Anastomosis, Surgical ; Anastomotic Leak/surgery* ; Drainage ; Gastrectomy ; Humans ; Suction

OBJECTIVETo investigate CT findings and incidence rate of gastric bare area involvement (GBAI), left adrenal gland involvement (LAGI) and perirenal space involvement (PSI) in acute pancreatitis, and to also explore the value of these appearances in predicting complications and mortality of patients.

METHODSCT imaging data of 575 patients with AP diagnosed by clinic from October 2009 to April 2011 were analyzed retrospectively. There were 339 male and 236 female patients, aging from 16 to 93 years with a mean of (51 ± 16) years. Involvement with or without gastric bare area, left adrenal gland, perirenal space were focused, and the relationship were analyzed between these CT findings and complications and mortality of patients.

RESULTSAmong 167 patients (29.0%) with GBAI, 132 had complications and 16 died. The sensitivity and specificity of GBAI for predicting complications were 45.4% and 87.7%, respectively, and 84.2%and 72.8% for predicting mortality. In all 107 patients (18.6%) with LAGI, 81 had complications and 18 died. The sensitivity and specificity of LAGI for predicting complications were 27.8% and 90.8%, respectively, and 94.7% and 84.0% for predicting mortality. Among 335 patients (58.3%) with PSI, 201 had complications and 19 died. The sensitivity and specificity of PSI for predicting complications were 69.1% and 52.8%, respectively, and 100% and 43.2% for predicting mortality. Of all patients, 210 (36.5%) owned two or more positive CT findings among GBAI, LAGI, and PSI. One hundred ninety-eight of these patients had complications and 19 died, that predicted the sensitivity and specificity for complications were 68.0% and 95.8%, respectively, and 100% and 65.6% for mortality. The risk of complications in the patients with GBAI or LAGI was increased than normal gastric bare area or left adrenal gland 5.9 or 3.8 times respectively, and the risk of death was improved 14.3 or 94.5 times respectively. The risk of complications in those patients with two or more positive findings increased by 48.3 times. By analyzing receiver operating characteristic (ROC) curve, the combination of GBAI, LAGI, and PSI was the best way to predict the complications of AP. The area under the ROC was 0.819.

CONCLUSIONSThe CT imaging could effectively indicate the signs of GBAI, LAGI and PSI of AP. The GBAI. LAGI and PSI were related with the severity and prognosis of AP, and these findings could be clinical indicators for evaluating prognosis of AP.

Acute Disease ; Adolescent ; Adrenal Glands ; diagnostic imaging ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney ; diagnostic imaging ; Male ; Middle Aged ; Pancreatitis ; complications ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Stomach ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: To compare the flow-mediated dilatation (FMD) among the newly diagnosed impaired glucose tolerance (IGT), type 2 diabetes mellitus (T2DM), and the normal controls (NC) and to analyze relevant factors under different glucose levels. METHODS: The study included IGT (n=34), DM1 (n=52), DM2 (n=33) and NC (n=25). Levels of fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (PPG), fasting insulin (FINS), 2-hour postprandial insulin (PINS), triglyceride (TG), total cholesterol (TC), and hemoglobin A1C (HbA1C) were determined in all participants. High resolution ultrasound examining FMD was performed to measure vascular endothelial function subsequently. RESULTS: There was statistically significant difference between IGT, DM, HG and NC group in FMD (P=0.008). Partial correlation analysis found that a significant negative correlation existed between FMD and homeostasis model assessment-index (HOMA-IRI), difference of plasma glucose (DPG), FPG and PPG (P<0.01), and a negative correlation between FMD and HbA1C (P<0.05). Setting FMD as dependent variable to conduct multiple linear stepwise regression, in IGT group it was the waist/hip ratio (WHR) and HOMA-IRI that entered the regression equation; in DM1 group it was HOMA-IRI, PPG and DPG that entered the regression equation; in DM2 group it was FPG and HOMA-beta that entered the regression equation. CONCLUSION There exists a flow-mediated vasodilatation dysfunction in patients of newly diagnosed IGT and T2DM. Effect of relevant factors on FMD differs with different glucose levels.
Adult ; Blood Glucose ; metabolism ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; physiopathology ; Endothelium, Vascular ; physiopathology ; Female ; Glucose Intolerance ; blood ; physiopathology ; Humans ; Male ; Middle Aged

