Objective The study aimed to observe the clinical effects and the adverse reactions of recombinant mutant human tumor necrosis factor-alpha ( rhu-TNF) on the treatment of malignant pleural effusion ( MPE) induced by lung adenocarcinoma . Methods 70 patients with MPE caused by lung adenocarcinoma hospitalized in our department were chosen as the research objects . After conventional drainage of pleural effusion , the patients were divided into two groups according to the weight , respectively receiving intra pleural injection of 2 000 000 units and 3 000 000 units of rhu-TNF, followed by the observation of clinical effects and adverse reac-tions.A further retrospective analysis were made on the effects of dexamethasone injected before operation on clinical effects and ad -verse events. Results The effective rates of 2 000 000 unit group and 3 000 000 unit group were respectively 75.68%and 87.88%(P=0.23), with no statistical difference.The adverse reactions in the group of patients being injected dexamethasone before operation significantly reduced(P=0.021) and the use of dexamethasone had no influence on the efficacy of rhu-TNF ( P=0 .486 ) . Conclusion Rhu-TNF is a safe drug with high efficiency in the treatment of MPE induced by lung adenocarcinoma , and the efficacy and safety of re-peated application in clinic still need more supporting data .

Objectives: To analyze the strategies of the diagnosis and treatment in patients with the pulmonary infection after renal transplantation. Methods: A retrospective analysis was made on 28 cases of pulmonary infections among 285 patients undergoing renal transplantation. Results: The morbidity of pulmonary infection was 9.82%(28/285). The majority pathogens of pulmonary infection in this study were pseudomonas, staphylococcus epidermidis, canadida and cytomegalovirus. Chest X ray was important in the diagnosis, but there was no specificity to determine the pathogens. The mortality in 28 pulmonary infection patients was 32.1%(9/28). Most of the patients suffered from pulmonary infection within 4 months after the operation, and the postoperative period from 2 months to 4 months was a high risk time window for death caused by pulmonary infections. Conclusions: The morbidity and mortality of pulmonary infections, especially severe pneumonia, in patients with renal transplantation, are higher than healthy people. Treatment following clinical epidemiology and strategy of microbiology play a very important role to reduce the mortality in those patients.

Objective To develop a network system for radiotherapy.Methods Delphi 6.0 lan- guage was used to program the system based on PACS through the model of client-server machine and local network.Data of different facilities were transferred among each other through Dicom 3.0 and Dicom RT pro- tocol.Results The main function of this system was a management software for radiotherapy,a PACS sys- tem,a TPS system and a therapeutic machine system.Conclusion The network system operates steadily with data safe and reliable,and is an important part of the information construction in the department of radio- therapy

Humans ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Tyrosinemias ; diagnosis ; therapy

Sixteen compounds were isolated from the aerial parts of Euphorbia sikkimensis by means of various chromatographic techniques such as silica gel, Sephades LH-20 and RP-18, and their structures were elucidated as naringenin (1), kaempferol (2), quercetin (3), kaempferol-3-O-alpha-L-arabinopyranoside (4), quercetin-3-O-alpha-L-arabinopyranoside (5), quercetin-3-O-(2"-galloyl)-alpha-L-arabinopyranoside (6), 5alpha, 8alpha-epidioxy-(22E, 24R)-ergosta-6,22-dien-3beta-ol (7), stigmast-5-ene-7-one-3beta-ol (8), 3beta-hydroxy4a, 14alpha-dimethyl-5alpha-ergosta-8, 24(28)-dien-7-one(9), beta-sitosterol (10) , 10-cucurbitadienol( 1) , scopoletin(12) , ethyl gallate(13), p-hydroxybenzaldehyde (14), 3 betahydroxybenzeneethanol( 15) ,and 2,4-dihydroxy-6-methoxy-acetophenone (16) on the basis of spectroscopic data analysis. All the compounds are isolated from this plant for the first time, and compounds 1, 4-8, 15 are obtained from Euphorbia species for the first time.
Chromatography ; Euphorbia ; chemistry ; Organic Chemicals ; analysis ; isolation & purification

OBJECTIVETo evaluate surgical strategy and clinical outcomes for the treatment of thoracolumbar metastatic tumor.

