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OBJECTIVE To evaluate the efficacy and safety of different drug regimens in the treatment of children with Kawasaki disease， and to provide evidence-based reference for clinical treatment. METHODS Retrieved from the Cochrane Library， Medline， Embase， CINAHL， Web of Science， ProQuest， Google Scholar， CNKI， Wanfang Data， Baidu academic database， World Health Organization International Clinical Trials Registration Platform and ClinicalTrials. gov， randomized controlled trials （RCTs） about intravenous immunoglobulin （IVIG）+glucocorticoid or cyclosporine or tumor necrosis factor-alpha （TNF-α） blocker （trial group） versus standard IVIG therapy （control group） were collected from the establishment of the database to Feb. 28th， 2023. After screening the literature， extracting data， and evaluating the quality of the literature， Stata 14.2 software was used for network meta-analysis. RESULTS Ten RCTs with a total of 1 323 participants involving six measures were included： standard IVIG therapy， glucocorticoid therapy，cyclosporine therapy， TNF- α blocker therapy， remedial glucocorticoid therapy and remedial TNF- α blocker therapy. Results of network meta-analysis showed that the incidence of coronary artery aneurysms （CAA） at 4-8 weeks was significantly lower in patients receiving glucocorticoid therapy than receiving standard IVIG therapy and TNF-α blocker therapy. The incidences of CAA at 4-8 weeks in children treated with remedial glucocorticoid therapy and remedial TNF- α blocker therapy were significantly higher than those treated with glucocorticoid therapy； there was no significant difference in the incidence of CAA at 4-8 weeks among other interventions （P＞ 0.05）； network meta-order of the incidence was glucocorticoid therapy＜cyclosporine therapy＜standard IVIG therapy＜remedial TNF-α blocker therapy＜remedial glucocorticoid therapy＜TNF-α blocker therapy. The incidence of initial IVIG resistance in children receiving cyclosporine therapy was significantly lower than those receiving standard IVIG therapy； there was no significant difference in the incidence of initial IVIG resistance among other interventions （P＞0.05）； network meta-order of the incidence was cyclosporine therapy＜glucocorticoid therapy＜TNF-α blocker therapy＜standard IVIG therapy. There was no significant difference in the incidence of ADR among different interventions （P＞0.05）； network meta-order of the incidence was remedial TNF-α blocker therapy＜TNF-α blocker therapy＜standard IVIG therapy＜glucocorticoid therapy＜cyclosporine therapy. CONCLUSIONS Glucocorticoid therapy at the initial treatment can significantly reduce the risk of CAA at 4-8 weeks in children with Kawasaki disease； cyclosporine has a significant effect on improving initial IVIG resistance， and the use of TNF-α blocker in the remedial stage may have the lowest incidence of adverse reactions.
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OBJECTIVE To compare the anticoagulant effectiveness and safety of new oral anticoagulants （NOACs）and warfarin after heart valve replacement ，and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed，Cochrane Library ，Embase，Web of Science ，CNKI，Wanfang database and VIP ，clinical studies about the use of NOACs versus warfarin after heart valve replacement were collected during the inception to July 2021. After literature screening and data extrac tion，the quality of included randomized controlled trials （RCTs）were evaluat ed by bias risk assessment tool recommended by Cochrane system evaluator manual 5.2.0. After the quality of the included cohort studies was evaluated by Newcastle-Ottawa scale （NOS），RevMan 5.3 software was used for meta-analysis and sensitivity analysis. RESULTS A E-mail：carolmeng_0813@163.com total of 9 studies involving 4 962 patients were included ，of which 7 were RCTs and 2 were cohort studie s. Results of meta-analysis showed that after biological valve replacement/repair ，the incidence of stroke and systemic embolism （SSE）[OR＝0.71，95％CI（0.52，0.97），P＝0.03]，major bleeding [OR ＝0.40，95％CI （0.30，0.54），P＜0.000 01] and intracranial hemorrhage [OR ＝0.20，95％CI（0.04，0.95），P＝0.04] in trial group were significantly lower than warfarin group ；there was no significant difference in all-cause mortality between 2 groups [OR ＝1.25，95％CI（0.88， 1.79），P＝0.22]. After mechanical valve replacement/repair ，there were no significant difference in the incidence of SSE [OR ＝1.52， 95％CI（0.04，60.29），P＝0.82] or all-cause mortality [OR ＝0.26，95％CI（0.04，1.84），P＝0.18] between 2 groups. The results of subgroup analysis according to the follow-up time showed that after biological valve replacement/repair ，the incidence of SSE in trial group was significantly lower than that in control group when the follow-up time was ≤3 months [OR ＝0.20，95％CI（0.06， 0.74），P＝0.03]；but there was no significant difference in the incidence of major bleeding between 2 groups [OR ＝0.67，95％CI （0.19，2.38），P＝0.53]；when the follow-up time was longer than 3 months，there was no statistical significance in the incidence of SSE between 2 groups [OR ＝0.74，95％CI（0.54，1.02），P＝0.07]，while the incidence of major bleeding in trial group was significantly lower than control group [OR ＝0.39，95％CI（0.29，0.52），P＜0.001]. Subgroup