Objective To examine epidermal growth factor receptor (EGFR) gene mutations in small bronchoscopic biopsy specimens, so as to provide guidance for clinical targeted therapy. Methods Fifty-six female patients with advanced-stage III B-IV lung adenocarcinoma underwent endoscopic endobronchial biopsy of tumor tissues or transbronchial needle aspiration of mediastinal and hilar lymph nodes. Under the endoscope, 20 patients underwent only bronchial biopsy, 28 underwent only transbronchial needle aspiration (TBNA) lymph node biopsy, and 8 underwent both endobronchial biopsy and TBNA biopsy of mediastinal and hilar lymph nodes. A total of 64 specimens were collected and were subjected to detection of EGFR gene mutations after confirmation of lung adenocarcinoma. The specimens were then divided into endobronchial metastasis group and lymph node metastasis group, and the mutations of exons 19 and 21 were detected and the clinical efficacy of targeted therapy was analyzed. Results Exon 19 had higher positive rate in the endobronchial metastasis group (χ2=4.304,P=0.038), and exon 21 had higher positive rate in lymph node metastasis group (χ2=18.727,P=0.000). A total of 24 cases were included for the clinical efficacy assessments: 10 had endobronchial metastasis (exon 19 mutations in 8 cases, 21 exon in 2 cases), with the disease control rate being 90% (9/10) and median progression-free survival period being 14.8 months; 14 patients had lymph node metastasis (19 exon 3 cases, 21 exon 11 cases), with the disease control rate being 78.57% (11/14) and the median progression-free survival period being 9.2 months; the disease control rates were not significantly different between the two groups (P>0.05) and the median progression-free survival periods were significantly different between the two groups(χ2 = 4.134, P=0.042). Conclusion Mutations of different EGFR exons might relate to the metastasis forms of female advanced lung adenocarcinoma, with exon 19 prone to endobronchial metastasis and exon 21 to lymph node metastasis. Targeted therapy for patients with endobronchial metastasis has a better outcome than that for patients with lymph node metastasis.

Objective To retrospectively analyze the incidence of bleeding during transbronchial needle aspiration (TBNA) procedures, so as to provide evidence for prevention and treatment of the condition. Methods TBNA procedures were performed in 178 patients with enlarged mediastinal and/or hilar lymph nodes, who were treated in the People's Hospital of Linyi. A total of 248 lymph node sites were punctured, including 100 for the groups of pretracheal and post-superior vena cava lymph nodes (4R), 10 for the groups of left paratracheal (aorta-pulmonary artery windows) lymph nodes (4L), 13 for the groups of pre-carinal lymph nodes (7),90 for the groups of sub-carinal lymph nodes (7), 12 for the groups of sub-subcarinal lymph nodes (7), 12 for the groups of right lung hilar lymph nodes (11R), and 11 for the groups of left lung hilar lymph nodes (11L).TBNA procedures were performed according to WANG's TBNA positioning and punctured method. The sites and incidence rates of bleeding sites during the procedures were analyzed. Results The highest incidence rate of bleeding (20%) was found during TBNA procedures in the sub-carinal lymph node groups (7), and the lowest incidence rate was found (2%) in the pretracheal and post-superior vena cava lymph node groups (4R).The incidence rates of bleeding were significantly different between different puncture sites as demonstrated by chi-square test (χ2=17.035,P=0.009). Conclusion Pretracheal and post-superior vena cava lymph nodes (4R) and sub-carinal lymph nodes (7) are the most common TBNA puncture position in the airway. TBNA procedure at sub-carinal lymph nodes (7) has the highest risk of bleeding. The massive bleeding during TBNA procedures can be avoided by prior enhanced CT and/or endobronchial ultrasound (EBUS)-TBNA of the lung.

OBJECTIVETo realize quadratic formula optimization of Renshen Jianxin Capsule (RJC) by screening Chinese herbs with major anti-myocardial ischemia effect in RJC and optimize their optimal dosages.

METHODSBy following "uniform design-pharmacodynamic experiment-mathematical modeling-formula optimization", authors employed U10(10(8)) uniform design in the experiment. Eight Chinese herbs contained in RJC were taken as observatory factors. Electrocardiograph (ECG) changes of myocardial ischemia induced by isoproterenol were taken as pharmacodynamic indices. The mathematical model between herbal factors and pharmacodynamic indices was established using stepwise regression analysis to screen Chinese herbs with major anti-myocardial ischemia effect. Their optimal dosages were optimized using the grid algorithm.

