0.05).The expression of NF-?Bp65 protein in epithelial ovarian cancer was significantly correlated with FIGO stage(P0.05).There was obviously negative correlation between KISS- 1 and MMP-9 expression in ovarian cancer(rs=-0.547,P

OBJECTIVETo study the evidence-based therapy of edema in nephrotic syndrome by analyzing the literatures systematically.

METHODSThe literatures related to the treatment of nephrotic edema were retrieved from the following: Chinese Biological Medicine Database (CBM-disk), Chinese Journals Full-text Database (CNKI, 1994-2006), Chinese Technological Periodicals Database (VIP, 1989-2006), Chinese Evidence Biological Medicine/Cochrane Central Database (CEBM/CCD), Cochrane Library Database, MEDLINE (1966-2006), EMBASE (1975-2006), MEDLARS, SCI (1985-2006) and OVID by electron and craft search with the following key words: nephrotic syndrome, edema, recalcitrant edema, refractory edema or resistant nephrotic edema, and treatment, diuretic therapy or human albumin treatment. The relevant literatures on randomized controlled trials (RCT) that met the criteria were statistically analyzed by the Coorporative network software RevMan 4.2.

RESULTSA total of 113 articles were searched (60 in Chinese and 53 in English), of which 12 were RCT. Three of the 12 articles were included for Meta analysis. Meta analysis showed that dextran-40 together with furosemide was effective for nephrotic edema. Human albumin solution could be used in nephrotic edema patients with coexistent severe hypoalbuminemia. A combination of diuretics by intravenous drip infusion was effective for diuretic-resistant nephrotic edema.

CONCLUSIONSThe treatment for nephrotic edema should be individualized. The evidence of treatment of nephrotic edema has not been fully elucidated. Further multicentre, large sample, and randomized controlled trials are needed.

Edema ; therapy ; Evidence-Based Medicine ; Humans ; Meta-Analysis as Topic ; Nephrotic Syndrome ; therapy ; Randomized Controlled Trials as Topic

OBJECTIVETo study the flavanoids extracted from onion on the blood-brain barrier (BBB) permeation, and their effects on primary cultured neuron cell proliferation and apoptosis of SD rats using ethanol reflux method.

METHODSThe brain microvascular endothelial cells (BMVECs) were first successfully primary cultured. Then rats BMVECs and astrocytes (ACs) were co-cultured to establish the in vitro BBB model. The flavanoids were extracted from onion using ethanol reflux method. The model was verified by transmission electron microscopy (TEM) and trans-epithelial electric resistance (TEER). The flavanoids permeability was tested using high performance liquid chromatography (HPLC). Meanwhile, rat neuron cells were cultured and exposed to H2O2 and flavanoids. Their effects on the cell proliferation and apoptosis were observed using MTT assay. The injury of neuron DNA was analyzed using single-cell gel electrophoresis (SCGE) and immunofluorescent assay.

RESULTSThe in vitro BBB model was successfully established by TEM and TEER. Results of HPLC proved flavanoids extracts could effectively permeate the BBB with the permeability of 60.58%. The extractive at 10 - 20 microg/mL showed obvious inhibition on the apoptosis of neuron cells induced by H2O2, and attenuated the injury of neuron DNA.

CONCLUSIONSThe flavanoids extracted from onion ethanol reflux method could effectively penetrate the BBB. They also showed obvious inhibition on the H2O2 induced neuron cell apoptosis and DNA injury.

Animals ; Animals, Newborn ; Apoptosis ; Astrocytes ; cytology ; drug effects ; Blood-Brain Barrier ; drug effects ; Cells, Cultured ; DNA Damage ; Endothelial Cells ; cytology ; drug effects ; Flavonoids ; pharmacology ; Hydrogen Peroxide ; Neurons ; cytology ; drug effects ; Neuroprotective Agents ; pharmacology ; Onions ; chemistry ; Rats

OBJECTIVETo investigate the perfusion characteristics of renal mass parenchyma on 64-slice spiral computed tomography (CT).

METHODSTotally 91 patients with renal mass were enrolled. Sixty-four slice spiral CT was used for renal perfusion scan that began with a contrast bolus injection of 50 ml (370 mgI/ml) at a rate of 5 ml/s. Perfusion characteristics, including blood flow (BF), blood volume (BV), and permeability (PM) of renal mass parenchyma and renal cortex in affected and normal kidneys were calculated from Siemens Body PCT (VB20B) software, and the perfusion characteristics among renal mass parenchyma and renal cortex in affected and normal kidneys were compared.

