The TNM staging is the most common tumor staging system of lung cancer.The new revisioned 7th lung cancer TNM staging is published by the international association for the study of lung cancer (IASLC) in the 13th world conference on lung cancer.Accurate clinical staging depends on the multi-analysis from medical histroy,clinical examination,imaging examination and invasive test,which has important significance for guiding the treatment of lung cancer.The 7th lung cancer TNM classification has been revised respectively from the primary focus,lymph node metastasis and remote viscera metastasis,so as to make it more accurately corresponding to the prognosis of patients.

Objective To evaluate the effects of peer education program on HIV/AIDS prevention among senior high school students. Methods Three senior high schools were randomly selected from Hongkou District of Shanghai as sample schools. One hundred and forty-three students from one class of each school were randomly selected as intervention group,and 152 students from another class of each school were served as control group. Six class hours of peer education program on HIV/AIDS prevention were conducted among intervention group. The same questionnaires which contained knowledge of reproductive health,HIV/AIDS and sexually transmitted diseases were administered before the program,one week and one year after the program. Results The knowledge scores before the program,one week and one year after the program in intervention group were 21.66?8.71,31.72?7.78 and 30.97?8.46,respectively,and those in control group were 22.32?9.24,22.61?8.66 and 22.51?9.16,respectively. There was no significant difference in the knowledge scores before the program between intervention group and control group,while there were significant differences in the knowledge scores one week and one year after the program between intervention group and control group (P

Objective To summarize the clinical and pathological characteristics of gastrointestinal stromal tumors with hepatic metastasis, and to analyze its survival and explore its principles of diagnosis and treatment. Methods Among 99 patients diagnosed as gastrointestinal stromal tumors who had a completely case history in our hospital, we retrospectively analyzed the clinical data of 26 patients with hepatic metastatic and the factors influencing survival. Results The average age at diagnosis of primary and hepatic metastatic gastrointestinal stromal tumors was 50.8 and 51.8 years old respectively. Five cases were confirmed by pathological examination, 12 cases were diagnosed by the exploration during the operation and 14 patients had an imaging diagnosis only. Synchronous and metachronous hepatic metastasis happened in 8 and 18 patients respectively. The median interval between the primary tumor and the metachronous hepatic metastasis was 12 months. The primary sites of 12 cases were in stomach, 5 in colorectum, 6 in small intestine and 3 in extra-gastrointestinal tract.Four cases of the hepatic metastatic tumors were treated with surgical resections, 2 with injections of anhydrous alcohol, 3 with interven-tional therapies, 7 with systemic chemotherapies, 8 with imatinib and 2 without treatment. The median survival was 21 months after hepatic metastasis. The administration of imatinib was an important factor prolonging the survival after hepatic metastasis. Conclusions The most frequent primary site of hepatic metastatic stromal tumor is the stomach while small intestinal stromal tumors are most inclined to metastasize to the liver. Treatment with imatinib for more than 3 months can prolong the survival.

History, 20th Century ; History, 21st Century ; Periodontics ; history

This study was aimed to observe curative effect of periarthritis of shoulder with activating brain and re-gaining consciousness acupuncture method combined with surrounding needling acupuncture on shoulder joint. A to-tal of 120 patients were randomly divided into the treatment group (60 cases) and the control group (60 cases) on the basis of routine internal medicine treatment and rehabilitation exercises. Cases in the control group received conven-tional acupuncture treatment. And cases in the treatment group received activating brain and regaining conscious-ness acupuncture method combined with surrounding needling acupuncture on shoulder joint. The treatment course was 28 days. And then, the curative effect evaluation was conducted. The results showed that the effective rate was 73.33% in the control group and 93.34% in the treatment group. There was statistical significance on effective rate between both groups(P< 0.05). It was concluded that the activating brain and regaining consciousness acupuncture method combined with surrounding needling acupuncture on shoulder joint had significant curative effects for peri-arthritis of shoulder. This treatment method is worthy of further popularization and application.

