Management of liver transplantation perioperative period in acute-on-chronic liver failure / 中华肝脏病杂志

Acute-on-chronic liver failure (ACLF) is a potentially reversible entity that occurs in patients with chronic liver disease accompanied with or without cirrhosis and is characterized by extrahepatic organ failure and high short-term mortality. Currently, the most effective treatment method for patients with ACLF is liver transplantation; therefore, admission timing and contraindications must be emphasized. The function of vital organs such as the heart, brain, lungs, and kidneys should be actively supported and protected during the liver transplantation perioperative period in patients with ACLF. Focusing on the anesthesia management level during anesthesia selection, intraoperative monitoring, three-stage management, prevention and treatment of post-perfusion syndrome, monitoring and management of coagulation function, volume monitoring and management, and body temperature monitoring management for liver transplantation should strengthen anesthesia management. Additionally, standard postoperative intensive care treatment should be recommended, and grafts and other vital organ functions should be monitored throughout the perioperative period to promote early postoperative recovery in patients with ACLF.

Progress of studies on medicinal fungus Phellinus / 中国中药杂志

The real sanghuang is a new species belonging to the Inonotus, which is commonly used for cancer treatment and human immune system improvement. This review summarized the progress on the studies of Phellinus Quel in recent years, including its taxonomy status, bioactive components, pharmacodynamics, separation and purification technologies. In addition, some related problems and perspectives were also discussed.

Study on preparation of testosterone undecanoate ethosomes and its in vitro transdermal penetration / 中国中药杂志

Ethosomes, as a new vector for transdermal drug delivery, could obviously improve the transdermal penetration of drugs. In this study, we prepared testosterone undecanoate ethosomes, with TU ethosomes as the basic remedy, to determine its appearance, particle size, entrapment efficiency (EE) and membrane fluidity. Meanwhile, a transdermal test was conducted in mice, in order to determine the permeability characteristics of ethosomes as a vector for transdermal drug delivery, and compare transdermal behaviors of TU ethosomes, liposomes and their ethanol solutions.

Synthesis of colon-specific prodrug of indomethacin and its inhibitory effect on liver metastasis from colon cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To develop a colon-specific prodrug of Indomethacin microbially triggered, carry out in vitro/in vivo evaluation of drug release, and appraise its inhibitory effect on liver metastasis from colon cancer.</p><p><b>METHODS</b>Indomethacin prodrugs were synthesized and characterized by FTIR and NMR, and dissolution test simulating gastrointestinal tract was employed to screen the colon-specific prodrug. Then, the pharmacokinetic profile of portal vein and peripheral blood in Sprague-Dawley rats was studied. Lastly, the inhibitory effect on liver metastasis from colon cancer in nude mice was observed.</p><p><b>RESULTS</b>The chemical structure characterized by FTIR and NMR demonstrated that six kinds of indomethacin-block-amylose with different drug loading (IDM-AM-1-6) were synthesized, among which IDM-AM-3 was degraded 1.3%, 9.3% and 95.3%, respectively, in simulated gastric fluid for 4 h, small intestine for 6 h, and colon for 36 h. The pharmacokinetic test of IDM-AM-3 showed that absorption was delayed significantly (P < 0.01), peak time [(11.35 + or - 2.45) h], elimination half-life [(16.74 + or - 4.04) h] and mean residence time [(22.27 + or - 0.52) h] were significantly prolonged (P < 0.01), as well as peak serum concentrations [(9.69 + or - 2.40) mg/L] and AUC(0-t) [(236.7 + or - 13.1) mg x L(-1) x h] were decreased markedly (P < 0.01) as compared with those of IDM regarding to portal vein. Additionally, its AUC(0-t) in peripheral blood was remarkably lower than that in Portal vein (P < 0.01). The tumor suppression observation showed that it could remarkably reduce the number of liver metastases in contrast to IDM (P < 0.05).</p><p><b>CONCLUSION</b>Colon-specific IDM-AM-3 possesses advantage of sustained release in portal vein providing some experimental basis for colon-specific delivery system applied to sustained release in the portal vein.</p>

