Objective To evaluate the impact of comorbidity and age on the tolerance of firstline single-agent chemotherapy in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods Clinical data of 61 elderly patients with advanced NSCLC(aged over 70 years,median age 72 years) receiving first-line single agent chemotherapy were retrospectively analyzed in this study.Performance status(PS) between 0-1 score was in 52 patients,PS 2 score in the other 9 patents.Patients were treated with gemcitabine or docitaxel as the first line chemotherapy,and the median number of chemotherapy cycles was 3.4.Comorbidity was assessed by Charlson comorbidity index (CC1).Patients with CCI equal to 0 were classified as non comorbidity group(n=26),and patients with CCI≥1 were classified as comorbidity group(n=35).Adverse reactions were graded by using the criteria of NCI-CTC v3.0.Results Age and PS could not predict adverse effects of grade 3 or 4.The incidence of hematologic toxicity of grade 3 or 4 was higher in comorbidity group than in noncomorbidity group(40.0％ vs.15.4％,x2 =4.36,P=0.037).The incidences of febrile neutropenia,non hematologic toxicity of grade 3 or 4 and treatment suspension were higher in comorbidity group than in non-comorbidity group.The most common types of comorbidity were diabetes and chronic pulmonary disease.The incidence of non-hematologic toxicity of grade 3 or 4 was increased in patients with chronic pulmonary disease as compared with patients without chronic pulmonary disease(41.4 ％vs.11.5％,x2=6.061,P=0.032).Conclusions The incidences of adverse reactions,especially hematologic toxicity of grade 3 or 4 are significantly increased in patients with comorbidity after singleagent chemotherapy.Evaluation of comorbidity before treatment is helpful to predict the tolerance of single-agent chemotherapy in elderly NSCLC patients.

Nerve agents (NAs) belong to the class of organic phosphorus compounds which are acetylcholinesterase ( AChE) inhibitors, including soman, sarin, tabun,VX, etc.NAs are extremely toxic and considered as the most danger-ous chemical warfare agents.The current standard treatment for poisoning by nerve agents consists of the combined adminis-tration of anticholinergic drugs such as atropine sulphate, AChE reactivators such as pralidoxime, obidoxime and HI-6 and diazepam for anticonvulsant effects, but oximes are therapeutic antidotes against nerve agent intoxications which exert the therapeutic purposes primarily by reactivating the NAs-inhibited AChE.In this paper, the mechanism of nerve agents, the main working procedure of anti-NAs drugs, the chemical structure of classic reactivator, the corresponding antitoxic action, in vivo and in vitro effects and metabolic kinetics are reviewed.

Objective To analyze the efficacy and safety of amiodarone in the treatment of patients with tachyarrhythmia in emergency department.Methods The clinical data of 112 patients with emergency tachyarrhythmia admitted to the Emergency Department of the First People's Hospital of Jinzhong from March 2017 to March 2018 were analyzed.According to the different treatment plans applied,the patients were divided into two groups,with 56 patients in each group.The control group was given routine emergency treatment,and the observation group was treated with routine emergency treatment and amiodarone.The efficacy,blood pressure,heart rate and safety in the two groups were compared.Results The total effective rate in the observation group was 91.07％,which was higher than that in the control group(69.64％) (x2 =8.145,P ＜ 0.05).The diastolic blood pressure,systolic blood pressure and heart rate in the observation group were (77.40:±:6.21) mmHg,(124.24 ± 6.15) mmHg and (130.18 ± 6.14) beats/min,respectively,which were lower than those in the control group[(93.47 ± 7.40)mmHg,(140.60 ± 7.48)mmHg and (150.35 ± 12.32) bests/main] (x2 =8.145,t =12.448,12.642,10.966,all P ＜ 0.05).The total incidence rate of adverse reactions in the observation group was 3.57％,which was lower than 19.64％ in the control group (x2 =7.049,P ＜0.05).Conclusion For patients with tachyarrhythimia in the emergency department,the application of amiodarone has significant curative effects and high safety,which can help stabilize their blood pressure,heart rate and improve their conditions,and yet incurs less adverse reactions.Therefore,it is of significant value to be popularized in clinical applications.

