Objective To evaluate the efficacy of itraconazole oral solution for prevention of invasive fungal infection ( IFI ) in neutropenic patients with acute leukemia after chemotherapy.Methods Clinical data of 136 neutropenic patients with acute leukemia after chemotherapy at the Department of Hematology,Nanfang Hospital from January 2008 to December 2010 were retrospectively analyzed.Patients were divided into itraconazole group ( n =67 ) and control group ( n =69).There were 36 patients with acute nonlymphocytic leukemia ( ANLL),31 with acute lymphoblastic leukemia (ALL) in itraconazole group;while in control group,there were 30 patients with ANLL,38 with ALL and 1 with biphenotypic acute leukaemia (BAL).Patients in itraconazole group received intraconazole after chemotherapy until the neutrophil count was increased to 0.5 × 109/L or the body temperature returned to normal and without any imaging evidence of IFI.The incidence of IFI and clinical features were compared between the groups using SPSS 13.0 software.Pearson x2 test was used for nominal variables,for measurement data,t (normal distribution) or Mann-Whitney U (skewed distribution) test were used.Results There were 12 cases ( 17.9％ ) suffering from IFI in itraconazole group and 32 cases (46.4％) in the control group (x2 =12.59,P ＜ 0.01 ).For ANLL patients,the incidence of IFI in itraconazole group was significantly lower than that in control group ( 16.7％ vs.56.7％,x2 =11.53,P ＜0.01 ).In itraconazole group,the incidence of IFI in female patients was significantly lower than that in male patients ( 8.6％ vs.28.1％,x2 =4.35,P ＜0.05 ).And for the female patients,the incidence of IFI in itraconazole group was significantly lower than thatin the control group (8.6％ vs.44.7％,x2 =11.98,P＜0.01).Conclusion Itranconzole oral solution can effectively prevent IFI in neutropenic patients with acute leukemia after chemotherapy,especially for the female patients with ANLL.

OBJECTIVETo investigate the effects of Bushen Huoxue Fang (BSHX) on the apoptosis of epithelial cells in the prostatic ductal system of rats with benign prostatic hyperplasia (BPH) and its possible action mechanism.

METHODSOne hundred 3- month-old male Wistar rats were randomly divided into four groups of equal number (control, castrated, BPH model, and BSHX). BPH models were made by subcutaneous injection of testosterone following castration; the rats in the BSHX group were treated intragastrically with BSHX at 2.34 g/ml after modeling, while those in the other two groups with equal volume of saline, all for 37 days. On the 38th day, all the rats were sacrificed and their prostates harvested for detection of the distribution of TGF-beta1 and alpha-actin and the count of positive cells in the prostatic ductal system by immunohistochemical staining. The apoptosis rate of epithelial cells in the prostatic ductal system was determined by TUNEL assay.

RESULTSThe expression of TGF-beta1 was significantly increased in the rats of the BSHX group as compared with the BPH models in both the proximal prostatic duct ([15.28 +/- 4.30]% vs [36.42 +/- 8.10]%, P < 0.01) and the distal prostatic duct ([4.42 +/- 2.07]% vs [8.71 +/- 2.28 ]%, P < 0.05), while the expression of alpha-actin in the proximal duct was remarkably higher in the BSHX-treated rats than in the models ([28.14 +/- 7.43]% vs [18.28 +/- 4.07]%, P < 0.01), but lower than in the control animals ([33.57 +/- 6.85]%, P < 0.05). Compared with the control group, the BPH models and BSHX-treated rats both exhibited markedly decreased apoptosis of epithelial cells in the proximal prostatic duct ([39.42 +/- 9.20]% vs [3.86 +/- 1.34]%, P < 0.01, and [31.14 +/- 5.64]%, P < 0.01) and distal prostatic duct ([17.60 +/- 4.86]% vs [3.07 +/- 1.14]%, P < 0.01, and [12.37 +/- 2.25]%, P < 0.05). The apoptosis rate of epithelial cells in the prostatic ductal system was significantly higher in the BSHX-treated rats than in the BPH models (P < 0.01).