RESULTSRenal clear cell carcinoma (RC-CC), renal pelvic transitional cell carcinoma (RPTCC), and renal angiomyolipoma (RAML) was pathologically confirmed in 40, 21, and 16 patients, respectively, while the remaining 14 patients were diagnosed as with renal simple cyst (RSC). Technical failure was experienced in 1 (1.1% ) patient. Perfusion parameters of tumor parenchyma were measured as follow: RCCC, BF (93.7 +/- 20.2) ml x (100 ml)(-1) x min(-1), BV (182.0 +/- 46.6) 1000:1, PM (115.7 +/-30.2) 0.5 ml x (100 ml)(01) x min(-1); RPTCC, BF (48.0 +/- 21.2) ml x (100 ml)(-1) x min(-1), BV (82.4 +/- 29.7) 1000:1, PM (65.7 +/- 17.2) 0.5 ml (100 ml)(-1) x min(-1); RAML, BF (52.6 +/- 18.5) ml x (100 ml)(-1) x min(-1), BV (110.1 +/- 45.9) 1000:1, PM (60.1 +/- 23.0) 0.5 ml x (100 ml)(-1) x min-1; RSC, BF (7.0 +/- 6.5) ml x (100 ml)(-1) min(-1), BV (16.2 +/- 9.7) 1000:1, PM (12.0 +/- 7.2) 0.5 ml x (100 ml) (-1) x min(-1). In all pathological groups, perfusion pa- rameters showed significant differences (P <0 . 1) between mass parenchyma and renal cortex in affected kidney, while there were no significant differences (P > 0. 5) in perfusion characteristics between renal cortex in affected and normal kidneys. Aslo, the perfusion characteristics were significantly different between parenchyma D in any two kinds of renal masses (P <0 . 5) except for RPTCC and RAML (P > 0. 5). C ONCLUSIONS: fDif-rent pathological types of renal mass have different perfusion characteristics. Perfusion imaging with multislice CT is potentially useful in the differential diagnosis of renal mass.

Adult ; Aged ; Blood Volume ; Female ; Humans ; Kidney Neoplasms ; diagnosis ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Perfusion Imaging ; Regional Blood Flow ; Tomography, Spiral Computed ; Young Adult

OBJECTIVETo investigate the efficacy and safety of peginterferon alfa-2a (Peg-IFNa-2a) therapy for treating chronic hepatitis B (CHB) in patients who failed to achieve a satisfactory end point with entecavir (ETV) treatment.

METHODSFifty-seven CHB patients with positivity for hepatitis B e antigen (HBeAg) who had completed a standard ETV monotherapy course, of at least 96 weeks, and who had achieved a virological response (defined as HBV DNA less than 500 copies/ml) but without HBeAg seroconversion (defined as 0.227 PEI U/ml less than HBeAg less than or equal to 50 PEI U/ml) were enrolled in the study. The patients were randomly assigned to receive a 48-week treatment with Peg -IFNa-2a (experimental group, n = 27) or continued ETV therapy (control group, n = 30). Serum samples were collected from all patients for assessment of biochemical, virological and serological responses to treatment. Inter-group differences were statistically evaluated by t-test or Chi-squared test.

RESULTSThe baseline levels of alanine aminotransferase, hepatitis B surface antigen (HBsAg), and HBeAg were similar between the patients comprising the experimental and controls groups. At treatment week 48, the experimental group showed significantly higher rates of HBeAg clearance (Peg-IFNa-2a: 40.7% vs. ETV: 16.7%, x2 = 4.079, P less than 0.05) and seroconversion (37.0% vs. 13.3%, x2 = 5.110, P less than 0.05). The experimental group also showed higher rates of HBsAg clearance (7.4% vs. 0%) and HBV DNA relapse (11.1% vs. 0%), but the differences did not reach statistical significance (x2 = 2.307 and 3.519, both P more than 0.05). However, the level of HBsAg was significantly lower in the experimental group (2866.0+2580.4 vs. 4335.8+2650.0 IU/ml, t = 5.11, P less than 0.05).

CONCLUSIONHBeAg-positive CHB patients with unsatisfactory response to initial ETV monotherapy achieved HBeAg seroconversion and clearance following sequential Peg-IFN a-2a treatment.