Objective To investigate the effect of hypertension and hyperuricemia (HUA) on renal function.Method Total 1 209 subjects undergoing health check up from December 2000 to December 2002 and 45 patients with renal disorders were enrolled in the study.The blood pressure,height,weight,renal function and liver function were measured; and the glomerular filtration rate (GFR) was calculated.The GFR in patients with hypertension,HUA and hypertension with HUA was compared.Results The incidence of hypertension in HUA group and non-HUA was 23.9％ (58/243) and 13.9％ (134/966),respectively (x2 =14.52,P =0.000).GFR in HUA with hypertension,HUA and hypertension groups were (69.1 ± 30.5),(82.8 ± 25.3) and (90.1 ± 21.7) ml · min-1 · (1.73 m2)-1,respectively (P ＜ 0.01).Logistic regression analysis showed that the risk factors for GFR were UA,systolic pressure and age.After 5 years of follow up,GFR in hypertension group was significantly decreased from (90.7 ± 18.1) to (85.6 ± 17.6)ml·min-1 · (1.73 m2)-1m,in HUA group from (86.3±10.9) to(62.1 ±8.2) and inHUAwith hypertension group from (77.9 ± 18.9) to (49.3 ±9.8) ml · min-1 · (1.73 m2)-1,UA and age were the long-term factors that affect GFR (P ＜ 0.05).Conclusions Both hyperuricemia and hypertension can impair the kidney function,if hypertension is complicated with hyperurecemia the effect is more marked.

Objective To observe blood plasma matrix metalloproteinase-9 (MMP-9) of the patients with different types of carotid plaque and investigate the relationship between MMP-9 and carotid plaque vulnerability. Methods Totally 64 patients were examined by CDI, TCD, cranium CT, MRI, DSA and nerves function score (NIHSS) to judge their types of carotid plaque. Their plasma levels of MMP-9 and C-reactive protein (CRP) were detected. Results Plasma MMP-9 had direct correlation with plaque vulnerability(r=0.92,P

Objective To investigate the expression of human bone morphogenetic protein-7(hBMP-7)in rat bone malTOW stromal cells(BMSC)with a recombinant adenovirai vector carrying the hBMP-7 gene(Ad-hBMP-7) and study the effecta of Ad-hBMP-7 transfection on BMSC difierentiation.in order to explore the possibility for hBMP-7 gene therpy.Methods The rat BMSC cultured in vitro.They were divided into 3 groups:untreated group,Ad-hBMP-7 and Ad-GFP transduced treated group.The rat BMSC were transfected by Ad-hBMP-7 and Ad-GFP. The expression of hBMP-7 was detected by RT-PCR and Western blot analysis.and the alkaline phosphatage (ALP)activity of the BMSC was observed.ResulIs In the Ad-hBMP-7 transduced treated group.hBMP-7 mRNA expression wag manifested detected by RT-PCR(470 bp),Westem blot analysis demonstrated that these cells indeed produced the hBMP-7 protein(Mr.15×103);10 days after transduction treatment,most of the BMSC were had brown black particles stained positively by ALP activity.But in Ad-GFP transduced treated group and untreated group they did not.Conclusions Ad-hBMP-7 could efficiently transfect BMSC and promote the conversion to osteoblast.The expression of hBMP-7 in rat BMSC provides a basis for hBMP-7 gene therapv.

Objective To evaluate effectiveness of ex vivo adenoviral gene transfer creating human bone morphogenetic protein 7-producing mesenchymal stem cells (Ad-hBMP-7 cells) compounded with nano-hydroxyapatite/collagen(NHAC) composite to induce spinal fusion in a rat posterolateral spine fusion model. Methods Mesenchymal stem cells were cultured and transduced by Ad-hBMP-7. Then Ad-hBMP-7 cells were cocultured with NHAC. Totally 56 Wistar rats were divided into four groups. Intertransverse spinal arthrodesis was attempted in four groups of Wistar rats with autogenous bone (group A); NHAC(group B); NHAC and BMSCs (group C); Ad-hBMP-7 cells and NHAC (group D). Each specimen underwent plain radiography, manual palpation and histological analysis. Results All spines in group D had fusion. In contrast, none of the spines in group A and group B had fusion. Three of ten rats in group C achieved fusion at the 12th week post-operatively.Conclusion BMP-7-producing mesenchymal stem cells compounded with NHAC composite may induce intertransverse fusion in the rat spine model.

