Colectomy ; Colorectal Neoplasms/surgery* ; Humans ; Laparoscopy ; Treatment Outcome

OBJECTIVE: To evaluate the effects of a 48-week course of adefovir dipivoxil (ADV) plus Chinese medicine (CM) therapy, namely Tiaogan Jianpi Hexue () and Tiaogan Jiedu Huashi () fomulae, in hepatitis B e antigen (HBeAg)-positive Chinese patients. METHODS: A total of 605 HBeAg-positive Chinese CHB patients were screened and 590 eligible participants were randomly assigned to 2 groups in 1:1 ratio including experimental group (EG, received ADV plus CM) and control group (CG, received ADV plus CM-placebo) for 48 weeks. The major study outcomes were the rates of HBeAg and HBV-DNA loss on week 12, 24, 36, 48, respectively. Secondary endpoints including liver functions (enzymes and bilirubin readings) were evaluated every 4 weeks at the beginning of week 24, 36, and 48. Routine blood, urine, and stool analyses in addition to electrocardiogram and abdominal B scan were monitored as safety evaluations. Adverse events (AEs) were documented. RESULTS: The combination therapy demonstrated superior HBeAg loss at 48 weeks, without additional AEs. The full analysis population was 560 and 280 in each group. In the EG, population achieved HBeAg loss on week 12, 24, 36, and 48 were 25 (8.90%), 34 (12.14%), 52 (18.57%), and 83 (29.64%), respectively; the equivalent numbers in the CG were 20 (7.14%), 41 (14.64%), 54 (19.29%), and 50 (17.86%), respectively. There was a statistically significant difference between these group values on week 48 (P<0.01). No additional AEs were found in EG. Subgroup analysis suggested different outcomes among treatment patterns. CONCLUSION Combination of CM and ADV therapy demonstrated superior HBeAg clearance compared with ADV monotherapy. The finding indicates that this combination therapy may provide an improved therapeutic effect and safety profile (ChiCTR-TRC-11001263).
Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; Double-Blind Method ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; immunology ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Male ; Medicine, Chinese Traditional ; Organophosphonates ; therapeutic use ; Young Adult

Objective:To explore the effect of VEGF overexpression on the Bcl-2 of TAMs /MCF-7 cell co-culture system.Methods:Application of PMA and IL-4 cells induced THP-1 cell differentiation into TAMs in vitro;TAMs and MCF-7 cell were co-cultured in non-contact Transwell system.MCF-7 cells' proliferation status after co-culture were detected by MTT method;Effect of VEGF over-expression in co-cultured system on Bcl-2 level s in the two cell lines by Western blot assay.Results:PMA and IL-4 induced THP-1 cell become TAMs in vitro.After co-cultured with TAMs 24 h,48 h,MCF-7 cell's proliferation activity increased by 16.16 ％ and 33.99％ vs the control group respectively.TAMs,MCF-7 cells were added VEGF and the supematant of co-culture system respectively,then Bcl-2 levels in both cells were significantly higher,the difference was statistically significant (P＜0.05).Conclusions Tumors secrete VEGF and other chemokines to recruit and activate TAMs.Proliferation,apoptosis and progression of tumor was affected by VEGF/Bcl-2 paracrine loop in tumor microenvironment.

