Adult ; Carcinoma, Renal Cell ; secondary ; Female ; Humans ; Kidney Neoplasms ; pathology ; Magnetic Resonance Imaging ; Vaginal Neoplasms ; secondary

BACKGROUND: Different derivatives of chitosan with different molecular weights or degrees of deacetylation show different anti-tumor effects.OBJECTIVE: To study the inhibition effect of water-soluble chitosan and its derivatives, such as sulfonated chitosan, carboxymethyl chitosan and chitooligosaccharides for the growth of hepatocellular carcinoma cell line SMMC7721.DESIGN, TIME AND SETTING: Controlled experiments based on observation were carried out in Jiangxi Institute of Digestive Disease (Nanchang, Jiangxi, China) from January 2004 to December 2006.MATERIALS: Hepatoma cell line SMMC7721 was provided by Jiangxi Institute of Digestive Disease (China). 85.5% deacetylated chitooligosaccharides and 85% deacetylated water-soluble chitosan were produced by Jinan Haidebei Ocean Biological Engineering Co., Ltd (China); Carboxymethyl chitosan and 88.5% deacetylated chitosan were the products of Shanghai Qisheng Biological Products Co., Ltd (China).METHODS: Sulfonated chitosan was prepared using 88.5% deacetylated chitosan and chlorosulfonic acid-formamide, and then was detected with infrared spectroscopy in the Detection Analysis and Test Center, East China University of Science and Technology. SMMC7721 cells in the log phase were inoculated into 96-well culture plates, which were then added with water-soluble chitosan, sulfonated chitosan, carboxymethyl chitosan and chitooligosaccharides with the final concentrations of 25, 50, 100, 200, 400 and 800mg/L. This test was repeated for 3 times, while the control group was also set each time. After 72 hours of routine culture, MTT solution was added into each well and inoculated for another 4 hours. After the culture was terminated, dimethyl sulfoxid was added. The absorbance value of each well was measured at 490nm wavelength on a microplate reader. Three tests were measured to obtain the mean value. Also the inhibition rate was calculated.MAIN OUTCOME MEASURES: Growth inhibition effect of chitosan and its derivatives on the hepatoma cell line SMMC7721.RESULTS: Among the chitosan and its derivates at four kinds of concentrations, water-soluble chitosan and sulfonated chitosan could significantly inhibit the growth of SMMC7721 cells (P<0.001), and the effect was the most significant in the case of sulfonated chitosan. Treatment with water-soluble chitosan and sulfonated chitosan at the concentration of 50mg/L could inhibit the growth of SMMC7721 cells in a dose-dependent manner, and reached a peak at the concentration of 400mg/L and 800mg/L, respectively. Carboxymethyl chitosan and chitooligosaccharides showed no growth inhibition effect (P>0.05).CONCLUSION: Water-soluble chitosan and sulfonated chitosan have significant antigrowth effects on hepatoma carcinoma cells, while carboxymethyl chitosan and chitooligosaccharides are ineffective.

Objective To investigate the therapeutic effect and advantage of laparoscopic appendectomy by concealed three-ports technique. Methods The clinical data of 283 patients received concealed three-ports laparoscopic appendectomy were retrospectively reviewed. Results All the patients were cured after appendectomy,including 5 patients required conversion to operation(because of adhesions around the appendix and difficult to dissect). The surgical time ranged from 25 min to 110 min and the mean time was 38 min. After 8 ～ 12h the patients could move and the average length of postoperative stay was 5d (range 4 ～ 6d). 3 cases had postoperative wound infection. None occurred complications such as postoperative bleeding, abdominal abscess, intestinal fistula, adhesion ileus and incision hernia in 6 months on average (range 1 ～ 18 months)after operation. Conclusion Laparoscopic appendectomy by concealed three-ports technique was a safe and available method and had advantages such as convenience and safety,good cosmetic results,less injury,rapid recovery,less complications,cheap and easy.

