Objective :To explore therapeutic effect of amlodipine atorvastatin calcium tablet on hypertensive pa-tients .Methods : A total of 112 hypertensive patients treated in our hospital were randomly and equally divided into amlodipine group (received amlodipine 5mg／d) and amlodipine atorvastatin group (received amlodipine atorvastatin calcium tablet 15mg／d) ,both groups were treated for eight weeks .Therapeutic effect and incidence of adverse reac- tions ,blood pressure and blood lipids before and after treatment were compared between two groups .Results : Com-pared with before treatment ,there were significant reduction in levels of blood pressure and blood lipids (except sig-nificant rise in HDL-C level) in two groups after treatment , P＜0-05 or ＜0-01 ;compared with amlodipine group , there was significant rise in total effective rate (62-5% vs.96-4%, P＝0-001) ,and significant reduction in inci-dence rate of adverse reactions (28-5% vs.3-5%) , P＝ 0-003 ;significant reductions in levels of blood pressure [ (147-5 ± 10-1)／(90-7 ± 8-2) mmHg vs.(133-2 ± 9-4)／(86-9 ± 8-2) mmHg] ,total cholesterol [ (5-7 ± 1-3) mmol／L vs .(5-2 ± 0-8) mmol／L] ,triglyceride [(2-5 ± 1-2) mmol／L vs.(1-9 ± 0-5) mmol／L] and low density lip-oprotein cholesterol [ (4-1 ± 0-7) mmol／L vs.(3-1 ± 0-6) mmol／L] in amlodipine atorvastatin group , P＜0-05 or＜0-01- Conclusion : Amlodipine atorvastatin calcium tablet can significantly improve blood pressure and blood lipids with few adverse reactions in hypertensive patients ,which is worth extending .

OBJECTIVETo analysis the early complications of tibial fracture and its related factors, and propose a solution.

METHODSFrom December 2003 to December 2013,38 patients with early complications of tibial plateau fracture after operation were retrospectively analyzed. There were 35 males and 3 females, aged from 37 to 69 years old (averaged 42.3 years). According to Schatzker classification, 3 cases were classified as type II, 2 cases as type III, 2 cases as type IV, 19 cases as type V, 12 cases as type VI. The intervals between injury and operation ranged from 9 hours to 9 days, 26 cases within 3 days. Fifteen cases were treated with internal fixation of plates and 23 were treated by plate fixation and bone transplantation. Early complications included skin necrosis in 15 cases, infection in 6 cases, osteofascial compartment syndrome in 3 cases, common peroneal nerve injury in 2 cases, the superficial peroneal nerve injury in 3 cases, popliteal artery injury in 2 cases, loss of reduction in 7 cases.

RESULTSThe wound of 14 cases healed at the first stage and 24 cases healed delay. Hospitalization days ranged from 7 to 67 days (averaged 25.6 days). All patients were followed up for 12 to 36 months with an average of 16.4 months. The fracture healing time ranged from 3 to 9 months (averaged 6.9 months). According to Merchant knee function evaluation criteria, the results were excellent in 19 cases, good in 12, fair in 5 and poor in 2.

CONCLUSIONEarly complications of tibial fracture after operation is closely associated with the severe fracture complexity and related with preoperative preparation, surgical timing, operation incision selection and surgical technique. Early detection and timely processing reduce damage.

Adult ; Aged ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Tibial Fractures ; surgery

OBJECTIVETo compare the effects of the treatment for the distal clavicle fracture with two different methods.

METHODSThere were 120 cases of the distal clavicle fractures involved in the study. Among them, 75 cases were treated by self-improved elastic band inclined "8" fixation (Manipulation group), 45 cases were treated by open reduction and internal fixation with clavicular hook plate (Operation group).