CONCLUSIONBy upregulating the expression of TGF-beta, BSHX can suppress the reduction of smooth muscle cells in the proximal prostatic duct, promote the apoptosis of prostatic epithelial cells, and thus effectively inhibit benign prostatic hyperplasia.

Actins ; metabolism ; Animals ; Apoptosis ; drug effects ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; Epithelial Cells ; drug effects ; pathology ; Male ; Prostatic Hyperplasia ; drug therapy ; metabolism ; pathology ; Rats ; Rats, Wistar ; Transforming Growth Factor beta1 ; metabolism

To study the pharmacokinetic process of Danshensu in cerebal ischemia injury model rats and the correlation with its anti-cerebral ischemia effect. In this study, the middle cerebral artery occlusion (MCAO) model was established, in which all of the rats were intravenously injected of Danshensu at a single dose of 40 mg x kg(-1). The HPLC-DAD method was applied to determine the plasma concentration of Danshensu at different time points and draw the drug-time curve. Meanwhile, the superoxide dismutase (SOD) and the lactate dehydrogenase (LDH) activity were determined to draw the time-effect curve. The DAS 3.2. 6 software was used to process the data, analyze their correlation, compare the pharmacokinetic difference between model and normal rats after the administration of the same doses of Danshensu and the changes in pharmacodynamic indicators of model rats after the administration, and evaluate the effect of Danshensu in treating the cerebral ischemia disease. According to the results, the pharmacokinetic processes of Danshensu in the cerebral ischemia-reperfusion and normal rats were consistent to the two-compartment model. The main pharmacokinetic parameters were: t1/2alpha were (0.267 +/- 0.026), (0.148 +/- 0.020) h;t1/2beta were (1.226 +/- 0.032), (1.182 +/- 0.082) h; AUC0-infinity were (42.168 +/- 4.007), (26.881 +/- 1.625) mg x L(-1) x h. After the cerebral ischemia-reperfusion, the activity of SOD decreased and the activity of LDH increased. Danshensu could inhibit the decrease in the SOD activity and the increase in the LDH activity within a certain period of time. This indicated that Danshensu could stay longer in cerebral ischemia-reperfusion rats than in normal rats and eliminated more slowly, which reflected the rationality of Danshensu in the clinical treatment of cerebral ischemia diseases. Danshensu's effect against the cerebral ischemic injury may be related with its level in vivo. Its plasma concentration is positively related to the SOD activity and negatively related to the LDH activity.
Animals ; Brain Ischemia ; drug therapy ; Drugs, Chinese Herbal ; pharmacokinetics ; pharmacology ; therapeutic use ; Male ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; chemistry

Objective To summarize the experience of microsurgical operation via single nostril-sphenoid sinus approach or via subfrontal approach on giant pituitary adenoma. Methods Microsurgical operations were performed on 51 cases of giant pituitary adenoma via single nostril-sphenoid sinus approach (n=13) or via subfrontal approach (n=38). Results Total resection was achieved in 18 cases by the operation via subfrontal approach, most resection in 13 cases, partial resection in 4 cases, postoperative death in 3 cases. Another a few patients were operated via single nostril-sphenoid sinus approach, in which total resection was executed in 7 cases, most resection in 4cases, partial resection in 2 cases. The statistical differences in the total removal rate and curative effect were meaningless between the two groups. Conclusion The giant pituitary adenoma can be treated by microsurgical operation via single nostril-sphenoid sinus approach or via subfrontal approach. The cure rate of giant pituitary adenoma can be increased by postoperative treatments with bromocriptine and γ-knife.

OBJECTIVEThe progression of prostate cancer (PCa) after endocrine therapy varies widely in different PCa patients. This study aims to analyze the factors that influence the progression-free survival time of PCa patients after endocrine therapy in an attempt to improve the prognosis of the disease.

METHODSWe reviewed the clinicopathological data of 116 cases of prostate cancer treated by endocrine therapy, analyzed the clinicopathological factors that influence the progression-free survival time of PCa patients using univariate (log-rank test) and multivariate Cox proportional hazard models, and investigated the correlation among these factors by Spearman rank correlation analysis.

