Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.

Objective To evaluate the accuracy of double contrast-enhanced ultrasonography(DCUS) and endoscopic ultrasonography (EUS) in the preoperative T staging of gastric cancer.Methods A total of 136 consecutive patients with histologically confirmed gastric carcinoma were enrolled into this study.DCUS and EUS were performed in all patients to estimate depth of invasionin (T stage) before surgery.All patients underwent surgery.The findings of the histopathologic examination of resected specimens were considered as gold standard and were retrospectively compared with the results of DCUS and EUS.Results The accuracy of DCUS and EUS in determining the T stage of gastric cancer were 80.1％ ( T165.5 ％,T2 79.5％,T386.5％,T487.5％) and 81.60％ ( T182.8％,T276.9％,T382.7％,T487.5％) respectively.There was no significant difference between two methods ( P ＞0.05) except T1 staging.Conclusions There is no significant difference between DCUS and EUS in overall T-staging of gastric cancers,but there is a significant difference between two methods in T1 staging.Either of these two methods has its advantages and disadvantages.If two methods are carried out simultaneously to make up for each other,the accuracy of preoperative T-staging of gastric cancers can be improved and this improvement can influence treatment algorithms.

Objective To observe the trend of temperature changes after ventriculoperitoneal shunt and its relation with postoperative infection.Methods A retrospective cohort study was conducted on 272 patients underwent ventriculoperitoneal shunt in our hospital from January 2015 to December 2018.Patients were divided into infected group and non-infected group according to whether intracranial infection occurred after surgery.According to the occurring time of postoperative intracranial infection,patients were divided into early infection group and delayed infection group.Temperature levels of all patients were monitored on the surgery day,and on the first,yd,5th and 7th d of surgery,and the temperature changes and fever rate of the two groups were compared.Results Among 272 patients,intracranial infection occurred in 25 (9.19％),including 21 with early infection and 4 with delayed infection,and un-infection in 247 (90.81％).As compared with those in the non-infected group,the fever rate and body temperature of the infected group were significantly higher on the 3rd,5th and 7th d after surgery (P＜0.05).There was no significant difference in fever rate and body temperature changes between the early infection group and the delayed infection group on the surgery day and on the first,3rd,5th and 7th d of surgery (P＞0.05).Conclusions The fever rate is higher and the body temperature decreases faster after ventriculoperitoneal shunt.The fever since the third d of surgery is closely related to postoperative intracranial infection,which has a certain predictive significance for postoperative infection,so we should consider anti-infection treatment in time.

Objective To explore the clinical value of double contrast-enhanced ultrasonography (DCUS) on evaluation of the chemotherapy effect in advanced gastric carcinoma. Methods A total of 21 patients with unresectable and received chemotherapy of advanced gastric carcinoma were examined using ultrasound after taking oral contrast agent and bolus injection of Sono Vue, and findings of DCUS of each patient before and after chemotherapy were compared. Results The thickness of lesions was slightly thinner than that after chemotherapy,but there was no significant difference ( P ＞0. 05). In addition, there was no significant difference in the basal intensity (BI), peak intensity (PI), arrive time (AT) and time to peak (TTP) of gastric carcinoma tissues after chemotherapy (P ＞0.05). While the enhanced intensity (EI) value of gastric carcinoma tissues after chemotherapy was significantly less than that before chemotherapy (P ＜0.05). Conclusions The EI value in gastric carcinoma tissues may be considered as a sensitive and effective index in assessing the therapeutic effect of the chemotherapy in patients with advanced gastric carcinoma.

Objective To investigate the effects of autologous blood transfusion and allogeneic blood transfusion on postoperative complications and outcome of patients underwent craniotomy with traumatic brain injury.Methods All transfusional cases underwent emergency craniotomy with trau-matic brain injury from January,2012 to June,201 6,1 61 males and 38 females,ASA physical statusⅠ-Ⅳ,were respectively analyzed and divided into autologous blood group (n = 108)and allogeneic blood group (n =91)based on whether or not using cell salvage.The restrictive transfusion strategy was applied in the two groups and the red blood cells were infused to maintain the hemoglobin concen-tration at 70-100 g/L.The incidence of postoperative complications and adverse transfusion reaction were analyzed and the clinical outcome was judged by Glasgow outcome score (GOS).Results The incidence of postoperative complications (33% vs.56%,P <0.01 )and adverse transfusion reaction (5% vs.14%,P <0.05)of the autologous blood group were lower than that in the allogeneic blood group,and the clinical outcome was better (P <0.01).Logistic regression analysis showed that allo-genetic transfusion (OR =1.953,95%CI 1.381-2.529)was an independent risk factor of postopera-tive complications.Conclusion The use of autologous blood transfusion in patients with traumatic brain injury can reduce the incidence of postoperative complications and the risk of blood transfusion and improve clinical outcome.

