Objective To summarise the experience of surgical treatment of invasive pulmonary fungal infection in patients with hematologic malignancies.Methods From Jan.2000 to Dec.2012,78 hematologic patients with invasive pulmonary fungal infections,including 49 males and 29 females with average age of 29.6 years,underwent surgical treatment.Preoperatively,all patients with 1 to 3 courses of chemotherapy had received average 4 weeks antifungal treatment.There were 58 cases received conventional open thoracic surgery and 20 cases received VATS including lobectomy,segmentectomy,wedgectomy.Results The procedures were successful,the average operation time w as(125.3 ± 35.7) min and intraoperative blood loss was(253.1 ± 42.8) nl.There were no severe postoperative complications.The main complications were excessive effusion (10.2％) and persistence airleak (7.7％).The hospital days was(7.8 ± 2.5) days,no reoperation and death case in 30 days after operation.The follow-up was from 6 to 24 months,38 cases(48.7％) received prophylaetic antifungal treatment,no ease with fungi spread and recurrence.Conclusion The surgical treatment is safe and useful for the hematologic patients with invasive pulmonary fungal infections,when internal medicine conservative treatment is invalid.

Proliferation and migration of vascular smooth muscle cells (VSMC) are common pathological features of diabetic vascular complications,such as atherosclerosis and hypertension. Phenotypic modulation of VSMC is the basis for VSMC proliferation and migration. Therefore, studies on VSMC phenotypic modulation and its mechanisms in diabetes mellitus were of important significance to the prevention and therapy of diabetic vascular complications. This paper introduces VSMC phenotypic modulation and the underlying mechanisms in diabetes mellitus, and summarizes advance of studies on traditional Chinese medicine intervention upon VSMC phenotypic modulation, so as to provide reference for preventing and treating diabetic vascular complications with traditional Chinese medicines.
Atherosclerosis ; drug therapy ; prevention & control ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Diabetes Mellitus ; drug therapy ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; drug therapy ; prevention & control ; Medicine, Chinese Traditional ; Muscle, Smooth, Vascular ; drug effects ; Myocytes, Smooth Muscle ; drug effects ; Phenotype

Objective To explore the significance of mediastinum drainage tube in prevention and treatment of intrathoracic anastomotic leak after esophagectomy. Methods The morbidity and prognosis of intrathoracic anas-tomotic leak after esophagectomy in 180 patients with esophageal or cardia carcinoma (group A) who used mediasti-num drainage tube in operation from 2006 to 2008 was studied retrospectively,and were compare with 154 patients (group B) without mediastinum drainage tube from 2004 to 2006. Results The morbidity of intrathoracic anasto-motic leak after esophagectomy was 1.67% (3/180) in group A,and 4.55% (7/154) in group B,but no difference between them(χ2=1.4807, P>0.05) were found. Compared to group B, the final diagnosis of anastomotic leak in group A was early [(6.7±0.6) vs (10.0±2.1) days after operation (t=2.62, P<0.05)] and the duration of fe-ver was short [(5.3±1.5)vs (43.0±20.9) hours (t=4.39, P<0.01)]. The prognosis of 3 cases in group A was well, who all recovered without operation and had shorten hospital days than group B [(23.7±5.9)d vs (45.3± 5.0)d,t=4.86,P<0.01)]. In 7 cases of group B,there were 5 cases underwent second operation,but only 3 cases recovered, the case fatality rate was 2.60% (4/154), higher than in group A (0, Fisher, P<0.05). Conclusions Although the mediastinum drainage tube used or not used in esophagectomy is unrelated with the occurrence of anas-tomotic leak, and the significance to use it is that it can help to discover anastomotic leak early, and control mediasti-num infection effectively without reoperation,and improve patients' prognosis.

Based on three aspects of academic research, academic morality and academic publication, this pa-per discussed the ethical quality that medical journal editors should possess. Medical knowledge and knowledge of medical ethics are the basic ethical qualities that a good medical editor should possess. Editor should strictly control the manuscript process, abide by the professional ethics, and contribute to the fast and correct spread of medical information.

micmRNA (miRNA) plays an important role in biological processes via regulating gene expression in the level of posttranscription.Increasing number of studies reveal that miR-375 is downregulated in digestive system tumors, and is related to tumorigenesis.Overexpression of miR-375 can inhibit growth and metastasis of tumors through repressing the expression of target genes.

