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BACKGROUND@#Interstitial lung disease (ILD) is a group of diffuse lung diseases that mainly involve the interstitial and alveolar cavities and result in loss of alveolar-capillary functional units, leading to restrictive ventilatory dysfunction and diffusion impairment. There was an increased incidence of lung cancer on the basis of ILD, and perioperative risk of patients with lung cancer combined with ILD (LC-ILD) was significantly increased. The aim of this study is to summarize the safety and experience of surgical treatment of LC-ILD.@*METHODS@#A retrospective analysis was performed on 23 patients with LC-ILD who underwent pneumonectomy in Beijing Hospital from January 2012 to December 2019, and their clinical manifestations, image feature, pathology, surgical safety, perioperative complications and treatment experience were summarized.@*RESULTS@#A total of 23 patients were included in this study, including 20 males (87.0%) with an average age of (69.1±7.8) years, and 19 cases (82.6%) were smokers. Of the ILD types, 14 cases (60.9%) were idiopathic pulmonary fibrosis, 7 cases (30.4%) were idiopathic nonspecific interstitial pneumonia, and 2 (8.7%) were interstitial lung disease associated with connective tissue diseases. The pathology of lung cancer included adenocarcinoma (30.4%, 7/23), small cell carcinoma (30.4%, 7/23), squamous cell carcinoma (26.1%, 6/23), small cell carcinoma mixed with squamous cell carcinoma (4.3%, 1/23) and large cell neuroendocrine carcinoma (8.7%, 2/23). Surgical approaches included video assisted thoracoscopy (69.6%, 16/23) and anterolateral thoracotomy (30.4%, 7/23), with lobectomy (52.2%, 12/23), double lobectomy (4.3%, 1/23), and sublobectomy (39.1%, 9/23). There were 11 cases (47.8%) of postoperative complications, including 8 cases (34.8%) of pulmonary complications, 4 cases (17.4%) of acute exacerbation of ILD (AE-ILD), 6 cases (26.1%) of atrial fibrillation, and 1 case (4.3%) of acute left ventricular dysfunction. The 90-day mortality is 8.7% (2/23) and the cause of death was acute exacerbation of ILD.@*CONCLUSIONS@#Most of LC-ILD were elderly patients with multiple comorbidities and decreased pulmonary function, leading to significantly increased surgical risk. The ILD should be fully evaluated and controlled before surgery, intraoperative trauma should be minimized, and special attention should be paid to pulmonary complications and AE-ILD after surgery. Postoperative AE-ILD has a poor prognosis and glucocorticoids may be effective. Early diagnosis and treatment is the key to treatment of AE-ILD.
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BACKGROUND@#DNA polymerase β is one of the key enzymes for DNA repair and it was reported that about 30 percent of different types of cancers carried mutations in its coding gene Polb. However, it is still controversial whether it is true or false because of the small sample size in these studies. In current study, we performed genetic screening of promoter and coding regions of Polb gene in 69 Chinese lung cancer patients using Sanger sequencing method, so as to elucidate real mutation frequency of Polb mutations in Chinese Han population.@*METHODS@#Salting out extraction method was used to get the genome DNAs from tumor and normal matched tissues of 69 lung cancer patients. The promoter and 14 coding regions of Polb gene were then amplified using these DNAs as the template. After purification, amplicons were sequenced and aligned to the wild type Polb gene in NCBI database, in order to find out the mutated sites of Polb gene in Chinese lung cancer patients.@*RESULTS@#In this study, we totally found only 5 mutated sites in Polb gene. In detail, 3 mutations (-196G>T, -188_-187insCGCCC, -168C>A) were located in the promoter region; 2 mutations (587C>G, 612A>T) were found in coding regions. Specially, mutations of -188_-187insCGCCC and 587C>G (resulting to the amino acid substitution of Thr to Ser at position 196) had never been reported by other groups before. However, all these 5 mutated sites could be detected in both tumor and matched normal tissues, which inferred that they are not lung tumor specific mutations.@*CONCLUSIONS@#No lung tumor specific mutations of Polb gene could be found in Chinese lung cancer patients and Polb gene mutation might not be a molecular marker for Chinese lung cancer patients.
