7?cm to a dose of 48-60?Gy in 8-10 fx over 21-24 days. Patients with positive supraclavicular lymph nodes received conventional fractionated radiotherapy with 12 MeV-E to a total dose of 66-70 ?Gy in 7 weeks. Therapeutic effect and survival rate were studied. Results Twelve patients achieved CR, 22 PR, 4 NR and 5 PD, with a total response rate of 79.1%(34/43). The 1-, 2- and 3-year survival rates were 75.2%, 53.2% and 35.4%. Conclusions Three-dimensional conformal hypofractionated high-dose radiotherapy combined with chemotherapy should be considered as an effective and feasible approach in the treatment of NSCLC patients. Long-term survival and possible specific injury await further study.

ObjectiveTo evaluate the effects of transcatheter arterial chemoembolization (TACE) combined with 3-dimensional conformal radiation therapy(3DCRT )for unresectable primary hepatic carcinoma (PHC). MethodsNinety-four patients with unresectable PHC were initially treated with TACE and then sequentially with 3DCRT. The therapeutic effect and survival rate of the patients were assessed as endpoints with Cox proportional hazard model used to define prognostic factors. Of these 94 patients,82 presented with a solitary lesion and 12 with multiple ones. Fifty-nine patients received only one course of TACE while 35 several courses. The total radiation dose of 42-52 Gy was delivered to 42 patients, and 53-60 Gy to 52. ResultsThe local response rates were 90.4% (85/94) in 3 months and 83.0% (78/94) in 1 year after treatment with 12 CR,73 PR,6 NR and 3 PD. The 1-,2-,and 3-year survival rates were 93.6%,53.8% and 26.0% respectively,with a median survival duration of 25.0 months. In the multivariate analysis,the number of tumor lesion,Child's classification and clinical stage presented prognostic significance for overall survival (P

Objective To explore the job burnout and its related factors among nurses.Methods 486 clinical nurses from a three grade second level general hospital were investigated by Moreno-Jimenez nursing burnout scale (NBS) and using SPSS17.0 software and ANOVA method to analyse the data.Results NBS results showed the score of job burnout in 486 objects was (164.92 ± 25.60).Significant differences of job burnout levels were showed among ages,marital status,professional titles,working periods,working relationship,work load,income,and housework periods (P ＜ 0.05).Conclusion Job burnout is a general phenomenon in these investigated nurses and its level is above average.Administrators should pay more attention to these related factors which can easily cause job burnout and take positive feasibility assistant strategies.

Objective To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with hypofractionated 3 dimensional conformal radiotherapy for hepatocellular carcinoma (HCC). Methods During May 1998 and Dec. 1999, 81 unresectable HCC patients were divided into two groups. Forty one patients in group A were treated with TACE and hypofractionated 3 dimensional conformal radiotherapy and 40 patients in group B were treated with TACE alone. Acute effects were analyzed and survival rates were assessed from the date of the beginning of treatment using the Kaplan Meier method. The survival rates of two groups were compared using Log rank. The Cox proportional hazards model was used to analyze the prognostic factors in group A. Results The objective response rate in group A was higher than that in group B (85.4% vs. 65.0% , P

Objective To investigate and analysis the clinical effect of pramipexole in Parkinson's disease with depression.Methods The patients with Parkinson disease patients with depression were selected in a total of 100 as the research object,and were randomly divided into two groups,the observation group and the control group with 50 cases in each group.The control group was taken conventional treatment,the observation group was given pramipexole based on the conventional treatment methods,the the effects of treatment were observed and compared. Results The MIHD score of the observation group after treated for 12 month (8.26 ±1.96)was lower than the score before treatment (24.91 ±4.6),and the score of the control group after treated for 12 month (11.15 ±2.10)was also lower than the score before treatment (24.48 ±5.34),the difference were all statistically significant(P<0.05). After treated for 12 month,the score in the observation group was lower than that in the control group,and the total effective rate in the two group were 94% and 80% respectively(P<0.05 ).The UPDRS score of the observation group was lower than in the control group,but the difference was not significant(χ2 =14.756,P<0.05).Conclusion Give pramipexole has notable curative effect on the depression disease in patients with Parkinson disease on the basis of conventional therapy method,and has the value of popularization.

