Objective To assess the value of one-stage hybrid technique for treatment of pernicious placenta previa. Methods 12 patients with pernicious placenta previa who had received simultaneously Cesarean section and temporary balloon occlusion of abdominal aorta or internal iliac artery in the hybrid operation room were included in this study. 12 patients with pernicious placenta previa who had preserved balloon ducts in internal iliac artery before Cesarean section were chosen as a control group. Balloons were filled to control hemorrhage during the procedure. The hemodynamic parameters including blood pressure and heart rate were monitored during the opera-tion. Surgical duration ,amount of blood loss ,amount of blood transfusion ,volume of infusion ,urine volume during the procedure,postoperative volume of blood loss within 24 hours,uterine hysterectomy rate and neonatal conditions were compared between the two groups. Results During the operation,the blood pressure and heart rate in hybrid group were more stable. The mean surgical duration was(72 ± 8)min,the intraoperative mean amount of blood loss was(620 ± 95)mL,the mean amount of blood transfusion was(550 ± 40)mL,the mean volume of infusion was(1850 ± 160)mL,the mean amount of blood loss in 24 h after the operation was(75 ± 9) mL in the hybrid group,which were significantly lower than those in the control group(P<0.05 for all comparisons). No serious complications occurred in any of the two groups after the operation. There were no significant differences in neonatal conditions between the two groups. Conclusions One-stage hybrid technique has an obvious effect in the control of intraoperative bleeding in patients with pernicious placenta previa. It is worth popularizing in the hospital whose conditions are permitted.

Objective To assess the efficacy and feasibility of neoadjuvant therapy of TPF regimen including docetaxel (TAX), cisplatin (DDP) and 5-fluorouracil (5-Fu) combined with concurrent DDP and radiotherapy (RT) in patients with local advanced nasopharyngeal carcinoma (NPC). Methods From April 2008 to May 2009, 40 patients with newly diagnosed UICC stage Ⅲ orⅣ local advanced NPC were enrolled. Patients were randomly assigned to group A(DDP every 3 weeks) and group B(DDP every week). Two cycles of induction chemotherapy with TAX 60 mg/m2 dl, DDP 60 mg/m3 dl and 5-Fu 600 mg/m2 dl-5 were given on a 3-weekly cycle, followed by RT and chemotherapy(group A: DDP 80 mg/m2 every 3 weeks for 2 times; group B: DDP 30 mg/m2 weekly for 6 times). Two-dimension conformal RT technique with 68-72 Gy/(34-36) fractions for 7 weeks was administered to the nasopharynx and 60-66 Gy/(30-33) fractions for 6-6.5 weeks to the node-positive area. Results 38 patients (78 Cycles) were evaluable for efficacy and toxicity. One patient in each group was excluded due to toxicity. 17 (17/19) patients of group A finished 2 cycles of planed DDP chemotherapy, while only 10 (10/19) patients of group B completed 6 weeks of planed DDP chemotherapy, 4 completed 5 weeks, 4 completed 4 weeks and 1 completed 2 weeks. Response to neoadjuvant TPF was as follows: 4 patients (10.5 %) achieved complete response(CR), 27(71.1%) achieved partial response(PR) and 7 (18.4 %) achieved stable disease (SD), so the overall response (CR+PR) rate was 81.6 %. After RT, 32 patients (84.2 %) achieved CR, 5 (13.2 %) PR and 1 (2.6 %) SD, so the overall response rate was 97.4 %. Conclusion TPF induction chemotherapy followed by concurrent DDP and RT is an effective regimen in the treatment of advanced NPC. Concurrent DDP chemotherapy on a 3-weekly cycle is recommended. Further study should be made to investigate how to increase the dose intensity of chemotherapy.

Objective To investigate the effects of valproic acid ( VPA) on cell proliferation and cell cycle in human pancreatic cancer cell line PaTu8988 in vitro. Methods PaTu8988 cells were treated with VPA in concentration of 0, 0.2, 1.0 or 5.0 mmol/L for 24 h and 48 h respectively. Cell viability was measured by WST-8 assay. Cell cycles were detected by flow cytometery. Dimethyl sulfoxide added to the medium was used as blank control group, while PBS added to the medium was used as PBS group. Results After VPA treatment for 24 h, the inhibition rate of VPA 5.0 mmol/L group was 18.9% , which was significantly higher than those in control group, PBS group and VPA 0.2, 1.0 mmol/L group (0, 4.4% , 6.8%, 6.1% , P <0.05). After 48 h, the inhibition rates of VPA 1.0, 5.0 mmol/L were 12.9%, 25.9% , which was significantly higher than those in control group, PBS group and VPA 0.2 mmol/L group (0, 6.2% , 4.6% , P <0.01). After VPA treatment for 24 h, the proportions of G2 phase cell in VPA 1.0, 5.0 mmol/L group were ( 26.57 ± 1.88) % , ( 34.11 ± 4.74 ) % , which was significantly higher than those in PBS group, control group, VPA 0.2 mmol/L group [(10.72 ± 2.02)% , ( 13.53 ± 2.28)% , (13.81 ±2.40)%, P <0.01 ], the changes 48 h after VPA treatment was consistent with the changes 24 h after VPA treatment. Conclusions VPA may significantly suppress the cell proliferation of human pancreatic cancer cell line PaTu8988, and induce cell cycle arrest in G2 phase in a time and dose-dependent manner.

Objective To detect the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in the early secondary infection of acute necrotizing pancreatitis (ANP) and to probe its diagnostic value for early infection. Methods Twenty-four male SD rats were randomly divided into the control (C) group, the ANP group and the secondary infection of ANP (SIANP) group. The constructions of the models were achieved through intraperitoneal injection of L-arginine and E. coli. After 24 hours, the blood and peritoneal fluid samples were collected for bacterial culture, and the serum levels of amylase, CRP, TNF-α and TREM-1 were detected. The pathological changes in the pancreas were observed. The expression of TREM-1 mRNA and TREM-1 protein in pancreatic tissue was detected by Real-time PCR and Western Blot. Results The histological score of pancreas, and serum amylase in ANP group and SIANP group were significantly higher than those in C group; the positive rate of bacterial culture of blood and peritoneal fluid in SIANP group was 100% , which suggested the model was successfully established. CRP and TNF-a levels in SIANP group were (8.7 ±3.1)mg/L and (185.7 ± 10.9) mg/L, which were not significantly different from that in ANP group [( 16.5 ±3.6) , ( 176.0 ± 18.6) mg/L]. The serum level of TREM-1, expression of TREM-1 mRNA and TREM-1 protein in pancreatic tissue was (9.3 ±0.9) ng/ml, 14.84 ± 3.45, 316.2 ± 59.2, which were significantly higher than those in ANP group [ (5.5 ±0.3)ng/ml, 4.51 ±1.44, 188.6 ±42.4, P <0.05]. Conclusions TREM-1 has diagnostic value for early secondary infection of ANP.