OBJECTIVE:To observe the clinical short-term efficacy and safety of brucea javanica oil injection combined with oxaliplatin and xeloda in the treatment of elderly patients with advanced gastric cancer. METHODS:82 elderly patients with ad-vanced gastric cancer were randomly divided into control group and observation group. Control group was treated with Oxaliplatin injection 130 mg/m2 added into 5% Glucose injection 250 ml for 2 h,iv,d1+Xeloda tablets 1 000 mg/m2,orally,twice a day, d1-14;based on the treatment of control group,observation group was additionally treated with 10% Brucea javanica oil injection 30 ml added into 0.9% Sodium chloride injection 250 ml,iv,once a day,d1-14. 21 days were as a treatment course,and it lasted 3 courses. The short-term efficacy,life quality and toxicity reactions were evaluated in 2 groups. RESULTS:The short-term efficacy in observation group was significantly higher than control group,life quality was significantly better than control group,and the in-cidences of leucopenia and liver damage were significantly lower than control group(P<0.05). CONCLUSIONS:Brucea javanica oil injection combined with oxaliplatin and xeloda has better efficacy than oxaliplatin combined with xeloda in the treatment of elder-ly patients with advanced gastric cancer,with good safety.

BACKGROUND:Traditional Chinese medicine plays a specific role in the clinical diagnosis and treatment of ischemia reperfusion injury. OBJECTIVE:To investigate the effect of Bu Yang Huan Wu Decoction on ischemia reperfusion injury in rats after replantation of of lower limbs, and evaluate the protective effect and mechanism of ischemic tissue. METHODS:A total of 120 Wistar rats were randomly divided into four groups:normal control (intragastric administration of saline after anesthesia), Bu Yang Huan Wu Decoction (intragastric administration of 10 mL/kg Bu Yang Huan Wu Decoction immediately after reperfusion), edaravone (intravenous administration of 10 mL/kg edaravone immediately after reperfusion), and blank control (intragastric administration of saline) groups. At 24 hours after reperfusion, the myeloperoxidase, lactate dehydrogenase, nitricoxide synthase, inducible nitricoxide synthase, constitutive nitricoxide synthase level in the blood were detected. At 1 week after reperfusion, the activity of superoxide dismutase in gastrocnemius tissue, nitrogen monoxidum and malondialdehyde, and the load of Ca2+were assayed. RT-PCR semiquantitative analysis was performed to detect bcl-2 mRNA and bax mRNA transcriptional levels in the gastrocnemius.RESULTS AND CONCLUSION:Bu Yang Huan Wu Decoction protected the rats from ischemia reperfusion injury by reducing the production of oxygen free radicals, reinforcing the activity of superoxide dismutase, lessening the calcium overload, decreasing the production of nitrogen monoxidum, up-regulating the expression of anti-apoptotic gene bcl-2, down-regulating the expression of pro-apoptotic gene bax, and attenuating the injury of skeletal muscle after ischemia reperfusion injury. Bu Yang Huan Wu Decoction has significant protection on cerebral ischemia reperfusion injury in rats after replantation of severed limb, which may be related to the scavenge of free radicals, inhibition of skeletal cells apoptosis, and attenuation of reperfusion injury.

OBJECTIVE: To evaluate the anticoagulation therapy regimen in one patient with dilated cardiomyopathy and severe heart failure. METHODS: Literatures and clinical practice guidelines were consulted, referring to the management of anticoagulation therapy in heart failure with sinus rhythm. RESULTS: Clinical pharmacist participated in the process of drug treatment and decided on optimal anticoagulation therapy. CONCLUSION: Individual bleeding and thrombotic risk should be evaluated to optimize the treatment of individual patients with heart failure.