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OBJECTIVE:To improve the quality standard of Compound shougong powder.METHODS:Gekko japonicas and Armeniaca mume were identified by microscopic identification.TLC method was adopted to identify processed Fallopia multiflora qualitatively.The content of 2,3,5,4-tetrahydroxystilbene-2-O-β-D-glucoside (stilbene glycoside) was determined by HPLC.The determination was performed on Agilent Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water (19 ∶ 81,V/V) at the flow rate of 1.0 mL/min.The detection wavelength was set at 320 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:Microscopic characteristics of skin fragments and scales of G.japonicas and the pollen grains of A.mume were significant without interference from negative control.TLC spots of F.multiflora were clear and well-separated without interference from negative control.The linear range of stilbene glucoside were 23-368 μg/mL (r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 1.0％.The recoveries ranged 98.69％-101.61％ (RSD=0.94％,n =9).CONCLUSIONS:Improved standard can effectively control the quality of Compound shougong powder.
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OBJECTIVE:To improve the quality standard of Compound shougong powder.METHODS:Gekko japonicas and Armeniaca mume were identified by microscopic identification.TLC method was adopted to identify processed Fallopia multiflora qualitatively.The content of 2,3,5,4-tetrahydroxystilbene-2-O-β-D-glucoside (stilbene glycoside) was determined by HPLC.The determination was performed on Agilent Zorbax Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-water (19 ∶ 81,V/V) at the flow rate of 1.0 mL/min.The detection wavelength was set at 320 nm,and column temperature was 25 ℃.The sample size was 10 μL.RESULTS:Microscopic characteristics of skin fragments and scales of G.japonicas and the pollen grains of A.mume were significant without interference from negative control.TLC spots of F.multiflora were clear and well-separated without interference from negative control.The linear range of stilbene glucoside were 23-368 μg/mL (r=0.999 9).RSDs of precision,stability and reproducibility tests were all lower than 1.0％.The recoveries ranged 98.69％-101.61％ (RSD=0.94％,n =9).CONCLUSIONS:Improved standard can effectively control the quality of Compound shougong powder.
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OBJECTIVE:To investigate the clinical characteristics and rules of allergic reaction caused by anti-copper treat-ment with Sodium dimercaptoproane sulfonate(DMPS)injection,and to provide reference for diagnosis,treatment and monitoring of drug-induced allergic reaction. METHODS:By using retrospective analysis,allergic reaction reports of DMPS injection were se-lected from our hospital during Jan. 2013-Dec. 2015 were analyzed statistically. RESULTS:A total of 131 cases of allergic reaction were reported. The average age of the patients was(23.26±9.63)years old,mainly concentrated on 10-39 years old(87.79%). Al-lergic reaction mainly occurred in the first and second courses of treatment,accounting for 71.76%. For systems-organs involved, skin and its appendages disorders had the highest proportion (85.90%),being mainly the lesion of limbs (27.45%) and body (22.22%) involved;followed by systemic damage (12.33%). Clinical manifestations of systemic impairment were mainly fever, with rash or itching at the same time frequently. 131 patients had good outcome after treatment. The symptoms of 115 patients (87.79%)disappeared in 7 d. Serious cases accounted for 25.19%. The proportion of drug allergy history,the rate of anti-copper treatment failure with allergy prevention or desensitization therapy,and symptom duration in patients with severe ADR were higher or longer than that in general ADR cases,the difference was statistically significant(P<0.05). CONCLUSIONS:The allergic reac-tion of DMPS injection increased the difficulty of anti-copper treatment. ADR monitoring should be strengthened in the process of using DMPS,specially for the history of allergies and the first,second treatment courses of patients.
