Background and purpose:At present, the advanced lung adenocarcinoma is mainly treated by chemotherapy-oriented comprehensive therapy. Pemetrexed as a multi-target antifolate chemotherapeutic drug, combined with platinum, was approved for treatment of advanced lung adenocarcinoma because of its low toxicity and high efifcacy. The purpose of this study was to compare the short-term clinical efifcacy and toxicity of pemetrexed and docetaxel combined with cisplatin for advanced lung adenocarcinoma.Methods:Fifty patients with stageⅢ-Ⅳ lung adenocarcinoma were randomly divided into two groups. Group PC received pemetrexed (500 mg/m2, d1) combined with cisplatin (75 mg/m2, d1) and group TP received docetaxel (75mg/ m2, d1) combined with cisplatin (75 mg/m2, d1) treatment. One cycle was 21 days in both two groups. The response rate (RR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) of the two groups were compared. The peripheral blood T lymphocyte subsets and natural killer (NK) cell activity of patients in both groups were measured before and after the treatment, while compared with healthy controls (25 cases).Results:Among 50 patients, no one got complete remission (CR), 20 patients got partial remission (PR), 17 patients had stable disease (SD) and 13 patients had progressive disease (PD).It showed no signiifcant difference in RR, DCR, PFS and OS (P>0.05) between two groups. Compared with group TP, the activity of CD3+, CD4+, CD4+/CD8+ T cells and NK cells increased and CD8+ T cells reduced in group PC after treatment, but the value had no obvious change (P>0.05). The common side effects were hematological toxicity and gastrointestinal response. The incidence of side effects in group PC was lower than that in group TP, and the degree was also slighter (P<0.05).Conclusion:The clinical efifcacy of pemetrexed combined with cisplatin is equal to docetaxel combined with cisplatin in treatment of advanced lung adenocarcinoma, but the former could reduce the adverse reaction rate.

OBJECTIVE:To establish a method for simultaneous determination of 4 effective components in the couple of Coptidis Rhizoma and Evodiae Fmctus,and to investigate rational proportion of the couple.METHODS:HPLC method was adopted.The determination was performed on Welch XB C18 column with mobile phase consisted of acetonitrile-1.5 mmol/L sodium dodecyl sulfate solution (pH adjusted to 5.0 with phosphoric acid) (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set at 265 nm,and the column temperature was 30 ℃.The sample size was 10 μL.RESULTS:The linear ranges of berberine hydrochloride,martin hydrochloride,evodiamine and rutacarpine were 2.24-44.80 μg/mL(r=0.999 9),1.26-31.50 μg/mL(r=0.999 8),2.70-81.00 μg/mL(r=0.999 8),1.65-49.50 μg mL(r=0.999 9),respectively.RSDs of precision,stability and reproducibility tests were all lower than 3.0％.The recoveries were 98.11％-100.73％ (RSD=1.04％,n=6),96.54％-103.47％(RSD=1.86％,n=6),95.49％-102.36％ (RSD=2.05％,n=6),97.19％-103.24％ (RSD=2.19％,n=6),respectively.When the proportion of Coptidis Rhizoma-Evodiae Fructus(m/m) was 2∶ 1,the comprehensive content of each component was the highest.CONCLUSIONS:The method is simple,accurate,stable and reproducible,and can be used for simultaneous determination of 4 effective components in different compatibility proportions of the couple of Coptidis Rhizoma and Evodiae Fructus.The rational proportion of the couple of Coptidis Rhizoma and Evodiae Fructus is 2 ∶ 1.

Objective To explore the clinical effects of injecting methotrexate with hysteroscopic tubal can-nulation combined with Huayu shapei prescription in the treatment of salpingocyesis.Methods 82 unruptured salpin-gocyesis patients were randomly divided into the two groups.41 patients in the observation group were treated by hyst-eroscopic tubal cannulation injection of methotrexate combined with Huayu shapei prescription,41 patients in the con-trol group were treated by methotrexate intramuscular injection with oral mifepristone.The clinical efficacy of the two groups were observed,the level of serumβHCG required for tubal pregnancy,the mass absorption and after treatment of tubal patency.Results Compared with the control group,the difference was significant of the decline of serum βHCG in the treatment group (t=2.67,P<0.05).Compared with the control group,the treatment effectiveness and the absorption of the mass in fallopian tube in the treatment group,the difference was significant (t =3.57,P<0.05 ).Tubal patency detected treated group was superior compared with the control group,the difference was signifi-cant(χ2 =100.23,P<0.05).Conclusion Compared with traditional treatments,injecting methotrexate with hyste-roscopic tubal cannulation combined with Huayu shapei prescription in the treatment of salpingocyesis can effectively reduce the HCG levels,promote the absorption and softening of the ectopic pregnancy mass,to achieve the purpose of killing embryos eliminate micro,it will help to improve patients with clinical symptoms and signs,to maximize the recovery of the patient's reproductive function and physical health.

