BACKGROUND: Interleukin-6 (IL-6) is a cytokine produced in the process of organic immune activities. The problems still need further exploration, including whether the changes of serum level of IL-6 after clozapine treatment ware induced directly by the drug, and whether IL-6 is directly correlated with the changes of the psychiatric symptoms in female patients.with first-episode schizophrenia.OBJECTIVE: To explore the changes of the serum level of IL-6 and its relation with the dose of clozapine and the amelioration of the symptoms in female patients with first-episode schizophrenia.DESIGN: A non-randomized case-control observation synchronically.SETTING: Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College.PARTICIPANTS: Twenty female patients with first-episode schizophrenia (patient group) were selected from Henan Psychiatric Hospital. They all met the diagnostic standards of schizophrenia in the 3rd edition of Chinese Classification and diagnostic criteria of Mental Disorders (CCMD-3), their score of positive and negative syndrome scale (PANSS)was above 60 points, and had not been treated or at least not taking medicine for 2 weeks during clinical treatment.Patients with physical disease, endocrine and immune system diseases, malnutrition and other mental problems, those with the history of being allergic and hormone treatment, those receiving immune pharmaceutical treatment, and recently having been vaccinated preventively, and the pregnant and breast-feeding women were excluded. Twenty healthy female volunteers, who had no significnat difference in age and gender from the subjects in the patient group,were taken as the control group, and the exclusive standards were the same as those in the patient group. All the subjects were enrolled with the approval of themselves and their guardians.METHODS: All the patients were adminsitrated with clozapine only, with the dose being added by 25-50 mg per day,and the maximal dose was reached within 3 weeks. The principle for the administration was the maximal effectiveness and the minimal side effect. ① Serum level of IL-6 in the patient group was detected using enzyme-linked immunoabsorbent assay (ELISA) before treatment and at 1, 2 and 4 weeks after treatment respectively. ② High performance liquid chromatography (HPLC) was used to determine the content of clozapine, and the levels of IL-6 in serum of the controls were taken as controls. ③ Correlations were analyzed in the patient group between the serum level of IL-6 before treatment and at 1, 2 and 4 weeks after treatment and the PANSS scores (scores of positive and negative symptoms, and general pathology, and the total score) at corresponding time points.MATN OUTCOME MEASURES: ① Serum levels of IL-6 before treatment and at each time point after treatment; ②Correlation analysis between the serum levels of IL-6 and clozapine content; ③ Correlation analysis between changes of schizophrenic symptoms and serum levels of IL-6.RESULTS: ① Serum level of IL-6 before treatment in the patient group was significantly higher than that in the control group [(137.72±18.84), (65.05±20.95) ng/L, t =11.53, P ＜ 0.01], those in the patient group at 1, 2 and 4 weeks after treatment were significantly lower than that in the control group [(28.11±5.42), (8.48±1.14), (13.90±2.55), (65.05±20.95) ng/L, t =7.63, 12.01, 10.84, P ＜ 0.01]. ② Correlation analysis between the serum levels of IL-6 and clozapine content: The results showed that the serum level of IL-6 had no significant correlation with the clozapine content at 1, 2and 4 weeks after treatment (r =-0.15, 0.12, -0.29, P ＞ 0.05). ③ Correlation analysis between IL-6 level and schizophrenic symptoms: In the patient group, there was significant positive correlation before treatment between the serum level of IL-6 and the score of positive symptoms (r=0.386, P＜ 0.01), and there was no significant correlation between the serum level of IL-6 and the total scores of PANSS and each factor scores at 1, 2 and 4 weeks after treatment (r=0.136-0.237, P ＞ 0.05).CONCLUSION: The serum level of IL-6 in female patients with first-episode schizophrenia was higher than that in healthy females, and it could be decreased by clozapine, and the amelioration of the schizophrenic symptoms had no significant correlation with the changes of IL-6 levels.

