Background and purpose:Colorectal carcinoma(CRC) is a major cause of cancer-related mortality. In the 1990s, several fi rst-line phase Ⅲ trails showed a signifi cant improvement in result with the addition of CPT-11(irinotecan, which is a specifi c inhibitor of topoisomerase Ⅰ) to FU-LV combination therapy(FOLFIRI).We observed the survival rate, effi cacy and adverse reaction of the combination chemotherapy of irinotecan plus folinic acid/continuous 5-? uorouracil bimonthly FOLFIRI regimen as second chemotherapy in treating advanced colorectal adenocarcinoma. Methods:Sixty patients with histologically proved advanced colorectal adenocarcinoma whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics agents were included to receive at least 2 cycles of chemotherapy with irinotecan 180 mg/m2 day 1 and folinic acid 200 mg/m2 iv,5-FU 400 mg/m2 iv bolus,days 1 and 2, 5-FU 600 mg/m2 iv infusion over 22 hours, days 1 and 2.Treatment was repeated every two weeks. Results:All patients were assessable for toxicity and 58 patients were evaluable for treatment response. The non-hematological toxicity was mild. Most was grade Ⅰ or Ⅱ. Only two patients experienced grade Ⅲ diarrhea and one patient experienced grade Ⅲ nausea and vomiting. There were no cases with grade Ⅳ toxicity. The most common hematological toxicity was neutropenia. Grade Ⅲ neutropenia were observed in fi ve patients. There was no case of febrile neutropenia. Based on intention to treat analysis, there were no complete responses (CR), 14(24.14%) partial response (PR), and 30 (51.72%) stable disease. the median time to disease progression was 6.09 months. The median overall survival was 9.65 months. Conclusions:Bimonthly irinotecan in combination with folinic acid and 5-fluorouracil was active with acceptable toxicities and a prolonged survival time in retreated colorectal cancer.

Objective To compare the pharmacokinetic profile of propofol administered by target-controlled infusion (TCI) during anesthesia in patients with and without obstructive jaundice. Methods Twenty-four ASAⅠorⅡpatients aged 40-65 yrs weighing 50-75 kg undergoing elective surgery under general anesthesia were divided into 3 groups (n = 8 each) : group A control (serum total bilirubin 171.1?mol?L-1) . Each group received propofol by TCI using Graseby 3500 infusion pump, based on pharmacokinetic parameter set published by Marsh. The target plasma concentration of propofol was set at 3?g?ml-1 . TCI of propofol was started from the induction of anesthesia and maintained until the end of the surgery. Arterial blood samples were taken at 0.5, 1, 2, 4, 6, 8 min after TCI of propofol was started and every 15 min during maintenance of anesthesia and at 2, 4, 6, 8, 10, 20, 30, 40, 50, 60, 90, 120, 180, 240 and 300 min after TCI was terminated. Plasma concentrations of propofol were determined by high-performance liquid chromatography (HPLC) with fluorescence detector. NONMEM was used to analyze the pharmacokinetic parameters. Results The 3 groups were comparable with respect to sex ratio, age and body weight. The pharmacokinetic profile of propofol given by TCI was best described by three-compartment open pharmacokinetic model in the majority of patients and by two-compartment open pharmacokinetic model in a few patients. There were no significant differences in the pharmacokinetic profile of propofol among the 3 groups. Conclusion Obstructive jaundice does not affect the pharmacokinetics of propofol.

lso.This result suggested that Th17 subset is differentiated in chronic stage of viral myocarditis.

