Objective:To evaluate the predictive value of 3 methods, namely plasma paraquat concentration, severity index of paraquat poisoning (SIPP), and acute physiology and chronic health evaluation (APACHE II) in severity evaluation and prognosis of acute paraquat poisoning. Methods:A total of 73 acute paraquat poisoning patients with oral administration were collected. Paraquat concentration in the plasma and other parameters on admission for SIPP and APACHE II were taken from medical records. According to the clinical outcome in the hospital or 7 days atfer the discharge, discrimination and calibration test were performed to evaluate the prognosis of the 3 methods. Results:Discrimination of the 3 methods was greater than 0.8, and the area under the receiver operator curve for SIPP (0.938) was greater than paraquat concentration in the plasma (0.857) and APACHE II (0.801) with statistical signiifcance (z=2.429, 2.021;P=0.015, 0.043). Difference in plasma paraquat concentration (0.857) and APACHE II (0.801) had no statistical signiifcance (z=0.755, P=0.450). Hosmer-Lemeshow good fit test suggested better calibration value with statistical signiifcance for the 3 methods (P>0.05). Conclusion:hTe 3 methods are valid in the severity evaluation and prognosis of acute paraquat poisoning. SIPP is the most preferred method, followed by paraquat concentration on admission. When there is no facility to measure paraqut concentration, APACHE II can be used as a reference for the death risk in acute paraquat poisoning.

Objective To discuss the correlations between hemoperfusion(HP) times and therapeutic effects/prognosis in patients with severe acute organophosphorus poisoning(AOPP). Methods According to the frequency of HP,82 patients with severe AOPP were divided into three groups:non HP(25 cases),HP1(27 cases) and HP2(30 cases)groups. The non HP group received only routine treatment,on the basis of routine treatment,the HP1 group accepted once HP within 12 hours after poisoning and the HP2 group underwent twice or more times of HP,the interval between each time being 24 hours. The comparisions of clinical indexes,incidences of complications and rates of mortality among the three groups were performed. Results With the increase of HP times,the dosages of atropine and pralidoxime chloride were significantly reduced,the times of serum cholinesterase(ChE)activity recovery,consciousness recovery,hospitalization and mechanical ventilation were significantly shortened,the score of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score in 48 hours after admission,incidence of complications and mortality were evidently decreased(all P<0.05). Compared with those in HP1 group,the dosages of atropine(mg:164.57±68.82 vs. 256.81±97.06)and pralidoxime chloride(mg:6.95±1.40 vs. 8.76±1.64) in HP2 group were significantly reduced,the times of ChE activity recovery(day:9.03±2.46 vs. 10.96±3.44), consciousness recovery(hour:23.83±6.29 vs. 39.93±8.24),hospitalization(hour:9.57±2.39 vs. 11.52±3.02) and mechanical ventilation(hour:40.50±16.55 vs. 65.74±18.88)in HP2 group were significantly shortened;APACHEⅡscore during 48 hours after admission(11.97±3.47 vs. 14.26±2.88)was obviously decreased,and the incidences of complications,such as intermediate syndrome(10.0% vs. 18.5%),rebound phenomenon(3.3% vs. 25.9%),arrhythmia(13.3%vs. 44.4%),multiple organ dysfunction syndrome(MODS,6.7%vs. 29.6%)and mortality rate(6.7% vs. 18.5%)in HP2 group were markedly decreased(all P<0.05). Conclusion It is recommendable that combined with routine treatment,early and multiple HP application would enhance the therapeutic effect and decrease the mortality in patients with severe AOPP.

Objective To investigate the effect of intravenous thrombolysis with different doses of alteplase on neurological function in patients with acute ischemic stroke.Methods 120 patients with acute ischemic stroke were selected as the research subjects.According to the admission time,the patients were divided into the observation group and the control group,60 patients in each group.The observation group was treated with low dose alteplase(0.6mg/kg),the control group was given standard dose(0.9mg/kg).The clinical curative effect,incidence rate of adverse event,NIHSS score and mRS score before and after treatment were observed and recorded in the two groups.Results Before treatment,there was no significant difference between the two groups in NIHSS score(t=0.288 0,P=0.773 9).After treatment for 3 days,the NIHSS score of the control group decreased compared with before treatment,and was lower than that of the observation group at the same period,there was significant difference between the two groups(t=0.778 5,P=0.000 0).Before treatment,the mRS score between the two groups had no siginificant difference(t=0.801 0,P=0.424 7).After treatment for 90 days,the mRS score of the two groups decreased,the difference was statistically significant(t=6.811 5,P=0.000 0).After treatment,1 patient with cerebral hemorrhage was observed in the observation group,while 3 cases in the control group,the difference between the two groups was not statistically significant(χ2=1.034 5,P=0.309 1).The mortality of the observation group was 11.47％,which of the control group was 1.67％,there was significant difference between the two groups(χ2=4.821 4,P=0.028 1).The good prognosis rate of the observation group was 45％,which of the control group was 68.33％,the difference was significant between the two groups (χ2=6.651 6,P=0.009 9).Conclusion Standard dose of alteplase in the treatment of acute ischemic stroke has better efficacy than low-dose alteplase,it has improved conditions of neurological deficits in patients,better recovery of neurological function,the prognosis is good,it can be widely recommended.

