Objective To investigate the changes in intrapulmonary shunting during controlled hypotension induced by sodium nitroprusside(SNP)in patients undergoing naso-endoscopic operation.Methods Forty ASAⅠorⅡpatients of both sexes(23 male,17 female)aged 16-50 yrs weighing 50-75 kg undergoing naso-endoscopic operation under general anesthesia with muscle relaxation and mechanical ventilation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Right internal jugular vein was cannulated and the catheter was advanced into right ventricle.Blood sample taken from right ventricle was used as mixed venous blood instead of blood from pulmonary artery.ECG,MAP,HR and P_(ET) CO_2 were continuously monitored during operation Cardiac output was monitored with noninvasive cardiac function monitor(NC-COM.)based on impedance principle.SNP infusion was started at the beginning of operation at 1-3?g?kg~(-1)?min~(-1) and was then adjusted.MAP was reduced by 30%-40% and maintained at this level until the end of operation.Blood samples were taken from artery and right ventricle simultaneously before SNP infusion(T_1,baseline)at 30 and 60 min of hypotension(T_2,T_3)and at 20 min after BP returned to the baseline level(T_4)for blood gas analysis.Qs/Qt was calculated.Results Qs/Qt was significantly increased during controlled hypotension at T_2 and T_3 as compared to the baseline value(P＜0.01)and returned to the baseline level at T_4.HR was increased and cardiac output and stroke volume was significantly reduced during hypotension as compared to the baseline value.Conclusion The intrapulmonary shunting is increased and the hemodynamics is depressed during SNP-induced controlled hypotension and they return rapidly to baseline level after SNP is discontinued.No hypoxemia develops during SNP- induced hypotension.

Objective To investigate the relationship between chromosome 6p copy number alterations (CNAs) and postoperative intrahepatic recurrence of hepatocellular carcinoma (HCC);and to screen for the target genes in CNA(s).Methods Array comparative genomic hybridization (CGH) and expression arrays were used to detect CNAs and differences in gene expression, respectively.The associations between CNAs in 6p and HCC recurrence were analyzed using the log-rank test, the Kaplan-Meier curves and the Cox proportional hazards models on 66 patients who had been follow-up for 2.6 ～ 73.3 months.The differentially expression of genes in the potentially recurrence-related CNAs were further evaluated by the MannWhitney U test on 117 HCCs, which included 109 cases with paired array CGH and expression data.Results 6p CNAs were detected in 46 (69.7％) of the 66 HCCs.Of the 8 CNAs with the most frequent recurrence of over 20％ , a gain at 6p21.1 was independently associated with a 2.3-fold (95％ CI =1.1 ～ 5.1, P ＜ 0.05) increased risk for intrahepatic recurrence and with a more pronounced 3.3-fold (95％ CI =1.4 ～ 8.2, P ＜0.05) risk for early recurrence (≤ 1 year).A panel of 9 genes, including BYSL and RPL7L1 within the documented 6p21.1, were observed to be upregulated in HCCs with 6p21.1 gain when compared with HCCs without (all P ＜ 0.05).A high BYSL expression significantly correlated with a larger tumor size (＞ 6 cm), vascular invasion and advanced tumor stage (all P ＜ 0.05), and high RPL7L1 expression significantly correlated with vascular invasion and advanced tumor stage (all P ＜ 0.05).Conclusion A gain at 6p21.1 was an independently prognostic marker for intrahepatic recurrence of postoperative HCC, particular for early recurrence, and BYSL and RPL7L1 might be the target genes in the recurrence-related 6p21.1 gain.

Traditional Chinese medicine (TCM) dispensing is the final step of TCM used for clinical treatment, the stability of TCM dispensing is the guarantee of good clinical effect. Establishment of effect-constituent equivalence for Chinese herbal pieces based on clinical efficacy, can not only guarantee the stability of TCM dispensing, but also relate to the precision of clinical effect. This study chose Coptidis Rhizoma as the model, established effect-constituent equivalence of Coptidis Rhizoma, based on the effect-constituent index already established by our research group, and taking into consideration of homogeneity of clinical dosage and compliance of decoction, the uniformity of dispensing for different specification of Coptidis Rhizoma decoction pieces was studied. This research model was then applied to guide the specification-optimization of Coptidis Rhizoma and its clinical dispensing. The result indicated, effective constituent equivalence could reflect the fluctuation of specification, dosage and decoction to the fluctuation of efficacy; Optimized Coptidis Rhizoma decoction pieces had the characteristic of high homogeneity as for clinical dispensing, good compliance as for decoction, and high effective constituent equivalence. In conclusion, effective constituent equivalence could improve relevance of methods of TCM dispensing control to clinical effect. Preparated Superior-standard Decoction Pieces based on effective constituent equivalence was featured by good quality and a good practice of adjustable dosage, which could promote the development of TCM decoction pieces toward precision medicine.
Chemistry, Pharmaceutical ; methods ; Coptis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Quality Control ; Rhizome ; chemistry ; Therapeutic Equivalency

