Objective To summarize our experience in the diagnosis and treatment of malignant peritoneal mesothelioma(MPM). Methods Clinical data of 10 patients admitted with MPM were analyzed retrospectively. Results The main symptoms of MPM were intraabdominal mass and abdominal pain in these patients; Seven patients were of localized type, 3 cases were of diffused type; Preoperatively 7 cases were misdiagnosed as other intraperitoneal tumor, 9 patients underwent laparotomy and tumor resection for a total 16 times, including once in 4 cases, two times in 3 cases, and three times in 2 cases. Seven patients received curative resection in initial operation. Five patients died within one year, 6 cases within two years, Tumors recurred postoperatively in 4 cases. 1 case is still survival 9 years after. Conclusion Being comparatively rare, MPM is often misdiagnosed, the prognosis is very poor, curative resection sometimes provides a long survival for localized type of MPM, when combined with perioperative comprehensive therapy.

Objective To build the cohort of drug resistance and analyze treatment efficiency of AIDS patients and situation of drug resistant mutations among HIV-1 infected individuals.Methods A cohort of 116 HIV-1 infected patients was built and their treatment progress were acquired once every 6 months.At the sanle time CD4+ T cell counts and HIV-1 viral load were measured and genotyping for drug resistance was determined by a home brew nested PCR.Results The CD4+ T cell count(470±251/ml)was higher than that before treatment in patients who were treated by AZT/DDI/NVP or D4T/DDL/NVP.The viral load was lower than that before treatmenL The drug resistant mutation frequency increased gradually along with treatment.The CD4+ T cell count was decreased and viral load was increased and the prevalence of drug resistant mutation was increased in the patients who changed regimens to AZT/3TC/NVP or D41/3TC/NVP.Only one primary mutation that was resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs)was detected in the naive patients.The cross-resistant mutation was detected in two patients after 6 months treatment. The intermediate resistance to lopinavir(LPV) was detected after 12 months treatment.The prevalence of high-grade resistances to NNRTIs was increased obviously,and the prevalence of multi-resistance and cross-resistance was detected in 5 patients after 36 months treatment.Conclusions The prevalence of primary mutation was rare in naive HIV-1 infected patients.The prevalence of drug resistant mutation was inereased gradually along with treatment.Ahhough few regimens were available,the treatment effect could last relatively long period of time if patients keep taking medicine stably.The regimens could be changed according to the results of drug resistant test.

Objective To study on the evaluation of haemodynamics in the normal and pulmonary hypertensive mouse hearts using pressure volume loops measured by electric catheter.Methods Compared the difference in haemodynamics between mice exposed to chronic hypoxia for 10 days,which causes hypoxia-induced pulmonary hypertension (experimental group,n =8),and mice raised under normal atmospheric pressure (control group,n =8).The right carotid artery was cannulated with a 1.2 F catheter and advanced into the ascending aorta,then punctured towards the right ventricular apex.A 1.2 F admittance pressure-volume catheter was introduced using a 20-gauge needle to obtain the pressure-volume measurements and calculate hemodynamic parameters.Results There were no significant differences in average by weight,ratio of right atrial weight to body weight,left atrial weight/body weight,left ventricular free wall and septum weight/body weight between the 2 groups(all P ＞ 0.05).The ratio of right rentricle/left rentricle and septum weight as well as right rentricular weight/body weight was increased in the experimental group and of significant difference when compared to the control.The mice in in the experimental group had a 61％ mean decrease in cardiac output,a 55％ decrease in ejection fraction,and a 63％ decrease in ventricular compliance(P ＜0.05).The increase in dP/dtmax-EDVand PRSWfound in the experimental group reflected significant increase in myocardial contractility.Increase in Ees was observed but without significant difference as compared to the control.Ea significantly increased in the experimental group resulting in significant decrease in Ees/Ea from (0.71 ±0.27) to (0.35 ±0.17) (P＜ 0.005).Conclusion This study demonstrates the feasibility of obtaining RV pressure-volume measurements in mice using electric catheter.These measurements provide insight into right ventricular-pulmonary artery interactions in healthy and diseased conditions.

AIMTo determine six effective components (aloe-emodin, rhein, emodin, rhaponticin, physcion and chrysophanol) in Rheum.

METHODSUsing buffer solution containing 20 mmol.L-1 borax, 20 mmol.L-1 sodium deoxycholate (SDC), 20 mmol.L-1 sodium taurocholate (STC), 15 mmol.L-1 beta-cyclodextrin (beta-CD) and O-phthalic acid as the internal standard, the six components were determined by cyclodextrin modified micellar electrokinetic chromatography.