Objective To explore the feasibility and safety of combination of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma.Methods Combining thoracoscopic and laparoscopic esophagectomy was attempted in 23 patients with esophageal cancer between August 2007 and July 2008.Being placed at a left lateral decubitus position,the patients received right thoracoscopic mobilization of the intrathoracic esophagus as well as lymph node dissection;then with lithotomy position,laparoscopic mobilization of the stomach and lymph node dissection were carried out,followed by creation of a gastric tube through a small incision under the xiphoid;finally we pulled out the gastric tube from the esophageal bed to the neck and made an intermittent gastroesophageal anastomosis.Results One of the patients was converted to open abdominal surgery,whereas no one was converted to open thoracic operation.The total operation time ranged from 240 to 330 minutes with a mean of 270 minutes,the operation time for laparoscopy was 38-90 minutes(mean,65 minutes),and for thoracoscopy was 55-100 minutes(mean,70 minutes).No massive hemorrhage occurred during the operation,the total blood loss ranged from 100 to 300 ml(mean,225 ml),of which 10 to 50 ml were intra-abdominal blood loss(mean,20.4 ml).Totally 225 lymph nods were removed(9.8 per patient in average).Of the resected lymph nodes,65 were para-left gastric arterial or pericardial lymph nodes(2.8 per case).The mean hospital stay in this series was 9.2 days(range:8-12 days).During the hospitalization,no patient died;postoperative complications included pulmonary infection(3 cases),cervical anastomotic leak(one case,occurred in 8 days after the surgery),chylothorax(1 patient,cured by ligation via open thoracic surgery),and hoarseness(3 cases).Of the patient,23 received an follow-up for 1 to 11 months(mean,7.7 months),during which,1 patient died and 1 patient showed extensive metastasis to the mediastinal lymph node.Conclusion Combination of thoracoscopy and laparoscopy with cervical anastomosis is feasible and safe for the treatment of esophageal carcinoma.

Objective To evaluate the effect of 3-dimensional conformal radiotherapy (3D CRT) and prognostic factors for cervical and upper-thoracic esophageal cancer. Methods Between July 1998 and July 2001, 33 patients with cervical and upper-thoracic esophageal cancer were treated with 3D CRT(2?Gy per day, 5 sessions a week to a total dose of 66-68?Gy over 6-7 weeks). Acute toxicities and survival rates were evaluated by Kaplan-Meier method and prognostic factors were analyzed by Cox proportional hazard model. Results The 1-, 2-, 3-year local control rates were 87.9%, 75.8%, 45.5% respectively. The 1-, 2-, 3-year disease-free and overall survival rates were 72.7%, 60.6%, 30.3% and 78.8%, 66.8%, 44.2% respectively. GradeⅠ-Ⅱ acute esophagitis and bronchitis were the most common radiation side effects. Multivariate analysis revealed that the depth of primary tumor invasion, regional lymph node metastasis and tumor length were independent prognostic factors (P

Objective To investigate the clinicopathologic characteristics of and HPV subtypes in vulvar condyloma acuminatum(CA)and subclinical HPV infection.Methods Eighty patients with a positive acetowhite test and suspected subclinical HPV infection were selected from 272 patients with typical CA lesions in perianal and external genital region.Tissue specimens were obtained from typical CA and suspected subclinical HPV-infected lesions followed by pathological examination and HPV-DNA detection.Finally,71 patients were confirmed to suffer from both CA and subclinical HPV infection.A comparative analysis was performed to assess the differences in histopathological manifestation and HPV genotypes between CA and subclinical infection lesions.Results Pathological examination revealed typical histological changes of CA in 71(88.75％)typical CA specimens and 4(5％)suspected subclinical infection specimens,as well as squamous dysplasia in 9(11.25％)CA specimens and 71(88.75％)suspected subclinical infection specimens.HPV-DNA was positive in all(80)of the CA specimens and 93.75％(75)of the suspected subclinical infection specimens,negative in 5(6.25％)suspected subclinical infection specimens.Obvious differences were observed in pathological manifestation,koilocyte number(P ＜ 0.05),but not in the distribution of HPV subtypes(P ＞ 0.05),between typical CA and concurrent subclinical HPV infection lesions in patients.Conclusion The diagnosis of subclinical HPV infection should be based on the result of acetowhite test,with the results of pathological examination and HPV DNA detection as an adjuvant.

