OBJECTIVE:To investigate the pharmacoeconomic efficacy of four chemotherapeutic schemes for advanced non-small cell lung cancer in elderly patients.METHODS:92 elderly patients with advanced non-small cell lung cancer were randomly divided into four groups:GP,NP,PC,and TP groups.The pharmacoeconomic efficacy of the four groups was analyzed and evaluated retrospectively using the cost-minimization analysis in pharmacoeconomics.RESULTS:The costs of GP,NP,PC,and TP schemes were 10 820.69 yuan,5 864.54 yuan,7 595.57 yuan,and 7 774.64 yuan,respectively(P0.05),respectively.The adverse drug reactions were characterized by different degree of myelosuppression and gastrointestinal reactions,all were cured on symptomatic treatment.CONCLUSION:The cost-minimization analysis showed that NP scheme is the optimal one of the four schemes.

Objective To investigate the efficacy and safety of intrathecal chemotherapy combined with concurrent radiotherapy in patients with leptomeningeal metastases from solid tumors.Methods The clinical and follow-up data of 29 patients with leptomeningeal metastases from malignant solid tumor who had intrathecal chemotherapy combined with concurrent radiotherapy were retrospectively analyzed.The treatment regimen was that 12.5-15.0 mg of methotrexate intrathecal injection once a week for 8 successive weeks combined with whole brain irradiation to a total dose of 40 Gy,20 fractions or with lumbosacral spinal canal irradiation to a total dose of 50 Gy,20-25 fractions.Results Nineteen patients completed the concurrent therapy and 19 patients were dead.There were 9 patients with complete remission of symptoms,11 with obvious improved symptoms,6 with alleviated symptoms,and 3 with no relief.All of the 29 patients,were followed up for 0.4-15.0 months.The median survival was 5 months.The 6-month survival rate was 48％ (11/23),excluding 4 patients with follow-up time less than 6 months and 2 patients noncancer deaths.The main toxicities were myelosuppression,methotrexate-related mucositis,chemical nerve root injuries,chemical meningitis,chronic neurotoxicity,seizures,and radiation-related mucositis.The incidence of severe toxicity was 17％ (5/29).Conclusions Combination of intrathecal methotrexate with concurrent radiotherapy can effectively alleviate the symptoms and improve the life quality of patients.The therapy with low incidence of severe toxicity and good tolerance has the trendency to prolong the median survival.

Objective To explore the MRI features of ejaculatory duct obstruction.Methods During January 2003 to Dccember 2010,transrectal ultrasonography (TRUS) was performed for 106 patients and underwent surgical treatment for ejaculatory duct obstruction.Among them,16 patients underwent MRI examination.The MRI features of ejaculatory duct obstruction in these patients were summarized.Results Ejaculatory duct cysts,ranging in size from 4 mm ×4 mm ×7 mm to 4 mm ×4 mm ×9 mm and locating in the paramedian line,were detected in 5 of the 16 patients; ejaculatory duct dilation located in the paramedian line was detected in 7 patients,with the internal diameter of 5 to 30 mm. After contrast injection,significant enhancement of the wall of the ejaculatory duct was observed in 2 patients.Mullerian duct cysts complicated with dilated ejaculatory duct and seminal vesicles were detected in 4 patients,in whom the cysts were located in the median line,ranging in size from 4 mm × 5 mm × 6 mm to 34 mm×35 mm ×44 mm,with inverted teardrop shaped pointing toward the seminal colliculus.ConclusionThe most common MRI features of ejaculatory duct obstruction are ejaculatory duct dilation and ejaculatory duct cysts.

Objective To explore the effect of depakine in the treatment of traumatic epilepsy relapse,and compared carbamazepine and lamotrigine combined with depakine in the treatment of traumatic epilepsy.Methods Open trial in 131 patients with traumatic epilepsy relapse treated with depakine,and all patients were aderministered with carbamazepine or lamotrigine combined with depakine.3 months before treatment,the epilepsy seizures frequency was compared,and 6 months after the treatment,the efficacy,adverse reactions and safety was compared between two mothods.Results Application of carbamazepine or lamotrigine combined with depakine treatment for 6 months,the seizure frequency significantly decreased compared with before treatment;The seizure frequency reduction( ≥50％ ) were 72.6％ and 91.3％,the difference was statistically significant between before and after treatment( P ＜ 0.01 ) ;The adverse reactions of carbamazepine combined with depakine was 37.1％,and it of lamotrigine combined with depakine was 8.7％.Conclusion Lamotrigine combined with depakine in the treatment of traumatic epilepsy recurrence was effective,and its side effects was light.

