Objective To observe the efficacy and safety of tiopronin supplemented with chemotherapy in treating advanced breast cancer.Methods Sixty patients with advanced breast cancer were randomly divided into two groups:treatment group(n = 28) and control group (n = 32).Two groups were treated the same of NVB + DDP,the treatment group was supplemented with tiopronin,given for 10 days.Efficacy,toxicity in two groups were compared.Results The effective rate in the treatment group and the control group were 46.4% and 46.9% respectively, with no significant difference between the two groups ,P > 0.05.But the improved quality of life of patients in the treatment group was higher than that in the control group, P < 0.05.The rate of adverse reaction in liver function damaged (9.4%)and leucocyte lassitude(46.4%) were apparent lower than those in the control group(31.2% ,81.2% ),with significant difference between the two groups(P < 0.05, P < 0.01).Conclusion Tiopronin supplemented with chemotherapy show apparent effect in decreasing the adverse reaction of chemotherapy,improving the quality of life and not influence efficacy in advanced breast cancer.So tiopronln may act as protective drug for chemotherapy and deserve further testing in the clinic.

Objective To investigate the diagnosis and treatment of post-transplant lymphoproliferative disease (PTLD) after hematopoietic stem cell transplantation (HSCT).Methods Clinical data of one case of PTLD,including clinical manifestations,diagnosis and treatment,were retrospectively analyzed.And the related literatures were reviewed.Results From January 2007 to November 2012,one case developed PTLD among 196 patients who were followed up after HSCT in the First Affiliated Hospital of Chongqing Medical University.The incidence of PTLD was 0.5％.Clinical manifestations of the patient were not typical,including frequent fever,multiple lymphadenopathy and multiple pulmonary nodules.The patient was diagnosed as diffuse large B-cell lymphoma (B-DLCL) by pathological examination of the swollen lymph node.After withdrawal of immunosuppressants,the temperature returned to normal,and lymphadenopathy and pulmonary nodules disappeared completely.Conclusion PTLD is a severe complication of HSCT with distinctive morphologic and clinical characteristics.The origin of this disease may be associated with Epstein-Barr virus infection and imrnunosuppressive therapy.It needs the pathologic detection to make a definite diagnosis.Several different treatment strategies have been employed,and reduction of immunosuppressive therapy may lead to regression of PTLD.

Objective To retrospectively analyze the influence factors during autologous peripheral blood stem cell (PBSC) mobilization and collection process in the patients with non-Hodgkin′s lymphoma (NHL).Methods Forty-eight patients with NHL in our hospital from January 2014 to August 2016 underwent PBPC mobilization and collection.The factors of age,sex,disease stage,bone marrow involvement at diagnosis,chemotherapy frequency,relapse and so on were analyzed retrospectively.Results PBSC mobilization and collection was successful in 37 cases (77.10%).The success rate was affected by the time from diagnosis to mobilization (P=0.038),chemotherapy courses (P=0.016),prior chemotherapy including fludarabine (P=0.049),relapse(P=0.033),and the levels of white blood cell (P=0.014) and platelet (P<0.01) before stem cells collection.Conclusion For the patients planning to receive autologous peripheral blood stem cell transplantation,many times of prior chemotherapy are unfavorable,mobilization and collection should be taken as early as possible,chemotherapeutic agents which possibly injure stem cells should be avoided,it is needed to simultaneously pay attention to peripheral blood WBC and platelet level for determining the collection timing.

Objective To investigate the prognostic value of prognostic nutritional index (PNI) in patients with non-small cell lung cancer.Methods A total of 179 patients with non small cell lung cancer was enrolled in our hospital from November 2010 to January 2014.All patients were pathologically confirmed to be non small cell lung cancer.The clinical data of patients were collected,and the PNI values of each patient were calculated.The patients were divided into 4 groups according to the patients in the PNI of the patients in the treatment group (PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group).The survival curve was drawn by Kaplan-Meier method,and the difference of progression free survival (DFS) and overall survival (OS) of each group was compared by Log-rank method.Results (1) compared with PNIQ0-25 group,PNIQ25-50 group,PNIQ50-75 group and PNIQ75-100 group,there was signifi cant difference in age,smoking and KPS score (P ＜ 0.05).(2) the PNIQ0-25 group had a median overall survival of 11.5 months (95％ CI:6.6 ～ 15.4),the 3 year survival rate was 6.7％;PNIQ25-50 group had a median overall survival of 12.2 months (95％ CI:9.1 ～ 18),the 3 year survival rate was 6.4％ in PNIQ50-75 group;the median overall survival was 14.1 the month of (95％ CI:8.7 ～ 13.3),the 3 year survival rate was 11.4％,the PNIQ75-100 group had a median overall survival of 15 months (95％ CI:12.3 ～ 17.8),the 3 year survival rate was 11.6％.The Log-rank test,the four groups of patients with a significant difference in overall survival (x2 =15.6,P =0.001).(3) the PNIQ0-25 group had a median progres sion free survival was 5 months for (95％ CI:4.3 ～5.6),the 3 year progression free survival rate was 4.4％;PNIQ25-50 group had a median progression free survival was 6.4 months for (95％ CI:4.7 ～8.1),the 3 year progression free survival rate was 4.3％ in the PNIQ50-75 group;the median progression free survival was 7.4 months (95％ CI:6 ～ 8.7),the 3 year progression free survival rate was 9.1％ in PNIQ75-100 group,the median progression free survival was 8.9 months for (95％ CI:6.4 ～ 10.8),the 3 year progression free survival rate was 9.3％ by Log-rank test,survival was statistically significant was no difference between the four groups (x2 =26.7,P =0.000).Conclusions PNI has a good application value in the prognosis of patients with non-small cell lung cancer.

