The overall 5-year survival rate for patients with metastatic colorectal cancer(CRC) is less than 10%.Median survival with 5-fluorouracil(5-FU)/leucovorin(LV) therapy is approximately 12 months.Recent additions to the chemotherapy armamentarium for this disease have begun to prolong median survival times.In trials in which patients are exposed to all three approved chemotherapy agents,oxaliplatin,irinotecan,and 5-FU/LV,or capecitabine during the course of their disease,median survival has reached 20 months. The addition of oxaliplatin and irinotecan to 5-FU/LV regimens has also led to the maintenance of quality of life for longer intervals than were traditionally observed with 5-FU/LV alone.Current standard first-line regimens for metastatic CRC are FOLFOX(infusional 5-FU/LV with oxaliplatin) and FOLFIRI(infusional 5-FU/LV with irinotecan).Ongoing investigations will identify a place for molecular targeted combination chemotherapy on metastatic colorectal cancer(CRC) and some trials achieved better efficiency.In this review,we discuss the current advances in combined management of metastatic colorectal cancer of 5-Fu,chemotherapy,Molecular targeted therapy.

In view of the transformation from traditional biomedicine to biology-psychology-social medicine,the comprehensive medical iournals,in order to advance the development of the medicine,should pay attention to the articles on psychology,society and environment with diseases;strictly investigate the ethics in the articles;and publish the articles on the medical humanity promptly.

Objective To explore the effect of health education on medication compliance of middle-aged and elderly hypertensive patients in rural areas. Methods Outpatients aged 45 hypertensive patients were divided into two groups, the intervention group was given health education knowledge, intervention of bad habits and knowledge of drug by oral presentations, banner ads, TV screen publicity, publicity, newspaper, telephone follow-up and other forms of propaganda. Results Hypertension knowledge, dietary knowledge, living habits, medication knowledge, medication compliance of patients in the intervention group were increased significantly, and there were significant difference in the four survey in the observation group with statistical significance(P<0.05). Conclusion Health education has a great influence on drug compliance among middle-aged and elderly hypertensive patients in rural areas, and has great significance for controlling blood pressure.

Objective To study the photodynamic therapeutical efficacy of a novel photosensitizer DTP on sensitive gastric cancer cells (SGC7901) and vincristine-resistant gastric cancer cells (SGC7901/VCR).Methods The P-gp expression on the SGC7901 and SGC7901/VCR cell membrane was indirectly confirmed by fluorescence microscopy.The survival rates of SGC7901 and SGC7901/VCR cells were evaluated by cell counting kit (CCK-8) after photodynamic therapy with DTP.The intracellular DTP uptake levels of two types of cell were determined using a fluorescence spectrophotometer,and the intracellular DTP distributions were observed by laser scanning confocal microscopy.Results The novel photosensitizer DTP has considerable photodynamic cytotoxic effect on SGC7901 and SGC7901/VCR cells.However,this effect on the SGC7901NCR cells was relatively weak (P＜0.05),and could not be enhanced by P-gp inhibitor verapamil or cyclosporine A(P＞0.05).The DTP uptake level in SGC7901 cells was higher than that in SGC7901/VCR cells (P＜0.05),and could not be enhanced by P-gp inhibitor verapamil and cyclosporin A (P＞0.05).It was found that DTP distributed in the lysosomes of SGC7901 cells and in the lysosomes and mitochondria of SGC7901/VCR cells.Conclusions The novel photosensitizer DTP is not the substrate of multidrug transporter P-gp,and its weaker photodynamic cytotoxic effect on SGC7901/VCR cells is independent of the P-gp overexpression on its cell membrane,which may be related to the distribution of intracellular DTP in the two types of cell.

Background and Purpose:Cervical cancer is one of the most common malignant neoplasms among women.The 5-year survival for patients with early stage disease is over 70%.While it is generally accepted that either radical surgery or radiotherapy can achieve cure for the majority of patients with early-stage cervical cancer,there is no standard approach to the patients with bulky disease,whose prognosis remains very poor in spite of the therapeutic advances achieved in recent years.Neoadjuvant chemotherapy has been used as part of the multidisciplinary treatment before either operation or radiation therapy.Although the approach still had many controversies,numerous studies have supported its effectiveness in bulky cervical cancer.The present study was conducted to explore whether neoadjuvant chemotherapy with the combination of vincristine,bleomycin and cisplatin could improve the operability and pathological response rate in Ⅰb_(2)~Ⅱb bulky cervical cancer patients.Methods:A total of fifty-six patients with bulky cervical cancer were histologically diagnosed and staged into Ⅰb_(2)~Ⅱb according to the standards of International Federation of Gynecology and Obstetrics(FIGO) and randomly selected,including 15 cases with Ⅰb_(2),15 with Ⅱa,26 with Ⅱb.They were treated by a regimen of PVB chemotherapy for 2 cycles and followed by operation.The immediate response and adverse effects were analyzed.Results:The overall response rate was 78.6%.The resectability rate for surgery after chemotherapy was 100%.No intolerable toxic and adverse effects were recorded during neoadjuvant chemotherapy.Preoperative neoadjuvant chemotherapy can apparently increase the possibility of resection by operation and enhance the remission rate.The primary tumor sizes were significantly decreased after chemotherapy before surgery(P

