Objective To evaluate the association between isotretinoin pharmacokinetic parameters and CYP2B6 (cytochrome p-450) gene polymorphisms. Methods Blood samples were collected at different time points from 21 healthy male volunteers who received a single 40-rng oral dose of isotretinoin. High performance liquid chromatography-electrospray ionization mass spectrometry (LC-MS) was used for the quantification of isotretinoin in plasma samples which were standardized by dosage and body weight. PCR and restriction fragment length polymorphism (RFLP) analysis were performed to detect the G516T mutation in exon 4 as well as A785G mutation in exon 5 of CYP2B6 gene in these subjects. Results There was an obvious genetic linkage imbalance in exon 4 and 5 of CYP2B6 gene among these volunteers. In the case of CYP2B6*4 allele,3 (14.29%) people were CYP2B6*4/*4 homozygotes, 6 (28.57%) CYP2B6*1/*4 heterozygotes, and 12 (57.14%) CYP2B6*1/*1 wild-type homogygotes, while as far as CYP2B6*6 allele was concerned, 3 (14.29%)people were CYP2B6*6/*6 homozygotes, 5 (23.81%) CYP2B6*1/*6 heterozygotes, and 13 (61.90%)CYP2B6*1/*1 wild-type homozygotes. The reaction half-time (t1/2) and mean residence time (MRT) of isotretinoin were longer in volunteers carrying wild-type CYP2B6*4 allele than those of CYP2B6*4/*4 homozygotes (both P ＜ 0.05 ), while no significant difference was observed in maximum concentration (Cmax), peak time (Tmax) or area under the plasma concentration time (AUC) between the two groups of volunteers. There was no statistical difference in any of the above parameters between subjects carrying wild type CYP2B6*6 allele and those of CYP2B6 *6/*6 homozygotes (all P ＞ 0.05 ). Conclusions The mutation of CYP2B6*4 allele ia relevant to the metabolism of isotretinoin, which seems to be more rapid in CYP2B6*4/*4 homozygotes.

Objective The aim of our study was to study the CT findings of cryptococcosis in immunocompetent children.Methods CT scan and clinical data of 21 immunocompetent children with proven pulmonary cryptococcosis were retrospectively collected and analyzed.Results The CT scans demonstrated 1 mm subpleural nodule in the lingula of left lung in 1 patient and multiple nodules in 20 patients.Of 20 patients with multiple nodules,peripheral or subpleural distribution was found in 12 patients,and diffuse distribution in 8 patients.Of 20 patients with multiple nodules,Nodules of ＜ 10 mm was found in 18 patients,＜3 mm in 14 patients,and ＞ 10 mm in 2 patients.Round nodular with smooth margin was detected in 15 of 20 patients with multiple nodules.Lymphadenopathy was found in 17 patients including 3 patients with mild contrast enhancement and 2 patients with circular enhancement.Extrapulmonary lesions distributing in liver,spleen,kidney,and the nervous system were found in 14 patients.In follow-up,1 patient died and 20 patients fully recovered.ConclusionsPulmonary multiple nodules with lymphadenopathy is the characteristic CT findings in immunocompetent children with pulmonary crytococcosis which is prone to involve multiple extra-pulmonary organs.

Objective To evaluate the feasibility and efficacy of subfascial endoscopic perforator surgery in treating varicose ulcer after great saphenous vein stripping.Methods Between July 2008 and July 2013,152 limbs of venous ulceration after great saphenous vein stripping were divided into two groups (conservative therapy and subfascial endoscopic perforator surgery therapy) and followed up at least for 2 years,respectively compared symptoms and signs improvement,ulcer healing time,ulcer healing and ulcer recurrence rate after healing for 6,12,24 months.Results No patient underwent the surgery occured pulmonary embolism or death,2 limbs appeared hematoma.Conservative and subfascial endoscopic perforator surgery group's symptoms and signs improvement rates were 81.9％ (59/72) and 86.3％ (69/80) (not significant,P =0.528),while the ulcer healing time,ulcer healing and ulcer recurrence rate respectively were 65.3％ (47/72) and 78.8％ (63/80),(73 ±15.7) d and (41 ± 12.6) d,34.0％ (16/47) and 14.3 ％ (9/63) (significantly different,P ＜ 0.05).According to the three time-points' (6,12,24 months) follow-up,the non-recurrence rate were 89.4％ (42/47) and 96.8％ (61/63),P=0.135;72.3％ (34/47) and 92.1％ (58/63),P=0.006;66.0％ (31/47) and 85.7％ (54/63),P =0.014.Conclusions Subfascial endoscopic perforator surgery is a reliable,safe and minimally invasive surgery,and has a long-term effect in treating varicose ulcer after great saphenous vein stripping.

