Purpose:To study the efficacy and toxicity of paclitaxel in the treatment of patients with advanced head and neck cancer. Methods:51 patients with stage Ⅲ-Ⅳadvanced head and neck cancer were enrolled, including l9 patients who had no prior chemotherapy, 32 patients who had recurrent head and neck cancer after surgery and/or radiation therapy, and then had become resistant after about two cycles of chemotherapy with fluorouracil plus cisplatin. Three to six cycles of chemotherapy with paclitaxel plus carboplatin or cisplatin were administered: paclitaxel 75-l00mg/m2, qd. d 1?d 8?d 15 plus carboplatin 300-350 mg/m2, qd. d 2 (or cisplatin 20 mg/m2,qd. d 1-5 ), q 4 wk.Results:The total response rate in 51 patents was 19 (37.2%), with 4 (7.8%) complete response, 15 (29.4%) partial respond, l8(35.3%) stable disease and 14 (27.4%) progression. Major toxicities were neutropenia, GI tract reactions and alopecia. One patient had allergic shock and patient died at the beginning of the second cycle of chemotherapy. Conclusions:Paclitaxel is efficient in treating the advanced head and neck cancer. Except for rare cases of allergy, major toxic effects can be tore rated by the patients.

Pluronic modified polyamidoamine (PAMAM) conjugate (PF127-PAMAM) was prepared and the inhibiting effect of MDR against MCF-7/ADR was investigated with doxorubicin (DOX) as model drug. 1H NMR and FTIR spectra showed that the conjugate was synthesized successfully. Element analysis accurately measured that 27.63% amino of per PAMAM was modified by pluronic (PAMAM : PF127, 1 : 35.37 mole ratio). PF127-PAMAM showed an increased size and a reduced zeta potential compared to PAMAM. PF127-PAMAM had lower hemolytic toxicity and cytotoxicity due to the reduced zeta potential and the protection of PF127. Each PF127-PAMAM molecular could load 19.58 DOX molecules, and the complex exhibited sustained and pH-sensitive release behavior. PF127-PAMAM/DOX exhibited weaker cytotoxicity than free DOX in MCF-7 cells; while the complex showed much stronger reverse effect of drug resistance in MCF-7/ADR cells, and resistance reversion index (RRI) was as high as 33.15.

Objective To investigate the effect of intermittent use of low molecular heparin (LMWH) on microembofic signal (MES) in patients with ischemic stroke on the basis of anti-platelet aggregation and statin therapy.Methods Ninety MES-positive patients with acute ischemic stroke detected by transcranial Doppler were randomly divided into a non-LMWH group (n =44) and a LMWH group (n =46).The non-LMWH group was treated conventionally with enteric-coated aspirin and atorvastatin.On the basis of conventional therapy,the LMWH group was treated with LMWH,subcutaneous injection of LMWH calcium 4 100 AXaIU every 3 months,twice a day,and one week as a course of treatment (a total of 3 courses).The number of MES,MES-positive rate and incidence of ischemic cerebrovascular events at 3 and 6 month were compared in both groups.Results There was no significant difference in the MES-positive rates at 3 month after treatment between the non-LMWH group and the LMWH group (70.45％ vs.61.36％ ;x2 =1.357,P =0.244),but the number of MES in the non-LMWH group was higher than that in the LMWH group (12.07 ± 10.16 vs.8.09± 8.13; t =1.470,P =0.043); the MES-positive rate at 6 month after treatment in the non-LMWH group was significantly higher than that in the LMWH group (36.96％ vs.19.57％;x2=3.982,P=0.046),and the number of MES in the non-LMWH group was also significantly higher than that in the LMWH group (10.32 ±9.93 vs. 1.46 ± 3.27; t =5.450,P =0.000).There was no significant difference in incidence of ischemic cerebrovascular events at 3 month (2.17％vs. 9.09％,P =0.198 ),but the incidence of ischemic cerebrovascular events at 6 month in the LMWH group was significantly lower than that in the non-LMWH group (4.35％ vs.20.45％,P =0.025).Conclusions On the basis of anti-platelet aggregation and statin therapy,the intermittent use of LMWH may decrease the MES-positive rate and the incidence of ischemic cerebrovascular events in the MES-positive patients with ischemic stroke at 6 month.

Objective To investigate the positive rate of microembolic signal (MES) and the related factors,as well as the correlation between MES and outcomes in patients with cardiogenic cerebral embolism.Methods Patients with cardiogenic cerebral embolism were enrolled.The baseline data of the patients were collected and the MES monitor was conducted.The baseline data of the MES positive group and MES negative group were compared.Multivariatelogistic regression analysis was used to identify the related factors of the positive MES.The patients were followed up regularly.The outcomes of stroke at 6 months and recurrent stroke within 2 years in the MES positive group and MES negative group were compared.Results A total of 165 patients with cardiogenic cerebral embolism were enrolled,including positive MES in 68 patients (41.2％).There were significant difference in the levels of brain natriuretic peptide (BNP),cardiac troponin-I (cTn-I),and D-dimer between the MES positive group and negative group.Multivariate logistic regression analysis showed that the increased levels of baseline BNP (odds ratio [OR] 1.001,95％ confidence interval CI 1.001-1.002;P＜0.001),cTn-I (OR 36.975,95％ CI 1.516-902.0;P=0.027),and D-dimer (OR 1.001,95％ CI 1.000-1.001;P=0.017) were independently associated with the positive MES in cerebral embolism within 48 h after onset.There was no significant difference in the proportion of patients in good outcome (modified Rankin scale score 0-2) and poor outcome (modified Rankin scale score ＞2) after 6 months between the MES positive group and MES negative group.When the average follow-up time was 20.8 months (range,7-24 months),there were 23 patients (33.8％) and 19 (19.6％) had recurrence in the MES positive group and MES negative group,respectively.Kaplan-Meier analysis showed that the recurrence rate of stroke in the MES positive group was significantly higher than that in the MES negative group (log-rank test:P=0.031).COX regression analysis showed that the positive MES was still an independent risk factor for stroke recurrence after adjusting for other confounding factors (OR 0.328,95％ CI 0.142-0.761;P=0.009).Conclusions The positive MES was associated with the increased BNP,cTn-I,and D-dimer levds.The positive MES was not associated with clinical outcomes at 6 month after the onset,but it was associated with the recurrence of stroke within 2 years.