OBJECTIVE: To compare the effect and safety between Velcade-Dexamethasone (VD)and revised Vinorebine+Pirarubicin+ Dexamethasone (VAD) regiment for multiple myeloma (MM). METHODS: Thirty-six patients with MM were reviewed, 16 of whom were treated with VD (VD Group) and the others with VAD. European Group for Blood and Marrow Transplant (EBMT) criteria and National Cancer Institute Common Terminology Criteria for Adverse Events (NCICTCAE) were chosen to analyze the efficacy and side effects. RESULTS: In the VD group and the revised VAD group, the rates of complete response, partial response, minimal response, no change and progress disease were 50% vs. 5%, 25% vs. 25%, 18.8% vs. 15%, 6.2% vs. 35% and 0 vs. 20%, respectively. The total response rates were 93.8% vs 45%. There was significant difference in the overall response rate between the 2 groups (P<0.05). The side effects were less serious, and the endurance was better in the VD group than those in the revised VAD group. No serious effects of hematology and cardiology were seen, and good endurance was showed in the renal dysfunction in the VD group. CONCLUSION Velcade combined with dexamethasone is a safe and effective regiment for multiple myeloma with good safety and endurance.
Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; adverse effects ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Boronic Acids ; administration & dosage ; adverse effects ; Bortezomib ; Dexamethasone ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; adverse effects ; Retrospective Studies

Objective To perform the ligand-based computer-aided drug design and construct the pharmacophore model of(1,3)-β-D-Glucan Synthase(GS)small molecule inhibitors.Method Six small molecules with diverse structures and good inhibitory activity were selected to construct the training set.The HipHop algorithm in Catalyst pharmacophore generation module was utilized to construct the pharmacophore models.The pharmacophore models were evaluated by constructed Decoy-set 3D database.Results Pharmacophore 02 has a good enrichment factor,sensitivity and specificity parameters.Pharmacoph-ore model validation with Decoyset 3D database proved that the model has good distinguishing capability.Conclusion The pharmacophore model of GS small molecule inhibitors was constructed and tested.It will provide valuable information for de-sign and discovery of novel small molecule GS inhibitors.