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OBJECTIVE:To provide reference for the individualized treatment of opioid drugs by investigating the effects of OPRM1 A118G gene polymorphism on opioids dosage in Chinese Han Population patients with cancer pain. METHODS:66 Chi-nese Han Population patients with medium and severe cancer pain were selected from a third grade class A hospital. Using fluores-cence in-situ hybridization,OPRM1 A118G genotypes were detected to compare the opioids dosage of different genotype in pa-tients with cancer pain. RESULTS:Among 66 patients,distribution frequency of AA,AG and GG genotype were 36.36%, 53.03% and 10.61%,respectively;those of A and G allele were 62.88% and 37.12%;the daily dosage of opioids in AA,AG, GG genotype patients respectively were(21.67±13.41),(42.00±32.18)and(87.14±73.65)mg,with statistical significance(P<0.001). Among 39 patients receiving opioids for the first time,the dosage of 6 AA genotype patients and 15 AG genotype patients had been adjusted,with statistical significance(P=0.026). After adjusting dosage,daily dosage of AA genotype and AG genotype patients were (16.11 ± 9.16) and(28.57 ± 18.52)mg,with statistical significance (P=0.011). CONCLUSIONS:OPRM1 A118G genotype can influence the dosage of opioid in Chinese Han Population patients with cancer pain,and gene polymorphism can be used as evidence for dosage guide of opioids.
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OBJECTIVE:To systematically review the efficacy and safety of Xiaoke pill versus glibenclamide in the treatment of type 2 diabetes mellitus,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Medline, PubMed,EMBase,Cochrane Library,CBM,CJFD,Wanfang Database and VIP Database,randomized controlled trials (RCT) about the Xiaoke pill(test group)versus glibenclamide(control group)in the treatment of type 2 diabetes mellitus were enrolled. Meta-analysis was performed by using Rev Man 5.2 software after document selection,data extract and quality assessment by Co-chrane systematical evaluation. RESULTS:A total of 15 RCT were included,involving 3 319 patients. Results of Meta-analysis showed the hemoglobin A1c (HbA1c) level [MD=-0.39,95%CI(-0.75,-0.02),P=0.04],fasting plasma glucose (FPG) level [MD=-0.70,95%CI(-1.27,-0.12),P=0.02],2 h PG[MD=-0.87,95%CI(-1.55,-0.20),P=0.01],incidence of thirst with desire for drinks [RR=3.35,95%CI(1.92,5.85),P<0.001],incidence of tiredness and debilitation[RR=5.74,95%CI(3.52, 9.36),P<0.001] and incidence of hypoglycemia [RR=0.67,95%CI(0.49,0.91),P=0.01] in test group were significantly lower than control group,the differences were statistically significant. CONCLUSIONS:Xiaoke pill has better efficacy and safety than glibenclamide in the treatment of type 2 diabetes mellitus,can obviously improve the HbA1c,FPG,2 h PG tevel and TCM symp-toms.
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Objective To study the best processing technology of Xanthii Fructus by determining the contents of chlorogenic acid and 3,5-dicaffeoylquinic acid in which processed by different temperature and time. Methods Sixteen batchs samples of Xanthii Fructus were propressed by stir-frying with sand, and the propressed temperature and time were set at 150-220 ℃ and 0.5-7 minutes. Two phenolic acid components in Xanthii Fructus were simultaneously determined. The column was UPLC Acquity BEH C18 (2.1 mm×100 mm, 1.7 μm). The mobile phase was acetonitrile-0.1% phosphoric acid, gradient elution. The flow rate was 0.25 mL/min, and the detection wavelength was 327 nm. Results The sample with highest contents of chlorogenic acid and 3,5-dicaffeoylquinic acid was the batch processed by stir-frying with sand at 160 ℃ for 7 minute, which was 2.498, 2.004 mg/g, respectively. Conclusion According to the appearance of processed sample and the content of chlorogenic acid and 3,5-dicaffeoylquinic acid, the optimal processing technology of Xanthii Fructus was stir-frying with sand at 160 ℃ for 7 min.