RESULTSThe regression equation was y =1. 7889 -0. 3247 Ginseng xSalvia Miltiorrhiza -0. 0663 Astragalus membranaceus xOriental Waterplantain tuber. Forecasting factors included were Ginseng, Salvia Miltiorrhiza, Astragalus membranaceus, and Oriental Waterplantain tuber. The optimal formula dosage calculated by the grid algorithm was Ginseng 1. 62 g, Astragalus membranaceus 4. 62 g, Salvia Miltiorrhiza 2. 43 g, and Oriental Waterplantain tuber 1. 66 g.

CONCLUSIONUniform design combined with stepwise regression analysis and grid algorithm were able to realize quadratic formula optimization of RJC.

Astragalus membranaceus ; Chemistry, Pharmaceutical ; standards ; Coronary Artery Disease ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Electrocardiography ; Humans ; Isoproterenol ; Myocardial Ischemia ; drug therapy ; Panax ; Salvia miltiorrhiza

Objective To observe the influence of combination therapy ofprobucol,aspirin and statins drugs (PAS) on levels of serum oxidized low-density lipoproteins (ox-LDL),pregnancy-associated plasma protein A(PAPP-A) and marix metalloproteinase-3(MMP-3) and resolution of carotid vulnerable plaque in patients with acute cerebral infarction (ACI).Methods One hundred and thirty-five patients with ACI,admitted to our hospital from September 2007 to July 2010,were chosen in our study; according to the results of carotid artery ultrasound,these patients were divided into carotid stable plaque group (n=45) and carotid vulnerable plaque group (n=90).Stable plaque group was considered as control group; 90 patients with carotid vulnerable plaque were randomly subdivided into aspirin and statins drugs (AS) group (n=45,aspirin 100 mg/d,atorvastatin 20 mg/d,orally) and PAS group (n=45,aspirin 100 mg/d,atorvastatin 20 mg/d,probucol 0.25 g/time,2 times/day,orally).Levels ofOx-LDL,PAPP-A and MMP-3 were detected in all patients before treatment and four weeks after drug therapy.The intima-media thickness,plaque area and echogenicity of carotid plaques were evaluated by Doppler ultrasonography during a 12-month follow-up period.Results Before treatment,serum ox-LDL,PAPP-A and MMP-3 levels in AS group and PAS group were significantly higher than those in the control group (P＜0.05); no significant differences of ox-LDL,PAPP-A and MMP-3 levels were noted between AS and PAS groups (P＞0.05).Four weeks after treatment,levels of serum ox-LDL,PAPP-A and MMP-3 in PAS group were significantly lower than those in AS and control groups (P＜0.05); the decrease of levels of ox-LDL,PAPP-A and MMP-3 in PAS group was obviously higher than that in AS and control groups (P＜0.05).Twelve months after treatment,significant decrease of plaque area and intima-media thickness (IMT) was noted in the AS and PAS groups (P＜0.05); the IMT and plaque area in PAS group were significantly smaller than those in AS group (P＜0.05); obvious decrease of echogenicity of carotid plaques in PAS group was noted as compared with that in AS group (P＜0.05).Conclusion Combination therapy of PAS might have strong anti-oxidant function and lipid-lowering effect,which could reverse and stabilize the atherosclerosis plaque.

OBJECTIVETo explore congenital heart diseases (CHD) in their offsprings in association with parental methylenetetrahydrofolate reductase (MTHFR) gene C677T, cystathionine beta-synthase (CBS) gene T833C, and environmental factors.

METHODSA 1:1 case-control study was carried out to investigate 115 pairs of case and controlled children and their parents, and the parents' MTHFR gene 677 C-->T mutation and CBS gene 833 T-->C mutation were also identified. The possible risk factors were analysed by simple and multiple factors logistic regression methods.

RESULTSResults revealed that 5 factors were related to the occurrence of CHD in the offsprings: maternal exposures to pesticides in the early stage of pregnancy (OR = 8.62), suffering from diseases during pregnancy (OR = 2.069), catching cold in the early stage of pregnancy (OR = 4.125), under depressed or nervous condition during pregnancy (OR = 4.653), maternal MTHFR 677TT genotype (OR = 3.872).

CONCLUSIONThese results suggested that maternal MTHFR 677TT genotype was one of the risks to the occurrence of CHD in offspring but parents' CBS gene 833 T-->C mutation did not get involved in CHD. In addition, the occurrence of CHD was related to maternal exposures to pesticides, catching a cold, suffering from diseases, depressed or under nervous condition in the early stage of pregnancy or during pregnancy.

