Objective To observe the clinical efficacy and safety of etoposide capsule (VP16) in the treatment of recurrent small cell lung cancer. Methods Retrospective analysis 39 patients,aged≥65, with relapsed small cell lung cancer, who were at least three months after the end of the first-line treatment since January 2012 to January 2014 in Tianjin fifth central hospital.Etoposide was administered by daily oral at 100 mg/day for seven consecutive days and withdraw for 14 days,21 days as a therapeutic cycle,repeat treatment until disease progression or intolerable side effects occur, analyze the progression-free survival and overall survival.Observe the clinical benefit rate,the overall response rate and safety.Results The clinical benefit rate (DCR) and overall response rate (ORR) after the treatment were 61.5% and 30.77%.The progression-free survival (PFS) was 2.8 months, and the overall survival (OS) was 7.3 months.Neutropenia is the most common toxicities, and grade Ⅲ or Ⅳ occurred in 7.7% of the patients.No grade Ⅲ or Ⅳ thrombocytopenia, or grade Ⅲ or Ⅳ non-hematologic toxicity was occured.Conclusion Etoposide oral capsules monotherapy may be considered as one of the safe and effective choice of the second-line treatment of elderly patients with relapsed small cell lung cancer.

[Objective] To observe the in-vitro inductive effect of ginsenosides (GS) on differentiation of rat bone marrow mesenchymal stem cells (MSC) into myocardial cells. [Methods] Marrow stromal cells were isolated from adult SD rats, and then were cultured and cloned by density gradient method and adhesive cultivation to prepare the primary MSC. The cell surface antigens of CD34 and CD44 were detected with flow cytometer to identify MSC. After subculture, the 8th generation of continuous MSC were induced by GS (250 mg/L) and 5-aza (5-azacytidine, 10 ?mol/L) and GS + 5-aza (250mg/L and 10 ?mol/L respectively) for 24, 48 and 72 hours to differentiate to myogenic cells. Meanwhile, a blank control group was set to compare the effect. After the induction, myocardial cell percentage was worked out after examining MSC count and positive cells count under the phase contrast microscope. The specific proteins of Desmin and cardiac troponin I (cTnI) in myocardial cells were detected by immunohistochemistry method, and the cardiac-specific gene expression of ?-MHC (myosin heavy chain) and ?-MHC in myocardiocytes was examined by reverse transcription-polymerase chain reaction (RT-PCR) analysis. [Results] The cultured marrow stromal cells grew well, spindle in shape, and their CD44 expression was positive, indicating that marrow stromal cells differentiated to MSC. After induction with GS and 5-aza, MSC differentiated to myocardial cells, and the myocardial cell percentage was 38% in GS group, 35% in 5-aza group and 39% in GS + 5-aza group, the difference being insignificant. The expression of Desmin, cTnI and MHC in MSC was positive, and MSC were spindle-shaped and looked like fibroblast, indicating that MSC differentiated to myocardial cells. [Conclusion] Ginsenosides can induce MSC to differentiate to myogenic cells in-vitro, and this will supply evidence for cell transplantation.

【Objective】To observe the in-vitro effect of panax notoginseng saponins(PNS) on bone marrow mesenchymal stem cells(MSCs) proliferation and on inducing MSCs to differentiate into cardiomyogenic cells.【Methods】MSCs were isolated from adult SD rats,and then were cultured and cloned by density gradient method and adhesive cultivation.The cell surface markers of MSCs were detected with flow cytometer.The effect of PNS on MSCs proliferation was observed with methyl thiazolyl tetrazolium(MTT) assay.The 8th generation of continuous cultured MSCs was used to observe the in-vitro differentiation of cardiomyogenic cells.The cardiomyogenic cells were identified under phase contrast microscope by immunohistochemical method and reverse transcription-polymerase chain reaction(RT-PCR) analysis.【Results】CD44 expression of MSCs was positive while that of CD34 expression of bone marrow hematopoietic stem cells was negative,indicating the success of the MSCs culture.After induction with PNS,the increase of MSCs was obvious as compared with the blank control group,and there existed histological changes of MSCs after in-vitro induction.The expression of specific proteins of Desmin and cardiac troponin I(cTnI) in MSCs was positive,and the results of RT-PCR analysis showed that the expression of myosin heavy chain(MHC) was increased.【Conclusion】PNS can increase the in-vitro proliferation of MSCs and induce MSCs to differentiate into cardiomyogenic cells in vitro,and this will supply experimental evidence of cell transplantation for the treatment of myocardial infarction.

Objective To build a digitized 3D model of the pulmonary venous system of Chinese people for the purpose of providing anatomic information of the pulmonary venous system for anatomic teaching,imaging diagnosis and surgical operation of pulmonary diseases. Methods The primal images from the first Chinese visible human data set of chest were converted into image sequence only cantaining the sections of pulmonary veins after manual registration and image segmentation.Then these images were imported into 3DMed software to build a 3D model of the pulmonary venous system through threshold registration algorithm. Results The three dimensional structures of the pulmonary venous system were reconstructed entirely.All reconstructed structures could be displayed individually or jointly,and could be rotated continuously on any plane.Conclusion The branches and the spacial characters of the pulmonary venous system can be clearly shown on the reconstructed 3D model.It will help anatomy teaching and provide morphological data for image diagnosis and lung operations.

