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Objective: To analyze the clinical characteristics of allergic reactions in patients with colorectal cancer after routine premed-ication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regimen and to provide a reference for reduc-ing the risk of oxaliplatin allergy. Methods: Retrospective analysis of 242 patients with colorectal cancer who received chemotherapy with an oxaliplatin-containing regimen at the Changzhou Cancer Hospital of Soochow University from January 2014 to October 2017 was performed, and the incidence of allergic reactions was calculated. The associations between multiple factors and allergic reactions were then assessed using univariate analysis. The independent factors of allergic reactions were assessed using multivariate Logistic analysis, and the treatment outcome of oxaliplatin rechallenge in allergic patients was discussed. Results: A total of 242 patients were studied. They received routine premedication with dexamethasone (5 mg) before chemotherapy with an oxaliplatin-containing regi-men. Twelve (4.9%) patients had type I allergic reactions, with a median onset time of 6 (5.5-10.5) cycles and a median cumulative dose of 895 (716.5-1 075.0) mg. Multivariate analysis identified undergoing an oxaliplatin-free interval as an independent risk factor (P=0.04). Rechallenging patients with prophylactic agents was successful in 1 (33.3%) of 3 patients who completed their treatment. Conclusions: Routine low-dose dexamethasone premedication before oxaliplatin administration is safe and exhibited a lower inci-dence of hypersensitivity reactions than that reported in literature. An oxaliplatin-free interval may increase the risk of hypersensitivity reactions. Caution should be exercised while rechallenging allergic patients with oxaliplatin.
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Objective:To establish a liquid chromatography tandem mass spectrometry ( LC-MS/MS) method for the determination of 5-fluorouracil (5-Fu) in patient’s plasma and apply it in clinics patients validation. Methods:5-Fu was analyzed on an Agela Inno-val NH2 (2. 1 mm × 50 mm, 5 μm) column. Methanol:ultra pure water (2 ∶98) was used as the mobile phase with isocratic elution. The flow rate was 0. 3 ml ·min-1 and the column temperature was set at 40℃. The ion transitions with electrospray ionization negative model were m/z 128. 8→42. 1 and m/z 188. 6→42. 1 for 5-Fu and 5-bromouracil (the internal standard), respectively. The LC-MS/MS method was verified according to the guideline of quantitative analysis validation of biological samples ( Chinese Pharmacopoeia, 2015 edition, the fourth part) . Results:The calibration curve of 5-Fu was linear within the range of 10-1 000 ng · ml-1 . The lower limit of quantification was 10 ng · ml-1 . The precision, accuracy, matrix effect and stability within the linear range were all in line with the requirements of method validation. Conclusion:The LC-MS/MS method developed in the study for the determination of 5-Fu is simple, rapid, accurate and reproducible, which can be used for the plasma concentration detection of 5-Fu in patients.
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Objective To sum up the experience of liposuction combined with periareolar small incision to treat gynaecomastia.Methods 25 cases of gynaecomastia were treated by liposuction combined with periareolaf small incision within local swelling anesthesia from Jun.2012 to Jun.2015 in Department of Burn and Plastic Surgery.Results All the 25 cases were satisfied with the postoperative cosmetic effect,such as no obvious scar,flat chest,no obvious uneven feeling.Pathological results showed there were mammary gland hyperplasia,mam mary gland dilatation and fat and fibrous tissues hyperplasia.Conclusion Liposuction combined with periareolar small incision under local swelling anesthesia can achieve satisfied cosmetic effect in treating gynaecomastia.
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Neurokinin I receptor antagonist (NK1RA) fosaprepitant is a new antiemetic drug. Fosaprepitant dimeglumine was ap-proved by FDA in January 2008, while it is still in the approval stage in China. Fosaprepitant, as a prodrug of aprepitant, is rapidly converted to aprepitant after intravenous administration in vivo. The indication of fosaprepitant is the prevention of chemotherapy in-duced nausea and vomiting ( CINV) , especially the delayed CINV. Fosaprepitant as a unique intravenous preparation overcomes the drawbacks of aprepitant with oral administration only. Its bioavailability is not affected by the vomiting of patients. It is also suitable for patients with oral mucositis, who are unfavorable for oral medication. The action mechanisms, pharmacokinetics, and clinical trials of fosaprepitant were reviewed in the paper.
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Objective To explore the pharmaceutical care approaches for patients with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy. Methods An elderly patient with lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy faced inevitable safety risks.Clinical pharmacists considered it as an intervention point, and provided individual pharmaceutical care. Results Clinical pharmacists fully assessed the safety risks of the case receiving pemetrexed chemotherapy with clinicians, assisted in improving the therapeutic regimen, and carried out medication education for the patient. No serious adverse drug reactions occurred in the patient, and anti-tumor efficacy was obtained. Conclusion For patients of lung cancer complicated with renal insufficiency receiving pemetrexed chemotherapy, clinical pharmacists should focus on creatinine clearance rate, and decide whether the combined use of platinum anti-tumor drugs, non steroidal anti-inflammatory drugs and zoledronic acid can be adopted, and follow-up on adverse drug reactions and anti-tumor efficacy.