Objective To investigate the expression of MMP-2 and c-erbB-2 and evaluate the correlation of clinical pathological parameters in non-small cell lung cancer. Methods Forty-five paraffin-embedded specimens of radical postoperative non-small cell lung cancer was detective for MMP-2 and c-erbB-2 using immunohistochemical method. Results The positive rates of MMP-2 and c-erbB-2 are 57.8 %, 75.6 %, there is a significance between the expression of MMP-2 and lymph node metastases(P =0.006), the expression of c-erbB-2 is related to clinical stage and lymph node metastases (P =0.015, P =0.032), The expression of MMP-2 and c-erbB-2 are related to 5-year survival rate (P =0.002, P =0.003). Conclusion The expression of MMP-2 and c-erbB-2 is significantly related to some clinical parameters and 5-year survival rate.

Objective To study the association of body mass index (BMI) and waist circumference (WC) with dyslipidemia and the risk of dyslipidemia at different BMI and WC level among adults in Suzhou Industrial Park District. Methods A total of 6219 participants were chosen by stratified random cluster sampling method. Four streets were selected form the district first, then one community as a cluster was selected randomly from each street. Questionnaire survey, physical examination and laboratory tests were done by all subjects. Results The prevalence of dyslipidemia was 35.9％;the rates of overweight, obesity and central obesity were 36.6％, 9.6％ and 49.5％ respectively. The prevalence of dyslipidemia in underweight group, normal weight group, overweight group and obesity group were 13.6％, 30.2％, 47.7％and 59.0％ for male, and 17.2％, 27.3％, 38.6％和 48.8％ for female respectively. The prevalence of dyslipidemia for male and female both rose with BMI (χ2=139.848, P<0.001; χ2=92.387, P<0.001). The prevalence of dyslipidemia in the high waist circumference group and normal group were 50.2％and 30.9％for male, and 40.8％and 23.8％for female respectively. Prevalence of groups with high waist circumference for male and female were significantly higher than normal groups (χ2=108.669, P<0.001; χ2=110.642, P<0.001). Pearson correlation analysis showed that total cholesterol (TC), triglyceride(TG), and low density lipoprotein cholesterol (LDL-C) were positively correlated with BMI ( r=0.153, P<0.001;r=0.227, P<0.001;r=0.192, P<0.001), and were also positively correlated with WC(r=0.138, P<0.001; r=0.234, P<0.001; r=0.159, P<0.001). High density lipoprotein cholesterol(HDL-C) was negatively correlated with BMI (r=-0.189, P<0.001) and WC (r=-0.185, P<0.001). Logistic regression analysis after age adjustment showed that, compared to the group with BMI<24 kg/m2 and WC<85 cm(male)/WC<85 cm (female), odds ratios (OR) for male in group with BMI<24 kg/m2 and WC≥85 cm, group with BMI≥24 kg/m2 and WC<85 cm and group with BMI≥24.0 kg/m2and WC≥85 cm were 1.602, 1.834 and 3.064 respectively, and ORs for female in group with BMI<24.0 kg/m2 and WC≥80 cm and group with BMI≥24.0 kg/m2 and WC≥80 cm were 1.703 and 2.381 respectively, however, the OR for female in group with BMI≥24.0 kg/m2 and WC<85 cm was not statistically significant (P>0.05). Conclusions BMI, waist circumference and dyslipidemia were closely correlated. Waist circumference is more important than BMI for female.

