Objective To study the effect and value of hepatoarterical catheter chemotherapy in treating gastric carcinoma with liver metastasis. Methods A total of 31 cases of gastric carcinoma with liver metastasis undergoing radical operation were preoperatively randomly divided into 2 groups: Regional infusion chemotherapy (treatment group, 17 cases) and peripheral venous chemotherapy (control group, 14 cases). Results The short-term effectiveness of the treatment group was 88.3 %(15/17). The survival rates of 1, 2, 3 year were 88.2 %, 62.7 %, 28.9 %, respectively. However, the short-term effectiveness of the control group was 28.6 %(4/14). The survival rates of 1, 2, 3 year were 68.1 %, 38.9 %, 13.0 %, respectively. There was obvious difference between the two groups (χ~2 = 12.87, P <0.05;χ~2 =5.511, P<0.01). Conclusion Hepatoarterical catheter chemotherapy is effective for gastric carcinoma with liver metastasis undergoing radical operation and has less toxic side effects.

Objective To investigate the clinical effect of nicorandil for treatment of patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted. A total of 40 cases of patients with ARDS admitted to Department of Critical Care Medicine of Guizhou Provincial People's Hospital from October 2012 to October 2014 were enrolled, and they were randomly divided into two groups, 20 cases in each group. The two groups were treated with routine western medicine after admission. On this basis, the observation group was given nicorandil 10 mg, while the control group was given warm boiled water 10 mL, through gastric tubes 3 times a day, the therapeutic course being consecutive 5 days in both groups. The length of stay in intensive care unit (ICU), duration of mechanical ventilation after treatment, oxygenation index (OI), alveolo-arterial oxygen partial pressure difference (PA-aO2), positive end-expiratory pressure (PEEP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS) before and after treatment, the predicted death rate (PDR) and 28-day mortality were compared between the two groups. The predicitive factors for 28-day mortality were screened by binary logistic analysis.Results The length of stay in ICU and duration of mechanical ventilation of control group were longer than those of observation group, but the difference was not statistically significant [ICU length of stay (day): 14.55±12.71 vs. 9.15±6.00, duration of mechanical ventilation (day): 13.25±12.27 vs. 7.75±5.32, bothP > 0.05]. After treatment, the GCS was higher than that before treatment in control group and observation group (11.95±3.98 vs. 10.75±4.89, 12.95±3.67 vs. 12.20±4.56), while APACHE Ⅱ score, PDR and PEEP were all lower than those before treatment [APACHE Ⅱ: 21.05±8.58 vs. 24.90±5.63, 18.70±11.21 vs. 26.65±7.67; PDR: (47.71±29.49)% vs. (61.00±23.29)%, (36.79±18.49)% vs. (56.12±18.16)%; PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.40±3.14 vs. 5.75±2.59, 3.80±2.55 vs. 7.55±3.32], but there were no statistically significant differences between the two groups before and after treatment (allP > 0.05). After treatment, the OI was significantly higher and the PA-aO2 was significantly lower than those before treatment in the two groups, and the degrees of improvement of the observation group were more remarkable than those of the control group [OI (mmHg, 1 mmHg = 0.133 kPa): 224.72±85.12 vs. 141.37±45.82, PA-aO2 (mmHg): 132.60±46.64 vs. 204.30±121.2, bothP < 0.05]. The 28-day mortality of observation group was lower than that of control group, but no statistically significant difference was seen [15% (3/20) vs. 25% (5/20),χ2 = 0.156,P > 0.05). Binary logistic regression analyses showed that the PA-aO2 [odds ratio (OR) = 0.958,P = 0.013, 95% confidence interval (95%CI) = 0.927 - 0.991], APACHE Ⅱ score (OR = 0.882,P = 0.010, 95CI = 0.803 - 0.970), GCS (OR = 1.399, P = 0.004, 95%CI = 1.111 - 1.761) and PDR (OR = 0.907,P = 0.002, 95%CI = 0.853 - 0.965) after treatment were the independent predictors of 28-day mortality.Conclusion Nicorandil can significantly improve oxygenation, but cannot reduce 28-day mortality in patients with ARDS.

OBJECTIVETo investigate clinicopathologic features of succinate dehydrogenase-deficient gastrointestinal stromal tumors (SDH-deficient GIST).

METHODSImmunohistochemical EnVision technique was used to assess the expression of succinate dehydrogenase subunit B (SDHB) in 192 cases of GIST. Cases of SDH-deficient GIST were further evaluated for the presence of CKIT exons 9, 11, 13 and 17 mutations and PDGFRA exons 12 and 18 mutations with clinical followed-up data.

RESULTSSeven of the 192 cases showed SDHB-deficiency (3.6%, 7/192). The patients ranged in age from 35 to 84 years (median=56 years; mean=60 years). Four were male and three were female. Six tumors involved stomach and one involved mesentery. Histopathologic features of SDHB-deficient GIST included four cases of mixed-cell type and three of epithelioid cell type. The tumors commonly involved muscularis propria of the stomach as multiple nodules, creating a plexiform pattern. The tumors had high cellularity with cytoplasmic vacuolization. Five cases developed lymph node metastases including one also metastasizing to liver and pancreas. Two cases showed no evidence of metastasis. None of the 7 cases of the SDHB-deficient GIST had CKIT exons 9, 11, 13 and 17 mutations and PDGFRA exons 12 and 18 mutations. Three of the seven SDHB-deficient GIST cases had followed-up data: two did not recur and one died after 24 months of surgery of unknown cause.