Objective The objective of this study was to investigate the levels of serum miR-21 and miR-34a in patients with advanced gastric cancer before and after Folfox chemotherapy and its relationship with chemotherapy efficacy.Methods Forty-five patients with advanced gastric cancer who underwent Folfox chemotherapy were enrolled from May 2015 to October 2015.The levels of miR-21 and miR-34a were analyzed by Real-time PCR before and after chemotherapy.The relationship between miR-21 and miR-34a levels and chemotherapy efficacy was analyzed.The predictive values of miR-21 and miR-34a on the efficacy of chemotherapy were evaluated by the receiver operating curve(ROC).Results After chemotherapy,6 cases(13.33%)were relieved,10 cases(22.22%)were stable disease(SD),29 cases(64.44%)were disease progress(PD),the objective response rate(ORR)was 13.33%,the disease control rate(DCR)was 35.56%,the median survival time was 8.1 months.The level of miR-21 was down-regulated and up-regulation for miR-34a after chemotherapy.They were statistically significant(P<0.05).The level of miR-21 in the chemotherapy group was lower than that in the ineffective group,and the level of miR-34a was higher than that of the ineffective group(P<0.05).MiR-21 was negatively correlated with the efficacy of chemotherapy(rs=-0.431,P<0.05),while miR-34a was positively correlated with it(rs=0.504,P<0.05).The median survival time was 7.6 months for low-level patients with miR-21 and 6.0 months for high-level patients.The median survival time of miR-34a patients was 5.5 months,compared with 8.3 months for high-level patients,with a statistically significant difference(P<0.05).The Log-Rank test showed that the median survival of patients with low miR-21 was higher than that of patients with high miR-21(P<0.05).The median survival of patients with high miR-34a was higher than that of patients with low miR-34a(P<0.05).The miR-21 combined with miR-34a in predicting chemotherapy efficacy under the curve(AUC)was 0.865,the sensitivity was 80.9% and the specificity was 89.8%.Conclusion miR-21 and miR-34a are correlated with chemotherapy efficacy median survival time of patients with advanced gastric cancer.

Objective To evaluate the clinical and pathological characteristics and treatment of malignant phyllodes tumor of the prostate. Methods A 60 year old male patient with malignant phyllodes tumor of the prostate was reported.The complaints consisted of dysuria,intermittent gross hematuria for 1 year,and recurrent symptoms after TURP for 2 months.The enlarged prostate was 5 cm?6 cm and palpated softly and smoothly by DRE,and heterogeneous by CT.His serum PSA level was 1.25 ng/ml.Sarcoma of the prostate was suspected and radical prostatectomy was performed on him. Results The pathology showed a special type of epithelial stromal tumor like cystosarcoma phyllodes of the mammary gland. Microscopically, the tumor was composed of cystically dilated ducts with leaf like stroma projections in the lumen.The stroma cell proliferated obviously with atypia and high mitotic rate,and the epithelial cell also proliferated but with no atypia and no mitosis.The seminal vesicle and bladder neck had tumor infiltration and the diagnosis of malignant phyllodes tumor of the prostate was confirmed.The tumor margin was negative.With immunohistochemical staining,the stromal cells were positive for vimentin,but negative for actin,with the epithelial cells positive for CK,PSA and AE1/AE3,and the basal cells positive for CK34BE12.The patient had tumor recurrence after 6 months,but refused to further treatment and was followed up till now. Conclusions Malignant phyllodes tumor of the prostate is rare but can be diagnosed properly based on clinical and pathological features.Radical prostatectomy is considered to be the most reliable treatment.

