An open-labeled, randomized, multicenter phase IIa study of gambogic acid injection for advanced malignant tumors / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gambogic acid is a pure active compound isolated from the traditional Chinese medicinal plant gamboge (Garcinia morella Desv.). Based on the preliminary results of a phase I study, this phase IIa study compared the efficacy and safety of different dosage schedules of gambogic acid in patients with advanced malignant tumors.</p><p><b>METHODS</b>Patients with advanced or metastases cancer who had not received any effective routine conventional treatment or who had failed to respond to the existing conventional treatment were randomly assigned to receive either 45 mg/m(2) gambogic acid intravenously from Days 1 to 5 of a 2-week cycle (Group A), or 45 mg/m(2) every other day for a total of five times during a 2-week cycle (Group B). The primary endpoint was objective response rate (ORR).</p><p><b>RESULTS</b>Twenty-one patients assigned to Group A and 26 to Group B were included in the final analysis. The ORRs were 14.3% in Group A and 0% in Group B. It was not possible to analyze the significant difference because one of the values was zero. The disease control rates (DCRs) were 76.2% in Group A and 61.5% in Group B (P = 0.0456). The observed adverse reactions were mostly Grades I and II, and occurred in most patients after administration of the trial drug. There was no significant difference in the incidence of adverse reactions between the two arms.</p><p><b>CONCLUSIONS</b>The preliminary results of this phase IIa exploratory study suggest that gambogic acid has a favorable safety profile when administered at 45 mg/m(2). The DCR was greater in patients receiving gambogic acid on Days 1 - 5 of a 2-week cycle, but the incidence of adverse reactions was similar irrespective of the administration schedule.</p>

Status of household disaster preparedness and affecting factors among the general public of four counties in Shaanxi / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the status of household disaster preparedness in 4 counties of Shaanxi province and explore the affecting factors.</p><p><b>METHODS</b>During the period from September to October in 2008, multi-stage sampling was used to select subjects from urban and rural residents in Xincheng district, Hantai district, Fuping county and Xunyang county of Shaanxi province. Questionnaire survey was conducted among 1945 subjects aged 18-88 years to investigate their experience and expectation of disaster events, preparedness knowledge, activities and emergency supplies. Logistic regression was used to analyze the factors influencing household disaster preparedness.</p><p><b>RESULTS</b>The average age of the 1945 subjects was (43.55 ± 12.76) years old. A total of 7.12% (138/1939) of respondents never experienced disaster. Earthquake and fire (57.35% (1175/2049), 19.81% (406/2049), respectively) were rated as the two disasters most likely to occur. The awareness rate of knowledge about household disaster preparedness was 51.43% (989/1923), and 23.41% (454/1939) discussed how to prepare for disaster with their family, only 9.27% (179/1932) attended evacuation drill. The rates of preparing household emergency supplies were 23.64% (230/973), 30.56% (55/180), 31.19% (141/452) and 54.49% (97/178) for urban residents, subjects with junior college or above education, subjects having frequent family discussions of disaster preparedness and subjects participating in emergency rescue drills, respectively. For subjects with junior high school, senior high school and junior college or higher education, the likelihood of preparing household emergency supplies was 5.02 (95%CI: 1.12 - 22.42), 5.74 (95%CI: 1.27 - 26.04) and 6.84 (95%CI: 1.44 - 32.39) times as that of illiterate, respectively. Urban residents, subjects who often discussed disaster preparedness with their family, and who participated in emergency rescue drills were more likely to prepare emergency supplies than rural residents (OR = 4.38, 95%CI: 2.74 - 7.00), those who never discussed (OR = 4.99, 95%CI: 2.52 - 9.91), and who didn't participate (OR = 5.72, 95%CI: 3.84 - 8.51).</p><p><b>CONCLUSION</b>The residents in 4 counties of Shaanxi lack comprehensive knowledge and appropriate activities of disaster preparedness, the rate of preparing household emergency supplies is low. Higher education, living in urban area, frequent family discussions of disaster preparedness and participating in emergency rescue drills are facilitating factors of preparing household emergency supplies.</p>