CONCLUSIONSDHB-deficient GIST has characteristic clinicopathologic features with wide-type CKIT gene and a favorable prognosis.

Adult ; Aged ; Aged, 80 and over ; Exons ; Female ; Gastrointestinal Stromal Tumors ; diagnosis ; genetics ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Mutation ; Prognosis ; Succinate Dehydrogenase ; genetics

OBJECTIVE:To establish a reasonable return level for Chinese pharmaceutical industry and to study the return level of the domestic pharmaceutical industry from 2000 to 2005.METHODS:In view of the financial data of Chinese pharmaceutical industry in the statistical yearbook from 2001 to 2006,the return level for Chinese pharmaceutical industry was established based on its risk level using the principle of "risk-return equilibrium",and the rationality of the return level of Chinese pharmaceutical industry over the 6 years was validated as well.RESULTS:Over the 6 years,the average lowest anticipating rate of return for the Chinese medicine industry was 7.72% and the actually average assets income rate stood at 8.53%,i.e.the average abnormal return rate over the 6 years was 0.81%.CONCLUSION:The return rate of Chinese pharmaceutical industry corresponds to the risk level as well as the reasonable return level.

OBJECTIVE:To probe into the profits level and profits-gaining capability of Chinese pharmaceutical industry.METHODS:Based on the data recorded in yearbooks between 2001 and 2006,the profits levels were compared between Chinese pharmaceutical industry and China social average assets,other industries in China and overseas pharmaceutical industry.RESULTS:Between 2000～ 2005,the profits level of Chinese pharmaceutical industry was lower than that of Chinese social average assets,i.e.the profit-gaining capability of Chinese pharmaceutical industry was lower than that of China social average assets.Between 2002～ 2004,the profits level of Chinese pharmaceutical industry ranked at the first 10 places among the 39 industries,but dropped far behind in 2005,meanwhile the number of pharmaceutical enterprises who suffered loss increased greatly.CONCLUSION:The prospect for the development of Chinese pharmaceutical industry and the industry environment they confronted are far from optimistic.

The formulations of pramipexole hydrochloride sustained-release tablets were screened by single factor test and optimized by Box-Behnken design. The effects of the viscosity and content of hydroxypropyl methyl cellulose, as well as the insoluble sustained-release material combined with HPMC K100M on the in vitro release behavior were investigated. After single factor screening, a three-factor, three-level Box-Behnken design was used for optimization using the contents of HPMC K100, Eudragit RSPO and Eudragit L100 as independent variables, and the cumulative release at different time as responses. The optimal range of the three-factor optimized by Box-Behnken design, one of the optimized formulations was achieved with HPMC K100M of 101. 5 mg, Eudragit RSPO of 98 mg, and Eudragit L100 of 13. 7 mg, and the observed responses of the optimized formulation were very close to the predicted values. The in vitro drug release mechanism of the tablet was studied by drug released model fitted with different equations. The results explained that Eudragit RSPO promoted the release of the pramipexole hydrochloride, while Eudragit L100 blocked the release, and there was an antagonism between them. In conclusion, the drug release behavior of optimized formulations prepared by Eudragit RSPO/L100 was stable, less pH-dependent, which improved the drug bioavailability in vivo.

Objective To observe curative effect and clinical outcome in 30 recipients undergoing allogcneic peripheral blood stem cell transplantation (PBSCT) combined with bone marrow transplantation (BMT). Methods 30 patients with a median age of 32.6 years underwent allo-HSCT, of which 11 patients with AML, 14 patients with ALL, and 5 patients with CML They all have a HLA-identical sibling. PBSCswere mobilized with G-CSF. Three hundreds milliliter bone marrow blood was transplanted to the patients on the day that the PBSC was transplanted. Amended Bu/Cy was used as the conditioning regimen. MTXcombined with CsA and MMF was used as GVHD prophylaxis. Results A median number of mononuclear cells of (5.13±2.6)x10~8/kg recipient's weight was collccted from peripheral blood, and (1.3±0.6)x10~8/kgrecipient' s weight from bone marrow blood. Engraftment of neutrophils and platelets was achieved at a median of (12.1±3.25) days and (14±5.33) clays respectively. Ⅰ - Ⅱ acute GVHD occurred in 40.0 % cases,Ⅲ - Ⅳ acute GVHD occurred in 3.3 % cases, and chronic GVHD developed in 43.3 % cases. Severe cGVHD developed in 3.3% cases. The 2 years disease free survival rate (DFS) by the day of transplantation was 72.0 %. Conclusion PBSCT combined with BMT was effective to cure leukemia. The results also suggested that PBSC recipients had an lower incidence of aGVHD and cGVHD as compared with previous reports.

