[Clinical comparison of modified laparoscopic and conventional placement of peritoneal dialysis catheters].

Objective: To explore the clinical efficacy of the modified laparoscopic placement of peritoneal dialysis catheters by nephrologists. Methods: A total of 188 patients diagnosed as end-stage renal disease (ESRD) were enrolled, who received catheter and continuous ambulatory peritoneal dialysis (CAPD) therapy from January 2011 to May 2016 in Zhejiang Provincial People's Hospital. They were divided into group A (with modified laparoscopic placement of peritoneal dialysis catheters, n=59) and group B (with conventional placement of peritoneal dialysis catheter, n=129). The demographic and clinical characteristics, past abdominal operation history, surgery time, hospital stay after operation, expenses for surgery and hospitalization, early and late complications including bleeding, pain, leakage, peritonitis and catheter displacement were observed. Results: Patients with previous abdominal surgery accounted for 11.9% in group A and 0 in group B(χ2=15.897, P<0.001). The duration of the operation was (38.9±12.8)min in group A and (64.1±12.7)min in group B(t=-6.466 6, P=0.000 0). The cost of the operation was (5 488.4±156.1) yuan in group A and (1 602.7±48.92) yuan in group B (t=257.129, P=0.000 0). Catheter displacement within one month was observed in 0 and 11.6%(χ2=7.455 3, P=0.003), pain in 15.3% and 41.9% (χ2=12.862 2, P=0.000), and catheter displacement after one month in 0 and in 16.3% (χ2=10.812 4, P=0.000) of the patients, respectively in group A and group B. The incidences of peritonitis within one month and beyond one month, leakage, bleeding and so on showed no difference between the two groups(P>0.05). Conclusions: Placement of PD catheter with laparoscope is suitable for renal failure patients with abdominal operation history and replacement PD catheter. It also has the advantages of shorter surgery time, less pain and lower incidences of catheter displacement, expanding the application of PD. However, bleeding, leakage, hernia and other complications are frequently seen.

Downregulation of caspase-9 is a frequent event in patients with stage II colorectal cancer and correlates with poor clinical outcome.

OBJECTIVE: To evaluate the clinical significance of caspase-9 mRNA expression and investigate its prognostic value in stage II colorectal cancer. METHOD: Quantitative real-time RT-PCR was used to analyse caspase-9 mRNA expression in cancer tissue and corresponding normal mucosa from 120 patients. RESULTS: Compared with normal mucosa, the expression of caspase-9 mRNA was found to be downregulated in cancer tissue (P = 0.001). Poorly differentiated cancer showed lower mRNA expression than cancer with greater differentiation (P = 0.031). The Kaplan-Meier survival analysis demonstrated that patients with downregulated caspase-9 showed a worse overall survival (P = 0.012) and disease-free survival (P = 0.022). Cox's proportional hazards regression model confirmed that expression of caspase-9 was the strongest prognostic factor in stage II colorectal cancer. CONCLUSION: The mRNA expression of caspase-9 can be used as an independent prognostic factor for patients with stage II colorectal cancer.

Pharmacokinetics and ex vivo pharmacodynamics of cefquinome in porcine serum and tissue cage fluids.

A tissue cage (TC) model was used to evaluate the pharmacokinetics and ex vivo pharmacodynamics of cefquinome after intravenous (IV) and intramuscular (IM) administration to piglets at 2 mg/kg bodyweight. The mean values of area under the concentration-time curve (AUC) were 21.28 (IV) and 21.37 (IM) µg h/mL for serum, and 17.40 (IV) and 16.57 (IM) µg h/mL for TC fluid (TCF), respectively. Values of maximum concentration (C(max)) were 6.15 µg/mL (serum) and 1.15 µg/mL (TCF) after IM administration. The elimination half-lives (t(1/2ß)) in TCF (10.63 h IV and 11.81 h IM) were significantly higher than those in serum (2.33 h IV and 2.30 h IM) (P<0.05). The values of AUC(TCF)/AUC(serum) (%) after IV and IM administration were 82.4% and 80.7%, respectively. The ex vivo time-kill curves were established for serum and TCF samples using Escherichia coli ATCC 25922. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration values of cefquinome against E. coli were 0.030 and 0.060 µg/mL in Mueller-Hinton broth, and 0.032 and 0.064 µg/mL in both serum and TCF, respectively. The ex vivo growth inhibition data of TCF after IM administration were fitted to the sigmoid E(max) model; AUC(24h)/MIC was 35.01 h for bactericidal activity and 44.28 h for virtual eradication, respectively. The findings from this study suggest that cefquinome may be therapeutically effective in diseases of pigs caused by E. coli when used at a dose rate of 1.33 mg/kg administered every 24 h for organisms with MIC90⩽0.50 µg/mL.