RESULTSThere was statistically significant difference between manipulation group (6.71+/-2.35 weeks) and operation group (11.38+/-4.58 weeks) in the time of fracture union (P<0.01); but, there was no statistically significant difference between manipulation group (100%) and operation group (97.8%) in the rate of fracture union (P>0.05). According to the evaluation of shoulder-joint function, 56, 14 and 5 cases obtained excellent, good and bad result respectively in manipulation group; 38, 5 and 2 cases obtained excellent, good and bad respectively in operation group. There was no statistically significant difference between manipulation group (93.3%) and operation group (95.5%) in the rate of excellent and good (P>0.05).

CONCLUSIONCompared with open reduction and internal fixation with clavicular hook plate, treatment with self-improved elastic band inclined "8" fixation can shorten the union time of fracture and reduce therapeutic risks, so it is an economical, practical and safe method for the distal clavicle fracture.

Adolescent ; Adult ; Case-Control Studies ; Clavicle ; injuries ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; therapy ; Humans ; Male ; Manipulation, Orthopedic ; methods ; Middle Aged

OBJECTIVETo investigate the effect of ulinastatin on intestinal mucosal barrier function of rats with obstructive jaundice.

METHODSSeventy-two male SD rats were randomly divided into sham operation, obstructive jaundice, and ulinastatin treatment groups (groups A, B, and C, respectively). In groups B and C, the common bile duct was ligated to induce obstructive jaundice. The rats in group C were given intraperitoneal injection of ulinastatin at the daily dose of 40,000 IU/kg after the operation, while those in groups A and group B received equal amount of normal saline. At 3, 5, 7 and 10 days after the operation, the liver function and plasma endotoxin level were evaluated and measured, and bacterial culture of the mesenteric lymph nodes, liver and spleen was performed. The terminal ileum mucosa was observed under light microscope, and the intestinal villi and mucosal thinckness was examined with image analysis system.

RESULTSThe indices relative to the liver function and plasma endotoxin level were higher at different time points of observation in group B than in group A (P<0.01), and were lower in group C than in group B (P<0.01). Plasma endotoxin level was similar between groups A and C 3 days after the operation (P>0.05). The rate of bacterial translocation was higher in group B than in group A and C (P<0.01, P<0.05), but comparable between groups A and C (P>0.05). Intestinal mucosal injury was observed in group B 3 days after operation, and aggravated with the passage of time. The injury was milder in group C. The intestinal villus length and mucosal thickness were greater in groups A and C than in group B (P<0.01 or P<0.05), but comparable between the former two groups 3 days after operation (P>0.05).

CONCLUSIONIn early stage of obstructive jaundice, the intestinal mucosal barrier may sustain injuries which aggravate with time; ulinastatin has significant effect in protecting the mucosal barrier function especially against early pathological changes.

Animals ; Bacterial Translocation ; drug effects ; Endotoxins ; blood ; Glycoproteins ; pharmacology ; Intestinal Mucosa ; drug effects ; microbiology ; pathology ; physiopathology ; Jaundice, Obstructive ; blood ; microbiology ; pathology ; physiopathology ; Liver ; drug effects ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Time Factors

OBJECTIVETo detect the oxidative DNA damage in diabetic patients and to investigate the relationship of oxidative DNA damage with diabetes and diabetic nephropathy.

METHODSSingle cell gel electrophoresis (SCGE) was used to detect the DNA strand breaks in peripheral blood lymphocytes, and oxidative DNA damage product and serum 8-OHdG were determined by a competitive ELISA in 47 cases, including 25 patients without diabetic complications, 22 patients with diabetic nephropathy and 25 normal control subjects.

RESULTSDiabetic patients showed greater oxidative damage to DNA. The percentage of comet cells and the length of DNA migration (comet tail length) of peripheral blood lymphocytes were significantly increased in patients with diabetes, and significantly higher in patients with diabetic nephropathy than in diabetic patients without vascular complications (P < 0.05). There was a significant increase in serum 8-OHdG in diabetic patients compared with normal subjects (P < 0.05). Moreover, serum 8-OHdG was much higher in patients with diabetic nephropathy than in diabetic patients without vascular complications (P < 0.05).

