Objective To study the clinical application of trigemino-cervical reflex(TCR)in migraine without aura(MWOA)and chronic tension-type headache(CTTH).Methods The TCR was recorded using surface electromyographic recordings bilaterally from the sternocleidomastoid muscle after stimulation of infraorbital branch of the trigeminal nerve.The reflex was investigated in 25 patients with unilateral MWOA,25 patients with CTTH and 36 healthy subjects.The patients were outpatients who visited Fujian provincial institution hospitals from January 2009 to February 2010.Results Compared with the healthy subjects,the bilateral peak latency of P19/N31(PLP19 and PLN31)was significantly shortened in the subjects with MWOA(left and fight side were(19.49 ± 1.95)ms and(19.81 ± 1.79)ms respectively)or CTTH(left:(19.56 ±2.02)ms,and right:(19.16 ± 1.67)ms),t values were between 2.027 and 3.654,all P ＜ 0.05.The values of PLP19 and PLN31 between the patients with MWOA and with CTTH were not significantly different.Conclusions The peak latency of P19/N31 was shortened in the subjects with MWOA or CTTH,suggesting that the trigeminal and brainstem may participate in the pathophysiology of MWOA and CTTH.There was no significant difference in PLP19 and PLN31 between the patients with MWOA and CTTH,indicating similar abnormalities in the endogenous pain control mechanisms in both migraine and

Purpose: To evaluate the efficacy and toxicity of vinorelbine combined with cisplatin (NP regimen) in the treatment of advanced non-small-cell lung cancer ( NSCLC). Methods: ninety-one patients with advanced NSCLC were confirmed by pathology or cytology. There were 56 patients with lung adenocarcinoma, 27 with squamous carcinoma and 4 with alveoli cell cancer, 3 with large-cell lung cancer, one case diagnosed by cytological smear section. The eighty patients had no prior chemotherapy and 11 were those without received previously chemotherapy. Thirty-two patients had stage Ⅲ disease and 59 had stage Ⅳ. Results: Partial response was observed in 37 patients with an overall response rate of 40. 7% (95%CI:30. 5%-50. 7%). Median time to progression (TTP) were 5 months(95% CI: 4-6 months). Median survival duration was 13 months (95% CI: 11-15months), one-year survival rate was 52. 7% ( CI: 42. 4%-62. 9%). The dose limiting toxicity was neutropenia that was observed in 87. 9% of the patients (40.7% in grades Ⅲ and Ⅳ). The remission response rate is 40. 6% , TTP is 5 months, MS is 13 months and 1-year survival rate was 52.7% . Conclusions: The results indicate NP regimen for advanced NSCLC is promise, and the toxicities are tolerable.

OBJECTIVE To review and analyze the change in the MICs of vancomycin,teicoplanin and linezolid in meticillin-resistant Staphylococcus aureus(MRSA) strains isolated in our hospital from 2003 to 2007. METHODS The MICs of vancomycin,teicoplanin and linezolid were tested by Etest method on a sample of randomly selected MRSA strains. RESULTS The incidences of MRSA increased from 52.2% in 2003 to 74.5% in 2007.MIC of vancomycin increased from 1.85 ?g/ml in 2003 to 2.15 ?g/ml in 2007,and teicoplanin MIC geometric mean increased even more markedly from 1.28 ?g/ml in 2003 to 2.07 ?g/ml in 2007.The linezolid MIC remained almost unchanged. CONCLUSIONS The incidences of MRSA were increasing from 2003 to 2007.There is a upward trend in MIC of glycopeptide over the years,in which the increase for teicoplanin is higher than others two.

