Objective To evaluate the feasibility of leucovorin(LCV) rescue protocol defined by us,we compared the plasma concentrations,toxicity,LCV doses of different high doses methotrexate(HD-MTX).Methods Seventeen children with acute lymphoblastic leukemia and 1 children with non-Hodgkin′s lymphoma were randomly treated with total 43 courses of HD-MTX.MTX plasma concentrations were measured by fluorescence polarization immuno-assay.Different LCV rescue protocols were prospectively defined for 3 kinds of HD-MTX protocols.Adjusting LCV dose by plasma MTX concentrations.Results No irreversible MTX-related toxicity was observed in all patients.Significant differences of mean steady-state plasma concentrations(Cpss) and total rescue doses were found between 3 groups(P

Objective To compare different susceptibility testing methods of tigecycline against Acinetobacter baumannii and Klebsiella pneumoniae.Methods Fifty carbapenem-resietant A.baumannii (CRAB) strains and 49 K.pneumoniae strains were collected from Tianjin Medical University General Hospital during January and March 2012.Minimum inhibitory concentration (MIC) and inhibitory zone diameters for tigecycline were determined by broth microdilution,Vitek-2,MTS and disk diffusion methods.The results of Vitek-2,MTS and disk diffusion methods were compared with those of broth microdilution method.Results According to FDA standards,the susceptibilities of CRAB and K.pneumoniae to tigecycline determined by broth microdilution,Vitek-2 and MTS were 94.0％/91.8％,68.0％/91.8％ and 90.0％/91.8％,respectively.For CRAB isolates,the essential agreement (EA) and categorical agreement (CA) produced by Vitek-2 and MTS were 94.0％/72.0％ and 92.0％/90.0％.MICs determined by Vitek-2 were 1-2 dilutions higher than the reference method in 33 (66.0％) strains,and those determined by MTS were higher in 16 (32.0％) strains and lower in 11 (22.0％) strains.For K.pneumoniae isolates,the EA/CA produced by Vitek-2 and MTS were 95.9％/98.0％ and 83.7％/91.8％,respectively.MICs determined by Vitek-2 were 1-3 dilutions lower than the reference method in 17 (34.7％) strains,and those determined by MTS were 1-3 dilutions lower than the reference method in 39 (79.6％) strains.None of thetwo methods produced very major error (VME) and major error (ME) against two kinds of isolates.The results were determined by disk diffusion method using different breakpoints according different isolates.For CRAB,using ≥14 mm/≤ 10 mm as breakpoint,CA was 94.0％,which was higher than the breakpoint recommended by Jones et al (≥16 mm/≤12 mm,CA was 82.0％) ; and for K.pneumoniae,using the ≥ 14 mm/≤ 10 mm as breakpoint,CA was 93.9％,higher than the FDA Enterobacteriaceae breakpoint (≥ 19 mm/≤ 14 mm,CA was 67.3％).Conclusion For CRAB strains,MTS produces better consistence with broth microdilution,with several higher or lower MIC results.For K.pneumoniae strains,Vitek-2 has better correlation with reference method,with several lower MIC results.The consistence between disk diffusion method and broth microdilution is comparatively lower,and the breakpoint should be adjusted according to different bacteria.