Objective To construct mitochondrial antiviral-signaling protein ( MAVS ) knockout ZR-751 breast neoplasms cells using CRISPR/Cas9 genome engineering technology , and study the effect of MAVS on cell proliferation . Methods Small guide RNA ( sgRNA ) was designed by targeting the first exon of MAVS gene and the pX 459-sgRNA recombinant eukaryotic expressional plasmid was constructed .Puromycin was used to screen monoclonal cells which stably knocked out MAVS gene .The knockout effect was measured by Western blotting .Cellular proliferation rates were detected by colony-forming assay when MAVS gene was knockout .The MTS assay was designed to detect the effect of MAVS on cell proliferation under DFX stimulus .Results The result of Western blotting suggested that no MAVS protein was detected in the MAVS gene knockout stable ZR-751 cells,showing that MAVS gene was knocked out completely .Proliferation became faster when MAVS was knocked out .MAVS promoted cell death under DFX stimulus .Conclusion The MAVS knockout ZR-751 stable cells have been constructed using CRISPR/Cas9 system.The preliminary experimental results show that MAVS inhibits breast cancer cell proliferation , which will facilitate studies on the function of MAVS in tumors in the future .

Objective To investigate the value and dynamic characteristics of diffusion-weighted imaging(DWI)in rabbit liver VX_2 tumor model,with correlation of pathology.Methods Forty New Zealand rabbits were included in the study and VX_2 tumor piece was implanted directly into the liver after laporotomy.Fiffteen had two intrahepatic implants while twenty-five had one implant.DWI was performed on the seventh,fourteenth and twenty-first day after implantation,while routine T_1WI and T_2WI sequences were done on the seventh and fourteenth day.Ten VX_2 tumor samples were studied by pathology.Results The lump detection rates on the seventh day after implantation of DWI,T_1WI and T_2WI were 78.7%(37/47), 10.7%(3/28)and 53.6%(15/28)respectively with statistical significance(x~2=32.61,P

Abdomen ; Hernia ; Humans ; Prostheses and Implants ; Prosthesis Implantation ; Treatment Outcome

[Objective]To explore an individualized treatment measure enjoying more practical,effective and safe characteristics through evaluating the efficacy and safety of combined medications of low-dose urokinase,low-molecular weight heparin nadroparin calcium and ozagrel sodium in treating patients with acute cerebral infarction.[Methods]One-hunderd patients with acute cerebral infarction patients were recruited in this trail,and grouped according to different treatment times:Group A (n=40,from January 2005 to February 2008,being selected into the group in accordance with standards of China Guideline for Cerebrovascular Disease Prevention and Treatment) and Group B (n=60,from March 2008 to June 2011,being selected into the group in accordance with indications for onset time within 24 h and allowing age more than 75 years).Standard thrombolytic therapy (high dose urokinase) was performed on Group A and combined medications of low-dose urokinase,low-molecular weight heparin nadroparin calcium and ozagrel sodium (triple antithrombotic therapy) were performed on group B.National Institute of Health Neurological Deficit Scale (NIHSS) and Evaluation Standard of Clinical Efficacy were used to evaluate the recovery of neurological function before treatment and 24 h,7 and 14 d after treatment.[Results] NIHSS scores after therapy rapidly decreased in both groups as compared with those before treatment (P＜0.05).The NIHSS scores of Group B at 24 h,and 7 and 14 d after treatment were significantly decreased as compared with those of Group A (P＜0.05).The efficacy rate of Group B was significantly higher than that of Group A (P＜0.05).Intraparenchymal hemorrhage rate was 10.0％ (4/40) in Group A and 3.3％ (2/60) in Group B.[Conclusion] Triple antithrombotic therapy is more effective and relatively safer than standard thrombolytic therapy in treatment of patients with acute cerebral infarction.

OBJECTIVETo evaluate the expression of epidermal growth factor receptor (EGFR) gene copy number and the expression of ERCC1 and BRCA1 proteins in patients with non-small-cell lung cancer (NSCLC) and the correlation between them.

METHODSThe status of EGFR gene copy number was determined by in situ hybridization (FISH), and the expression of ERCC1 and BRCC1 proteins was examined by immunohistochemistry (IHC). The relationship of EGFR gene copy number with the expression of ERCC1 and BRCA1 and the clinical pathologic features were analyzed.