CONCLUSIONThere is severe oxidative DNA damage in diabetic patients. Enhanced oxidative stress may be associated with diabetes, especially in patients with diabetic nephropathy.

Adult ; Aged ; Biomarkers ; blood ; Case-Control Studies ; Comet Assay ; DNA Damage ; physiology ; Deoxyguanosine ; analogs & derivatives ; blood ; Diabetes Mellitus, Type 2 ; genetics ; metabolism ; Diabetic Nephropathies ; genetics ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Lymphocytes ; pathology ; Male ; Middle Aged ; Oxidative Stress

Purpose To detect Wnt5a and Wnt11 expression in lung cancer,to explore the relationship between their expression and the types of lung cancer,and to assess the relationships between their expression and clinicopathologic factors (such as gender,age,degree of cell differentiation,lymph node metastasis).Methods The 120 cases of lung cancer were selected as the experimental group.In addition,20 cases of normal lung tissue were selected as the control group.Immunohistochemistry EnVision method was used to detect the expression of Wnt5a and Wnt11.The results were analyzed by the statistical software.Results The positive expression rate of Wnt5a and Wnt1 1 was 36％ and 38％ in 84 cases of non-small cell lung carcinoma.While the expression rate of Wnt5a and Wnt11 were low (8.3％ and 0,respectively)in 36 cases of small cell lung carcinoma.Both expression in non-small cell lung carcinoma was significantly higher than that of small cell carcinoma.The expression rate of Wnt11 in adenocarcinoma was higher (56％,while Wnt5a was 9％),and the expression rate of Wnt5a in squamous cell carcinoma was higher (50％,while Wnt11 was 25％).However,there was no significant difference between the two groups in the sex,age,differentiation and lymph node metastasis.Conclusion Both Wnt5a and Wnt11 expression was associated with lung cancer types.The positive expression rate of Wnt5a and Wnt11 in non-small cell lung carcinoma is significantly higher than that of small cell lung carcinoma.The expression level of Wnt5a is higher in squamous cell carcinoma,while Wnt11 is higher in adenocarcinoma.Both of their expression show no significant correlation with the lung cancer clinicopathological indicators (including the gender,age,degree of differentiation and lymph node metastasis in patients).

Background and objective Recent studies have indicated that Nm23-H1 is found in the nucleus,but previous studies have been based on the overexpression or suppression of Nm23-H1 in the cytoplasm.Due to the lacking nuclear localization signal of Nm23-H1,these results cannot reflect or repeat cells in which Nm23-H1 mainly positioned in nuclei and whether they cause clinical biological effects.Therefore,to explore the effects of transposing Nm23-H1 from the cytoplasm to the nucleus during lung cancer cell proliferation,a vector with a nuclear localization signal of Nm23-H1 was constructed and A549 cells were transfected.Methods Gene recombination technology was used to construct pLentis-CMV-NME1-IRES2-PURO lentiviral vectors using a nuclear localization signal sequence,and the recombinant plasmid was verified using restriction enzyme analysis and sequencing.Nm23-H1 positioning and expression were performed after the stably transfected A549 cells were assessed by Western blot and confocal laser scanning microscope.The A549 cell proliferation was assessed using a cell counting kit-8.Flow cytometry was performed to assess the cell cycle distribution ofA549 cells.Results The directional Nm23-H1 lentiviral vector was successfully constructed within the nucleus.Compared with that of the empty vector group,the proliferation rates of the transfection groups at 72 h,96 h,and 120 h were remarkably increased (P＜0.000,1).Moreover,the empty vector group ofA549 cells in the G0/G1 phase proportion was 35.69％,which was higher than the 28.28％ of the transfection group (t=1.461,P=0.217);furthermore,the transfection group ofA549 cells in the G2/M phase proportion was 58.7％ and that of the empty vector group was 31.30％ (t=4.560,P=0.010).Conclusion Human lung adenocarcinoma cell line A549 cells of Nm23-H1 nuclear localized mainly in the G2/M phase and the nuclear Nm23-H1 promoted A549 cell proliferation in vitro.