RESULTSIn less than 25 min, aloe-emodin, rhein, emodin, rhaponticin, physion and chrysophanol were separated. The separation conditions were optimized by adjusting buffer pH, concentrations of SDC, STC and beta-CD. The linearity ranges of aloe-emodin, rhein, emodin, rhaponticin, physcion and chrysophanol were 4-34, 5-40, 4-60, 5-80, 6-90 and 5-85 micrograms.mL-1 respectively. Relative standard deviation (RSD) of the method was less than 2.2%. The recoveries of aloe-emodin, rhein, emodin, rhaponticin, physcion and chrysophanol were 100.0%, 98.3%, 100.4%, 94.6%. 95.2% and 93.8% respectively. Raw Rheum, Mongolian Rheum and Rheum tanguticum samples were analyzed.

CONCLUSIONThis method can be an effective one for identification of Rhubarb.

Anthraquinones ; analysis ; Chromatography, Micellar Electrokinetic Capillary ; methods ; Cyclodextrins ; chemistry ; Emodin ; analogs & derivatives ; analysis ; Plants, Medicinal ; chemistry ; Quality Control ; Rheum ; chemistry ; Stilbenes ; analysis

OBJECTIVETo explore the related issues concerning salvage surgery for stomal recurrence (SR) after total laryngectomy.

METHODSA retrospective study was conducted to analyse the clinical data from 36 patients suffering from SR after total laryngectomy, who were treated by salvage surgery from January 1990 to January 2006. Some related issues concerning salvage surgery for SR were studied and analysed, which include preoperative evaluations, surgical approaches and techniques, management of perioperative complications and outcomes of treatment.

RESULTSAfter careful preoperative evaluations and predictions, a complete resection of tumor was achieved in 33 out of 36 SR patients. Two patients sacrificed because of ruptures of major vessels including the common carotid eaters and the innominate artery 3 weeks and 2 months after the operation. The overall 1-year, 2-year and 3-year survival of this group of patients were 68.8%, 42.8% and 12.5%, respectively. Besides, postoperative complications comprise 23 cases of hypothyroidisms, 6 cases of wound infection and saliva leakage, 8 cases of donor site complications (including dehiscence of wound in 3 cases, chest wall hematomas in 4 cases, and tumor seeding in 1 case), and hypopharyngeal stenosis in 4 cases, all of which were properly and promptly managed with uneventful outcomes.

CONCLUSIONSSR after total laryngectomy is a dangerous and complicated status with poor prognosis. For the purpose of saving or elongating the patients's lives, the salvage surgery needs to be done on the condition that indicated candidates are properly selected, preoperative evaluations carefully conducted, and perioperative abnormal conditions unerroneously delt with.

Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; surgery ; Prognosis ; Retrospective Studies ; Salvage Therapy

AIMTo explore the molecular biological mechanism of hemoglobin with high oxygen affinity in Tibetans by determining the sequence of globin cDNA in Tibetans living at high altitude.

METHODSTotal RNA was isolated from human bone marrow samples of three Tibetans who live in Qinghai-Tibet plateau. cDNA fragments coding for alpha and beta genes of human hemoglobin were obtained through RT-PCR and were ligated to plasmid pGEM-T easy vectors, and then the ligation liquid were transformed to Escherichia coli and cloned and sequenced. Nucleotide sequences were compared with GenBank data by BLAST method.

RESULTSsequence of a globin cDNA in Tibetans were the same with the registering globin genes in the GenBank, and Hb Abruzzo (beta143 (H21), His- > Arg) gene mutation, a high oxygen affinity beta globin mutation, was found in one Tibetan' beta goblin coding gene (CAC- > CGC).

CONCLUSIONThis hemoglobin gene mutation may be associated with high altitude adaptation of Tibetans living at high altitude.

Adult ; Altitude ; Asian Continental Ancestry Group ; genetics ; Cloning, Molecular ; DNA, Complementary ; genetics ; Hemoglobins, Abnormal ; genetics ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; RNA ; Sequence Analysis, DNA ; Tibet ; alpha-Globins ; genetics ; beta-Globins ; genetics

OBJECTIVETo establish an animal model of non-transthoracic cardiopulmonary bypass (CPB) in rats.

METHODSTen adult male Sprague-Dawley rats, weighing 350-500 g, were used in this study. CPB was established in these animals through cannulating the left carotid and right jugular vein for arterial perfusion and venous return. The components of perfusion circuit, especially the miniature oxygenator and cannula, were specially designed and improved. The mean arterial pressure was measured with a blood pressure meter through cannulating the left femoral artery. The hemodynamic and blood gas parameters were also monitored.

RESULTSThe rat model of non-transthoracic CPB was established successfully. The hemodynamical parameters were changed within an acceptable region during CPB. The miniature oxygenator was sufficient to meet the standard of satisfactory CPB.