The xylose reductase of Pichia stipitis is one of the most important enzymes. It can be used to build up recombinant Saccharomyces cerevisiae strain for utilizing xylose and producing ethanol. Intercellular redox imbalance caused by NADPH preference over NADH for Pichia stipitis xylose reductase (PsXR) has been considered to be one of the main factors for poor ethanol productivity. Some key amino acids of PsXR, which affect the activity or coenzyme preference, were investigated in our previous study. In this study, Lys21 were rational designed for site-directed mutagenesis to alter coenzyme specificity of PsXR from NADPH and NADH into single NADH. The wild gene and mutagenesis genes were ligated into pET28b, and were transferred into E.coli BL21(DE3). After induced by IPTG, the xylose reductases were purified. Purified mutants K21A (Lys21-->Ala), K21R(Lys21-->Arg) were characterized by steady-state kinetic analysis. The results showed that the coenzyme dependence of K21A was completely reversed to NADH.
Aldehyde Reductase ; metabolism ; Amino Acid Substitution ; genetics ; Coenzymes ; pharmacology ; Escherichia coli ; genetics ; metabolism ; Ethanol ; pharmacology ; Lysine ; genetics ; Mutagenesis, Site-Directed ; NAD ; metabolism ; NADP ; metabolism ; Pichia ; chemistry ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; metabolism ; Recombination, Genetic ; Xylose ; pharmacology

The combination of submerged primary molars and permanent teeth deletion is rare. This article reported a case of several submerged primary molars, permanent teeth deletion and a cone-shaped maxillary lateral incisor and discussed based on relevant literatures.
Dentition, Permanent ; Humans ; Incisor ; Molar ; Tooth, Deciduous

Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)in patients with rosacea erythema telangiectasia and analyze the characteristics of dermoscopy.Methods Thirty patients with erythema telangiectasia rosacea treated in our hospital from January 2021 to August 2023 were collected as the observation targets.All of them received oral drugs(doxycycline hydrochloride combined with hydroxychloroquine sulfate),and were randomized,double-blind,face-divided.The patients with rosacea were injected with botulinum toxin type A(treatment side)and normal saline(control side)respectively,and the skin physiological indexes(transepidermal water loss,oil content,cuticle water content,erythema index)of the patients before and after treatment were compared.The vascular changes before and after dermoscopic treatment were analyzed,and the incidence of adverse reactions of the patients were calculated.Results After treatment,compared with the control side,the water loss,erythema index and oil content in the epidermis of the treatment side were decreased,and the water content in the stratum corneum was increased after treatment,with statistical significance(P<0.05).There was no difference before and after treatment on the control side(P>0.05).On the treatment side,the therapeutic effect was the best at 4 weeks after treatment,and the effect lasted until the 8th week,with no statistical significance(P>0.05),and the therapeutic effect was weakened at 8 weeks to 12 weeks,with statistical significance(P<0.05).The results of dermoscopy showed that after 4 weeks of treatment,compared with before treatment,the distribution proportion of dark red background,red background and polygonal blood vessels decreased,while the distribution proportion of light red background,linear blood vessels,branched blood vessels and punctured blood vessels increased,with statistical significance(P<0.05).There were no significant differences in yellow and red background and blood vessel distribution(P>0.05).The incidence of adverse reactions was 6.67%in the control group and 10.00%in the treatment group,with no statistical difference between the two groups(P>0.05).Conclusion BTX-A has a significant improvement effect on the symptoms of erythematous telangiectatic rosacea with high safety.