Objective To investigate the behavioral characteristics of circadian rhythm disturbance in 3xTg-AD mice.Methods The free-running period,average activity per hour,total amount of exercise and circadian amplitude were examined with voluntary wheel-running test in 3-to 9-month-old C57BL/6 and 3xTg-AD mice under 12 h light/12 h dark cycle and constant darkness environment.Results In constant darkness environment,the free-running period in 3-month-old 3xTg-AD mice was (23.2±0.4) h,and shorter than the period((23.5±0.2) h) in C57BL/6 mice.In 6-and 9-month-old 3xTg-AD mice,activity pattern was disorganized,without clear boundary between activity and rest phase.The free-running period was unavailable.The circadian amplitude and total exercise amount were(40.6± 11.5) counts/5 min and(2.6±0.1) × 104 counts/d,(37.0±20.8) counts/5 min and(2.3±0.4) × 104 counts/d,(29.3± 11.0) counts/5 min and(1.6± 0.9) × 104 counts/d in 3-,6-and 9-month-old 3xTg-AD mice,respectively,which was significantly lower than that in age-matched C57BL/6 mice.In 12 h light/12 h dark cycle,the circadian amplitude and total exercise amount of 3-,6-and 9-month-old 3xTg-AD mice were (87.0 ± 37.8) counts/5 min and (2.2 ± 0.8) × 104 counts/d,(25.9± 6.3) counts/5 min and (1.1 ± 0.2) × 104 counts/d,(14.3 ± 5.7) counts/5 min and (0.6 ± 0.3)× 104 counts/d respectively,and with a significant decrease from the age of 6 months.Meanwhile,the locomotor activity decreased at night and increased during the day.Conclusion The endogenous circadian rhythm disturbance emerges in 3xTg-AD mice at 3-month-old,while the exogenous circadian rhythm disorder appears at 6-month-old;the degree of disorder in circadian rhythm is gradually aggravated with the increase of age in of the AD mice.

Objective To investigate mupiroein resistance in Staphylococcus aureus (SAU) and the resistance to commonly used antibiotics in mupirocin-resistant strains. Methods Four hundred and ninety clinically isolated SAU strains froin January 2005 to May 2007 in the First Affiliated Hospital,Wenzhou Medical College were screened by mupirocin(5μg)disc diffusion method.Minimum inhibition concentration(MIC)and the amplification of mupA gene were performed to determine the resistance to mupirocin.Resistance to cefoxitin,gentamycin, levofloxacin, trimethoprim/sulfamethoxazole, rifampin, erythromycin, clindamycin, tetracycline and vancomycin in mupirocin-resistant strains was detected by disc diffusion method, and the amplification of mecA gene was performed to confirm the methieillin resistance among mupiroein-resistant strains.Results Twenty-seven mupirocin-resistant strains were obtained,in which 22(81.5%)were hish-level mupirocin resistant(MuH)and the rest were low-level mupirocin resistant(MuL).Among 27 mupirocin-resistant strains,24 were methicillin-resistant Staphylococcus aureus (MRSA)in which 21 were MuH and 3 were MuL strains.Drug sensitivity tests showed that the resistance to gentamycin,levofloxacin,trimethoprim/sulfamethoxazole,rifampin,erythromycin,elindamycin and tetracycline were hish among MuH and MuL strains,and most of these strains were multi-drug resistant.All strains were susceptible to vaneomycin.Conclusions Most of the clinical emerged mupirocin-resistant SAU strains are MuH and show hish resistance to commonly used antibiotics.Therefore,detection and drug sensitivity test of mupirocin-resistant strains should be strengthened in clinic practice in order to prevent it from dissemination.