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Objective To study the relationship between bisphenol A and precocious puberty in 6-8 years girls. Meth-ods Atotal of 103 girls aged 6-8 years with precocious puberty in our Endocrine clinic from August to December 2012 were se-lected. According to the classiifcation standard of precocious puberty, girls are divided into idiopathic central precocious puberty (ICPP) group (n=47) and permature thelarche (PT) group (n=56), 53 girls with no puberty development were chosen as control group. BPA concentrations were determined with HPLC-MS-MS, sex hormones were determined with chemiluminescence meth-od and Kisspeptin concentrations were determined with ELISA, then the differences among the three groups were compared and the relationships between bisphenol A and sex hormones and Kisspeptin were analyzed. Results The BPA relevance ratio and concentration in ICPP group were higher than those of PT group and control group (P0.05). There were correlations between the concentrations of BPA and E2 and LH peak concentration and LH/FSH (P<0.05). Conclusions There is a certain correlation between the concentrations of BPA and ICPP.
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<p><b>OBJECTIVE</b>To verify the existence and significance of calcium/calmodulin dependent serine protein kinase/inhibitors of differentiation 1 (CASK/Id1) pathway in fibroblasts of human keloid.</p><p><b>METHODS</b>Immunofluorescence laser was used to confirm CASK and Id1 protein expression and localization in fibroblasts of the keloid and normal skin. RT-PCR and Western-blot were adopted to analysis the CASK and Id1 expression and differences between keloid and normal skin fibroblasts. The natural combination of CASK and Id1 protein of keloid fibroblasts was tested by immunoprecipitation.</p><p><b>RESULTS</b>CASK and Id1 protein expression were both found in fibroblast cells of keloid and normal skin under normal circumstances. Most of CASK and Id1 were distributed in the cytoplasm and nucleus of fibroblasts. The results of RT-PCR showed that the expression of CASK mRNA in the keloid group was 0.658 +/- 0.024, which was lower than that in the normal control group (1.076 +/- 0.008, t = 11.159, P < 0.05). The expression of Id1 mRNA was 0.497 +/- 0.014, which was higher than that in the normal control group (0.307 +/- 0.017, t = 15.148, P < 0.05). The results of Western-blot showed that the expression level for CASK protein in the keloid group was 0.057 +/- 0.006, which was lower than that in the normal control group (0.168 +/- 0.012, t = 13.524, P < 0.05); the expression of Id1 protein was 0.812 +/- 0.035, which was higher than that in the normal control group (0.368 +/- 0.031, t = 16.356, P < 0.05). The results of immunoprecipitation showed that Id1 could be detected in the CASK precipitate, while CASK also could be detected in the Id1 precipitate. There was a natural binding of CASK and Id1 in keloid fibroblasts.</p><p><b>CONCLUSION</b>CASK/Id1 signal pathway may be existed and involved in the proliferation of keloid fibroblasts, which is related with the occurrence of keloid.</p>
Subject(s)
Humans , Cell Proliferation , Genetics , Cyclin-Dependent Kinase Inhibitor Proteins , Genetics , Metabolism , Fibroblasts , Metabolism , Inhibitor of Differentiation Protein 1 , Genetics , Metabolism , Keloid , Metabolism , Pathology , RNA, Messenger , Metabolism , Signal TransductionABSTRACT
OBJECTIVE： To evaluate the clinical therapeutic effect of L-glutamine granules on intestinal damage of severe burn patients and the safty of the drug.METHODS： Thirty-nine severe burn patients were randomly divided into two groups： control group（C group， nineteen patients） and L-glutamine treatment group（GLN group， twenty patients） .GLN group patients were given L-glutamine in a dose of 30g per day for 7 days， and C group patients were given the same dosage of placebo for 7 days.The plasma L-glutamine concentration， the degree of intestinal mucosa damage， blood biochemistry and complication were observed and wound healing rate of burn area was determined， then the length of hospital stay was recorded.RESULTS： After 7 days of taking L-glutamine orally， plasma L-glutamine concentration in GLN group was significant higher than that in C group（P<）. The degree of intestine damage and intestinal mucosal permeability in GLN group were lower than those in C group. In addition, the wound healing rate was faster and the length of hospital stay was shorter in GLN group than those in C group. CONCLUSION: Administration of L-glutamine could abate the degree of intestine damage obviously, lessen intestinal mucosal permeability, ameliorate wound healing rate and reduce the length of hospital stay.
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0.05),but the 24h urine zinc level increased markedly(P
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Objective:To perform the rhytidectomy of the lateral canthus in combination with blepharoplasty for youth and middle-aged persons.Methods:The rhytidectomy of the lateral canthus with subdermal incision were used in 36 patients at the age of 28～45 years who underwent simultaneous blepharoplasty.The 36 cases were divided into four groups of 28～30,31～35,36～40,and 41～45 years old in order to observe and evaluate the changes of the lateral canthus before and after operation.The keys to operative technique were presented.Results:Postoperative and follow-up results demonstrated the effects were desirable in the cases lower than 40 years of age who showed slight-middle degree crow's feet wrinkles,but unsatisfactory results were showed in the cases above 40 years of age who showed rough-deep degree wrinkles at the lateral canthus preoperation.Conclusion:The rhytidectomy with subdermal incision is an excellent method to reconstruct the skin structure and to eliminate slight-middle degree wrinkles.