RESULTSIn the stepwise Cox proportional hazard model, the independent prognostic factors for PCa progression after endocrine therapy were found to be Gleason score (P < 0.01) and clinical stages (P < 0.01). The hazard of PCa progression after endocrine therapy increased 2.126 times that of the baseline for each unit of increase in Gleason score, and 6.625 times for each unit of increase in the clinical stage. The pretreatment PSA level was correlated with both clinical stages (P < 0.01) and Gleason score (P < 0.01).

CONCLUSIONClinical stages and Gleason score were important factors that influenced the progression-free survival time after endocrine therapy in this cohort of PCa patients.

Aged ; Aged, 80 and over ; Disease-Free Survival ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Prostate ; pathology ; Prostatic Neoplasms ; mortality ; pathology ; therapy

It is well known that cytoskeleton system is the sensor of gravity in cells. Under microgravity condition, cytoskeleton is associated with the changes of cell shape, function, signaling and so on; but the relationship between cytoskeleton and gene expression is not fully understood. In present study, we discussed the effects of cell microfilament on the activity of collagen type I alpha 1 chain gene (COL1A1) promoter under microgravity simulated by clinostat and/or cytochalasin B as microfilament depolymerizer in the established EGFP-ROS cell line using the method of fluorescence semi-quantitative analysis and the fluorescent stain of microfilament. Compared with the normal control, the microfilament of ROS17/2.8 cell tended to disassemble, marginal distribution of fiber stress, and showed reducing stress fibers after spaceflight in Photon-M1 or clinorotation simulated microgravity, which suggested that microgravity destroyed the well-order cell cytoskeleton and induced a rearrangement. Treatment with suitable concentration of cytochalasin B in normal gravity induced disruption of microfilament, increased the activity of COL1A1 promoter and resulted in a dose-dependent increase of EGFP fluorescence. Therefore, a certain extent disruption of the microfilament system was associated with increased activity of the COL1A1 promoter. All above demonstrate that microfilament cytoskeleton system takes part in the regulation of COL1A1 promoter activity and plays an important role in the signaling of microgravity.
Actin Cytoskeleton ; pathology ; physiology ; Animals ; Bone Neoplasms ; pathology ; Cell Line, Tumor ; Collagen Type I ; genetics ; Cytoskeleton ; pathology ; physiology ; Green Fluorescent Proteins ; genetics ; Osteosarcoma ; pathology ; Promoter Regions, Genetic ; Rats ; Transfection ; Weightlessness Simulation

The paper analyzes the current problems of medical students'humanistic quality and the causes,points out the necessity of strengthening the humanistic quality of medical students,and puts forward the countermeasures to be taken by libraries of medical colleges in the humanistic quality education for college students,including strengthening the construction of medical humanistic resources,doing well of medical humanistic reading guide and entrance education for new students,and strengthening reading promotion activities,etc.

BACKGROUNDHer-2/neu gene overexpression has been found in several malignancies, and is associated with poor prognosis; while its role in the tumorigenesis and progression of prostate cancer (PCa) is still controversial. This study aimed to evaluate the prognostic value of Her-2/neu protein expression and clinicopathologic factors in antiandrogen-treated Chinese men with PCa for disease progression and PCa-specific death.

METHODSHer-2/neu protein expression was determined using immunohistochemistry (IHC) in specimens collected from 124 prostate biopsies and transurethral resection of prostate (TURP) from seven prostate cancer patients.

RESULTSHer-2/neu protein expression was 0, 1+, 2+, and 3+ in 40 (30.5%), 8 (6.1%), 67 (51.1%), and 16 (12.2%) cases, respectively. Her-2/neu protein expression showed significant correlation as judged by Gleason score (P = 0.049), clinical tumor-node-metastases (cTNM) stage (P = 0.018) and disease progression (P = 0.001), but did not correlate with prostate-specific antigen (PSA) (P = 0.126) or PCa-specific death (P = 0.585). PSA (P = 0.001), Gleason score (P = 0.017), cTNM (P = 0.000) and Her-2/neu protein expression (P = 0.001) had prognostic value for evaluating the progression of PCa in univariate analysis. In Kaplan-Meier plots, both Gleason score (P = 0.035) and cTNM (P = 0.013) correlated with PCa-specific death. In multivariate analysis, only cTNM was significant for both disease progression (P = 0.001) and PCa-specific death (P = 0.031).