Cell Differentiation ; drug effects ; Cell Line ; Connective Tissue Growth Factor ; metabolism ; Epithelial Cells ; cytology ; drug effects ; metabolism ; Epithelial-Mesenchymal Transition ; drug effects ; Humans ; Kidney Tubules, Proximal ; cytology ; Lead ; toxicity ; Transforming Growth Factor beta ; metabolism

BACKGROUND:Previous research indicated that iron-fluorouracil-phenanthroline complex has good antitumor activity in vitro, which can inhibit the proliferation of human cancer cels. OBJECTIVE:To detect the antitumor activity and toxicity of iron-fluouracil-phenanthroline complex, [Fe(5-Fu)2(Phen)SO4],in vivo. METHODS:A total of 40 Kunming mice were randomly divided into four groups, which were intraperitoneally injected with 72, 102.9, 147, 210 mg/kg [Fe(5-Fu)2(Phen)SO4] and the half lethal dose of the complex was detected. One day after the establishment of mouse S180 sarcoma models, the model mice were randomly divided into eight groups, and administered with the intraperitoneal injection of 15 mg/kg (low dose group), 30 mg/kg (middle dose group), 60 mg/kg (high dose group) [Fe(5-Fu)2(Phen)SO4], normal saline (negative control group), cisplatin (positive control group), 5-fluorouracil, iron-salt and phenanthroline, respectively. The injection was done once a day, lasting for 7 days. The weight of sarcomas, body weight, the main organ coefficient and histopathological changes of the main organs were detected. RESULTS AND CONCLUSION: The half lethal dose of [Fe(5-Fu)2(Phen)SO4] was 103.9 mg/kg. Compared with the negative control group, high dose group, positive control group and 5-fluorouracil could significantly inhibit the growth of the tumor (P< 0.05 orP< 0.01), and the effect of high dose group was the most obvious (P < 0.01). Compared with cisplatin, 60mg/kg [Fe(5-Fu)2(Phen)SO4] had a weaker inhibitory effect on the kidney, but higher inhibitory effect on the liver, spleen and thymus, indicating the complex has a lower nephrotoxicity, but stronger immunotoxicity and hepatotoxicity than cisplatin.

Objective To assess the level of radiation exposures of operators in three typical types of interventional fluoroscopic procedures.Methods Alderson Radiation Therapy (ART) phantom was used to stimulate the practices of diagnosis and therapy using TLDs for dose measurement.The radiation exposures of eye lens, neck, and breast were measured when the lead shielding of machine was on/off and the equivalent dose and effective dose to the eye lens were estimated.Results Radiation exposure of head was obviously reduced by 85% -90% when the lead shielding was on.The doses in different procedures were different.In cerebral angiography the dose equivalent of eye len was the highest in the three procedures.The annual effective dose for the operators was smaller in peripheral vascular interventions than that in cardiovascular interventional therapy and that in cerebral angiography.Conclusions The operators involved in intervention will receive an annual effective dose of less than 20 mSv as recommended by the ICRP under the protection conditions provided by the current study, except for eye lens.Attention should be paid to the protection of the eyes of operators.

Objective To measure the in vitro antibacterial activity of tigecycline against carbapenems-resistant Acinetobacter calcoacetcus-Acinetobacter baumannii complex.Methods The isolated strains of carbapenems-resistant Acinetobacter calcoacetcus-Acinetobacter baumannii complex were collected in our hospital from December 2013 to February 2014.The MIC test strip was a-dopted to measure the MIC value of tigecycline.The break point adopted the judgment criteria published by FDA.Results All 61 strains of carbapenems-resistant Acinetobacter calcoacetcus-Acinetobacter baumannii complex had extremely high drug resistant rate to the commonly used antimicrobial agents.The sensitive rate of tigecycline was 80.3%,intermediation was 19.7% and no re-sistant strain was found in this study.MIC50 and MIC90 were 2 μg/mL and 3 μg/mL respectively.Conclusion Tigecycline has bet-ter in vitro antibacterial activity to the carbapenems-resistant Acinetobacter calcoacetcus-Acinetobacter baumannii complex isolated in our hospital.

