Endodernal sinus tumors(EST) are generally recognized as a germ cell tumors with extraembryonicdifferentiation that resemble the endodermal sinus of the rat placenta. Like other germ cell tumors the primaryEST may either occur in the gonads or in specific extragonadal sites. CT is the most accurate study in delineatingthe extent of primary and metastatic lesions particularly in the pelvis. Recently authors experienced six cases ofthe pathologically proven extragonadal endodermal sinus tumors in children and retrospectively analyzed theradiological findings including the CT. The results were as follows: 1 Of the 6 cases of extragonadal EST, theprimary lesion presented in the sacrococcygeal region in 5 patients and liver in one patient. 2. There were 4females and 2 males. Of the sacrococcygeal lesions 3 were females and 2 were males. 3. The age of presentationranged from 9 months to 3 years of age(mean age=21 months) 4. Conventional radiographic study of thesacrococcygeal lesion showed presacral, retrorectal soft tissue mass without calcification which extended into thebuttock. CT revealed well circumscribed enhancing soft tissue mass with irregular central low density areas. 5.Primay EST of the liver revealed ill-defined inhomogeneous mixed echogenic mass( ultrasound) and ill-defined lowdensity mass(CT). Angiography showed hypervascular mass with areas of necrosis and no evidence portal veininvasion. A-V shunting was not present. 6. Reginal lymph node metastasis was present at the time of diagnosis in 2cases of sacrococcygeal EST. 7. Local recurrence of tumor was noted in 2 patients with sacrococcygeal lesion aftersurgery and chemotherapy.
Angiography ; Animals ; Child ; Diagnosis ; Drug Therapy ; Endoderm ; Endodermal Sinus Tumor ; Female ; Gonads ; Humans ; Liver ; Lymph Nodes ; Male ; Necrosis ; Neoplasm Metastasis ; Neoplasms, Germ Cell and Embryonal ; Pelvis ; Placenta ; Rats ; Recurrence ; Retrospective Studies ; Sacrococcygeal Region

Objective:To analyze the effect of morphine hydrochloride sustained-release tablets given by different administration routes on patients with cancer pain.Methods: Chosen patients with cancer pain as research subjects, underwent morphine hydrochloride sustained-release tablets for treatment of pain, randomized to receive oral administration as control group and rectally administration as observation group, observed pain relief degree, onset time of analgesia and adverse reaction rates.Results:1)After treatment, the observation group patients’ overall response rate was 94.05%,no significant difference compared with the control group; 2) After treatment, the observation group patients had a mean onset time (0.68 ±0.17) h, significantly shorter than the control group,0.5h, 1h, 2h, 4h of onset percentages of analgesia were higher than control group; 3)After treatment, the observation group patients’ incidence of adverse reactions was 2.38%, significantly lower than the control group.Conclusion: The morphine hydrochloride sustained release tablets rectal administration route can significantly alleviate cancer pain, shorten onset time of analgesia, and don’t increase the incidence of adverse reactions.

No abstract available.
Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans

Aim To produce poly (lactic-co-glycolic acid) (PLGA) microspheres, containing a staphylokinase variant (K35R, DGR) with reduced immunogenecity and antiplatclet aggregation activities,which allowed the preservation of protein stability during both particle processing and drug release.Methods DGR-loaded microspheres were fabricated using a double emulsion-solvent evaporation technique. The effects of preparative parameters, such as stirring rate, polymer concentration, and the excipients of both internal and external aqueous phase (W2 ), on DGR encapsulation efficiency and microsphere characteristics were investigated. In vitro and in vivo release of DGR were conducted and the cause for instability of DGR during release was also investigated. Results Moderate ultrasonic treatment of aqueous DGR/dichloromethane mixtures caused approximately. Eighty four per cent DGR denaturation.However, the activity recovery of DGR almost amounted to 100% when 2% polyvinyl alcohol (PVA) was added into the aqueous phase. It was found that NaCl in the external water phase significantly increased DGR encapsulation efficiency. Furthermore, NaCl in the external water phase played a role in determining size and surface morphology of microsphere. In vitro release test showed a burst release of DGR from microspheres, followed by sustained release of 50% total activity over 15 days. In vivo experiments showed that DGR released from microspheres sustained 5 days. Denaturation of DGR within microspheres might be resulted from acidic microclimate. Conclusion The stability of DGR was effectively protected during microencapsulation and a relatively high encapsulation efficiency of DGR was obtained. PLGA microspheres could be an effective carrier for DGR.

To investigate the effect of naringenin on ovariectomy-induced postmenopausal osteoporosis comprehensively and systemically, thirty-two virgin Sprague-Dawley rats about 3-month-old were used and randomly divided into 4 groups: sham control group (Sham), OVX control group (OVX), naringenin treatment group and 17β-estradiol (E2) treatment group. After 12 weeks treatment with different drugs, 24 h urine were collected, organs were weighed and the organ indies were computed. Uterine pathological changes were observed by making paraffin section. Biochemical parameters and bone turnover markers: serum osteocalcin (BGP) and urine deoxypyridinoline (DPD) were analyzed with automatic biochemical analyzer or ELISA assay. Bone mineral density (BMD) and bone mineral content (BMC) were analyzed by DEXA, bone biomechanical properties was measured by three point bending test and the trabecular bone microarchitecture was evaluated by Micro CT. From the results, we can see that: the gaining of weight and the increasing of bone turnover markers such as serum BGP and urinary DPD could be inhibited by naringenin. The treatment could also enhance the bone strength and prevent the deterioration of trabecular microarchitecture, increase the bone volume, trabecular number and thickness, and decrease the trabecular space. The effects mentioned above were not accompanied with stimulating effects on uterus. Long-term using of naringenin had no obvious influence on other organs and the liver and kidney functions. The study suggests that naringenin had obvious antiosteoporotic effect on ovariectomized rats and it had the potential value for the treatment of postmenopausal osteoporosis.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.

