Objective: To evaluate the effect of postoperative chemotherapy on bone density change in the patients with breast cancer and the therapeutic effect of 99 TC-MDP.Methods: Totally 58 breast cancer patients with postoperative chemotherapy were se-lected, and the changes of bone density , blood calcium element (BGP), alkaline phosphatase (ALP) and 24 h urinary calcium levels were observed .After the chemotherapy , the osteoporosis patients were divided into the control group and the observation group , and the control group was given calcium carbonate D 3, while the observation group was given calcium carbonate D 3 combined with 99 TC-MDP. The bone density , BGP, ALP and 24 h urinary calcium levels were compared between the two groups .Results:After the chemothera-py, the bone mineral density of lumbar vertebra and thighbone was decreased significantly , BGP, ALP and 24 h urine Ca were in-creased significantly, and compared with those before the treatment , the differences were statistically significant (P<0.05).After the 3-course postoperative chemotherapy , the incidence of osteoporosis was 22.4%(13/58), and after the six-course chemotherapy, the incidence of osteoporosis was 39.7%(23/58).The bone mineral density of lumbar vertebra and thighbone in the observation group was increased significantly , BGP, ALP and 24 h urine Ca were decreased significantly , and compared with those in the control group , the differences were statistically significant (P<0.05).Conclusion: Postoperative chemotherapy for breast cancer can lead to reduced bone density , and 99 TC-MDP in the treatment of osteoporosis induced by breast cancer postoperative chemotherapy is safe and effective .

Objective To explore the evaluation of contrast enhanced CT with multi -direction adjusting multi -planar reformation(MPR)on the stomach wall invasion of advanced gastric cancer.Methods 105 cases of advanced gastric cancer proved by pathology after surgery were checked by contrast enhanced CT before surgery.All the images were reconstructed by multi -direction adjusting MPR to show perfectly the lesions of gastric cancer,T stage diagnosed by CT were compared with the T stage diagnosed by pathology.Results T1,T2,T3,T4 stage diag-nosed by pathology were 9 cases,23 cases,46 cases and 27 cases respectively,the accuracy of multi -direction adjus-ting MPR in diagnosing T1,T2,T3,T4 stage were 98.1%,93.3%,86.7%,91.4% respectively.Conclusion Con-trast enhanced CT with multi -direction adjusting MPR can improve the accuracy in diagnosing the T stage of ad-vanced gastric cancer,which can be used to evaluate the staging of advanced gastric cancer.

Objective To study the inhibitory effects of gene combined radiotherapy on mice transplanted with B16 melanoma.Methods Alkaline lysis assay was used to extract and purify the plasmid.Plasmid DNA was injected into tumor by microinjection assay.Mice were inoculated with 5?10~5 of B16 melanoma in right hind legs and the therapy was performed when the diameter of tumor reached at 0.30.5 cm.pNE-mIL-12 and pcDNA-B7-1 plasmids were injected locally three times following with irradiation three times.The tumor growth rate of mice was observed.Results The anti-tumor effect of pNE-mIL-12 combined with pcDNA-B7-1 plasmid following with 2 Gy X-ray irradiation was much better than other groups.It showed that the tumor growth rate was slowed,the survival days of mice were delayed significantly(P

Objective To investigate the evaluation of plasma osteoprotegerin (OPG) measurement for assessing the prognosis of intermediate coronary lesions in elderly patients.Methods We retrospectively analyzed patients met the inclusion criteria of suspicious chest pain or confirmed coronary artery disease (CHD),and intermediate stenosis lesions (20 ％ ～ 70 ％) in 3 main coronary arteries served as target vessels for qualitative comparative analysis (QCA).Plasma OPG level was detected by protein array method,and the concentration of hypersensitive C-reactive protein (hs-CRP)was determined by enzyme-linked immunosorbent assay(ELISA).Clinical endpoints were followed up.Results A total of 890 patients with intermediate coronary stenosis were enrolled in this study,and were divided into＜60 years of age group(n＝370)and ≥ 60 years of age group(n＝520).There were statistical differences in age,smoking history,hypertension history,triglycerides (TG),high-density lipoprotein cholesterol(HDL-C),white blood cell count,OPG,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI)between the two groups.The morphological indices in coronary lesions assessed by QCA had no differences between the two groups.During a median of 24 months of follow-up,58 patients(l1.2％)had clinical endpoints events.Age,smoking history,hypertension history,TC,TG,HDL-C,white blood cell count,levels of OPG above-median,hs-CRP,SBP,DBP,and BMI were used as the independent variables,and the clinical end events as the dependent variable.Forward stepwise logistic regression analysis showed that HDL-C,levels of OPG above-median,hs-CRP were the independent risk factors in elderly patients.The risk of cardiovascular events in patients with levels of OPG above-median was 2.510 fold higher than those with levels of OPG below-median.Conclusions The high levels of OPG and hs-CRP are the independent risk factors for the occurrence of coronary heart disease in the elderly with intermediate coronary lesions.

