Background and purpose:More than 70 percent of ovarian cancer patients were diagnosed in the advanced stage. Currently the 5-year disease free survival (DFS) of stageⅢC-Ⅳovarian cancer patients wsa about 10 percent after first line chemotherapy. This study aimed to improve the 5-year DFS by three-step chemotherapy according to the mechanisms of ovarian cancer biological characteristics, cytodynamics and pharmacology. Methods:In arm A, the patients received three-step chemotherapy after primary debulking surgery, step one with paclitaxel plus carboplatin (TC regimen), every 3 weeks for 6 to 8 cycles;step two with etoposide plus cyclophosphamide, every 4 weeks for 6 cycles;step three wit carboplatin plus cyclophosphamide every eight weeks for six cycles. In control arm B, we retrospectively analysed 51 cases withⅢC-Ⅳstage ovarian cancer, who had completely response after standard chemotherapy with six to eight cycles of TC after primary surgery during 2007. We compared the 5-year DFS between the two arms. Results:The 5-year DFS of 15 cases in arm A was 80%(12/15), which was signiifcantly higher than that of arm B (5.9%, 3/51, P<0.01). Conclusion: The three-step chemotherapy after optimal debulking surgery in stageⅢC-Ⅳ can improve the 5-year DFS. This regimen is high efficacy, mild side-effect witn low cost, which deserves further exploration.

Objective To investigate individualized and multi-phase management of recurrent epithelial ovarian carcinoma in order to improve survival of the patients. Methods From 1998 to 2002, 70 patients with recurrent epithelial ovarian carcinoma were enrolled in the present study. The treatments were divided into: (1) Induction of tumor remission:platinum sensitive patients were treated with paclitaxol + cisplatin (TP) or carboplatin + cyclophosphamide(CP)regimen; platinum resistant patients used Taxol + mitomycin(TM)or etoposide+ mitomycin(VM)regimen. Resection of tumors was done in an attempt to reduce the residual tumor with a diameter less than 1cm. Local radiotherapy was performed for those with residual tumor and who achieved clinical response after chemotherapy or surgery. (2) Consolidation therapy: chemotherapy with lower doses was administrated after disease remission. Interferon was used as immunotherapy during chemotherapy and radiotherapy. Survial analysis was done. Results (1) The 1, 2, 3, 4, 5-year survival rates were 67%, 51%, 45%, 38%, 32% . Median survival was 38.57 months. (3)The 1,2,3-year progression-free survival rates of the research arm were 41%, 37%, 24%. Median progression-free survival was 12.00 months. (4) Multivariate analysis revealed that platinum-free interval (P

AIM:To compare the clinical effects of 25G+ and 27G+ transconjunctival sutureless vitrectomy in treating idiopathic macular hole.METHODS: We retrospectively reviewed the clinical outcomes of 56 eyes (56 patients) with idiopathic macular hole which were treated with micro-incision vitrectomy from June 2015 to September 2016.Patients were divided into two groups, 28 patients (28 eyes) were treated with 25G+ vitrectomy and the rest (28 eyes) were treated with 27G+ vitrectomy.The operative time and intraoperative complications were recorded and patients were followed up for 3-6mo.During the follow up period, best correct vision acuity (BCVA), intraocular pressure, macular hole healing and postoperative complications were documented and statistically analyzed.RESULTS: BCVA in two groups were significantly improved after surgery(P<0.001) and there was no significant difference between the two groups(P=0.84).No serious complications occurred.No statistically significant difference was found between the two groups in surgical time and healing rate of macular hole (P=0.57, 0.64).The incidence of low intraocular pressure (IOP<10mmHg) in 27G+ group was lower than that in 25G+ group on the first day after surgery(P=0.31).There was no significant difference between preoperative and postoperative intraocular pressure at 1wk after operation in both groups (P=0.72, 0.92).CONCLUSION: Both 25G+ and 27G+ vitrectomy are safe and effective technique in treating idiopathic macular hole.Besides, 27G+ showed better superiority on the maintenance of intraocular pressure and reduce the trauma.

OBJECTIVETo investigate the potential role of intestinal bifidobacteria in the pathogenesis of gut-origin bacteria/endotoxin translocation in scalded rats.

METHODSWistar rats inflicted with 30% III degree scalding on the back were employed as the model with the rats undergoing sham injury as the control. The intestinal bacteria/endotoxin translocation and the changes in cecal mucosal microflora were determined by routine methods. And the plasma IL-6 concentration was measured with ELISA.

RESULTSThe incident of bacterial translocation into internal organs increased markedly in scalded rats (P = 0.001). The plasma LPS levels on 1, 3 and 5 postburn days (PBDs) in scalded rat group were much higher than those in sham injury group. The number of bifidobacteria decreased sharply 20 - 250 fold, the fungi increased 5 - 60 fold and E. coli increased 0.5 - 30 fold in the caecal mucosal microflora in the scalding group. The ratio of bifidobacteria to E. coli in the scalding group (4 - 800:1) was much lower than that in the sham injury group (25000:1). Furthermore, the plasma IL-6 level increased evidently in the scalding group. It was indicated by further analysis that compared with the rats without bacterial translocation, the bifidobacteria decreased 120 fold, the fungal number increased 50 fold and the E. coli number increased 30 fold in the scalded rats. The bifidobacterial number in the caecal mucosal microflora was negatively correlated with the plasma concentrations of IL-6 and LPS (P < 0.01) in the scalding rat group, and the plasma concentration of IL-6 was significantly and positively correlated with that of LPS.