Objective To investigate the risk factors for delayed graft function (DGF) recovery in the recipients of kidney transplantation after the operation. Methods The data of 209 recipients who received kidney transplantation during January 2005 to March 2007 were analyzed retrospectively. The DGF group comprised of 47 cases. 162 cases without DGF constituted the control group. Chi-square analysis method was employed to look for the risk factors of DGF, including warm ischemia time ≥10min, hypovolaemia in the recipient, acute tubular necrosis (ATN), nephrotoxicity of calmodulin inhibitors, acute rejection (AR), 12h ≤ cold ischemia time ≤ 24h, sex, age ≥ 50, the modus of dialysis, the number of times of transplantation, human leucocyte antigen (HLA) zygosity, urinary fistula or obstruction of ureter during early period after operation, blood-transfusion before transplantation and hepatitis virus infection. Then Logistic regression analysis was used to assess and rank the relative risk of potential variables. Results The incidence of DGF was 22.5%(47/209). All patients recovered within 20.8?10.3 days except 2 cases due to AR and 1 case due to graft phlebothrombosis. The relative risk factors include AR, ATN, nephrotoxicity of calmodulin inhibitors, recipient hypovolaemia and warm ischaemia time ≥ 10min. Conclusion The ranking of risk factors is as following, ATN, nephrotoxicity of calmodulin inhibitors, recipient hypovolaemia, AR and warm ischaemia time ≥ 10min, according to decrement of the coefficient correlation. It is very important to comprehend the risk factors thoroughly in order to prevent them effectively.

Objective To investigate the expression of human leukocyte antigen-G5 (HLA-G5) in healthy Chinese people and the recipients of renal and liver transplantation. The regulating mechanism of the expression of HLA-G5 was discussed by comparing the expression of HLA-G5 in the healthy people with that in renal and liver transplantation recipients. Furthermore, the changing regularity with time was studied by kinesis supervising the expression of HLA-G5 in renal and liver transplantation recipients. Methods The peripheral blood samples (3ml) from 30 health people, 50 recipients of liver transplantation (liver function was stable 3 months after liver transplantation) and 50 recipients of renal transplantation (renal function was stable 3 months after renal transplantation) were collected. Peripheral blood samples were also collected in same amount from 33 recipients of renal and liver transplantation before operation and 1, 4 and 12 weeks and 1 year after operation. The HLA-G5 of all serum samples was analyzed by ELISA. Results For 30 healthy people, the OD value of HLA-G5 in 28 people was below 0.5, for which the contents were defined as 0.0ng/ml according to standard and the contents for the other 2 people were 8ng/ml and 9ng/ml, respectively. 16 of 50 recipients undergone liver transplantation were positive for the expression of HLA-G5, the positive ratio was 32%. The contents in 4 recipients were higher than 30ng/ml. 10 of 50 recipients of renal transplantation were positive in the expression of HLA-G5, the positive ratio was 20%. The contents in one recipient were higher than 25ng/ml. The average contents in sera of healthy people, recipients of liver or renal transplantation were 0.56?0.20ng/ml, 8.34?1.50ng/ml and 3.26?0.25ng/ml, respectively. For 33 recipients of liver or renal transplantation, the expression of HLA-G5 was detected by ELISA, and it was found that one recipient the expression of HLA-G5 was positive before operation and within 1 week after operation; expression of HLA-G5 was positive in 4 recipients within 4 weeks after operation; expression of HLA-G5 was positive within 12 weeks after operation in 12 recipients; and the expression of HLA-G5 was positive within 1 year after operation in 11 recipients. Conclusion The expression of HLA-G5 in healthy people is low. There are correlation between the expression of HLA-G5 and immunotolerance to transplants. In minor rejection condition after transplantation, there are different expression levels of HLA-G5, and it is higher after liver transplantation than!renal transplantation. The time for expression of HLA-G5 corresponds with the time for mRNA of HLA-G5 transcription into protein, and it is about 15-60 days, with 60 days as the peak time.

Objective Based on the detection of soluble leukocyte-associated immunoglobulin-like recepter-1 (sLAIR-1) in the serum of the recipient after transplantation, the role of sLAIR-1 in graft rejection was analyzed. Methods Serum sLAIR-1 level was determined by double mAb sandwich enzyme linked immunosorbent assay (ELISA) in 20 healthy volunteers and 162 patients of liver or kidney transplantation, and the results were analyzed and compared. Results In the healthy volunteers and 98 recipients with normal graft function, the sLAIR-1 were detected at the low levels of 4.3?2.3?g/L and 6.3?3.7?g/L, which showed no significant difference (P=0.054). In the 6 cases of acute rejection of liver transplantation, 20 cases of acute rejection of renal transplantation, and 5 cases of graft loss, serum sLAIR-1 was found to be increased remarkably to high levels of 47.2?35.9, 36.3?14.7 and 28.8?19.4?g/L, and they had significant differences compared with that of the healthy volunteers and with the recipients with normal graft function (P

