Objective To evaluate the effects of fentanyl transdermal system on intractable postherpetic neuralgia .Methods 30 patients(after 1 course of conventional drugs with nerve block therapy ,VAS score>5 points)were randomly divided into tramadol group(group T ) and fentanyl group(group F) ,15 cases in each group .Results VAS of the two groups decreased after treatment (P<0 .05) ,group F decreased more significantly(P<0 .05) .The quality of life scores after treatment in two groups were signifi-cantly increased(P<0 .05) ,group F scoring was higher(P<0 .05) .The incidence of side reaction ,nausea and vomiting was lower in group F(P>0 .05) .The incidence of dysuria was 26 .67% in group T ,and there was no dysuria in group F(P<0 .05) .Constipation of group T was 40% after treatment(P<0 .05) .The incidence of somnolence of group F was higher than T group(P<0 .05) .The two groups were no respiratory depression .Conclusion Fentanyl transdermal system for intractable postherpetic neuralgia has good analgesic effect ,less side effect ,and well-tolerated .

BACKGROUND:Polysulfone membrane holds good anti-biodegradation ability, but how to use it to prepare hol ow fiber dialysis membrane and its blood compatibility have not been ful y understood. OBJECTIVE:To study the preparation, transfer property and biocompatibility of hol ow fiber dialysis membrane. METHODS:With polysulfone as the film material, diethylene glycol as the porogen, polyvinyl pyrrolidone as the modifier, N, N-dimethylacetamide as the solvent, and the hol ow fiber dialysis membrane was prepared using nonsolvent-induced phase separation. The performance was measured using scanning electron microscopy, ultra-depth three-dimensional microscope imaging and porosity test;the transfer parameters including reject rate and water flux were detected by ultrafiltration device;the blood compatibility was determined through hemolysis test, dynamic clotting time test and platelet adhesion test. Type II medical polyurethane material served as negative control. RESULTS AND CONCLUSION:The section of hol ow fiber dialysis membrane was asymmetric. 17%dialysis membrane showed a porous middle layer, while 19%, 21%and 23%membrane showed a sponge-like middle layer. Under the same membrane area, the density of fiber dialysis membrane was significantly lower than that of the negative control material, and the porosity of fiber dialysis membrane was significantly higher than that of the negative control material (P<0.05). The water volume and water flux of the hol ow fiber dialysis membrane were significantly higher than those of the negative control material (P<0.05). Results from three hemolytic tests showed that the average absorbance values and hemolysis rate of the hol ow fiber dialysis membrane were significantly higher than those of the negative control material (P<0.05). The dynamic clotting time test and the platelet adhesion test revealed that the dynamic clotting time of hol ow fiber dialysis membrane at 20, 40 and 70 minutes was significantly shorter than that of the negative control material (P<0.05). These results suggest that polysiloxane can be used as the membrane material to prepare hol ow fiber dialysis membrane using nonsolvent-induced phase separation, and holds a good biocompatibility, blood compatibility and transfer efficiency.

ObjectiveTo investigate the clinical significance and histological origin of glomerular epithelial proliferative lesion in patients with focal segmental glomerulosclerosis (FSGS). MethodsSeventy-four patients with idiopathic FSGS hospitalized in Peking University First Hospital from Jan. 2000 to Dec.2005 were enrolled in this study. Patients were classified into two groups according to with or without glomerular epithelial proliferative lesion. Estimation of active and chronic pathological scores was carried out using a semi-quantitative grade system by two pathologists. Clinical and pathological characteristics were compared between two groups. Immunohistochemical studies were performed to analyze the histological origin of glomerular epithelial proliferative lesion. ResultsThirty-one patients with glomerular epithelial proliferative lesion showed shorter interval from presentation to biopsy (P<0.05), higher percentage of nephrotic syndrome (NS) (P<0.05), higher frequency of segmental glomerulosclerosis(P<0.05), higher pathological active scores (P<0.05) and lower pathological chronic scores (P<0.05)as compared to 43 patients without glomerular epithelial proliferative lesion. Twenty-nine patients were followed up and renal survival rate in patients with glomerular epithelial proliferative lesion (39.7%) was significantly lower than that in patients without glomerular epithelial proliferative lesion (83.3%) (P=0.049). The frequency of glomerular epithelial proliferative lesion and the serum creatinine (Scr) level at biopsy were independent predictors of ESRD (OR value was 1.204, 1.008 respectively ). Glomerular epithelial proliferative lesion did not express mature podocyte markers including WT-1 and pedocalyxin, but stained positive for PCNA, PAX-2 and CK-8. ConclusionsGlomerular epithelial proliferative lesion represents the pathological change of acute stage and active lesion of FSGS, and also may be the pathological marker of severe clinical presentation and worse renal survival. Glomerular epithelial proliferative lesion may be derived from proliferation of parietal epithelial proliferation or de-differentiated podocytes.