Objective To study the vascular endothelium growth factor(VEGF) antisense oligonucleotide(ASON) Cinobufotalin in enhancing apoptosis induced by human chronic myeloid leukemia K562 cell line.Methods The synthesis of VEGF ASON was transfected into the K562 cells;Cinobufotalin of four concentrations(1,3,5 and 7mg/L) acted on the K562 cell line for 24h,48h and 72h.Western blot was used to detect VEGF protein expression,while in situ apoptosis(TUNEL) and flow cytometry method(FCM method) were employed to detect the apoptosis.Results The different doses of Cinobufotalin all inhibited K562 cell line in time-and dose-dependent manners.K562 cell line transfected by VEGF ASON had a more pronounced induction of apoptosis.Conclusion The in vitro Cinobufotalin at a certain range of concentration can induce apoptosis in K562 cell line,and VEGF ASON enhances Cinobufotalin's effect in inducing apoptosis of K562 cells.

In recent years, the subthreshold micropulse laser is a kind of laser mode which is characterized by long intermittence. It achieves effective therapeutic effect while minimizes the damage to tissues. At present, it has been used to treat diabetic macular edema. Early studies suggested that the laser selectively acts on retinal pigment epithelial cells to reduce macular edema by regulating the expression of inflammatory biomarkers, growth factors, heat shock proteins and other substances. In recent years, with the development of research, more and more emphasis has been placed on the role of retinal glial cells. Müller cells are also considered as one of the target cells affected by micropulse laser, but there is no evidence of direct or indirect effects of micropulse laser on Müller cells. In the near future, it is expected that we will have more clinical evidence to confirm the target cells of the micropulse laser, which may be further confirmed by in vitro experiments through Müller cells or Müller cells co-cultured with retina pigment epithelium cells, so as to make a more detailed statement on the mechanism of it.

Objective To observe the clinical results of combination therapy for multiple myeloma by arsenic trioxide,melphalan,vitamin C and dexamethasone.Methods 18 cases with multiple myeloma,12 males and 6 females were given the treatment including arsenic trioxide,melphalan,vitamin C and dexamethasone combination therapy;the dosage of arsenic trioxide 10 mg,d1～5,d8～12;vitamin C 1.0 g,d1～5,d8～12;dexamethasone 20 mg,d1～4,d8～11;melphalan 2 mg,tid,d1～12.Complete response(CR),partial response(PR),minimal response(MR),no ehange(NC)were observed.Results The CR werel6.7%(3/18),PR were 77.7%(14/t8),MR were 5.6%(1/18).Conclusion Combinational arsenic trioxide,melphalan,vitamin C and dexamethasone is an effective therapy with less side effects,which can be considered for treating the initial or relapsed or refractory MM.

Objective To assess the ability of ABCD3-Ⅰ score in evaluating the early risk of cerebral infarction after transient ischemic attack ( TIA ).Methods A total of 107 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrences of cerebral infarction within 2 days and 7 days were observed.Results The AUCRoc of ABCD2,ABCD3 and ABCD3-Ⅰ were 0.61,0.66 and 0.71 in predicting the risk of cerebral infarction within 2 days,and were 0.62,0.68 and 0.74 in predicting within 7 days,respectively.Among 107 patients with TIA,13 evolved into cerebral infarction within 2 days,accounting for 12.1％,and 24 within 7 days,accounting for 22.4％.According to ABCD3-Ⅰ criteria,17 patients were of low risk scored 0-3 ; 54 patients were of medium risk scored 4-7 ; and 36 patients were of high risk scored 8-13.The different incidence of cerebral infarction after TIA was related to ABCD3-Ⅰ score:the higher the score was,the higher incidence was.Except for age factor,every score item of ABCD3-Ⅰ display obvious influence to the occurrence of cerebral infarction within 2 days and 7 days after TIA (P ＜ 0.05 ).Conclusion ABCD3-Ⅰ criteria could more effectively predict the occurrence of early risk of cerebral infarction after TIA,which could be used in regular clinical practice for assistance in TIA risk stratification and treatment.

Objective To research the pathogeny and the electromyographic characteristics of myokymia.Methods The clinical features and electromyography of 42 elderly patients with myokymia were examined. Results Symptomatic myokymia (SM) in 27 cases was caused by low salt syndrome, thyrotoxemia, urinaemia, chronic wasting diseases (such as carcinoma of the stomach or liver), brachial plexus neuropathy, lead poisoning, chronic inflammatory demyelinating polyradiculoneuritis, succinylcholine narcosis, restless leg syndrome or Isaac's syndrome.Symptomatic facial myokymia was caused by neoplasm of the brain stem or in posterior cranial fossa, multiple sclerosis or other causes. Primary myokymia ( PM ) in 15 cases involved idiopathic generalized and benign myokymia.Compared with PM, SM was more constant and powerful. Myokymia potential appeared in the electromyograms of 42 of the patients. The majority of patients with SM had accompanying myotonic discharge. Conclusion The pathogeny and electromyographic characteristics of symptomatic myokymia are different from the primary stage.