The application of uncut Roux-en-Y esophagojejunostomy with distal jejunal pouch on behalf of the stomach surgery in the digestive tract reconstruction after total gastrectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinical value of uncut Roux-en-Y esophagojejunostomy with distal jejunal pouch on behalf of the stomach (URYAJP) surgery in the digestive tract reconstruction after total gastrectomy.</p><p><b>METHODS</b>A retrospective analysis of radical resection of the whole stomach in 486 cases of gastric cancer patients, divided into the URYAJP group (n = 189), the P-loop Roux-en-Y behalf of the stomach surgery (PRY) group (n = 150) and pure Roux-en-Y reconstruction (RY) group (n = 147). Three groups were compared in patients with surgical reconstruction time, the occurrence of postoperative complications, the postoperative weight after 6, 12 and 24 months, the single meal food intake and prognostic nutritional index (PNI) and Visick points class situation after 12 and 24 months.</p><p><b>RESULTS</b>(1) The URYAJP group and RY group had no significant difference in digestive tract reconstruction time ((37 ± 6) minutes and (38 ± 6) minutes respectively), but PRY group was significantly prolonged ((47 ± 6) minutes, t = 7.52 and 6.54, P < 0.05). (2) In the comparison of the incidence of complications, URYAJP group has 2.1% rate of Roux stay syndrome (RSS) incidence, significantly less than PRY group (21.3%) and RY group (19.7%) (χ² = 14.84, P < 0.05). (3) In the comparison the postoperative nutritional status, URYAJP group clear asset, showing the degree of ((3.1 ± 1.0) kg) weight loss after 12 months (t = 25.03 and 22.99, P < 0.05). And after 12, 24 months, a single meal eating reached the preoperative level is 94.8% and 96.9% in URYAJP group, while PRY group and RY group is less than 50% (χ(2) = 61.10, 69.17, 65.17 and 73.29, P < 0.05). URYAJP Group reach the preoperative levels of PNI in 24 months after surgery, while PRY and RY group were still lower than per-operation (t = 106.97 and 100.37, P < 0.05). (4) The Visick points class I-II postoperative 12 and 24 months in URYAJP group were 92.7% and 93.8%, significantly better than group B and C (χ² = 10.63, 14.19, 10.10 and 10.74, P < 0.05).</p><p><b>CONCLUSIONS</b>URYAJP surgery give full play to maintain intestinal continuity, simple operation, and advantages of food storage bags, it can reduce the long-term postoperative complications, improve the nutritional status of patients and improve quality of life. It is worthy of promoting a way of gastrointestinal reconstruction.</p>

The role of nitric oxide in ethanol postconditioning induced cardioprotection / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate whether the release of nitric oxide (NO) was involved in the cardioprotection of ethanol postconditioning in isolated rat hearts.</p><p><b>METHODS</b>Hearts isolated from male SD rats were subjected to 30 min of regional ischemia (occlusion of left anterior descending artery) followed by 120 min of reperfusion. Ethanol postconditioning was fulfilled through perfusion of 50 mmol/L ethanol for 15 min (at the end of cardiac ischemia for 5 min and at the beginning of reperfusion for 10 min). The rats were divided into five groups: normal, ischemia and reperfusion, ethanol postconditioning, ethanol postconditioning + L-nitro-arginine-methylester (L-NAME) and ethanol postconditioning + atractyloside. The ventricular hemodynamic parameters and lactate dehydrogenase (LDH) release during reperfusion were measured. The infarct size was measured by TTC staining method and NO content was measured by nitric acid reductase method. The expressions of Bcl-2 and Bax mRNA were detected by RT-PCR analysis.</p><p><b>RESULTS</b>In contrast to ischemia and reperfusion, ethanol postconditioning improved left ventricular developed pressure, rate pressure product during reperfusion, reduced LDH release and infarct size. NO content was decreased. The ratio of Bcl-2/Bax was increased. Administration of nitric oxide synthase inhibitor L-NAME or mitochondrial permeability transition pore opener atractyloside both attenuated the role of ethanol postconditioning, which inhibited the recovery of hemodynamic parameters, the decreases of LDH and infarct size. NO content was decreased further. The ratio of Bcl-2/Bax was decreased.</p><p><b>CONCLUSION</b>The cardioprotection of ethanol postconditioning may be associated with reducing nitric oxide release, inhibiting the opening of mitochondrial permeability transition pore and decreasing the happening of apoptosis.</p>