METHODSFrom January 2009 to December 2010,42 patients with thoracolumbar metastatic tumor were treated surgically. Among the patients, 30 patients were male, and 12 patients were female, ranging in age from 28 to 76 years old, with an average age of 56.8 years old. Twenty-five patients had metastatic tumor in thoracic vertebraes, and 17 patients had metastatic tumor in lumbar vertebraes. Thirty-four patients had metastatic tumor in 1 segment, 6 patients had metastatic tumor in 2 segments and 2 patients had metastatic tumor in 3 segments. Two patients had no symptoms and 40 patients had back or leg pain. Eighteen patients had neurologic deficits, and 5 patients had injuries of A degree, 3 patients had injuries of B degree, 4 patients had injuries of C degree, 6 patients had injuries of D degree according to ASIA grading system. The operation goal was made according to Tomita evaluation. The surgical procedures included pallative decompression, tumor curettage and total vertebrectomy, which were decided based on Tomita classification. The pain, spinal cord function,part control of tumor,survival rate and conditions of internal fixation were evaluated at 1 week, 3 months, 6 months, 1 year and 2 years after operation.

RESULTSOne patient died in the operation. Pain relief was obtained in 38 patients after operation. Among 18 patients suffering from spinal cord compromise, 17 patients improved 1 to 4 grades after surgery according to the ASIA grading system. All the patients were followed up and the duration ranged from 24 to 48 months, with a mean time of 34.2 months. Five patients got recurrence. The postoperative survival rates at 3 months, 6 months, 1 year and 2 years were 95.2%, 85.7%, 58.2%, 37.6% respectively.

CONCLUSIONAccording to Tomita system, the different surgical treatments can be selected for patients with spinal metastatic tumors, which can relieve pain, improve the neurological status and spine stabilization, maintain local control, improve quality of life.

Adult ; Aged ; Female ; Humans ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spinal Neoplasms ; diagnosis ; secondary ; surgery ; Thoracic Vertebrae ; Treatment Outcome

Isolation and purification of chemical constituents from solid culture of endophyte Chaetomium globosum in Imperata cylindrical was performed through silica gel column chromatography, gel filtration over Sephadex LH-20 and preparative HPLC. Nine compounds were obtained and their structures were determined as chaetoglobosin F(1), chaetoglobosin Fex(2), chaetoglobosin E(3) cytoglobosin A(4), penochalasin C(S), isochaetoglobosin D (6), N-benzoylphenylalaninyl-N-benzoyphenylalaninate(7), uracil(8) and 5-methyluracil(9), respectively, based on HR-MS and NMR data and comparison with literatures. Compound 7 was isolated from Chaeeomium sp. for the first time. In vitro cytotoxicity of compounds was evaluated using MTT mothed and 1,3,4 and 5 showed inhibition activity to the human cervical carcinoma cell HeLa with IC50 values of 99.43, 23.77, 97.92, 86.25 micromol x L(-1), while positive cotolocisnin Ad apno1ch alse IC50 24.33 micromol x L(-1).
Biological Factors ; chemistry ; pharmacology ; Cell Line ; Cell Survival ; drug effects ; Chaetomium ; chemistry ; Endophytes ; chemistry ; Humans ; Molecular Structure ; Poaceae ; microbiology ; Spectrometry, Mass, Electrospray Ionization

Objective To investigate the percentages of Th17 and CD4+CD25+FoxP3+ regulatory T(Tr) cells and the levels of related cytokines IL-6,IL-23,IL-17 and TGF-β in serum of patients with anlylosing spondylitis(AS).Methods Forty patients with AS and 37 age-matched healthy donors were studied.Flow cytometry Was used to analyze the percentages of blood Th17 and CD4+CD25+FoxP3+Tr cells.The levels of serum IL-6,IL-23,IL-17 and TGF-β were assayed by enzyme-linked immunosorbent assay ( ELISA).Results The proportion of Th17 cells in AS group was significantly higher than those in normal group [ (1.02±0.34)％ vs (0.68±0.29)％,P＜0.05) ],and the proportion of CD4+CD25+FoxP3+ cells was lower in AS group comparing with normal group [(3.77±0.81)％ vs (4.69±1.23)％,P＜0.05)].Meanwhile,serum levels of IL-6,IL-23 and IL-17 were significantly higher in AS group than those in normal group [ (6,15±2.71) ng/L vs (3.31±1.65) ng/L; (9.44±3.12) ng/ml vs (5.82±2.61) ng/ml;(10.53±4.97) ng/L vs (6.78±3.26) ng/L,all P＜0.01 ].In contrast,TGF-β level was decreased in AS group compares with the normal group [ ( 4.76±2.15) ng/ml vs (5.16±2.02) ng/ml,P＞0.05 ],but the difference was not significant.No associations of serum eytokine levels with clinical and laboratory parameters were found in AS.Conclusion The abnormality Th17 cells and Tr cells and their related cytokines IL-6,IL-23,IL-17 and TGF-β changes in patients with AS,which may be involved in immunological pathogenesis of AS.

