OBJECTIVE: Photodynamic therapy has become an important method in clinical tumor treatment. This study aimed to investigate the effects of hematoporphyrin on multiple myeloma (MM) and its potential applications. METHODS: The MM cell line RPMI 8226 was treated with hematoporphyrin derivative (HPD), and CCK-8 assay was used to determine cell viability, apoptosis was detected by flow cytometry, intracellular reactive oxygen species (ROS) levels were measured using a detection kit combined with flow cytometry, and Western blot assay was used to detect apoptosis-related proteins and key signaling pathway protein levels. RESULTS: The optimal incubation time for the maximum absorption of HPD in RPMI 8226 cells was 4 hours. HPD significantly inhibited the proliferation of RPMI 8226 cells in a dose- and illumination time-dependent manner ( r =0.981; r =0.961). Additionally, HPD induced apoptosis in RPMI 8226 cells, but had no significant inhibitory effect on peripheral blood mononuclear cells derived from healthy individuals. HPD combined with illumination treatment significantly increased the intracellular ROS level, upregulated the expression of apoptosis-related proteins such as cleaved PARP, cleaved caspase-3 and Bax, and down-regulated the expression of proteins that maintain cell survival, such as NF-κB and Akt. CONCLUSION The HPD can inhibit the proliferation and induce apoptosis of multiple myeloma cells.
Humans ; Multiple Myeloma/pathology* ; Hematoporphyrins/pharmacology* ; Apoptosis/drug effects* ; Cell Line, Tumor ; Reactive Oxygen Species/metabolism* ; Cell Proliferation/drug effects* ; Photochemotherapy ; Cell Survival/drug effects* ; Signal Transduction

ObjectiveTo compare the effects of programmed intermittent epidural bolus （PIEB） and continuous epidural infusion （CEI） on enhanced recovery after cesarean section. MethodsTotally 120 women scheduled to undergo elective cesarean section under combined spinal and epidural anesthesia， aged 18-45 years， with single fetus， full-term pregnancy （≥37 weeks）， ASA grade II or III， were recruited， with 60 cases in each group. At the end of the surgery， after a similar epidural loading dose， patients were randomLy assigned to receive either PIEB （6 mL·h^-1 beginning 30 minutes after the loading dose） or CEI （6 mL·h^-1， beginning immediately after the loading dose） for the maintenance of analgesia with 0.1% ropivacaine. At 2， 6， 12， 24 and 36 h postoperatively， VAS score was used to evaluate the composite pain， and Bromage Score was used to evaluate the degree of lower extremity motor block. The time to first flatus， time to first ambulation and the satisfaction scores were also recorded. ResultsThe VAS scores at 12， 24 and 36 h postoperatively and the lower extremity motor block scores at 6， 12 and 24 h postoperatively in the PIEB group were significantly lower than those in the CEI group （P < 0.01）. The epidural analgesic dosage was less in the PIEB group than that of the CEI group （P=0.002）. The time to first flatus and time to first ambulation were significantly shorter than those in the CEI group （P < 0.05）. The satisfaction scores were significantly higher in the PIEB group than in the CEI group （P < 0.05）. There was no significant difference in the first urination time after urinary catheter removal and the length of hospital stay between the two groups （P > 0.05）. ConclusionCompared with CEI， PIEB provides better postoperative analgesia， less motor block scores， lower epidural analgesic dosage， shorter the time to first flatus and defecation and time to first ambulation， and greater patient satisfaction， which is more consistent with the ERAS concept of analgesia.

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.