RESULTSFISH-positive EGFR expression was identified in 40 of 166 samples (24.1%). More FISH-positive EGFR in the female than male patients (31.9% vs. 18.6%, P = 0.048), and non-smoker than smoker (32.8% vs. 16.7%, P = 0.045). FISH-positive EGFR was not associated with age, pathological type, clinical stage and metestasis status (P > 0.05). The expression of ERCC1 protein was identified in 60 of 132 samples (45.5%). The expression of ERCC1 protein varied significantly in tumors of different pathological types (P = 0.046), but not associated with age, gender, clinical stage, metestatic status and smoking status (P > 0.05). The expression of BRCA1 protein was identified in 46 of 131 samples (35.1%). The expression of BRCA1 was not associated with age gender, pathological type, clinical stage, metestatic ststus and smoking status (P > 0.05). There was a moderate correlation between the expressions of ERCC1 and BRCA1 (r = 0.449, P < 0.001), but EGFR gene copy number was not correlated with the expression of ERCC1 or BRCA1 protein.

CONCLUSIONSFISH-positive EGFR expression is associated with gender and smoking status, but not correlated with the expression of ERCC1 and BRCA1 proteins. There is a moderate correlation between the expressions of ERCC1 and BRCA1.

Adult ; Aged ; Aged, 80 and over ; BRCA1 Protein ; metabolism ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; pathology ; DNA-Binding Proteins ; metabolism ; Endonucleases ; metabolism ; Female ; Gene Dosage ; Gene Expression Regulation, Neoplastic ; Genes, erbB-1 ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Smoking ; Young Adult

OBJECTIVETo observe the effect of postoperative transcatheter hepatic arterial chemoembolization (TACE) and thymosin alpha(1) (T(alpha1)) treatment on recurrence of hepatocellular carcinoma (HCC).

METHODSFrom Jan 2000 to Dec 2002, 57 patients with HCC were randomly divided into three groups: group A (n = 18) received hepatectomy plus postoperative TACE and T(alpha1), group B (n = 23) received hepatectomy plus postoperative TACE and group C (n = 16) received hepatectomy only. The recurrence rate, the time to tumor recurrence and the median survival for the three groups were investigated.

RESULTSFor group A, B and C, the 1 year recurrence rate was 83.3%, 87.0% and 87.5% (P = 0.926), respectively. The time to tumor recurrence was 7.0, 5.0 and 4.0 months (P = 0.039), respectively. The median survival was 10.0, 7.0 and 8.0 months (P = 0.002), respectively.

CONCLUSIONPostoperative TACE plus Talpha(1) treatment for HCC patients does not decrease the recurrence rate but may delay its occurrence and prolong surviving time.

Adjuvants, Immunologic ; administration & dosage ; Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; Antineoplastic Agents ; administration & dosage ; Carboplatin ; administration & dosage ; Carcinoma, Hepatocellular ; surgery ; therapy ; Chemoembolization, Therapeutic ; Doxorubicin ; administration & dosage ; Female ; Hepatectomy ; Humans ; Iodized Oil ; administration & dosage ; Liver Neoplasms ; surgery ; therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Survival Rate ; Thymosin ; administration & dosage ; analogs & derivatives

OBJECTIVETo investigate the effect of temperature on hospital admission among patients with chronic systolic heart failure (CSHF).

METHODSData regarding in-hospital patients with CSHF were gathered from 12 hospitals in Hubei province, between 2000 and 2010. Patients with a history of congenital heart disease and the history of cancer from this series, were excluded. Chi-square (χ(2)) tests and t tests were used for descriptive analysis. Univariate and multivariate logistic regression methods were performed to determinate the risk of hospital admission of every month to compare with the previous one. We used 2-tailed 95% confidence interval (CI), and tests with P < 0.01 to consider the significant levels, statistically. We also used the SPSS 13.0 for Windows, release 15, 2006 (SPSS Inc, Chicago, Ill) for data analyses.

RESULTS(1) 48 964 patients were enrolled in the present study. The numbers of admission increased 18.71%, 13.84%, -21.90%, -34.62%, -21.97%, -3.81%, -2.04%, 10.13%, -17.13%, -0.85%, 21.54% and 42.70% from January to December when compared to the average number of admission. (2) The odds ratios (ORs) (95% CI, P values) of hospital admission in January, February and December were 1.09 (0.96 - 1.23, 0.54), 0.98 (0.84 - 1.10, 0.46) and 0.96 (0.84 - 1.08, 0.59), respectively in females which did not show any significant differences when compared to the number in August. However the ratios were 0.61 (0.54 - 0.69, < 0.01), 0.80 (0.68 - 0.92, < 0.01) and 0.73 (0.64 - 0.83, < 0.01), respectively, in males that showed significant differences when, compared to the figures in August. (3) The OR of admission increased more when temperature got lower for patients with coronary artery disease, hypertension heart disease or rheumatic heart disease, but not with dilated cardiomyopathy. (4) The OR of admission showed a different impact on patients with different occupation, along with the change of temperature. Low or high temperature did not seem to have different effects on the OR of admission in patients who were free-lanced or unemployed.

CONCLUSIONTemperature seemed to have significant effects on the risk of admission, which related to gender, etiology or occupation.

Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Climate ; Female ; Heart Failure ; Humans ; Inpatients ; statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Temperature