BACKGROUND: In patients with obstructive sleep apnea(OSA),the degree of severity of OSA is mostly related to the sleep time spent in the supine position. According to the apnea-hypopnea index(AHI), positional and n onpositional OSA has been distinguished.OBJECTIVE: To compare the clinical characteristics of positional and nonpositional OSA and investigatethe relationship between sleep position and respiratory function of patients with OSA.DESIGN: A comparative clinica] observation based on the OSA patients.SETTING: Center of Sleep Disorders,Nanjing General Hospital of Nanjing Military Area Command of Chinese PLA.PARTICIPANTS: From October 1998 to May 2002,225 patients were examined with overnight polysomnography in the Center of Sleep Disorders,Department of Respiratory Disease, Nanjing General Hospital of Nanjing Command. According to the inclusion criteria of ① AHI≥10 times/hour;② Sleep time in supine and lateral positions≥30 minutes; ③ Over 20years of age; 225 patients were selected from the total of 415 consecutive patients,including 63 with positional and 162 with nonpositional OSA.METHODS: All patients received overnight monitoring with HMS-5500polysomnography system(Respironics Inc USA) in the sleep laboratory. Queries for a detailed case history and physical examination were performed with the pulmonary functions evaluated with body p lethysmography. The clinical data and results of polysomnographic and pulmonary function tests were compared between the two groups of patients and a multiple stepwise regression analysis was employed to evaluate the determinant factors for sleep position dependence of the patients' condition.MAIN OUTCOME MEASURES: Main outcome: Comparisons of the clinical data,polysomnographic result and pulmonary function between the two groups. Secondary outcome: Correlation between classification of OSA and the clinical data.RESULTS: Totally 63 (28%) of the 225 OSA patients were identified as the positional type,who had significantly greater body mass index (BMI)then the nonpositional type patients [(43.46 ± 16.43) kg/m2 vs (23.90 ± 12.36) kg/m2,t =3. 977,P<0.01]. Except for sleeping time in lateral and supine positions, minimal SatO2 and basic SatO2 before the matching for BMI,all the other factors in polysomnograms of the two groups were significant different(P<0.05 or P<0.01). After BMI matching,all the measurements were identical to those recorded for the primary grouping with the exception of nocturnal limb movement frequency,which differed but insignificant between the two groups. The pulmonary function in the two groups was no significant difference(P>0.05) . Multiple stepwise regression analysis indicated that AHI and BMI were the two determinant factors for positional dependence of OSA with a predictive power of 26. 2%. Linear correlation analysis showed correlation of AHI and SatO2 with BMI in the whole group and nonpositional group(P<0.05 or P<0.01),but not in the positional group (P>0.05).CONCLUSION: About one-third of the OSA patients shows sleep position dependence,who may respond favorably to sleep position training. Sufficient patency can be retained in the upper airway of these patients to relieve respiratory obstruction during sleep and improve the respiratory function.

Objective To study the changes of phosphatidylcholine-specific phospholipase D (PC-PLD) enzyme activity of glomerular mesangial cells (GMCs) in high glucose and the effect of PLD on cytoskeleton. Methods Rats GMCs were cultured in high glucose(30 mmol/L) for 48 hours. PLD enzyme activity was measured by enzyme coupled colorimetry. PKC activity was measured by substrate phosphorylation, and fluorescence intensity of F-actin was observed by FITC-labeled antibody and laser scan cofocal microscopy (LSCM) . Results In high glucose, PLD and PKC activities were obviously elevated, but fluorescence intensity of F-actin was decreased and its cytoskeletal pattern was disassembly. After treatment with inhibtor of PLD, PKC activity was significantly decreased, and intensity and organization of F-actin were recovered. Conclusion Elevation of PLD activity induced by high glucose may influence the cytoskeleton and contraction of CMC through PKC pathway.