Adult ; Antiviral Agents ; administration & dosage ; therapeutic use ; Female ; Guanine ; analogs & derivatives ; therapeutic use ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; administration & dosage ; therapeutic use ; Prospective Studies ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Treatment Outcome ; Young Adult

Adult ; Antiviral Agents ; pharmacology ; therapeutic use ; DNA, Viral ; Female ; Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

OBJECTIVETo examine the genetic polymorphisms in the promoter region of cyclooxygenase-2 ( COX-2) and evaluate their association with the risk of gastric cancer.

METHODSSingle-strand conformational polymorphism and DNA sequencing were used to screen the genetic variants of the COX-2 promoter region. Total 323 patients with gastric cancer and 646 frequency-matched controls were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression. Haplotype frequency was estimated using Haplo. stat software.

RESULTSThree single nucleotide polymorphisms, including - 1290A > G, -1195G > A, and -765G > C were identified in the promoter of COX- 2. Case-control analysis showed an increased risk of developing gastric cancer for the -1290AG (OR 1.64; 95% CI 1.03-2.61), -1195AA (OR 2.68; 95% CI 1.65-4.33), and -765CG (OR 2.66; 95% CI 1.53-4.64) genotype carriers, respectively, compared with noncarriers. A greater risk of developing gastric cancer was observed for the A(-1290) -A(-1195) -C(-765) haplotype compared with the A(-1290) -G(-1195) -G(-765) haplotypes (OR 11.80; 95% CI 2.43-57.25).

CONCLUSIONGenetic polymorphisms in COX-2 promoter region may play a role in gastric carcinogenesis.

Adult ; Aged ; Cyclooxygenase 2 ; genetics ; Female ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; genetics ; Risk ; Stomach Neoplasms ; enzymology ; genetics

OBJECTIVETo investigate the perfusion characteristics of normal pancreas and insulinoma on multi-slice spiral CT (MSCT).

METHODSTotally 21 subjects with suspected insulinoma were enrolled. Sixteen-slice spiral CT was used for perfusion scan following a standard contrast-enhanced scan. The surgical and pathological outcomes were collected for comparison. Perfusion characteristics, including blood flow (BF), patlak blood volume (pBV), time to peak (TTP), permeability, and peak enhancement (PE) of insulinomas and normal pancreas parenchyma were analyzed based on the MSCT data sets subsequently.

RESULTSBenign insulinoma was pathologically confirmed in 12 out of the 21 subjects, while the remaining 9 subjects were normal. Technical failures were experienced in 2 (9.5%) subjects. In both normal and tumor-suffered subjects (n = 19), perfusion parameters of normal pancreatic parachyma were measured as follows: BF (p) = 104. 9 +/- 28.9, pBV (p) = 166.4 +/- 41.8, TrP (p) = 133.3 +/- 24.4, Permeability (p) = 81.3 +/- 24.4, and peak enhancement (p) = 121.3 +/- 31.1. In subjects with insulinoma (n = 11), perfusion parameters of tumor tissue were measured as follows: F (i) = 206.5 +/- 42.2, BV (i) = 315.9 +/- 79.0, TFP (i) = 123.2 +/- 18.8, Permeability (i) = 102.5 +/- 54. 8, and peak enhancement (i) = 221.3 +/- 48.5. Results of F, BV, and peak enhancement in these two kinds of tissue showed significant differences (P < 0.01), while there were no significant difference (P > 0.05) in TTP and permeability between normal pancreatic parenchyma and insulinoma.

CONCLUSIONSBenign insulinoma has perfusion characteristics of increased blood flow and blood volume, but its TTP is consistent with normal pancreas and has normal permeability. MSCT allows further understanding of the blood flow of the normal pancreas and its benign tumor insulinoma.

Adult ; Aged ; Female ; Humans ; Insulinoma ; blood supply ; diagnostic imaging ; Male ; Middle Aged ; Pancreas ; blood supply ; diagnostic imaging ; Pancreatic Neoplasms ; blood supply ; diagnostic imaging ; Perfusion ; Regional Blood Flow ; Tomography, Spiral Computed ; methods

OBJECTIVETo study individualized treatment of chronic hepatitis C (CHC) genotype 1 patients using respond guided therapy (RGT) of peginterferon α-2a in combination with ribavirin.

