The single brain metastases of lung cancer is defined as limited brain metastases .Mechanism of brain metastasis from lung cancer remains to be further studied .Based on surgery ,radiotherapy ,and chemother-apy,the comprehensive treatment on limited brain metastasis of non -small cell lung cancer gets a better result , however ,the indications for combination therapy must be strictly controlled .Increasing radiation doses of local tumor area,followed by whole-brain radiotherapy,can improve tumor local control rate and prolong overall sur-vival.Prophylactic irradiation of whole brain showed no evidence on prolonging the overall survival .For patients with poor general state,targeted drugs combined with whole brain radiotherapy can be tolerated well ,as well as prolonged the overall survival to ertain extent .

Objective:To observe the emergency treatment effect of levosimendan combined noninvasive mechanical ventilation on acute heart failure during emergency treatment period .Methods :According to random number table , 120 cases with acute heart failure were randomly and equally divided into routine treatment group and levosimendan group (levosimendan + noninvasive mechanical ventilation ) .Improvements of arterial blood gas [partial pressure of carbon dioxide and oxygen (PaCO2 ,PaO2 ) ,pH etc .] after 72h ,change of N terminal pro brain natriuretic pep-tide (NTpro-BNP ) level 4d after hospitalization and mortality rate were observed and compared between two groups .Results:After treatment ,PaO2 ,mean arterial pressure and NTpro-BNP level of the two groups significant-ly improved compared with before treatment ;compared with routine treatment group ,there was significant rise in PaO2 [ (78.2 ± 9.4) mmHg vs .(86.2 ± 10.5) mmHg] and significant reductions in mean arterial pressure [ (86.3 ± 8.2) mmHg vs .(82.2 ± 9.0) mmHg] and NTpro-BNP level [ (4340.5 ± 540.7) pg/ml vs .(4012.1 ± 426.3) pg/ml] in levosimendan group , P<0.01 all;total effective rate of levosimendan group was significantly higher than that of routine treatment group (86.7% vs .76.6% , P=0.047);after three-month follow-up ,mortality rate of le-vosimendan group was significantly lower than that of routine treatment group (11.7% vs .20.0% , P= 0.026 ) . Conclusion:Emergency treatment effect of levosimendan combined noninvasive mechanical ventilation on acute heart failure is significant ,which is worthy of further research and extension .

The molecular weight of matrix metalloproteinase (MMP)-9 is the largest in MMP family which comes mainly from macrophage and neutrophil.MMP-9 is considered to be involved in the occurrence and metastasis of colorectal cancer.It also provides a new way for colorectal cancer in clinical prevention and treatment.

Nasopharyngeal carcinoma is the commonest head and neck cancer in China and especially sensitive to both chemotherapy and radiotherapy. But radiotherapy alone has disappointing effect to local advanced cases. Nevertheless,chemoradiotherapy provides long term survival. This paper summarized the current status of the different ways of chemoradiotherapy such as induction,concurrent,adjuvant chemotherapy.

Adenosine deaminase (ADA) activity in pleural fluid from 81 patients was measured by colorime-tric method. Of these cases, 55 cases were tuberculous pleural effusion, 22 cases were malignant pleura! effusion and 4 cases were transudate pleural effusion.The mean ADA, activity in pleural fluid of tuberculous group was 188.3?58.2u and that of malignant group was 52. 2?15. 4u. Statistically the difference is highly significant (p0.05). In tuberculous group, pleural fluid ADA levels higher than 110u were found in 53. cases (96.3%), and those above 120u were found in 52 cases (94.5%), while no case in malignat group had the ADA level higher than 90u, and in 20 cases it is lower than 70u (20/22 cases, 90.9%). These data suggest that pleural fluid ADA activity may be a useful index in the differential diagnosis of tuberculous and malignant pleural effusions.

0.05);and in combined test,the combined ORe=0.989 7 and ORs=0.565 7 with the combined ORe and ORs(at 95% confidence interval)stood at 0.783 6～1.248 4 and 0.418 8～0.764 1,respectively.In OR combined test:?2=13.790 9(P

Objective To explore the clinical effect of hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps.Methods 126 patients with abnormal uterine bleeding of endometrial polyps were selected,and they were selected and randomly divided into control group and research group according to the digital table,63 cases in each group.The control group received traditional curettage surgery, the research group received hysteroscopic eletrosurgery.The intraoperative blood loss,operative time,length of hospital stay,postoperative menstruation recovery time,therapeutic effect and complications were compared between the two groups.Results The intraoperative blood loss and operation time of the research group were significantly lower than those of the control group (t1=7.44,P1<0.01,t2=7.78,P2<0.01).And there were no statistical differences between the two groups in length of hospital stay and postoperative menstruation recovery time(t1=1.82,P1=0.07,t2=1.71,P2=0.09).The total cure rate of the research group was 100.00%,which of the control group was 92.14%,the difference was statistically significant(x2=8.18,P=0.00).The incidence rate of complications of the research group was 3.17%, which of the control group was 17.50%,the difference was statistically significant(x2=11.08,P=0.00).Conclusion Hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps has remarkable clinical effects and low incidence of complications,and it is worthy of clinical application.

Objective To investigate the positive influence of telephone follow-up on primiparas′exclusive breastfeeding during puerperal period. Methods By using convenience sampling method, 90 primiparas were selected who had given birth in the integration ward of our hospital from October to December 2015 as the control group, and 60 primiparas were selected who had given birth in the integration ward of our hospital from December 2015 to January 2016 as the experimental group. For the experimental group, every 2 weeks, a telephone follow-up was executed according to primiparas′parturition time after leaving hospital. For the control group, telephone follow-up was not executed. The influence of periodic telephone follow-up on primiparas′ exclusive breastfeeding was observed. Results The exclusive breastfeeding rate of primiparas in the experimental group was increased as the telephone follow-up was executed. It was up to 91.7%(55/60) 6 weeks since parturition. The exclusive breastfeeding rate of primiparas in the control group was 71.1% (64/90). The difference was significant (χ2=9.28, P<0.01). Conclusions Periodic telephone follow- up according to necessity provides breastfeeding publicity and guidance after parturition, maintaining the continuous education and caring for the primiparas after leaving hospital which efficiently increased the pure breastfeeding rate of primiparas during puerperal period.

Objective To explore the influence pulmonary function and inflammatory factors of symbicort combined with ambroxol hydrochloride in the treatment of acute exacerbation of chronic obstructive pulmonary disease( AECOPD) .Methods 86 patients with AECOPD were divided into control group 43 cases and treatment group 43 cases according to the computer random number table method.The control group was given intravenous injection of ambroxol hydrochloride 60 mg/time, 2 times/day, and the treatment group was given inhalation of symbicort 2 inhaling/times, 3 times/day on the basis of the control group.After 7 day treatment, the clinical efficacy and adverse reactions of two groups were observed.The percentage of forced vital capacity ( FVC%) , percentage of forced expiratory volume of 1 seconds( FEV1 %) , percentage of mid expiratory flow predicted value( MMF%) , percentage of max volume predicted value(MVV%) were measured by pulmonary function test apparatus, and the value of FEV1%/FVC% was calculated.The levels of serum tumor necrosis factor alpha(TNF-α), c-reactive protein(CRP) and interleukin 6(IL-6) were detected by ELISA.Results The total effective rate of treatment group and control group were 93.02%(40/43) and 74.42%(32/43), the difference was statistically significant(P <0.05).After treatment the FVC%(2.58 ±0.25),FEV1%(1.87 ±0.15),MMF%(70.24 ±5.86)and MVV%(72.43 ±4.35) in treatment group were higher than the control group (2.21 ±0.27),(1.68 ±0.16),(63.14 ±5.68)and 65.12 ±4.16), the difference was statistically significant(P<0.05).The levels of serum TNF-α(13.87 ±4.12)μg/mL,CRP(9.14 ±3.76)mg/mLand IL-6(76.07 ±10.14)pg/mL in treatment group were lower than the control group (16.56 ±6.48)μg/mL,(12.46 ±3.89)mg/mL and(89.55 ±11.24)pg/mL,the difference was statistically significant(P<0.05).The adverse reactions were mainly for heartburn, nausea, vomiting and skin rashes in the control group,and the adverse reactions were mainly for heart palpitations, headache, nausea, rashes, vomiting in the treatment group, the incidences of adverse reactions 23.26%(10/43) in treatment group compared to control group 18.60%(8/43) was no statistically significant difference.Conclusion The symbicort combined with ambroxol hydrochloride in the treatment of AECOPD have clinical curative effect, can improve the patient's lung function, reduce inflammation, have less adverse reactions.It was worthy of clinical popularization and application.

Objective To investigate the risk factors for postoperative anastomotic leakage in geriatric patients with esophageal carcinoma and provide new insights into clinical prevention and treatment.Method The fifty-six patients with anastomotic fistula were chosen from 636 esophageal carcinoma patients who underwent esophagectomy in Department of Thoracic Surgery from January 2011 to January 2016.In the 56 patients,the ratio of male (39 cases) to female (17 cases) was 2.3 ∶ 1.0,with the age range of 60-81 years,average of (66.4±8.6) years.The retrospective analysis was performed for obtaining the risk factors for anastomotic leakage.Results Fifty six cases who suffered from anastomotic fistula showed 10 cases (17.9％)with hormone administration,17 cases (30.4％) with preoperative chemo-radiotherapy,32 cases (57.1％) with the basic diseases,27 (48.2％) with preoperative dystrophia.In addition to the old age and tumor,the other risk factors for anastomotic leakage included the hormone use,preoperative malnutrition,and preoperative chemoradiotherapy.Conclusion High attentions have to be paid to the prevention and treatment of anastomotic fistula patients with chronic diseases,hormone use,preoperative malnutrition and preoperative chemo-radiotherapy.