To evaluate JAK2V617F point mutation in patients with polycythemia vera (PV) and its clinical significance, the point mutation was detected by allele specific polymerase chain reaction (AS-PCR), and the clinical and laboratory features of 50 PV patients with JAK2V617F positive and negative mutations were analyzed and compared each other. The results showed that among 50 patients, 31 patients (62.0%) had JAK2V617F point mutation; 12 patients (24.0%) showed thrombosis and microvascular disturbances; 3 patients had chromosome karyotype abnormalities. As compared with negative mutation group, the age and leukocyte count in patients with JAK2V617F point mutation were older (57.5 +/- 10.0 vs 45.6 +/- 14.9, p < 0.05) and higher (16.2 +/- 6.7 vs 9.0 +/- 5.2, p < 0.05) respectively. It is concluded that the frequency of the JAK2V617F point mutation is 62.0% in PV patients, the age and leukocyte count of patients with JAK2V617F point mutation are older and higher respectively than those in negative mutation group.
Adult ; Aged ; Female ; Humans ; Janus Kinase 2 ; genetics ; Leukocyte Count ; Male ; Middle Aged ; Point Mutation ; Polycythemia Vera ; genetics ; Young Adult

OBJECTIVEThe expanded programme on immunization (EPI) is an important part of the social commonwealth projects providing health care service by the government, which benefits communities. Government has the responsibility for EPI's financing which should be covered by the national budget. It is essential that the cost of EPI service be scientifically estimated to provide propriety information for policy makers.

METHODSThis study, using the cost accounting theory of health economics, to calculate EPI service cost at different levels. 3 provinces, 3 prefectures, 9 counties, 18 towns and 12 villages were selected from three provinces Guizhou, Heilongjiang and Zhejiang from the western, central and eastern regions of the country.

RESULTSThe average costs for one EPI-targeted child in Guizhou, Heilongjiang and Zhejiang, were 15.68 Yuan, 29.00 Yuan and 31.09 Yuan, and the costs for one dose were 10.99 Yuan, 18.64 Yuan and 16.51 Yuan, respectively. The costs for complete immunization program for one child were 131.88 Yuan, 242.32 Yuan and 280.67 Yuan, respectively. The main factors affecting the cost would include the average personnel cost (salary and benefit cost) by different economic levels of areas, the number of EPI items developed, and the number of total doses for one child.

CONCLUSION(1) Obvious differences were found between different areas. (2) The proportion of the cost was not reasonably set because of the shortage of input. (3) Guideline for different areas to compensate the working item cost according to the number of the items should be formulated.

China ; epidemiology ; Cost-Benefit Analysis ; Health Expenditures ; statistics & numerical data ; Humans ; Immunization Programs ; economics ; organization & administration ; Population Surveillance ; methods ; Program Evaluation ; Socioeconomic Factors ; Vaccination ; statistics & numerical data

BACKGROUNDCilostazol is a newly developed antiplatelet drug that has been widely applied for clinical use. Its antiplatelet action appears to be mainly related to inhibition of intracellular phosphodiesterase activity. Recently, cilostazol has been used for antiplatelet therapy after coronary bare metal stent implantation for thrombosis and restenosis prevention. This prospective randomized and double blind trial was designed to investigate the safety and efficacy of cilostazol for the prevention of late restenosis and acute or subacute stent thrombosis.

METHODSOne hundred and twenty patients who underwent elective stent were randomly assigned to treatment group with cilostazol 200 mg/d (n = 60), clopidogrel 75 mg/d and aspirin 100 mg/d or to control group with clopidogrel treatment 75 mg/d (n = 60) and aspirin 100 mg/d. Follow-up coronary angiography was performed 6 - 9 months later.

RESULTSNine months major adverse cardio-cerebral event (MACCE) were lower in treatment groups (P < 0.05). The quantitative coronary angiography (QCA) at 6 months follow-up showed that minimum lumen diameter (MLD) was higher in treatment group than that of control group [(2.14 +/- 0.52) mm vs (1.82 +/- 0.36) mm, P < 0.05]. Late lumen loss (LL) [(0.82 +/- 0.42) mm vs (1.31 +/- 0.58) mm; P < 0.01], restenosis rate (RR) (14% vs 32%; P < 0.05) and target lesion revascularizaion (TLR) rate (5% vs 17%; P < 0.05) were lower in treatment group than in control group.

CONCLUSIONCilostazol therapy is an effective regimen for prevention not only stent thrombosis but also RR and TLR through reducing MLD without the risk of increasing bleeding.

Adult ; Aged ; Coronary Angiography ; Coronary Disease ; blood ; therapy ; Double-Blind Method ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; therapeutic use ; Prospective Studies ; Stents ; Tetrazoles ; therapeutic use ; Ticlopidine ; analogs & derivatives ; therapeutic use

OBJECTIVETo construct replication selective adenovirus AdhepE1 targeting human melanoma and observe its specific killing of human melanoma cells in vitro.