analysis by study type showed that after biological valve replacement/repair ，the incidence of SSE in the RCT in trial group was significantly lower than that in control group [OR ＝0.51，95％CI（0.29，0.92），P＝0.03]，but there was no significant difference in the incidence of major bleeding between 2 groups[OR＝0.58，95％CI（0.33，1.03），P＝0.06]. In cohort study ，there was no significant difference in the incidence of SSE between 2 groups [OR ＝1.03，95％CI（0.40，2.66），P＝0.95]，while the incidence of major bleeding in trial group was significantly lower than control group [OR ＝0.20，95％CI（0.06，0.74），P＜0.001]. Sensitivity analysis results showed that the results of the above-mentioned meta-analysis were relatively robust. CONCLUSIONS For the patients underwent biological valve replacement/repair，the effectiveness and safety of NOACs are better than or similar to those of warfarin ；for the patients underwent mechanical valve replacement/repair ，there is no significant difference in the effectiveness and safety between NOACs and warfarin.
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Objective:To analyze the current problems in the management of stem cell clinical research in China, explore how to improve the construction ability of stem cell research and management, and promote the well development of stem cell clinical research.Methods:By searching the relevant laws and policies of stem cell clinical research in China, identifying problems that need to be solved at the regulatory level, institutional level and individual research personnel, proposing countermeasures and suggestions on strengthening the construction of stem cell clinical research management in medical institutions.Results:There are uncertainties and high risks in the clinical application of stem cells, which is full of opportunities and challenges in the process of promoting the clinical research and application transformation of stem cells. There are many problems to be solved, such as the lack of detailed management standards, the imperfect internal system at the level of specific management institutions, and the lack of regulations and ethical concepts at the researcher level.Conclusions:Stem cell research is one of the promising new frontiers of science and technology. The management of stem cell clinical research needs the joint efforts of government departments and institutional management departments to discuss and establish the management system of stem cell clinical research. At the same time, it also needs the active engagement of stakeholder, such as researchers, stem cell enterprises and human subjects to work together in promoting the well development of stem cell clinical research.
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Objective:To investigate the clinical significance of quantitative detection of myocardial edema in acute myocardial infarction based on T 2 mapping. Methods:From July 2018 to February 2019, a total of 20 patients (observation group) who underwent cardiac MRI after interventional therapy in the People's Hospital of Wenzhou were enrolled.Another 20 healthy volunteers were selected as the control group.The image data of the observation group were collected, and the image data were post-processed.The T 2 value, edema area and microcirculation obstacle area of the infarcted myocardium and its contralateral normal myocardium were measured and recorded by the image information.The infarcted myocardium and the contralateral normal myocardium were recorded.The T 2 values were compared and the cardiac MRI, cardiac function, serological markers and heart failure related products of the two groups were compared. Results:The patients in the observation group underwent self-comparison between infarcted myocardium and normal myocardium.The T 2 value of the distal infarcted myocardium was (90.14±.51)ms, which was greater than that of the normal myocardium [(60.71±5.15)ms], the difference was statistically significant( t=8.49, P<0.05). The number of myocardial microvascular obstruction (MVO) in the observation group was 17 cases, which in the control group was 0 cases, the difference was statistically significant (χ 2=41.45, P<0.05). The left ventricular end-diastolic volume of the observation group[(88.5±16.2)mL] was higher than that of the control group[(72.4±15.1)mL], and the difference was statistically significant ( t=12.51, P<0.05). The ejection fraction of the observation group was (54.1±11.2)%, which was lower than that of the control group [(71.2±7.9)%], and the difference was statistically significant ( t=18.71, P<0.05). The T 2 value of the observation group was (69.4±6.4)ms, which was higher than that of the control group[(55.2±11.4)ms]( t=11.98, P<0.05). The degree of myocardial delayed imaging (LGE) in the observation group was 13%, which in the control group was 0%, the difference was statistically significant ( Z=27.62, P<0.05). T 2 mapping showed that myocardial infarction sensitivity and positive predictive value were higher, but its specificity was relatively low. Conclusion:Quantitative T 2 mapping has high clinical value in the evaluation of myocardial edema after acute myocardial infarction.T 2 mapping can be used to analyze the extent of lesions in patients with acute myocardial infarction.
