In Vitro and In Vivo Assessment of Docetaxel Formulation Developed for Esophageal Stents.

Esophageal cancer (EC) mostly affects the elderly population and is frequently diagnosed at an advanced stage. Self-expanding metal stents (SEMS) are the most popular mode of palliation, but they are associated with reocclusion caused by tumor growth. To overcome this problem, docetaxel (DTX)-loaded polyurethane formulations were prepared for stent application. The films were evaluated against the cancer cell lines, OE-19 and OE-21, and normal esophageal cell line Het-1A. The DTX and the formulations were evaluated in vitro for the cytotoxicity and in vivo in nude mice. It was found that DTX and the formulations have a weak activity against the EC cell lines and an even weaker activity against Het-1A cell line. Preliminary in vivo studies showed skin toxicity in nude mice necessitating modification of the formulation. Reevaluation in a mouse xenograft model resulted in toxicity at high dose formulations while the low dose formulation exhibited modest advantage over commercial IV formulation; however, there was no significant difference between the commercial IV and blank formulation. DTX combination with an anti-cancer agent having complementary mode of action and non-overlapping toxicity could yield better outcome in future.

Row Ratios of Intercropping Maize and Soybean Can Affect Agronomic Efficiency of the System and Subsequent Wheat.

Intercropping is regarded as an important agricultural practice to improve crop production and environmental quality in the regions with intensive agricultural production, e.g., northern China. To optimize agronomic advantage of maize (Zea mays L.) and soybean (Glycine max L.) intercropping system compared to monoculture of maize, two sequential experiments were conducted. Experiment 1 was to screening the optimal cropping system in summer that had the highest yields and economic benefits, and Experiment 2 was to identify the optimum row ratio of the intercrops selected from Experiment 1. Results of Experiment 1 showed that maize intercropping with soybean (maize || soybean) was the optimal cropping system in summer. Compared to conventional monoculture of maize, maize || soybean had significant advantage in yield, economy, land utilization ratio and reducing soil nitrate nitrogen (N) accumulation, as well as better residual effect on the subsequent wheat (Triticum aestivum L.) crop. Experiment 2 showed that intercropping systems reduced use of N fertilizer per unit land area and increased relative biomass of intercropped maize, due to promoted photosynthetic efficiency of border rows and N utilization during symbiotic period. Intercropping advantage began to emerge at tasseling stage after N topdressing for maize. Among all treatments with different row ratios, alternating four maize rows with six soybean rows (4M:6S) had the largest land equivalent ratio (1.30), total N accumulation in crops (258 kg ha(-1)), and economic benefit (3,408 USD ha(-1)). Compared to maize monoculture, 4M:6S had significantly lower nitrate-N accumulation in soil both after harvest of maize and after harvest of the subsequent wheat, but it did not decrease yield of wheat. The most important advantage of 4M:6S was to increase biomass of intercropped maize and soybean, which further led to the increase of total N accumulation by crops as well as economic benefit. In conclusion, alternating four maize rows with six soybean rows was the optimum row ratio in maize || soybean system, though this needs to be further confirmed by pluri-annual trials.

Classification criteria of early rheumatoid arthritis and validation of its performance in a multi-centre cohort.

OBJECTIVES: To develop classification criteria for early rheumatoid arthritis (ERA) based on a large cohort of early inflammatory arthritis patients and to evaluate the performance of these criteria. METHODS: The study population comprised a cohort of early inflammatory arthritis patients with symptom duration less than one year. Classification criteria of ERA were developed by incorporating the most sensitive or specific variables. Performance of the ERA criteria, 1987 ACR and 2010 ACR/EULAR criteria were evaluated. RESULTS: A total of 803 patients were enrolled in this study. By the end of the one year follow-up, 514 patients were diagnosed with RA, 251 with other rheumatic diseases, and 38 patients with undifferentiated arthritis. The ERA criteria are as follows: 1) morning stiffness ≥30 minutes; 2) arthritis of 3 or more joint areas; 3) arthritis of hand joints; 4) positive RF; 5) positive anti-CCP antibody. Rheumatoid arthritis is defined by the presence of 3 or more of the criteria. The sensitivity (84.4%) of the ERA classification criteria was much higher than the 1987 ACR criteria (58.0%). In a validation cohort of early inflammatory arthritis patients, the area under the ROC curves (AUC) showed a better performance for the ERA criteria (0.906, 95%CI 0.866 to 0.945) than the 1987 ACR criteria (0.786, 95%CI 0.725 to 0.848) and the 2010 ACR/EULAR criteria (0.745, 95%CI 0.677 to 0.814). CONCLUSIONS: A set of ERA classification criteria has been developed with good performance for early RA. It is applicable in clinical practice and research.

