Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; physiopathology ; psychology ; Quality of Life ; psychology ; Survivors ; psychology

Objective To study the effects of pirfenidone on total enzyme and isoenzyme of liver microsomal cytochrome P450 in rats. Methods The activites of liver microsomal dimethyl nitrosamine N-demethylase( NDMA )and erythromycin demethylase( ERD ) were determined. Fifty-six SD rats were randomly divided into six groups,in which they received CMC,dexamethasone 100 mg·kg-1 ,ketoconazole 40 mg·kg-1 ,pirfenidone 25,50,100 mg·kg-1 ,respectively. After administration for 6 and 12 days,livers were prepared liver microsome,the concentration of proteinum in microsome and shade selection to plasma samples were determined by spectrophotometer. Results After administration of pirfenidone for 6 days, cytochrome P450 was significantly increased in 50 and 100 mg·kg-1 pirfenidone groups,as compared with solvent control group (1%sodium carboxymethylcellulose)(P﹤0. 01). After administration of pirfenidone for 6 and 12 days,NDMA of liver microsome was not changed significantly(P﹥0. 05). ERD of liver microsome was significantly increased in 100 mg·kg-1 pirfenidone group after administration for 12 days(P﹤0. 01). Conclusion Pirfenidone can induce P450 and ERD activities in a dose-and time-dependent manner.

Objective We reported 16 eosinophilic fasciitis (EF) patients with eosinophilic fasciitis and performed a systematic review of the literature to improve the disease awareness.Methods The clinical course of 16 patients with eosinophilic fasciitis at the Peking Union Medical College Hospital were described,inclu-ding demographic data,clinical manifest-ations,laboratory tests,pathology and treatment.Results The mean age at diagnosis was (47±8) years,with 13 female and 3 male patients.Three cases had exertion or strenuous sports before the onset of EF.Positive ANA was noted in 6 of 12,positive RF was noted in 3 of 10,hyper-gammaglobulinemia was noted in 6 of 7,elevated IgG was noted in 8 of 13,peripheral blood eosinophilia was noted in 10 of 16,while thrombocytopenia was found in one patient.Conclusion Based on this and other reported cases in the literature,EF may be a kind of autoimmune disease.Genetic influence and environ-mental factors are involved in the development of this disease.Systemic involvement is rare.In general,corticosteroids and immunosuppressive are effective in EF.

A series of andrographolide derivatives with the structure of 12-N-substituted-14-deoxyandrographolide were synthesized from the parent compound andrographolide.Their antitumor activities were preliminarily evaluated on various cancer cell lines and compound 4d stood out due to its potent growth inhibitory effect in comparison with andrographolide.Compound 4d also demonstrated significant antitumor effect on human hepatoma HepG2cells in vitro and on sarcoma 180 (S180) and hepatoma 22(H22)-bearing mice in vivo.Then,the apoptosis induced by compound 4d in HepG2cells was detected by Annexin V/PI double staining assay.Further mechanic study showed that the expression of p53 and Bax was significantly elevated and that of Bcl-2was downregulated in 4d-treated HepG2cells.Collectively,these data suggested that compound 4d had remarkable antitumor effect both in vitro and in vivo and could effectively induce apoptosis via a p53-dependent pathway in HepG2 cells,thus deserving further investigation.

Tramadol and its metabolites in rat urine were identified by LC-MS(n). Rat urine samples of 0-36 h were collected after ip 9.0 mg x kg(-1) tramadol, then the samples were enriched and purified through solid-phase extraction cartridge. Purified samples were analyzed by LC-MS(n). Possible metabolites were discovered by comparing the full scan and SIM chromatograms of the test samples with the corresponding blanks and analyzing the retention time, quasi-molecular ion and fragment ion of all chromatograms. Nine phase I metabolites and four phase II metabolites were identified in rat urine. One of the metabolites was found first time in living body. The metabolites were formed via the following metabolic pathways: O-demethylation, N-demethylation, hydroxylation, N-oxidation and conjugation. The method can be used to identify tramadol and its metabolites in other animals and human.