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Objective:To study the magnetic resonance imaging (MRI) features of hepatocellular adenomas (HCA).Methods:The MRI images of 36 patients who were diagnosed to have HCA by pathology at Wenzhou Chinese Medicine Hospital and Wenzhou People’s Hospital between January 2013 to May 2018 were reviewed retrospectively. There were 14 males and 22 females, age ranged from 27 to 85 (46±4) years. The location, size, morphology, signal intensity and enhancement modes of tumors were observed.Results:For plain scans of MRI: among 36 patients, the lesions of 10, 23 and 3 patients respectively were located in the left, right and both left and right hemilivers. The lesions of 15, 12 and 9 patients were round-like, oval-like and nodular shape, respectively. The maximum diameter ranged from 2.0 to 11.0 (4.8±2.6) cm. T 1 weighted imaging (T 1WI) of 21, 11, and 4 patients showed low signal, iso-signal, and slightly high signal, respectively. T 2 weighted imaging (T 2WI ) of 33, and 3 patients showed high, or slightly high signal and iso-signal, respectively. T 2WI on fat-suppression of 32 and 4 patients showed high, or slightly high signal and iso-signal, respectively. Diffusion weighted imaging (DWI) of 24, and 12 patients showed high or slightly high signal and iso-signal, respectively. T 2WI of 11 patients showed a high signal ring while the center had a relatively low signal, called the " atoll" sign. Of the 36 patients, 30 had a peritumoral low-signal pseudo-envelope, 11 had intratumoral necrosis, and 8 had intratumoral hemorrhage. On dynamic contrast enhancement scanning: the arterial phase of 22 and 14 patients showed uniform enhancement and uneven enhancement, respectively, while 16 lesions showed significant enhancement, in 15 patients moderate enhancement, and in 5 patients mild enhancement. In the portal venous phase of 7, 12 and 17 patients, the tumor signals were higher, equal and lower than the liver parenchyma signal, respectively. In the delayed phase of 1, 18 and 17 patients, the tumor signals were higher, equal and lower than the liver parenchyma, respectively. In the portal vein and delayed phase, 30 and 6 patients, the pseudocapsules showed mildly enhanced and no enhancement, respectively. Conclusion:HCA is mostly round or oval, T 1WI low signal, T 2WI, T 2WI fat suppression and DWI showed high or slightly high signal. Significant enhancement of arterial phase enhancement, mild enhancement of portal phase and delayed phase, a " atoll sign" and a peritumoral pseudocapsule are helpful for diagnosis.
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Objective@#To analyze the changes and significance of serum soluble programmed death-1 (sPD-1) in patients with chronic hepatitis C (CHC) and study its role in the progression of CHC.@*Methods@#Serum levels of sPD-1 in CHC patients and healthy controls (HC) were measured using ELISA and compared. Correlations of serum sPD-1 with peripheral hepatitis C virus (HCV) RNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver fibrosis (indicated by APRI) were analyzed.@*Results@#The serum sPD-1 level in the CHC group was significantly higher than that in the HC group (P<0.05), and positively correlated with peripheral HCV RNA, ALT and AST (P<0.05). In addition, the serum sPD-1 levels in patients with APRI greater than 1.2 (indicating severe liver fibrosis) were higher than those in patients without or with mild liver fibrosis (P<0.05).@*Conclusions@#sPD-1 might be involve in the progression of CHC. Measuring serum sPD-1 in CHC patients would assist the prediction of disease progression and help to make the correct diagnosis and appropriate clinical therapy decision.