Objective To analyze the clinical features and prognosis of CD34-positive and CD34-negative adult patients with acute T-lymphoblastic leukemia (T-ALL),and to explore the value of CD34 expression for prognosis of patients with T-ALL.Methods 75 adult patients diagnosed with T-ALL from January 2012 to July 2015 in the Department of Hematology,the First Affiliated Hospital of Zhengzhou University,were analyzed retrospectively.According to the expression of CD34,the patients were divided into CD34-positive group and CD34-negative group,and then the clinical characteristics and prognosis of both groups were analyzed.Results In 75 patients,CD34-positive group had 24 (32.0 ％) patients and CD34-negative group had 51 (68.0 ％) patients.Between the two groups,there was no significant difference in these factors,such as sex,age,infiltration of liver,spleen and lymph nodes,thrombocytopenia,high white blood cell count,abnormal karyotype,complete remission within 4 weeks and central nervous system leukemia (CNSL).The proportions of patients with hemoglobin (Hb) ＜ 90 g/L and expression of myeloid lineage marker were higher in the CD34-positive group than those in the CD34-negative group (x2 =5.888,P=0.015;x2 =10.758,P =0.001,respectively).There were only 18 patients treated with hematopoietic stem cell transplantation (HSCT),57 patients were not.In patients without HSCT,the median survival time in the CD34-positive group and CD34-negative group was significant different (5 months vs.32 months,x2 =9.172,P =0.002).Conclusions CD34 expression in adult patients with T-ALL appears to be associated with Hb ＜ 90 g/L and the expression of myeloid lineage markers.For the patients without HSCT,CD34 is likely negatively related with the prognosis.

Objective To explore the effects of motor acupuncture based on movement pattern adjustment theory on Oswestry Disability Index(ODI),modified Japanese Orthopedic Association(JOA)score and the prognosis in patients with non-specific low back pain(NLBP).Methods A total of 98 patients with NLBP who were admitted to the hospital from March 2020 to March 2023 were randomly divided into control group and observation group,with 49 patients in each group.The con-trol group received lumbar and pelvic rhythm training,while the observation group received motor ac-upuncture based on movement pattern adjustment theory.The Visual Analogue Scale(VAS)score,ODI score,JOA score,low back electromyographic signals[the ratio of maximum EMG during exten-sion to maximum EMG during maximum voluntary flexion(EXT/MVF)and the ratio of maximum EMG during flexion to maximum EMG during maximum voluntary flexion(FLEX/MVF)],and serum inflammatory factors[interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α]in both groups were observed before and after treatment.Clinical efficacy and 3-month recurrence rate were compared between the two groups.Results After 2 weeks of treatment,VAS score and ODI score of the observation group were lower than those of the control group,and JOA score was higher than that of the control group(P＜0.05).EXT/MVF and FLEX/MVF of the erector spinae and multifidus muscle in the observation group were higher than those in the control group(P＜0.05).Serum IL-6,IL-1 β and TNF-α levels two weeks after treatment in the observation group were lower than those in the control group(P＜0.05).The effective rate of the observation group was higher,and 3-month recurrence rate of the observation group was lower than that of the control group(P＜0.05).Conclusion Motor acupuncture based on movement pattern adjustment theory can achieve significant therapeutic effect in treating NLBP,which can effectively alleviate pain,improve lumbar function,and reduce inflammatory reactions,with good prognosis and a low recurrence rate.

Objective To explore the effects of motor acupuncture based on movement pattern adjustment theory on Oswestry Disability Index(ODI),modified Japanese Orthopedic Association(JOA)score and the prognosis in patients with non-specific low back pain(NLBP).Methods A total of 98 patients with NLBP who were admitted to the hospital from March 2020 to March 2023 were randomly divided into control group and observation group,with 49 patients in each group.The con-trol group received lumbar and pelvic rhythm training,while the observation group received motor ac-upuncture based on movement pattern adjustment theory.The Visual Analogue Scale(VAS)score,ODI score,JOA score,low back electromyographic signals[the ratio of maximum EMG during exten-sion to maximum EMG during maximum voluntary flexion(EXT/MVF)and the ratio of maximum EMG during flexion to maximum EMG during maximum voluntary flexion(FLEX/MVF)],and serum inflammatory factors[interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α]in both groups were observed before and after treatment.Clinical efficacy and 3-month recurrence rate were compared between the two groups.Results After 2 weeks of treatment,VAS score and ODI score of the observation group were lower than those of the control group,and JOA score was higher than that of the control group(P＜0.05).EXT/MVF and FLEX/MVF of the erector spinae and multifidus muscle in the observation group were higher than those in the control group(P＜0.05).Serum IL-6,IL-1 β and TNF-α levels two weeks after treatment in the observation group were lower than those in the control group(P＜0.05).The effective rate of the observation group was higher,and 3-month recurrence rate of the observation group was lower than that of the control group(P＜0.05).Conclusion Motor acupuncture based on movement pattern adjustment theory can achieve significant therapeutic effect in treating NLBP,which can effectively alleviate pain,improve lumbar function,and reduce inflammatory reactions,with good prognosis and a low recurrence rate.