A detailed analysis on the curriculum status of profession degree for the fourth batch of master-disciple postgraduates in Guangzhou University of traditional Chinese Medicine (TCM) was provided.The basic idea on the construction of the curriculum system was proposed in view of strengthening TCM clinical thinking,skills and scientific research capacity.The course content was optimized combining the classic TCM theory with clinical skill practice course and innovate teaching methods depending on the inservice and remote learning of students were used.A relatively perfect professional degree curriculum system for master-disciple postgraduates of TCM was built.

Objective To explore the clinical and imaging characteristics of traumatic carotid cavernous fistula(TCCF) with hemorrhage.Methods There were thirteen cases of TCCF underwent car accidents combined with epistaxis or intracranial hemorrhage between 1990 and 2000.Their clinical symptoms,CT,MR,and digital substract angiogram(DSA) were retrospectively analysed.Results There were special clinical and imaging characteristics in TCCF.Small amount of epistaxis and isolateral loss of sight might be found in cases with epistaxis at early stage,but delayed fatal and massive epistaxis occured at various time after trauma.Cranial base fracture and pseudoaneurysm were special imaging signs.In the TCCF cases with intracranial hemorrhage,prominent and tortuose cortical drainage veins might be found.And pseudoaneurysm at posterio-lateral wall of cavernous sinus might be another special imaging sign.Conclusion Small amount of epistaxis at early stage,cranial base fracture,pseudoaneurysm,prominence and tortuosity of cortical veins are characteristic diagnostic references for TCCF with hemorrhage.Emergent DSA examination at early stage should be regarded as a key step for diagnosis and treatment.

AIM: To investigate the effects of ?-elemene,extracted from curcuma wenyujin,on proliferation, cell cycle and apoptosis of human multiple myeloma RPMI-8226 cells. METHODS: The effect of ?-elemene on the growth of human multiple myeloma RPMI-8226 cells was studied through MTT assay,cell cycle and apoptosis was studied by combined Annexin-V protein iodide staining,The morphological changes was studied by combining Hoechst33342-PI staining. RESULTS: ?-elemene inhibited the proliferation of RPMI-8226 cells in a time-and dose- dependent manner. Compared with the control cells,the proportions of the RPMI-8226 cells in the G0 /G1 phase rose,and the proportions of the RPMI-8226 cells in the S and G2 /M phases fell decreased. RPMI-8226 cells treated with ?-elemene for 48 h induced apoptosis in a dose-dependent manner. CONCLUSION: ?-elemene is able to inhibit the proliferation of RPMI-8226 cells by arresting the cell cycle and inducing the cell apoptosis.

The brain tissue of patients with chronic internal carotid artery occlusion is in a state of hypoperfusion for a long time, which often presents as asymptomatic cognitive impairment. Even with the best medical treatment, patients with chronic internal carotid artery occlusion still have a higher risk of stroke and cognitive impairment. Recent studies have shown that recanalization can reduce the incidence of stroke in patients with chronic internal carotid artery occlusion, but whether it can improve the cognitive function remains controversial. This article reviews the treatment of chronic internal carotid artery occlusion and its effect on cognitive function.

Objective To study the feasibility of DCE-MRI application in the orthotopic transplantation model of gastric cancer in nude mice.Methods Orthotopic transplantation model of gastric cancer in nude mice was established, and 15 models underwent DCE-MRI using the contrast agent of gadopentetate.Subsequently, the tumor was dissected in order to detect the MVD.The MVD was compared between orthotopic transplantation tumor model of gastric cancer and normal gastric mucosa.Results Fifteen nude mice with orthotopic transplantation of gastric cancer successfully underwent DCE-MRI examination.As for the cancer, the values of Ktrans, Kep and Ve were (2.11±0.44) min-1, (4.59±0.93) min-1, and 0.46±0.06, respectively.The MVD in gastric cancer tissues was significantly higher than that in normal gastric mucosa (χ2=16.205, P<0.001).Conclusion DCE-MRI can be used for noninvasively quantitative evaluation of vascular parameters of gastric carcinoma.

OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).

METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.

RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.

CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.

Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies