Two ent-kauranoids were isolated from the ethanol extraction of rhizomes of Canna generalis (Cannaceae), and were purified by various technologies, including silica gel and high performance liquid chromatography, and their structures were determined by modern spectroscopy techniques as (5R,8S,9S,10R,13R)-2-oxo-ent-kaur-15-en-17-oic acid (1) and (4R,5S,8S,9S,10S,13R)-19-hydroxy-ent-kaur-15-en-17-oic acid (2). Compound 1 is a new ent-kauranoid, and compound 2 is obtained from rhizomes of Canna generalis for the first time.

Aged, 80 and over ; Chronic Disease ; Female ; Humans ; Mucor ; pathogenicity ; Mucormycosis ; microbiology ; pathology ; Orbit ; pathology ; Sinusitis ; microbiology ; pathology

OBJECTIVETo evaluate the outcomes of T3a prostate cancer with unfavorable prognostic factors treated with permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy.

METHODSFrom January 2003 to December 2008, 38 patients classified as T3a prostate cancer with unfavorable prognostic factors were treated with trimodality therapy (brachytherapy + external radiotherapy + hormone therapy). The prescription dose of brachytherapy and external radiotherapy were 110 Gy and 45 Gy, respectively. The duration of hormone therapy was 2-3 years. The endpoints of this study included biochemical failure-free survival (BFFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS). Survival curves were calculated using the Kaplan-Meier method. The Log-rank test was used to identify the prognostic predictors for univariate analysis.

RESULTSThe median follow-up was 71 months. The serum pre-treatment prostate-specific antigen (PSA) level ranged from 10.0 to 99.8 ng/ml (mean 56.3 ng/ml), the Gleason score ranged from 5 to 9 (median 8), and the percentage of positive biopsy cores ranged from 10% to 100% (mean 65%). The 5-year BFFS, DMFS, CSS, and OS rates were 44%, 69%, 82%, and 76%, respectively. All biochemical failures occurred within 40 months. The percentage of positive biopsy cores was significantly correlated with BFFS, DMFS, and OS (all P=0.000), and the Gleason score with DMFS (P=0.000) and OS (P=0.001).

CONCLUSIONST3a prostate cancer with unfavorable prognostic factors presents not so optimistic outcome. Hormone therapy should be applied to prolong the biochemical progression-free or metastasis-free survival. The percentage of positive biopsy cores and the Gleason score are significant prognostic factors.

Androgen Antagonists ; therapeutic use ; Brachytherapy ; Combined Modality Therapy ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Male ; Neoplasm Grading ; Prognosis ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Treatment Outcome

Adult ; Aged ; Boronic Acids ; therapeutic use ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; complications ; drug therapy ; Pyrazines ; therapeutic use ; Renal Insufficiency ; complications ; drug therapy

Adult ; Female ; Hemangioma ; complications ; diagnosis ; physiopathology ; Humans ; Hydrops Fetalis ; diagnosis ; etiology ; physiopathology ; Infant, Newborn ; Placenta Diseases ; diagnosis ; physiopathology ; Pregnancy

Child ; Humans ; Proteomics ; methods

Objective To investigate the relation between positive fluid balance and the prognosis in severe sepsis patients with acute kidney injury (AKI).Methods A retrospective analysis of clinical data of 90 patients in our department was carried out.According to the final outcome,patients were divided into survival group (n =26) and non-survival group (n =64),in which the relation between patients' positive fluid balance and the prognosis was evaluated.Results (1) There was no statistically significant difference in the age and severity between survival group and non-survival group of patients with severe sepsis and consequent AKI,but the patients in non-survival group had greater volume overload.Compared with the survival group,higher mean fluid balance [(1 112.12±546.85) mLvs.(644.69±474.93) mL,P=0.00],and less urine output [(1 224.07 ± 708.79) mL vs.(2 032.36 ± 723.53) mL,P =0.00) in non-survival group.(2) There was no significant difference in mortality between early and late continuous renal replacement therapy (CRRT) during ICU care.However,the average daily fluid load in late CRRT patients was significantly greater than that in early CRRT patients [(1178.81 ±397.03) mLvs.(287.22 ± ± 433.53) mL,P =0.00] and the lung oxygenation index in late CRRT patients was significantly worse thanthat in early CRRT patients [(211.22±42.56) vs.(169.46±57.40),P=0.04] (3) The relevant variables to 28-day mortality in AKI patients with severe sepsis included CRRT treatment,oxygenation index and the average daily fluid balance ＞ 500 mL.Among them,fluid balance ＞ 500mL was an independent risk factor for AKI patients with severe sepsis.Their prognosis was worse if they had greater positive fluid balance.CRRT was the protective factor which could affect the prognosis of patients with severe sepsis complicated by AKI.Conclusions Patients with severe sepsis complicated by AKI has a high mortality.Persistent fluid overload can lead to increased mortality in patients with severe sepsis complicated by AKI.Early CRRT can reduce fluid retention in patients with renal failure and improve oxygenation index.