[Characteristics of patients and their medical cost on 14,398 hospitalized patients suffered form hepatitis B, from a hospital of infectious diseases located in Beijing].

OBJECTIVE: This article was to focus on the study of patient's profile, type and distribution of the disease and the related factors contributing to medical cost on 14 398 cases of hospitalized patients with hepatitis B from a hospital of infectious diseases located in Beijing, in order to provide basic information on optimizing the prevention and treatment strategies. METHODS: Information on hospital admission of patients with hepatitis B was collected and SPSS 16.0 statistics software package was used to analyze the profile, disease patterns distribution, structure of medical costs and main contributors related to medical costs. RESULTS: Through analysis, we found that the proportion of male patients was much bigger than that of female patients, with ratio as 2.9. The average age of patients with hepatitis B was 45.2 years old. The treatment process was time consuming, and the mortality rate was high. Our data showed that the mortality of hospitalized patients was up to 7% and the average age of death was 55 years old. Hepatitis B infection was easy to develop into chronic, cirrhosis and even liver cancer. For treatment cost, the largest cost share was the drugs being used which accounted for 62.4%. In terms of health care costs, it was high and the total cost of hospitalization was related to the following factors:days of hospitalization;complexity of the disease condition and the factors as the severity of the disease complications as surgery, frequencies of rescue, type of disease etc; basic information of the patients as age, occupation, origin. CONCLUSION: Compared with other diseases, the proportion of male patients with hepatitis B was much higher than that of the female. Hepatitis B had a longer duration and difficult, treatment high cost of medical care, poor prognosis, high mortality rate; Cost control, can not simply fixed by single disease, but by complexity of the disease and patient characteristics.

On-line identification of 4''-isovalerylspiramycin I in the genetic engineered strain of S. spiramyceticus F21 by liquid chromatography with electrospray ionization tandem mass spectrometry, ultraviolet absorbance detection and nuclear magnetic resonance spectrometry.

LC-hyphenated techniques were applied to the on-line identification of isovalerylspiramycin I (isp I), a spiramycin-like macrolide in the crude extract of fermentation broth from a genetically engineered strain of S. spiramyceticus F21. In the structural characterization of the large molecular secondary metabolite of isp I, LC-DAD-UV-ESI-MS(n) analysis played a crucial role, and stop-flow LC-(1)H NMR measurement, with bitespiramycin used as reference, was a valuable complement approach. This rational approach proved to be an efficient means for the rapid and accurate structural determination of known microbial secondary metabolites, by which targeted isolation of component(s) of interest can be subsequently performed for further biological and pharmacological studies in drug development.

[Using diagnosis relative groups mortality risk classification to assess medical quality].

OBJECTIVE: To introduce diagnosis related groups to assess the medical quality and try to establish an effective quality evaluation approach. METHODS: Using Australia-Refined Diagnosis Related Groups, version 5.0 (AR-DRGs v5.0) to classify the 160 000 discharged cases from 7 large hospitals in Beijing in 2005. Based on this, mortality risk classification was established to adjust the whole-hospital risks. And then hospital mortality of all the risk groups from each hospital was calculated respectively, which was used as the basic quality assessment criterion. The differences between the assessment results from using the raw hospital mortality and from using Diagnosis Relative Groups Mortality Risk Classification (DRGs-MRC) were compared. RESULTS: (1) The risk types were different among the discharged cases in different hospitals; (2) The assessment results from these two approaches about No.6 hospital were similar in that No.6 hospital had a good quality performance; (3) The raw hospital mortality was the lowest in No.2 hospital (0.98%), but the mortality of low risk group in this hospital was higher than the average level of the same risk group among these 7 hospitals; the status of No.5 hospital was much the same. CONCLUSION: Compared with raw hospital mortality, DRGs-MRC improved the comparability of cases and the reliability of the assessment result.