Objective To study the role of maintaining ventilator tubing at low position in prevention of ventilator-associated pneumonia (VAP).Methods From January 2010 through December 2011,110 cases with invasive mechanical ventilation in Intensive Care Unit (ICU) were randomly divided into observation group (n =55) and control group (n =55).The patients of control group were given conventional prevention method including the head elevated 30°-45°.The patients of observation group were given prevention method of keeping ventilator tubing at low position in addition to conventional prevention method so as to avoid the condensate in ventilator tubing into the airway.After mechanical ventilation support for 28 days,the incidence of VAP,duration of mechanical ventilation,length of ICU stay,incidence of condensate flowing back,clinical pulmonary infection score (CPIS) and mortality were respectively recorded.At the same time,risk of mistakenly extubation by nurses was recorded.Results The comparison between two groups showed the incidence of VAP (16.36％ vs.34.55％),duration of mechanical ventilation (5.86 ± 2.66) d vs.(11.24 ± 3.80) d,length of stay in the ICU (13.60 ± 4.83) d vs.(19.58 ±5.27) d,incidence of condensate backflow (3.64％ vs.49.09％),presenting significant differences between two groups (P ＜ 0.05).The CPIS of observation group was lower than that of the control group (P ＜0.05),and the mortality in observation group (21.82％) was lower than that in the control group (27.27％),but the difference was not significant (P ＞0.05).There was no statistically significant difference in risk of mistakenly extubation between two groups (P ＞ 0.05).Conclusion Maintaining the ventilator tubing at low position can reduce the incidence of VAP,improve the prognosis,and the risk of mistakenly extubation did not increase compared with the conventional methods

AIM: To explore the effect of melatonin (MLT) on the apoptosis of thymocytes and splenocytes in mice induced by ionizing radiation and its mechanism. METHODS: The percentages of apoptotic bodies and the DNA lytic rates of thymocytes and splenocytes in mice in vitro and in vivo were detected with flow cytometry and fluorospectrophotometry, respectively. RESULTS: The apoptosis of mouse thymocytes and splenocytes in vitro increased with significant dose-dependence in 0 5-6 0 Gy X-irradiation. When MLT of 2 mmol?L -1 was added into thymocytes or splenocytes in vitro before irradiation with 0 5-6 0 Gy X-rays, the percentages of apoptotic bodies and the DNA lytic rates all decreased significantly as compared with those in the irradiation group. The percentages of apoptotic bodies in these two kinds of cells were 86 25% and 89 22% of those in the irradiation group, respectively, and the DNA lytic rates were 87 23% and 89 16%, respectively. When MLT was injected into intraperitonium in mice 60 min before whole-body irradiation with 2 Gy X-rays, the percentages of apoptotic bodies and the DNA lytic rates were significantly lower than those in the irradiation group, and near or lower than those in the sham-irradiation group. MLT of 0 1-2 5 mg/kg decreased the lymphocyte apoptosis, but without significant dose-dependence. CONCLUSION: The protective effects of MLT on mouse lymphocytes damaged by irradiation in vivo are obvious than those in vitro. [