Objective:To study the impact factors of psychological distress in patients with first diag-nosed lung cancer.Methods:The cross-sectional study was applied to newly diagnosed lung cancer pa-tients who received treatments in Cancer Center of West China Hospital of Sichuan University in Chengdu from June 201 3 to March 201 5 by distributed questionnaires.The general information of the patients,the hospital anxiety and depression scale (HADS)and distress management screening measure (DMSM) were included in the questionnaire to evaluate the states of distress,pain and the factors related to the distress of the patients.Results:The survey investigated a total of 390 patients with first diagnosed lung cancer,including 291 male patients and 99 female patients.The proportion of the patients with positive anxiety symptom was 26.7% (1 04 /390),with positive depression symptom was 27.7% (1 08 /390), and with positive distress symptom was 30.0% (1 1 7 /390).On the top five problem list of DMSMwere worry,disease treatment,breathing,pain and sleep.The Spearman correlation analysis showed that an-xiety score,depression score,and the pain intensity were positively correlated with the distress.Multiple linear regression analysis showed that gender (β=-0.209,P =0.003),age (β=-0.098,P =0.042),chronic disease (β=0.378,P <0.001 ),and pain score (β=0.1 00,P =0.029)could affect the distress of the patients.Smoking (β=0.1 1 1 ,P =0.041 )could affect the anxiety of newly diagnosed lung cancer patients.Conclusion:The gender,age,chronic disease and pain score of the patients are the independent factors of the psychological distress of first diagnosed lung cancer patients.Smoking is the predictive factors of the patients with anxiety.Controlling the pain intensity and the clinical process of chronic disease of the patients actively,solving the sleep and breathing problem and helping the patients to quit smoking progressively could alleviate the psychological distress of the patients.

OBJECTIVE: To study the tissue distribution of doxorubicin-loaded cholesterol-modified glycol chitosan nanoparticles (named as DCN-16) in S180-bearing mice. METHODS: After intravenous administration of doxorubicin (DOX) or DCN-16, DOX concentrations in plasma and tissues samples which were collected at predetermined time were determined by high performance liquid chromatography (HPLC). And DOX distribution and targeting performance in vivo were evaluated. RESULTS: DCN-16 displayed long circulation time in S180-bearing mice. The area under the curve (AUC0-∞) of DCN-16 was lower in heart (P < 0.05), lung (P < 0.05) and kidney (P < 0.05) than that of free DOX. In addition, compared with free DOX, DCN-16 also produced significantly increased drug accumulation in liver (P < 0.05), spleen (P < 0.05) and tumor (P < 0.05). The relative tissue exposure (Re) of DCN-16 in tumor was 2.56-folds of free DOX. CONCLUSION: Encapsulating DOX with cholesterol-modified glycol chitosan nanoparticles can prolong the systemic circulation time of DOX, increase its anti-tumor targeting activity and reduce its cardiac toxicity.

Animals ; Blood Gas Analysis ; Endothelin-1 ; blood ; Hypertension, Pulmonary ; pathology ; Hypoxia ; blood ; physiopathology ; therapy ; Male ; Oxygen ; administration & dosage ; therapeutic use ; Oxygen Inhalation Therapy ; Swine

Laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection is still difficult to accomplish,which restrains its application in total gastrectomy for advanced proximal gastric cancer.Based on our anatomical understanding of pre- and retropancreatic spaces,features of splenic vessels and distribution of perigastric lymph nodes,we combined the characteristics of laparoscopic surgery and developed a novel technique for laparoscopic pancreas- and spleen-preserving splenic hilar lymph nodes dissection through retropancreatic space.The key lies in mobilization of the splenic pedicle through retropancreatic space,dissection of peri-vascular lymph nodes in sequence of trunk-to-branch,in-sheath vascularization of the splenic vessels.From August 2009 to December 2010,this technique was performed on 6 patients in Nanfang hospital.The initial results suggested that this technique could be safe and feasible for skillful surgeons.Further studies on the application of this technique in total gastrectomy for advanced proximal gastric cancer would be needed.