OBJECTIVE: To explore the application of a 289bp fragment of the 16S rDNA gene to identify various species of sarcosaphagous Calliphorid flies. METHODS: Twenty-six Calliphorid flies were collected from 14 Chinese provinces. All specimens were properly assigned into three genera and six species. The DNA of the pectoralis was extracted using CTAB method. Then PCR amplification was done for the 289 bp fragment of the 16S rDNA gene. The PCR products were then purified and sequenced, and the obtained sequences were uploaded to GenBank. The phylogenetic tree was built by the neighbor-joining method and intraspecific and interspecific divergences were calculated by sequence analysis. RESULTS: The above 26 sarcosaphagous flies could be well clustered according to different genera and species. The evolutional intraspecific values were all zero, the evolutional interspecific variations varied from 0.3% to 6.5%. CONCLUSION The 289 bp fragment of the 16S rDNA of sarcosaphagous flies can be effectively used to identify most of the flies at species level. This method appears to be fast and low dissipative, which might be used to estimate postmortem interval by sarcosaphagous flies.
Animals ; DNA Primers ; DNA, Mitochondrial/genetics* ; DNA, Ribosomal/genetics* ; Diptera/genetics* ; Entomology ; Forensic Medicine/methods* ; Phylogeny ; Polymerase Chain Reaction/methods* ; RNA, Ribosomal, 16S/genetics* ; Rabbits ; Sequence Analysis, DNA ; Species Specificity

Objective:To examine the survival and influential factors of an integrated approach of novel agents, autologous hematopoietic stem cell (auto-HSCT) , and maintenance therapy in patients with multiple myeloma (MM) patients from a single center over the past 15 years.Methods:In our center, 300 MM patients who received an integrated strategy of new agents, auto-HSCT, and maintenance therapy over 15 years were retrospectively and prospectively analyzed.Results:The complete remission rates (CR) and ≥very good partial remission rates (VGPR) following induction therapy, transplantation, and maintenance therapy were respectively 35.3% and 55.2% , 72.4% and 80.0% , 89.2% , and 93.4% . When compared to patients receiving double-drug induction, the ≥VGPR and ORR of patients receiving triple-drug induction were improved. No difference existed in CR, ≥VGPR, and ORR between the PAD (bortezomib + liposome doxorubicin+ dexamethasone) and RAD (lenalidomide + liposome doxorubicin + dexamethasone) regimens, but the benefits speed differed. The negative rate of flow minimal residual disease following induction, transplantation, and maintenance was 18.8% (54 cases) , 41.4% (109 cases) , and 58.7% (142 cases) , respectively. The median time to progress (TTP) was 78.7 months and the median overall survival (OS) was 109 months. The median TTP for RISS-Ⅰ-Ⅲ patients were 111.8 months, 77.4 months, and 30.6 months, and the median OS was 118.8 months, 91.4 months, and 48.5 months, respectively. At various points during treatment, the TTP and OS of patients obtaining CR and MRD negative were longer than those of patients who did not obtain CR and MRD negative. TTP was noticeably shorter in high-risk cytogenetic patients compared to standard-risk patients even when CR was acquired during induction. There was no difference in TTP between patients with high-risk cytogenetics and those with standard-risk cytogenetics if MRD negative was acquired during induction. According to a multivariate analysis, the R-ISS stage was a poor predictor of TTP and OS at various treatment intervals. Therapeutic effectiveness was a newly independent prognostic factor following treatment.Conclusion:A median survival of almost 10 years is possible for MM patients who receive an integrated strategy of induction regimens followed by auto-HSCT and maintenance therapy, which significantly improves prognosis. However, this approach did not significantly benefit high-risk cytogenetic MM patients.

Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.