Malignant mesothelioma is an aggressive malig na ncy that may be caused by environmental carcinogens(asbestos),viruses(SV40),and genetic predisposition.Diagnosis relies on radiographic studies as well as patho logy and mdecular bidogy tests.Most such patients are not suitable for surgical or radiotherapy treatment,and cytotoxic agents are the only options.Historically ,no single or combinations of agents consistently yielded response rates over 20 %.Recently,pemetrexed,a folate-based inhibitor of thymidylate synthase,has been evaluated in phase Ⅰ,ⅡandⅢ clinical trials with promising results.Moreover, low-dose folic acid and vitamin B 12 supplementation significantly reduced the toxicity observed with the use of pemetrexed.In light of these data,it is l ikely that pemetrexed/cisplatin will soon be recommended for malignant pleural m esothelioma as first-line standard chemotherapy.

Objective To study the feasibility of endoscopic thyroidectomy with bipolar electrocoagulation. Methods Endoscopic partial thyroidectomy via precordial approach, mainly by using bipolar electrocoagulation and scissors, was accomplished in 21 patients with thyroid tumors with a diameter of 0.7～5.5 cm. Results The operation was accomplished endoscopically in 20 patients, whereas a conversion to open thyroidectomy was conducted in 1 patient. The mean incision length was 22 mm, the operation time was 69?47 min, and the blood loss was 55?41 ml. Postoperative analgesic treatment was required in 2 patients and no serious complications happened. Conclusions Endoscopic thyroidectomy with bipolar electrocoagulation is feasible in the absence of ultrasonic scalpel.

Objective To evaluate the feasibility of hand-assisted laparoscopic colorectal resection. Methods Clinical data of 21 cases of hand-assisted laparoscopic colorectal resection in this hospital from October 2003 to August 2004 were retrospectively reviewed. Results The hand-assisted laparoscopic resection was accomplished in 20 cases. The mean operation time was 144 min, the mean blood loss was 120 ml, the mean number of dissected lymph nodes was 8.5, and the mean time to intestinal function recovery, 69 h. Postoperative abdominal bleeding was found in 1 case, which was cured with conservative therapy. A conversion to open surgery was needed in 1 case. Conclusions Hand-assisted laparoscopic colorectal resection safe, feasible, and radical, with advantages of fewer complications and simplicity of performance.

Objective To explore the clinical features and diagnosis of pulmonary sarcoidosis.Methods The data of 60 cases of pulmonary sarcoidosis confirmed by pathology was reviewed to determine the clinical features and the value in the diagnosis of sarcoidosis.Results The main clinical manifestations of sarcoidosis included bilateral hilar and mediastinal lymphadenopathy.The results of lung function tests showed that these patients had restrictive ventilating obstacles with decreased DLCO.The diagnosis was confirmed in 80% of the bronchial mucosa biopsies and 77.8% of the transbranchial lung biopsies through fiberotic bronchoscopy,87% of the biopsies of peripheral lymphnodes and 87.5% of the subskin nodes biopsies.Conclusion Nonspecific constitutional symptoms may occur in the cases of sarcoidosis.To the diagnosis of intrathoracic sarcoidosis,peripheral lymph nodes biopsies,the bronchical mucosa biopsies and TBLB are the convenient methods with highly definite diagnosis rate and microinvasion in clinical practice.

OBJECTIVE To find the efficient anti-infection strategy.METHODS The incidence,pathogenic microorganism,prophylaxis,treatments of infectious complications in 30 patients who accepted hematopoietic stem cell transplantation in our hospital were analyzed retrospectively.The results were analyzed statistically compared with reference.RESULTS Incidence of infectious complications was 70.0%.One patient(3.3%) died of hepatic failure and sepsis.CONCLUSIONS There is high incidence of infection in the early stage after hematopoietic stem cell transplantation.It is related with the decrease and recovery time of WBC.Fluconazole has better clinical effects on prevention of fungal infection.Early strong antibacterial therapy can reduce the incidence of severe infection and death rate.