CONCLUSIONSevere scalding injury could lead to an the imbalance of intestinal microflora and the increased intestinal translocation of bacteria and LPS. The decrease of the ratio and number of bifidobacteria in the caecal mucosal microflora might be a contribute to the occurrence of postburn intestinal bacteria/endotoxin translocation.

Animals ; Bacterial Infections ; blood ; microbiology ; Bacterial Translocation ; physiology ; Bifidobacterium ; isolation & purification ; physiology ; Burns ; microbiology ; Colony Count, Microbial ; Escherichia coli ; isolation & purification ; physiology ; Female ; Interleukin-6 ; blood ; Intestines ; microbiology ; Kidney ; microbiology ; Lipopolysaccharides ; metabolism ; Liver ; microbiology ; Lymph Nodes ; microbiology ; Male ; Rats ; Rats, Wistar ; Spleen ; microbiology ; Time Factors

OBJECTIVERecently studies showed infections of Chlamydia pneumoniae (Cp), Helicobacter pylori (Hp) and cytomegalovirus (CMV) played roles in the development of atherosclerosis. The aim of this study was to study relationship between infection of Cp, Hp and CMV, systemic inflammation and coronary artery disease (CAD).

METHODSFourty-five patients with at least one coronary artery stenosis > 50% and 33 control subjects with negative coronary angiography were recruited for this case-control study from May 2000 to October 2001. Antibodies against Cp, Hp and CMV were measured and serum C-reactive protein (CRP) levels determined for each case. CRP level > 0.8 mg/dl was defined at elevated CRP level.

RESULTSThe prevalence of Cp IgG, Hp IgG or Hp IgA antibody was associated with CAD (P = 0.017, P < 0.001, P = 0.009). After adjustment for age, gender, smoking, hypertension, hyperlipidemia and diabetes, the association was still seen. Mean CRP value was significantly higher in patients with CAD, compared to those without CAD (P < 0.001). Multivariate analysis showed statistical significance (P = 0.03). Elevated levels of CRP were found to be an important parameter for CAD (P = 0.032). The prevalence of Cp IgG antibody, Hp IgG and CMV IgG antibody all showed no association with elevated levels of CRP (P = 0.391, P = 0.253, P = 0.724). The ratio of elevated levels of serum basic CRP in the group with IgG antibodies to 3 pathogens was 32.1% while in the group with IgG antibodies to

CONCLUSIONSTwo chronic infections, Cp and Hp, might increase the risk of CAD. There was no association of CMV infection with CAD. C-reactive protein was an independent parameter of CAD, but the increased systemic inflammation in CAD did not seem to be related to aforesaid infection.

Adult ; Aged ; Aged, 80 and over ; C-Reactive Protein ; analysis ; Chlamydophila Infections ; complications ; Chlamydophila pneumoniae ; Coronary Disease ; etiology ; Cytomegalovirus Infections ; complications ; Female ; Helicobacter Infections ; complications ; Helicobacter pylori ; Humans ; Inflammation ; complications ; Male ; Middle Aged

AIM:To evaluate the feasibility and advantages of two-port 27-gauge pars plana vitrectomy for treatment of recurrent retinal detachment in silicone oil dwelling eyes.METHODS:A retrospective study.Two-port 27-gauge pars plana vitrectomy was performed in 7 eyes with recurrent retinal detachment without remove of silicone oil.Proliferative membrane peeling, endolaser treatment, and drainage of subretinal fluid were performed.Scleral bulking was performed if necessary.RESULTS:Sucessful retina re-attachment was accomplishied in all eyes.No visually significant intraoperative complication occurred.All eyes expericend quick recoveray of visual acuity and mild postoperative irritation.One eye developed a recurrent inferior retinal detchment in 20d after the surgery using non-remove technique, and recovered after conventional silicone oil removal and retinal reattachment surgery.CONCLUSION:Two-port 27-gauge pars plana vitrectomy is an efficacious (and potentially cost-efficient) method to treat early stage recurrent retinal detachment in silicone oil dwelling eyes.