32 patients with old atlantoaxial dislocation with bulb-spinal cord compression were treated surgically from 1971 to 1989. Their diagnoses were confimed mainly by X-ray examination and measurement. The average time of follow-up after operation was 6 years. The rate fo excellence and good was 87.5% per cent. The causes of atlantoaxial dislocation, operative techniques involved and results are discussed. The authors think that the key to the increase of the therapeutic effects is early diagnosis and surgical treatment before the irreverisible changes of bulb-spinal cord compression occur.

Objective To study the characteristics of molecular genetics concerning Chinese mitochondr ial encephalomyopathy,lactic acidosis and stroke-like episodes (MELAS). Methods A3243G and T3271C point mutations in the mtDNA of muscle and (or) blood cells were investigated in 9 patients with MELAS and some o f their maternal relatives from 7 families by using PCR-RFLP. Furthermore,mut ant mtDNA in the sample harboring mutation was quantitatively analysed. Results The mtDN A A3243G point mutation was unanimously identified in tissues of all patients an d 1 of their relatives. However,the T3271C point mutation was identi f ied in none of series in our study. The proportion of mtDNA A3243G was 46.8%～ 61. 0% in muscle (4 cases) as well as 26.8%～50.3% in blood (9 cases). In the 3 p atie nts with muscles and blood cells available,their mutant mtDNA proportion in mus cle is consistently higher than in blood cells. The study of leukocytes of some maternal relatives from 6 families showed that,while only 1 proband had a siste r harboring A3243G mutation and none of the mothers of another 3 probands or sib lings of the other 2 probands had the point mutation. However,the sons of 2 pr o bands had not only phenotype of MELAS,but also mtDNA A3243G point mutation in t heir blood. Conclusion mtDNA A3243G mutation highly exists in the series with M E LAS syndrome in our study and can be detected in various tissues,which is consi stent with reports abroad. However,most of our cases are sporadic rather than m aternal inherited. It is presumedly caused by a de novo mutation. Whether i t is due to ethnic difference or sporadic event needs to be investigated further.

Objective To develop a new method with using surgical procedures for multiple correction of nasal deformity with cleft lip and palate.Methods Our operation procedures included elevation of the nasal floor depression in cleft side with the transplantation of autogenous cancellous bone, frustration and elevation of the nasal bone and part of the frontal process of maxilla, and replacement of septum between alar cartilages.Through these procedures, the nasal deformity could be multiply corrected.Results Postoperative follow up for 1～8years in 45 patients demonstrated satisfactory results. Conclusion Multiple correction is a new method of treatment for nasal deformity with cleft lip and palate.

Objective To investigate the clinical and pathological features of adult form nemaline myopathy. Methods Biopsied muscle specimens from two patients were observed using enzymatic histochemical method and electron microscope. Results These two patients were found with an initial onset from neck muscle weakness at the age of 52 and 36 years respectively, followed by trunk and limb muscle involvement to a variant degree. Type Ⅰ fiber atrophy and numerous granules (rod) were found in both patients in light microscopy. In case 1, the centralized nuclei were seen almost in all normal sized muscle fibers. Electron microscopic observation showed marked myofibril disorganization and numerous rod-like formations. Two inclusion-carrying nuclei were detected in case 1. The intranuclear inclusion showed a lattice pattern of Z-disc line or sarcoplasmic rod. Conclusions Adult form nemaline myopathy is clinically nonspecific. Rod-like structures might be found either in sarcoplasma or in nucleus. Centralized nuclei might coexist with rods in adult form nemaline myopathy. As compared to the child form, the adult one might often show a marked muscle fiber atrophy.

Red cell isoenzymes EsD and PGM and serum Hp are of genetic polymorphism which is inheritedsccording to the Law of Meqdelian Segregation. The distribution of their gene frequencies varies withraces. In this paper,the phenotype frequencies of the EsD,PGM and Hp have been investigated by theemthod of mixed starch/agarose gel electrophoresis and polyacrylamide gel electrophoresis among fivenationalities in Inner Mongolia, namely Creqen, Ewenki, Dawuor, Northeast Mongolian and Buryat.The gene Oroqen,Ewenki,Dawuor,Northeast Mongolian and Buryat. The gene frequencies were alsocalculated. The phenotype frequencies of EsD,PGM and Hp are compared not only among the five nationalities but with those reported by other countries.