Studies confirm that gefitinib treatment of epidermal growth factor receptor(EGFR)muta-tions for patients with non-small cell lung cancer(NSCLC)has a clear effect,and with radiotherapy sensitiza-tion effect. Many studies both at home and abroad show that gefitinib combined with radiotherapy can signifi-cantly improve the survival times of patients,especially for the elderly patients or the patients with brain metas-tases,which has fewer adverse reactions and with higher life qualities. Therefore,gefitinib combined with radiotherapy will be an effective treatment for the patients with advanced NSCLC.

ObjectiveTo investigate the efficacy of different methods of anesthesia for laparoscopic hysterectomy.MethodsSixty ASA Ⅰ or Ⅱ patients,aged 45-60 yr,weighing 55-65 kg,scheduled for laparoscopic hysterectomy,were equally and randomly divided into 2 groups:combined intravenous-inhalational anesthesia group (group Ⅰ ) and combined spinal-epidoral anesthesia (CSEA) + general anesthesia group (group Ⅱ ).In group Ⅰ,anesthesia was maintained with inhalation of sevoflurane and infusion of remifentanil after induction of anesthesia.In group Ⅱ,CSEA was performed,after the upper level of sensory block was stable,general anesthesia was induced and maintained with inhalation of sevoflurane,and state entropy (SE) was naintained at 45-60.Arterial blood samples were taken to determine the plasma concentrations of adrenaline ( AE ),norepinephrine (NE) and dopamine (DA) after admission to the operation room,after completion of pneumoperitoneum,at 10 min after pneumopentoneum,during uterus traction,during removal of the laryngeal mask airway,and at 10 min after removal of the laryngeal mask airway (T0-5).The time for recovery of spontaneous breathing,extubation time,and time of regaining consciousness were recorded at the end of operation.The side-effects and number of patients requiring increments of analgesics were also recorded within 48 h after operation.Patient' s satisfaction was recorded at 48 h after operation.ResultsCompared with group Ⅰ,the plasma concentrations of AE and NE at T3-5 and the plasma concentrations of DA at T3,5 were significantly decreased,the time for recovery of spontaneous breathing,extubation time,and time of regaining corsciousess were significantly shortened,and the incidence of agitation and the number of patients requiring increments of analgesics were significantly decreased in group Ⅱ ( P ＜0.05).There was no significant difference in the incidence of intraoperative awareness,and nausea and vomiting after operation,and the level of patient' s satisfaction at 48 h after operation between the two groups ( P ＞ 0.05).ConctusionCSEA + general anesthesia has better efficacy than combined intravenous-inhalational anesthesia when used for laparoscopic hysterectomy.

Long noncoding RNAs (lncRNAs) have great impact on the carcinogenesis and progression of gastric cancer (GC).Recent studies show that the over-expression of H19,HOTAIR,TINCR and LINC00152 and the down-expression of MEG3,GAS5,LET and AA174084 are closely related to the occurrence,invasion,metastasis and prognosis of GC.lncRNAs provide an opportunity to develop new strategies for the diagnosis and treatment of GC.

Objective To investigate the clinical efficacy of transabdominal preperitoneal laparoscopic hernia repair (TAPP). Methods Three trocars were introduced into the abdomen at the umbilicus and both sides 10 cm from the umbilicus, respectively. The parietal peritoneum was opened at 5 cm above the internal ring and near the external border of the umbilicus. The hernial sac was dissected and a patch overlying the defect was stapled with the pectineal ligament and the conjoined tendon. Results The laparoscopic operation was completed successfully in all the 50 cases. The operation time was 20~70 min (39.8?10.5 min). Postoperatively, there were 1 case of groin pain and 2 cases of urine retention. The duration of postoperative hospital stay was 1~4 days (mean, 2 days). Follow-up observations in the 50 cases for 1~11 months (mean, 7 months) found no recurrence. Conclusions Transabdominal preperitoneal laparoscopic hernia repair is a safe and effective tension-free hernioplasty.

Objective To establish phage splitting method for Mycobacterium tuberculosis and explore its application in the diagnosis of pulmonary tuberculosis.Methods Two hundred and fifteen sputum specimens were tested by L-J medium culture method,fluorescent microscopy method and phage splitting method concurrently.Results Comparing with L-J medium method,the sensitivity and specificity of phage splitting method were 71.0%,97.9%,respectively,however for routine microscopic method,the sensitivity and specificity were 55.7% and 91.2%.Conclusion With very high specificity and comparatively better sensitivity,phage splitting method can rapidly detect Mycobacterium tuberculosis and can be used in the rapid diagnosis of pulmonary tuberculosis.

Objective To evaluate the correlation between the expression level of Nanog gene and clinical outcomes of GP regimen in the advanced non-small cell lung cancer (NSCLC).Methods 62 patients of NSCLC were treated by GP method,and the outcomes were investiged between Nanog positive and nagetive patients.The expression level of Nanong was evaluated by RT-PCR and immunohistology.Results 30 out of 62 patients (48.4 ％) were Nanog positive,9 patients (28.1％) were Nanog positive,and 23 out of 32 patients were Nanog negative (71.9 ％) who have the positive effect (CR+PR).However,among 32 treatment nagetive cases,there were 21 cases (70.0 ％) who were Nanog positive and 9 cases (30.0 ％) were Nanog negatve.Survival analysis showed that 5-years lifetime of Nanog positive patients was shorter than Nanong nagetive patients.Conclusion Nanog overexpression decreases the sensitivity of GP regimen and lifetime of NSCLC patient.Nanog expression level may provide a useful factor for clinical treatment and prognosis of NSCLC patient.