Objective To study the clinical significance of the expression of D-amino acid oxidase(DAO) in hepatocellular carcinoma(HCC) tissues.Methods The gene expression profiles and related clinical data of 214 HCC cases were collected.Univariate and multivariate analyses were conducted to investigate the association between DAO expression levels,clinical traits,the prognosis.Results Univariate analysis indicated that there were a lower level of blood alpha fetoprotein(AFP,P=0.001),a smaller number of nodules(P=0.042),a better TNM stage(P=0.014),a lower metastasis risk(P=0.001) and a better prognosis(P=0.011)in the samples with high DAO expression.Multivariate analysis also indicated a lower AFP level(OR:0.162,95%CI:0.078-0.336) and metastasis risk(OR:0.140,95%CI:0.069-0.284) in the samples with high DAO expression,as well as a better prognosis(OR:0.833,95%CI:0.700-0.992).Conclusion DAO expression was associated with blood AFP levels,metastasis risk and prognosis in HCC,and its high expression was a protective factor for HCC.

Objective To analyze the clinical effect of biliary-enteric anastomosis and biliary stent to palliative treatment of malignant obstructive jaundice.Methods A total of 40 patients with inoperable malignant obstructive jaundice were enrolled in this study,and 20 patients were performed biliary stent placement (stent group),simultaneously 20 patients were performed biliary-enteric anastomosis (operation group).The fatality rate after operation,the level of total bilirubin before treatment and after treatment for 4,7,14 d,the rate of hyperpyrexia,nausea and vomiting,postoperative recurrence of jaundice were compared between two groups.Results There were no dead in two groups.The level of total bilirubin was decreased after treatment,and there was no significant in two groups before treatment and after treatment for 4,7,14 d (P ＞ 0.05).The rate of hyperpyrexia in operation group was significantly lower than that in stent group (0 vs.4/20) (P ＜ 0.05).Conclusion For palliative treatment of malignant obstructive jaundice,the biliary-enteric anastomosis should be performed first if there is no significant contraindication.

Adult ; Aged ; Alleles ; China ; ethnology ; Female ; HLA-DQ Antigens ; genetics ; HLA-DQ alpha-Chains ; HLA-DQ beta-Chains ; Haplotypes ; Humans ; Linkage Disequilibrium ; Male ; Middle Aged ; Phylogeny ; Polymerase Chain Reaction ; Polymorphism, Genetic

This study established a population pharmacokinetics-pharmacodynamics model of clopidogrel in patients with acute coronary syndrome. Fifty-nine patients were enrolled. The plasma concentration of clopidogrel active metabolite and vasodilator stimulated phosphoprotein platelet reactivity index (VASP-PRI) were selected as the pharmacokinetics index and the pharmacodynamics index, respectively. The covariates including demographic characteristics, laboratory indexes, combined medication, complications and genetic polymorphisms of related enzymes were screened for their influence on the pharmacokinetic and pharmacodynamics parameters. Population pharmacokinetic and pharmacodynamics data analysis was performed using NONMEM software. The general linear model and the indirectly effect model-turnover model for pharmacokinetic and pharmacodynamic analysis were selected as the basic model, respectively. The population typical values of K12, CL/F, V/F, EC50, K(in), and E(max) were 0.259 h(-1), 179 L x h(-1), 632 L, 1.57 ng x mL(-1), 4.29 and 0.664, respectively. CYP2C19 was the covariate in the final pharmacokinetic model, and the model was to design a prior dosage regimen.
Acute Coronary Syndrome ; metabolism ; Humans ; Polymorphism, Genetic ; Ticlopidine ; analogs & derivatives ; pharmacokinetics