Case-Control Studies ; Child, Preschool ; Cystathionine beta-Synthase ; genetics ; Depression ; Environmental Exposure ; Female ; Genetic Predisposition to Disease ; Genotype ; Heart Diseases ; congenital ; Humans ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Odds Ratio ; Pesticides ; toxicity ; Pregnancy ; Pregnancy Complications ; Risk Factors

BACKGROUNDTo summarize the clinical results of bronchoplastic procedures and pulmonary artery reconstruction or combined with other resection and plasty of heart, great vessels in the treatment of 304 patients with locally advanced lung cancer.

METHODSFrom February, 1983 to December, 2001, double sleeve resection and reconstruction of bronchus and pulmonary artery, or combined with other resection of heart, great vessels were carried out in 304 patients with locally advanced lung cancer. The operations included double sleeve left upper lobectomy in 199 cases; double sleeve right upper lobectomy in 21 cases; double sleeve right upper middle lobectomy in 14 cases; double sleeve left upper lobectomy combined with resection of left atrium in 8 cases; double sleeve right upper lobectomy combined with superior vena cava (SVC) resection and reconstruction with Gortex graft in 29 cases; double sleeve right upper middle lobectomy combined with SVC resection and reconstruction in 21 cases; double sleeve right upper middle lobectomy, carinal and SVC resection and reconstruction in 11 cases; left pneumonectomy combined right main pulmonary artery and pulmonary artery trunk resection and reconstruction with Gortex graft in 1 case.

RESULTSThere were 3 operative deaths. The operative mortality was 1% in this series. Sixty four patients had operative complications. The operative complication rate was 21.05% (64/304). The 1-, 3-, 5- and 10 year survival rates were 81.75%, 60.14%, 37.21% and 24.39% respectively.

CONCLUSIONSDouble sleeve lobectomy or comblined with other resection and reconstruction of heart, great vessels can significantly improve the prognosis and increase the curative rate and long term survival in patients with locally advanced lung cancer.

ABSTRACT:In recent years ,there has been high prevalence of murine typhus in Yunnan Province ,People's Republic of China .A large outbreak of murine typhus occurred in Xishuangbanna Prefecture ,Yunnan Province in 2010 .However ,not all cases were confirmed by laboratory assays ;therefore ,field epidemiologic and laboratory investigations of murine typhus in Xishuangbanna Prefecture were conducted in 2011 .Blood samples were collected from clinical diagnostic cases at the acute and convalescence stages of murine typhus in Xishuangbanna Prefecture ,Yunnan Province ,from June to September of 2011 ,and blood and spleen samples were collected from mice sharing the same habitats as the patients .Immunofluorescence assays were used to test for the presence of IgM and IgG antibodies against Rickettsia typhi in sera from patients and mice .Real‐time PCR was used to detect the groEL gene of R .typhi in blood clots from patients at the acute stage and in spleen tissue from mice .A total of 1 157 clinically diagnosed murine typhus cases occurred in Xishuangbanna Prefecture ,Yunnan Province in 2011 ,with an incidence of 102 .10/100 000 .Of these cases ,80 were investigated by laboratory assays and 74 of 80 patients were confirmed to have murine typhus .The coincidence rate between the clinical diagnosis and laboratory detection was 92 .50% .The positivi‐ty rate for IgG antibodies against R .typhi was 14 .0% (14/100) for Rattus f lavipectus ,while the rate by PCR was 9 .0%(9/100) .That laboratory diagnoses confirmed that the severity of the murine typhus outbreak in Xishuangbanna cannot be ig‐nored .The distribution of host animals transmitting R .typhi underscores this conclusion .

