This study aimed to evaluate emerging trends of drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) among 290 former blood donor HIV-1 infected patients in Hubei,China,from 2004 to 2006,all of whom had received anti-HIV-1 therapy.The presence of NRTI- and NNRTI-associated mutations were established by sequencing; genotypic and predicted phenotypic drug resistance were evaluated using HIVdb Program version 5.0.1 (http://hivdb.stanford.edu/pages/algs/HIVdb.html).Genotypic drug resistance analysis showed significant increases in percentages of patients carrying HIV-1 strains with M41L,T215Y/F,D67N,K103N,G190A/S,Y181C/F or L210W mutations.Of the variants' predicted phenotypic drug resistance,highly significant increases were detected in percentages of patients carrying HIV-1 with high resistance to zidovudine (AZT) or stavudine (D4T) in NRTIs,and to delavirdine (DLV),efavirenz (EFV) or nevirapine (NVP) in NNRTIs; intermediate resistance to abacavir (ABC),AZT,D4/T,didanosine (DDI) or tenofovir disoproxil fumarate (TDF) in NRTIs,and to etravirine (ETR) in NNRTIs; and low and potential low resistance to lamivudine (3TC),ABC,emtricitabine (FTC) or TDF in NRTIs,and to ETR in NNRTIs.

Recurrent low back pain and reflex sciatica of lower limbs are the two leading symptoms of prolapsed lumbar intervertebral disc, which can be confirmed in the history, symptoms, signs and imaging examination such as CT scan and MRI. It should be differentiated from those conditions characterized by lumbago and/or possible sciatica. Tuina was performed mostly on the Bladder Meridian,Gallbladder Meridian and Governor Vessel, as well as their acupoints such as Jiaji (Ex-B 2) points,Shenshu (BL 23), Dachangshu (BL 25), Yaoyangguan (GV 3), Huantiao (GB 30), Weizhong (BL 40),Chengshan (BL 57), Yanglingquan (GB 34) and Ashi points. Thumb-massaging manipulation, rolling manipulation, pulling manipulation, pressing manipulation, kneading manipulation and grasping manipulation are often performed.

Combined use of acupuncture and drug is extensively applied for its wide indications,simple manipulation and good results.Combined use of acupuncture and drug is not in effect the mechanic addition of acupuncture and drugs.It has been proved that acupuncture and drug are of synergism,but there may be an antagonism between acupuncture and drug.How to choose the optimum acupoint in the combination of acupuncture and drug to exert better effects is of great theoretical and practical significance for acupuncturists to make further researches.

Age Factors ; Cardiac Output ; physiology ; Cardiography, Impedance ; methods ; Child ; Child, Preschool ; Electric Impedance ; Female ; Heart ; physiology ; Humans ; Male ; Stroke Volume ; physiology ; Tomography ; methods

Objective To establish VX2 hepatic carcinoma model in rabbits by implanting the tumor fragment into the liver through percutaneous puncture under ultrasound guidance and to observe its growing and metastatic characteristics, to determine the optimal time for interventional experiment study with the model. Methods Inoculation of VX2 carcinoma fragment was performed in 28 New Zealand white rabbits. PET/CT and ultrasonography (US) examinations were carried out in the second, third and forth week after the inoculation, and each time two tumor-bearing rabbits were sacrificed for pathologic study. Results The successful rate of model establishment was 89.28% (25/28). On PET or CT scans, single lesion in the liver was demonstrated in 25 rabbits. Two, three and four weeks after the inoculation, the maximum diameter of the tumor was (4.82±0.80) mm, (16.05±2.89) mm and (30.08±5.38) mm respectively, while the metastasis rates was 0% (0/25), 13.04% (3/23), 76.19% (16/21) respectively. No significant necrosis was found in the second week after inoculation, only tiny coagulation necrosis was revealed in the third week, and massive necrosis was seen in the forth week. Conclusion Percutaneous inoculation of the tumor fragment into the liver under ultrasonographic guidance is a simple method to establish VX2 hepatic carcinoma in rabbits with a high successful rate. The third week after inoculation is the suitable time for making interventional experiment study.

0.05).The most common toxicity was neutropenia and nausea.There are no serious nausea,damage of liver and kidney functions and grade 4 neutropenia in the study group.The side-ef- fects,in the study group,such as hemorrhage,infection,medicine outleakage,catheter obstruct,catheter slough,gastric-intestinal perforation,and fever did not appear.Conclusion Although this study was conduct- ed in a small number of patients and short time,compared with the control group,the study group had a ben- eficial effect in peritoneal recurrence after curative gastrectomy for advanced gastric cancer and had less side effect and good toleration.It played a role in enhancing 1-year overall survival rate.The combination of intra- venous and intraperitoneal chemotherapy after gastrectomy may have better treatment effect on gastric cancer than that of intravenous chemotherapy alone.The randomized controlled trials are required.