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Objective To analyze the changes and significance of serum soluble programmed death-1 (sPD-1) in patients with chronic hepatitis C (CHC) and study its role in the progression of CHC. Methods Serum levels of sPD-1 in CHC patients and healthy controls ( HC) were measured using ELISA and compared. Correlations of serum sPD-1 with peripheral hepatitis C virus ( HCV) RNA, alanine amin-otransferase (ALT), aspartate aminotransferase (AST) and liver fibrosis (indicated by APRI) were ana-lyzed. Results The serum sPD-1 level in the CHC group was significantly higher than that in the HC group (P<0. 05), and positively correlated with peripheral HCV RNA, ALT and AST (P<0. 05). In addition, the serum sPD-1 levels in patients with APRI greater than 1. 2 (indicating severe liver fibrosis) were higher than those in patients without or with mild liver fibrosis (P<0. 05). Conclusions sPD-1 might be involve in the progression of CHC. Measuring serum sPD-1 in CHC patients would assist the prediction of disease progression and help to make the correct diagnosis and appropriate clinical therapy decision.
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OBJECTIVE： To explore the role of clinical pharmacist in individualized treatment for osteosarcoma patients with periprosthetic joint infection （PJI）. METHODS： An osteosarcoma patient was admitted to our hospital and then suffered from PJI after operation. Clinical pharmacist adjusted the initial anti-infection plan and carried out pharmaceutical care according to the results of patients’ etiology and drug sensitivity. According to the PK-PD principle， combined with the therapeutic drug monitoring （TDM）， the dose of antibiotics was adjusted. With the occurrence of ADR， the antibiotic therapeutic regimen was adjusted again. RESULTS： The patient was administrated cefotiam for empiric therapy initially after the diagnosis of PJI. After obtaining the results of etiology and drug sensitivity， the clinical pharmacist suggested that vancomycin sensitive to penicillin-resistant Staphylococcus epidermidis should be used for targeted anti-infection treatment. After adjusting the dosage according to the steady-state valley concentration， the patient had slight liver function damage， accompanied with chest tightness and shortness of breath. After analysis， the clinical pharmacist considered the adverse drug reactions related to vancomycin， and again suggested that the patient should be treated with teicoplanin. After the doctor adopted the treatment plan recommended by the clinical pharmacist， PJI of the patient was effectively controlled， and the adverse reaction symptoms disappeared. The patient was effectively cured for PJI and discharged eventually. During the treatment period， the clinical pharmacist also carried out medication education for the drugs used by the patient. CONCLUSIONS： Clinical pharmacist should master the principle of antibiotic drug PK-PD theory and evaluate the clinical efficacy and safety of anti-infective drugs dynamically based on the guidance of TDM， so as to develop individualized anti-infection therapeutic regimen for osteosarcoma patient with PJI， improve the effect of clinical treatment and guarantee the safety of drug use.
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Objective@#To compare the short-term and long-term outcome between robotic gastrectomy and laparoscopic gastrectomy.@*Methods@#The clinical data of 517 patients who had received robotic gastectomy and laparoscopic gastrectomy between December 2011 and December 2013 at Department of General Surgery, Chinese People′s Liberation Army General Hospital was collected. After propensity score matching, 70 patients in robotic gastectomy and 70 patients in laparoscopic gastectomy were identified. Perioperative outcome and overall survival were compared between the two groups using t test, χ2 test, Kaplan-Meier curve and Log-rank test, respectively. Prognosis factors were analyzed by Cox′s proportional hazards regression.@*Results@#There were comparable baseline characteristics between patients in robotic group (RG) and those in laparoscopic group (LG). The conversion rate for RG and LG were 5.7% and 4.3% respectively (P=1.000). Compared with LG, RG had similar lymph node retrieval (25.5±7.2 vs. 24.5±8.3, t=0.770, P=0.443) and less blood loss ((147.0±96.8) ml vs. (188.0±111.2) ml, t=-2.326, P=0.021). There were also similar complications (χ2=0.233, P=0.629) and severity of complications (W=70.500, P=0.053). Although there tended to be early mobility, early flatus and less hospital stay for patients in RG group, the difference between RG and LG was not statistically significant. The 3-year survival rate was 72.9% and 60.0% for patients in RG and patients in LG (P=0.578). Multivariable analysis revealed gender (HR=2.529, 95% CI: 1.042 to 6.140, P=0.040), neoadjuvant chemotherapy (HR=0.272, 95% CI: 0.104 to 0.710, P=0.008) and vascular invasion (HR=2.135, 95% CI: 1.027 to 4.438, P=0.042) were independent prognostic factors.@*Conclusion@#Compared with laparoscopic gastrectomy, robotic gastectomy could achieve similar short-term and long-term outcomes.