The effect of cyclosporine A on lipopolysaccharide-induced acute lung injury in mice / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the effect of mitochondrial permeability transition pore inhibitor cyclosporine A (CsA) on lipopolysaccharide (LPS)-induced acute lung injury in mice.</p><p><b>METHODS</b>All male ICR mice were randomly divided into five groups (n = 24): control group, LPS group, dexamethasone group, cyclosporine A(CsA) group and CsA + atractyloside(Atr) group. Six hours after treatment with LPS, the activity of lactate dehydrogenlase (LDH) in bronchoalveolar lavage fluid (BALF) and level of tumor necrosis factor-alpha (TNF-alpha) in lung tissue were detected. The lung wet weight/dry weight ratio and the pulmonary capillary permeability index were also detected.</p><p><b>RESULTS</b>In contrast to LPS group, the mitochondrial permeability transition pore inhibitor CsA induced a decrease in LDH activity in the BALF and TNF-alpha level in lung tissue, lung wet weight/dry weight ratio and the pulmonary capillary permeability index were declined. Atractyloside, the activator of mitochondrial permeability transition pore, almost abolished the role of CsA on LPS-induced lung injury.</p><p><b>CONCLUSION</b>These results suggested that CsA plays the protective effect on LPS-induced lung injury in mice, it is likely through inhibiting the opening of mitochondrial permeability transition pore.</p>

Effect of early enteral nutrition supplemented with glutamine on postoperative intestinal mucosal barrier function in patients with gastric carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of early enteral nutrition (EEN) supplemented with glutamine on postoperative intestinal mucosal barrier function of patients with gastric carcinoma.</p><p><b>METHODS</b>Eighty patients with gastric carcinoma who underwent intraoperative peritoneal hyperthermic chemotherapy(IPHC) were randomized into two groups: EEN+glutamine (EEN+Gln) group(n=40) and EEN group(n=40). Intestinal mucosal barrier function was evaluated by serum diamine oxidase (DAO), ratio of lactulose to mannitol(L/M), endotoxin lipopolysaccharides(LPS), and tumor necrosis factor-α(TNF-α) at 1 day before operation, 1 day, 7 days, 12 days after operation. Time to first flatus and tolerance to EEN were recorded as well.</p><p><b>RESULTS</b>There were no significant differences in the two groups in demographics(all P>0.05). Two cases(5%) in the EEN+Gln group and 1 case (2.5%) in the EEN group could not tolerate well(P>0.05). On postoperative day 1, there were no differences in serum DAO, L/M ratio, LPS, TNF-α between the two groups (P>0.05). On postoperative day 7, all the parameters for mucosal barrier function were significantly lower in the EEN+Gln group. On postoperative day 12, the urinary L/M and DAO, LPS, and TNF-α were still significantly lower in the EEN+Gln group, however, urinary L/M was comparable between the two groups. There were no differences between the two groups in the time to first flatus (P>0.05).</p><p><b>CONCLUSION</b>The immunologic tolerance of enteral nutrition supplemented with glutamine is favorable, which provides protective effect on intestinal mucosal barrier in patients with gastric carcinoma undergoing IPHC.</p>

Nutritional therapy of duodenocutaneous fistula / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the experience in nutritional support for the management of duodenocutaneous fistula.</p><p><b>METHODS</b>Data of 32 patients with duodenocutaneous fistula in Zhejiang provincial people's hospital from January 1999 to December 2009 were analyzed retrospectively.</p><p><b>RESULTS</b>The mean duration of nutritional support was 35.6 days (range, 8-82 days). Eight received total parenteral nutrition, 2 total enteral nutrition, and 22 parenteral nutrition combined with enteral nutrition respectively. Succus entericus reinfusion with enteral nutrition was used in 11 cases, glutamine-enriched nutritional support in 28 cases, somatostatin in 12 cases. In these patients, the healing rate was 75.0% after conservative treatment. In the 8 patients who underwent surgery, 6 were cured and 2 died (due to severe abdominal infection and multiple organ failure). A total of 30 patients had the fistulas cured and discharged.</p><p><b>CONCLUSIONS</b>Parenteral nutrition combined with enteral nutrition, succus entericus reinfusion combined with enteral nutrition, glutamine-enriched nutritional support and somatostatin are important factors for the healing of duodenocutaneous fistulas.</p>

Study on indicator system for evaluating the adult health literacy in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To establish a comprehensive evaluation indicator system for healthy literacy based on national survey data.</p><p><b>METHOD</b>A multi-stage stratified sampling method was carried out to select the sample population in six provinces of China, which were adults aged 18 - 69 years old. The national health literacy questionnaire was used to investigate the sample populations. The answers were scored according to the error answer of 0, uncertain answer of 1 and the correct answer of 2. The degrees of difficulty and difference were calculated and be used to screen the indicators from the questionnaire as to establishing the comprehensive evaluation indicator system of the health literacy. The Cronbach alpha coefficient, correlation analysis, regression analysis and cluster analysis methods were used to assess the reliability and validity of the indicator system.</p><p><b>RESULTS</b>The samples were 11 759 people, the valid questionnaires were 11 693 and the effective recovery rate was 99.4%, the Myer' index of sample was 4.92. There were 40 indexes selected to establish the comprehensive evaluation indicator system of health literacy. The correlation coefficient between indicator system and the questionnaire scores was 0.948 (P < 0.01), there were the significant differences between groups of being clustered by Q cluster analysis method (P < 0.01). The VIF of these four dimensions was less than 5.</p><p><b>CONCLUSION</b>In this study, the comprehensive evaluation indicator system had a good reliability and validity, and there existed no collinearity among four dimensions of indicator system, it should be the foundation for developing comprehensive evaluation index of health literacy.</p>

