Objective To evaluate the efficacy of pegylated interferon ( PegIFN ) α-2a plus ribavirin ( RBV) therapy for chronic hepatitis C ( CHC) in non-responders, and to investigate the related influencing factors.Methods A prospective, open, multicenter and randomized study was conducted.A total of 81 CHC non-responders were recruited from 10 clinical centers during February 2009 to November 2011.Patients were randomly assigned into two groups:group A (n=37) was given PegIFNα-2a plus RBV treatment for 72 weeks and group B (n=44) was given PegIFNα-2a plus RBV treatment for 96 weeks.Both groups were followed up for 24 weeks after treatment.Virological responses in two groups were observed, and treatment efficacies among patients with different genotypes, and among those with different previous treatment were compared.SAS software was used for statistical analysis.Results Fifty-two patients ( 28 from group A and 24 from group B) completed the study in total.The rates of rapid virological response ( RVR) , complete early virological response ( cEVR ) , end of treatment viral response ( ETVR ) and sustained virological response (SVR) in group A were 25.0% (7/28), 60.7% (17/28), 67.9%(19/28) and 60.7%(17/28), respectively; while those in the group B were 41.7% (10/24), 70.8%(17/24), 70.8%(17/24) and 70.8% (17/24), respectively; and there were no significant differences between two groups (P>0.05).SVR was observed in 82.9%(29/35) of patients with CC genotype of IL-28B, which was higher than that in patients with other genotypes ( 3/13 ) , and the difference was of statistical significance (P<0.01).There was no significant difference in viral responses between patients previously treated with IFN plus RBV and those treated by IFN only (P>0.05).The rates of RVR, cEVR, ETVR and SVR in patients who were previously treated with IFN were 36.4%(12/33), 81.8%(27/33), 81.8%(27/33) and 75.8%(25/33), and the rates of cEVR, ETVR and SVR were higher than those in patients who were previously treated with PegIFN (P<0.05), but no significant difference was observed in RVR (P>0.05).Adverse events occurred in 38 patients (46.9%), but no severe ones were observed. Conclusion The efficacy of PegIFNα-2a plus RBV therapy for CHC in non-responders is satisfactory, which may influenced by IL-28B genotypes and previous treatment.

Humans ; Liver ; abnormalities ; anatomy & histology ; Liver Transplantation ; methods ; Male ; Middle Aged ; Situs Inversus ; complications ; Tissue Donors

Objective To explore the effects of disease adaptation intervention in young and middle-aged patients undergoing early stage of peritoneal dialysis.Methods Using convenience sampling method,a total of 88 patients undergoing early stage of peritoneal dialysis were assigned into the experimental group and the control group from the inpatient ward of Nephrology Department of a tertiary hospital in Zhengzhou City.The experimental group received the comprehensive adaptation intervention and routine care,and the control group only received routine care.Before and after the intervention,the Psychosocial Adjustment to Illness Scale(PAIS-SR) and Short Form of 36 health survey questionnaire (SF-36) were used to assess the disease adaptability and quality of life of two groups,and the degree of edema and serum albumin index of two groups were recorded.Results Before and after the intervention,there were significant differences in the scores of psychosocial adaptation and each dimension,the scores of physical health and mental health in the experimental group,and the differences were statistically significant (P＜ 0.05);there were significant differences in the scores of psychosocial adaptation and each dimension in control group,and the differences were statistically significant(P＜0.05),but the differences of the scores of physical health and mental health were not statistically significant(P＞0.05).After the intervention,there were significant differences in the scores of psychosocial adaptation and each dimension,the scores of physical health and mental health between the two groups(P＜0.05);but the differences of serum albumin and edema index of two groups were not statistically significant(P＞0.05).Conclusion Comprehensive adaptation intervention can improve the ability of disease adaptation and the quality of life in young and middle-aged patients undergoing early stage of peritoneal dialysis.

OBJECTIVETo set up a stand for surgical classification of pancreatic duct stone and evaluate the benefits of different management according to the classification.

METHODSRetrospectively analysis the diagnosis and prognosis of different management of 33 cases pancreatic duct stones to establish a new standard of classification and strategy of management of pancreatic duct stone.

RESULTSAccording to the results of imaging examination (B-US, CT, ERCP) and finding during surgery, pancreatic duct stone can be classified into four different types: Type I: The stones mainly located in the head of pancreas. Endoscopic pancreas drainage and remove of stones is the first line choice of treatment. If it fail the Whipple procedure should be applied. Type II, The stones mainly located in the body of pancreas. It can be treated by Pusetow procedure. Type III, The stones mainly located in the tail of pancreas. The resection of the tail of pancreas or combined with spleenectomy was recommended for the management of this type stones. Type IV, The stones can be found from the head to tail of the main duct of pancreas. The Pusetow-Gillesby procedure or dividing of the neck of pancreas removing stones from both ends of pancreatic duct and reconstructed by two ends pancreatic duct-ileostomy in Roux-en-Y fashion are the choice of management.