OBJECTIVETo investigate the tumor proliferation and apoptosis changes after preoperative hepatic and regional arterial infusion chemotherapy (PHRAIC) after radical colorectal cancer resection.

METHODSFive hundred and nine patients with stage II or stage III colorectal cancer from June 2001 to June 2007 were randomly assigned to PHRAIC group (n = 256) or control group (n = 253, surgery alone). Tumor proliferation and apoptosis index were evaluated in tumor tissues of the control and PHRAIC group (pre and after intervention). The survival rates were also recorded in the two groups.

RESULTSThere was no significant differences in sex, age, tumor location, tumor size, tumor stage, tumor differentiation and follow-up time for the two groups (P > 0.05). There was no significant differences in all the evaluation factors between the control group and PHRAIC group before intervention (P > 0.05). Before and after intervention for PHRAIC group: stage 3 necrosis rate were 3.1% and 22.7%, stage 4 necrosis rate were 0 and 13.5% (P < 0.05); label index of Ki67 were 48.6 +/- 17.1 and 38.4 +/- 13.3 (P < 0.05); expression rate of Bax, bcl-2 and survivin were 48.0% vs 77.0%, 75.0% vs 43.0%, 52.0% vs 31.6%, respectively (P < 0.05); apoptosis rate were 4.3% +/- 2.2% and 16.7% +/- 6.4%(P < 0.05). In the PHRAIC group, 42.1% +/- 11.2% of the cells in the tumor tissue were in S phase before intervention and the rate fell to 21.8% +/- 10.7% after intervention (P < 0.05); and G0-G1 phase rate of the group pre and post intervention were 35.1% +/- 12.1% and 57.1% +/- 18.1% (P < 0.05). All the patients were followed-up for a mean time of 42 +/- 14 months. For patients with stage III tumor in PHRAIC group and control group, the 5-year liver metastasis rate were 18.9% and 27.3% (P = 0.033), recurrence and metastasis rate were 26.3% and 38.0 (P = 0.024), overall survival rate were 81.0% and 60.4% (P = 0.011), median survival time were 45 and 40 months (P = 0.02); no significant differences of aforementioned factors was found in patients with stage II tumors between the two groups.

CONCLUSIONThe schedule of preoperative hepatic and regional arterial infusion chemotherapy before surgery can restrain proliferation, promote apoptosis and reduce liver metastasis and improve survival rate in stage III colorectal cancer.

Adult ; Aged ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; drug therapy ; pathology ; surgery ; Female ; Follow-Up Studies ; Hepatic Artery ; Humans ; Infusions, Intra-Arterial ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Preoperative Care ; Retrospective Studies

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.

Objective To investigate the prevalence of anxiety and depression among the persons with disabilities in Shanghai and the factors related to them. Methods From November to December, 2014, 731 persons with disabilities were consecutively enrolled in this cross-sectional study. They were assessed with Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS). Binary Logistic regression analysis was employed to reveal potential related factors of anxiety and depression. Results The prevalence rates of anxiety and depression among the disabled in Shanghai were 9.58%and 8.48%, respectively. The duration (OR=0.967, P<0.05) and severity (OR<1, P<0.05) of disability were associated with depression, whereas retiral (OR=2.047, P<0.05), living alone or in care unit (OR=3.073, P<0.01) and duration of disability (OR=0.956, P<0.01) were associated with anxiety. Conclusion The frequency of anxiety and depression is mild among the persons with disabilities in Shanghai, and a special intervention is needed.