Objective To screen a sensitive method for detecting respiratory viruses from three different methods of singleplex conventional PCR , multiplex conventional PCR and multiplex real-time RT-PCR.Methods Parallel examination of 17 respiratory viruses was performed on 73 throat swab specimens collected from patients with upper respiratory tract infection by the three methods .The detection rates of dif-ferent respiratory viruses were used as evaluating indicator for the three methods .Results The numbers of respiratory viruses detected by singleplex conventional PCR , multiplex conventional PCR and multiplex real-time PCR were 56, 41 and 87, respectively.Conclusion The multiplex real-time RT-PCR might be used for the detection of respiratory viruses in laboratory as its high detection rate in comparison with the other two methods .

OBJECTIVETo study the contribution of puberty maturation to smoking behavior in Chinese adolescents.

METHODSA cross-sectional survey was carried out. One thousand four hundred and fifty-three senior middle school students aged from 15 - 18 years were recruited in Shanghai in 2000. A standardized self-administrated questionnaire was designed to obtain information on smoking, age at first nocturnal ejaculation in boys, age at menarche in girls and variables that might be associated with smoking in adolescents.

RESULTSIn boys, the prevalence of experimental smoking was highest among later maturers (28.6%), followed by the earlier (21.3%) and the average (21.7%), and the prevalence of current smoking was highest among earlier maturers (16.4%), followed by the later (7.1%) and then the average (4.8%). In girls, the prevalence of ever smoked among earlier, average and later maturers were as follows: 24.2%, 12.0%, 6.3% respectively. When psychosocial variables which might be associated with smoking were under control, early maturation was a significant risk factor for current smoking in boys (OR = 3.68, 95% CI: 1.23 - 10.99), and might be a risk factor for ever smoked in girls (OR = 2.23, 95% CI: 0.89 - 5.60). Whereas late maturation might have been a risk factor for boys to experiment smoking (OR = 1.48, 95% CI: 0.72 - 3.06), while in girls it might be protective (OR = 0.64, 95% CI: 0.22 - 1.86).

CONCLUSIONEarlier or later matured boys and earlier matured girls were at higher risk of smoking. Pubertal changes and timing need to be considered in smoking prevention.

Adolescent ; Adolescent Behavior ; Female ; Humans ; Male ; Puberty ; physiology ; psychology ; Risk Factors ; Sexual Maturation ; physiology ; Smoking ; epidemiology ; psychology ; Statistics as Topic

Objective To study the influence of radiation on autophagy and its protective effect on radiation injury of hepatic cells.Methods Autophagy in mouse liver tissues was examined by GFP-LC3 staining and Western blot.Radiation-induced hepatic injury was evaluated by ALT and AST in mouse serum,protein expressions,and H & E and TUNEL staining of liver tissue.L02 cells were used for in vitro study.Chloroquine and rapamycin were used to manipulate the level of autophagy.Results Total body irradiation (TBI) of 8 Gy caused an increase of autophagy in mouse liver tissue and AST level in serum (t =-7.47,P ＜0.05) at 12 h after irradiation.Irradiation significantly increased the apoptotic level in liver tissue as well.Inhibition of autophagy by chloroquine caused a further increases of AST [IR:(345.42±35.25)U/L vs.IR +CQ:(433.42 ±40.07)U/L,t =-2.86,P＜0.05] and ALT [IR:(35.67 ± 8.08) U/L vs.IR+CQ:(98.5±26.67)U/L,t=-3.09,P＜0.05] in the serum,and it also promoted apoptosis in live tissue.However,rapamycin as an autophagy promoter showed protective effect for radiation-induced hepatic injury [AST:IR:(345.42 ± 35.25) U/L vs.IR + Rap:(278.42 ± 20.09)U/L,t =-2.86,P ＜ 0.05].Similar changes of autophagy and apoptosis in L02 cells were also observed in the cells treated with chloroquine and rapamycin.Inhibition of autophagy by CQ caused an increase of ROS in vitro and in vivo and further increased ALT and AST levels in serum,reduced L02 cell viability.Activation of autophagy by Rap effectively reversed those changes.Conclusions Autophagy protects hepatic cells from radiation injury by decreasing ROS induction,which provides a potential target for the development of new clinical regimens against radiation induced liver injury.

OBJECTIVETo explore the clinicopathologic features of CD30-positive sinusoidal large B-cell lymphoma (CD30 + SLBCL) and its relative correlation with Epstein-Barr virus (EBV).

METHODSTwo cases of CD30 + SLBCL, a 65-year-old men and a 85-year-old women were morphologically and immunophenotypically analyzed. EBV status was also evaluated through not only the polymerase chain reaction (PCR) amplification to the EBV Bam HIW DNA sequence, but also an immunohistochemical detection of the latent membrane protein 1 (LMP1).

RESULTSThe patients presented with similarly superficial lymphadenopathy. One of them died of the tumor within 10 months. Microscopically, both of the neoplasms were characterized by a cohesive sinus growth pattern and the monomorphic cytology of the tumor cells. Immunohistochemically, They were both positive for CD45, CD30, and CD20 or CD79alpha, whereas neither expressed EMA, ALK1, nor any histiocytic/T-lineage markers. No evidence of EBV-infection could be found either.

CONCLUSIONSCD30 + SLBCL is a morphologically and immunophenotypically distinctive variant of diffuse large B-cell lymphoma, which should be distinguished from T/null cell type anaplastic large cell lymphoma and some other nodal lesions with a predominantly sinusoidal infiltrative pattern. CD30 + SLBCL may not be correlation with EBV.

Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Ki-1 Antigen ; analysis ; Lymphoma, B-Cell ; diagnosis ; pathology ; Lymphoma, Large-Cell, Anaplastic ; diagnosis ; pathology ; Male ; Middle Aged