15-Deoxy-Δ(12), 14-prostaglandin J2 (15d-PGJ2), a well known peroxisome proliferator activated receptor (PPAR) γ ligand, has been shown to inhibit cellular proliferation and induce apoptosis and differentiation. However, whether 15d-PGJ2 influences the cytokines in the culture supernatant of bone marrow mesenchymal stem cells (BM-MSC) is unknown. This study was purposed to investigate the influence of 15d-PGJ2 on cytokines in the culture supernatant of BM-MSC. The fibroblast-like cells attached to the culture dish from bone marrow of healthy donors were isolated. The immunophenotype and differentiation potential of the obtained cells were detected by flow cytometry and oil red O and von kassa staining respectively to confirm that these cells were BM-MSC. Thereafter, the BM-MSC were cultured with complete medium supplemented with 10, 20, 40 and 60 µmol/L 15d-PGJ2 for 24 hours respectively. The real-time PCR was used to assay the PPARγ mRNA level, the confocal immuno fluorescence technique was used to detect the expression level of PPARγ. The results showed that the BM-MSC underwent apoptosis and got detached from the culture dish when the concentration of 15d-PGJ2 was no less than 20 µmol/L. The PPARγ mRNA level of BM-MSCs cultured with medium containing 10 µmol/L 15d-PGJ2 was higher than that cultured without 15d-PGJ2, and the difference was statistically significant (P < 0.05). The enhancement of PPARγ expression was observed after stimulated by 15d-PGJ2. The protein chip detecting the culture supernatants of BM-MSC cultured with 10 µmol/L 15d-PGJ2 or without 15d-PGJ2 for 24 hours demonstrated that expression levels of some of the cytokines varied. It is concluded that the down-regulation of TIMP-2 exists after treatment of 15d-PGJ2, which is statistical significant.
Adult ; Bone Marrow Cells ; drug effects ; metabolism ; Cells, Cultured ; Culture Media ; chemistry ; Cytokines ; metabolism ; Humans ; Mesenchymal Stromal Cells ; drug effects ; metabolism ; Prostaglandin D2 ; analogs & derivatives ; pharmacology ; Tissue Inhibitor of Metalloproteinase-2 ; metabolism ; Young Adult

OBJECTIVETo observe the impact of inducing the formation of the post-moxibustion sore on the efficacy of bronchial asthma treated with scarring moxibustion.

METHODSThree hundred and seventy-two cases diag nosed definitely as bronchial asthma at remission stage were randomly divided into a modified nursing group (248 cases) and a conventional nursing group (124 cases). The scarring moxibustion was applied at Dazhui (GV 14), Feishu (BL 13), Danzhong (CV 17) and Tiantu (CV 22) in either group. The direct moxibustion with moxa cone was adopted. In modified nursing group, 0.5% Iodine was used for the sterilization at moxa abscess. The herbal plaster was cut into an inverted triangle and compressed on the wound. After suppuration, the fester was not cleaned in each dressing change. Additionally, the patients were advised to have high-protein diets after moxibus tion till abscess dropped. In conventional nursing group, 0.5% Iodine was used for the sterilization at moxa abscess. The herbal plaster was cut into a round shape that could cover completely the moxa wound. After suppuration, in each dressing change, the wound was cleaned and sterilized. Additionally, the patients were advised to avoid any stimulating food after moxibustion till abscess dropped. The clinical efficacy, the change of C3 content in blood serum and the clinical symptom score were observed in two groups.

RESULTSThe total effective rate was 93.5% (232/248) in modified nursing group, which was better than 79.0% (98/124) in conventional nursing group (P < 0.01). C3 content increased apparently after treatment as compared with that before treatment in either group (both P < 0.01), but C3 level increased much more apparently in modified nursing group as compared with that in conventional nursing group (P < 0.01). The clinical symptom score reduced apparently after treatment in either group (both P < 0.01), but that reduced much more apparently in modified nursing group as compared with that in conventional nursing group (P < 0.01).

