Objective To investigate the efficacy and side effect of induction chemotherapy plus concurrent chemoradiotherapy ( IMRT) in the treatment of 81 patients with locally advanced nasopharyngeal carcinoma ( NPC) . Methods 81 patients with locally advanced NPC were divided into the vinorelbine group and fluorouracil group . Patients in the vinorelbine group were given vinorelbine 25-30mg/m2 d1,d8,DDP 75mg/m2 ,d1-d3.Patients in the fluorouracil group were given DDP 75mg/m2,d1-d3,fluorouracil 750 mg/m2 d1-d5.The treatment schedules were recycled every 3 weeks.After 2-4 cycles, the patients received concurrent chemoradiotherapy .In the vinorelbine group,IMRT with NVB 25-30mg/m2,DDP 40mg d1,d8,d22,d29,d43,d51 from the first day of IMRT.In the fluorou-racil group,IMRT with fluorouracil 750mg/m2 ,DDP 25/m2 d1,d8,d22,d29,d43,d51 from the first day of IMRT. Results The overall leukopenia and thrombocytopenia decline was 47.5% vs 24.4% in patients with Ⅲ and Ⅳgrade(χ2 =4.73,P<0.05).5-year locoregional relapse-free survival rates were 85.0% vs 65.9%(χ2 =4.05,P<0.05).5-year overall survival rates were 85.0%vs 68.3%(χ2 =3.18,P<0.05).Conclusion NP regiment induc-tion chemotherapy plus concurrent chemoradiotherapy for advanced NPC can achieve better result in clinical response and 5-year locoregional relapse-free survival rate compared with FP and the effect is clinically acceptable .

Objective To observe the preventive effect of immune tolerance induced by immature myeloid dendritic cell(iMDC) loading P2 58-73 peptide(P2 58-73aa-iMDC) in experimental autoimmune neuritis(EAN),and the effect on the expression of IFN-? and IL-33 mRNA.Methods(1)The iMDC were cultured in vitro for loading P2 58-73aa.(2) 21 adult female Lewis rats were randomly divided into the EAN(A)group,iMDC(B)group and P2 58-73aa-iMDC(C)group,and subcutaneously injected PBS,iMDC and P2 58-73aa-iMDC respectively.After 7 d,all the rats were immunized with P2 53-78aa and complete freunds adjuvant(CFA) to inducing EAN.Then,the situation of onset were observed and clinical score were evaluated till 16 d(the crest-time of onset) after immunization.(3) The lymphocyte proliferative response were assayed by 3H-TdR incorporation.The expression of IL-33,IFN-? mRNA in sciatic nerves,spleen and lymph node were detected by RT-PCR.Results(1)In the crest-time of onset,the clinical scores in groups A,B and C were(7.4?1.9),(5.2?1.6) and(3.4?0.9) respectively.There were significant differences between each two groups(allP

Objective To investigate the involvement of apoptosis in the lesions of patients with psoriasis. Methods The apoptosis was detected with terminal deoxynucleotidyl transferase mediated dUTP biotin nick end labeling (TUNEL), and the expression of p53, PCNA and apoptosis suppressing protein bcl 2 was assessed with immunoperoxidase technique in psoriatic lesions and normal skin. Results A large number of keratinocytes showing biochemical and morphologic features of cells undergoing apoptosis were observed in all the suprabasal layers of the psoriatic epidermis. The plaques from all patients analysed showed marked increase in the number of PCNA positive cells in the middle and basal keratinocytes, and a dramatic reduction in the number of bcl 2 positive cells in the basal cell layer. Conclusion The increased apoptosis of keratinocytes in the lesions of psoriasis might be a homeostatic mechanism to the hyperplasia of cells.

Objective To explore the factors that affect the teaching effect of medical statistics study for clinical postgraduates and to provide a reference for further improving teaching Quality. Methods Four hundred and eighty-nine students who had attended Medical statistics in 2013 Fall semester were surveyed by the self-designed questionnaire. The Logistic regression model was used to analyze the factors affecting the learning effect. Results A total of 489 questionnaires were distributed and 488 valid questionnaires were returned (the return rate was 99.80%). 71.11% (347/488) were entirely in favor of giving medical statistics course while 23.98% were relatively supportive. Statistics recognition, learning motivation, finishing homework and the satisfaction of learning were the factors that affect the grades. The OR values are 1.547, 1.723, 1.374, 1.433 for the above four factors respectively. The difference was statistically significant (P<0.05). Conclusion In medical statistics teaching, it can improve students' performance by introducing case study, simplifying the mathematical formula, combi-ning the theory and computer statistical software practice, and improving teaching methods, which helps improve the quality of teaching.

