ObjectiveTo investigate the value of aspartate aminotransferase-to-platelet ratio index （APRI） and platelet-albumin-bilirubin （PALBI） score in predicting the risk of esophagogastric variceal bleeding in patients with liver cirrhosis. MethodsA total of 119 patients with liver cirrhosis who were admitted to The First Affiliated Hospital of Soochow University from May 2021 and June 2022 were enrolled， and clinical data， routine blood test results， serum biochemistry， and coagulation test results were collected from all patients. According to the presence or absence of esophagogastric variceal bleeding， the patients were divided into non-bleeding group with 59 patients and bleeding group with 60 patients， and a comparative analysis was performed for the two groups. The independent samples t-test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-squared test or the Fisher’s exact test was used for comparison of categorical data between groups. The multivariate Logistic regression analysis was used to identify the independent risk factors for esophagogastric variceal bleeding in patients with liver cirrhosis and establish a nomogram predictive model. ResultsThe male patients accounted for 75.00% in the bleeding group and 40.68% in the non-bleeding group， and there was a significant difference in sex composition between the two groups （χ²=14.384， P<0.001）. Chronic hepatitis B was the main etiology in both the bleeding group and the non-bleeding group （53.33% vs 38.98%）， and there was no significant difference in composition ratio between the two groups （χ²=2.464， P=0.116）. Compared with the non-bleeding group， the bleeding group had a significantly higher activity of AT-IIIA （t=3.329， P=0.001） and significantly lower levels of PLT， TBil， Ca， TC， and TT （all P<0.05）. There were significant differences in APRI and PALBI between the two groups （χ²=6.175 and 19.532， both P<0.05）. The binary logistic regression analysis showed that APRI （odds ratio ［OR］=0.309， 95% confidence interval ［CI］： 0.109‍ ‍—‍ ‍0.881， P=0.028）， PALBI （OR=7.667， 95%CI： 2.005‍ ‍—‍ ‍29.327， P=0.003）， Ca （OR=0.001， 95%CI： 0.000‍ ‍—‍ ‍0.141， P=0.007）， TC （OR=0.469， 95%CI： 0.226‍ ‍—‍ ‍0.973， P=0.042）， and TT （OR=0.599， 95%CI： 0.433‍ ‍—‍ ‍0.830， P=0.002） were independent influencing factors for esophagogastric variceal bleeding in liver cirrhosis. A nomogram model was established based on the above factors and had an index of concordance of 0.899 and a well-fitted calibration curve. ConclusionAPRI and PALBI have a good value in predicting esophagogastric variceal bleeding in patients with liver cirrhosis， and the nomogram model established based on this study can predict the incidence rate of esophagogastric variceal bleeding in patients with liver cirrhosis.

PURPOSE: Rapid decompressive craniectomy (DC) was the most effective method for the treatment of hypertensive intracerebral hemorrhage (HICH) with cerebral hernia, but the mortality and disability rate is still high. We suspected that hematoma puncture drainage (PD) + DC may improve the therapeutic effect and thus compared the combined surgery with DC alone. METHODS: From December 2013 to July 2019, patients with HICH from Linzhi, Tibet and Honghe, Yunnan Province were retrospectively analyzed. The selection criteria were as follows: (1) altitude ≥1500 m; (2) HICH patients with cerebral hernia; (3) Glascow coma scale score of 4-8 and time from onset to admission ≤3 h; (4) good liver and kidney function; and (5) complete case data. The included patients were divided into DC group and PD + DC group. The patients were followed up for 6 months. The outcome was assessed by Glasgow outcome scale (GOS) score, Kaplan-Meier survival curve and correlation between time from admission to operation and prognosis. A good outcome was defined as independent (GOS score, 4-5) and poor outcome defined as dependent (GOS score, 3-1). All data analyses were performed using SPSS 19, and comparison between two groups was conducted using separate t-tests or Chi-square tests. RESULTS: A total of 65 patients was included. The age ranged 34-90 years (mean, 63.00 ± 14.04 years). Among them, 31 patients had the operation of PD + DC, whereas 34 patients underwent DC. The two groups had no significant difference in the basic characteristics. After 6 months of follow-up, in the PD + DC group there were 8 death, 4 vegetative state, 4 severe disability (GOS score 1-3, poor outcome 51.6 %); 8 moderate disability, and 7 good recovery (GOS score 4-5, good outcome 48.4 %); while in the DC group the result was 15 death, 6 vegetative state, 5 severe disability (poor outcome 76.5 %), 4 moderate disability and 4 good recovery (good outcome 23.5 %). The GOS score and good outcome were significantly less in DC group than in PD + DC group (Z = -1.993, p = 0.046; χ CONCLUSION PD + DC treatment can improve the good outcomes better than DC treatment for HICH with cerebral hernia at a high altitude.
Adult ; Aged ; Aged, 80 and over ; Altitude ; China ; Decompressive Craniectomy ; Drainage ; Encephalocele/surgery* ; Hematoma ; Humans ; Intracranial Hemorrhage, Hypertensive/surgery* ; Middle Aged ; Prognosis ; Punctures ; Retrospective Studies ; Treatment Outcome

BACKGROUNDAn zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.

METHODSThis prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.

RESULTSIn terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.

CONCLUSIONAZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.

Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stavudine ; administration & dosage ; adverse effects ; therapeutic use ; Zidovudine ; administration & dosage ; adverse effects ; therapeutic use

Two sample pretreatment methods of pesticide residues in Panax notoginseng of Chinese traditional medicine were developed. For Method I, the residues were extracted from homogenized tissue with n-hexane-dichloromethane (6:4) by means of ultrasonication, the crude extract was purified by an Envi-carb/NH2 solid-phase extraction (SPE) column. For Method II, matrix solid-phase dispersion (MSPD) technique was used for extracting and cleaning up. The eluates were concentrated by rotary evaporation, and then were redissolved in dichloromethane prior to GC-MS determination. The determination was performed in selected ion monitoring (SIM) mode with the external calibration for quantitative analysis. Under the optimal conditions, the results indicated that the methods are easier and faster, the recoveries of method I for the spiked standards at concentration of 0.01, 0.5, and 2.0 mg x kg(-1) were 81.90%-102.10% with the relative standard deviations (RSDs) of 3.60%-7.10%. The recoveries of method II were 96.26%-104.20% with the RSDs of 3.52%-7.94%. The detection limits (S/N) for residues of pesticides were in the range of 0.48-1.34 ng x g(-1). The results indicated that these multiresidue analysis methods can meet the requirements for determination of residue pesticides and can be appropriate for trace analysis of residue pesticides in Panax notoginseng.
Analytic Sample Preparation Methods ; methods ; Gas Chromatography-Mass Spectrometry ; Hexanes ; chemistry ; Methylene Chloride ; chemistry ; Panax notoginseng ; chemistry ; Pesticide Residues ; analysis ; Solid Phase Extraction ; Solvents

OBJECTIVETo investigate the alkaloids from Aconitum handelianum.

METHODThe column chromatographic methods were employed for the isolation and purification of the chemical constituents. The structures were elucidated by spectroscopic methods.

RESULTEight diterpenoid alkaloids were isolated and identified as acoforine (1), acoforestinine (2), 14-O-acetylsachaconitine (3), vilmorrianine C (4), vilmorrianine D (5), talatizamine (6), chasmanine (7) and yunaconitine (8).

CONCLUSIONAll compounds were isolated from this plant for the first time.

Aconitum ; chemistry ; Alkaloids ; analysis ; isolation & purification ; Diterpenes ; analysis ; isolation & purification ; Drugs, Chinese Herbal ; analysis ; isolation & purification

[Objective] The aim of this study was to establish a quantitative SYBR Green Ⅰ real-time PCR method for detection of wide-type p53-induced phosphatase 1 (Wip1 or PPM1D) gene expression level in non-small cell lung cancer (NSCLC),and to investigate the relationship between Wip1 mRNA expression level and the clinicopathological characters.[Method] Real-time PCR was employed to determine the expression level of Wip1 mRNA in 44 specimens of NSCLC tissues and their adjacent normal tissues.[Results] In the 44 specimens,the expression of Wip1 mRNA in both cancer tissues and adjacent normal lung tissues were positive.Wip1 gene was overexpressed in 17 specimens among 44 NSCLC specimens.The rate was 38.6%.The relative level of Wip1 mRNA in NSCLC tissues was significantly higher than the adjacent normal lung tissues (Ratio ＝ 2.1644 ± 1.394,P ＜ 0.01).The expression of Wip1 mRNA was also correlated with pathological staging (F ＝ 5.08,P ＝ 0.013).[Conclusion] The established SYBR Green Ⅰ quantitative real-time PCR method can successfully detect the expression level of Wip1 mRNA.The results suggested that Wip1 may be involved in the development of NSCLC.

OBJECTIVE To investigate the resistance and the distribution of the main ?-lactamases encoding gene in Acinetobacter baumannii isolated from four hospitals in Hangzhou city to provide the basic data for the optional treatment of A.baumannii infection.METHODS The identification of A.baumannii was performed using VITEK-AMS60.The minimum inhibitory concentrations(MIC) was examined by agar dilution and E-test.The homology of the resistant isolates was finished by pulsed field gel electrophoresis(PFGE).PCR and sequencing were used to analyze the ?-lactamases encoding gene of the 36 strains of imipenem-resistant A.baumannii.RESULTS All of the imipenem-resistant isolates produced carbapenemase OXA-23,and 5 isolates produced PER-1,2 isolates produced TEM-1 except OXA-23.No metallo-?-lactamases were detected.No plasmid was extracted.Clone transmission of the imipenem-resistant strains existed in the 4 hospitals.Most strains were isolated from intensive care unit(ICU). CONCLUSIONS The clone transmission of imipenem-resistant A.baumannii strains is occurred in 4 hospitals.All strains produce carbapenemase OXA-23.Five strains also produce PER-1 type extended-spectrum ?-lactamases.Two strains also produce TEM-1 type extended-spectrum ?-lactamases.

Purpose:To investigate the relation of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) to tumor progression of cervical carcinoma. Methods:The expression and localization of COX-2 and iNOS protein in the 25 patients with cervical carcinomas were determined by immunohistochemical and the gene expression of COX-2 and iNOS were examined by reverse-transcription polymerase chain reaction ( RT-PCR). Results:Immunohistochemical staining for COX-2 and iNOS expression was strongly positive in 15 of 25 (60 %) and 20 of 25 (80 %) cases,respectively. Increased COX-2 and iNOS mRNA levels were confirmed by RT-PCR. There was negative correlation between COX-2 expression and tumor cell differentiation(r=-0.420, P

Wip1 is a nuclear protein and a member of serine/threonine specific protein phosphatase type 2C(PP2C)family.It was initially identified as a gene whose expression was induced in response to ? or UV radiation in a p53-dependent manner and a negative feedback regulation of p38MAPK-p53 signaling.Then,Wip1 gene was confirmed a proto-oncogene and amplified or overexpressed in several human tumor types.This review will introduce the structures and functions of Wip1 and details on the signaling process of cancer progression.