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Objective To investigate the features of soft tissue myxofibrosarcoma (MFS)on MRI.Methods The MRI data of 15 cases with MFS confirmed by surgery and pathology were analyzed retrospectively.Results Of all the 1 5 cases,7 were located in the thigh,3 were located in the lower leg,2 were located in the forearm,1 was located in the shoulders,1 was located in the back and 1 was located in the buttocks.The average maximum diameter of all lesions was (9.43±3.1)cm.Fifteen cases showed isointensity with slightly hypointensed fiber septa on T1WI.The signal intensity of MFS on T2WI was mixed.Five cases of low-grade MFS with myxoid area showed slightly hyperintensity,with sporadic small nodular and striped fibrous septa which showed hypointensity on T2WI and inhomogeneous enhancement.In 5 cases of high-grade MFS,the solid part and the septa showed hypointensity on T2WI;the myxoid matrix area and the necrotic area showed hyperintensity on T2WI.The myxoid matrix part showed mild inhomogeneous enhancement with peritumoral enhancement of"tail sign".Among the 5 cases,the solid part of 4 cases showed middle to severe annular heterogeneous enhancement,while the solid part of the remaining 1 case showed nodular enhancement.Five cases of intermediate-grade MFS showed slightly hyperintensity or isointensity on T2WI,and nodules and fibrous septa showed hypointensity.The enhanced solid part and myxoid matrix area showed mild to moderate inhomogeneous enhancement,and there were 2 cases with"tail sign".Conclusion MRI features of soft tissue myxofibrosarcoma have some characteristics including isointensity on T1WI,mixed signal intensity on T2WI,heterogeneous enhancement and peritumoral enhancement of"tail sign".
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Objective To investigate the correlation between semen parameters with spontaneous abortion in early pregnancy after in vitro fertilization (IVF) assisted pregnancy operation .Methods 220 patients with successful pregnancy after IVF assisted pregnancy operation in the reproductive center of this hospital were selected as the research subjects .Among them ,40 cases of early spontaneous abortion served as the observa-tion group and 180 cases without early spontaneous abortion occurrence as the control group .The related pa-rameters of sperm hyaluronic acid unbinding rate ,sperm nucleoprotein immaturity rate and sperm morphology normal rate were measured and analyzed by adopting the computer assisted sperm analysis (CASA) .Results The sperm hyaluronic acid unbinding rate and sperm nucleoprotein immaturity rate in the observation group were significantly higher than those in the control group ,the difference was statistically significant ( P<0 .05);the sperm morphology normal rate in the observation group was significantly lower than that in the control group ,the difference was statistically significant (P<0 .05);the other semen parameters had no statis-tical differences between the two groups (P>0 .05) .The statistical analysis result showed that the sperm hy-aluronic acid unbinding rate ,sperm DNA fragmentation rate and sperm nucleoprotein immaturity had the posi-tive correlation between each other ,which had the negative correlation with the other indicators .After the stepwise analysis by the binary Logistic regression model ,the results showed that the high risk factors affect-ing spontaneous abortion in early pregnancy after IVF included sperm nucleoprotein immaturity rate and sperm hyaluronic acid unbinding rate .Conclusion The sperm nucleoprotein immaturity rate and sperm hyalu-ronic acid unbinding rate are two high-risk factors inducing early spontaneous abortion after IVF .