AIM: To explore the influence of CD47 molecules on the maturation and function of cultured dendritic cells (DCs). METHODS: Monocyte cell-derived DCs were propagated in granulocyte-macrophage colony-stimulating factor (GM-CSF) and lipopolysaccharide (LPS) plus interleukin (IL)-4, in the presence or absence of anti CD47 monoclonal antibodies (anti-CD47 mAbs). Flow cytometry was used to detect the cell surface phenotype. The concentration of IL-12P70 in supernatant was measured by ELISA technique. The antigen-presenting functions of DCs were determined in one-way mixed leukocyte reaction by Brdu-ELISA. Electrophoretic mobility shift assays (EMSA) was used to examine NF-?B activity. RESULTS: The anti-CD47 mAbs markedly suppressed the expression of CD80,CD86,CD83,CD1a,HLA-DR on the surface of DCs (P

AIM: To clone and express the gene of SLC24A6, which provide the basis to illuminate the relationship between the SLC24A6 and insulin release. METHODS: The gene expression of SLC24A6 was analyzed in the insulinoma and normal pancreatic tissues by RT-PCR. The full-length cDNA sequence was subcloned into pET32a vector, and induced expression and purified in ROSSET (DE3) strain. At the same time, the ORF of SLC24A6 was cloned into green fluorescence protein vector pEGFP-C3 to study the location of SLC24A6 in the mouse insulinoma ?-TC3 cells. RESULTS: The mRNA expression of SLC24A6 in the human insulinoma tissue was significantly higher than that in normal pancreatic tissue. The fusion protein of SLC24A6 was a 80 kD protein and was purified successfully by prokaryotic vector in ROSSET strain. The localization of SLC24A6 in the mouse insulinoma ?-TC3 cells was located in the membrane of the cells. CONCLUSION: SLC24A6 might be related with insulin release. The prokaryotic expression of SLC24A6 provides the basis for the study on biological function and protein structure, and the location of SLC24A6 in the insulinoma cell will throw light on the relationship with insulin release.

OBJECTIVE: To prepare doxorubicin (DOX)-loaded micelles based on folic acid-modified cholesterol-glycol chitosan (FCHGC), and study its physicochemical properties and cytotoxicity in vitro. METHODS: FCHGC copolymer was synthesized by conjugating carboxyl groups of folic acid with the primary amino groups of cholesterol-modified glycol chitosan (CHGC) in the presence of coupling agent. FCHGC conjugate was characterized by 1H-NMR and fluorescence measurement using pyrene as a probe. The DOX-loaded micelles were prepared by an emulsion/solvent evaporation method. The size and shape of the micelles were analyzed by dynamic light scattering (DLS) and transmission electron microscopy (TEM). DOX release behavior was studied in vitro by a dialysis method in phosphate buffer saline (PBS, pH 7.4). The cytotoxicity and celluar uptake of drug-loaded micelles in vitro were investigated by 3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay and flow cytometry. RESULTS: The critical aggregation concentration (CAC) of the FCHGC micelles in aqueous solution was 0.0163 mg·mL-1. Its particle size was 227 nm. The drug loading and encapsulation efficiency of DOX-loaded FCHGC (DFCHGC) micelles were 10.5% and 78.5%, respectively. The shape of DFCHGC micelles was almost spherical. DOX was released from DOX-loaded micelles in a biphasic manner, which displayed an initial rapid release phase and a later sustained release phase. The 50% inhibitory concentrations (IC50) of DOX, DOX-loaded CHGC (DCHGC) and DFCHGC micelles, incubated with folate receptor (FR)-negative A549 cells for 48 h, were 1.493, 0.620 and 0.974 μg·mL-1, respectively. Therefore, DCHGC micelles exhibited much more potent cytotoxicity against A549 cells than DFCHGC micelles. In FR-positive HeLa cells, the IC50 values of DOX, DCHGC and DFCHGC micelles were 1.398, 0.662 and 0.259 μg·mL-1, respectively. The DFCHGC micelles showed the greatest cytotoxicity among three DOX formulations for HeLa cells. And DFCHGC micelles exhibited greater cellular uptake than free DOX and DCHGC micelles in HeLa cells. CONCLUSION: The FCHGC micelles as a drug carrier for DOX delivery show selectively targeting to FR-positive cells, and improve the anti-tumor activity of DOX. These results suggested that FCHGC micelles could be a potential carrier for active targeting drug delivery.