Background In recent years,incidence of drug-induced keratopathy is increasing highly.Druginduced keratopathy is lack of typical clinical features and offen confused with the primary disease.Therefore,summarizing and concluding the clinicals feature and standard treatments of drug-induced keratopathy are key problem need to be solved urgently for us.Objective This study was to retrospectively analyze the clinical features and therapeutic procedure of drug-induced keratopathy.Methods A retrospective case series analysis method was adopted.The clinical data of 36 eyes (31 patients) with drug-induced keratopathy were collected by Shandong Eye Hospital from 2008 to 2012,including eye disease history,medication history,medication dosage and duration.A series of relevant examinations were performed,including best corrected visual acuity (BCVA) before and 1 month after treatment,Schirmer test Ⅰ (S Ⅰ t),tear film break-up time (BUT),meibomian gland findings,the location of the keratopathy,the characteristics of keratophthy before and after fluorescein staining.The treating were given,including cessating of the original drugs,applying corneal repair promotion and anti-inflammatory drugs as well as the comprehensive treatment for meibomian gland embolization and dry eye,such as the hot packs and massage in the eyes with meibomian gland dysfunction and a tear dot embolization therapy in the eyes with S Ⅰ t ＜ 5 mm and BUT＜5 s.Paired t test and repeated measured one-way analysis of variance in SPSS 17.0 software were used to compare the BCVA,BUT and S Ⅰ t outcomes.The correlation between corneal repair duration and S Ⅰ t results was analyzed by Pearson linear correlation analysis.Results The primary cause of drug-induced keratopathy was irrational use of drugs,including antiviral drugs,antibiotics,hormone,antiallergic,lowering-intraocular pressure drugs,turn for 23 eyes,12 eyes,10 eyes,1 eye and 1 eye,respectively.Improper route of administration included 25 cases of overuse of eye drops and 6 cases of subconjunctival injection.BCVA was 0.69 ± 0.28 1 month after treatment,which was significantly improved in comparison with before treatment (0.32 ± 0.26) (t =11.02,P ＜ 0.01).Clinical manifestations included corneal epithelial diffusive and point-like roughness,corneal epithelial defect and even corneal ulcer for severe cases,corneal edema,Descemet membrane folds and partially visible corneal filiform.Drug-induced keratophthy was mainly located in the central and lower cornea.Comprehensive therapy was effective with the treating duration about 1 week to 8 weeks.A negative correlation was found between the corneal restore duration and S Ⅰ t results (r =-0.835,P＜0.01).Conclusions Corneal changes secondary to topical medications may affect all layers of the cornea.Clinicians should be mindful of drug-induced ocular disorders.The early diagnosis of druginduced keratopahthy depends on the medical history and clinical features.A comprehensive treating based on ocular surface conditions is available.

Interleukin 23 (IL-23) is a recently discovered cytokine, and growing evidence suggests that IL-23 plays an important role in the development and progression of autoimmune diseases and inflammatory diseases. In recent years, certain research advances in association between IL-23 and liver diseases have been achieved at home and abroad. General features and biological characteristics of IL-23 are described, and its role in the development and progression of diseases such as hepatitis B, hepatitis C, and hepatocellular carcinoma is reviewed here, so that clinicians will have a deeper understanding of the effect of IL-23 in liver diseases and provide optimized therapies for patients with liver diseases.