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Objective To study the medical imaging findings and the pathological features of hepatic inflammatory myofibroblastic tumor (HIMT) using CT,MRI and histopathology.Methods The CT and MRI findings of 31 patients with HIMT which were confirmed by histopathology on surgically resected specimen were analyzed retrospectively.The location,size,shape,edge,density or signal,and contrast enhancement of these tumors were analyzed.Results The tumors were located in the right liver in 26 patients,in the left liver in 5 patients,and under the hepatic capsule in 27 patients.The tumors were solitary in 28 patients and multiple in 3 patients.The maximum diameter of the tumor ranged from 2.1 cm to 12.5 cm.The average diameter was (3.6 ± 1.2) cm.The tumors were round or oval in 21 patients and irregular in 10 patients.19 patients underwent CT examination and all tumors showed low density,with a CT value which ranged from 5 to 35HU.The average value was (27.6 ±5.3) HU.The density of tumors was homogeneous in 6 patients and inhomogeneous in 13 patients,and among these 13 patients,3 were alveolate.Twenty-one patients underwent MRI scan and all showed a low signal on T1WI,12 patients showed an equal signal and 9 patients showed a slightly higher signal on T2WI.In 6 patients the signals were homogeneous and in 15 patients they were inhomogeneous.On CT and MRI enhanced scans the whole tumor was enhanced in 12 patients,the edge was enhanced in 9 patients,the septum was enhanced in 8 patients and no enhancement was observed in 2 patients.Pathological examination under microscopy observed the presence of proliferation of spindle cells,chronic inflammatory cells which included the proliferation of lymphocytes,plasma cells and collagen fiber formation.The spindle cells had the characteristics of fibroblasts and myofibroblast cells.Immunohistochemical examination showed the wave type protein (Vimentin) was positive in 23 patients,the smooth muscle actin (SMA) was positive in 18 patients,the muscle actin (MSA) and the specificity of junction protein (Desmin) were positive in 12 patients,CD68 was positive in 4 patients,and the ALK,S-100 protein,CDll7 and CD35 were all negative.Conclusions The radiological features of CT and MRI plain scan varied.The patterns of contrast enhancement included full tumor filling,marginal enhancement,compartment enhancement,and no enhancement.The enhanced features varied from mild to moderate enhancement in the arterial phase,further enhancement in the portal phase and mild enhancement in the delayed phase.
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Objective To study the medical imaging findings and the pathological features of hepatic inflammatory myofibroblastic tumor (HIMT) using CT,MRI and histopathology.Methods The CT and MRI findings of 31 patients with HIMT which were confirmed by histopathology on surgically resected specimen were analyzed retrospectively.The location,size,shape,edge,density or signal,and contrast enhancement of these tumors were analyzed.Results The tumors were located in the right liver in 26 patients,in the left liver in 5 patients,and under the hepatic capsule in 27 patients.The tumors were solitary in 28 patients and multiple in 3 patients.The maximum diameter of the tumor ranged from 2.1 cm to 12.5 cm.The average diameter was (3.6 ± 1.2) cm.The tumors were round or oval in 21 patients and irregular in 10 patients.19 patients underwent CT examination and all tumors showed low density,with a CT value which ranged from 5 to 35HU.The average value was (27.6 ±5.3) HU.The density of tumors was homogeneous in 6 patients and inhomogeneous in 13 patients,and among these 13 patients,3 were alveolate.Twenty-one patients underwent MRI scan and all showed a low signal on T1WI,12 patients showed an equal signal and 9 patients showed a slightly higher signal on T2WI.In 6 patients the signals were homogeneous and in 15 patients they were inhomogeneous.On CT and MRI enhanced scans the whole tumor was enhanced in 12 patients,the edge was enhanced in 9 patients,the septum was enhanced in 8 patients and no enhancement was observed in 2 patients.Pathological examination under microscopy observed the presence of proliferation of spindle cells,chronic inflammatory cells which included the proliferation of lymphocytes,plasma cells and collagen fiber formation.The spindle cells had the characteristics of fibroblasts and myofibroblast cells.Immunohistochemical examination showed the wave type protein (Vimentin) was positive in 23 patients,the smooth muscle actin (SMA) was positive in 18 patients,the muscle actin (MSA) and the specificity of junction protein (Desmin) were positive in 12 patients,CD68 was positive in 4 patients,and the ALK,S-100 protein,CDll7 and CD35 were all negative.Conclusions The radiological features of CT and MRI plain scan varied.The patterns of contrast enhancement included full tumor filling,marginal enhancement,compartment enhancement,and no enhancement.The enhanced features varied from mild to moderate enhancement in the arterial phase,further enhancement in the portal phase and mild enhancement in the delayed phase.