A 6-azido-β-cyclodextrin was synthesized and derivatized with p-nitrophenyl isocyanate as chiral ligand. Following that the ligand was chemically bonded to mesoporous SBA-15 via a ‘Click Chemistry ’ reaction of the azido group with alkynyl group. A new p-nitrophenylcarbamoylatedβ-cyclodextrin bonded SBA-15 chiral stationary phase ( NPCSP ) for HPLC was obtained. The new stationary phase was first used to enantioseparate propranolol in human plasma under the polar organic solvent mode. The effects of methanol content , additive concentration of glacial acetic acid/triethylamine in mobile phase and the temperature on the enantioseparation were studied. The optimal chromatographic conditions were as follows: mobile phase was acetonitrile/methanol/glacial acetic acid/triethylamine (90:10:1. 25:2. 25, V/V), temperature 288 K, flow rate of 0. 5 mL/min, injection volume of 20 μL, detection wavelength at 290 nm. The resolution was 2. 04 with a short run time (< 15 min) under the above conditions. The composition of propranolol in plasma was quantitatively measured by HPLC-MS selected ion monitoring mode ( [ M +H ]+ m/z 260 . 10 ) with hydrochlorothiazide as internal standard. And linear range was 2. 5-250 μg/L and with a good linear relationship. The detection limit was 1 μg/L according to S/N=3. The experimental results showed that the chiral stationary phase exhibited excellent chiral separation ability to propranolol and the analysis method for propranolol in plasma was sensitive, accurate, simple and fast, which could be used for the determination of propranolol in plasma and pharmacokinetic studies.

Objective To explore the relationship between plasma protein Z level and severity of coronary atherosclerosis in patients with coronary heart disease,and analyze the clinical value of plasma protein Z detection.Methods Eighty-five patients who undertaken coronary arteriography were selected,and the patients were divided into coronary heart disease group (63 patients) and control group (22 patients)according to coronary arteriography results.The patients in coronary heart disease group were divided into three groups according to the Gensini score:A group (≤30 scores),B group (31-60 scores) and C group (＞ 60 scores).All patients' plasma was collected and stored at-80 ℃ until examined,and the plasma PZ level was detected by enzyme-linked immunosorbent assay method.Results The plasma protein Z level in coronary heart disease group was significantly lower than that in control group [(721.82 ± 289.53) μ g/L vs.(1 077.80 ± 338.12) μ g/L],and there was statistical difference (P＜ 0.05).The plasma protein Z level in A group,B group and C group was (856.09 ± 312.53),(665.27 ± 267.15) and (643.04 ±248.39) μg/L,respectively.The plasma protein Z level in B group and C group was significantly lower than that in A group,and there was statistical difference (P ＜ 0.05),but there was not statistical difference between C group and B group (P ＞ 0.05).There was negative correlation between the plasma Z level and Gensini score (r =-0.300,P =0.017).In coronary heart disease group,the plasma Z level in patients with smoking was significantly lower than that in patients without smoking [(687.83 ± 249.94) μ g/L vs.(844.29 ± 454.71) μ g/L,and there was statistical difference (P ＜ 0.05).There was negative correlation between the plasma Z level,age and hypersensitive C reactive protein (r =-0.349,-0.339,P ＜ 0.05).Conclusions Plasma protein Z level in patients with coronary heart disease is significantly decreased,and the plasma protein Z level has negative correlation with the severity of coronary atherosclerosis.Smoking can induce the decrease of plasma protein Z level,and the decrease of protein Z level maybe a predictor for coronary heart disease.