Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Combined Modality Therapy ; Humans ; Neoplasms ; drug therapy ; radiotherapy ; surgery ; Particle Accelerators ; Radiation Dosage ; Radiotherapy, High-Energy ; methods ; Salvage Therapy

With a high invasive ability and poor prognosis, the morbidity of pancreatic cancer is about 98%.Combination of chemotherapy and radiotherapy is the primary management for locoregionally advanced pancreatic cancer, but its efficacy is limited. Results from a number of meta-analysis have confirmed that gemcitabine is associated with significantly better clinical response and one-year overall survival rates;therefore, currently gemcitabine is the standard chemotherapy for advanced pancreatic cancer. Gemcitabine-based multi-drug regimens may have potentially favorable effects on patients' survival. However, evidence from phase Ⅲ clinical trials is lacking. Newer chemotherapy and targeted therapy agents are clearly needed for patients with advanced pancreatic cancer.

BACKGROUND:The patients with lumbar intervertebral disc protrusion can be treated with internal fixation of posterior surgery way. We can choose the conventional posterior intervertebral fusion nail stick system internal fixation. Isobar non-fusion internal fixation system was used in recent years. As a kind of a strong internal fixation of lumbar posterior dynamic screw rod fixation system, it has been gradual y applied in clinic, and has been one of patient’s treatment options. OBJECTIVE:To compare and analyze the clinical efficacy of Isobar non-fusion internal fixation system and traditional intervertebral fusion nail rod system internal fixation operation method in treatment of lumbar disc herniation. METHODS:From September 2011 to September 2012, 40 patients with lumbar disc herniation who were treated in the Department of Orthopedic, Changhai Hospital, the Second Military Medial University of Chinese PLA were enrol ed in this study. They were equal y assigned to the Isobar non-fusion internal fixation system group (Isobar group) and the traditional intervertebral fusion nail rod system internal fixation group (rigid internal fixation group) and subjected to corresponding treatments. RESULTS AND CONCLUSION:Surgery was successful y completed in patients of the two groups. These patients received at least 2 years of fol ow-up, no drop out. Compared with pre-fixation, low back pain Visual Analog Scale and Oswestry Disability Index were improved significantly after fixation in both groups. Compared with the rigid internal fixation group, range of motion of lumbar spine was larger in the Isobar group. Low back pain Visual Analog Scale and Oswestry Disability Index were similar between the two groups. These results indicated that posterior Isolbar non-fusion internal fixation obtained identical outcomes as traditional treatment, and showed more advantages in range of motion of lumbar spine.

BACKGROUND:The current fixation methods for clavicle fracture are mainly anatomy plate or reconstruction plate. The specific devices for maintaining fracture alignment and fixation are rarely reported. The majority of physicians prefer reduction forceps to maintain fracture alignment and retain plate for internal fixation. However, reduction forceps have many disadvantages, such as large damage, instable fixation and difficult to bend or mould plates.
OBJECTIVE:To compare the clinical effect of new-style bone holder and reduction forceps in treatment of clavicular fractures.
METHODA total of 75 patients with clavicular fractures were recruited from Department of Orthopedics, Huai’an First Hospital, Affiliated to Nanjing Medical University, between December 2011 and December 2013. The involved patients were randomly divided into two groups, new-style bone holder (39 cases) and reduction forceps (36 cases). In new-style bone holder group, the wounds were opened and reduced using reduction forceps, then new-style bone holder was applied to maintain fracture alignment and internal fixation;in reduction forceps group, the wounds were opened and reduced using reduction forceps, then reduction forceps was applied to maintain fracture alignment and internal fixation. The length of incision, the time of operation, intraoperative blood loss, fracture healing time and clinical efficacy in two groups were compared.
RESULTS AND CONCLUSION:Al cases were fol owed up for over half a year. There was no significant difference between the two groups in the length of incision (P>0.05). The new-style bone holder group was obviously better than reduction forceps group in the time of operation, intraoperative blood loss and fracture healing time, with significant difference (P<0.01). The clinical efficacy was significantly higher than reduction forceps group. Experimental findings indicate that, new-style bone holder is characterized by simple operation, few trauma, stable fixation, short operation time, and rapid fracture healing.

