Abstract Background Due to the unique anatomical location of retroperitoneal metastatic lymph nodes, current treatment options are limited. This study was designed to explore the clinical efficacy and prognostic factors of CT-guided 125 I brachytherapy for the treatment of retroperitoneal metastatic lymph nodes. Methods We retrospectively evaluated 92 patients received 125 I brachytherapy for retroperitoneal metastatic lymph nodes. A layered Cox proportional hazards model was established to filter out the independent factors affecting local tumor progression-free survival (LTPFS). Results The median LTPFS was 8 months. Metastatic lymph node with uniform density (p-0.009), clear boundaries (p-0.011), regular morphology ( P < 0.001), and < 3 organs at risk of metastasis (p-0.020) were associated with better LTPFS. Necrotic lymph nodes ( p < 0.001), fusion (p-0.003), and invasion of vessels visible on images ( p < 0.001) were associated with poor LTPFS. Puncture path through abdominal wall or paravertebral approach were also associated with better LTPFS than a hepatic approach ( P < 0.05). A maximum diameter ≤ 3 cm (P-0.031) or 3–5 cm (P-0.018) were also associated with significantly better LTPFS than a maximum diameter ≥ 5 cm. The Cox proportional hazards model suggested that lymph nodes invaded the large vessels visible on images, maximum diameter and puncture path were independent risk factors for LTPFS. Conclusion CT-guided 125 I brachytherapy is an optional palliative treatment modality for retroperitoneal metastatic lymph nodes, which can provide high local control without severe complications. Better preoperative planning, intraoperative implementation, better choice of puncture path, and selection of appropriate tumor size are important factors that can improve the clinical efficacy of 125 I brachytherapy for retroperitoneal metastatic lymph nodes.
Sansanmycins, members of the uridyl peptide antibiotics, are assembled by nonribosomal peptide synthetases (NRPSs), the substrate promiscuity of which results in the diversity of products. Further exploration of the NRPSs' substrate promiscuity by reinvestigating sansanmycin producer strain led to the isolation and structural elucidation of eight new uridyl peptides, sansanmycins H–O (1–8). Among them, sansanmycin L, containing a 6-OH-bicyclic residue and Phe3 first found at the position AA3, exhibited activity against M. tuberculosis H37Rv with an MIC value of 2 μg/mL, 8-fold more potent than that of the major compound, sansanmycin A (MIC = 16 μg/mL).
Background: The aim was to describe the characteristics and outcomes of patients treated for electric bicycle-related open-globe injuries (OGIs). Methods: A retrospective chart review of all patients who presented with electric bicycle-related OGIs was performed at the Hebei Eye Hospital in North China between January 2012 and December 2018. Demographic data, injury type, presenting clinical examination findings, best-corrected visual acuity (BCVA), secondary ocular complications, necessary surgical procedures and long-term outcome data were recorded. Results: Twenty-six patients with electric bicycle-related OGIs met the inclusion criteria and were enrolled in the study. Eighteen of the 26 patients (69.2%) were males. the average age of these patients was 44.0 years old. The injuries peaked in winter in the hour between 15:00 and 20:00. Among the patients, 23 (88.5%) were farm workers, 2 (7.7%) were industrial workers, 1 (3.8%) was student. The types of OGIs were 23 ruptures (88.5%), 3 penetrating injuries (11.5%). Data on zone of injuries included 1 zone I injuries (3.8%), 12 zone II injuries (46.2%), 13 zone III injuries (50.0%). Nine eyes (34.6%) had traumatic cataract, 24 eyes (92.3%) had vitreous hemorrhage, 20 eyes (79.9%) had retinal detachment, 19 eyes (73.1%) had choroidal detachment. Ten eyes (38.4%) had hand motion or worse vision at final follow-up. four eyes (15.4%) which had injuries involving all 3 zones resulted in enucleation or evisceration. With respect to BCVA, the initial BCVA was 2.7±0.3 and the final BCVA was 2.0±0.7, indicating that the patients’ BCVA was significantly improved by surgery ( t =4.3, P <0.001). Conclusions: Electric bicycle-related OGIs may have severe consequences. Modern surgical techniques can increase the rate of globe salvage although final vision remains poor. Therefore, increased awareness, proposed policies and suggestions should focus on regulating the use of electric bicycles and reinforcing laws and regulations to improve safety and prevent injuries.
The studies reported here were conducted to investigate the transport characteristics of apixaban and to understand the impact of transporters on apixaban distribution and disposition. In P‐gp and BCRP‐cDNA transfected cell monolayers, as well as Caco‐2 cell monolayers, the apparent efflux ratio of basolateral to apical (Pc B‐A ) versus apical to basolateral permeability (Pc A‐B ) of apixaban was 10–38 compared to the apixaban efflux ratios of 1–4 in control cells. The P‐gp and BCRP‐facilitated transport of apixaban was concentration‐and time‐dependent and did not show saturation over a wide range of concentrations (1–100 μM). The efflux transport of apixaban was also demonstrated by the lower mucosal to serosal permeability than that of the serosal to mucosal direction in the isolated rat jejunum segments. Apixaban did not inhibit digoxin transport in Caco‐2 cells. Ketoconazole decreased the P‐gp‐mediated apixaban efflux in Caco‐2 and P‐gp‐cDNA transfected cell monolayers, but did not affect the apixaban efflux to a meaningful extent in BCRP‐cDNA transfected cell monolayers. Co‐incubation of a P‐gp inhibitor (ketoconazole or cyclosporin A) and a BCRP inhibitor (Ko134) provided more complete inhibition of apixaban efflux in Caco‐2 cells than separate inhibition by individual inhibitors. These results demonstrate that apixaban is a substrate for efflux transporters P‐gp and BCRP, which helps explain the observed disposition characteristics of the drug in rat studies that include its low brain penetration, low fetal exposure, and extensive excretion into milk.
Objective To investigate the clinical efficacy of Baofukang suppository combined with policresulen solution in the treatment of cervical intraepithelial neoplasia(CINⅠ) patients with high risk human papillomavirus(hr-HPV) infection. Methods A total of 240 women diagnosed as CINⅠcombined with hr-HPV infection were randomly divided into 4 groups:Baofukang suppository group(n=60),policresulen solution group(n=60),Baofukang suppository+policresulen solution group(n=60),and blank control group(n=60).The response rates of CINⅠand hr-HPV infection were compared. Results The response rates in treatment groups were significantly higher than that in control group,especially in Baofukang suppository+policresulen solution group(P0.05).No severe side effects occurred. Conclusion Baofukang suppository combined with policresulen solution in the treatment of CINⅠand hr-HPV infection is a safe and effective method.
Fat embolism syndrome refers to after severe trauma, especially long bone fracture or postoperative orthopedic surgery, the traumatic reaction results in the formation of lipothrombosis in the blood and bone marrow adipose tissue (>8 μm in diameter) through fractured blood vessels into the blood, causing a series of pathophysiological changes.This article reviews the understanding of the pathogenesis, diagnosis and treatment of fat embolism syndrome in recent years.
Key words:
Fat embolism syndrome; Pathogenesis; Diagnosis; Treatment
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