Objective To explore the value of OTSC( over-the-scope-clip) for upper digestive tract perforation. Methods Thirteen patients with old and fresh upper digestive tract perforation, treated with an OTSC clip at the Department of Digestive Endoscopy from May 2015 to June 2016, were enrolled. All OTSCs were 11/6t, and all procedures were performed by experienced endoscopists. Results Seven cases of fresh perforation were iatrogenic after treatment for gastric submucosal tumor. Six cases of old perforation included 2 cases of spontaneous esophageal rupture, 2 fistula after operations for esophageal foreign body, 1 fistula after the operation for gastric stromal tumor, and 1 anastomotic fistula after esophagectomy. Eight cases of perforation occurred in stomach and 5 in esophageal. Fresh lesion sizes were from 4 to 30 mm ( average 15. 3 mm), old lesion sizes from 5 to 10 mm(average 7. 8 mm). OTSC′s release time in fresh lesions was 6-27 min(average 15. 1 min), that in old 15-80 min(average 42. 3 min) with significant difference. Technical success rate was 100％(13/13),clinical success rate in fresh lesions was 100％(7/7),and 50％ (3/6) in old lesions. No patient had special treatment or complication. Conclusion OTSC is useful and safe for the treatment of upper digestive tract perforation, which is superior for fresh perforation than for the old. The perfect time to release OTSC for old perforation is when there is no obvious fibrosis caused by inflammation. The success rate is higher when the lesion size is smaller than 30 mm. Self-releasing of OTSC is rare. The necessity and the timing to take them out still needs further study.

Objective To investigate the value of mean platelet volume(MPV)combined with red blood cell distribution width(RDW)in prognosis of severe acute pancreatitis(SAP). Methods 65 SAP patients from January 1,2013 to December 31,2016 were included in the study and were divided into pospital death group(n=7) and survival group(n = 58). The basic clinical data of two groups were compared,the risk factors for hospital death and the prognostic value of MPV and RDW were analyzed. Results Compared with the survival group,the APACHEⅡ score,RDW,PLT,MPV,PDW were statistically different(P < 0.05). Logistic regression analysis was used to show APACHEⅡ score(OR = 1.793,95% CI: 1.212 ~ 2.654),PLT(OR = 0.982,95% CI: 0.967 ~0.997),MPV(OR=2.964,95% CI: 1.341~6.549),PDW(OR=1.470,95% CI: 1.019~2.122),RDW(OR=3.274,95% CI: 1.271 ~ 8.429)(P < 0.05). ROC curve analysis showed that the area under the curve of APA-CHEII score was 0.861(95% CI: 0.743 ~ 0.979,P = 0.001),MPV was 0.828(95% CI: 0.689 ~ 0.967,P =0.003,RDW was 0.849(95% CI: 0.749 ~ 0.949,P = 0.001),MPV+RDW was 0.914(95% CI: 0.832 ~ 0.997, P = 0.000). Conclusion The APACHEⅡ score,PLT,MPV,PDW,RDW are all the independent risk factors for hospital death with SAP. MPV combined with RDW has an important reference value for the prognosis of SAP patients.

Objective To compare the effects of visual rigid laryngoscope and visual laryngoscope in nasotracheal intubation(NTI)for patients with cervical spine immobilization simulated difficult airway.Methods Ninety patients scheduled for selective surgery under general anesthesia requiring NTI,52 males and 38 females,aged 18-64 years,BMI 18.5-25.0 kg/m2,ASA physical status Ⅰ or Ⅱ,were scheduled for selective surgery under general anesthesia requiring NTI.Before anesthesia induction,the spinal surgeon selected an appropriate cervical collar and adjusted it to fix patient's neck to establishing difficult airway sim-ulation model.All patients were randomly assigned into two groups:visual rigid laryngoscope(group R)and common visual laryngoscope(group C),45 patients in each group.NTI was performed using either visual rigid laryngoscope or visual laryngoscope in groups R and C,respectively.The nasal passage time,glottic exposure time,intubation time,number of successful first intubation attempts,and intubation attempts were recorded.Glottic exposure was assessed using the Cormack-Lehane(C-L)grading system,and the intuba-tion condition was quantitatively evaluated using the modified nasal intubation difficulty scale(NIDS).The blood pressure and heart rate were measured at baseline(T1),immediately after intubation(T2),and at 1 minute(T3)and 3 minutes(T4)after intubation.The occurrence of intubation-related complications(nasal bleeding,sore throat,hoarseness)was recorded.Results Compared with group C,the nasal passage time and proportion of successful intubations without difficulty were significantly increased in group R,and the glottic exposure time and intubation time were significantly decreased in group R(P<0.05).Compared with group C,the HR and MAP at T2 and T3 were significantly decreased in group R(P<0.05).Com-pared with group C,group R had significantly lower incidence rates of nasal bleeding,sore throat,and hoarseness(P<0.05).There were no statistically significant differences in the first intubation success rate,number of intubation attempts,or C-L grade between the two groups.Conclusion Patients with cer-vical spine immobilization simulated difficult airway,both visual rigid laryngoscope and visual laryngoscope can be performed safely and effectively in NTI.Compared with visual laryngoscope,visual rigid laryngoscope can provide faster glottic exposure,shorter intubation time,lower intubation difficulty,less hemodynamic impact,and lower incidence of complications.