Objective To investigate the effects of acupuncture at acupoints at different time points on the occurrence of postoperative nausea and vomiting ( PONV ) in patients undergoing radical rectal cancer operation.Methods One hundred and thirty ASA Ⅰ - Ⅲ patients,aged 40-59 yr,with body mass index of 20-25 kg/m2,scheduled for elective radical rectal cancer operation,were randomly divided into 5 groups ( n =25 each):control group ( group Ⅰ ),treatment with the conventional drug group (group Ⅱ ),preoperative acupuncture group ( group Ⅲ ),acupuncture during operation group (group Ⅳ ),and postoperative acupuncture group (group Ⅴ ).Granisetron 3 mg was injected intravenously before the end of the operation in group Ⅱ.Acupuncture was performed at 30 min before induction of anesthesia,at skin incision and at the end of operation in groups Ⅲ,Ⅳ and Ⅴ respectively.Bilateral Neiguan ( PC6 ),Hegu ( LI4 ),Zhigou ( SJ6 ),and Quchi ( LI11 ) acupoints were selected in groups Ⅲ,Ⅳ and Ⅴ.Acupuncture stimulation lasted for 30 min.Blood samples were collected from the peripheral vein after admission to the operating room (T0),at 1 h after skin incision (T1),at the end of operation (T2 ),and at 24 h after operation (T3) to determine the plasma gastrin concentration.The occurrence of PONV was recorded within 2 h after operation,during 2-6 h,6-12 h and 12-24 h after operation,and within 24 h after operation.Results Compared with group Ⅰ,the incidence of PONV within 2 and 24 h after operation,and the plasma gastrin concentration at T3 were significantly decreased in groups Ⅱ and Ⅲ ( P ＜ 0.05),and no significant change was found in the indexes mentioned above in groups Ⅳ and Ⅴ (P ＞ 0.05).Compared with group Ⅱ,the plasma gastrin concentration at T3 was significantly decreased in group Ⅲ,the incidence of PONV within 2 and 24 h after operation was significantly increased in groups Ⅳ and Ⅴ ( P ＜ 0.05).Compared with group Ⅲ,the incidence of PONV within 2 and 24 h after operation,and the plasma gastrin concentration at T3 were significantly increased in groups Ⅳ and Ⅴ ( P ＜ 0.05 ).Conclusion Preoperatvie acupuncture at acupoints can decrease the occurrence of PONV in patients undergoing radical rectal cancer operation,the efficacy is similar to that of the conventional drugs,and the decreased concentration of the plasma gastrin after operation is involved in the mechanism.

The continuing education system at the Peking University Health Science Center for vis-iting scholars (Research program for young and middle-aged doctors) is a relatively advanced and compre-hensive medical continuing education system in China, among which, the tutorial system is a good method to guide the visiting scholars of continuing education. On this basis we conducted scholars learning effect questionnaire survey and combined with the feedback results, discussed the advantages and disadvantages of the current educational system of visiting scholars in China, and put forward some concrete suggestions on the development of the continuing education in China.

The composition, nutritional evaluation and clinical trials of a nutritionally complete enteral preparation were presented. It was composed of glucose oligosaccharides, emulsified fat, solubilized proteins, twelve vitamins, certain minerals and trace elements. Rats were forced to negative nitrogen balance by means of protein-free diet. Body weight and serum total protein declined accordingly. When the feed was changed to this preparation in one group, and a routine one with equal nitrogen content in another, nitrogen balance was turned to positive, body weight increased, serum total protein returned to normal in both groups. The increments of nitrogen balance and body weight were, however, higher significantly in the group fed with the preparation than that with routine diet. The biological value, net protein utilization and protein efficiency ratio of the solubilized proteins in the preparation were higher than casein in the routine feed. Twenty surgical patients having the preparation as the sole source of nutrients could take around 8.37MJ(2000 kcal)a day. Nitrogen balance turned from negative to positive in an average time of 3.6 days. Body weight, serum total protein, serum albumin were all increased. Fourty patients took this as dietary supplement and the similar results were observed too. Clinical effects were excellent in all cases, especially for healing of surgical wounds and fistula. Incidence of diarrhea was 3.3%.

Objective To summarize the contrast enhanced ultrasonographic (CEUS) features of benign focal liver lesions, on and to investigate the value of contrast enhanced ultrasound techniques in the diagnosis of benign focal liver lesion. Methods The contrast enhanced ultrasonographic performance of 68 benign focal liver lesions cases which were dififcult for routine ultrasound diagnosis and conifrmed by pathology or follow-up were retrospectively analyzed. Chi-square test of four-fold table were used to compare the diagnostic coincidence rate of conventional ultrasound and contrast-enhanced ultrasound. Results The 68 cases of benign focal liver lesions included complex cysts (n=7), liver hydatids (n=2), liver abscess (n=15), focal nodular hyperplasia (n=8), angiomyolipoma (n=2), hepatocellular adenoma (n=4), focal fat accumulation (n=16), inlfammatory pseudotumor (n=12), solitary necrotic nodule (n=1), intrahepatic biliary cystadenoma (n=1). There were no enhancement among 7 complex cysts, 2 liver hydatids and 1 solitary necrotic nodule. Isoenhancement was detected in focal fat accumulation (n=16);hypoenhancement during the arterial phase and sustained enhancement during the portal or late phase was found in focal nodular hyperplasia (n=8) and angiomyolipoma (n=2). Grid-like enhancements during the arterial phase and isoenhancement or hypoenhancement during the portal phase, and hypoenhancement during the late phase was presented in liver abscess (n=15). Hyperenhancement during the arterial phase were detected in 4 cases of hepatocellular adenoma, 3 of which showed isoenhancement or hyperenhancement during the portal and delayed phase, one case showed hypoenhancement during the portal phase. Eight cases of all the inlfammatory pseudotumor showed no enhancement during all phases;3 cases showing grid enhancement during the arterial phase and the enhancement washed out rapidly;1 case showed mild edge enhancement during the arterial phase and hypoenhancement during the delayed phase. The solid part of the intrahepatic biliary cystadenoma showed hyperenhancement during the arterial phase and hypoenhancement during the portal and late phase.The central area showed no enhancement during all phase. The coincidence rate between pathology and conventional ultrasound diagnosis was 61.8%(42/68). The coincidence rate between pathology and contrast- enhanced ultrasound diagnosis was 92.6%(63/68). The coincidence rate of contrast-enhanced ultrasound diagnostic was higher than that of conventional ultrasound, with a statistically signiifcant difference (χ2=8.17, P < 0.01). Conclusion Real-time gray-scale contrast-enhanced sonography can improve the accuracy of the diagnosis and differential diagnosis for benign focal liver lesions.