CONCLUSIONThe invadulaized strategy of the management based upon correct diagnosis and classification play the most important role in the treatment of pancreatic duct stone.

Adult ; Aged ; Calculi ; classification ; diagnosis ; surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Diseases ; classification ; diagnosis ; surgery ; Pancreatic Ducts ; diagnostic imaging ; pathology ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVETo clone novel gene from suppression subtraction library established for screening down-regulated genes in gastric carcinoma, and the effects of novel gene on gastric tumorigenicity were analyzed.

METHODSSequencing results of 860 positive colonies chosen randomly were compared by Blast program in GenBank. Novel gene fragment was amplified by rapid amplification of cDNA ends (RACE). The mRNA expression of novel gene was detected by Northern blot and semi-quantitative PCR in 25 cases of gastric carcinoma tissue and counterpart normal gastric mucosa. The structure and chromosomal location of novel gene were investigated by Bio-message technique.

RESULTSA 233 bp novel gene fragment was screened out from 860 clones and a 802 bp novel gene was obtained by RACE. The novel gene was named as GDDM, registered in the number of AF494508 by GenBank. The mRNA expression of GDDM in gastric carcinoma tissue (4.496+/-0.637) was significantly lower than that in the counterpart normal gastric mucosa (36.919+/-6.290)(P<0.01). Chromosomal location of GDDM gene was at 4q31.

CONCLUSIONThe cloned novel gene, GDDM, is down-regulated in gastric carcinoma, and it is likely to be involved in gastric tumorigenicity.

Base Sequence ; Cloning, Molecular ; DNA, Complementary ; Down-Regulation ; Gene Amplification ; Gene Expression Regulation, Neoplastic ; Gene Library ; Genes, Neoplasm ; Humans ; Molecular Sequence Data ; Stomach Neoplasms ; genetics ; metabolism

OBJECTIVETo confirm the GDDR cDNA property of novel down-regulated full-length gene in gastric cancer, structure of genomic GDDR DNA and its promotor region. To predict its transcription factors and transcription factor binding sites. To explore function of GDDR gene in vitro.

METHODSGDDR mRNA was located by in situ mRNA hybridization of gastric mucous membranes, and was amplified in 13 human organs and tissues. The structure and location of GDDR on chromosome, property of protein encoded by full-length GDDR were investigated by Bio-message technique. Promotor region of GDDR was confirmed, and transcription factors or their binding sites were predicted in software Gene2promoter and Matinspector of Genomatix. Both of vector pcDNA3.1/Myc-His(-)A inserted by GDDR ORF and control vector pcDNA3.1/Myc-His(-)A were respectively transfected into gastric cell lines 7901 by lipofectamin. Growth curve, MTT test and a morphological analysis were respectively performed.

RESULTSGDDR mRNA was located in gastric mucous epithelial cells, and only was expressed in gastric tissue. 7739 bp genomic GDDR DNA located on chromosome 2p13.3, 21701 bp away from CA11-one stomach-specific gene related to gastric cancer. 618 bp promotor region of GDDR located at position +96 bp,and -419 bp of transcription start site of GDDR. The structure of genomic DNA or cDNA between gene GDDR and CA11 was mostly similar. Sequences of their promotor region were different, transcription factors and their binding sites also varied between gene GDDR and CA11. GDDR encoded protein including a trans-membrane peptide homologed to CA11 that have been proven to encode secrete protein. GDDR was another new member of BRCHOS family just was found. Gastric cell lines 7901 transfected by GDDR showed a marked decrease in growth rate by growth curve and MTT test (72 h, 0.341 +/- 0.014 vs 0.488 +/- 0.015 A, P < 0.01).

CONCLUSIONSStamoch-specific, novel down-regulated gene GDDR in gastric cancer locates in gastric mucous epithelial cells can markedly inhibit growth of gastric cancer cell lines 7901, GDDR is another new member of BRICHOS family related to gastric cancer except CA11.

Amino Acid Sequence ; Animals ; Base Sequence ; Carrier Proteins ; Chromosomes, Human, Pair 2 ; genetics ; DNA, Complementary ; chemistry ; genetics ; Down-Regulation ; Humans ; In Vitro Techniques ; Membrane Proteins ; genetics ; Neoplasm Proteins ; Promoter Regions, Genetic ; genetics ; Stomach Neoplasms ; genetics ; Tumor Cells, Cultured

OBJECTIVETo assess the clinical outcomes of rotational atherectomy followed by drug-eluting stenting via the transradial approach for the treatment of heavily calcified coronary lesions.

METHODSFrom January 2009 to October 2012, 114 consecutive patients with heavily calcified coronary lesions underwent rotational atherectomy and drug-eluting stents via transradial approach in our hospital were enrolled in this retrospective study. Characteristics of heavily calcified coronary lesions, the success rates of rotational atherectomy and stenting, rates of complication during perioperative treatments, and adverse cardiovascular events during hospitalization and follow up were analyzed.