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Objective To establish an UPLC method for determination of Triptolide in serum and explore its pharmacokinetics in patients with rheumatoid arthritis after oral administration of tripterygium glycosides tablet. Methods Three patients with rheumatoid arthritis were enrolled. Using Estazolam as internal standard, serum was extracted with acetic ether, and determination was performed on column of Waters Acquity C18 (2.1 mm×100 mm, 1.7 μm) with mobile phase consisted of acetonitrile-0.1% glacial acetic acid (30∶70) at the flow rate of 0.2 mL/min. The column temperature was 30 ℃, and the detection wavelength was set at 220 nm. The serum concentration of Triptolide was processed by DAS 2.1.1 computer program. Results Triptolide was well-separated from internal standard, and the retention time were about 4.9 min and 8.9 min, respectively. Linear range of Triptolide was 13.13-840.00 ng/mL. RSD of intra-day and inter-day were lower than 15%and the recoveries were 88.25%-99.33%. Pharmacokinetic parameters were as follows:Cmax was (159.97±42.43) ng/mL, Tmax was (1.33±0.58) h, T1/2βwas (7.51±2.26) h, and AUC0-12 h was (1131.12±89.20) mg?h/L, respectively. Conclusion Pharmacokinetics of Triptolide conformed to two compartment model. Triptolide can be quickly absorbed, and exists differences among individuals.
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Objective To investigate the dynamic changes of serum autoimmune antibodies before and during treatment in auto-immune liver disease(AILD)and to study their clinical application and the practical significance.Methods The indirect immunoin-fluorescence was used to measure serum anti-nuclear antibody(ANA)on admission and at different clinical treatment time (1,3,12, 24 months)in 64 cases of autoimmune hepatitis(AIH)and 57 cases of primary biliary cirrhosis(PBC).At the same time the immu-noblot analysis was adopted to detect the liver disease related antibodies (anti-AMA-M2 antibody,anti-Sp100 antibody,anti-gp210 antibody,anti-LKM-1 antibody,anti-LC-1 antibody and anti-SLA antibody).The correlation analysis was performed by combining with the detection results of the liver enzymology.Results The detection rate of serum ANA before treatment was 57.8% in the AIH patients and 61.4% in the PBC patients respectively,and the titer was mostly distributed in 1∶320 and 1∶640.During treat-ment,the positive rate and titer of serum ANA in the AILD patients had no obvious change with the disease condition relief(P>0.05);in the liver disease antibodies detection,only anti-AMA-M2 antibody,anti-Sp100 antibody and anti-gp210 antibody were de-tected in the PBC patients,and the detection rates were in turn 73.7%,17.5% and 26.3% respectively;6 items of antibody were detected to different extent in the AIH patients,but which was dominated by the specific detection of anti-LKM-1 antibody,anti-LC-1 antibody and anti-SLA antibody;the liver function indexes in the ALID patients were gradually recovered after 1,3,12,24 months treatment(P0.05).Conclusion The autoimmune antibodies detection plays a very important role in diagnosis and differential diagnosis of AILD,but which has no change with the disease condition relief,thus can not be used as the index of the clinical curative effect observation.
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ObjectiveTo optimize Chonglian oral solution extracting craft. MethodsWith the obtaining rate of extract and the total content of the Pariphyllin Ⅰ and Phillyrin presented in the extract as the indexes for the water extraction process,and with the total content of the Pariphyllin Ⅰ and Phillyrin presented in the extract as the indexes for the alcohol deposition process,orthogonal design was used to optimize the conditions for the extraction process respectively. ResultsThe optimal conditions for the water extraction of Chonglian oral solution was as following:to add water 10 times,decocting 3 times,1 hour each time.The optimal conditions for the alcohol deposition of Chonglian oral solution was as following:concentrated for the relative density to 1.10(80C hot test),cold,add ethanol to the solution for the ethanol content of the solution reached 80%,static settlement for 24 hours. ConclusionThe extracting method is reasonable,stable,and suitable to industrialized producting.
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The purpose of this paper is to establish sulfhydryl site-directed PEGylation method for lysostaphin and to evaluate effects of mutagenesis and modification of amino acid residue within putative linker on enzyme activity. On the basis of structural analysis of lysostaphin, amino acid 133-154 of tentative linker between the N-terminal and C-terminal domain were chosen as the candidate residues for site-directed mutagenesis to cysteine. Subsequently, sulfhydryl site-directed PEGylation was performed by reacting PEG-maleimide reagent with the newly introduced cysteine residue of the mutant lysostaphin. The Cys-mutant and PEG-modified proteins were both purified, and their enzymatic activity were further PEGylated lysostaphins. The mono-PEGylated lysostaphins were separated from unmodified lysostaphins through highly efficient one step method with Ni(2+)-NTA column chromatography. However, both Cys-mutant and PEGylated lysostaphin only retained partial activities of the wild-type enzyme. It suggests that sulfhydryl site-directed PEGylation modification of the tentative linker between the N-terminal and C-terminal domain may affect the catalytic activity of lysostaphin.