Background and purpose:Pain is one of the most common symptoms in advanced cancer patients, and morphine is a representative drug in controlling moderate to severe cancer-induced pain, but some unacceptable adverse effects limited its use in part of patients.We evaluated the effect and safety of morphine sulfate controlled-release tablet (MS-CRT) combined with celecoxib for the treatment of moderate to severe cancer pain, and assessed the life quality of patients. Methods:Retrospective analysis of 125 cancer patients with moderate to severe cancer pain who were divided into two groups, one(including 67 patients) was treated by single drug of MSCRT whose initial dosage was 20 mg/12 hrs, then evaluated by verbal rating scale within 24 to 48 hrs, dosage was adjusted personally according to the state of pain (increasing rate was 50% and declining rate was 25%) until the maintenance dosage was reached; the other(including 58 patients) was treated by MS-CRT with the same initial dosage and combined with celecoxib whose dosage was 200 mg/12 hrs at first, and increased to 400 mg/12 hrs if the pain was not relieved well, then gradually increased the dosage of MS-CRT to the maintenance dosage, and analyzed the effect, dose adjustment,side effect of drug combination and improvement of quality of life for the patients. Results:The mean of maintenance dosage for MS-CRT alone was 67.3 mg/day, and for the combination of MS-CRT and celecoxib was 51.3 mg/day, the reduction rate of MS-CRT in the drug combination group compared with MS-CRT alone was 23.77% with the same analgesia effect, and the incidence of side effects such as constipation and nausea/vomiting was statistically reduced compared with the single drug group. The quality of life in both groups was improved aftertreatment. Conclusion:The combination of MS-CRT and celecoxib can effectively control moderate to severe cancer pain, , improve the quality of life in advanced cancer patients, and reduce the consumption of MS-CRT with similar side effects as morphine alone.

Objective To analyze the effect of bifrontal decompressive craniectomy on patients with refractory diffusing of brain swelling after severe traumatic brain injury.Methods The clinical data of 68 patients with refractory diffusing of brain swelling after severe traumatic brain injury were analyzed retrospectively.Thirty-five patients were performed with bifrontal decompressive craniectomy as observed group,continued intracranial pressure monitoring after surgery.Thirty-three patients were treated conservatively to reduce intracranial pressure as control group,continued intracranial pressure monitoring.The Glasgow outcome scale after discharge 6 months were assessed.The efficacy,the incidence of complications were observed in observed group.Results The admission intracranial pressure in observed group was significantly higher than that after surgery [(35.9 ±6.9) mmHg (1 mmHg =0.133 kPa) vs.(17.5 ±5.2) mmHg,P ＜0.05].The admission intracranial pressure in control group was (34.2 ± 8.6) mmHg,after admission 10.5 h was (32.0 ±4.8) mmHg (P ＜0.05),difference was no statistically significant (P＞ 0.05).The intracranial pressure after admission 10.5 h in control group was significantly higher than that in observed group after surgery (P ＜0.05).Two cases of subdural effusion,1 case of postoperative hydrocephalus in observed group.The better prognosis rate in observed group was significantly higher than that in control group [45.7％ (16/35) vs.18.2％ (6/33),P ＜ 0.05].Conclusions Bifrontal decompressive craniectomy is a suitable measure to decrease the intracranial pressure in the patients with refractory diffusing of brain swelling.If carried out early,it could provide better outcome for these patients.

ObjectiveTo compare the accelerating effect of topical recombinant human epidermal growth factor (rhEGF) and recombinant bovine basic fibroblast growth factor (rb-bFGF) on wound healing after fractional CO2 laser therapy.MethodsTwenty male guinea pigs were included in this study.After hair removal and irradiation with fractional CO2 laser,the back of each guinea pig was divided into 4 regions to be topically treated with rhEGF of 10 μg/cm2 (rhEGF group),rb-bFGF of 262.51 IU/cm2 (rb-bFGF group),the combination of rhEGF and rb-bFGF (combination group),or normal saline (control group),twice daily until the healing of wound.Skin physiology parameters including elasticity index and melanin index were detected before the irradiation,7,14 and 28 days after the irradiation,and compared between the 4 groups by analysis of variance.Tissue specimens were obtained from 4 mice at the above time points and subjected to pathological examination for the observation of collagen fibers and quantification of fibroblasts.ResultsAfter fractional CO2 laser therapy,the crusts fall off completely in growth factor-treated regions,while partly in the control regions,within 3 to 7 days; the wounds healed completely in 14 to 28 days in all the groups,with the regenerating tissue being more tender and redder compared with the surrounding unirradiated tissue.The wound surface was smaller in area and redder in color in the 3 growth factor-treated groups than in the control group.At 28 days after the irradiation,the elasticity index was 262.29 ± 62.40 in the combination group,202.00 ± 65.62 in the rhEGF group,188.86 ± 35.02 in the rb-bFGF group,167.14 ± 42.49 in the control group.Statistical difference was observed in elasticity index,but not in skin melanin index among the 4 groups.Pathological examination showed a dense and organized arrangement of collagen fibers in the combination group but a sparse and disorganized arrangement of collagen fibers in the control group.ConclusionThe combined application of rhEGF and rbbFGF can accelerate the healing of wound and increase the elasticity of regenerating tissue after fractional CO2 laser therapy.

