Objective To investigate the effect of donors' activating killer cell immunoglobulin-like receptor (aKIR) on recipients prognosis post haemopoietic stem cell transplantation (HSCT).Methods Fifty-nine cases of related HLA full matched HSCT were studied. Sequence specific primer polymerase chain reaction (SSP-PCR) was used to type donors' KIR. Virus,bacterium,and fungi infection as well as bleeding,relapse,survival were observed in the recipients post transplantation. Relationship between aKIR and clinical indexes mentioned above were analyzed.Results Donors' aKIR showed no beneficial effects on recipients' virus and bacterium infection. Furthermore,the incidence of fungi infection was increased in HSCT if donors expressed KIR3DS1 (?2= 4.804 ,P= 0.028 ). No significant difference was found in survival curve between donor aKIR positive HSCT or negative one (KIR2DS1+/-: P= 0.651 ; KIR2DS2+/-: P= 0.847 ; KIR3DS1+/-: P= 0.341 ). No effect of donor's aKIR on relapse was observed,too.Conclusion In Guangdong Han,so far as related HLA full matched HSCT is concerned,no improvement in recipient prognosis due to donor's aKIR is verified.

Objective To evaluate the influence of the resolution of medical grayscale LCD over the detective efficiency of pulmonary nodule.Methods By reviewing PACS, 93 on-line chest DR images were collected.These radiographs included 23 normal images that had no nodule confirmed by CT, 32 doubtful images that also had no nodule confirmed by CT,and 38 positive images that had nodules confirmed by CT.These nodules didn't show obvious calcification and their diameters were from 0.30 to 1.90 cm. Nine patients had multi-nodules.Three residents or postgraduates, three attending physicians, and three associate professors or professors interpreted the 93 chest images by using three types of displays: Barco Z-2261, Barco Z-3620 and Barco Z-5620.All observers evaluated their confidence of the presence of pulmonary nodule with five-point level rating scale : ( 1 ) definitely positive, ( 2 ) probably positive, ( 3 ) uncertain, (4) probably negative, (5)definitely negative.SPSS 11.5 software was used to analyze the results ,including to draw the ROC curves and to perform Z test.Results The areas under the ROC curves of 2 M display, 3 M display and 5 M display were 0.774,0.784,0.816 for experienced radiologists; for instructors were 0.754,0.764,0.768 ;for teaching assistants were 0.695,0.754,0.774.However, for the detection of pulmonary nodules,there was no significant difference between observers with different ranks using the same modality of display,and no significant difference was found between the different modalities of displays used by observers with the same rank.Conclusion It's equivalent for detection performance with 2,3 and 5 M medical grayscale LCD display in detecting pulmonary nodule; Experienced radiologists can get more information using 5 M display;By reasonably matching displays, we could improve the cost-efficacy.

Nasopharyngeal cancer is a low differentiated squamous cell carcinoma, and the radiation therapy is the primary choice. It's 5 year survival rate may reach 64.4%, while 10.0% cases may suffer from the local recurrence. The salvage radiation or surgery is still the main choice for recurrent cases now. However the recurrent tumor become radiation insensitive and meanwhile, morbidity and mortality become higher. The experience of open salvage surgery on the recurrent radiation insensitive tumor had been proved safely, and the related morbidity and mortality are acceptable. Recently, the endoscopic salvage surgery has been developed, some preliminary experience has been obtained and the result looks promising. In this article, the pathobiological characteristics of the postradiation local recurrent nasopharyngeal cancer, the anatomy of nasopharyngus and related skull base area, especially the petroclival region and current situation of endonasal endoscopic salvage surgery were reviewed here. Basic principle of oncological surgery that endoscopic surgery should followed and possible endoscopic surgical approaches were proposed.
Carcinoma ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Endoscopy ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neoplasm Recurrence, Local ; radiotherapy ; surgery ; Radiation Tolerance ; Salvage Therapy ; methods ; Skull Base ; Survival Rate

Animals ; Cerebral Cortex ; metabolism ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred Strains ; Morphine Dependence ; metabolism ; Neurotrophin 3 ; metabolism ; Prosencephalon ; metabolism

By Silica gel, Sephadex LH-20 and other materials for isolation and purification and by physicochemical methods and spectral analysis for structural identification, 23 compounds were isolated and identified from ethyl acetate portion of alcohol extract solution of Osmanthus fragrans fruits. Their structures were identified as nicotinamide (1), D-allitol (2), 5-hydroxymethyl-2-furancarboxaldehyde (3), acetyloleanolic acid (4), benzoic acid (5), ergosta-7,22-dien-3-one (6), beta-sitosterol (7), borreriagenin (8), cerevistero (9), c-veratroylglycol (10), methyl-2-O-beta-glucopyranosylbenzoate (11), 3', 7-dihydroxy-4'-methoxyisoflavon (12), umbelliferone (13), caffeic acid methyl ester (14), oleanolic acid (15), (-) -chicanine (16), dillapiol (17), 3beta,5alpha, 9alpha-trihydroxyergosta-7-22-dien-6-one (18), 2alpha-hydroxy-oleanolic acid (19), betulinic acid (20), betulin (21), 3, 3'-bisdemethylpinoresinol (22), and lupeol (23). All compounds were isolated from the osmanthus fruit for the first time. Except for compounds 4, 7, 15, 19, 23, the rest ones were isolated from the this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; Fruit ; chemistry ; Oleaceae ; chemistry

