Lung cancer is the leading cause of morbidity and mortality of malignant tumor.Surgery,radiotherapy and chemotherapy remain the primary means of treatment for lung cancer,while the discoveries of molecular targets and targeted agents for lung cancer are making revolutionary changes and will almost certainly propel progress in this field into the foreseeable future.Biomarker-based individualized comprehensive treatment strategy is expected to benefit the lung cancer patients' survival.Meanwhile,chemotherapy remains the major treatment of advanced non-small cell lung cancer,which requires implementing the "three combinations" dialectical therapy principles,that is,systemic with local,conventional with personalized,eliminating with supporting.

To cultivate the high quality graduate is the aim of discipline construction as well as the graduate's cultivation.By raising graduate's humanities knowledge,establishing the "?" type knowledge structure,we want to make them grasp commonly used computer knowledge,improve their English proficiency,take part in the international lab cross-talking,hold the laboratory conference regularly,and encourage the graduate to present their articles to international biomedicine periodical.All these contribute to construct the platform which helps the graduate students grow into the innovated talent.

Objective To explore the diagnosis for early stage lung cancer with "normal" plain CT scan in order to draw the concern of physician to these patients. Methods We reviewed and analyzed 3 cases of central bronchogenic carcinoma with normal plain CT scan at first visit who were confirmed through fiber bronchoscope examination and PET/CT scan later. Then we compared the values of some diagnostic methods for early-stage central bronchogenic carcinoma. Results Three patients were all males with long smoking history. They came to hospital for cough and bloody sputum. All their plain CT scan showed "no abnormal findings", but their symptom continued. Later, the fiber bronchoscope examination and PET/CT scan strongly suggested that they were suffered from central bronchogenic carcinoma, and then the pathological findings and sputum cytology confirmed the diagnosis. Two patients received lobectomy, and the other one was suggested to accept radiotherapy because of his poor lung function. Conclusions The positive rate of plain CT scan for early-stage central bronchogenic carcinoma is relatively low. Thus, some of these patients lost the chance of surgery and combined therapy. So physicians should pay more attention to these patients with symptoms of persistent bloody sputum or obstructive pneumonia, even if the plain CT scan is negative at first visit. Using PET/CT and fiber bronchoscope examination, physicians can confirm the diagnosis of central bronchogenic carcinoma. So these two methods are important in the diagnosis for early-stage central bronchogenic carcinoma without any abnormal plain CT scan findings.

Purpose: To explore the relationship between the effect of docetaxel inducing apoptosis of non-small-cell lung cancer cell and intracellular level of reactive oxygen. Methods: SPC-AI lung cancer cells were treated with 10 -8mol/L docetaxel for 24 hours to observe the apoptotic morphological change under the electromicroscope and fluorescence microscope in ritro. The treated cells were harvested to analyze the cell cycles using flow cytometry and to estimate the intracellular reactive oxygen levels by staining with 2', 7-dichlorodihydrofluorescein diacetate and dihydroethidine. Results: After SPC-AI lung cancer cells were exposed to 10 ~ mol/L docetaxel for 24 hours, the typical apoptotic morphological changes were observed under the electromicroscope and fluorescence microscope. There was a higher reactive oxygen level in docetaxe-treated cells group than in control group. After 24 hours docetaxel exposure, there was a significant G2 ~'M phase arrest of SPC-AI lung cancer cells. Conclusions: Docetaxel can induce apoptosis in SPC-AI lung cancer cells through the mechanism of G2 ~ M phase arrest and by elevating intracellular level of reactive oxygen.

The signal transduction system induced by epidermal growth factor receptor(EGFR) regulates cell cycle ,modulates cell growth and differentiation and improves damage repair.The overexpression of EGFR in several epithelial tumors including non small cell lung cancer(NSCLC) forecasts low survival rate, poor prognosis and metastasis. Thereby EGFR can be a potential target for gene therapy. Tyrosine kinase inhibitors(TKIs) selectively inhibit tyrosine kinase activity,supress tumor growth ,and increase the sensitivity of radio chemotherapy. [

Standardized resident training is necessary for residents.The article focused on the establishment of standardized resident training model in the department of respiratory in Zhongshan Hospital of Fudan University.Zhongshan Hospital developed reasonable training plan,formulated strict evaluation and examination system and emphasized on cultivating practical,innovative and independent talents.Detailed measures included strengthening the basic knowledge and practical skills,developing independent learning ability,communication ability and innovative thinking and promoting medical ethics.All these experiences and explorations of standardized resident training in the department of respiratory will be beneficial.

Background and purpose:The epidermal growth factor receptor (EGFR) is commonly overexpressed in a variety of solid tumors, and has important roles in cancer pathogenesis and progression. EGFR thus provides a rational target for cancer therapy. We studied siRNA-mediated inhibition of epidermal growth factor receptor expression and its biologic effects in different human cancer cell lines (A431, HeLa and SPC-A-1). Methods:Cells were transfected with chemically synthesized siRNA-EGFR. EGFR mRNA was quantified by real-time PCR and was detected by immunofluorescence staining and flow cytometry. The biologic effects on cell growth were assessed by colony-formation assay.Results:siRNA-EGFR significantly decreased mRNA level of EGFR by 73.9 %, 44.6 % and 57.7 %, protein expression of EGFR by 77.0 %, 61.3 % and 65.2 %, and reduced colony number by 27.2 %, 53.9 % and 59.1 % in A431, HeLa and SPC-A-1, respectively.Conclusions:Our data suggested that RNA interference could downregulate EGFR and inhibit colony forming ability and EGFR expression at mRNA/protein levels in human cancer cell lines with different pathological types. siRNA could be one of the promising strategies in future targeted cancer therapy.