Objective To study interleukin-23 (IL-23) levels in serum and dendritic cells of acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B (CHB) and to explore its relationship with the prognosis.Methods Peripheral blood mononuclear cells and serum were collected from 40 ACLF patients with CHB (including survival group 27 cases and non-survival group 13 cases) and 26 healthy controls.Monocytes were induced to immature dendritic cell in vitro and TNF-α was added to induce dendritic cell maturation.IL-23 mRNA of dendritic cells was detected by real time polymerase chain reaction (PCR), and serum IL-23 level was measured by enzyme-linked immuno sorbent assay (ELISA).Differences among the parameters with normal distribution were compared using t test, those with non-normal distribution were compared using non-parametric Mann-Whitney U-test, and the relationship between two variables was assessed by Spearman′s rank correlation.Results International normalized rate (INR) and model for end-stage liver disense (MELD) scores in non-survival group of ACLF were higher than those in survival group (INR: 2.32 vs 1.64, U=69.00, P=0.002 2;MELD:36 vs 30, U=64.50, P=0.001 4).However, there were no significant differences between two groups at gender, age, alanin aminotransferase (ALT), aspartate aminotrans ferase (AST), bilirubin, creatinine, hepatitis B virus (HBV) DNA, hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and serum IL-23.IL-23 mRNA level in dendritic cells at baseline in non-survival group of ACLF was significantly higher than that in survival group (76 vs 43, U=71.50, P=0.002 8).After treatment, serum IL-23 was significantly declined in survival group ([160±75] ng/L vs [91±49] ng/L, t=4.012, P=0.000 2), but not in non-survival group.Significant positive correlation was observed between IL-23 mRNA level in dendritic cells and MELD score at baseline (r=0.7198,P<0.01).Conclusions Persistent high serum IL-23 level suggests poor prognosis in ACLF patients with CHB.IL-23 mRNA expression in dendritic cells has good consistency with MELD score and the patients with high IL-23 mRNA expression has poor outcome.

ObjectiveTo investigate the effects of over expression of miR-34a on cellular proliferation and migration in bladder cancer cell line J82 by targeting Notchl.MethodsmiR-34a was predicted as a putative gene which can target Notchl through bioinformatics analysis,qRT-PCR and Western blot were performed to measure the expression levels of Notchl and miR-34a in invasive transitional cell carcinoma of bladder (TCCB) tissues and J82 cells transfected with miR-34a.Luciferase assay was employed to determine if miR-34a could target Notchl through binding to the 3'-untranslated region (3'UTR) of Notchl mRNA.J82 cells were transfected with pcDNA3.0-miR-34a or pcDNA3.0 control plasmid.MTS colorimetry was used to evaluate the effect of miR-34a on cell proliferation.The effect of miR-34a on cell migration was assessed by transwell migration assay.ResultsThe expression level of miR-34 in invasive TCCB tissues was lower than in adjacent bladder tissues (0.016(0.018) vs 0.042 (0.059),N =16; P =0.0006).On the contrary,the average levels of Notchl mRNA and protein were higher in tumors than in adjacent bladder tissues (2.765(2.156) vs 2.312(1.365),N =16; P =0.0025 and 0.857 ±0.197 vs 0.648 ±0.171 ;P ＜0.0001 ).After the transfection of miR-34a,the expressive level of miR-34a in J82 was highly induced ( (2.408 ±0.789) × 10-4 vs(0.153 ±0.029) × 10-4; P =0.0026).However,the expressive levels of Notchl mRNA and protein were obviously decreased (3.001 ± 0.106 vs 4.998 ± 1.053 ; P =0.0308 and 0.747 ± 0.050 vs 0.988 ± 0.102 ; P =0.0215 ).The results of luciferase assay showed that firefly activity was highly dimished (0.422 ± 0.028 vs 2.392 ± 0.148 ; P ＜ 0.0001 ).Cellular proliferation was inhibited after the transfection of miR-34a in J82 (P ＜ 0.0001 ).Moreover,number of migration cells of J82 was significantly reduced after the ectopic expression of miR-34a ( 179.3 ± 21.02 vs 269.7 ± 23.71 ; P =0.0078 ).ConclusionsmiR-34a inhibits the cellular proliferation and migration of bladder cancer cell line J82 via binding to the 3UTR of Notchl mRNA.