Objective To investigate the value of partial hepatectomy and vascular resection in the treatment of hilar cholangiocarcinoma. Methods Seventy four patients with hilar cholangiocarcinoma who underwent hepatectomy of Chinese People' s Liberation Army from January 2008 through December 2011 were analyzed retrospectively.Results Of the 74 patients,33 underwent radical resection and 19 palliative resection,22 received internal or external drainage.In the radical resection group,the median survival time was 27 months,and the overall survival rate at 1,2 and 3 years were 79％,64％ and 49％.In the palliative resection group,the median survival time was 14 months and the overall survival rate at 1,2 and 3 years were 56％,25％,and 19％.In the drainage group,the median survival time was 9 months and the overall survival rate at 1,2 and 3 years were 23％,15％,0.Conclusions Hepatectomy combined with hilar vascular resection helps increase survival rate of patients in radical excision of hilar cholangiocarcinoma and Surgical resection is the most elective method for treatment of hepatic hilar cholangiocarcinoma,and the radical resection might improve the prognosis of the patients with hilar cholangiocarcinoma.

Objective To investigate the short term effect of licartin transarterial infusion in combination with chemoembolization (LTACE) and compare its effect with conventional transcatheter arterial chemoembolization (TACE) for advanced hepatocellular carcinoma (HCC).Methods Seventy-two cases of advanced HCC were included in this analysis.There were 50 males and 22 females with the average age of (58±12) yrs (range 34-86 yrs).Twenty-nine patients received LTACE treatment while the other forty three patients received conventional TACE treatment.Before intervention,there was no variation (P>0.05) in gender (X2 =0.202),Child-Pugh grading for hepatic function (X2=2.428),as well as in white blood cell count (t=1.101)and platelet count (t =0.080) between the two groups except for age and portal vein thrombosis.For LTACE group,30 minutes after the infusion of licartin (27.75 MBq/kg) into proper hepatic artery,an emulsion of 40 rag pharmorubicin and 30 ml uhrafluid lipidol was infused until hemostasis within target artery.For TACE group,only an emulsion of 40 nag pharmorubicin and 30ml uhrafluid lipidol was infused until hemostasis within target artery.Following these interventions,the two groups were given the same treatment to stabilize hepatic function and relief embolization-relating symptoms; Patients' follow-up included clinical symptoms and signs,hepatic and renal function,peripheral blood test,CT and radionuclide study(ECT).All data were analyzed with SPSS 11.5.Measurement data were expressed with mean and processed by t test; numeration data were processed by Chi square test and Fisher precise test; Kaplan-Meier analysis and log-rank test were applied for comparing the survival rate of the two groups.P <0.05 means the exist of a statistic variation.Results After treatment,there was no variation of Albumin,GPT,serum bilirubin,white blood cell,platelet and serum creatinine level between the two groups [t=0.250,0.907,0.629,0.005,0.250,0.453 (7 days) and 0.978,1.250,1.942,0.733,0.315,1.243 (14 days); P >0.05].ECT imaging demonstrated a 55.17% (16/29) uptake ratio of licartin within tumor areas by the time of 7-days follow-up study.The lesions in both LTACE and TACE groups exhibited a decrease in their size and statistically significant difference was demonstrated before and after treatment in either group( t=7.207,8.006,P <0.01).But between the two groups,the tumor size reduction showed no statistical difference,the tumor size in LTACE and TACE groups were( 1.68±0.32),(1.74±0.31)respectively (t =0.786,P>0.05)before treatment and(1.52±0.38),(1.61±0.36) respectively(t=0.891,P>0.05) after treatment.There was no variation between the two groups comparing the 6 months cumulative survival rate(LTACE 52%,TACE 76%,log-rank test,X2=3.080,P >0.05).Conclusion There was no statistically significant differences between LTACE and TACE groups concerning the short term effect and adverse reaction for treatment of advanced HCC.The long term outcomes should be established on the basis of a large-sample,multiconter,randomized trail.