CONCLUSIONIn the treatment of bronchial asthma with scarring moxibustion, to induce the formation of the post-moxibustion sore achieves the better clinical efficacy as compared with conventional nursing.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Asthma ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

Overexpression of human epidermal growth factor receptor-2 (HER2) in metastatic breast cancer (MBC) is associated with poor prognosis. This single-arm open-label trial (EGF109491; NCT00508274) was designed to confirm the efficacy and safety of lapatinib in combination with capecitabine in 52 heavily pretreated Chinese patients with HER2-positive MBC. The primary endpoint was clinical benefit rate (CBR). Secondary endpoints included progression-free survival (PFS), time to response (TTR), duration of response (DoR), central nervous system (CNS) as first site of relapse, and safety. The results showed that there were 23 patients with partial responses and 7 patients with stable disease, resulting in a CBR of 57.7%. The median PFS was 6.34 months (95% confidence interval, 4.93-9.82 months). The median TTR and DoR were 4.07 months (range, 0.03-14.78 months) and 6.93 months (range, 1.45-9.72 months), respectively. Thirteen (25.0%) patients had new lesions as disease progression. Among them, 2 (3.8%) patients had CNS disease reported as the first relapse. The most common toxicities were palmar-plantar erythrodysesthesia (59.6%), diarrhea (48.1%), rash (48.1%), hyperbilirubinemia (34.6%), and fatigue (30.8%). Exploratory analyses of oncogenic mutations of PIK3CA suggested that of 38 patients providing a tumor sample, baseline PIK3CA mutation status was not associated with CBR (P = 0.639) or PFS (P = 0.989). These data confirm that the lapatinib plus capecitabine combination is an effective and well-tolerated treatment option for Chinese women with heavily pretreated MBC, irrespective of PIK3CA status.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Asian Continental Ancestry Group ; Breast Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; Capecitabine ; Class I Phosphatidylinositol 3-Kinases ; Deoxycytidine ; administration & dosage ; adverse effects ; analogs & derivatives ; Diarrhea ; chemically induced ; Disease Progression ; Disease-Free Survival ; Exanthema ; chemically induced ; Female ; Fluorouracil ; administration & dosage ; adverse effects ; analogs & derivatives ; Hand-Foot Syndrome ; etiology ; Humans ; Middle Aged ; Mutation ; Neoplasm Staging ; Phosphatidylinositol 3-Kinases ; genetics ; Quinazolines ; administration & dosage ; adverse effects ; Receptor, ErbB-2 ; metabolism ; Remission Induction

OBJECTIVETo identify the active material of anti-hepatic fibrosis from Amydae Carapax.

METHODSMembrane separation technology was adopted to screen active fraction in Amydae Carapax, and the active components were isolated from the active fraction using gel chromatography and high performance liquid chromatography. The purified active components in Amydae Carapax were further analyzed using 4700 series time-of-flight mass spectrometer.

RESULTSProteins and peptides of Amydae Carapax with molecular weight less than 6000 were proved to have biological activity. 8 components (Bj1-Bj8) were isolated from the active fraction. Bj4, Bj6 and Bj7 were screened as active components. Bj7 was further purified, resulting in 7 components (Bj701-Bj707). Bj704 and Bj707 showed significant biological activity. Mass spectrometry showed three molecular ion peaks with highest abundance, i.e. m/e 526, 542 and 572, i.e. m/e 526, 542 and 572, in Bj707 -A The amino acid sequences of above three peptide compounds were NDDY (Asn-Asp-Asp-Tyr), NPNPT (Asn-Pro-Asn-Pro-Thr), and HGRFG (His-Gly-Arg-Phe-Gly), respectively. And M572 was the most abandunt components.

CONCLUSIONThree active peptide compounds of anti-hepatic fibrosis of Amydae Carapax were identified.

Animals ; Cell Line ; Humans ; Liver Cirrhosis ; Medicine, Chinese Traditional ; Tissue Extracts ; isolation & purification ; pharmacology