BACKGROUND: Metal implants have been extensively applied in joint arthoplasty, but the stress shielding effect caused by its high elastic modulus results in a series of complications, such as bone resorption, bone atrophy and prosthesis loosening. Carbon fiber-reinforced polyetheretherketone (CF-PEEK) composites are anisotropic and exhibit more advantages used for prosthesis due to its low elastic modulus and high intensity.OBJECTIVE: To investigate the blood compatibility of CF-PEEK composites, and compare the biomechanical properties after arthroplasty between CF-PEEK composites and Co-Cr-Mo used for femoral head prosthesis. METHODS: (1) The blood compatibility of CF-PEEK composites was evaluated through hemolysis test. (2) Femoral samples from eight fresh cadavers were collected and randomly divided into two groups, followed by subjected to CF-PEEK and Co-Cr-Mo prosthesis replacement, respectively. The displacement between the prosthesis and bone was measured under loading 200, 400, 600, 800 and 1000 N, and the torsional strength after arthroplasty was detected.RESULTS AND CONCLUSION: (1) The hemolysis rate of the CF-PEEK composites was 3.23% < 5%, which was in line with the national standards for biological evaluation of medical devices. (2) The micromovement in distal prosthesis was significantly less than that of proximal prosthesis under different loads in both two groups (P < 0.05). (3) The torsion angle under different loads in the CF-PEEK group was significantly less than that in the Co-Cr-Mo group (P < 0.05), and the torsion stiffness in the CF-PEEK group was significantly higher than that in the Co-Cr-Mo group (P < 0.05). (4) To conclude,the CF-PEEK composites possess good blood compatibility and stability, which can be used as a prosthesis material.

OBJECTIVE: To analyze social-psychological causes of acute exacerbation or re-decompensation of chronic tinnitus and provide theoretical basis for controlling and preventing tinnitus exacerbation and re-decompensation. METHOD: Systemic audiological tests and tinnitus handicap inventory were performed on 136 chronic tinnitus patients with acuteexacerbation or re-decompensation. For the patients with new hearing loss, a further investigation of living conditions and assessment of social support rating scale were utilized. The patients with relatively definite causes were treated accordingly. RESULT: (1) There were 89 patients complained of new changes of hearing, all of whom could tell the definite time point of tinnitus exacerbation, and 5 of them felt the exacerbation of hearing loss meanwhile. (2) Forty-two patients encountered adverse events on life or working, and tinnitus exacerbation occurred within several weeks to 3 months afterwards. Most of these patients could not tell the definite time point of tinnitus exacerbation or re-decompensation. Five cases of tinnitus exacerbation didn't tell any adverse events on life or working, but showed mood disorders, and the anti-anxiety treatment was effective to them. (3) Forty-seven cases without new hearing loss scored significantly lower in SSRS than healthy adults. CONCLUSION Emerging hearing loss is the main cause of acute exacerbation of chronic tinnitus. To find it in time and give effective treatment can save newly presented hearing loss, cure or relieve tinnitus. Adverse events in life(or working) and short of social support is another important cause of acute exacerbation of chronic tinnitus or decompensation recurrence, which suggests that social-psychological factors besides of hearing loss should be concerned in diagnosis and treatment of tinnitus.
Adult ; Disease Progression ; Hearing Loss ; Humans ; Social Support ; Tinnitus ; psychology

BACKGROUND:Stroke is the leading cause of death and long-term disability. This study was undertaken to investigate the factors influencing daily activities of patients with cerebral infarction so as to take interventional measures earlier to improve their daily activities. METHODS:A total of 149 patients with first-episode cerebral infarction were recruited into this prospective study. They were admitted to the Encephalopathy Center, Department of Neurology, the First Affiliated Hospital of Wenzhou Medical College in Zhejiang Province from August 2008 to December 2008. The baseline characteristics of the patients and cerebral infarction risk factors on the first day of admission were recorded. White blood cell (WBC) count, plasma glucose (PG), and many others of laboratory targets were col ected in the next morning. Barthel index (BI) was calculated at 2 weeks and 3 months respectively after onset of the disease at the outpatient clinic or by telephone cal . Lung infection, urinary tract infection and atrial fibrillation if any were recorded on admission. The National Institute of Health Stroke Scale (NIHSS) scores and the GCS scores were recorded within 24 hours on and after admission, at the second week, and at the third month after the onset of cerebral infarction respectively. RESULTS:The factors of BI at 2 weeks and 3 months after onset were the initial PG level, WBC count and initial NIHSS scores. Besides, urinary tract infection on admission was also the factor for BI at 3 months. CONCLUSION:Active measures should be taken to control these factors to improve the daily activities of patients with cerebral infarction.