ObjectiveTo investigate the correlation of hippocampal synaptic plasticity with spatial learning and memory under normal and pathological condition,and provide experimental evidence for the coincidence of hippocampal late-phase long-term potentiation (L-LTP) and behavioral experiments.Methods 38 SD rats were randomly divided into two groups,control and AD model.First,Morris water maze was used to test the ability of spatial learning and memory of rats.The escape latencies for rats to search for an underwater platform in 5 days of navigation tests and the swimming time percentage in target qtuadrant on the 6th day after withdrawing the platform in probe trails were recorded.Then,in vivo hippocampus L-LTP of field excitatory postsynaptic potential (fEPSP)in CA1 region was recorded after delivering high frequency stimulation (HFS).ResultsBilateral intrahippocampal injection of 4 nmol amyloid β peptide ( Aβ 25-35 ) significantly impaired spatial learning and memory of rats in water maze tests,as well as in vivo hippocampal L-LTP.In control group,there was a significant negative correlation between the amplitude of fEPSP and the escape latency ( r =-0.8306,P ＜ 0.01 ) and a significant positive correlation between the amplitude of fEPSP and the swimming time percentage in target quadrant ( r=0.7709,P＜0.01 ).In AD model group,similar correlations were found,with a correlation coefficient of r =-0.7675 (P ＜0.01 ) and r =0.8049 (P ＜ 0.01 ),respectively.When putting all data from the two groups together,the hippocampal L-LTP was more correlated with escape latency ( r =-0.9124,P ＜ 0.01 ) and swimming time percentage ( r=0.9745,P＜0.01).ConclusionThere is very close correlation between the hippocampal L-LTP and the spatial learning and memory behavior in rats,suggesting that the hippocampal L-LTP may be involved in the electrophysiological mechanism of spatial learning and memory in rats,and the impairment of L-LTP could partly represent the deficits in cognitive function of animals.

Aim Toinvestigatetheanalgesiceffectsof epidural osthole application on the mechanical allodyn-ia and the ERK/MAPK signaling pathway and the expression of COX-2 mRNA in the spinal dorsal horn.Methods 125adultmaleSDratswererandomizedin-to five groups( n=25 each) :Blank, Sham, NP, Ost and vehicle. At postoperative day 6, 1mg/rat osthole 50 μl was injected epidurally into group Ost and the same volume of vehicle was given into group vehicle. The mechanical pain threshold was measured by 50%MWT at 1 day before operation and the 3 rd,6 th,7 th, 14 th,21 st day after operation. After the measurement of pain threshold on postoperative day 14 , the L4-6 segment of spinal dorsal horn was removed for determi-nation of the expression of ERK, pERK and COX-2 mRNAbyWesternblotandRT-PCR.Results Com-pared with blank group, the mechanical pain threshold was only down-regulated at day 1 after operation in sham group, the expression of pERK and COX-2 mR-NA in sham group showed no significant difference ( P>0. 05 ); the mechanical pain threshold was signifi-cantly down-regulated after operation in NP, Ost and vehicle groups( P<0. 05 ) and the expression of pERK and COX-2 mRNA was significantly increased ( P <0. 05). Compared with vehicle group, the pain thresh-old in Ost group was significantly increased after drug administration( P<0. 05 ) and the expression of pERK and COX-2 mRNA was significantly reduced ( P <0. 05 ) . The expression of ERK showed no significant difference among each group(P>0. 05). The correla-tion analysis on pERK1/2 and COX-2 mRNA revealed the Pearson correlation coefficient was 0 . 878 and 0 . 910 , suggesting a strong positive correlation between pERKandCOX-2mRNA.Conclusions Ostholead-ministrated in the early stage after surgery can alleviate the nucleus pulposus-induced radicular inflammatory pain probably by inhibiting the expression of pERK and COX-2 mRNA in spinal dorsal horn.

BACKGROUNDTo investigate the prognostic factors of 355 patients with advanced non-small cell lung cancer for researching an individual treatment module.

METHODSFrom March 1988 to October 2000, after diagnosed by histology or cytology and staged by staging examinations, 355 novel advanced NSCLC patients (stage III, 134; stage IV, 221) were enrolled, who were given at least 2-cycle chemotherapy. Response rate and survival were observed and prognostic factors were analysed.

RESULTSOut of 355 patients, 101 got partial response and 147 had stable disease. Response rate was 28.45%, and tumor control rate was 69.86%. Median survival duration was 16 months. The 1-, 2-, 3- and 5-year survival rates were 58.41%, 29.35%, 14.60% and 8.60%, respectively. In the patients with stage IV, median survival duration was 14 months, and 1-, 2-, 3- and 5-year survival rates were 54.62%, 25.59%, 12.70% and 6.73%, respectively. COX multiple variable analysis showed that improved/stable ECOG score (P=0.044 0) and chemotherapy (after second line failure) combined with γ-IFN (P=0.039 0) had prognostic significance.

CONCLUSIONSImprovement of quality of life is quite important in the treatment of advanced NSCLC. Combination with γ-IFN or TAM and radiotherapy of primary tumor may be helpful to improve the survival of patients with stage IV.

BACKGROUNDNow the treatment of non-small cell lung cancer (NSCLC) patients with brain metastasis is not a standard program. The aim of this study is to summarize the factors related to survival of patients with brain metastases from NSCLC.

METHODSA total of 111 NSCLC patients with brain metastases (from September 1995-May 2004) were defined as symptomatic group (37 patients) and asymptomatic group (74 patients) according to central nervous system (CNS) symptoms. The patients in the symptomatic group were given whole brain radiation therapy (WBRT, DT 30-40Gy/20f) first, and then received cisplatin-based chemotherapy. The patients in the asymptomatic group were given cisplatin-based chemotherapy first, and then received WBRT. During the treatment, 49 patients received chemotherapy of BCNU or VM-26 irregularly.

RESULTSThe median survival time was 11 months. The 1-and 2-year survival rate was 40.79% and 13.26% respectively. The survival time was not significantly different between the symptomatic group and asymptomatic group. Median chemotherapy of asymptomatic group was 3 cycles (1-6 cycles) before WBRT. Those patients who received 3 or 4 cycles of chemotherapy before WBRT had better survival (P= 0.0188 , P=0.0035). The treatment of BCNU or VM-26 was a benefit factor for survival (P=0.0219) in asymptomatic group. The hematologic toxicity of grade III or IV was not significantly different between the two groups (P > 0.05). The number of brain metastasis (P=0.000), extracranial metastasis (P=0.022) and WHO performance status (P=0.001) were independent prognostic factors.

CONCLUSIONSThe patients with asymptomatic brain metastases receive 3-4 cycles of chemotherapy before WBRT may be reasonable. During the therapy, the patients with administration of BCNU or VM-26 may have survival benefit.

Objective To investigate the therapeutic effect of endoscopic plastic stent and metal stent placement in relieving obstructive jaundice in patients with pancreatic cancer,and to analyse the cost effectiveness.Methods A retrospective review was performed on the clinical data of 102 pancreatic cancer patients with obstructive jaundice in General Hospital of Northern Theater Command between January 2013 to January 2014.The patients were divided into plastic stent group (n =26) and metal stent group (n =76)based on the type of biliary stent placed under endoscopy.The complication and short-term therapeutic effect were compared between two groups.The number of endoscopic stent placement,treatment interval,hospitalization cost and median survival time were recorded.Results The levels of alanine aminotransferase (ALT) and total bilirubin (TBiL) in the two groups 5-7 days after endotherapy were significantly lower than those before treatment,but the difference was not statistically significant between the two groups (P ＜0.05).No severe complication was observed.The average number of treatments in the metal stent group was significantly lower than that in the plastic stent group (1.7 times vs 2.9 times),and the treatment interval was significantly longer[(271.7 ± 42.3) d vs (113.4 ± 38.2) d].The difference above between these two groups was statistically significant (P＜0.05).However,there was no significant difference on the average total hospitalization cost (84227.2 yuan vs 86906.8 yuan) or median survival time (15.6 months vs 13.1 months)between these two groups.Conclusions Primary placement of metal biliary stents for obstructive jaundice in adult patients with metastatic pancreatic carcinoma was cost-effective than plastic stents,and their effects were comparable.