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Anti-Infective Agents, Local , Chemistry , Metabolism , Base Sequence , Catalysis , Cysteine , Chemistry , Genetics , Metabolism , Escherichia coli , Genetics , Metabolism , Lysostaphin , Chemistry , Metabolism , Molecular Sequence Data , Mutagenesis, Site-Directed , Mutant Proteins , Chemistry , Metabolism , Polyethylene Glycols , Chemistry , Recombinant Proteins , Genetics , Metabolism , Staphylococcus , Metabolism , Sulfhydryl Reagents , PharmacologyABSTRACT
Objective To analyze the mid- and long-term results after coronary artery bypass graft surgery (CABG), to evaluate the accuracy of multi-detector CT coronary angiography (MDCT) on the graft patency status and to compare the patency for different grafts. Methods One hundred and one cases underwent CABG from June 1992 to March 2008 were followed up by searching the database of MDCT (42 cases) and selective coronary angiography (SCA, 59 cases). The mean following up period was (66.79 ±44.27) months. Three hundreds and 10 grafts including 115 arterial and 195 venous were analyzed.A comparison of the patency rate between the arterial and venous grafts was also carried out. At the mean time, 2 groups were divided according to the paft lesions( patency of not). Uunivariate analysis and Logistic regression analysis were made for statistics. Results At the follow-up of (53.93 ± 36.80) months, the patent rate of LIMA, RA, SV and CV examined by MDCT was 94.7%, 92.0%, 85.9% and 60.0%, respectively. The patent rate for MDCT patients with angina was 83.5%, and 95.2% for angina-free group ( P = 0.046). At the follow-up of (75.95 ±47.09) months, the patent rate of LIMA, RA, SV and CV examined by SCA was 87.1%, 81.0%, 53.6% and 57. 1%, respectively. In SCA patients the patent rate was 62.0% for angina group and 100% for angina-free group ( P = 0.025 ). According to logistic regression analysis, only the postoperative period was statistically related to the graft lesion. Conclusion MDCT could find out the occlusions and obvious stenoses of the grafts after CABG. It might be served as a noninvasive method to evaluate the grafts patency postoperatively. The mid- and long-term patency of arterial grafts is better than venous grafts. Graft lesion is an important factor leading to postoperative recurrent angina pectoris. The severity of the graft lesion has a close relation to the lenth of postoperative period.
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<p><b>OBJECTIVE</b>To evaluate radial artery (RA) and internal mammary artery (IMA) grafts in coronary artery bypass and the use of color Doppler ultrasound in the peri-operative evaluation of IMA and radial-ulnar collateral circulation.</p><p><b>METHODS</b>From June 1998 to June 2000, sixty cases of coronary bypass revascularization with RA and IMA were performed. Preoperatively, the radial-ulnar collateral circulation was evaluated with the modified Allen's test, color Doppler ultrasound and noninvasive oxygen saturation measurement. The IMA lumen and blood flow were measured at the first intercostal space with color Doppler ultrasound preoperatively and postoperatively.</p><p><b>RESULTS</b>One patient (1.7%) died of serious cardiac arrhythmia on the fourth postoperative day. There were no arterial graft harvest related complications. Before harvesting, the ulnar artery blood flow was 30.78 +/- 9.71 ml/min, and it increased to 43.36 +/- 13.98 ml/min (40.87% increase, P < 0.01) after the operation. Compared with the baseline, there was no obvious change of IMA blood flow postoperatively (P > 0.05), but the systolic/diastolic flow ratio markedly decreased from 8.57 +/- 3.98 ml/min to 3.41 +/- 4.87 ml/min (P < 0.01).</p><p><b>CONCLUSIONS</b>Arterial grafts can be safely used for coronary bypass revascularization with good results. The ulnar artery blood flow can increase compensatively after RA harvesting. The diastolic blood flow of grafted IMA markedly increased postoperatively. Color Doppler ultrasound was very helpful both in evaluating the radial-ulnar collateral circulation before RA harvesting and in assessing the patency of the grafted IMA after coronary artery bypass grafting (CABG).</p>