CONCLUSIONSHer-2/neu protein expression is significantly correlated with Gleason score, cTNM and disease progression, although it is not an independent predictor of disease progression and PCa-specific death. cTNM staging serves as an independent prognostic factor for disease progression and PCa-specific death.

Aged ; Aged, 80 and over ; Disease Progression ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Prostatic Neoplasms ; metabolism ; mortality ; pathology ; Receptor, ErbB-2 ; metabolism

OBJECTIVETo provide novel spectral domain optical coherence tomography (SD OCT) findings of Vogt-Koyanagi-Harada (VKH) disease as well as new insights into the pathogenesis of this disease.

METHODSDetailed SD OCT and fluorescein angiography (FA) findings of 18 consecutive VKH patients (11 women and 7 men) from December 2007 to April 2009 who were in acute uveitic stage at presentation were reviewed. All the patients had been followed up for at least 6 months with reevaluation(s) of SD OCT performed in 10 patients.

RESULTSIntraretinal cysts were found to be located in various layers of the outer retina. In addition to the photoreceptor layer, they could also be found between the outer plexiform layer and the outer nuclear layer, or spanning the external limiting membrane. On FA, intraretinal cysts could be hypofluorescent, normofluorescent, or hyperfluorescent. Some intraretinal cysts had a characteristic FA pattern, in which a small round hypofluorescent area was surrounded by a ring of hyperfluorescence (donut-shaped dye pooling). Subretinal fibrinoid deposit appeared in acute uveitic stage in two severe VKH patients and seemed to develop from subretinal exudates and evolved into typical subretinal fibrosis. Gradual transfiguration/migration and progressive proliferation/pigmentation of the subretinal fibrinoid deposit/subretinal fibrosis was observed in one patient.

CONCLUSIONSIntraretinal cysts could form in various layers of the outer retina and may result from extension of choroidal inflammation. Subretinal fibrosis may develop from subretinal exudates in VKH patients and may cause substantial visual impairment.

Adolescent ; Adult ; Cysts ; pathology ; Female ; Fibrosis ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retina ; pathology ; Tomography, Optical Coherence ; methods ; Uveomeningoencephalitic Syndrome ; etiology ; pathology

OBJECTIVETo investigate the clinical characteristics, treatment outcomes, prognosis, delayed toxicity of Hodgkin's lymphoma with extranodal Involvement.

METHODSThirty patients newly diagnosed as Hodgkin's lymphoma with extranodal involvement from April 2008 to September 2014 were retrospectively analyzed.

RESULTSTwenty-seven patients suffered from the advanced-stage diseases, their major pathological changes were nodular sclerosis and mixed cellular type, the most commonly involeved extranodal sites were the lung and bones, followed by the liver, stomach and intestine. The common clinical presentation was assotiated with the involved organs. Multivariate analysis showed that albumin and the international prognostic score (IPS) were independent prognostic factors for 5-year DFS rate, the 5-year OS rate was only associated with IPS. Out of 20 patients received chemotherapy, 10 received the combined modality therapy. At the median follow-up of 51 months, the estimated 5-year OS and PFS rates were 89.3% and 78.9%, respectively. Delayed toxicities were observed in 3 patients, including Ewing's sarcoma of llium, hyperplasia of mammary glands and diabetes millitus. 5 patients kept fertility, no interstitial lung disease, lung cancer and cardiovascular disease occurred. It was not found that patients died from the treatment-related complications.

CONCLUSIONThe therapeutic strategies for the Hodgkin's lymphoma patients with extranodal involvement should be similar to normal Hodgkin's lymphoma.

Antineoplastic Combined Chemotherapy Protocols ; Combined Modality Therapy ; Hodgkin Disease ; diagnosis ; drug therapy ; pathology ; Humans ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Treatment Outcome