Objective To analyze the clinical and ultrasonic features of primary squamous cell carcinoma of the thyroid(PSCCT)and diagnostic value of ultrasonography (US) in PSCCT in order to improve the cognition of PSCCT.Methods The clinical data and ultrasonic characters of 5 patients with PSCCT confirmed by pathology post surgery were retrospectively reviewed.Results The average age of the 5 patients was 62 years (range from 46 to 79).All of 5 patients with PSCCT were presented with a painless neck mass in clinical palpation examination.Of them,2 patients had different degrees of difficulty in breathing and swallowing,2 patients had hoarseness.Four of 5 patients had died after surgery with average survival time of 9.5 months.On US,the size of lesions was large(a maximum diameter of 2.9-5.5 cm),all of 5 lesions appeared as single solid mixed-echogenicity mass including irregular lamellate marked hypoechoic region,with irregular margin and undefined boundary.Of them,2 lesions presented with lobulated,only 1 lesion exhibited microcalcification and another 4 lesions had no calcification,3 lesions exhibited a? sign of breakthrough thyroid envelope.Color Doppler flow imaging showed few blood flow (3/5) and moderate blood flow (2/5),a higher vascular resistance spectrum was detected in 4 lesions (RI 0.72-0.88).Three patients exhibited suspicious cervical lymph nodes.Conclusions The characteristic ultrasonic appearance combined with the clinical features enables a confident preoperative diagnosis of PSCCT.

Objective To observe the delayed brain myelination of children with phenylketonuria(PKU)combined with epilepsia,and explore effectiveness of the treatment and provide an objective criteria for patient recovering evaluation.Methods There were 42 PKU patients,aged 3 to 72 months were selected.The concentration of phenylalanine tested by high pressure liquid chromatography was greater than 1.2 mmol/L in blood,diagnosed as PKU.According to electroencephalogram and clinical symptom,21 cases were diagnosed as epilepsy,the other 21 cases were used as control group.All patients were taken MRI before treatment.Myelination in 10 sections(cerebellum,pons,mesencephalon,internal capsule posterior limb,corpus callosum,internal capsule anterior limb,occipital lobe,parietal lobe,temporal lobe,frontal lobe)were evaluated.Results Delayed myelinations were located mainly in the cerebral lobes and corpus callosum,average delayed incidence of the 10 region was 44.8% in epilepsy group and 30.9% in control group.The incidence of the corpus callsum was 80.9% in epilepsy group,52.4% in control group,the number of sections of delayed myelination showed statistically significant between 2 groups(P

Objective To explore the changes of Clara cell secretory protein(CCSP) in asthmatic children and the effects of inhaling glucocorticoid (ICS) on CCSP.Methods Sixty children with asthma were selected as asthma group(in which 39 cases were male and 21 cases were female,aged 3-12 years old) and 30 healthy children were selected as healthy control group(in which 20 cases were male and 10 cases were female,aged 3-12 years old).Venous blood samples were collected in asthma group and healthy control group in morning before breakfast,and then sera were obtained by centrifuge in speed of 1 500 r?min-1 in 10 min.The dynamic levels of CCSP were measured in sera by enzyme-linked immunosorbent assay.Results 1.In asthmatic children,the CCSP levels in acute episode,3 months after ICS,6 months after ICS, and 12 months after ICS[(5.140?2.331)?g?L-1,(8.730?3.392)?g?L-1,(10.510?2.813)?g?L-1]were all lower than that in healthy control group[(13.230?4.010)?g?L-1](Pa0.05).2.Compared with acute episode,the patients who ICS for 3 months,6 months and 12 months had significantly higher levels of CCSP (Pa0.05).Conclusions CCSP may play a protective role in the airway inflammation of asthma.Glucocorticoid may increase CCSP level in asthmatic children.Glucocorticoid and CCSP may cooperate in anti-inflammation in airway of asthmatic children.