METHODS140 patients with CHC genotype 1 received peginterferon α-2a 180 microg injection once a week in combination with ribavirin 800-1200 mg/d. Patients achieved RVR after 4 weeks treatment (group A) were randomized into 2 subgroups and proceeded with 24 and 48 weeks treatments (subgroups A1 and A2) respectively. Patients who had not received RVR but achieved cEVR at week 12 (group B) were further divided into 2 subgroups randomly and treated for 48 and 72 weeks (subgroups B1 and B2), respectively. Patients with PVR at week 24 were treated for 72 weeks (group C1), while patients without PVR at week 24 discontinued treatment (group C2). All Patients were followed-up for 24 weeks after the end of treatment.

RESULTSFor patients treated for 24 weeks, the ETR rate was 100%, the SVR rate was 65.9%, and the relapse rate was 34.1%. For those treated for 48 weeks, the ETR, SVR and relapse rate were 95.3% , 82.8% and 12.5% respectively. For those treated for 72 weeks, the above rates were 82.1%, 67.9% and 14.3% respectively. SVR rates of subgroup A1 and A2 were 65.9% and 84.4% respectively and the difference was statistically significant (P<0.00). The HCV RNA loads were less than 1x10(6) copy/ml in group A and the SVR were 72.7% and 100% respectively with 24 and 48 weeks treatment, and the difference was insignificant statistically (P>0.05). SVR in subgroup B1 and B2 were 78.9% and 73.7% respectively and the difference was statistically insignificant (P>0.05). The SVR in group C1 was raised to 55. 6%.

CONCLUSIONSRVR and cEVR were respond guided prediction factors for CHC treatment. SVR among patients with RVR was higher in 48-week treatment than those with 24 weeks treatment. For patients with baseline virus load less than 1x10(6) copy/ml and achieved RVR, treatment duration can be shortened to 24 weeks. Treatment extension to 72 weeks can not result in SVR increase among patients without RVR but with cEVR. However, treatment extension to 72 weeks can increase SVR among those patients with PVR.

Adolescent ; Adult ; Aged ; Antiviral Agents ; therapeutic use ; Drug Therapy, Combination ; Female ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; Prospective Studies ; Recombinant Proteins ; Ribavirin ; therapeutic use ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the efficacy of Telbivudine and Entecavir for therapy of HBeAg positive chronic hepatitis B for 52 weeks.

METHODSIn this random and control study, the efficacy of Telbivudine and Entecavir treatments were compared in 180 patients with HBeAg positive chronic hepatitis B.The patients were randomly assigned to a daily 600 mg Telbivudine treatment group or daily 0.5 mg Entecavir group for 52 weeks.

RESULTSAt week 52, HBV DNA undetectable rate was better in the Entecavir-treated group than in the Telbivudine-treated group, but didn't reach statistical significance. The viral breakthrough rates were significantly lower in the Entecavir-treated group than in the Telbivudine-treated group (x2 = 4.09, P <0.05). The clearance and seroconversion of HBeAg and the mean reductions of HBeAg from baseline at week 52 were significantly greater in the telbivudine-treated group than in the entecavir-treated group (x(2) clearance = 4.63, x(2) seroconversion = 4.80, (t-mean) reductions = 2.02; P < 0.05). The HBeAg seroconversion rates were not associated with both baseline ALT and baseline HBV DNA in both groups (P more than 0.05). In Telbivudine-treated group, the HBeAg decline is more than 2 log at week 24, HBeAg decline is more than 1 log at week 12 and the HBeAg baseline were independent factors correlated to HBeAg seroconversion rates at week 52 by Binary Logistic analysis, and also in entecavir-treated group the HBeAg decline is more than 2 log at week 24, HBeAg decline is more than 2 log at week 36 and the HBeAg decline is more than 2 log at week 12 were independent factors correlated to HBeAg seroconversion rates at week 52.

CONCLUSIONSignificant difference of HBeAg seroconversion rates at week 52 existed between Telbivudine-treated group and Entecavir-treated group. Entecavir is significantly superior to Telbivudine with less resistance to nucleosides. HBeAg decline is more than 2 log at week 24 is the best predicting factor for HBeAg seroconversion at week 52.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; blood ; Female ; Guanine ; analogs & derivatives ; therapeutic use ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Male ; Middle Aged ; Nucleosides ; therapeutic use ; Pyrimidinones ; therapeutic use ; Thymidine ; analogs & derivatives ; Treatment Outcome ; Young Adult