plasma PAI-1 levels.

OBJECTIVETo detect putative suppressor loci involved in tumor progressing or metastases.

METHODSThirty microsatellite marker primers were employed to amply the corresponding loci of the genome DNA from 83 patients with sporadic colorectal cancer. The PCR products were electrophoresed on a 377 PRISM sequencer and the fluorescent signals were analyzed by Genotyper and Genescan software.

RESULTSThe data were obtained from 24 loci, with an average LOH frequency of 15.16%. The LOH at D2S206 and D2S364 was more frequent than 30%, and was less than 20% at the rest loci. Significant difference was observed between the percentage of LOH and tumor staging or differentiation at D2S142 (2q24.1), D2S126 (2q35), D2S2211 (2p24.2), D2S305 (2p23.3). Occarrence of deletion at the later two loci was correlative.

CONCLUSIONSFrequent LOH was not observed at the loci around known mismatch repair genes on chr. 2. The region between D2S305 (2p23.3) and D2S2211 (2p24.2) deleted holistically, and was correlated to the stage and differentiation of tumor attended by D2S142 (2q24.1) and D2S126 (2q35) on 2q. It is suggested that unknown genes associated with tumor progressing or metastases reside in the two loci on 2q or the region on 2p.

Adult ; Aged ; Aged, 80 and over ; Cell Differentiation ; Chromosome Mapping ; Colorectal Neoplasms ; genetics ; pathology ; Female ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged ; Neoplasm Metastasis

OBJECTIVETo evaluate and map the putative tumor suppressor loci on chromosome 5 involved in tumor progress or metastasis.

METHODSChromosome 5 of 83 patients with sporadic colorectal cancer was systemically screened. Fifteen microsatellite marker primers labeled with 3 different fluorescents were used to amplify the corresponding loci of the genome DNA. The PCR products were electrophoresed on a 377 PRISM sequencer and the fluorescent signals were analyzed with Genotyper and Genescan software.

RESULTSThe highest loss of heterozygosity (LOH) ratio was found at D5S416 (48.15%) on 5p and at D5S471 (38.71%) on 5q. The region (5q13.3 - 31), where D5S471 and 3 neighboring loci (D5S428, D5S2027 and D5S2115) reside, presented high frequent LOH.

CONCLUSIONThe deletion of APC, MCC, CTNNA1 and IL cluster in the 5q 13.3 - 31.1 area play important role in the tumorogenesis of colorectal cancer, and the expected existence of another novel tumor suppressor gene on 5p is possible.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Chromosome Deletion ; Chromosomes, Human, Pair 5 ; Colorectal Neoplasms ; genetics ; Female ; Genes, Tumor Suppressor ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; genetics ; Middle Aged

OBJECTIVETo analyze the loss of heterozygosity (LOH) of chromosome 20 in patients with sporadic colorectal cancer to identify additional loci involved in colorectal tumorigenesis.

METHODSPolymorphic microsatellite markers were analyzed in 83 colorectal cancer patients' tumor and normal DNA by PCR. PCR products were electrophoresed on an 377 DNA sequencer. Genescan 2.1 and Genotype 2.1 software were used in the LOH scanning and analysis. Comparisons between LOH frequency and clinicopathological data were performed by chi(2) test. P < 0.05 was considered statistically significant.

RESULTSThe average LOH frequency in the long arm, short arm and whole chromosome 20 was 21.1%, 26.7% and 22.8%, respectively. Chromosome 20 exhibited relatively high LOH frequency, particularly in the regions of 20p and 20q11.1-q13.1.

CONCLUSIONThere is notable genetic instability on chromosome 20 in sporadic colorectal carcinoma patients; that is, mutation on chromosome 20 is closely associated with sporadic colorectal carcinogenesis. Also, there may be tumor suppressor genes related to sporadic colorectal carcinoma near the region 20q11.1-q13.1.