Objective To explore the clinical application effects of the logistics robot as innovative mode in consumables management in operating room.Methods Clinical application experiment using self-designed medical logistics robot was conducted.During single point distribution,indicators including the average time/trip of logistics robots,the error rate of transporting goods,replacing the workload of the distributor,the incidence of cost loss,the right rate of avoiding pedestrians,the right rate of avoiding obstacles,the number of being lost,and the speed of operational reaction were recorded.The time of picking(T1),the delivery time(T2),and the check time(T3) of test between logistics robot and manual operation were compared.Results Experiment results were obtained from 422 trips using logistics robot during single point distribution,and the average time for each trip was 1.75 min.one logistics robot was able to take the workload of 3 to 4 people;logistics robot avoided pedestrians for 420 times;it avoided obstacles for 414 times,it was lost for 13 times,and its speed of operational reaction was normal for 419 times;the comparison results between logistics robot and manual operation showed that T1,P＞0.05;T2 and T3,P＜ 0.01,and the distribution time using robot was less than that of manual operation.Conclusion Using logistics robot for distribution of high value consumables can shorten the time of applying consumables,operation with high distribution accuracy and information precision.

This study aimed to examine the optimal conditions of laser-induced interstitial thermotherapy (LITT) via a single-needle delivery system, and the ablation-related pathological and ultrasonic changes. Ultrasound (US)-guided LITT (EchoLaser system) was performed at the output power of 2-4 Wattage (W) for 1-10 min in ex vivo bovine liver. Based on the results of the ex vivo study, the output power of 3 and 4 W with different durations was applied to in vivo rabbit livers (n=24), and VX2 tumors implanted in the hind limbs of rabbits (n=24). The ablation area was histologically determined by hematoxylin-eosin (HE) staining. Traditional US and contrast enhanced ultrasound (CEUS) were used to evaluate the treatment outcomes. The results showed: (1) In the bovine liver, ablation disruption was grossly seen, including a strip-like ablation crater, a carbonization zone anteriorly along the fiber tip, and a surrounding gray-white coagulation zone. The coagulation area, 1.2 cm in length and 1.0 cm in width, was formed in the bovine liver subjected to the ablation at 3 W for 5 min and 4 W for 4 min, and it extended slightly with the ablation time. (2) In the rabbit liver, after LITT at 3 W for 3 min and more, the coagulation area with length greater than or equal to 1.2 cm, and width greater than or equal to 1.0 cm, was found. Similar coagulation area was seen in the implanted VX2 carcinoma at 3 W for 5 min. (3) Gross examination of the liver and carcinoma showed three distinct regions: ablation crater/carbonization, coagulation and congestion distributed from the center outwards. (4) Microscopy revealed four zones after LITT, including ablation crater/carbonization, coagulation, edema and congestion from the center outwards. A large area with coagulative necrosis was observed around a vessel in the peripheral area with edema and hyperemia. (5) The size of coagulation was consistent well to the CEUS findings. It was concluded that EchoLaser system at low power can produce a coagulation area larger than 1.0 cm×1.0 cm during a short time period. The real-time US imaging can be used to effectively guide and assess the treatment.
Animals ; Bone Neoplasms ; diagnostic imaging ; pathology ; therapy ; Cattle ; Hindlimb ; pathology ; Laser Therapy ; instrumentation ; methods ; Liver Diseases ; diagnostic imaging ; therapy ; Rabbits ; Treatment Outcome ; Ultrasonic Therapy ; instrumentation ; methods ; Ultrasonography

AlM:To investigate the factors and solutions of Tibetan Plateau excimer laser in situ keratomileusis ( LASlK ) for myopia overcorrection.METHODS: The relevant information, 32 cases ( 58 eyes) in 126 cases (252 eyes) had obvious overcorrection after LASlK were analyzed.RESULTS: Two months after surgery, 32 cases ( 58 eyes) overcorrection (23. 0%), uncorrected visual acuity of 0. 5 ~0. 8, overcorrection range of +1. 50 ~ +2. 25DS, subjective inserts were ≥ 1. 0; Five case ( 7 eyes ) overcorrection 6mo after surgery (2. 8%), uncorrected visual acuity 0. 8~1. 0-2 , overcorrection range is +0. 75 ~+1. 25DS, subjective inserts were≥1. 0. Corneal thickness of overcorrection was 500~563μm, preoperative refraction was -5. 00 ~ -7. 50D, astigmatism -1. 50 ~ -2. 75DC, preoperative best corrected visual acuity ≥1. 0.CONCLUSlON: Overcorrection and long recovery time after LASlK in Tibet, possibly with local factors altitude, temperature, humidity, surgical parameters and situation.