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Objective:SFRP2 gene is a member of the SFRPs family.The gene is located on chromosome 4q31.3 with 3 exons and 2 introns and first exons have higher density near the island of CpG.Many studies showed that the methylation level of SFRP2 gene and colon cancer,esophageal cancer,gastric cancer and other tumor occurrence relating to,development and prog nosis.This study aims to study the clinical characteristics of CpG SFRP2 promoter island hypermethylation in colorectal cancer and whether there is a certain correlation.Methods:by matrix assisted laser desorption ionization time of flight mass spectrometry for detecting specific CpG island methylation.Methylation status of SFRP2 promoter by Sequenom EpiTYPER was detected in 20 cases of normal tissue of colorectal cancer and tumor tissues.Results:Our study using multiple linear regression analysis in tumor tissue of SFRP2 methylation at promoter Ⅰ and Ⅱ,found that SFRP2 promoter methylation and clinical features of.SFRP2_01_CpG_5 significantly correlated (P=0.018),SFRP2_02_CpG_5 (P=0.018) associated with the location of the tumor,SFRP2_02_CpG_6,7,8,9(P=0.039) and the number of lymph node metastasis of.SFRP2_01_CpG_1.2(P=0.043),SFRP2_02_CpG_16 (P=0.044) correlated with tumor size.Conclusion:we from epigenetic aspects of its promoter CpG methylation level and colorectal cancer clinical and pathological features,found a correlation between clinical and pathological features of colorectal cancer and CpG methylation in its promoter,suggesting that the SFRP2 promoter may be at this stage of colorectal cancer and future biological genetics the progress of the potential surface markers.
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Objective To explore the effect of human leukocyte antigen B* genotype and age on serum homocysteine (Hcy) levels in children with seizures or epilepsy. Methods Fifteen children with seizures or epilepsy in whom HLA-B*15:02 genotype was detected during October 2015 to June 2016 were included. The plasma Hcy concentration in children with different genotypes was compared. The association of Hcy concentration and age was performed by linear-regression analysis. Results The mean concentration of Hcy was 8.38±4.23 μmol/L in children not carrying HLA-B*15:02 gene, which was obviously higher than that in children carrying HLA-B*15:02 gene 13.03±0.97 μmol/L (P<0.05). The Hcy concentration increased with the age (r2 =0.29, P<0.05). Conclusions Elder children with seizures or epilepsy carrying HLA-B*15:02 gene tend to have higher Hcy concentration and increased potential risk of disease. HLA-B*15:02 gene type and age can predict the changes of Hcy concentration in children with convulsions.
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Objective:To determine the concentration of meropenem in human serum and investigate its pharmacokinetics in Chi-nese elderly patients. Methods:Meropenem with single dose of 0. 5-1. 0 g was given to 25 elder patients by infusion administration. The concentration of meropenem was detected by an HPLC method. The pharmacokinetic parameters were calculated according to the pharmacokinetic model for adults and T>MIC was calculated by simple mathematical simulation. Results: The major pharmacokinetics parameters were as follows:Cmax of (46. 2 ± 24. 4) μg·ml-1;t1/2 of (3. 3 ± 1. 8) h,CL of (8. 7 ± 5. 0) L·h-1 ,V of (9. 8 ± 1. 3) L and AUC of (148. 2 ± 75. 4)μg·h·ml-1 . Compared with that of the healthy subjects reported in the literatures, t1/2 significantly pro-longed, V significantly decreased and AUC significantly increased (P<0. 01). Conclusion: The pharmacokinetics of meropenem in elder patients is significantly different from the healthy subjects. The clinical application should pay attention to monitoring the blood concentration of meropenem.