Endoscopy ; Humans ; Skull Base ; anatomy & histology ; surgery

Objective To observe hemodynamic characteristics and the correlation with syndrome types of traditional Chinese medicine (TCM) in patients with septic shock, so as to direct the treatment based on syndrome differentiation. Methods A prospective observation was conducted. Sixty-eight patients with septic shock admitted to the Department of Critical Care Medicine of Dade Road General Hospital of Guangdong Hospital of TCM from January 2013 to July 2015 were enrolled. Pulse indicating continuous cardiac output (PiCCO) was used to monitor the hemodynamic changes, including heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP), cardiac index (CI), global end diastolic volume index (GEDVI), extravascular lung water index (EVLWI), maximum rate of the increase in pressure (dPmax) and systemic vascular resistance index (SVRI), for assessment of hemodynamics. According to the CI, the patients were divided into two groups , i.e. high CI group (CI ≥ 50.0 mL·s-1·m-2, n = 34) and low CI group (CI < 50.0 mL·s-1·m-2, n = 34), and the clinical and hemodynamic characteristics of two groups were investigated. The TCM differentiation was conducted with four syndromes and four methods, and the hemodynamic characteristics of different syndrome types were investigated, the correlation between the TCM syndrome factors and hemodynamic parameters was analyzed. The patients were divided into survival group and death group, and clinical parameters and hemodynamic characteristics were compared between two groups. Results The acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and blood glucose of low CI group were higher than those of high CI group [APACHEⅡ score: 24.4±7.2 vs. 19.8±7.4, t = -2.279, P = 0.023; blood glucose (mmol/L): 9.7 (7.7, 14.6) vs. 6.7 (5.6, 10.0), Z = -2.257, P = 0.024], CI and GEDVI were lowered [CI (mL·s-1·m-2): 36.7±8.3 vs. 68.4±16.7, t = 10.285, P = 0.000; GEDVI (mL/m2): 689.0 (566.0, 883.8) vs. 838.5 (692.8, 1 247.3), Z = -2.711, P = 0.007], while SVRI was increased [kPa·s·L-1·m-2: 248.7 (202.1, 324.5) vs. 143.4 (102.7, 171.4), Z = -5.336, P = 0.000]. Accompanied symptoms were found to occur more commonly in septic shock patients, and the most common syndrome elements were Qi deficiency syndrome (n = 45), blood stasis syndrome (n = 40), heat-toxin syndrome (n = 37), Fushi syndrome (n = 24) and Yin deficiency syndrome (n = 10), respectively. There was no significant difference in hemodynamic parameters among patients with five types of syndrome (all P > 0.05). However, only the CI of those with Qi deficiency syndrome was significantly lower than that of heat-toxin syndrome (mL·s-1·m-2: 48.3±18.3 vs. 53.3±21.7, P < 0.05). While the results after removing the effect of accompanied symptoms showed that CI of Qi deficiency syndrome was significantly lower than that of non-Qi deficiency syndrome (mL·s-1·m-2: 48.3±18.3 vs. 61.7±21.7, t = -2.783, P = 0.007), CI of heat-toxin syndrome was significantly higher than that of non-heat-toxin syndrome (mL·s-1·m-2: 58.3±21.7 vs. 48.3±16.7, t = 2.133, P = 0.037), EVLWI of blood stasis syndrome was significantly lower than that of non-blood stasis syndrome [mL/kg: 10.0 (7.0, 15.1) vs. 14.9 (8.5, 26.8), Z = -2.075, P = 0.038]. Compared with survival group (n = 38), APACHEⅡ score in death group (n = 30) was increased (25.8±8.4 vs. 19.1±5.4, t = -3.940, P = 0.000), the proportion of continuous renal replacement therapy (CRRT) was increased [60.0% (18/30) vs. 31.6% (12/38), χ2 = 5.493, P = 0.019], HR was increased (bpm: 118.5±20.5 vs. 98.1±19.9, t = -4.157, P = 0.000), and the proportion of Qi deficiency syndrome was increased [86.7% (26/30) vs. 50.0% (19/38), χ2 = 10.070, P = 0.002]. Conclusions Patients with sepsis shock may be divided into high-output and low-resistance & low-output and high-resistance groups according to hemodynamics, with respective hemodynamic characteristics. Hemodynamic performance differed among different syndrome types, and there was a certain relationship. Hemodynamic monitoring with PiCCO was a useful supplement of TCM, which was good for the evidence-based medicine.

Since the development of civil basic medical insurance, it exerts subtle influence on medical conduct. The medical insurance economically affects the medical conduct. And medical ethics is one of the important factors which influence medical conducts greatly. Therefore, it is very important for the medical insurance enterprise's development to discipline the medical conducts by medical ethics.