Objective To investigate the effect of early using periplaneta americana extract on gastrointesti-nal function in critically patients with infection,and to evaluate its possible mechanism.Methods 66 patients with infection in Intensive Care Unit(ICU)were divided into control group and treatment group(33 cases in each group) according to the random number table.All patients in the two groups were given conventional cluster treatment,the patients in the treatment group additionally received periplaneta americana extract.At the beginning of treatment and 3,7 and 10 days after treatment,the indicators of bowel sounds,gastrointestinal function,APACHEⅡ and blood lactic acid level were respectively tested or recorded.Results At the beginning of treatment,there were no statistically sig-nificant differences between the two groups in terms of gastrointestinal function,bowel sounds,APACHE II score and blood lactic acid level(t =0.132,0.201,0.329,0.190,all P >0.05).3,7 days after treatment,the gastrointestinal function[(1.56 ±0.49)points vs.(1.32 ±0.45)points,(1.27 ±0.44)points vs.(1.02 ±0.42)points],bowel sounds[(1.58 ±0.76)times/min vs.(2.27 ±0.75)times/min,(2.15 ±0.91)times/min vs.(3.11 ±0.97)times/min],APACHE II score[(19.61 ±4.02)points vs.(17.50 ±4.37)points,(17.69 ±3.94)points vs.(15.24 ± 3.82)points]and blood lactic acid level[(2.94 ±0.88)mmol/L vs.(2.45 ±0.75)mmol/L,(2.51 ±0.59)mmol/L vs.(2.20 ±0.55)mmol/L],the terms in the treatment were better than those in the control group,the differences were statistically significant(t3 =2.072,t7 =2.361;t3 =3.712,t7 =4.146;t3 =2.041,t7 =2.565;t3 =2.434,t7 =2.208,all P <0.05).Conclusion Early using periplaneta americana extract has protective effect on gastrointestinal function in critically patients with infection,and improve the condition in a certain degree.

OBJECTIVETo determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.

METHODSSince 1996 to 2002, 30 consecutive patients underwent ablation procedures for isthmus-dependent atrial flutter. There were 23 males and 7 females [mean age (47.85 +/- 9.35) years]. With the use of fluoroscopic view of anatomy, radiofrequency ablation was performed during coronary sinus pacing at a cycle length of 600 ms.

RESULTSBidirectional block was achieved with ablation in 29 (97%) of 30 patients. The transisthmus intervals before ablation and after complete transisthmus block were (73.82 +/- 13.01) ms and (140.47 +/- 20.48) ms, respectively, in the clockwise direction (P < 0.0001), and (77.63 +/- 8.36) ms and (138.17 +/- 15.55) ms, respectively, in the counterclockwise direction (P < 0.0001). A period of incomplete isthmus block was observed during 17 (58%) of the 29 ablation procedures. The clockwise transisthmus intervals during incomplete block [(107.65 +/- 21.33) ms] were (45.5 +/- 8.7)% longer than the baseline transisthmus intervals. An increase in the transisthmus interval by > or = 50% in both directions after ablation predicted complete bidirectional block with 100.0% sensitivity and 83.3% specificity. The positive and negative predictive values were 90.6% and 100.0%, respectively. The diagnostic accuracy of a > or = 50% prolongation in the transisthmus interval was 83.3%.

CONCLUSIONThe analysis of transisthmus interval is a valuable method for determining complete bidirectional isthmus block.

Atrial Flutter ; diagnosis ; surgery ; Catheter Ablation ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate the regulatory mechanism of bone marrow mesenchymal stem cells(BMSC) on the biological profiles of KATO-III( cell lines of gastric cancer.

METHODSTranswell cubicle was applied to build the co-cultured model in non-contact style. The differences of cell proliferation and the resistance of anti-tumour drug (5-fluoropyrimidinedione, 5-FU and Cisplatin, CDDP) between co-cultured group and single cultured group were evaluated by Cell Counting Kit 8-assay(CCK-8). The invasion ability was detected by Transwell assay. The expressions of stem cell makers, apoptosis-related factors and epithelium-mesenchymal transition (EMT)-related factors were detected by RT-PCR.

RESULTSThe proliferation ability of KATO-III( cells in co-cultured group was significantly stronger than that in single cultured group. The growth rate of KATO-III( cells in co-cultured group was significantly higher than that in single cultured group after treatment of 5-FU and CDDP(P<0.05). The mRNA expression level of Bcl-2 was significantly higher in co-cultured group KATO-III( cells(P<0.05), while the mRNA expression level of Bax was significantly lower in co-cultured group KATO-III( cells(P<0.05) in comparison with those in single cultured group. As compared to KATO-III( cells in single cultured group, the number of infiltrating-membrane cells was significantly higher (37.33±5.22 vs 14.56±2.54, P<0.01) in co-cultured group, and the mRNA expression levels of Snail and N-cadherin were significantly higher in co-cultured group KATO-III( cells (P<0.05), while the mRNA expression level of E-cadherin was significantly lower in co-cultured group KATO-III( cells (P<0.05). The expressions of CD133, Nanog and Sox-2 mRNA in co-cultured group KATO-III( cells were significantly higher than those in single cultured group(P<0.05).

