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.

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.

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.

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

The development of TCM acupuncture represents a internationalized and modern trend. A recent study with the title of "Acupuncture for chronic knee pain: a randomized clinical trial" published in Journal of the American Medical Association on October 1st, 2014, which raised doubts on acupuncture efficacy as well as traditional manipulation and acupoint theory, makes some negative impact and challenges on the development of acupuncture. From the view of future development of acupuncture, the potential influence of this research on acupuncture development is proposed, and by combining acupuncture theory, some discussions and doubts on the research design and outcome explanations are made. Additionally, enlightenments of this research on further clinical research are summarized.
Acupuncture Therapy ; Chronic Pain ; therapy ; Female ; Humans ; Low-Level Light Therapy ; Male

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 investigate the pharmacological effect and mechanism of mouse intermedin (IMD)for antagonizing cardiac hypertrophy by using isoproterenol (ISO)induced mouse cardiomegaly model.Methods The mouse cardiomegaly model was constructed by small dose of ISO subcutaneous injection.The mouse blood dynamic indexes and heart weight/body weight rati-o were investigated.Then the cardiomyocyte cross-sectional area,apoptosis and cardiac tissue fibrosis were evaluated by using the cardiac tissue section.ANP,BNP,mRNA expression levels of endogenous IMD and its receptors system in cardiac tissues were de-tected by using real time fluorescence PCR method.Results Compared with the ISO induced mouse cardomegaly model group,the intraperitoneal injection of IMD significantly decreased the heart weight/body weight ratio and cardiomyocyte cross-sectional area increased by ISO treatment,cardiomegaly marker ANP and BNP mRNA level,cardiomyocyte apoptosis and cardiomyocyte fibrosis, improved the cardiac function,left ventricular pressure,maximal and minimal rate of LV pressure increase and decrease during the isovolumetric contraction phase,stroke volume,cardiac output and ejection fraction,but significantly decreased the left ventricle end-diastolic pressure.In addition,the ISO treatment significantly induced the expressions of endogenous IMD and its receptors in heart tissues.Conclusion ISO induces the expressions of endogenous IMD and its receptors in cardiac tissues,and exogenous IMD sup-plementation therapy realizes the pharmacological protective effect for antagonizing cardiomegaly by ISO activated IMD receptor system.

OBJECTIVE:To observe therapeutic efficacy and safety of different gemcitabine dosage regimens combined with oxaliplatin in the treatment of recurrent metastatic cholangiocarcinoma.METHODS:A total of 100 patients with recurrent metastatic cholangiocarcinoma were randomly divided into group A(50 cases) and B(50 cases).Group A was given Gemcitabine hydrochloride for injection 1 000 mg/m2,d1.8,for fixed drip time 30 min+Oxaliplatin for injection 130 mg/m2,d1,intravenously.Group B was given gemcitabine 1 000 mg/m2,d1.8,with fixed infusion speed of 10 mg/(m2.min)+ Oxaliplatin for injection (same usage and dosage as group A).A treatment course lasted for 3 weeks,and both groups received 2 courses.Clinical efficacies and toxic reaction of 2 groups were observed,and total survival time,progression-free survival time of 2 groups were followed up for 3 years.RESULTS:Both groups completed at least 2 courses of treatment.The objective remission rate and disease control rate of group B were significantly higher than those of group A;total survival time and progression-free survival time of group B were significantly longer than those of group A.The incidence of Ⅲ-Ⅳ degree thrombocytopenia and leucopenia in group B were significantly higher than group A,with statistical significance(P＜0.05).CONCLUSIONS:Gemcitabine dosage regimen of fixed infusion speed combined with Oxaliplation is better than Gemcitabine dosage regimen of fixed drip time for recurrent metastatic cholangiocarcinoma patients in controlling the disease progression,prolonging the survival time and improving the long-term prognosis,but may increase the risk of blood related ADR.