Objective To investigate the value of radiofrequency device in liver resection for the treatment of primary liver cancer.Methods The clinical data of 82 patients with primary liver cancer who received liver resection at the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to February 2012 were retrospectively analyzed.All patients were divided into radiofrequency liver resection group (41 patients) and routine liver resection group (41 patients).The clinical characteristics including Child classification,operation time,intraoperative blood loss,and postoperative complications of the 2 groups were compared.All data were analyzed using the t test or chi-square test.Results The mean operation time of the radiofrequency liver resection group was (77 ± 28 ) minutes,which was significantly shorter than ( 129 ± 34) minutes ( t =7.432,P ＜ 0.05 ).The number of patients who received inflow occlusion in the radiofrequency liver resection group was 4,which was significantly smaller than 23 in the routine liver resection group ( x2 =19.934,P ＜ 0.05 ).The volumes of operative blood loss and rate of patients who received blood transfusion were (241 ± 214)ml and 15％ (6/41) in the radiofrequency liver resection group,(751 ± 421 )ml and 49％ (20/41) in the routine liver resection group (t =6.920,x2 =11.038,P ＜ 0.05 ).There were no significant difference in the rate of postoperative blood loss and biliary leakage between the 2 groups ( x2 =0.213,1.822,P ＞ 0.05).The mean postoperative hospital stay of the radiofrequency liver resection group was ( 9 ± 4) days,which was significantly shorter than ( 12 ± 7 ) days of the routine liver resection group ( t =2.368,P ＜ 0.05 ).No patients died intraoperatively.Conclusion The radiofrequency device could effectively control blood loss,shortens operation time and postoperatively hosptial stay,and it has great value in the liver resection for the treatment of primary liver cancer.

Objective To explore the correlation between the change of regional cerebral blood flow (rCBF) and brain tissue injury from interictal epileptic activity in patients with epilepsy. Methods Fortyeight patients with epilepsy and 30 healthy persons were included in the styudy from which the serum S100β protein levels were determined by double antibody sandwich ELISA method. SPECT rCBF imaging was performed in all patients. The visal and semi-quantitative analyses were used to analyze the epileptic foci.SPSS 11.0 was applied for variance and linear correlation analyses. Results Serum S-100β in patients with interictal epileptic activity was significantly higher than that in control group ((0.572 ± 0. 163) μg/Lvs (0.218 ±0. 134) μg/L, t =9.96, P <0.01). According to epilepsy control criteria, 20 cases achieved complete control (CC), 18 cases acheived partial control (PR). However, 10 cases got no improvement,whose serum S-100β protein ((0. 809 ±0. 056) μg/L) and the percentage change of rCBF ((0. 337 ±0. 060) %) were significantly higher than those of CC ((0.443 ± 0. 083) μg/L, (0.035 ± 0.038) %) and those of PC ((0.585 ±0. 108) μg/L, (0. 187 ±0.075)%), F=56. 740, 92. 316, P <0.01. There were high correlation between serum S-100β and the percentage change of rCBF in epilepsy patients (r =0. 887,P<0.01). Conclusion Serum S-100β protein assay combined with rCBF on SPECT imaging can make semi-quantitative diagnosis of epilepsy and help evaluate the brain damage from interictal epileptic activity.

To investigate the metabolic rate and metabolites of 9-dehydro-17-dehydro-andrographolide, which is the main active ingredient in Xiyanping injection, by using the in vitro rat liver microsome incubation system. 9-dehydro-17-dehydro-andrographolide was incubated together with liver microsome mixed with NADPH. Its metabolic rate was studied by determining its residual concentrations with the UHPLC-MS/MS method; Its metabolites were identified by the UPLC-TOF-MS(E) method. The results showed that 9-dehydro-17-dehydro-andrographolide was metabolized faster than rat liver microsomes mixed with coenzymes, with t½ and CL of (19.7 ± 0.5) min and (35.1 ± 0.8) mL x min(-1) x g(-1) (protein), respectively. Based on the high resolution mass spectrum data and information from literatures, altogether nine metabolites of 9-dehydro-17-dehydro-andrographolide were identified in the incubation system, particularly hydroxylated and dehydrogenized products. The results of identification would provide a basis for screening out more active andrographolide derivatives.
Animals ; Chromatography, High Pressure Liquid ; Diterpenes ; chemistry ; metabolism ; Drugs, Chinese Herbal ; chemistry ; metabolism ; Microsomes, Liver ; chemistry ; metabolism ; Molecular Structure ; Rats ; Tandem Mass Spectrometry