METHODSAdenovirus E1 region, the murine tyrosinase promoter and enhancer DNA sequences were acquired respectively by PCR cloning. The shuttle plasmid of replication-selective adenovirus targeting human melanoma was constructed by DNA recombination. Replication-selective adenovirus AdhepE1 was generated by homologous recombination. The human melanoma cell line SK-Mel-1 and hepatocellular carcinoma cell line HepG2 were attacked separately by lower dose of AdhepE1. Change of cell morphology was observed and the surviving cells were calculated. The expression of E1A was assayed by RT-PCR to verify the specific-replication of AdhepE1.

RESULTSReplication selective adenovirus AdhepE1 targeting human melanoma was acquired by PCR. Human melanoma cell line SK-Mel-1 was sensitive to oncolytic killing of AdhepE1 whereas HepG2 was little responsive. The results of RT-PCR suggested that AdhepE1 replicated specifically in human melanoma cells.

CONCLUSIONAdhepE1 can selectively kill human melanoma cells.

Adenoviridae ; genetics ; Animals ; Cell Line, Tumor ; Genetic Therapy ; Humans ; Liver Neoplasms ; therapy ; Melanoma ; therapy ; virology ; Mice ; Reverse Transcriptase Polymerase Chain Reaction ; Virus Replication

Background Cilostazol is a newly developed antiplatelet drug that has been widely applied for clinical use. Its antiplatelet action appears to be mainly related to inhibition of intracellular phosphodiesterase activity. Recently,cilostazol has been used for antiplatelet therapy after coronary bare metal stent implantation for thrombosis and restenosis prevention. This prospective randomized and double blind trial was designed to investigate the safety and efficacy of cilostazol for the prevention of late restenosis and acute or subacute stent thrombosis.Methods One hundred and twenty patients who underwent elective stent were randomly assigned to treatment group with cilostazol 200 mg/d (n = 60), clopidogrel 75 mg/d and aspirin 100 mg/d or to control group with clopidogrel treatment 75 mg/d (n = 60) and aspirin 100 mg/d. Follow-up coronary angiography was performed 6-9 months later.Results Nine months major adverse cardio-cerebral event (MACCE) were lower in treatment groups (P＜0.05).The quantitative coronary angiography (QCA) at 6 months follow-up showed that minimum lumen diameter(MLD) was higher in treatment group than that of control group [(2.14±0.52)mm vs (1.82 ±0.36)mm, P＜0.05].Late lumen loss (LL) [(0.82 ± 0.42)mm vs (1.31 ± 0.58)mm; P＜0.01 ], restenosis rate (RR) (14% vs 32%; P＜0.05)and target lesion revascularizaion (TLR) rate (5% vs 17%; P＜0.05) were lower in treatment group than in control group.Conclusion Cilostazol therapy is an effective regimen for prevention not only stent thrombosis but also RR and TLR through reducing MLD without the risk of increasing bleeding.

Objective To study the bioequivalence of two glipizide tablets in healthy Chinese subjects.Methods Randomized,open,single-administration,two-period,self-cross-over trial design was used in the study.There were 28 Chinese healthy subjects in the fasted state and 28 in the fed state,complete repeat cross single dose oral glipizide tablets test preparation or reference preparation 5 mg.The plasma concentration of glipizide was determined by liquid chromatography/tandem mass spectrometry at different time points after administration.The non-compartmental model was used to calculate the pharmacokinetic parameters and evaluate the bioequivalence of the two formulations.Results The main pharmacokinetic parameters of glipizide in the fasted state were as follows:Cmax were(551.60±91.26)and(518.10±105.10)ng·mL-1;AUC0-t were(3 074.33±861.91)and(3 026.77±934.25)h·ng·mL-1;AUC0-∞ were(3 204.85±990.78)and(3 166.35±1 107.36)h ng·mL-1.The parameters of glipizide in the fed state were as follows:Cmax were(517.30±98.97)and(472.80±114.48)ng·mL-1;AUC0-t were(3 001.12±830.87)and(2 932.79±736.35)h·ng·mL-1;AUC0-∞ were(3 067.00±918.84)and(2 997.44±819.14)h·ng·mL-1.The 90％confidence interval of the Cmax,AUC0-t and AUC0-∞ of the test formulation and the reference formulation were from 80.00％to 125.00％.The incidence of adverse events in fasted group and fed group was no serious adverse events.Conclusion The two glipizide tablets were bioequivalent under fasted and fed conditions,and good security.