We wished to assess the role of chlamydia micro virus capsid protein Vp3 in recombinant molecules, chart its molecular evolution, screen the wild-type strain, and reveal its value in clinical research. Using a protein BLAST multiple-alignment program, we compared various strains of Chlamydia micro virus capsid protein Vp3 sequences. Using a "distance tree" of those results, we created a phylogenetic tree. We applied the Karplus-Schulz method of flexible-region analyses for highly conserved alignments of amino-acid sequences. Gamier-Robson and Chou-Fasman methods were employed to analyze two-level structures of sequences. The Emini method was used for analyses of the accessibility of surface epitopes. Studies of hydrophilic proteins were undertaken using Kyte-Doolittle and Hopp-Woods methods. Analyses of antigen epitopes helped to reveal the antigen index using the Jameson-Wolf method. All sequences in the six strains of chlamydia micro virus capsid protein Vp3 were highly conserved, with the main differences being between Vp3 protein in Chp1 and the other five strains of the micro virus. The viral strain of Vp3 protein was based mainly on micro-alpha helix structures, and multiple epitopes were noted in highly conserved regions. Vp3 protein was highly conserved structurally, and was an important protein of the chlamydiaphage capsid. Vp3 protein has a complicated molecular structure, highly conserved regions with strong immunogenicity, and has considerable research value.
Amino Acid Sequence ; Capsid Proteins ; chemistry ; genetics ; immunology ; Chlamydia ; genetics ; immunology ; Conserved Sequence ; Epitope Mapping ; Evolution, Molecular ; Molecular Sequence Data ; Recombination, Genetic

AIM To investigate the effects of Wuzi Yanzong Prescription (Lycii Fructus,Cuscutae Semen,Rubi Fructus,Plantaginis Semen and Schisandrae chinensis Fructus) on DNA damage of testis cells in adult male mice induced by cyclophosphamide (CTX).METHODS Forty out of fifty adult male Balb/C mice were injected intraperitoneally with CTX and then were randomly and equally divided into model control group (normal saline),Wuzi Yanzong Prescription low-,medium-and high-dose groups (100,200 and 400 mg/kg),and the other ten mice served as normal control group (normal saline).All mice were anesthetized by inhalation of ether,and then were sacrificed by cervical dislocation.The sperm count,sperm motility and malformation rate of sperm were tested.The content of 8-hydroxy-deoxyguanosine (8-OHdG) in serum was measured using ELISA;the DNA damage degree of cells in testis was detected by single cell gel electrophoresis;the protein expressions of p-P53 and γ-H2AX in testis were examined by Western blot.RESULTS Compared with the model control group,Wuzi Yanzong Prescription groups showed significant increase in the sperm count,sperm motility and significantly decreased malformation rate of sperm,the level of 8-OHdG in serum,and the protein expressions of p-P53 and γ-H2AX in testis were also significantly decreased.CONCLUSION Wuzi Yanzong Prescription can significantly alleviate the DNA damage of testis cells in mice induced by CTX through down-regulating protein expressions of p-P53 and γ-H2AX.