Objective: o investigate the features of pathogenic bacteria for community-acquired bloodstream infection due to Gram-negative bacilli in patients with liver cirrhosis and optimal therapeutic strategy. Methods: A retrospective analysis was performed for the clinical data of patients with liver cirrhosis who were admitted to 302 Hospital of PLA due to community-acquired bloodstream infection from January 2010 to December 2015, and a statistical analysis was performed for their clinical features, pathogenic bacteria, and results of drug sensitivity test. The Pearson chi-square test was used for comparison of rates, and the Wilcoxon rank sum test was used for comparison of ranked data. Results: A total of 240 patients (including 178 male patients) with liver cirrhosis caused by various reasons were enrolled, with a mean age of 51.7 ± 11.1 years, an overall clinical remission rate of 80.42%, and an ineffective/mortality rate of 19.58%. The patients who used sensitive antibiotics within 12 hours after the onset of community-acquired bloodstream infection achieved a significantly higher improvement rate than those who used such drugs at more than 12 hours after onset (88.2% vs 58.1%, P < 0.001). The improvement rate achieved by the application of sensitive antibiotics at more than 12 hours after onset decreased with the increase in the Child-Pugh grade (P < 0.05). A total of 245 strains of Gram-negative bacilli were isolated, among which the six most common ones were 135 strains of Escherichia coli (55.1%), 62 strains of Klebsiella pneumoniae (25.3%), 16 strains of Aeromonas (6.5%), 4 strains of non-typhoidal Salmonella (1.6%), 3 strains of Enterobacter cloacae (1.2%), and 2 strains of Acinetobacter baumannii (0.8%). These Gram-negative bacilli had the highest sensitivity to meropenem (98.5%), followed by imipenem (97.9%), amikacin (97.5%), piperacillin/tazobactam (94.7%), cefmetazole (93.7%), and cefoperazone/sulbactam (93%). Different bacteria had different sensitivities to antibiotics. Conclusion Once community-acquired bloodstream infection occurs in patients with liver cirrhosis, highly sensitive antibiotics should be used as early as possible. Cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, and meropenem can be used as first-line empirical antibiotics, and drug combination should be considered when necessary.

Objective:To investigate the current status of family management function of patients with advanced lung cancer and to explore the correlation between family management function and quality of life in patients with advanced lung cancer.Methods:A total of 187 patients with advanced lung cancer who were admitted to Shanghai Pulmonary Hospital Affiliated to Tongji University from January 2019 to January 2020 were selected as research object. The general data questionnaire, Family Assessment Device (FAD) and WHO Quality of Life-100 (WHOQOL-100) were used to investigate patients with advanced lung cancer to analyze the correlation between family management function and quality of life.Results:The total scores of FAD and WHOQOL-100 of patients with advanced lung cancer were respectively (88.72±11.46) and (102.92±3.65) , which were negatively correlated ( r=-0.896, P<0.05) . Conclusions:The family management function of patients with advanced lung cancer is closely related to the quality of life, and the quality of life of patients can be improved by improving the family management function of patients.

BACKGROUND/AIMS: To investigate the role of selected serum microRNA (miRNA) levels as potential noninvasive biomarkers for differentiating S0–S2 (early fibrosis) from S3–S4 (late fibrosis) in patients with a chronic hepatitis B virus (HBV) infection. METHODS: One hundred twenty-three treatment-naive patients with a chronic HBV infection who underwent a liver biopsy were enrolled in this study. The levels of selected miRNAs were measured using a real-time quantitative polymerase chain reaction assay. A logistic regression analysis was performed to assess factors associated with fibrosis progression. Receiver operating characteristic (ROC) curve and discriminant analyses validated these the ability of these predicted variables to discriminate S0–S2 from S3–S4. RESULTS: Serum miR-29, miR-143, miR-223, miR-21, and miR-374 levels were significantly downregulated as fibrosis progressed from S0–S2 to S3–S4 (p < 0.05), but not miR-16. The multivariate logistic regression analysis identified a panel of three miRNAs and platelets that were associated with a high diagnostic accuracy in discriminating S0–S2 from S3–S4, with an area under the curve of 0.936. CONCLUSIONS: The levels of the studied miRNAs, with the exception of miR-16, varied with fibrosis progression. A panel was identified that was capable of discriminating S0–S2 from S3–S4, indicating that serum miRNA levels could serve as a potential noninvasive biomarker of fibrosis progression.
Biomarkers ; Biopsy ; Early Diagnosis* ; Fibrosis ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Liver Cirrhosis* ; Liver* ; Logistic Models ; MicroRNAs* ; Polymerase Chain Reaction ; ROC Curve