Adult ; Aged ; Aged, 80 and over ; Chromosomes, Human, Pair 20 ; Colorectal Neoplasms ; genetics ; pathology ; Female ; Humans ; Loss of Heterozygosity ; Male ; Microsatellite Repeats ; Middle Aged

Pulsatile blood flow plays an important role in maintaining normal vascular endothelial function. Quantitative measurement of pulsatility of artery blood pressure and blood flow in dogs and effects of enhanced external counterpulsation (EECP) on the pulsatility were taken in this study. Common carotid artery blood pressure and blood flow were measured in 6 beagle dogs that had suffered from an acute myocardial infarction 6 weeks before. A 6F tip transducer catheter was inserted into the right common carotid artery to measure blood pressure, and blood flow was measured in the left common carotid artery by an electromagnetic blood flow probe under anesthesia before and during EECP. Blood pulse pressure, pulsatility index (ratio of peak pressure to end diastolic pressure) and standard deviation of blood pressure were calculated to evaluate the pulsatility of arterial blood pressure. Blood pulse flow, pulsatility index (ratio of peak flow to trough flow) and standard deviation of blood flow were calculated to evaluate the pulsatility of blood flow. Mean vascular resistance (MVR) was calculated as MVR = mean blood pressure/mean blood flow. Blood pulse pressure, pulsatility index and standard deviation of blood pressure were elevated from 30 +/- 9 mmHg, 1.26 +/- 0.05 and 8.7 +/- 2.5 mmHg to 43 +/- 8 mmHg (P < 0.05), 1.54 +/- 0.13 and 12.4 +/- 2.0 mmHg (P < 0.05) before and during EECP, respectively. Blood pulse flow, pulsatility index and standard deviation of blood flow were elevated from 317 +/- 48 ml/min, 2.85 +/- 0.21 and 96 +/- 21 ml/min to 447 +/- 88 ml/min, 4.56 +/- 0.90 and 131 +/- 39 ml/min before and during EECP (P < 0.05). MVR was decreased from 578 +/- 72 before EECP to 476 +/- 85 Wood units during EECP(P < 0.05). These data demonstrate that EECP gives an elevation of pulsatility to blood pressure and blood flow, thus it may lead to the decrease of vascular resistance.
Animals ; Blood Pressure ; Carotid Arteries ; physiology ; Counterpulsation ; Dogs ; Hemodynamics ; Pulsatile Flow ; Regional Blood Flow ; Vascular Resistance

Pulsatile blood flow plays an important role in maintaining normal vascular endothelial function. Quantitative measurement of pulsatility of human arterial blood pressure and the influence of enhanced external counterpulsation (EECP) on the pulsatility were investigated in this study. Eight healthy young male volunteers aged 22 to 35 were included. A 4F tip transducer catheter was inserted under local anaesthesia into the radial artery up to the aortic arch. Intraarterial blood pressure was recorded before and during EECP. Blood pulse pressure, pulsatility index (ratio of peak pressure to end diastolic pressure) and standard deviation of blood pressure in 5 cardiac cycle was calculated to evaluate the pulsatility of arterial blood pressure. The results showed that blood pulse pressure, pulsatility index and standard deviation of blood pressure were elevated from 47 +/- 5 mmHg, 1.64 +/- 0.11 and 13.6 +/- 1.5 mmHg to 77 +/- 3 mmHg, 2.46 +/- 0.25 and 19.3 +/- 2.2 mmHg before and during EECP respectively (P < 0.05). Decreasing of systolic pressure and increasing of diastolic pressure during counterpulsation were also observed. EECP gives an elevation of pulsatility to human blood pressure.
Adult ; Blood Pressure ; physiology ; Blood Pressure Determination ; Counterpulsation ; Humans ; Male ; Pulsatile Flow

Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.

Antimicrobial resistance of Neisseria gonorrhoeae has become a big challenge in the control and prevention of sexually transmitted diseases. Recently, a ceftriaxone-resistant Neisseria gonorrhoeae strain FC428 has spread across the world including China, which has worsened the antimicrobial resistance problem. This strain is highly resistant to ceftriaxone due to a novel mosaic penA gene. In order to better understand the characteristics of FC428 and control its further spread, this review summarizes its origin, spread, main molecular characteristics, resistance mechanisms, detection methods, and strategies for clinical treatment and antimicrobial resistance surveillance.