The diagnosis of postradiation nasopharyngeal skull base lesions in petients with nasopharyngeal carcinoma (NPC) is still a tough problem in clinical practice. An early and accurate diagnosis is important for subsequent management. We prospectively evaluated the diagnostic value of plasma Epstein-Barr virus(EBV) DNA in detecting postradiation nasopharyngeal skull base lesions in NPC patients. From July 2006 to September 2010, 90 patients with postradiation NPC (34 women and 56 men; median age: 42 years) met the selection criteria and were recruited in this study. All postradiation nasopharyngeal skull base lesions were found in the latest magnetic resonance imaging (MRI) examinations before endoscopic surgery, and the nasopharyngeal cavity was normal under flexible nasopharyngoscopy. Plasma EBV DNA detection was performed within 2 weeks before endoscopic surgery. A total of 90 endoscopic operations were successfully performed without any postoperative complications. Recurrences confirmed by postoperative pathology were found in 30 patients. The specificity, positive and negative predictive values of plasma EBV DNA detection were better than those of MRI. In addition, combining plasma EBV DNA detection with MRI improved the specificity and positive predictive values of MRI. Plasma EBV DNA detection followed by MRI would help to diagnose recurrence whereas MRI was unable. These results indicate that plasma EBV DNA is an effective and feasible biomarker for detecting postradiation nasopharyngeal skull base lesions in NPC patients.
Adult ; Carcinoma, Squamous Cell ; blood ; radiotherapy ; virology ; DNA, Viral ; blood ; Endoscopy ; Female ; Follow-Up Studies ; Herpesvirus 4, Human ; genetics ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; blood ; radiotherapy ; virology ; Nasopharynx ; pathology ; Neoplasm Recurrence, Local ; diagnosis ; virology ; Neoplasm, Residual ; Osteoradionecrosis ; diagnosis ; surgery ; Prospective Studies ; Skull Base ; pathology

Objective To identify the epidemic characteristics and risk factors of an emerging infectious disease-severe fever with thrombocytopenia syndrome (SFTS) in Hubei province.Methods Active surveillance program on SFTS was set up in monitoring sites-hospitals,at the township level or above,in Suizhou,Huanggang and Wuhan from January to December,2010.Specific surveillance program on SFTS was launched across the province in hospitals above the county level.Cases that matched the definition of surveillance case were identified and reported to Centers for Disease Control and Prevention (CDCs).Cases were interviewed and their blood samples collected and detected using PCR and virus isolation.We also conducted serum antibody surveys among healthy population and livestock and surveillance on vector ticks in those high-epidemic areas.Results 188 cases that matched the definition of surveillance case and 21 deaths were reported in 11 cities,32 countries and 100 towns in 2010,with an incidence rate of 0.33/106.The fatality rate was 11.2％.Data showed that the patients were from hilly areas at the altitude elevated between 28-940 meters.The epidemic period was between April and December with the peak from May to September.The youngest case was an 11-year old,while the eldest was 81 with median age as 56-year old.95.3 ％ of the patients were farmers.All Patients did not have the history of traveling,two weeks before the onset of SFTS.93.6％ of the patients engaged in different kind of work which was associated with agriculture.52.8％ of the patients had been exposed to ticks.22.0％ of the patients had been bitten by ticks.Skin injury was found in 64.2％ of the patients.Samples from 129 cases (68.6％) were collected and detected,with 67.4％ of them (87 cases) showed positive by Real time-PCR for SFTS virus.An elevation in antibody titer by a factor of four or evidence of sero-conversion was observed in 11 patients; SFTS virus was isolated from 2 patients.The total antibody positive rates were 3.8％,55.0％ (6/11 ),36.7％ (2/3) and 80.0％ (4/5) respectively in healthy population,dogs,sheep and cows.Ticks from grass,cattle and sheep were detected positive by Real time-PCR.Conclusion Most cases of SFTS in Hubei were infected by SFTS virus,and cases of livestock were infected by SFTS virus.Ticks might serve as an important vector.Skin injury,exposure to tick bites seemed to be the risk factors.