Rhubarb anthraquinone derivatives (AQs) have been documented to have both therapeutic and toxic effect on liver and kidney, leading to a complex puzzle to assess their benefits and risks. In this study, the tissue distributions of AQs in SD rats after orally administrated extracts of raw and prepared rhubarb were examined whether they undergo different uptake. The total rhubarb extract (14.49 g x kg(-1) of body weight per day od, counted on the quantity of crude material) was administrated orally for 12 weeks. The concentrations of the AQs in different tissues were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The five major AQs, aloe-emodin, rhein, emodin, chrysophynol and physcion, could all be detected in the liver, kidney and spleen, while only rhein, aloe-emodin and emodin reached the quantitative limit. The tissue concentrations of AQs in raw rhubarb group were higher than that in steamed rhubarb group with rhein > emodin > aloe-emodin in the same tissue. On the whole, the tissue distribution of rhein was higher than that of emodin and aloe-emodin in liver, spleen and kidney. AQs could not be detected in those tissues after drug withdraw for 4 weeks, which suggested scarcely any accumulative toxicity of rhubarb. The result indicated that raw rhubarb had more tissue toxicity than steamed rhubarb and rhein may be one of the major poisonous ingredients. The results were concordant with the traditional Chinese medicine theory of toxicity-attenuating effect of processing.

Objective To provide molecular genetic basis for oncobiological difference in left sided colon cancer and right sided colon cancer. Differentially expressed proteins in left sided colon cancer and right sided colon cancer were screened by proteomic technique. Methods Tissue samples including left sided colon cancer and right sided colon cancer were collected and preserved in the -80℃ refrigerator. In the first part of our experiment, protein was separated by 2-dimensional gel electrophoresis (2-DE) and the images of the gels were acquired by the scanner and then analyzed to find the differentially expression protein-spots in different groups. The peptide mass fingerprintings (PMF) was acquired by matrix assisted laser desorptiorn/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascotdatabase. Differentially expressed proteins were assayed by RT-PCR, Western blot, and immunohistochemical method. Results Altogether 55 differentially expressed protein spots were screened and 21 spots of them were identified. Compared with the right sided colon cancer, 14 proteins were up-regulated and 7 proteins down-regulated including HSP27 in the left sided colon cancer. HSP27 expressed higher in the right sided colon cancer than in the left sided colon cancer.Conclusion There are differentially expressed proteins in left sided colon cancer and right sided colon cancer, especially difference in HSP27 expression at mRNA and protein level, which may be molecular genetic basis for oncobiological difference in left sided colon cancer and right sided colon cancer.

Objective To investigate the relationship between endoscopic diagnosis and pathological nature of gastric mucosal leukoplakia. Methods Analysis of gastric mucosal leukoplakia patients’ endoscopic features and pathological characteristics of last 3 years. Results Endoscopic diagnosis was made in 116 cases of gastric mucosal leukoplakia. Samples were gray white, round, round shaped or patchy in general observation. Diameter was 0.2 ~1.6 cm, foam cell aggregation appeared in the natural layer of mucous membrane in 88 cases (75.9 %), with varying degrees of inflammatory cells infiltration. The foam cells accumulation were observed in high rate among the gastric mucosal leukoplakia cases. Conclusion Pathological changes of gastric mucosal leukoplakia is gastric xanthoma with chronic inflammation of mucosa.

Objective To analyze the changes of clinical and pathological features in the patients of IgA nephropathy with anemia.Methods Four hundred and nine patients of IgA nephropathy diagnosed by renal biopsy were classified into two groups:IgA nephropathy with nonanemia (group 1) and IgA nephropathy with anemia (group 2).Changes were studied retrospectively between the groups.Results Serum hemoglobin level was correlated with the clinical parameters of IgA nephropathy.Companed to group 1,changes in group 2 were as followed:serum creatinine increased,eGFR decreased,proteinuria increased; the global sclerosis,segmental sclerosis,crescents and tubulointerstitial lesions worsened.The glomerular and tubulointerstitial lesions were negatively correlated with serum hemoglobin and eGFR,but positively correlated with serum uric acid and proteinuria (P＜0.05).Multivariate Logistic regression analysis revealed that anemia was an independent risk factor for the tubulointerstitial lesion.Conclusion Clinical feature and pathological damages in the patients of IgA nephropathy with anemia are more serious than those with non-anemia.

