Brain ; metabolism ; Brain Chemistry ; Creatine ; deficiency ; Humans ; Syndrome

Germany ; Hazardous Substances ; analysis ; Workplace

Objective To investigate the feasibility and clinical significance of D2 lymphadenectomy for distal gastric cancer in which the pancreas were regarded as the central landmark. Methods 26 patients of advanced distal gastric cancer were performed D2 lymphade-nectomy centered on the pancreas from March 2012 to February 2013. The operation time, amount of bleeding,number of lymph nodes,and postoperative complications were recorded. Results All the 26 patients underwent the operation successfully. The amount of bleeding was 50~200 mL(averagely 110 mL),and the number of lymph nodes which were cleaned was 16~35 (averagely 26). One patient had intra-ab-dominal hemorrhage and one patient had lymphorrhagia after the operation,and they were cured finally. There was no local recurrence,no dis-tant metastasis,and no death case occurred during the follow-up. Conclusion D2 lymphadenectomy for distal gastric cancer with pancreas as the central landmark is safe and feasible, and it is of lower incidence of complications .

Objective To compare effects of compound Xueshuantong capsule and benazepril on inflammatory cyto-kines in type 2 diabetic patients with early diabetic nephropathy (DN), and its therapeutic mechanism thereof. Methods Ninety-four patients with type 2 diabetes were divided into diabetes without albuminuria group (DM,n=24) and early DN group (DN,n=70). DN group was then divided into three subgroups:group A (n=24) treated by benazepril alone, group B (n=22) treated by compound Xueshuantong capsule and group C (n=24) treated by compound Xueshuantong capsule combined with benazepril for 3 months. Levels of fasting blood glucose, glycosylated hemoglobin, serum creatinine, blood urea nitro-gen, lipid profiles, fibrinogen and urinary albumin excretion rate (UAER) were examined before and after treatment. The se-rum levels of hypersensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were determined as well. Results The serum levels of hs-CRP, IL-6 and TNF-αwere significantly higher in DN group than those of DM group (P<0.01). After treatment, the serum levels of UAER, hs-CRP, IL-6 and TNF-αwere significantly re-duced in groups A, B and C compared with those before treatment (P<0.01), and which were decreased more significantly in group C. The levels of blood lipids and fibrinogen decreased obviously in group C compared with those of group A and B ( P<0.01). Conclusion Compound Xueshuantong capsule combined with benazepril not only can improve the blood fat and high coagulation state in patients, but also impossibly retard the development of early DN through decreasing serum concen-trations of hs-CRP, IL-6 and TNF-αand inhibiting inflammatory reaction.

Objectivo To analyze urine organic acids in the urine using gas chromatography-mass spectrometry(GC/MS)for diagnosis of inherited metabolic diseases,especially for organic acids metabolic disorders.Methods 195 clinical urine samples from the patients with suspected organic acids metabolic disorders and 5 normal urine from adults were collected.After mixing some urine with intemal standards according to the concentration creatinine and adding hydroxylamine hydrochloride to mixture,the organic acids with hydroxyl group were oximated to the ketobodies.Organic acids were extracted twice with ethyl acetate and ethyl ether and derivatized with BSTFA-TMCS.An the organic acids were determined with Agilent GC/MS 6890/5973i with scan model.the mass-to-charge ratio range is 50-550 m/z,all data were nalyzed with Agilent GCMSD ChemStationG1701DA.We also investigated the linearity, accurate,precision.recovery and Carry-over by determining the internal standards in normal samples and positive organic acids in spiked control samples.Results More than one hundred kinds of organic acids in urine samples can be analyzed with this method.According to the two internal standards in normal urine samples,the minimal detection limit MMA and 2.PA was 2.5-2.8 μmol/L.Intra-and interassay coefficient of variation for MMA and 2-PA are both less than 10%.Pre-processing Interassay coefficient by sequential preparations of the same sample was 14%.The recoveries of the spiked samples were 95%-105%.Carryover analysis was less than 1%.All the parameters meet the requirement for clinical diagnosis.12 samples demonstrated positive including 6 cases of methylmalonic acidemia,1 case of propionic acidemia,3 cases of tyrosinemia Ⅰ,1 case of maple syrup urine disease and 1 cases of ketosis.Conclusions The method for the determination of organic acids in urine by GC/MS has been successfully established.It can be used for clinical screening and diagnosis for inherited genetic metabolic diseases.