Objective To explore the feasibility and effectiveness of channel-assisted spatium intermusculare approach interbody fusion for treating lumbar vertebra diseases.Methods A total of 81 patients with lumbar vertebra diseases were treated from June 2012 to December 2013,including 35 males and 46 females between 29 and 76 years old with an average age of 54.6.There were 36 cases of lumbar disc degeneration,10 cases of recurrence in situ after lumbar disc herniation surgery,6 cases of huge lumbar disc herniation,11 cases of lumbar disc herniation with spinal canal stenosis,5 cases of extreme lateral lumbar disc herniation and 13 cases of lumbar degenerative spondylolisthesis.There were 67 cases of single segment lesion and 14 cases of two segment lesions.Lesion sites contained L1,2 in 1 case,L3,4 in 4 cases,L4,5 in 50 cases,L5S1 in 12 cases,L3,4 and L4,5 in 8 cases,and L4,5 and L5S1 in 6 cases.Results The length of incision was 2.42±0.45 cm in cases of single segment lesion and 4.28±0.38 cm in cases of two segment lesions.The operation time was 96.00±21.53 minutes and intraoperative blood loss was 347.50± 241.62 ml.During the operation,one case suffered from dural laceration,cerebrospinal fluid leakage and ipsilateral nerve root injury.Two cases suffered from pedicle fractures.Eight cases experienced epidermal necrosis of the incision.One case had poor wound healing.Three cases suffered from nerve injury.A total of 76 patients were followed up for 12-30 months,averagely 20.5 months.Intervertebral height of lesion segments was apparently recovered after surgery,and maintained in good condition during the final follow-up.No significant difference in the changes of area and grade of multifidus was detected 12 months after surgery and before surgery.Except 4 cases,the remaining had interbody fusion with a fusion rate of 94.7％.The balance between the coronal plane and sagittal plane of the lumbar spine was evidently improved.Average Japanese Orthopaedic Association score increased from 12.66±1.88 points preoperatively to 26.4±1.92 points during the final follow-up,which showed significant differences.Conclusion The method of channel-assisted spatium intermusculare approach interbody fusion has some advantages for treating lumbar vertebra such as small incision,fewer traumas,less bleeding,fast recovery,and high fusion rate.However,there is a long time of operation in the early stage and high occurrence rate of complications.

ObjectiveTo compare the clinical results of pedicle screw fixation via the injured vertebra versus across the injured vertebra for thoracolumbar spine fracture.MethodsThe study reviewed 56 patients (41 males and 15 females,at age range of 21-66 years,mean 41.5 years) with thoracolumbar spine fractures managed with the two fixation methods from June 2005 to December 2008.The fracture segment included T12 in 13 patients,L1 in 27 and L2 in 16.According to the AO classification,there were six patients with type A1.2,29 with type A3.1,nine with type A3.2 and 12 with type A3.3.McCormack load score was 5-8 points (average 6.3 points). The spinal cord injury was classified as grade A in three patients,grade B in four,grade C in eight,grade D in 17 and grade E in 24 according to Frankel scale.The patients were divided into two groups,ie,across vertebral fixation group (27 patients) and via the vertebral fixation group (29 patients).All patients were selectively treated with monosegment bone graft simultaneously.The Cobb' s angle,restoration of the anterior height of the injured vertebra,improvement of spinal canal stenosis rate and Denis scale in local pain and work status were compared between the two groups.The bone graft fusion and spinal cord recovery of both groups were observed during follow-up.ResultsAll patients were followed up for 12-48 months (average 25.8 months).Implantation loosening occurred in one patient 1.5 month after operation in across vertebral fixation group.There were no significant differences in aspects of correction of Cobb' s angle,restoration of the anteriorheight of injured vertebra and improvement of spinal canal stenosis rate postoperatively as well as in aspects of restoration of anterior height of injured vertebra and improvement of spinal canal stenosis rate at the latest follow-up between the two groups ( P ＞ 0.05).The postoperative loss of correction rate of Cobb's angle of both groups existed,with significant difference (P ＜0.05). The differences of the Cobb's angle at the latest follow-up and after operation were significant in the across vertebral fixation group ( P ＜ 0.05) but insignificant in the via vertebral fixation group (P ＞ 0.05 ).Bone graft fusion occurred in 21 patients (78％) in the across vertebral fixation group and in 27 patients (93％) in the via vertebral fixation group ( P ＜ 0.05 ).Denis scale indicated a better recovery in the local pain of via vertebral fixation group compared with the across vertebral fixation group ( P ＜ 0.05 ),but showed no significant differenc e in work status between the two groups ( P ＞ 0.05 ).ConclusionsCompared with across vertebral fixation,the pedicle screw fixation via the vertebra has the advantages of higher fusion rate and better correction rate of Cobb' s angle and is a better choice for thoracolumbar spine fracture with posterior approach.