The study was aimed to investigate the potential immunotherapeutical values of umbilical cord tissue-derived mesenchymal stem cells (UC-MSC) on patients with chronic idiopathic thrombocytopenic purpura (ITP). UC-MSC was cocultured in vitro with splenocytes isolated from ITP patients who experienced splenectomy. The level of IgG antiplatelet antibody (PAIgG) was determined by a competitive micro-enzyme-linked immunosorbent assay (ELISA) method. The proliferation of platelet-reactive CD4+ T lymphocytes was also measured in the presence of UC-MSCs. The results showed that UC-MSCs could stimulate the spontaneous secretion of PAIgG in supernatants; In the platelet-inducing condition, UC-MSC inhibited the production of PAIgG at a low ratio of 1 UC-MSC to 100 splenocytes, but promoted at a high proportion of 1 UC-MSC to 10 splenocytes. Moreover, UC-MSC exerted a suppressive effect on proliferation of platelet-reactive T helper cells in a dose-dependent manner. It is concluded that the UC-MSCs can regulate secretion of antiplatelet antibodies in vitro. Its concrete regulation mechanism and potential immunotherapeutical value are need to further study.
Antibodies ; metabolism ; Blood Platelets ; immunology ; CD4-Positive T-Lymphocytes ; cytology ; Cell Proliferation ; Humans ; Infant, Newborn ; Lymphocyte Activation ; Mesenchymal Stromal Cells ; physiology ; Purpura, Thrombocytopenic, Idiopathic ; metabolism ; Spleen ; cytology ; Umbilical Cord ; physiology

OBJECTIVETo discuss the use of free jejunal flap in reconstruction for circumferential defect after tumor resection of hypopharyngeal and cervical esophageal cancer.

METHODSRetrospective review of 51 patients who underwent circumferential pharyngoesophageal reconstruction with free jejunal flap after tumor ablation.

RESULTSIn 51 patients, 5 had flap failure and the flap success rate was 90% (46/51). Forty-five patients had oral intake after operation excluding one who had anastomosis stenosis and 5 who had flap failure. The 1-year and 3-year survival rate was 62% and 48% respectively. Positive surgical marginal status and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area were indicators for bad prognosis. Except 5 patients who had flap failure, one of which died from mediastinal infection, no other severe complications occurred.

CONCLUSIONSPatients reconstructed with free jejunal flap after resection of hypopharyngeal and cervical esophageal cancer had low mortality and few complications. Those without positive surgical margin and external invasion including thyroid gland, carotid artery, skin and pre-vertebral area had higher survival rate. Most of them had good quality of life. The choice of free jejunal flap for reconstruction of hypopharyngoesophageal defect was appropriate in selected patients who had guarantee of negative surgical margin and no external invasion.

Adult ; Aged ; Esophageal Neoplasms ; mortality ; surgery ; Esophagectomy ; Female ; Humans ; Hypopharyngeal Neoplasms ; mortality ; surgery ; Jejunum ; surgery ; Male ; Middle Aged ; Pharyngectomy ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgical Flaps ; Survival Rate

OBJECTIVETo study the mechanism of Tongjiang granule on treating GERD.

METHODThe rats in the model group received steel wire ring-cardiamyopexy. A steel wire ring was fixed firmly on cardia. The rats in the control group underwent the cardia-plasty plus pylori ligation plus stomach-empty intestine Roux-en-Y anastomosis. The rats were divided into six groups after operations at random, which were fed up respectively with Tongjiang granule of different dosage and perpulsid. No treatment groups were taken as control.

RESULTThe experiment showed that Tongjiang granule could lighten or cure RE in the pathology, decrease the hydrochloric acid in gastric juice, in the meantime, increase the motilin in the animal blood. This study indicated that the effect of Tongjiang granule group from experimental research was better than that of the control group (perpulsid).

CONCLUSIONThe effects of Tongjiang granule on treating GERD can be achieved by decreasing the hydrochloric acid in gastric juice, increasing the motilin in blood and promoting the gastric impetus in the animal experiment.

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Esophagitis, Peptic ; drug therapy ; physiopathology ; Esophagus ; pathology ; Female ; Gastric Acid ; metabolism ; Gastric Emptying ; drug effects ; Hydrochloric Acid ; metabolism ; Male ; Motilin ; blood ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley