Circulating tumor cells (CTCs) play an important role in tumor metastasis.Detections of CTCs are contribute to tumor treatment,which can provide reliable basis for predicting the prognosis and efficacy.CTCs are related to the staging and distant metastasis of non-small cell lung cancer (NSCLC).The number changes of CTCs are associated with the chemotherapy and radiotherapy effects and prognosis in NSCLC.Almost the same phenomena have been discovered in small cell lung cancer.In the future,CTCs may be used to monitor the occurrence of drug resistant tumor cells and help individual therapy for lung cancer.

This paper reviewed the policies on private medical institutions in Henan province since the new healthcare reform.Combined with relevant statistical data,the authors found that conceptual obstacles,policy implementation,lack of unified management and restriction of human resource flow as important constraints of the development of such institutions in the province.In view of this finding,the authors made in-depth study of the development positioning,general role of planning and market functions,as well as support and regulation in parallel of such institutions,in order to promote the healthy and sustainable development of private medical institutions in China.

Uveitis is a kind of inflammatory disease affected in ocular posterior segment.Uveitis sustains a long duration and causes a significant damage of visual function.It often leads to serious complications,such as cystoid macular edema (CME),cataract,glaucoma,retinal detachment and choroidal neovascularization (CNV).In the pathological process of uveitis,inflammatory factors promote the release of vascular endothelial growth factor (VEGF) through a variety of pathways.It has been verified that VEGF level is elevated in vitreous in the patients with uveiticinduced CME.Intravitreal injection of anti-VEGF drugs,including ranibizumab and bevacizumab,can improve the visual acuity in most patients with noninfectious uveitic-induced CME and CNV.However,intravitreously repeated injections of anti-VEGF drugs may be required in some patients.Intraocular injection of anti-VEGF drugs is an optional and effective way for those with persist macular edema and not being suitable for the use of corticosteroid or immunosuppressive therapy.However,anti-VEGF drugs may affect the efficacy of corticosteroid.Therefore,more clinical and basic researches are still needed.The status and progresses in the use of anti-VEGF drugs for uveitisinduced CME and CNV were reviewed.

Objective To evaluate the localization and the correlation with cardiovascular risk factors of cerebral arteries damage in patients with transient ischemic attack (TIA). Methods Digital subtraction angiography (DSA) was performed in the 97 patients with TIA. The localization, the degree of stenosis, the numbers of the arteries involved and their correlation with the cardiovascular risk factors were analyzed. Results DSA showed occlusive findings of cerebral arteries in 91.8% of the patients, and 68 cases (76.4%) among them were involved more than one artery. The proximal internal carotid arteries (35.5%) and the proximal vertebral arteries (28.2%) were the most frequently involved in this series. And the number of the arteries involved and the degree of stenosis were positively correlated with the level of risk factors. Conclusion There is a high incidence of cerebrovascular stenosis in patients with TIA. Most of them are involved more than one artery. The degree of the stenosis is positively related with the quantity of the risk factors.

The determination of tumor markers is of great value for esophageal squamous cell carcinoma. This article reviews the application status of routine tumor markers and the progression on the role of tumor markers in early diagnosis, predicting chemotherapy or radiotherapy response, monitoring disease recurrence and evaluation of prognosis in esophageal squamous cell carcinoma.

ObjectiveTo investigate the clinical efficacy of abdominal catgut embedding therapy for chronic lumbago.Method Sixty patients with chronic lumbago were randomly allocated to abdominal catgut embedding (treatment) and abdominal acupuncture (control) groups, 30 cases each. An evaluation was made using the JOAscore in the two groupsbefore and after one month of treatment. The therapeutic effects were compared between the two groups.ResultThere was a statistically significant difference in the JOA scale score between before and after one month of treatment in both groups (P<0.01,P<0.05) and between the treatment and control groups after one month of treatment (P<0.05); the total effective rate and recovery rate of the treatment group were significantly higher than that of the control group (P<0.01).ConclusionAbdominal catgut embedding therapy is more effective than acupuncture therapy for chronic lumbago.

The ABCB4 gene,also called MDR3,encodes the MDR3 protein which is localized to the hepatocyte canalicular membrane and is demonstrated to be a phosphatidylcholine translocase.The recent study showed that ABCB4 deficiency was associated with several cholestatic disorders,but the pathogenesis is not clear.This review highlights recent advances in the structure and function of ABCB4 gene,and the relationship between ABCB4 gene and cholestatic diseases.

Purpose:To observe the toxic reactions of all trans retinoic acid in the treatment of acute promyelocytic leukemia. Methods:Analysis of toxic reaction was done for 38 patients who suffered from acute promyelocytic leukemia treated with all trans retinoic acid. Results:In the treatment of acute promyelocytic leukemia with all trans retinoic acid, the common toxic reactios are dry mouth, skin desiccation, desquamation, rhagadia (100%). 19 patients had gastro intestinal symptoms with higher ALT(50%),18 patients had hyperleukocytosis syndrome (47.5%), 16 patients had headache and dizziness (42.4%),8 patients had pain in muscle and joint (21.2%). The rare toxic reactions included 4/38 who had intracranial hypertension syndrome, 2/38 had hyperglycemia, 1/38 and hyperhistaminemia syndrome. Conclusions:The toxic reactions of all trans retinoic acid in the treatment of acute promyelocytic leukemia usually have dry mouth ,skin desiccation, desquamation, rhagadia, gastro intestine symptom with higher ALT, and hyperleukocytosis syndrome ets. THe treatment with lower dose of all trans retinoic acid(20～30 mg/d)for acute promyelocytic leukemia could decrease the toxic reactions without influencing its effectiveness.

Objective To assess the predictive and prognostic role of the alteration of serum carcinoembryonic antigen (CEA),squamous cell carcinoma antigen (SCC-Ag) and cytokeratin 19 fragment (CYFRA21-1) during chemotherapy in patients with advanced esophageal squamous cell carcinoma (ESCC).Methods The serum levels of CEA,CYFRA21-1 and SCC-Ag were measured in 50 patients with advanced ESCC at baseline and after first line chemotherapy.The data was correlated with objective efficacy and overall survival.To evaluate the role of tumor marker change in predicting response to therapy,receiver operating characteristic (ROC) curves were constructed.Results CEA,SCC-Ag and CYFRA21-1 increased higher than the cutoffs in 22.0 %,34.0 %,and 44.0 % of tested patients,respectively.Statistically significant correlations were observed between CYFRA21-1 and SCC responses and objective efficacy evaluated by RECIST criteria (Z =3.181,2.389; P = 0.001,0.017).Based on the ROG curve analysis,a post treatment 32 % and 38 % increase in serum concentration was used as cut-off level for defining CYFRA21-1 and SCC-Ag change,respectively.When the cut-off levels were used to predict chemotherapy efficacy,the accuracy for CYFRA21-1 and SCC-Ag were 76 % and 70 %.In the univariate survival analysis,a statistically significant prognostic impact on survival from the change of CYFRA21-1 and SCC-Ag was observed.Conclusion CYFRA21-1 and SCC-Ag are useful for diagnosis,predicting chemotherapy objective efficacy and prognosis in advanced ESCC.

Neurological rehabilitation involves the most functional impairments. The students of rehabilitation medicine are required to master diagnosis and treatments of diseases, and assessments and rehabilitation of disabilities in neurological field during practice. This article introduced the experience of teaching for the students practised neurological rehabilitation.