Objective To investigate the efficacy of the hospital intensive treatment by auto-CPAP on elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to analyse the possible factors related to the effectiveness.Methods Subjects were selected from elderly OSAHS patients over 60 years old.The eligible subjects were divided into intensive treatment group and non-intensive treatment group (non-ITG).Patients in intensive treatment group were intensively treated using auto-CPAP for 3 consecutive days,assisted with targeted health education and guidance,and making proper adjustments to parameters of the auto-CPAP according to treatment outcomes at the previous day.But those in non-intensive treatment group were just treated with auto-CPAP for only 1 day,supplemented by regular health education and guidance.The apnea-hypopnea index (AHI),minimum oxygen saturation (SaO2min),mean oxygen saturation (SaO2mean) and the time spent at SaO2 lower than 90％ (tSaO2＜90％),the occurrence of clinical symptoms and adverse effect,Epworth sleepiness scale(ESS) were compared between both groups.The correlation analyses were also conducted.Results ESS (3.58±3.76 vs.6.84 ± 3.22),AHI [(7.85±6.53) time/h vs.(10.42±7.27) time/h] and tSaO2＜90％[(5.65±15.43) min vs.(15.26±33.14) min] were lower(t=6.902,2.760,2.765,allP＜0.05),while SaO2mean [(96.57±1.53)％ vs.(94.63±1.38)％] and SaO2min [(88.24±4.43)％ vs.(83.28±5.06)％]were higher(t=-9.870,-7.740,both P＜0.05)in intensive treatment group than in non intensive treatment group.The occurrences of clinical symptoms and adverse effect (except for skin allergy) were decreased in intensive treatment group versus non-ITG (all P＜0.05).The AHI after intensive treatment was decreased in females versus males [(7.85±5.19) times /h vs.(11.27±7.78) times/h,t=2.133,P＜0.05].BMI,age,gender and the state of OSAHS were correlated to AHI,SaO2 mean,SaO2 min and tSao2＜90％ after intensive treatment (all P＜0.05).Conclusions The hospital intensive treatment can improve the clinical results and decrease the occurrences of clinical symptoms and adverse effect for elderly OSAHS patients,and is expected to improve therapy compliance,and its curative efficacy is correlated to BMI,age,gender and state of OSAHS before therapy.

ObjectiveTo evaluate the effect of psychological and behavioral intervention combined with varenicline smoking cessation clinics and to analyze predictors of successful quitting.Methods Subjects were collected from quitters who went to receive consultation and intervention in “smoking and related diseases” clinic at Zhongshan Hospital,Fudan University from March 2009 to September 2010.Eligible subjects were screened and divided into strengthen follow-up group and control group.The 4 weeks continuous abstinence rate from week 9 through week 12 were observed logistic regression model and used to analyze the predictors of successful quitting.Results Subjects who are addicted to nicotine received strengthening psychological and behavioral intervention combined with varenicline in smoking cessation clinics.The total continuous cessation rate during the 9th-12th week was 52.3％,with 60.9％ (28/46) and 46.2％ (30/65) of strengthen follow-up group and control group respectively.The most frequent adverse effects were nausea 39.6％ (44/111),insomnia and abnormal dreams 17.1％ ( 19/111 ).Adverse effects were tolerable and withdraw symptoms were few.Preparation and medication time can be used as predictors of successful quitting.Conclusion The quit rate of varenicline therapy combining with strengthen intervention is high and strengthening psychological and behavioral intervention could increase the success rate more obviously,which is a good choice for cessation therapy in smoking cessation clinics.Better preparation and regular adequate treatment can improve quit rate.

Objective To evaluate the potential effects of RS504393, CC chemokine receptor (CCR) 2b and CCR1 antagonist, on LPS-induced acute lung injury (ALI) and to investigate the underlying mechanisms. Method A549 cell line was stimulated with LPS (10 μg/mL) and then treated with RS504393 (10 μg/mL) for 6 hours. ALI model was established with intranasal administration of LPS (5 mg/kg) in C57BL/6J mice. RS504393 (5 mg/kg) was administered 30 min before LPS dripped nasally. IL-8, IL-1β, plasminogen activator inhibitor (PAI)-l,monocyte chemoattractant protein (MCP)-2,and the expressions of CCR1 and CCR2b were studied by using Realtime-RT-PCR, ELISA and cyto-flowmetry. Results In A549 cell line treated with RS504393,the expressions of CCR1, CCR2b and IL-8 were significantly inhibited after LPS stimulation. In rats with LPS-induced ALI, treatment with RS504393 significantly protected mice against lung injury by attenuating influx of leukocytes and protein into bronchoalveolar space and by lessening pathological changes of lung. Treatment with RS504393 down-regulated IL-1β and PAI-1 expressions in bronchoal veolar lavage fluid (BALF) and lungs at mRNA and protein levels along with up-regulation MCP-2 expression compared to rats of vehicle-treated groups. Conclusions CCR2b and CCR1 play pivotal roles in the development of ALl,and RS504393 as a antagonist can halt the development of ALI.