Objective To investigate the in vitro susceptibility of 16 strains of Exophiala dermatitidis to 6 commonly used antifungal agents. Methods The Glinical and Laboratory Standards Institute (CLSI)M27-A2 protocol was carried out to determine the MIGs of terbinafine (TRB), itraconazole (ITC), amphotericin B (AMB), fluconazole (FLC), voriconazole (VRC), and caspofungin (GAS) to 16 strains of E. dermatitidis, and E-test was performed to determine those of VRG, ITC and AMB. Besides, the minimal fungicidal concentrations (MFGs) of the above antifungal agents to the 16 strains of E. dermatitidis were further assessed.The activity of TRB in combination with ITC and VRG against E. dermatitidis was also estimated. Results The MIC ranges of TRB, VRC, ITC, AMB, FLC, and CAS were 0.125 - 0.25 mg/L, 0.25 - 0.5 mg/L, 2.0 mg/L,2.0 mg/L, 16 - 32 mg/L and 16 - 64 mg/L respectively as shown by M27-A2 microdilution assay, while the MIC ranges of VRG, ITG and AMB, as determined by E-test, were 0.032 - 0.094 mg/L, 0.047 - 0.5 mg/L and 0.125 - 3.0 mg/L, respectively. The MFC ranges of TRB, VRC, ITG, AMB and FLG were 0.125 - 0.5 mg/L,0.25 - 0.5 mg/L, 2.0 - 4.0 mg/L, 2.0 - 4.0 mg/L and 16 - 64 mg/L, respectively. No synergism in the acitivity against E. dermatitidis was observed for the combination of TBR with ITC or VRC. Conclusion E. dermatitidis is susceptible to TRB, ITC, AMB, and VRC, but less sensitive to both FLC and GAS.

Objective To observe the incidence of acute radiation pneumonitis (ARP) in patients with nonsmall cell lung cancer treated by three-dimensional conformation radiotherapy or intersity-modulated radiation therapy,and investigate the predictive value of high dose volume and low dose volume of the total and ipsilateral lung on ARP.Methods 174 patients with non-small-cell lung cancer verified by pathology who received radical radiotherapy in our hospital from Aug 2013 to Nov 2015 were screened.Radioactive dose was 60 Gy-70 Gy,with 97 patients' dose of 60-64 Gy and 77 patients' dose of 65-70 Gy.Chemotherapy was done by paclitaxel + pentium first line treatment.155 patients were treated with radiotherapy alone and 19 with radiotherapy combined with chemotherapy.The V5～ V30,MLD (mean lung dose),V5ipis ～ V30ipsi,MLDipsi were calculated from the dose volume histogram system.The ARP was evaluated according to Common Toxicity Criteria 4.0 (CTC4.0).Univafiate and nultivariate analysis and receiver operating characteristic (ROC) curves were performed to assess the correlated factors of ARP.Results Of 174 patients,26 patients (14.94％) developed radioactive pneumonia at grade 2,11 patients (6.32％) at grade 3,2 patients (1.15％) at grade 4.The correlative factors included the radiochemotherapy regimen (sequential chemotherapy to radiotherapy or concurrent radiochemotherapy),V5,V10,V20,V30,MLD of the total lung and ipsilateral lung according to univariate analysis.Multivariate analysis of all the factors mentioned above showed the V5,V20ipsi and MLD were the independent predictive factors associated with ARP.ROC analysis indicated that the cut-off point of V5,V20ipsi,MLD were 62.38％,47.14％and 16.85Gy respectively.According to the V5,V20ipsi value,174 patients were divided into three groups:B group V5＜62％+V20ipsi≥47％,C group V5≥62％+V20ipsi＜47％,D group V5≥62％+V20ipsi≥47％.The chisquare test between the C group and D group has statistical significance.Conclusion V5,V20ipsi,and MLD are the independent risk factors of ARP.Compared with V5,limiting V20ipsi threshold is more likely to result in ARP.