Objective To study the effect of thyrotrophin releasing hormone (TRH) analogue, YM14673, on the brain edema and blood brain barrier after brain injury in rat.Methods The model of brain injury of rats was built by Feeney's methods. The Evans blue solution had been injected i.v. into the rats before the models were made. The rats were divided into four groups: normal, treated with saline, treated with YM14673(Ⅰ:0.1mg/kg and Ⅱ:1mg/kg). The water content in brain was measured 24 h after brain injured. The concentration of Evans blue in brain tissue and blood was measured with fluorometry.Results The rats treated with saline after traumatic injury showed significantly high water content compared with normal group(P<0.01)and the water content of the left hemisphere, which was hit straightly, was higher significantly than that of the right global(P<0.01). The brain water content decreased in the rats treated with YM14673 in all global(P<0.05).There was no significant different between the treated group Ⅰ and groupⅡ.After brain injury, the concentration of Evans blue in brain tissue showed a higher level contrasted with normal group. YM14673 did not influence the concentration of Evans blue in brain tissue. Conclusion YM14673 can decrease the brain edema after brain injury but it cannot decrease the permeability of blood brain barrier.

Objective:To observe the expression of S100A8 in plasma exosomes, microvesicles (MV), plasma and vitreous in patients with diabetic retinopathy (DR), and verify it in a diabetic rat model, and to preliminarily explore its role in the occurrence and development of DR.Methods:A case-control study. From September 2018 to December 2019, a total of 73 patients with type 2 diabetes, hospitalized patients undergoing vitrectomy, and healthy physical examinations in the Tianjin Medical University Eye Hospital were included in the study. Among them, plasma were collected from 32 patients and vitreous fluid were collected from 41 patients, which were divided into plasma sample research cohort and vitreous sample research cohort. The subjects were divided into simple diabetes group (DM group), non-proliferative DR group (NPDR group) and proliferative DR group (PDR group) without fundus changes; healthy subjects were regarded as normal control group (NC group). In the study cohort of vitreous samples, the control group was the vitreous humor of patients with epimacular membrane or macular hole. Plasma exosomes and microvesicles (MVs) were separated using ultracentrifugation. Transmission electron microscopy, nanometer particle size analyzer and Western blot (WB) were used to characterize exosomes and MVs. The mass concentration of S100A8 was determined by enzymelinked immunosorbent assay. Eighteen healthy male Brown Norway rats were divided into normal control group and diabetic group with 9 rats in each group by random number table method. The rats of diabetes group were induced by streptozotocin to establish diabetic model. Five months after modeling, immunohistochemical staining and WB were used to detect the expression of S100A8 in the retina of rats in the normal control group and the diabetes group. t test was used for the comparison of measurement data between the two groups. Single-factor analysis of variance were used for the comparison of multiple groups of measurement data.parison of measurement data between the two groups. Single-factor analysis of variance were used for the comparison of multiple groups of measurement data. Results:Exosomes and MVs with their own characteristics were successfully separated from plasma. The concentrations of plasma exosomes and vitreous S100A8 in the PDR group were higher than those in the NPDR group, DM group, NC group, and the difference was statistically significant ( P=0.039, 0.020, 0.002, 0.002, P<0.000,<0.000). In the plasma sample cohort study, It was not statistically significant that the overall comparison of the S100A8 mass concentrations of plasma and plasma MV in the four groups of subjects ( F=0.283, 0.015; P=0.836, 0.996). Immunohistochemical staining showed that retinal ganglion cells, bipolar cells, cone rod cells and vascular endothelial cells in the diabetic group all expressed S100A8 protein. Compared with the normal control group, the expression level of S100A8 in the retina of the diabetic group increased, and the difference was statistically significant ( t=8.028, P=0.001). Conclusions:The level of S100A8 protein in circulating exosomes increases significantly with the severity of DR in patients with type 2 diabetes. S100A8 may be an influential factor in the inflammatory environment of DR and a potential anti-inflammatory therapeutic target.

Adolescent ; Female ; Humans ; Leukemia ; etiology ; Leukemia, Promyelocytic, Acute ; complications ; Male ; Young Adult

OBJECTIVEThis study aims to do the following: construct a three-dimensional finite element model of an labial inverted impacted maxillary central incisor and its supporting tissues, analyze stress distribution in the periodontal tissue when various tractions are exerted, and provide references for treating impacted maxillary central incisor.