CONCLUSIONSThe rat model of non-transthoracic CPB established through the carotid and jugular cannulation is feasible, easily operated, safe, reliable, and economic. It is an ideal model for the pathophysiological research of CPB.

Animals ; Blood Gas Analysis ; Blood Pressure ; Cardiopulmonary Bypass ; methods ; Disease Models, Animal ; Heart Rate ; Male ; Rats ; Rats, Sprague-Dawley

Objective To study the associations between daily mortality and the status of exposure to air pollution.Methods A time-series analysis was conducted to assess the relations between acute mortality and exposure to respiratory particulate matter (PM10),sulfur-dioxide (SO2) and nitrogen dioxide (NO2) in urban residents of Guangzhou (2004-2008),using Poisson regression.Results Through controling the factors as temperature,relative humidity,age,gender and time,significant increases were observed in all-cause mortality of 0.94％ (0.79-1.09) for PM10,1.55％(1.31-1.78) for NO2,and 1.09％ (0.91-1.27) for SO2,per 10 μg/m3,when increase of the lagging 2-day average concentrations of air pollution was seen,in Guangzhou.Stronger effects of exposure to air pollution were found on cardiovascular and respiratory mortality,as well as in elderly( ≥65 years) and female population.Conclusion Our results suggested that exposure to ambient pollution was significantly associated with the increase of excess risks,on total and cardio-respiratory mortality in the residents of Guangzhou.

Objective To explore latent class of psychological distress among the elderly with multiple chronic conditions in the community and to analyze differences in demographic and alexithymia characteristics across class.Methods A total of 685 urban and rural elderly with chronic disease co-morbidities in 6 prefecture-level cities in Jiangsu Province were selected for the study using the General Information Questionnaire,the Depression Anxiety and Stress Scales-21,and the Toronto Alexithymia scale from November 2022 to March 2023 using a convenience sampling method.Results A total of 662 older adults with multiple chronic conditions were finally investigated with a total psychological distress score 30.00(16.00,52.00).Psychological distress manifested itself in 4 different potential categories named"stress-depressive"(19.9%),"low distress"(26.0%),"stress-anxiety"(23.4%),and"overall high distress"(30.7%).The comparison of the different psychological distress categories with respect to age group,marital status,residential status,financial stress of illness,acute events within 1 year,and self-perceived health status showed statistically significant differences(P＜0.05).The comparison of alexithymia scores for the 4 potential categories showed statistically significant differences(F=136.544,P＜0.001).Conclusion Psychological distress in older adults with multiple chronic diseases has distinct categorical features,and alexithymia varies across different categories of psychological distress.Healthcare professionals can adopt targeted interventions according to different categories of chronic disease co-morbidities in order to reduce their psychological distress,and at the same time they should focus on older adults with the alexithymia of"stress-depressive"and"overall high distress".

OBJECTIVETo determine the efficacy and safety of combined L-carnitine and acetyl-L-carnitine therapy in infertile males with oligoasthenozoospermia.

METHODSOne hundred fifty patients with oligoasthenozoospermia were randomized selected into treatment and control groups. The treatment group with 90 patients were given L-carnitine (2 g/d) and acetyl-L-carnitine (1 g/d) orally, twice a day. The patients in control group were given Vitamin E 100 mg plus Vitamin C 100 mg, tid. The oral therapy lasted three months and patients accepted sperm analysis every one month. The L-carnitine level in seminal plasma was examined by high performance liquid chromatography (HPC). Side effects as well as pregnant rate were observed.

RESULTSIn the treatment group, 85 patients out of 90 finished the three month treatment. Female spouses of 10 patients (11.6%) achieved pregnancy. Moreover, their forward motile sperm per ejaculation, total motile sperm, as well as the concentration of L-carnitine in seminal plasma were increased significantly (P < 0.01). In control group, 53 patients out of 60 completed three months therapy. Two pregnancy (3.7%) was observed. Though some increase was seen in number of forward motile sperm and total motile sperm per ejaculation, the changes were not statistically significant (P > 0.05). The difference of the pregnant rate between two groups was statistically significant. No side effects were found.

CONCLUSIONCombined treatment with L-carnitine and acetyl-L-calmitine can be an effective and safe option for treating oligoasthenozoospermia by means of significantly improving forward motile sperm and total motile sperm per ejaculation, as well as increasing pregnant rates.

Acetylcarnitine ; administration & dosage ; adverse effects ; Administration, Oral ; Adult ; Carnitine ; administration & dosage ; adverse effects ; Double-Blind Method ; Drug Administration Schedule ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Oligospermia ; drug therapy ; Pregnancy ; Pregnancy Rate