Objective To analyze the clinical data of living related donor kidney transplantation,and to evaluate the related problems including the donor selection and safety,the surgical approach of living donor nephrectomy,preoperative intervention,and the relation of type matching with transplantation result.Methods Data of 30 cases of living donor kidney transplantation during 07/2002 to 07/2007 were studied retrospectively.29 cases were primary transplantation and only in one patient the transplantation was repeated,2 patients secured their transplants from the spouse,while in 28 cases transplants were donated by relatives.The blood type of all the patients was identical with an exception in 2 cases,in whom the blood type was compatible.The HLA matching results were:1 case with no-mismatch,3 cases with 4-loci mismatch,13 cases with 2-loci mismatch and 13 cases with 1-locus mismatch.The kidney was obtained with open nephrectomy in 21 cases,and in 9 donors the was harvested laparoscopically.In the 30 cases,one right kidney was donated,and the left kidneys were donated in other 29 cases.Triple-combined immunosuppressive protocols consisted of calcineurin inhibitors(CNI),MMF/Aza and steroid.Results Except in one case the allograft was removed for hyperacute rejection,and in one recipient who was again retransplanted with a cadaveric kidney due to dysfunction of transplanted kidney,28 recipients recovered smoothly in 6.3?8.0 days.In 4 cases infection with cytomegalovirus after the surgery occurred,but recovered after anti-virus treatment with ganciclovir.One patient suffered from urinary leakage,and recovered after adequate drainage,nutritional support and infection prevention.Two patients suffered from acute rejection in the first month after transplantation and reversed after hormone stosstheraphy.All donors recovered.The renal function also recovered.Conclusion Both the strict selection of donor and the overall preoperative evaluation of the donor and recipient are critical for the success of transplantation.Living relative donor kidney transplantation is worth of popalarizing,as it has preferable HLA match,short waiting time and renal ischemia time,and the source of donor kidney is expanded.

Objective To study the chimerism formation in kidney transplantation recipient receiving peripheral blood stem cells (PBSCs) of the donor after the patient received preoperative total lymphoid irradiation (TLI). Methods 5 patients of living donor kidney transplantation were involved in present study. The mean age of donors was 40 and that of recipients was 27. There was one patients with 4 HLA antigen mismatches out of 6 HLA-A, B, DR antigens, two patients with 3 HLA-mismatches, and two patients with 1 HLA-mismatch. The patients received TLI in doses 90cGy/d from day -5 to day -1. The immunosuppression protocol for these patients during operation and afteroperation was similar to that for other cases, but the dosage was slightly reduced. Donor PBSCs were harvested twice via leukapheresis after the administration of human recombinant granulocyte colony stimulating factor (G-CSF). PBSCs were infused intravenously to the recipients on postoperative day 4 and 7. Chimerism of peripheral blood cell in recipients was detected by PCR-SSP assays. The grafted kidney function, acute rejection frequency and GVHD episodes were also observed. Results After 5 days of G-CSF based mobilizing regimen, the average number of PBSCs harvested from donors was 34?10~6. At 1 month post-transplantation, donor type HLA-DR gene was detected in all the recipients. At 2 and 3 months post-transplantation, chimerism was not detectable in the recipient with 4 HLA antigens (including 2 HLA-DR) mismatched donor kidney and in the recipient with 3 HLA (including 2 HLA-DR and 1 HLA-B) mismatched donor, respectively. In the other 3 recipients, chimerism was still positive 3 months post-transplantation. There were no symptoms of GVHD or infections after infusion of PBSCs. Transplanted kidneys functioned normally and no rejection episodes were observed till the end of the study. The immunosuppressant dosage was lower for these 5 cases than those after conventional cadavar renal transplantation. Conclusions Non-myeloablative TLI conditioning regimen is a safe and effective method which can promote the engraftment of donor PBSCs and induce hemopoietic chimerism. Chimerism can alleviate rejection of the transplanted kidney and reduce the immunosuppressant dosage. Collection and infusion of PBSCs are simple, convenient, effective, and inexpensive, and it is an optimal source of hemopoietic stem cells.