Objective To study multiple cytokine mRNA expressions of bone marrow stromal cells in patients with multiple myeloma(MM),as well as to explore the role of these cytokines in the occurrence and development of MM.Methods Semi-quantitiative RT-PCR was used to detect the mRNA expressions of IL- 1?,IL-6,SCF,TPO.Results The mRNA expression levels of IL-1? and IL-6 were higher than that of nor- mal controls and other hematological malignancies(P

Objective To evaluate the treatment of hypervascular hepatic metastasis with TACE. Methods One hundred and twenty nine cases of hepatic metastasis treated by TACE were selected retrospectively and then analyzed the survival rate,clinical effectiveness and lipidol deposition quantity in tumor.Results Malformation of tumor vessels and rich blood supply were found in all cases of this study.The survival rates of 6 months,1 year and 3 years were 100%,73.6% and 26.4% respectively.The clinical effective rate was 68.2%(88/129)and no-progress rate was 23.3%(30/129).The satisfactory lipidol deposition quantity was obtained in 80.9%(97/129).Conclusions TACE is a favorable method for hepatic metastasis,and discerning the hypervascular subgroup could improve the treating effectiveness and be useful to make an appropriate planning.

Objective To investigate the effects of fast-track surgery on postoperative rehabilitation of patients with liver cancer. Methods Forty-one patients with liver cancer who had been admitted to Zhongshan Hospital of Fudan University from 9 to 30 in July 2008 were randomly divided into fast-track surgery group (n =20) and routine treatment group (n =21) according to the random number table. Patients in fast-track surgery group were preoperatively educated in order to lessen their anxiety. Bowel preparation was not applied before operation, and they were orally administered with 1000 ml of enteral nutrition emulsion (1300 kcal), then they were fasted for 4 hours before operation. Urethral catheter and gastric tube were removed after operation. They were orally administered with 1000 ml of enteral nutrition emulsion on postoperative day 2, and were encouraged to partake in off-bed activity shortly after the operation. The off-bed time, anus exhaust time, postoperative complica-tions, hospitalization time, expense, nutritional and metabolic indexes on postoperative day 1, 3 and 5, hepatic and renal function, immune and stress indexes between the 2 groups were compared by t test and chi-square test. Results There were significant differences in off-bed time, anus exhaust time, patients' weight, expense, total bilirubin level on postoperative day 1, 3 and 5, and level of serum TNF-α on postoperative day 3 between the 2 groups (t =7.065, 5.483, 3.754, 2.291,2.289, 3.218, 3.192, 2.434, 2.089, P <0.05). Conclusions Fast-track surgery can accelerate the postoperative rehabilitation of patients with liver cancer.

Objective To investiga~ the effect of remote ischemic preconditioning (RIPC) combined with dexmedetomidine on the lung injury during one-lung ventilation (OLV) in the patients undergoing thoracic surgery.Methods Thirty ASA physical status Ⅰ or Ⅱ patients,aged 45-70 yr,weighing 51-69 kg,scheduled for elective radical operation for esophageal cancer,were randomly divided into 2 groups (n =15 each) using a random number table:control group (group C) and RIPC combined with dexmedetomidine group (group ORD).In ORD group,at 10 min after endotracheal intubation,RIPC was induced by 3 cycles of 5 min lower extremity ischemia followed by 5 min reperfusion,and at the same time a loading dose of dexmedetomidine 1.0 μg/kg was infused intravenously over 15 min and then dexmedetomidine was infused at a rate of 0.5 μg· kg-1 · h-1 until the end of operation.At 0,30 min,1 h and 2 h of OLV (T1-4),blood samples were obtained from the radial artery for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β) and IL-10.Oxygenation index and respiratory index were calculated.Exhaled breath condensate was collected at T1,T3 and T4,and the pH value was measured.Results Compared with group C,oxygenation index was significantly increased,and respiratory index was decreased at T2-4,the plasma concentrations of TNF-α and IL-1β were decreased,and the pH value of exhaled breath condensate was increased at T3-4,and the plasma concentration of IL-10 was increased at T4 in group ORD.Conclusion RIPC combined with dexmedetomidine can inhibit inflammatory responses and reduce airway acidification,thus attenuating the lung injury during OLV in the patients undergoing thoracic surgery.