ObjectiveTo investigate influence of sedation and analgesia on stress reaction of post-cardiac surgery in infants with congenital heart disease.MethodsForty children with congenital heart disease were randomly divided into 2 groups after cardiac surgery.The analgesia group was given 0.5-2.0 ?g/(kg?h) fentanyl intravenous infusion in 20 children undergoing cardiovascular surgery.The control group was given 5-8 mg/(kg?dose) lbuprofen orally.Midaiolam 0.01-0.20 mg/(kg?h) was used in 2 groups for sedation by intravenous infusion or 0.05-0.10 mg/(kg?dose)by intravenous push intermittently.The effects and adverse effects of sedation and analgesia were observed on 2,8,24,48 h after surgery in each group.The levels of cortisol,growth hormone,insulin and blood glucose were measured,respectively.ResultsThere were significant differences in Ramsay,Comfort value on 2,8,24 h(Pa

To study the cognitive effects of diterpene ginkgolides (DG), transient middle cerebral artery occlusion (tMCAO)-induced rats were established. tMCAO-rats induced by suture method were divided into sham operation group, solvent control group, NBP group, DG group. The animal experiments in the present study were performed in accordance with the Ethical Guidelines of the Laboratory Animal Welfare Ethical Committee of Peking Union Medical College (00000646, 00000635). The effects of DG on tMCAO rats were evaluated by neurological severity score, cerebral infarction volume measurement, step-down and Morris water maze test. In the acute tMCAO rat model, 100 mg·kg^-1 DG improved the neural score and infarction volume. In the chronic tMCAO rat model, DG 100 mg·kg^-1 significantly improved the survival rate of tMCAO-induced rats. The Morris water maze results showed 100 mg·kg^-1 DG decreased the latency of tMCAO-induced rats to find the platform, while the effect was weaker than the NBP. However, DG 30 mg·kg^-1 did not show a significant effect. In conclusion, DG exerted a therapeutic effect on transient middle cerebral artery occlusion.

Biopsy ; Humans ; Kidney ; pathology ; Staining and Labeling ; methods

OBJECTIVETo observe the effects of Danlou Tablet (DT) on inflammatory reaction, and expressions of lipoprotein-associated phospholipase A2 (LP-PLA2), secretory phospholipase A2 (sPLA2), and to analyze potential mechanisms.

METHODSForty male Wistar rats were randomly and equally divided into five groups, i.e., the normal control group, the model group, the Western medicine (WM) group, the low dose DT group, the high dose DT group, 8 in each group. Rats in the normal control group were fed with basic forage for 12 successive weeks, while AS rat model was established in rats of the other four groups by feeding high fat and sugar forage plus intraperitoneal injection of vitamin D₃. Normal saline, atorvastatin calcium suspension (at the daily dose of 1.8 mg/kg), low dose DT suspension (at the daily dose of 450 mg/kg), and high dose DT suspension (at the daily dose of 900 mg/kg) were administered to rats in the model group, the WM group, the low dose DT group, the high dose DT group respectively by gastragavage for 8 successive weeks. The general condition of all rats was observed. Rats were sacrificed after gastric administration and their serum collected. Serum levels of lipids (TC, TG, HDL-C, LDL-C) and inflammatory factors [IL-6, TNF-α, monocyte chemoattractant protein 1 (MCP-1), oxidized low-density lipoprotein (ox-LDL), lipoprotein-associated phospholipase A2 (LP-PLA2), secretory phospholipase A2 (sPLA2)] were detected. Pathological changes of thoracic aorta were observed by HE staining. Protein and gene expressions of LP-PLA2 and sPLA2 in thoracic aorta were measured by Western blot and real-time fluorescent quantitative PCR respectively.

RESULTSCompared with the normal control group, rats in the model group were in low spirits and responded poorly. Typical atherosclerotic plaque could be seen in thoracic aorta of rats in the model group. Serum levels of TC, TG, LDL-C, IL-6, TNF-α, MCP-1, ox-LDL, LP-PLA2, and sPLA2 significantly increased (P < 0.05); protein and gene expressions of LP-PLA2 and sPLA2 in rat thoracic aorta increased (P < 0.05) in the model group. After 8 weeks of intervention, rats in 3 medication groups appeared active, and HE staining showed subsidence of plaque in rat thoracic aorta. Compared with the model group, serum levels of TC, TG, LDL-C, IL-6, TNF-α, MCP-1, ox-LDL, and LP-PLA2 decreased in 3 medication groups (P < 0.01, P < 0.05); serum sPLA2 level decreased, protein and mRNA expressions of LP-PLA2 and sPLA2 in rat thoracic aorta decreased in the WM group (P < 0.01, P < 0.05); protein and mRNA expressions of LP-PLA2 in rat thoracic aorta significantly decreased in the low dose DT group (P < 0.01, P < 0.05), and those of LP-PLA2 and sPLA2 decreased in the high dose DT group (P < 0.01, P < 0.05).

CONCLUSIONDT could fight against inflammatory reaction and AS possibly through inhibiting LP-PLA2 expression and reducing ox-LDL production.

1-Alkyl-2-acetylglycerophosphocholine Esterase ; blood ; Animals ; Aorta, Thoracic ; pathology ; Atherosclerosis ; drug therapy ; Chemokine CCL2 ; blood ; Drugs, Chinese Herbal ; pharmacology ; Inflammation ; drug therapy ; Interleukin-6 ; blood ; Lipids ; blood ; Lipoproteins, LDL ; blood ; Male ; Phospholipases A2 ; blood ; Plaque, Atherosclerotic ; Random Allocation ; Rats ; Rats, Wistar ; Tablets ; Tumor Necrosis Factor-alpha ; blood