OBJECTIVE: To evaluate the curative effect and adverse effect of low dose cytarabine and aclarubin in combination with granulocyte colony-stimulating factor priming (CAG regimen) on patients with the intermediate and high-risk myelodysplastic syndrome. METHODS: A: total of 46 patients with intermediate and high-risk myelodysplastic syndrome was retrospectively analyzed. Twenty-eight patients received CAG regimen and 18 received conventional chemotherapy. CAG regimen: aclarubicin 10 mg/(m2.d)intravenously daily, Day 1~8; cytarabine 10 mg/ m2 subcutaneously once every 12 hours, Day 1~14; and subcutaneously use of granulocyte colony-stimulating factor 200 mug/(m2.d) until 12 hours before the last use of cytarabine. The initial outcome was evaluated after the first course of treatment. The responders received the second course. The ultimate therapeutic effect was evaluated after the 2 courses. RESULTS: The overall response rate in the CAG regimen group was 78.6% (22/28). Thirteen patients (46.4%) responded, 5 (17.9%) showed partial response, and 4 (14.3%) hematologic improvement. The overall response rate in the conventional chemotherapy group was 50%(9/18). Six patients (33.3%) achieved complete response, 2 (11.1%) partial response, and 1(5.6%) hematologic improvement. The overall response rate of the CAG group was significantly higher than that in the control group (P<0.05). The adverse effects of CAG regimen were bearable. CONCLUSION With acceptable adverse effect, CAG regimen is effective for the intermediate and high-risk myelodysplastic syndrome. Long-time outcome needs further observation.
Aclarubicin ; therapeutic use ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; drug therapy ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To investigate the nucleolus expression in the diabetic cardiomyopathy. METHODS: The rats were divided into a control group and a type II diabetic cardiomyopathy group (model group). In the model group, rats were fed with high-fat and high-sugar food (rats were intravenously injected with 60 mg/kg chain urea with cephalosporins in the 5th and 6th weeks in mice). The level of blood glucose was determined at the end of 8th week and the level of fasting blood glucose was examined at the end of 20th week. The ratio of the heart mass and body mass was calculated, and the pathological changes in myocardial morphology were observed. The immunohistochemical method and Western blot were used to detect the expression level of myocardial nucleolin. RESULTS: The level of fasting blood glucose was significantly increased in the diabetic model group than that in the control group (P<0.05). Rats in the model group were found hypertrophic cardic cells, with fracture, dissolusion, and disordered arrangement. Immunohistochemical staining and Western blot showed the protein levels of myocardial nucleolin in the model group were obviously higher than those in the control group (P<0.05). CONCLUSION Nucleolin may play a role in the pathogenesis and development of the diabetic cardiomyopathy.
Animals ; Blood Glucose ; Diabetes Mellitus, Experimental ; metabolism ; Diabetic Cardiomyopathies ; metabolism ; Myocardium ; pathology ; Phosphoproteins ; metabolism ; RNA-Binding Proteins ; metabolism ; Rats

Objective:To evaluate the clinical application potential of a novel prostate specific membrane antigen (PSMA) targeted PET tracer 68Ga-PSMA-NYM032 in patients diagnosed initially with prostate cancer. Methods:A total of 63 patients (age (68.7±8.7) years) with suspected prostate cancers who received 68Ga-PSMA-NYM032 PET/CT imaging in Affiliated Hospital of Jiangnan University between March 2022 and January 2023 were enrolled prospectively. The diagnostic efficiency of 68Ga-PSMA-NYM032 PET/CT imaging was evaluated in a patient-centered manner. The ROI was drawn to obtain SUV max by semi-quantitative analysis with visual analysis, and the diagnostic threshold of SUV max was obtained by ROC curve analysis. The correlations of SUV max in primary foci with total prostate specific antigen (tPSA) and Gleason score (GS) were analyzed by Spearman rank correlation analysis. Based on the D′Amico risk stratification (prostate specific antigen (PSA)>20 μg/L and ≤20 μg/L, GS>7 and ≤7), the detection rates of metastases by 68Ga-PSMA-NYM032 PET/CT imaging in different stratifications were analyzed by Fisher exact test, and the differences between SUV max of metastases in different stratifications were determined by Mann-Whitney U test. Results:The accuracy of 68Ga-PSMA-NYM032 PET/CT imaging was 92.06%(58/63), the sensitivity was 96.55%(28/29), the specificity was 88.24%(30/34), the positive predictive value was 87.50%(28/32), the negative predictive value was 96.77%(30/31), and the optimal SUV max threshold was 6.9. 68Ga-PSMA-NYM032 showed varying degrees of high uptake in the primary foci of prostate cancer, and SUV max were positively correlated with tPSA and GS ( rs values: 0.657, 0.592, P values: <0.001, 0.001). Stratified analysis showed a statistically significant difference in the detection rate of bone metastases by 68Ga-PSMA-NYM032 PET/CT between the GS>7 and GS≤7 subgroups (9/17 vs 1/12; P=0.019), while no statistical significances were observed in the detection rates of bone metastases or lymph node metastases of another subgroups (all P>0.05). In addition, none of the differences in SUV max of metastases in patients with different stratifications were statistically significant ( z value: from -1.57 to -0.50, all P>0.05). Conclusions:68Ga-PSMA-NYM032 PET/CT imaging has good diagnostic efficacy for prostate cancer, and it may provide a new strategy for the precise diagnosis and treatment of prostate cancer. Besides, GS stratification may affect the detection rate of bone metastases by 68Ga-PSMA-NYM032 PET/CT imaging.