Purpose To purify recombinant angiogenesis inhibitor r-K4K5 and investigate its inhibitoryeffects on bovine capillary endothelial (BCE) cell proliferation, chick embryo chorioallantoic membrane(CAM) angiogenesis and growth of experimental human non-small cell lung cancer (adeno). Methodsr-K4K5 was obtained by salting out and gel filtration with the purity of 95% determined by SDS-PAGE.BCE cells were cultured with DMEM media containing r-K4K5. The cells were counted in 24,48,72 hrespectively. r-K4K5 was injected daily into all 7-day chick embryo CAMs and CAM angiogenesis wasobserved at 72 h after incubation. The Balb/c (nu/nu) mice implanted with human SPC-Al tumor pieceswere grown for 10 days and then randomly divided into three groups. One group was treated with PBS, theother two groups were treated with local subcutaneous injection of purified r-K4K5 at 8 μg and 80 μg lpermouse every other day. They were daily observed and sacrificed in 14 days. Each tumor was weighed.Results The number of BCE cells, blood vessels diameter less than 50 μn of chick embryo CAM and theaverage weight of experimental tumor were decreased markedly in all the groups treated with r-K4K5.Conclusions r-K4K5 inhibits proliferation of BCE cells, angiogenesis of chick embryo CAMs and thegrowth of experimental human SPC-A1 non small lung cancer (adeno).

Objective To improve the awareness,diagnosis and treatment of pneumocystis carinii pneumonia (PCP) after renal transplantation.Methods A retrospective review was performed in 28 patients who underwent renal transplantation and developed PCP afterwards.The main clinical manifestations were fever(28 cases),nonproductive cough(28 cases),chest distress (12 cases).Occurrences of PCP were described 1.5 to 7 months after the renal transplantation.There were 10 patients treated with tacrolimus (FK506 2-6 rag/d,FK506 concentration 4-10 ng/ml) and 18 patients treated with cyclosporine (CsA 200-500 mg/d,CsA trough level:150-250 ng/ml) based immunosuppressive regimen.Anti-CD_(25)~+ monoclonal antibody (anti-CDCD_(25)~+mAb) was used in 10 cases for immune induction before operation while single steroid in 18 cases.Creatinine of patients with PCP was 70 to 106 μmol/L.CD_4~+ lymphocyte counts of the peripheral blood were 245±32/μl before PCP treatment and 536±25/μl after recovery.The most abnormal chest radiological findings were bilateral patchy ground-glass opacity.All the patients were diagnosed with PCP by bronchoalveolar lavage.Treatment was performed by reducing immunosuppressive agents and giving SMZco.Nineteen patients who had a PaP2 less than 70 mm Hg were given intravenous small-dose steroid.Results All the patients recovered from PCP 2 to 3 weeks after treatment.One patient experienced recurrence half year later.Five patients with higher creatinine after treatment recovered to normal levels after stopping the treatment of SMZco.No significant differences were seen in PCP patients treated with CsA and FK506,P＞0.05.The similar results were observed in use of anti-CDCD_(25)~+ mAb and single steroid,P＞0.05.Significant differences were observed in PCP patient peripheral blood CD_4~+ lymphocyte counts before and after treatment (P=0.001).Conclusions Patients who have fever,cough and hypoxia,chest imaging showing bilateral lung interstitial inflammation,might be PCP patients in the early post-renal transplantation period.Effective treatment should be performed by reducing immunosuppressive agents and giving SMZco.

Objective To research the feasibility and accuracy on echocardiography measurement aortic annulus diameter(AAD)at the plane of three Junctions of aortic valve leaflets by real-time three-dimensional transesophageal echocardiography(RT-3D-TEE).Methods Twenty-three patients underwent echocardiography and aortic valve replacement because of acquired aortic valve disease.The AAD was measured in parasternal left ventricle long axis view(TTE-AAD)by transthoracic echocardiography(TTE)preoperative.The AAD was measured in left ventricle long axis view(TEE-AAD)and the distance of three iunctions of aortic valve leaflets (N,L,R) was measured in aortic short axis view by RT-3D-TEE intraoperative.The three-dimensional full volume images were analyzed by online QLAB 7.0 software.The AAD was measured by standard cylindrical valve sizer (OP-AAD)before aortic valve replacement surgery,too.Results Comparing with the three aortic valve leaflets of acquired aortic valve disease,the lines between their junctions constituted an approximate equilateral triangle regardless of the cause and degree of disease,and the length of the three groups was no significant difference(P>0.05).There was no significant difference between TTE-AAD and OP-AAD group(P>0.05),and the correlation was good(r=0.84).The N,L and R group compared separately with the OP-AAD group, there was no significant difference(P>0.05)and correlation was superior to TTE-AAD group(r=0.94, 0.97, 0.96).The difference between TEE-AAD and OP-AAD were significant(P<0.01).Conclusions Echocardiography measurement of AAD at the plane of three junctions of aortic valve leaflets is feasible,and it is better accuracy and repeatability comparing with parasternal left ventricle long axis view.

Adult ; Female ; Humans ; Male ; Middle Aged ; Palatine Tonsil ; surgery ; Tonsillectomy ; instrumentation ; methods