Public health situation and needs assessment after Wenchuan earthquake in Anxian, Sichuan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the public health situation and needs in Anxian after Wenchuan earthquake so as to make an effective strategy for disease control and prevention.</p><p><b>METHODS</b>69 concentrated settlements with 100 residents were investigated. Probability proportion to size was adopted for sampling of 2200 residents from 687 scattered households (about 440 000 scattered residents). The content of this survey included drinking water, food hygiene, environment sanitation, planning immunity and medical health service, disease surveillance and so on. SPSS 16.0 was used for data analysis, and statistical interpretation was used to describe the results.</p><p><b>RESULTS</b>90.9% (31/66) resettled residents in Anxian lived in tents, 7.6% (5/66) lived in the movable-plate house, 93.3% (621/666) scattered households lived in tents and 71.9% (446/621) of them lived in tents which were built by residents themselves; the rate of drinking water disinfection in resettlement sites and scattered households were 97.1% (66/68) and 94.6% (650/687); 12.8% scattered residents had mouldy or food; 50% of resettlement sites raised animals; 43.6% (17/39) medical station didn't have bacterin inoculation service; 66.7% (10/15) lacked sufficient disinfection equipment; register rate was 50.0% (33/66) and report rate of symptoms and infectious diseases was 56.1% (37/66).</p><p><b>CONCLUSION</b>There was still some risk of enteric and vector-borne diseases in Anxian, therefore, some tailored measures should be very important.</p>

Mental health assessment among scattered residents after Wenchuan earthquake in Anxian, Sichuan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the mental health status of residents scattered living in Anxian after Wenchuan earthquake so as to provide scientific basis for further mental health intervention.</p><p><b>METHODS</b>A face to face interview was conducted among the scattered residents with designed questionnaire, which had three parts of the physical and emotional reaction, the relax methods and the social care and supports expected. Two-stage probability proportional to size (PPS) sample method was performed to sample 2184 from 0.44 million scattered residents in Anxian. On the basis of statistical description, mental health of different characteristics groups was compared.</p><p><b>RESULTS</b>Three main symptoms of posttraumatic stress disorders in 2184 residents (11.23+/-3.44) were higher than the 103 fire victims in Hunan in 2003 (10.06+/-3.26), three factor scores of SCL-90 (5.76+/-1.74) were higher than normal in 1998 repair mode (n=23 891) (4.72+/-1.44), and the statistical difference was observed (t=10.77, P<0.05; t=706.04, P<0.05). Comparing the mental health of different groups, some significant differences were found by age, gender and education background.</p><p><b>CONCLUSION</b>The earthquake disaster brought prevalent physical and emotional reaction. Elderly people, female, junior students need mental intervention immediately. Therefore, strengthen the mental education and assistance (especially in high risk groups) would be of more significance.</p>

Meta analysis for relationship between exposure of free silicon dioxide and lung tumor / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>Meta-analysis is applied to process a systematic, comprehensive evaluation on the relationship between silica exposure and lung cancer in order to provide scientific evidences for controlling measures and offer a case for EBOM.</p><p><b>METHODS</b>According to established entrance standards, the collected original articles on silica exposure and lung cancer were classified and put in order, then fixed effects model and random effects model were used which suited to analyze occupational epidemiology and occupational tumor materials, and their correlation intensity were analyzed. First, combined SMR and 95% CI values for case-control study and cohort study were calculated respectively. Then all case-control studies and cohort studies were combined according to different study designs, mixed factors adjusted and stratification analysis processed, and their SMR and 95% CI calculated respectively. In order to lessen bias or errors, fail safe number was calculated.</p><p><b>RESULTS</b>When combining all the cohort study and all the case-control study respectively, corresponding combination SMR(cohort) = 1.93, 95% CI is 0.55 - 6.92; SMR case = 1.73, 95% CI is 1.01 - 2.99; SMR(sum) = 2.19, 95% CI is 1.45 - 3.31. Statistical test showed a statistically significant relationship lied between silica exposure and lung cancer, with P < 0.05.</p><p><b>CONCLUSION</b>Middle intensity relation is drawn between silica exposure and lung cancer incidence at worksite. This result is consistent with a lot of public reports.</p>

