[Quantitative structure characteristics and fractal dimension of Chinese medicine granules measured by synchrotron radiation X-ray computed micro tomography].

The shape and structure of granules are controlled by the granulation process, which is one of the main factors to determine the nature of the solid dosage forms. In this article, three kinds of granules of a traditional Chinese medicine for improving appetite and promoting digestion, namely, Jianwei Granules, were prepared using granulation technologies as pendular granulation, high speed stirring granulation, and fluidized bed granulation and the powder properties of them were investigated. Meanwhile, synchrotron radiation X-ray computed micro tomography (SR-µCT) was applied to quantitatively determine the irregular internal structures of the granules. The three-dimensional (3D) structure models were obtained by 3D reconstruction, which were more accurately to characterize the three-dimensional structures of the particles through the quantitative data. The models were also used to quantitatively compare the structural differences of granules prepared by different granulation processes with the same formula, so as to characterize how the production process plays a role in the pharmaceutical behaviors of the granules. To focus on the irregularity of the particle structure, the box counting method was used to calculate the fractal dimensions of the granules. The results showed that the fractal dimension is more sensitive to reflect the minor differences in the structure features than the conventional parameters, and capable to specifically distinct granules in structure. It is proved that the fractal dimension could quantitatively characterize the structural information of irregular granules. It is the first time suggested by our research that the fractal dimension difference (Df,c) between two fractal dimension parameters, namely, the volume matrix fractal dimension and the surface matrix fractal dimension, is a new index to characterize granules with irregular structures and evaluate the effects of production processes on the structures of granules as a new indicator for the granulating process control and optimization.

Immunohistochemical detection of X-linked inhibitor of apoptosis in head and neck squamous cell carcinoma.

The X-linked inhibitor of apoptosis (XIAP) is the most potent member of the IAP group of structurally related caspase inhibitors. Experimental and clinical evidence implicates XIAP in resistance to cancer therapy and in clinical aggressiveness of certain tumors. We examined the expression of XIAP in head and neck squamous cell carcinoma (SCC). Four-micrometer sections from 59 routinely processed specimens of head and neck SCC were subjected to citrate-based antigen retrieval, followed by incubation with monoclonal anti-XIAP antibody (BD Biosciences, San Jose, Calif) and EnVision Plus reagents (Dako, Carpinteria, Calif). Granular cytoplasmic staining was considered positive; the extent and intensity of staining were recorded. Normal squamous epithelium was either nonstaining (n=22), displayed generally weak basal staining (n=9), or moderate basal staining (n=1). Squamous dysplasia or carcinoma in situ was either nonstaining (10 of 18 cases) or displayed generally weak staining (8 of 18 cases). Varying degrees of XIAP positivity were found in 41 (69.5%) of 59 carcinomas. Most of the nonstaining and weakly staining carcinomas were well or moderately differentiated. In contrast, intense and extensive staining was most frequently found in poorly differentiated carcinomas. In keratinized tumor nests, staining was strongest peripherally and became diminished in central keratinized zones. New parameters of tumor aggressiveness are needed for more effective triaging of patients to appropriately aggressive therapies. The present findings suggest that the potent apoptotic inhibitor XIAP may be such a biomarker in head and neck SCCs, of resistance to apoptosis-inducing therapies, and, possibly, of responsiveness to a new class of XIAP-suppressive drugs presently in clinical trials for other malignancies or in preclinical development.

[Continuous renal replacement therapy for severe acute renal failure].

OBJECTIVE: To estimate the clinical value of continuous renal replacement therapy (CRRT) in the treatment of severe acute renal failure (ARF) and identify the factors influencing the patients' prognosis. METHODS: The clinical characteristics, disease severity and prognosis were retrospectively studied in 116 patients with severe ARF undergoing CRRT from January, 1998 to May, 2004, in comparison with those in 102 such patients treated with intermittent hemodialysis (IHD). RESULTS: The mean score of Acute Physiology and Chronic Health Evaluation II (APACHE II) was 27.0+/-7.5 in patients receiving CRRT, of whom 56 (48%) had a score no less than 29, 36 (31%) between 24 to 29 and 24 (21%) less than 24. The mean APACHE II score was 21.9+/-5.2 in patients with IHD, and none of them had a score over 29, 44 (43%) had a score between 24 to 29 and 58 (57%) less than 24. The mean APACHE II score of CRRT group was significantly higher than that of IHD group (t=4.769, P=0.000), suggesting that most of the patients treated with CRRT were in critical condition. The patients' survival rate, however, did not differ significantly between the two groups, being 37% (43/116) in CRRT group and 48/ (49/102) in IHD group (X2=2.678, P=0.101 8). When only the patients with a score no less than 24 were compared, the survival rate of CRRT group was significantly higher than that of IHD group (24% vs 9%, X2=4.229, P=0.039 7), demonstrating better effect of CRRT than IHD in the management of critical ARF cases. In patients treated with CRRT, the patients in fatal cases had significantly older age, more critical condition (indicated by APACHE II score) and greater dependence on mechanical ventilation or vasoactive support than those who survived (P<0.05). CONCLUSIONS: CRRT is one of the effective methods for management of severe ARF patients, especially in those with critical conditions, with better effect than that of IHD. The prognosis of severe ARF patients treated with CRRT can be influenced by the patients' age and disease severity, and the need of vasoactive drugs or mechanical ventilation may help predict the patients' prognosis.