Objective To investigate the expression of thymosin beta4 ( Tβ4 ) in the liver tissues of children with hepatoblastoma ( HB) , and further study the function of Tβ4 in HB metastasis in vitro. Methods Immunohisto-chemistry (IHC) was used to determine expression of Tβ4, E-cadherin andβ-catenin in liver tissues from 19 chil-dren with HB,and further to analyze its function in metastasis of HB cells. Results The positive rate of Tβ4 ( P<0.01 ) in HB liver tissues was significantly higher than it in the adjacent tissues. The positive rates of Tβ4 and nu-clearβ-catenin in HB with lymphnode metastasis were significantly higher than in HB without lymphnode metastasis ( P <0.01 ) . While expression of E-cadherin in HB with lymphnode metastasis was lower than in HB without lymphnode metastasis ( P<0.01 ) . Scratch-wound assay showed that HepG2 cells with Tβ4 knockdown had signifi-cantly lower metastatic ability (P<0.05). Conclusion Tβ4 plays an important role in HB metastasis, suggesting it is a potential target for HB metastasis.

With medical system reform advancing,social requirement on comprehensive capability for health service management professionals enhances unceasingly.However,health service management in our country is a new branch of edge-crossed and needs to be improvd and perfected constantly to reduce the shortage in mode construction for talent cultivation. It is meaningful to explore and construct innovative cultivation mode for health management professionals from three aspects,management capability,learning capability and information feedback based on system self-organization principle.

Objective To provide a theoretical reference for building a discharge planning program suitable for China's national conditions based on a comprehensive content analysis of international discharge planning guidelines.Methods Discharge planning guidelines from 1995 to 2012 which were retrieved from PubMed,NGS (National Guideline Clearinghouse),google were analyzed by 5W1H method.Results A total of 11 discharge planning guidelines were collected from 21 through the full text screening.Conclusions This study shows that discharge planning should focus on patients with their needs as orientation,to provide continuous care through interdisciplinary and interagency coordination and cooperation,and an effective planning should be implemented standardized management and carried out early on admission.

OBJECTIVE To investigate the relationship between state trait anxiety and behavioral status in patients with sudden deafness. METHODS From April 2015 to June 2016, 140 cases of hospitalized patients with sudden hearing loss were selected as the observation group, and 140 healthy volunteers in our hospital for medical examination were selected as the control group. Average data, state trait anxiety, quality of life, and behavior survey were investigated in the two groups and correlation analysis was conducted. RESULTS The state trait anxiety score of the observation group was 51.20±4.19 points, and the control group was 34.40±3.49 points, and the state trait anxiety score of the observation group was significantly higher than that of the control group(t=12.949, P<0.05). The scores of physical, compulsive, interpersonal sensitivity, hostility and depression in the observation group were significantly higher than those in the control group(P<0.05). The problem solving and help scores in the observation group were significantly lower than that of the control group, while the fantasy and self accusation scores was significantly higher than that of the control group(P<0.05). In the observation group, Pearson correlation analysis shows anxiety scores were significantly correlated to the dimensions scores of quality of life, fantasy and self accusation scores(P<0.05), and were significantly negative correlated to the problem solving and help scores (P<0.05). CONCLUSION The patients with sudden deafness is accompanied by state trait anxiety and fantasy, self accusation and other bad behavior, it can seriously affect the patient's quality of life and form vicious circle, so the nursing intervention should be strengthened in clinical practice.

Objective To compare the clinical effect of tube bone fractures with a modified bone holding and the traditional three -claw bone holding. Methods 94 cases of tube bone fractures were compared based on their sequence,the odd number (group A) were treated with the modified bone holding; the even number (group B) were treated with the traditional three-claw bone holding; and then the length of incision,the time of operation,the lost blood during the operation,the reduction of those fractures,the time for those fractures to get cicatrization were compared. Results All cases were followed up over half a year,which was no significant difference between the two groups in the reduction of those fractures. The group A had significant advantages than group B in the length of incision,the time of operation,the lost blood during the operation,the time for those fractures to get cicatrization. Conclusion The modified bone holding is better than the traditional three-claw bone holding in the length of incision,the time of operation,the lost blood during the operation,the time for those fractures to get cicatrization.

Objective To identify the effect of insulin-like growth factor-1(IGF-1) gene transfer on motoneurons apoptosis in anterior horn after acute spinal cord injury in adult rats.Methods Thirty-six male Wistar rats were randomly divided into 3 groups: IGF-1 group,model group and control group.The SCI models were made by cutting half spinal cord of rats on the T_8 segment by ophthalmogy scissors.Lipofectamine and recombinant plasmid pcDNA-hIGF-1 complexes were injected into the injury spinal cord by microinjector in IGF-1 group while pcDNA3.1,LipfectAmine and saline were administered in model group.The expression of IGF1 was detected by immunohistochemistry method,the apoptosis of the motoneurons in anterior horn was detected by TUNEL,and moting function of hindlimbs was evaluated by BBB locomotor scale.Results Compared with model group and control group,the expression of IGF-1 was increased significantly(P