Preparation and antitumor effects of nanovaccines with MAGE-3 peptides in transplanted gastric cancer in mice / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>As a prospective vaccine carrier, nanoparticles can protect antigens from degradation and enhance immune response. This study prepared nanovaccines with MAGE-3-derived CD4+-CD8+T cell epitope peptides, and investigated its character and antitumor effects on transplanted gastric cancer in mice.</p><p><b>METHODS</b>We adopted the self-assembly method to prepare peptide/chitosan conjugated with deoxycholic acid (chitosan-deoxycholic acid) nanoparticles. We observed the appearance of the chitosan-deoxycholic acidnanoparticles through a transmission electron microscope (TEM) and analyzed the peptide content and its release pattern by fluorescence spectrophotometry. We observed tumor-suppression efficacy in vivo through animal experiments.</p><p><b>RESULTS</b>We successfully prepared nanoparticles with MAGE-3 peptide antigen, and its encapsulation efficiency and loading level were about 37% and 17.0%, respectively. These nanoparticles presented a delayed release pattern in phosphate buffered saline (PBS) at pH 7.4, and the full release time was about 48 h. In 2 mg/mL lysozyme, the nanoparticles showed a sudden release, and the full release time was about 24 h. ELISPOT and cytotoxic experiments showed that the MAGE-3 peptide loaded nanoparticles could stimulate immune response in vivo and could generate MAGE-3-targeted cytotoxic T lymphocytes (CTLs), and kill MAGE-3-specific tumor cells. Tumor suppression experiments showed that the regression ratio of the peptide-loaded nanoparticles group was 37.81%.</p><p><b>CONCLUSIONS</b>MAGE-3 peptide/chitosan-deoxycholic acidvaccine-loaded nanoparticles can stimulate antitumor immune response in vivo and can regress the growth of mouse forestomach carcinoma cell line MFC.</p>

Target-controlled infusion of propofol combined with remifentanil or fentanyl: A comparison of anesthetic depth / 第二军医大学学报

Objective: To compare the anesthetic depth and postoperative recovery of propofol combined with remifentanil or fentanyl when administered through target-controlled infusion (TCI). Methods: Ninety patients receiving elective epigastric surgery were randomly divided into 3 groups: PF-A, PF-B and PR group. Through TCI, patients in PF-A group were administered with propofol (3 μg/ml) and fentanyl (2 μg/L), in PF-B group with propofol (3 μg/ml) and fentanyl (4 μg/L initially and 2 μg/L after intubation), and in PR group with propofol (3 μg/ml) and remifentanil (6 μg/L). Vital signs (including mean aortic pressure and heart rate) and bispectral index values were recorded pre-anesthesia, pre- and post-intubation, post-incision and during operation in 3 groups. Results: In PF-A group, post-intubation MAP and HR were significantly higher than those of pre-intubation (P<0.05), with obvious stress response during intubation. Whereas there was no significant difference in all parameters between those pre-intubation and post-incision. The vital signs maintained stable during anesthesia and operation in PF-B and PR groups. There was no significant difference in BIS values between 3 groups. During recovery phase the awakening time of PR group was significantly shorter than those of PF-A and PF-B groups. Conclusion: Clinical administration of 4 μg/L fentanyl or 6 μg/L remifentanil can effectively suppress the hemodynamic response to tracheal intubation and incision in propofol TCI anesthesia. However, 2 μg/L fentanyl is only enough to suppress the response to incision but not to intubation.

Clinical experience from treatment of seven SARS patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To summarize the clinical experience from treatment of patients with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Retrospective analysis of seven patients with SARS in Ditan hospital treated since April 22 in 2004 was performed.</p><p><b>RESULTS</b>In the 7 patients, 2 were male, 5 were female, and the average age was (35.3 plus/minus 11.3) years. The main clinical manifestations were fever, cough, minor or serious dyspnea, nausea, signs of injury to other organs, and so on. The treatment regiments included oxygen, small dosage and short period of methylprednisolone (1 to 2 mg/kg), use of ventilator, psychological intervention, and treatment of underlying diseases, after which, all the 7 patients recovered.</p><p><b>CONCLUSION</b>Rational use of methylprednisolone and timely use of ventilator were the key steps of treatment.</p>