CONCLUSIONSIn co-cultured model sharing non-contact style, BMSC can enhance such properties of KATO-III( gastric cancer cells as the proliferation, the invasion and the chemoresistance. Furthermore, the regulatory mechanisms may be related to the increase of the expressions of some stem cell markers in gastric cancer cells.

Antineoplastic Agents ; Apoptosis ; Bone Marrow Cells ; Cadherins ; Cell Line, Tumor ; Cell Proliferation ; Cisplatin ; Coculture Techniques ; Epithelial-Mesenchymal Transition ; Fluorouracil ; Humans ; RNA, Messenger ; Stem Cells ; Stomach Neoplasms

Objective: To compare the long-term clinical outcomes of consecutive patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention(PCI) with drug-eluting stents (DES) for bifurcation lesions in unprotected left main coronary artery (ULMCA). Methods: A total of 663 consecutively patients with unprotected left main bifurcation disease (defined as stenosis≥50%) who received either drug-eluting stents (DES) implantation (n=316) or underwent CABG (n=347) between January 2003 and July 2009 in Beijing Anzhen Hospital were enrolled retrospectively in this study.The endpoints of the study were death, repeat revascularization, myocardial infarction (MI), stroke, the composite of cardiac death, MI or stroke and MACCE (major adverse cardiac and cerebrovascular events, the composite of cardiac death, MI, stroke or repeat revascularization). To reduce the bias between two compared groups , our study applid propensity score matching by logistic regression.Cumulative survival rate was calculated by Kaplan-Meier method.Multiple regression analyses, hazard ratio(HR) and 95%CI were tested by Cox proportional hazard models with the CABG group as the reference category. Results: The median follow-up was 7.2 years (interquartile range 5.1 to 8.3 years) in the overall patients.Unadjusted analysis showed that MACCE rate (PCI 44.5% vs. CABG 45.7%, P=0.036), the rate of repeat revascularization (PCI 33.7% vs. CABG 19.5%, P<0.001), the composite rate of serious outcomes (cardiac death, MI or stroke) (PCI 20.4% vs. CABG 34.3%, P=0.032), stroke rate (PCI 3.7% vs. CABG 23.5%, P<0.001) were significantly different for patients undergoing PCI or CABG. Death rate (PCI 13.0% vs. CABG 18.9%, P=0.12) and MI rate (PCI 11.3% vs. CABG 6.1%, P=0.108) were similar between PCI and CABG group.After adjusting covariates with multivariate Cox hazard regression model, there was no significant difference in rates of death (P=0.286), MI(P=0.165) and the composite rate of serious outcomes (cardiac death, MI or stroke) (P=0.305) between the two groups. Patients in PCI group suffered significant higher rates of MACCE(P=0.011), mainly driven by the significant higher rates of repeat revascularization(HR=2.46, 95%CI 1.662-3.642, P<0.001). However, stroke rate was still significantly higher in CABG group than in PCI group(P=0.001)after multivariate adjusting. After propensity score matching (PSM), there was no more significant difference for all covariates in the matched cohorts (202 pairs). Further PSM analysis showed that overall findings were consistent with multivariate Cox hazard regression model except for MI (PCI 12.7% vs. CABG 3.8%, P=0.039). Conclusions During a follow-up up to 8.3 years, the survival rate is similar between the PCI and the CABG group in patients with unprotected left main bifurcation disease.The rate of repeat revascularization is significantly higher whereas stroke rate is significantly lower in the PCI group compared to CABG group.After propensity score matching, PCI group not only had a significant higher rate of repeat revascularization, but also had significantly higher risk of MI in the matched cohorts; while they did not seem to translate into any disparity of mortality in ULMCA bifurcation disease patients.Accordingly, PCI for ULMCA disease can be used as a reasonable treatment option alternative to CABG.