Objective To explore the clinic application value of ultrasonography examination of optic nerve sheath diameter(ONSD) in brain injury.Methods From July 2008-June 2011,90 cases of brain injured patients were chosen as experimental group including light (A group),medium (B group),and heavy (C group) brain injured patients according to the admission GCS score ;50 cases of conventional physical examination and 90 cases of volunteers 50 in neurosurgical outpatient were chosen as control group.The ONSD of both groups were measured 3 mm behind the globe through orbital using color sonographic with different time after admission.3 times measurements were carried out for every optic nerve sheath.All client's ONSD mean and standard deviation were calculated.In 0.5 h after color dopplar ultrasound examination,lumbar vertebra puncturing measured intracranial pressure in different groups.Results After admission (1d,3 d,7 d,14 d),the ONSD of A group was (4.54 ±0.32)mm,(4.42 ±0.30)mm,(4.44 ±0.32) m,and (4.43 ± 0.25) mm,respectively; The ONSD of B groups was (4.48 ± 0.28) mm,(4.52 ± 0.24) mm,(4.46 ±0.28)mm,and (4.38 ±0.22)mm,respectively; The ONSD of C group was (5.67 ±0.35)mm,(6.36 ± 0.42) mm,(5.65 ± 0.23) mm,and (4.76 ± 0.35) mm,respectively.After admission (1 d,3 d,7 d,14 d),the intracranial pressure (IP) of A group was (82 ± 11) mmH2O,(79 ± 12) mmH2O,(90 ±15) mmH2O,and (86 ± 14) mmH2O,respectively; The IP of B group was (78 ± 15) mmH2O,(85 ± 10)mmH2O,(78 ± 16) mmH2O,(80 ± 11) mmH2O,The IP of C group was (225 ± 26) mmH2 O,(288 ± 23)mmH2O,(256 ± 23) mmH2O,(122 ± 18) mmH2O,respectively.Group D had the ONSD average of (4.58± 0.41)mm and IP of (88 ± 10)mmH2O after eyeball 3-mm place.No difference was found between A and B,A and D,or B and D (P＞0.05) ; A difference was found between A and C,B and C,or D and C (t =12.24～24.67,P＜0.01).Conclusions The ONSD and IP in light medium brain injured patients had no change.In patients with severe brain injury,IP changed with the time after injury,the ONSD increased with the IP,the ultrasonography examination of ONSD with the important value in the diagnosis and treatment can respond the IP increase,which is a non-invasion,convenient,fast,and feasible method for evaluation of cranial high pressure.

In the context of internationalization of education,the military graduate education concepts and models also come to change,and opportunities and challenges coexist.In this article,the challenges and problems of army medical college graduate education were mentioned and analyzed,and the exploration and attempt of graduate education in the process of international were summarized.

OBJECTIVETo investigate the perioperative and postoperative long-term complications of procedure for prolapse and hemorrhoids(PPH) for the treatment of circular internal hemorrhoids and circular mixed hemorrhoids.

METHODSA retrospective study was performed in 2152 patients with circular internal hemorrhoids and circular mixed hemorrhoids eligible for PPH from January 2002 to December 2011. The perioperative and postoperative long-term complications were recorded and assessed.

RESULTSThe median length of follow-up was 73 months. Perioperative complications and adverse events were reported including acute urinary retention(n=360, 16.7%) which was managed by temporary cathether indwelling, anastomotic bleeding(n=45, 2.1%) managed by surgical or endoscopic procedures, chronic anoperineal sustained pain(n=30, 1.4%) managed by local treatment or stapler removal, and thrombosed external hemorrhoid(n=28, 1.2%) managed by conservative treatment or resection. Long-term postoperative complications were reported including mild fecal incontinence(n=112, 6.3%), postoperative recurrence(n=82, 4.6%), anal distention and defecatory urgency(n=50, 2.8%), anastomotic stenosis(n=4, 0.2%). Postoperative recurrence developed in 82 patients(4.6%), 28 of whom were managed by repeat PPH and 54 by conservative treatment.

CONCLUSIONPPH appears to be a safe technique for patients with circular internal hemorrhoids and circular mixed hemorrhoids.

Digestive System Surgical Procedures ; Hemorrhoids ; diagnosis ; surgery ; Humans ; Postoperative Complications ; Postoperative Period ; Prolapse ; Recurrence ; Retrospective Studies ; Thrombosis