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Objective To evaluate antimicrobial effect and mechanism of meropenem in the model of PA infection by C.elegans.Methods To evaluate drug effects of PA infection with caenorhabditis elegans by different concentrations of culture medium, determinate the lethal rate of C.elegans.Western blot detected mitogen activated protein kinase ( Mitogen-activated protein kinase MAPK ) activity change, and PCR detected antimicrobial peptide genes expression in C.elegans after PA infection,the effect of meropenem on MAPK activity change and antimicrobial peptide genes expression.Results Compared with the control group (OP-50), the death rate of C.elegans in PA infection group changed significantly (P<0.01). Meropenem showed protective effect after C.elegans infection ( P <0.01 ) .Detection of MAPK kinase activity showed that PA infection caused PMK-1 kinase activation, further study showed that antibiotics meropenem did not affect the activation of PMK-1 kinase (no significant difference).C.elegans antimicrobial peptide gene Lys-1, clec-85, F55G11.7, K08D8.5 activity increased in PA infection (P<0.01).Meropenem promoted the expression of the antimicrobial peptide gene increased (P<0.01),with synergistic effects.Conclusion Our results show that a C.elegans pathogenicity model can be applied screening drug susceptible to pathogens infection quickly and easily.
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Tacrolimus exhibits varied individual pharmacokinetic and a narrow therapeutic window, resulting in difficulties in personalized medication.In order to improve the safety of tacrolimus in clinical application and its efficiency and rationality in clinical practice, many countries and regions in the world have issued a number of guidelines for tacrolimus application.However, these guidelines generally aim at particular disease and race, and have certain limitation.In this article, the guidelines were explicated and analyzed in detail.Moreover, an individual tacrolimus medication recommendation for Chinese population was summarized based on the latest research of tacrolimus pharmacogenomics and therapeutic drug monitoring so as to provide assistance for the rational use of tacrolimus.
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Primary retroperitoneal liposarcoma is a rare low-grade malignant tumor and accounts for approximately 1% of all adult malignancies. Complete gross resection is the most important and maybe only method to cure retroperitoneal liposarcoma. The addition of advanced- modality radiotherapy to surgery for primary retroperitoneal liposarcoma is associated with improved local recurrence-free survival, and the toxic effect is tolerable. Several new drugs, especially targeted drugs, have achieved good efficacy. The aim of this article is to improve the understanding of treatment of primary retroperitoneal liposarcoma. The multidisciplinary therapy model, including surgery, radiotherapy, chemotherapy and targeted therapy, is recommended for patients with retroperitoneal liposarcoma.
ABSTRACT
Objective To explore the correlation of S100 protein with the prognosis of patients with primary retroperitoneal liposarcoma. Methods Analyzed the clinical data about 108 patients with primary retroperitoneal liposarcoma managed with surgery from January 2009 to June 2014. All patients were followed up. Patients were divided into S100-positive group(58 patients) and S100-negative group (50 patients) according to the immunohistochemical staining results. The overall survival time and all clinical data between two group were compared. Results All patients with primary retroperitoneal liposarcoma received radical surgical resection for the first time. The overall 5-year recurrence rate were 88.9%(96/108), and the median recurrence time was 32.7 months. The 1-year, 2-year, and 5-year recurrence rates of the S100- positive group were 25.9% (15/58), 53.4% (31/58), 96.6% (56/58), respectively, and the median recurrence time were 26.2 mouths. The 1-year, 2-year, and 5-year recurrence rates of the S100-negative group were 10.0%(5/50), 36%(18/50), 80.0%(40/50) and the median recurrence time were 40.0 mouths. Log-rank test showed that S100 protein expression was significantly associated with postoperative recurrence rates (c2=9.931, P=0.002) and survival time (c2=4.571, P = 0.033). The difference between gender, age, removal of the joint organs and tumor size showed no statistical significance on disease special survival (P>0.05). Cox regression analysis showed that S100 protein expression (OR=1.582, 95%CI:1.005-2.491) and histologic subtype (OR=1.531, 95%CI: 1.254-1.870) were independent risk factors of the prognosis of primary retroperitoneal liposarcoma patients. Conclusions S100 protein played a critical role in retroperitoneal liposarcoma carcinogenesis and its expression may be used as a potential survival predictor in patients with primary retroperitoneal liposarcoma.