AIM To get an insight into intracellular signaling steps, a very early step in the signaling cascade, the biphasic Ca 2+ elicited by 5 HT in rat stomach fundus smooth muscle cells was investigated. METHODS Cells were cultured and loaded with Fluo 3 AM. [Ca 2+ ] i was measured by fluorescent intensity (FI) in each cell with confocal microscopy. RESULTS The resting FI level of SFSMC was 264?15. Stimulation of SFSMCs by 5 HT produced an elevation of [Ca 2+ ] i; Depletion of external Ca 2+ by addition of EGTA led to a significant attenuation of [Ca 2+ ] i change induced by 5 HT; Pre treatment of SFSMCs with ryanodine (10 ?mol?L -1 , 5 min) in D Hanks, the effect of 5 HT was completely inhibited; The stimulation of SFSMCs by 5 HT was partly attenuated by miaserin(10 ?mol?L -1 ), however, L type Ca 2+ channel antagonist lacidipine and G protein inhibitor NEM completely abolished the increase of [Ca 2+ ] i mediated by 5 HT; 5 HT mediated Ca 2+ release was reduced by phospholipase C specific inhibitor compound 48/80(1 2 ?g?ml -1 ); When protein kinase C was activated by phorbol 12 myristate 13 acetate (PMA 0 1 ?mol?L -1 , 5 min) the effect of 5 HT was inhibited, and the inhibitory effect of PMA was reversed by D sphingosine, a PKC inhibitor. CONCLUSION Our data suggest that G protein coupled 5 HT 2B receptor in the rat stomach fundus modulates 5 HT stimulated Ca 2+ increase, and it is coupled to calcium influx through L type calcium channels, and also intracellular calcium release by the opening of ryanodine receptor. The 5 HT 2B receptor mediated signal of 5 HT is transduced by PLC and PKC.

Reverse transcription-PCR and methylation-specific PCR (MSP) were used to determine the expression levels of Syk gene and the methylation status of its promoter in tissue samples from 60 patients with cervical cancer, 50 patients with cervical intraepithelial neoplasia (CIN), and 20 normal controls. We also analyzed the association of the methylation status and expression levels of Syk gene with linicopathological features of patients. The expression rates of Syk gene in 20 normal cervical tissue samples and 18 CIN Ⅰ samples were both 100% ; those of CIN Ⅱ- Ⅲ and cervical carcinoma were 56% (18/32)and 35% (21/60) respectively. Among cervical carcinoma patients, the expression of Syk mRNA was detected in one out of 13 cases with lymph node metastasis (1/13) and in 20 out of 47 cases with no lymph node metastasis (43%). The methylation of Syk gene in promoter region was detected in 34 out of 60 cases of cervical carcinoma (57%) ; while there was no methylation in CIN cases. In 13 cases with lymph node metastasis, 11 were found to have the methylation of Syk gene. The methylation rate of Syk promoter in cervical carcinoma was higher than that of CIN tissue( x~2 = 7. 13, P ＜0. 01 ). The methylation status of Syk gene was correlated with the lymph node metastasis ( P＜ 0. 05 ), but not with other clinicopathological parameters ( P ＞ 0. 05). There was a significant correlation between methylation status and expression level of Syk gene ( P ＜ 0. 05 ). The hypermethylation leads to silencing of the Syk gene in human cervicalcarcinoma. Syk hypermethylation may be associated with oncngenesis, metastasis of cervical carcinoma.