This study was aimed to observe effects of herbal pair of semen Ziziphi Spinosae (SZS) and A lbizia Julib-rissin flower (AJF) on cognitive function and serum BDNF among depression patients. A total of 60 depression pa-tients were enrolled and randomly divided into two groups. In the SZS-AJF group, 30 patients were administered with SZS-AJF decoction. In the control group, 30 patients were administered with venlafaxine hydrochloride sus-tained-release tablets. Hamilton Depression Rating Scale (HAMD), Wisconsin Card Sorting Test (WCST), and the serum-brain derived neurotrophic factor (BDNF) were detected before treatment and after six weeks of treatment. The results showed that there were no significant differences on the HAMD score, WCST (Response Administered (Ra), Categories Completed (Cc), Correct Responses (Cr), Perseverative Errors (Pe), Non-perseverative Errors (Npe)), serum BDNF before and after treatment between two groups. Compared with pretreatment, HAMD score, Ra, Cc, Cr, serum BDNF were increased after treatment in both groups. The Pe and Npe were decreased after treatment. There was sta-tistical significance between pretreatment and posttreatment (P< 0.05, or P< 0.01). It was concluded that the herbal pair of SZS-AJF has anti-depressant effect. It can improve cognitive function of depression patients. The anti-de-pressant mechanism of herbal pair of SZS-AJF may be related to the increasing of serum BDNF level.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Objective To study the changes of resting-state brain activity in knee osteoarthritis(KOA)patients with chronic pain.Methods The data of 21 KOA patients (KOA group) and 21 healthy controls (HC group) who underwent standard resting-state fMRI scan were analyzed with regional homogeneity (ReHo) method to observe the changes in the patients in contrast to the controls.Results Compared to HC group,patients of the KOA group showed ReHo changes in bilateral frontal lobe,bilateral parietal lobe,bilateral temporal lobe,bilateral cerebellum,limbic system and default-mode network.Conclusion Patients with chronic pain demonstrate abnormal neuron activities in the brain regions, and control loops not only related with pain but also related with emotive function disorder and cognitive impairment.

Object To observe the effect of Tianyizhike Syrup on dispelling phlegm and relieving asthma. Methods The phenol red secreting tests in mice, capillary method in rats, asthma induced by spraying and trachea screwy strip method on guinea pig were adopted for observing the related pharmacological effect in different doses of Tianyizhike Syrup. Results Tianyizhike Syrup could obviously increase the amount of the mice secreting phenol red and the rat dispelling phlegm, prolong the latent period of the guinea pig asthma and significantly enlarge the bronchia smooth muscle. Conclusion Tianyizhike Syrup has a significant effect of dispelling phlegm and relieving asthma.

Objective To investigate the reliability of intramyocardial electrogram (IMEG) in monitoring acute rejection after human heart transplantation. Methods From June 2004 to March 2009, 32 patients underwent orthotopic heart transplantations. During the operation telemetric pacemakers were placed under the skin of the body with connected bipolar electrodes implanted into epimyocardium. Postoperative IMEGs, including the autonomous IMEG and ventricular evoked response (VER) were recorded routinely. The endomyocardium biopsy (EMB) was taken routinely and performed once again when positive IMEG results or other positive signs were observed. Results Totally 523 IMEGs has been produced, 41 of VERs were recorded together with autonomous IMEGs and EMBs, in which 17 EMB specimens were confirmed positive and 24 negative. AUC of QRS was 0.7537, Se was 88.24%, Sp was 62. 50%; AUC of Tslew was 0. 9081, Se was 94. 12%, Sp was 87. 50%. QRS and Tslew had significant difference in AUC of ROC, with x2 = 4. 22, P＜0. 05; AUC of combined diagnostic index (positive when either QRS or Tslew is positive and negative when both values are negative) was 0. 7917, Se was 100.00%, Sp was 58. 33%. Conclusion QRS amplitude of the autonomous IMEGs, Tslew of VERs and combined diagnostic index are reliable indexes for monitoring acute allograft rejection after human heart transplantation. Furthermore, Tslew has a better prognostic value than QRS.