Objective To study on thyroid bilateral gland lobe disease with endoscopic monolateral anterior chest approach. Methods Twenty patients experienced thyroid bilateral gland lobe surgery with endoscopic monolateral anterior chest approach;24 experienced conventional surgery simultaneously and were enrolled in control group. Two groups were compared at surgical style, complications, surgical time, length of stay in hospital, incision cosmetic result and incision pain etc. Criteria of patients selected for thyroid bilateral gland lobe surgery with endoscopic monolateralanterior chest approach: with no surgical history of thyroid or other neck-related diseases and no chemotherapy; diagnosed with benign tumor according to presurgery CT result and thyroid functional examination. Diameter of tumor on both sides should be smaller than 4 cm, one side smaller than 2 cm, located at lower middle part of gland lobe and near to glandsurface. Results Patients in both groups matched in age and sex; scorings on surgical style, hospital stay, postoperative drainage, and postoperative pain were not significantly distinctive. Endoscopic group had less bleeding volumm than conventional group during surgery, better cosmetic results, but longer surgical duration and higher cost of hospitalization. Both groups occurred no permanent glottic paralysis and hypocalcemia, norecurrence. Endoscopic group had one case ecchymoma; one case temporary glottic paralysis; both recoveredin one month. Complication incidence in both groups was not significantly distinctive(x~2=2.514,P=0.201).Conclusions Gasless endoscopic monolateral anterior chest approach can well treat selected thyroid bilateral gland lobe disease and with a better cosmetic result than conventional surgery.

OBJECTIVETo search for the best way to elevate the clinical therapeutic effect in the hemiplegic patient of cerebral thrombosis at convalescent period.

METHODSAdopting single-blind, randomized controlled method, 90 cases of cerebral thrombosis at convalescent period were assigned to 3 groups: a scalp acupuncture group (group A), a rehabilitation therapy group (group B) and a scalp acupuncture combined with rehabilitation therapy group (group C). Group A were treated with scalp acupuncture at the anterior oblique line of vertex-temporal and the posterior oblique line of vertex-temporal on the healthy side; group B were treated with modern rehabilitation medical therapy, making limb function treatment; group C were treated with the scalp acupuncture in the group A combined with the rehabilitation therapy in the group B. Improvement of neural function defect and activity of daily life (ADL), and clinical therapeutic effect were observed.

RESULTSAfter treatment, the scores of neural function defect of 6.14 +/- 0.36 in the group C was significantly lower than 8.94 +/- 0.56 in the group A and 8.64 +/- 0.49 in the group B (P<0.05); the score of ADL of 88.39 +/- 10.02 and clinical therapeutic effect of 90.0% in the group C were significantly higher than 74.19 +/- 12.12 and 76.7% in the group A and 72.29 +/- 11.52 and 73.3% in the group B (P<0.05).

CONCLUSIONThe scalp acupuncture and rehabilitation therapy have synergistic action in improving motor function for the hemiplegic patient of cerebral thrombosis at convalescent period, and it is a better method for cerebral thrombosis at the convalescent stage.

Activities of Daily Living ; Acupuncture Therapy ; methods ; Aged ; Female ; Hemiplegia ; physiopathology ; rehabilitation ; therapy ; Humans ; Intracranial Thrombosis ; complications ; physiopathology ; therapy ; Male ; Middle Aged ; Scalp ; Single-Blind Method