Objective To investigate the diagnostic value of EBUS imaging features for metastatic mediastinal/hilar lymph node enlargement in lung cancer.Methods The lung cancer patients with a pathological diagnosis and without preoperative anti-tumor treatment who got the EBUS-TBNA examination from October 2009 to September 2011 were retrospectively analysis.422 lung cancer patients with 683 mediastinal / hilar lymph nodes were enrolled in this study,including 335 males and 87 females; the median age is 61 years old (range 24-82),EBUS lymph node ultrasound image and the final pathological or follow-up results were compared by the statistical analysis.Homogeneity in the lymph node EBUS image feature was defined as:uniform echo in the ultrasound images,cortex existed in the peripheral areas,medulla existed in lymph central with a slightly stronger echo and represent as a small strip.Heterogeneity was defined as: the ultrasound image was defined as uneven echo involved with coagulation necrosis sign,which was the hypoechoic areas without blood flow in the lymph nodes and represent no blood flow in the CDPI mode.The coagulation necrosis was associated with necrosis within the lymph node.In addition,if the CNS region occupied more than 11％ of the entire lymph node in a complete lymph node or just a part of huge lymph nodes in the EBUS imaging window frame,we also regard it as heterogeneity.If a complete lymph node was seen in the EBUS imaging window frame,we measured the longest diameter to the long axis and its vertical maximum diameter to the short axis.If the lymph node was huge and extended the EBUS imaging window frame,we measured the longest diameter in the frame as the long axis of its vertical maximum diameter to be the short axis.As to the EBUS-TBNA negative lymph nodes,we regarded it was malignant lymph node if the diameter of the lymph node increased by 20％ in the patients who did not received any chemotherapy or radiotherapy or the diameter of the lymph node increased or decreased by 20％ in the patients who received any chemotherapy or radiotherapy six month later in the chest enhanced CT scan,otherwise,it was identified as benign lymph node.We used the RECIST 1.1 solid tumors criteria to evaluate the efficacy of the chemotherapy.Results 422 patients were enrolled this study including 93 squamous carcinomas,137 adenocarcinomas,97 small cell lung cancer,42 poorly differentiated non-small cell lung cancer,29 adenosquamous carcinoma and 24 other malignant tumors (including large cell carcinoma,sarcomatoid carcinoma,carcinoid tumors,etc).The sensitivity of the EBUS-TBNA was 93.8％ (396/422).The diagnostic methods and results in the 683 lymph nodes were as the following: 506/683 (74.1％) was confirmed as cancer by the EBUS-TBNA while 177/683 (25.9％) was diagnosed as benign disease.Among these,32/683 (4.7％) was confirmed as cancer and 57/683 (8.3％)was confirmed as benign disease by surgery,9/683 (1.3％) was confirmed as cancer and 79/683 (11.6％) was confirmed as benign disease by the method of follow-up.the sensitivity for the EBUS-TBNA to be malignant was 506/547 (92.5 ％),specificity was 136/136 (100％),positive predictive value was 506/506 (100％),negative predictive value was 136/177(76.8％) and accuracy was 642/683 (94.0％).The short axis diameter in the 683 lymph nodes ranged from 0.40cm to 4.60cm with an average diameter of (1.58 ± 0.68) cm.Among them,the short axis diameter in the malignant lymph node was (1.75 ± 0.63) cm,and in the benign lymph nodes was (0.92 ± 0.40) cm.527 lymph nodes presented heterogeneity under the ultrasound imaging,in which,519/527 (98.5 ％)were malignant lymph nodes.While,156 lymph nodes presented homogeneity and 28/156 (17.9％) were malignant lymph nodes (x2 =489.5,P ＜0.01).In the heterogeneous lymph node with a short axis diameter more than 1.0cm,the sensitivity to be malignant was 89.4％,specificity was 100％ and accuracy was 89.6％.In the homogeneous lymph node with a short axis diameter less than 0.8cm,the sensitivity to be benign was 43.8％,specificity was 67.8％ and accuracy was 48.1％.Conclusion EBUS-TBNA is new biopsy method for the mediastinal / hilar lymph node.The classification based on EBUS imaging-based lymph node ultrasound image features was helpful to identify the procedure for the diagnostic purposes and could help to distinguish the benign or malignant mediastinal / hilar lymph node in lung cancer patients.

ObjectiveTo discuss the quantitative criteria of grading nursing of three common psychiatric diseases in psychiatric department. MethodsUsing SI、N-BPRS,BRMS and HAMD scales to evaluate180 patients with schizophrenia,mania and depression upon admission and after admission.The quantitative evaluation of grading nursing of these three diseases was compared. ResultsFor the three common mental diseases N- BPRS scale scores were as follows.Superfine nursing:schizophrenia (80.66+11.22)points; mania (80.05± 15.44)points; depression (76.88±9.82)points.Primary care:schizophrenia (67.47± 10.18)points; mania ( 62.91 ± 10.19 )points; depression ( 56.63±9.52 )points; Secondary nursing:schizophrenia ( 44.04 ±8.67 )points;mania( 39.57±9.47 )points ;depression( 37.73±7.75 )points.The three- level nursing:schizophrenia( 27.97±2.19 )points;mania(27.89±2.28)points;depression(27.45±1.31 )points. ConclusionsUsing evaluating scores of NBPRS scale to determine the quantitative criteria of grading nursing of three common psychiatric diseases is a feasible choice,after training,nurses of high qualification can grasp skillfully the operation process.