RESULTSAll 114 patients were successfully treated with rotational atherectomy and drug-eluting stent placement, and totally 120 target lesions of type B or C were treated including 8 left main lesions, 93 left anterior descending and 2 circumflex, 17 right coronary lesions. No-reflow was observed in 7 patients during the procedure, there was one case of entrapped rotablator burr which was successfully retrieved together with guiding catheter without serious complication. During the 6 months (median) follow-up, angina was reported in 11 patients and revascularization was performed in 8 patients due to stent restenosis and intensified medical therapy was applied in 3 patients. There was no acute myocardial infarction and death during follow-up.

CONCLUSIONRotational atherectomy followed by drug-eluting stenting via transradial approach is feasible, effective and safe and the short-term outcome is satisfactory for patients with heavily calcified coronary lesions.

Adult ; Aged ; Aged, 80 and over ; Atherectomy, Coronary ; methods ; Coronary Artery Disease ; surgery ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radial Artery ; surgery ; Retrospective Studies ; Treatment Outcome

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Disease ; therapy ; Coronary Restenosis ; prevention & control ; Drug Delivery Systems ; Female ; Follow-Up Studies ; Humans ; Male ; Metals ; Middle Aged ; Retrospective Studies ; Stents

OBJECTIVETo compare the clinical and angiographic outcome in patients with total occlusion lesion treated with drug-eluting stent (DES) or bare-metal stent (BMS).

METHODSA total of 155 (138 males) consecutive patients with total occlusion lesion underwent successful revascularization with DES (n = 74) or BMS (n = 81) in our hospital were included in this study. All patients received aspirin 300 mg and clopidogrel 75 mg once daily for at least 3 months after the procedure. Clinical and angiographic follow-up were completed in all patients at 6 months post stenting.

RESULTSDemographic data between the two groups were similar except there was more diabetic patients in DES group (33.8% vs. 18.5%, P < 0.05). A total of 232 stents for 159 target lesions (77 treated with DES, 82 treated with BMS) were implanted. There were 85.4% C ACC/AHA type lesions and 17.0% lesions were treated with overlapping stents. Six months post stenting, the incidence of restenosis (15.6% vs. 41.5%, P < 0.001), the cumulative rate of major adverse cardiac events (MACE) (1.4% vs. 11.1%, P = 0.032) and TLR (5.8% vs. 19.9%, P = 0.001) were significantly lower in DES group than that of BMS group. The incidence of local restenosis in DES group is higher in DES group than that in BMS group (58.3%, 17.6%, P < 0.001). Two DES treated patients developed late in-stent thrombosis.

CONCLUSIONFor patients with total occlusion lesion, the clinical and angiographic outcome 6 months post DES stenting is clearly superior to that of BMS stenting.

Aged ; Coronary Angiography ; Coronary Disease ; complications ; diagnostic imaging ; therapy ; Diabetes Mellitus, Type 2 ; complications ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Hypertension ; complications ; Male ; Middle Aged ; Prognosis ; Stents

OBJECTIVECompare drug-eluting stent (DES) to bare-metal stent (BMS) in prognosis on treating diffuse coronary lesions and analysis risk factor of treating complex and diffuse lesions in PCI.

METHODS205 consecutive patients with complex and diffuse coronary lesions enrolled our hospital, who were treated with more than 25 mm long DES or BMS. We exclude unsuccessful operation and location. All patients received medical treatment by guideline, and aspirin 300 mg and clopidogrel 75 mg once daily were continued at 6 months after the procedure. The patients were followed up after 6 months.

RESULTSThe study population were consisted of 205 patients that there were 181 man, and 24 women, who got 382 stents for 227 target lesions in coronary. There were 93.8% C and 6.2% B2 ACC/AHA type lesion. There were 86.8% patients with binary or above vessel treated. The average reference vessel diameter was 2.88 +/- 0.43 mm. The average stent length of per lesion was 40.09 +/- 12.94 mm. There were 54.2% lesions treated with overlapping stent. There were not different between DES and BMS in patients baseline characteristics, but RVD of group DES less than of group BMS (2.80 +/- 0.37 mm, 3.10 +/- 0.48 mm, P = 0.005) in lesion baseline characteristics. After 6 months, restenosis rate in group DES was less than in group BMS (15.4%, 48.4%, P < 0.001). There were obvious superiority TVR of DES than of BMS (11.6%, 38.5%, P < 0.001). The rate of local restenosis in group of DES was higher than that in group of BMS (33.3%, 18.2%, P = 0.029). We analyzed the risk factors for diffuse lesion by a logistic regression model, the significant univariate clinical and angiographic predictors of restenosis were treating with overlapping stent (OR = 2.82, P = 0.017) and drug-eluting stent (OR = 5.71, P < 0.001).

CONCLUSIONSWe find that implantation of DES in patients with diffuse lesions in coronary is relatively more safe and associated with more good clinical outcomes, than of BMS.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Artery Disease ; diagnostic imaging ; therapy ; Coronary Restenosis ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Stents ; Treatment Outcome