Protective effect of Gastrodia elata and E-gelatin on lead-induced damage to the structure and function of rat hippocampus / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the counteraction of Gastrodia elata and E-gelatin on the effect of subchronic lead poisoning on the ability of learning and memory and the ultrastructure in hippocampus.</p><p><b>METHODS</b>Subchronic lead acetate exposure was given to rats (0.2 g x kg(-1) x d(-1)). Single and combined administration of Gastrodia elata (4 g x kg(-1) x d(-1)) and E-gelatin (1 g x kg(-1) x d(-1)) were conducted at the same time. Pb concentration in blood, and the ability of learning and memory (Y-maze test) of rats were measured. Ultrastructure of CA3 pyramidal cells in hippocampus under transmission electron microscope was observed.</p><p><b>RESULTS</b>Blood Pb concentrations in each group (Pb group: 690.6 micro g/L, Pb + Gastodiae eleta group: 688.8 micro g/L, Pb + E-gelatin group: 663.8 micro g/L, Pb + combined group: 667.2 micro g/L) were higher than that in the control (28.24 micro g/L, P < 0.01). But there was no significant difference (P > 0.05) among these groups. In Y-maze test, the number of electric stroke in Pb group is higher than that in control (P < 0.01). Gastrodia elata or E-gelatin used singly could significantly reduce the number of electric stroke of lead-exposed groups (P < 0.05 in the first month and P < 0.01 in the second and third month). And the effect of combined use of them was more efficient than single use (P < 0.01). Under electron microscope, no anomaly was seen in the pyramidal cells of CA3 area in hippocampus of control group. But there was significant anomaly such as neucleus separation in the cells of Pb exposed group. In Pb-Gastrodia elata group, there were some stress response phenomena such as the occurrence of huge mitochondria while in Pb-E-gelatin group, the anomaly was mild. The cells in the CA3 area in hippocampus of the pb-Gastrodia-E-gelatin group were almost normal, and also showed some stress response phenomena.</p><p><b>CONCLUSION</b>Gastrodia elata and E-gelatin may protect the neurons in CA3 area of hippocampus against damage induced by lead to improve the ability of learning and memory, and they have synergistic effect.</p>

The antagonistic action of Gastrodia elata combined with E-gelatin on lead-induced down regulation of c-fos expression in rat brain / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To observe the effect of lead on the expression of c-fos mRNA in hippocampus and cerebellum and the ability of learning and memory in rat, and to observe the antagonistic action of Gastrodia elata and E-gelatin on the effect mentioned above.</p><p><b>METHODS</b>Rats were exposed to lead acetate (0.2 g x kg(-1) x d(-1) and 0.1 g x kg(-1) x d(-1)). The single and combined administration of Gastrodia elata (4 g x kg(-1) x d(-1)) and E-gelatin (1 g x kg(-1) x d(-1)) were conducted at the same time. Blood lead concentration in rats were measured. The ability of learning and memory by Y-maze test were examined. The expression of c-fos mRNA in hippocampus and cerebellum during Y-maze test were observed by in situ hybridization (ISH).</p><p><b>RESULTS</b>(1) Blood lead concentrations were significantly increased in both high and low doses of lead-exposed rats (P < 0.01). But there were no differences among high dose groups or low dose groups (P > 0.05). (2) In Y-maze test, the number of electric stroke during learning in lead-exposed group was significantly increased (P < 0.01) while that in Gastrodia elata and E-gelatin groups was significantly decreased (P < 0.05), and that in combined use group was more significantly decreased (P < 0.01). (3) There were much more deep-colored c-fos positive cells in CA3 area of hippocampus in low dose of Pb-exposed with Gastrodia elata + E-gelatin group. These cells were also found in high Pb with combined use or single use group, but which were not so densely distributed as the former. And they were hardly found in high and low doses of Pb alone groups. The changes of expression of c-fos cells in cerebellam were similar to those in hippocampus.</p><p><b>CONCLUSION</b>The down regulation of c-fos expression may be one of the molecular mechanism of lead-induced impairment of learning and memory. Gastrodia elata and E-gelatin may antagonize the effect of lead on c-fos expression, and combined use of both drugs may potentiate the antagonism.</p>