ObjectiveTo evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell (UC-MSC) transplantations in decompensated liver cirrhosis patients with ascites.MethodsFifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group (n=38) and control group (n=16) in a prospective controlled single-blinded trial.UC-MSC (0.5-1.0) × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group,respectively.The liver function,hepatitis B virus (HBV) DNA level,ascites and the model for end-stage liver disease(MELD)scores at different time points were compared between two groups.The comparison between groups was done by Mann-Whitney U test,and the data before and after transplantations were compared by Wilcoxon signed rank sum test.ResultsThere were no significant differences of alanine transaminase (ALT),total bilirubin (TBil),cholinesterase (CHE),HBV DNA positive rate and MELD scores at different time points between two groups (P＞0.05).However, the albumin ( A1b)level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were (28.47±4.45)g/L at week 0 and ( 34.82±4.50)g/L at week 48 (P=0.046). Meanwhile, the ascites reduced markedly in treatment group with (46.6 ±30.6) mm at week 0 and (6.6±13.6) mm at week 48,which were significantly different from control group at the end of follow-up (P =0.037). Conclusion UC-MSC transplantations may help to increase A1b level and reduce ascites in patients with decompensated liver cirrhosis.

Objective:To investigate the effects of Liuweidihuang pill on the insulin levels in sera and pancreatic islets from spontaneous mouse models of human type 2 diabetes administrated with different doses .Methods:The 6-8 week-old KK-Ay mice were randomly divided into three groups including no drug control group ,low-dose group and high-dose group,in addition C57BL/6J mice were used as a genetic control group .All the animals were given with different dose Liuweidihuang pill solutions or sterile distilled water by intragastrical administration for fifteen weeks .The fasting blood glucose ,body mass and food consumption were measured weekly .The serum insulin levels were surveyed by ELISA .And the insulin levels in the pancreas islets were detected by immunofluorescence and immunohistochemistry .Results:Decreased fasting blood glucose ,controlled body mass and food consumption ,and lower levels of insulin in the sera and pancreas islets were confirmed from the KK-Ay mice administered with Liuweidihuang pill .Furthermore,the low dose program exhibits a stronger effect .Conclusion:Liuweidihuang pill has exhibited relatively therapeutic effects in the spontaneous type 2 diabetes mice including controls of hyperglycemia and body mass and relieving insulin resistance .In addition , the low-dose regimen showed even better treatment in controlling insulin levels in the sera and pancreas islets .

Ranpirnase (onconase, ONC) is a new drug, with weak RNase activity and strong cytotoxicity to various tumor cells in vitro and in vivo. This study is to obtain recombination onconase (rONC) with high bioactivity. Based on the codon preference of Pichia pastoris, we designed and synthesized the gene according to cDNA sequences of ONC and the α mating factor's prepeptide. We screened positive clones after transforming the recombination plasmids into P. pastoris X-33, GSS115 and SMD1168. We screened the best combination of seven different vectors and host strains. Moreover, we optimized culture condition in shake flasks and 10 L bioreactor, and purified rONC from the supernatant after inducing it with 0.25% methanol by aqueous two-phase extraction coupling G50 molecular exclusion method. The highest rONC production was 13 mg/L in pPICZα-A/X-33/ONC combination under the condition of pH 5.5 and 23 degrees C in shake flasks for 7 d; and that the highest rONC production was 180 mg/L when the induction is performed in the lower basic salt medium with pH 5.5 in the 10 L bioreactor for 7 d. The yield of rONC is more than 90% at a purity of above 95%. rONC can kill various tumor cells in vitro. The expression and purification of rONC would be useful for further investigation of this new drug.
Antineoplastic Agents ; metabolism ; Bioreactors ; Cell Line, Tumor ; Codon ; DNA, Complementary ; Genetic Vectors ; Humans ; Pichia ; metabolism ; Recombinant Proteins ; biosynthesis ; Ribonucleases ; biosynthesis

Adult ; Aged ; Female ; Humans ; Joint Instability ; complications ; diagnosis ; physiopathology ; surgery ; Lumbar Vertebrae ; pathology ; physiopathology ; Male ; Middle Aged ; Spinal Canal ; pathology ; physiopathology ; Spinal Stenosis ; complications ; diagnosis ; physiopathology ; surgery