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Adult , Aged , Humans , Middle Aged , Coronary Artery Bypass , Methods , Coronary Circulation , Mammary Arteries , Transplantation , Radial Artery , TransplantationABSTRACT
<p><b>OBJECTIVE</b>To investigate the distribution of HBV genotypes in Changzhou area and to clarify the genotype-related difference in the liver function, the level of HBV DNA and the long-term effect of lamivudine in the pathogenicity of HBV.</p><p><b>METHODS</b>Nested PCR and sequence analysis were conducted in 14 acute hepatitis (AH), 104 chronic hepatitis (CH), and 28 liver cirrhosis or hepatocellular carcinoma (LC/HCC) patients.</p><p><b>RESULTS</b>One hundred and forty six samples were positive for HBV DNA, and 51 samples were classified as genotype B (34.9%), 95 samples were classified as genotype C, serum ALT value was 383.8 +/- 335.7 IU in patients with HBV genotypes B, and 364.3 +/- 333.7 IU in genotypes C, HBV DNA value was 10(7.795 +/- 1.22) copies/ml in genotypes B and 10(7.69 +/0- 1.19) copies/ml in genotypes C, and there were 36 and 64 HBeAg positive cases in patients with genotypes B and C; there were no significant difference on the level of ALT, HBV DNA and the expression of HBeAg (P>0.05), but genotype C in LC/HCC was higher than CH (P<0.01). Twenty three genotype B and forty five genotype C patients received lamivudine treatment, after 48 weeks, 18 genotype B and 14 genotype C patients had higher ALT or HBV DNA positive.</p><p><b>CONCLUSIONS</b>These results indicate that genotype B and C existing Changzhou area; genotype C is associated with the development of severe liver disease and better therapeutic effect could be obtained in the patients with genotype C.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Antiviral Agents , Therapeutic Uses , DNA, Viral , Genetics , Genotype , Hepatitis B , Drug Therapy , Hepatitis B virus , Genetics , Lamivudine , Therapeutic Uses , Liver Cirrhosis , Virology , Liver Neoplasms , Virology , Polymerase Chain Reaction , Treatment OutcomeABSTRACT
Objective To explore the therapeutic effect of different postoperative chemotherapy and administration pathways in primary hepatocellular carcinoma (PHC) patients with portal vein tumor thrombus (PVTT). Methods 60 PHC patients with PVTT were divided into A, B, C and D groups. A group was treated by transcatheter arterial chemo-embolization (TACE); B group was treated by TACE and portal vein intubation(PVI) with quick intravenous injection; C group was treated by TACE and PVI with slow infusion controlled by computer; and D group was treated by hepatic arterial intubation chemo-embolization (HAI) and PVI with slow infusion controlled by computer. Results The survival rate among groups A, B and C had a significant difference (P0.05). Conclusion PHC patients with PVTT could be treated by both hepatic arterial chemotherapy and portal vein chemotherapy throug portal vein continuous infusion. TACE or HAI was suitable for postoperative chemotherapy.
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Objective To analyze the reaction in rabbit's esophagus after inserting metallic nitinal stent and obtaining suggestion for the clinical application.Methods The selfexpanding nitinal stent was placed in each of eight rabbits's esophagus. The rabbits were killed at 2,4,6,8 weeks after implantation. Tissue around the stent was investigated with naked eye and microscopy. Results Chronic inflammation and edema were seen in the submucous tissue 2 week after stenting. Slight stenosis occurred at the regions of two ends of the stent and scattered vegetations like polyp were seen with naked eye at 4 weeks, with inflammatory cell infiltration, partial mucous polypoid hyperplasia under microscopy. The pathological changes were more obvious at 6 weeks comparing with the 4 weeks. The lower end of one stent was embedded in esophageal wall. Two rabbits of 8 weeks' group died of obstruction with food tarried inside the stents.Conclusions The restenosis after stenting were mainly seen at the region of terminals of stent. Thus reformation of stent should be taken place urgently especially at the terminals for the prevention of restenosis.