Choriocarcinoma ; diagnosis ; Female ; Humans ; Liver ; pathology ; Pregnancy

Objective To analyze the clinical data of diagnosis and treatment of Wegener' s granulomatosis (WG) in order to understand the nature of this disease. Methods The clinical data including clinical manifestations,laboratory findings imaging features,pathological changes and efficacy of treatment of 34 patients with WG admitted from January 2002 to March 2012 were analyzed.Results Of the 34 patients,male to female ratio was 18 to 16,and the average age subjected to WG onset was (45 ± 15)years old ranged from 18 to 81 years old.The average duration before the diagnosis confirmed was ( 140 ±72) mouths,while 29.4％ was diagnosed within 3 months. The presenting symptoms included initial involvements in lung (41.1％),nose (38.2％ ),eyes ( 11.7％ ),ear (8.8％ ) and constitutional symptoms such as fever (26.4％ ). Throughout the whole disease course,the incidence of systemic impairments were as follows:lung (76.4％),nose (73.5％),kidney (67.6),eyes (58.5％),ear (47.0％),nervous system (41.1％),oral ulcer (20.5％ ).Of laboratory findings,C - ANCA/PR3 -ANCA was positive in 61.7％ patients,P - ANCA/MPO - ANCA positive in 20.5％ patients,ANCA negative in 11.7％ patients,P- ANCA positive with MPO- ANCA negative in one patient (2.9 ％ ) and C -ANCA positive with PR3 and MPO positive in one patient (2.9％ ).Of imaging findings,nodules or masses were most commonly observed (34％), followed by fibrotic lesions (20.5％ ), cavitations ( 17.6％ )、opacities ( 17.6％ ).Typically pathological triad ( vasculitis,necross and granuloma formation)was found in one patient ( 4.3％ ),while two pathological changes of the triad occurred in 10 patients (43.4％). Pulmonary infection was highly prevalent (50％), and of them,20.5％ patients were misdiagnosed as tuberculosis,malignancy or abscess.After admission,high dose of corticosteroids and cyclophosphamide were administered as bolus and maintenance therapy. Plasma exchange,intravenous immunoglobulin,and rituximab were added for refractory cases and optimal response were obtained in most cases.Conclusions Wegeners granulomatosis is a clinically complicated entity and sometimes can have progression,leading to misdiagnosis. Early and prompt use of steroids and cyclophosphamide may confer good therapeutic efficacy and avoid life -threatening complications.

Objective To evaluate the effects of the improved monitoring system for pressure ulcers? Method The monitoring system for pressure ulcers was improved and the measures were as follows:completing the organizational system for managing ulcers, fulfilling the regulations,revising the report form and enforcing classified nursing training? Result The accuracy rate of risk assessment and the methods for using wet dressings and negative pressure drainage were significantly improved and the effects by using decompression and skin-prevention pads were significantly better than those before improving the monitoring system(P < 0?05)?Conclusion The improved monitoring system for pressure ulcers may help to improve the clinical practice of pressure ulcers?

Objective To investigate the advantage of detaining peripherally inserted central catheter through the veins of lower extremity in neonatal intensive care unit.Methods 165 cases of infants were randomized into veins of lower extremity group (first saphenous veins,then popliteal vein) and veins of upper extremity group (first basilic vein,then median cubital vein,cephalic veins) from January to December 2012.We observed the success rate of detaining,catheter tip location,and complications such as phlebitis in the two groups.Results The success rate of detaining of lower extremity group was higher than that of upper extremity group,and ectopic rate of lower extremity group was lower than that of upper extremity group.There was no significant difference in complications such as phlebitis between two groups.Conclusions Peripherally inserted central catheter through the veins of lower extremity has more advantage over through the veins of upper extremity group.

Objective To evaluate the imaging features of benign fibrous histiocytoma (BFH).Methods Imaging data were retrospectively collected and reviewed in 11 patients with pathologically proved BFH.Of the 11 patients,X-ray was performed in all patients,MR scans in 6 patients,and CT scans in 4 patients.Results ALL lesions detected were a solitary lesion.The distribution of BFH was in the tibia (n =5 ),femur ( n =3),fibula ( n =1 ),sacrum ( n =1 ),and thoracic vertebrae ( n =1 ).X-ray features included eccentric osteolytic lesions in 7 patients and centric in 2 patients,with clear boundary and thinning of the cortex,and 7 patients with varying degrees of ossified border were found. CT scan shows bone destruction with density similar to soft tissue.The majority of lesions ( n =3 ) were observed in the expanding shell of bone,2 patients in the tibia and 1 patient in the thoracic lesions with cortical bone perforation.The thoracic lesion as soft tissue mass was detected. All of the lesions detected in CT showed no periosteal reaction.In patients with MR images,hypo to isointense signal intensity on T1WI and hyperintense signal intensity on T2WI was found. All lesions on post-contrast T1WI were detected with homogeneous or heterogeneous lesion with moderate or significant enhancement.Conclusion Imaging features were typical for MFH which is useful tool helping correct diagnosis of MFH.