Objective To reverse P-glycoprotein-mediated muhiple drug resistance using RNA interference(RNAi)in cultured rat astrocytes.Methods Astroeytes overexpressing P-glyeoprotein induced by coriaria lactone were transfected with the short-hairpin RNA expression vector-p-SIREN shuttle designed to target Mdrl mRNA.The mRNA level of Mdrl gene was evaluated by real-time PCR;the P-glycoprotein was examined by immunocytochemistry and image analysis,meanwhile the rhodamine efflux was assessed by flow cytometry.Results The astrocyte model overexpressing P-glycoprotein were established and successfully transfected with the short-hairpin RNA expression vector-p-SIREN shuttle.The mRNA level of Mdrl gene was knocked down by 67.70%(P

Adolescent ; Antimetabolites, Antineoplastic ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Leucovorin ; administration & dosage ; Lymphoma, Non-Hodgkin ; drug therapy ; Male ; Methotrexate ; administration & dosage ; adverse effects ; blood ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; drug therapy

BACKGROUND:Vascular endothelial growth factor is a potent angiogenesis and permeability inducible factor. Vascular endothelial growth factor 165 and vascular endothelial growth factor 121 are mainly expressed in vivo, with a strong role of angiogenesis.
OBJECTIVE:To observe the feasibility of vascular endothelial growth factor 165 gene transfected bone marrow mesenchymal stem cel s to differentiate into vascular endothelial cel s.
METHODS:Bone marrow derived mesenchymal stem cel s were isolated and col ected from 50 g Sprague-Dawley rats,and identified by flow cytometry. The plasmid pGLV-EF1a carrying a vascular endothelial growth factor 165 gene was transfected to the mesenchymal stem cel s using lentiviral. Expression of green fluorescent protein was observed under a fluorescence microscope.
RESULTS AND CONCLUSION:After 12 hours of transfection, expression of green fluorescent protein was observed, increased at 48 hours, peaked at 72 hours and gradual y declined thereafter. Results prove that vascular endothelial growth factor 165 gene transfected bone marrow mesenchymal stem cel s have the expression of green fluorescent protein, indicating successful transfection. It is feasible to induce bone marrow mesenchymal stem cel s to differentiate into vascular endothelial cel s.

Frequency-domain electricity properties of four objects, including bullfrog skin, bullfrog muscle, triply distilled water and 0.9% NaCl, were tested in the range of 100Hz-10MHz using home-made electrode and measuring system. The experimental results showed that the resistance of 0.9% NaCl decreased dramatically, that the amplitude frequency characteristics of bullfrog's muscle and skin were similar, but that of triply distilled water did not change significantly. The frequency dependence of 0.9% NaCl showed that the electrode had great influence on the measuring system, so a new equivalent circuit model based on the electrode system was needed. These findings suggest that the new five-parameter equivalent circuit model, which embodies considerations on the interaction between electrodes and tissues, is a reasonable equivalent circuit for studying the electrical characteristics of biological materials.
Animals ; Electric Capacitance ; Electric Impedance ; Electricity ; Electrodes ; Muscle, Skeletal ; physiology ; Rana esculenta ; Skin ; Sodium Chloride