Objective To investigate the effect of allogeneic bone marrow mesenchymal stem cell transplantation on the cardiac structure and function in rats with acute myocardial infarction. Methods Thirty SD rats were randomly divided into blank group, model group, and stem cells group, 10 rats in each group. The model group received left coronary artery ligation to induce acute myocardial infarction, and the stem cells group received myocardial injection of stem cells after coronary artery ligation. After four weeks, cardiac function and heart tissue pathological changes were observed. Results In the model group, left ventricular end-diastolic volume, left ventricular end-systolic volume and end dias-tolic volume were increased, and left ventricular ejection fraction, left ventricular fractional shortening rate and cardiac output were decreased as compared with the normal group and the stem cells group (P < 0. 05). The results of pathologi-cal examination showed that myocardiac fibers dissolved or even disappeared, and fibric proliferation and sear occurred in the model group; in the stem cells group, the arrangement of myocardiae fibers was in disorder and there were a few pro-liferated fibers and scar compared with the normal group. Conclusion Allogeneic bone marrow mesenchymal stem cell transplantation can improve the cardiac structure and function in rat model of acute myocardial infarction.

In order to protect the trial subjects' rights and benefits in drug clinical trials,we must pay special attention to the risk and benefit of the trial subjects(striving to minimize the risk and maximize the benefit),ensure the trial subjects' complete realization of the clinical trials and the successive informed consent,pay special attention to the protection of the specific trial subjects,and avoid the conflict of interests.

Objective To explore the role of the computerized 3D reconstruction in studying the anatomy of the jugular foramen. Methods Plastination was used to make equidistant serial thin sections with 1^2*!mm in thickness.A SGI workstation was employed to reconstruct the jugular foramen and relative structures in three-dimensions. Results The computerized 3D-reconstruction could clearly display the important nerves and vessels of the jugular foramen,delineate the relationships between the internal carotid artery,internal jugular vein,the bundle of glossopharyngeal,vagus and accessory nerve and the skull base.All structures reconstructed can be represented individually or jointly and rotated continuously in any plane.Any diameter and angle of the structures reconstructed could be measured conveniently.Conclusion The computerized 3D-reconstruction possesses important value in studying the anatomy of the jugular foramen.

Objective To systematically evaluate the effect of routine insertion of double-J stents to prevent major urological complications(MUCs)in kidney transplant recipients.Methods Medline,Embase,Cochrane Library,and Chinese Biomedicine database were searched to locate relevant randomized controlled trials(RCT).Data extraction and assessment of methodologic quality were performed independently by two reviewers.Meta-analysis was performed by Revman 5.0 software.Results Ten RCT(including 1616 patients)were identified.By comparing the routine stent group with the no stent group,the meta-analysis showed:(1)incidence of urine leak,urinary obstruction and UTI was 4 times lower,6 times lower,increased by 52 % respectively(P＜0.0001);(2)Patient and graft survival,rate of acute rejection,delayed graft function and hematuria were of no significant difference.In subgroup analysis,it was found:(1)Compared with the no stent group,the group in which stent duration was≤ 4 weeks had a lower incidence of MUCs and a higher incidence of UTI;meanwhile,the group in which stent duration was ＞ 4 weeks had a much lower incidence of MUCs and the rate of UTI was increased without significant difference;(2)In the RCT of which urethral catheter duration was ＜ 5 days,there were no significant differences between the two groups in MUCs and UTI.In the RCT of which urethral catheter duration was ≥5 days,the stent group had a lower incidence of MUCs and a higher incidence of UTI.Conclusion Routine stenting reduces the incidence of MUCs.Although the double-J stent increases the risk of UTI,it seems that UTI doesn't affect the outcome of transplantation.The stent duration should be within 4 weeks.For the stent recipients,the longer duration of urethral catheter,the lower incidence of MUCs,the higher incidence of UTI;thus,it is up to clinicians to decide the optimal duration of urethral catheter.Long term prescription of 480 mg cotrimoxazole once daily,from the operation day till after stent removal,effectively reduces the risk of UTI associated with stent placement.

Objective To develop a hepatic surgical planning software for hepatic operation on deciding the rational operational scheme, simulating procedures before the operation to accomplish the precise operation and decrease the operative risk. Methods The software was used in clinical practice to analyze the surgical anatomy of human liver, calculate the liver volume and vascular territory, disclose the hepatic structures and simulate the operation before operation. Results The surgical planning software is very convenient in analyzing the surgical anatomy of human liver, calculating the liver volume or vascular territory and simulating the operation before operation. Conclusion The developed surgical planning software is very helpful in clearly disclosing hepatic structures, rationally deciding operation scheme and virtually simulating the operation.

Objective To explore the therapeutic mechanism of kidney-reinforcing,blood-activating and phlegmresolving therapy for left ventricular fibrosis of spontaneously hypertensive rats (SHR).Methods Twenty SHR were randomly assigned to Chinese medicine group and model group.Additionally,ten Wistar-Kyoto(WKY) rats served as normal control group.After 12-week prevention,Masson staining method was used to measure the degree of fibrosis of left ventricular myocardial tissues,reverse transcription-polymerase chain reaction(RT-PCR) was used to detect Smad3 mRNA expression,and Western blotting method was used for the detection of Smad3 protein expression.Results The degree of left ventricular fibrosis myocardial tissue in Chinese medicine group was milder than that in the model group,and Samd3 protein and mRNA expression levels in Chinese medicine group were lower than those in the model group (P ＜ 0.05).Conclusion Kidney-reinforcing,blood-activating and phlegmresolving therapy can improve left ventricular fibrosis in SHR by inhibiting Smad3 expression.