Objective To investigate the molecular mechanisms of cross-resistance to azoles in a clinical isolate of Aspergillus fumigatus. Methods A. fumigatus was isolated from a patient with invasive aspergillosis.Clinical Laboratory Standard Institute M38-A2 broth microdilution method and E-test method were used to determine the minimum inhibitory concentrations (MICs) or minimum effective concentration (MEC) of itraconazole, voriconazole, amphotericin B, posaconazole and caspofungin for the A. fumigatus isolate. DNA was extracted from the isolate and subjected to the amplification of cyp51A gene encoding the target enzyme of azole antifungal agents followed by sequence analysis. Results The broth microdilution test showed that the MEC of caspofungin was 0.5 mg/L, and MICs of itraconazole, voriconazole and amphotericin B were ≥ 16 mg/L,8 mg/L and 1 mg/L, respectively, for this isolate; while E-test assay revealed that the MICs of caspofungin,itraconazole, voriconazole, amphotericin B and posaconazole were 0.047 mg/L, ≥32 mg/L,≥32 mg/L, 12 mg/L and ≥32 mg/L, respectively. Sequence analysis showed an insertion of a 34-bp tandem sequence in the promoter region of the cyp51A gene as well as a T364A point mutation causing the substitution of leucine 98 (L98H). In addition, there were some other mutations in the cyp51A gene of this isolate, such as A137T,G585A, C814A, G836C, T991C and A1350G, which could result in corresponding amino acid substitutions.Conclusions An A. fumigatus strain with cross-resistance to azole antifungal agents is isolated. There is an insertion of a 34-bp tandem sequence into the promoter region as well as a T364A point mutation in the cyp51A gene, which contribute to the cross resistance to azole antifungal agents including itraconazole, voriconazole,and posaconazole. In addition, other mutations causing amino acid substitutions have also been detected in the cyp51 A gene of this isolate.

Abstract: Objective　To explore the value of real-time shear wave elastography in evaluating the severity of liver fibrosis in hepatitis B, and to analyze the factors that affecting its accuracy. Methods　A total of 196 chronic hepatitis B patients, who admitted to the Third Affiliated Hospital of Chengdu Medical College from February 2018 to October 2020, were selected for retrospective analysis. Demographic indicators such as gender, age, body mass index(BMI), and laboratory indicators such as fasting blood glucose, liver function, and blood lipid composition were collected. The patients were detected by real-time shear wave elastography. Taking the pathological test results as the gold standard, the diagnostic value of real-time shear wave elastography in the severity of liver fibrosis in chronic hepatitis B was analyzed, and the comprehensive effect of various factors on the diagnostic accuracy of real-time shear wave elastography was evaluated by Logistic regression analysis. Results　The differences in real-time shear wave elastography of patients with different severity of liver fibrosis in hepatitis B were statistically significant, and F0 grade

Objective To investigate whether emodin enhances chemosensitivity of pancreatic cancer cells and the mechanism. Methods Normal human skin fibroblasts and pancreatic BXPC-3 cells were divided into control group, cisplatin (5 mg/L) treatment group, gemcitabine (0.5 μmol/L) treatment group, emodin (50 μmol/L)+ cisplatin (5 mg/L) co-treatment group and emodin (50 μmol/L) + gemcitabine (0.5 μmol/L) co-treatmentgroup. The cell viability was detected by MTT assay, the cell apoptosis rate by flow cytometry, the expression of the multidrug resistance-associated protein 1 ( MRP1 ), MRP2, breast cancer resistance protein (BCRP) and P-glycoprotein (P-gp) mRNA in different cell lines was determined by reverse transcription polymerase chain reaction.All data were analyzed using the t test. Results The cell viability and apoptosis rate of pancreatic BXPC-3 cells after treatment were 62.44% ± 3.42% and 27. 10% ± 4.24% in the cisplatin treatment group, and they were 30.53% ±0.05% and 66.33% ±9.37% in the emodin + cisplatin co-treatment group. There were significant differences in cell viability and apoptosis rate between the two groups (t = 13.20, 5. 35, P < 0.05 ). The cell viability and apoptosis rate of pancreatic BXPC-3 cells after treatment were 79.82% ±2.83% and 13.48% ± 1.65%in the gemcitabine treatment group, and they were 45.65% ± 2.46% and 62.74% ± 10. 18% in the emodin +gemcitabine co-treatment group. There were significant differences in cell viability and apoptosis rate between the two groups (t = 12.89, 8.28, P < 0. 05 ). There was no significant difference in the viability of normal human skin fibroblasts between the cisplatin treatment group and the emodin + cisplatin co-treatment group, and also between the gemcitabine treatment group and the emodin + gemcitabine co-treatment group (t = 2. 08, 0. 64, P >0.05 ). Expression of MRP1 mRNA was detected in pancreatic BXPC-3 cells, whereas the expression of MRP2,BCRP and P-gp mRNA was undetectable. The expression of MRP1 mRNA in pancreatic BXPC-3 cells was significantly down-regulated in the cisplatin treatment group, and cisplatin + emodin co-treatment had an additive effect on down-regulating the expression of MRP1 mRNA. Conclusion Emodin may enhance chemosensitivity of pancreatic cancer cells to cisplatin by down-regulating the expression of MRP1 mRNA.