METHODSA three-dimensional finite element model oflabial inverted impacted maxillary central incisor and its periodontal tissues was established using Mimics 10.01 and Ansys 14.0 software based on original cone beam computed tomography (CBCT) data. Various traction values (20, 30, 40, 50, 60, and 70 g) were exerted on the incisal margin in the direction perpendicular to the impacted tooth. Different Von Mises stress values were determined.

RESULTSStress distribution on the periodontal ligament increased with traction size. When 30 g traction was exerted on the labial inverted impacted maxillary central incisor, the Von Mises stress was 24 919.0 Pa, which was within the range of the optimum force and close to its maximum value.

CONCLUSIONThe optimum traction for early orthodontic treatment of labial inverted impacted maxillary central incisor is nearly 30 g.

Objective To observed the clinical effect of vidarabine and interferonα-2b aerosol inhalation in the treatment of children with infantile herpangina.Methods 58 children with infantile herpangina were divided ran-domly into the observation group and control group,29 cases in each group.All children were given theroutine nursing and general supportive therapy.The patients in the control group were treated by ribavirin and those in the observation group treated by vidarabine and interferon aerosol inhalation.The fever clearance time,the disappearance time of her-pes,the days of hospitalization and cases of adverse reaction was observed and recorded.Results The cooling time, bleb disappear time and hospital stay of the observation group were lower than those of the control group,the difference were statistically significant(P <0.05).Comparation of the clinical effects of the two groups showed that the test group were significantly better than those in the control group(P <0.05).The total effective rate in the observation group was 96.6%,which was higher than 75.9% in the control group(χ2 =5.22,P <0.05).No obvious adverse e-vents took place in both groups.Conclusion Vidarabine and interferon aerosol inhalation in treating infantile herpan-gina takes a good effect,no obviously adverse reaction and is worth being widely applied in clinic.

OBJECTIVE:To observe the changes of heart type fatty binding protein (H-FABP) and brain natriuretic peptide (BNP)when carvedilol and bisoprolol in the treatment of elderly patients with chronic heart failure(CHF). METHODS:110 CHF patients were randomly assigned into carvedilol group and bisoprolol group (n=55). Carvedilol group was given carvedilol 3.125 mg,bid,doubling dose every 2 weeks to reach target dose 25mg or maximum tolerant dose;bisoprolol group was given bisoprolol 1.25 mg,qd,doubling dose every 2 weeks to reach target dose 10 mg or maximum tolerant dose. Treatment course lasted for 6 months. Clinical effective rate of 2 groups were observed after treatment. Echocardiography was used to measure the changes of LVEDD,LVEF,SBP and DBP before and after treatment. The plasma concentration of BNP and H-FABP were measured by radio-immunoassay. RESULTS:After treatment,total effective rate of carvedilol group(96.4%)was higher than that of bisoprolol group (89.2%),with statistical significance(P<0.05). Compared with before treatment,the levels of LVEDD,LVEF,BNP,H-FABP, SBP and DBP in 2 groups were all decreased significantly after treatment,with statistical significance (P<0.01 or P<0.05). CON-CLUSIONS:Both carvedilol and bisoprolol can significantly improve cardiac function,but carvedilol efficacy is more significant. At the same time,significant decrease of H-FABP before and after treatment indicate that H-FABP can be used as a reliable index of heart failure treatment effect.

Objective To study the value and clinical significance of diffusion tensor imaging(DTI)in differentiating high-grade astrocytomas and solitary metastatic tumors of brain.Methods 16 patients with intracranial solitary metastasis and 25 patients with high-grade astrocytoma confirmed pathologically were examined with MR DTI.Mean diffusivity(MD)and fractional anisotropy(FA)were measured in the regions of interest(ROI)of peritumor and cerebral parenchyma of the normal side on DTL Fiber tractography was reconstructed and the encountered patterns of tumor-related alteration to cerebral white matter were observed.Results The peritumor were all depicted as hyperintense or isointense signals on DTI.The FA values were 0.227±0.05 and 0.169±0.07 in the peritumor of high-grade astrocytoma and metastasis respectively,which was of significant difference(P＜0.05).Furthermore,fiber tractography could display the course of white matter tracts in three-dimensional space.Conclusion DTI may be help to differential diagnosis of solitary metastasis and high-grade astrocytoma in clinical practice.