OBJECTIVE: To investigate the effects of Pinggan Prescription (, PGP) on hypertension by the associated methods of metabonomic and pharmacodynamic. METHODS: A total of 32 male spontaneously hypertensive rats (SHRs) were randomly divided into two groups by using the random number table method: a treatment group (n=18) and a model group (n=14). The Wistar rats (n=14) were used as the normal group. Different prescription were used to intervene three groups: the treatment group in which PGP extract was administered orally at a dose of 18.336 g/kg (PGP/body weight), and the model group in which physiological saline was administered at the equivalent dose. The same treatment was applied to the normal group as the model group. The blood pressure was measured by tail-cuff method, and pharmacodynamic indexes including cyclic adenosine monophosphate (cAMP) and angiotensin II (Ang II) were tested by enzyme-linked immunosorbent assay. The plasma samples from three groups were detected by gas chromatography-mass spectrometry (GC-MS). RESULTS: Compared with the model group, blood pressure of treatment group was obviously reduced after continuous curing with PGP (P<0.01). The pharmacodynamic results illustrated that the content of Ang II increased with the raised blood pressure and the cAMP expressed the converse trend. After curing with PGP, the content of Ang II decreased, the difference between model group and treatment group was significant (P<0.01), and the cAMP expressed the converse trend. Five potential biomarkers were identified, including arachidonic acid, hexadecanoic acid, elaidic acid, octadecanedioic acid and 9,12-octadecadienoic acid. These metabolites had shown significantly changes as followed: arachidonic acid, hexadecanoic acid and elaidic acid were significantly higher and octadecanedioic acid and 9,12-octadecadienoic acid were lowered in the model group than those in the normal group. After the treatment of PGP, the metabolites had the trends of returning to normal along with the reduced blood pressure. CONCLUSIONS PGP intervention for hypertension played a major role in the metabolism of arachidonic acid and linoleic acid. Metabonomic with pharmacodynamic methods could be potentially powerful tools to investigate the mechanism of Chinese medicine.
Animals ; Biomarkers ; blood ; Discriminant Analysis ; Drugs, Chinese Herbal ; pharmacology ; Gas Chromatography-Mass Spectrometry ; Hypertension ; blood ; drug therapy ; Least-Squares Analysis ; Male ; Metabolic Networks and Pathways ; drug effects ; Metabolomics ; Models, Biological ; Principal Component Analysis ; Rats, Inbred SHR ; Rats, Wistar

OBJECTIVE: To detect the expression of different transcripts of lactamase β（LACTB) gene in leukemic cell lines. METHODS: NCBI website and DNAstar software were used to detect the Bioinformatics analysis of LACTB. The expression of different transcripts of LACTB gene in leukemic cell lines (THP-1, HL60, K562, U937, Jurkat and Raji) was detected by reverse transcription PCR (RT-PCR), DNA and clone sequencing; the expression of different transcripts of LACTB gene in leukemic cell lines was detected by Quantitative Real-time PCR. RESULTS: There were a variety of splicing isomers in LACTB, and it could produce a variety of protein isomers with conserved N-terminal and different C-terminal, moreover, there were many splice isoforms of LACTB in leukemia cell lines, and there were different expression patterns in different cell lines, including XR1, V1, V2 and V3. The expression of total LACTB showed high in HL60 cells, while low in Raji cells, and the difference was statistically significant (P<0.05). The V1 was high expression in U937 cells but low in Raji cells, and the difference was statistically significant (P<0.05). V2 was high expression in HL60 cells but lowly in Raji cells, and the difference was statistically significant (P<0.05). The expression of V3 was low in THP-1 cells, which was significantly different as compared with that in normal bone marrow (P<0.05). CONCLUSION The reaserch found that there are many splice isomers of LACTB in leukemic cell lines, and there are different expression patterns in different cell lines.
Alternative Splicing ; HL-60 Cells ; Humans ; Leukemia/genetics* ; Membrane Proteins/genetics* ; Mitochondrial Proteins/genetics* ; RNA Splicing ; U937 Cells ; beta-Lactamases/genetics*

Objective: To make a preliminary assessment on the immunogenicity of a quadrivalence recombinant human papillomavirus (HPV) vaccine (6, 11, 16 and 18 types) (Hansenulapolymorpha) in healthy women aged 18-45 years in phaseⅠclinical study. Methods: It was a single-center, double-blind, randomized, placebo-controlled phaseⅠ clinical study. Women aged 18-45 years were randomized (2∶1) to receive HPV vaccine (n=60) or placebo control (n=30) at months 0, 2 and 6. Antibodies against HPV6/11/16/18 were detected by pseudovirus-based neutralisation assay in serum samples collected at 0 d, 180 d and 210 d. Seroconversion rates and geometric mean titres (GMT) of antibodies against the four types of antigens were calculated. Results: Seroconversion rates of the vaccination group at 180 d (before the third dose) and 210 d (one month after the third dose) were generally similar and between 85%-100% for all types of antibodies. The GMT of antibodies at one month after the last dose improved significantly compared with those before immunization. Conclusions These results showed that the HPV vaccine had good immunogenicity in the population of healthy women aged 18-45 years. Higher antibody titers were elicited by the vaccine compare with the tites before the first dose and in the placebo control group.