OBJECTIVE To discuss the available methods of preventing the mattress pollution in the wards of the(hospital), and to keep the mattresses clean and dry and eliminate the hidden danger of nosocomial infection.(METHODS) The mattress protective covering is used of a new type of textile materials,and then applied into clinic.Selected 100 pieces of mattresses in the wards,divided them equally into two groups at random,the(experimental) group and the control group.After cleaning and pasteurization(surface) sampling and bacterial culturing for every mattress were undertaken.For the experimental group,spread the protective(covering) before the sheet,and for the control group,used the sheet directly.The colony number of each group was compared in the 3rd,7th,and 14th days.RESULTS The mattresses of experimental group were clean,light polluted and with less colonies,and that of the control group were heavy polluted and with more colonies.The comparisons of the total colony number and the number of every sampling point in the 3rd,7th,and 14th days of the two groups showed that there was a(significant) difference(P

Objective:Pyoderma gangrenosum(PG) is regarded as a possibly immunity-mediated ulcerative skin disease,which is difficult to be managed and easy to relapse.Few cases of PG have been reported to be treated successfully in the world.This study aimed to investigate the clinical characteristics and difficulties and strategies in the management of mosquito bite-induced ulcer by PG.Methods: We analyzed the clinical characteristics and difficulties in the treatment of a case of mosquito bite-induced leg ulcer complicated by PG.Following the TIME(tissue removal,infection/inflammation control,moisture imbalance correction,and edge of wound revision) principles of wound bed preparation,we treated the ulcer by silver ion dressing + infrared rays,hypertonic saline dressing + infrared rays,hypertonic saline dressing + electrotherapy,and honey dressing + medication at different times.The ulcer size and scores on pain and healing were assessed before each wound care,and the results of each method were analyzed by the SPSS11.0 software.Results: The pain score was continuously reduced with the treatment and the ulcer size and healing score were gradually decreased in the later stage,while in the earlier stage,the ulcer size was even enlarged,with one ulcer becoming two,and the healing score obviously increased.The differences were statistically significant(P

Objective: Vacuum-assisted closure(VAC) is a new technique for wound treatment,whose clinical application at home is but at the initial stage.The aim of this study was to investigate the procedure,therapeutic course and the effectiveness of the technique in the treatment of chronic wounds.Methods: This study included 12 cases of chronic or infected wound,which were more than 100 cm2 in size,either undermined,or drainage-obstructed,or difficult to heal despite over a month of previous treatment.We used the Freedom Negative Pressure Wounds Therapy Machine and the Ten-Step Management Procedure for a regular course of 30-50 days.We recorded and analyzed the pre-and post-treatment PUSH(pressure ulcer scale for healing) scores,healing modes,healing time and cure rate of all the cases.Results: The 12 cases were treated by VAC for(27.7 ? 22.6) days,of which 9 were cured,1 improved and 2 healed after moisture therapy followed by further treatment in the surgical department.The average healing time was(59.36 ? 22.88) days and the total cure rate was 91.7%.Age is positively correlated with healing time,but other factors showed no significant correlation with healing time and cure rate.Conclusion: The VAC technique is applicable to chronic wounds in patients of all ages,and the best therapeutic course is 30-50 days,which helps to raise the cure rate of intractable wounds.

Objective To investigate the occurrence of postoperative healthcare-associated infection(HAI)and its risk factors in neurosurgical patients undergoing removal of intracranial tumor,so as to provide theoretical basis for formulating intervention measures.Methods Prospective survey was adopted to monitor the occurrence of postoperative HAI in patients who admitted to the department of neurosurgery of a hospital and underwent selective removal of intracranial tumor between April 2013 and December 2014 ,risk factors for HAI were analyzed with univariate and multivariate logistic regression analysis.Results A total of 1 218 patients were surveyed,163 patents developed 193 times of postoperative HAI,inci-dence of postoperative HAI was 13.38%,case incidence of HAI was 15.85%.The main HAI site was intracranial site(n=125,64.77%),the next was lower respiratory tract (n=55,28.49%).Multivariate logistic regression analysis showed that operation grade and subtentorial operation were independent risk factors for postoperative HAI in neurosurgical patients undergoing removal of intracranial tumor,OR and 95%CI were 4.352(1.878-10.080)and 1.812(1.280-2.564)respec-tively.Conclusion Risk of postoperative HAI in neurosurgical patients undergoing high grade operation and subtentorial removal of intracranial tumor is high,effective prevention and control measures should be taken to prevent the occurrence of HAI.

Objective:To investigate the surgical methods and results of enlarged translabyrinthine approachin the removal of large acoustic neuromas. Method:A large mastoidectomy involved complete exposure of sigmoidsinus, the dura behind the sinus for at least lcm, the superior petrosal sinus and the middle fossa dura. Thejugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonizedand uncovered for at least 270°. The debulking of the tumor began inside the anterior and inferior poles in orderto find the brainstem and the facial nerve root as early as possible, then the dissection of the nerve was performedmedially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were performed in allcases. Result:Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size:4.2 cm).There were no death as well as other complications such as intracranial infection and persistent cerebrospinalfluid leakage. There were no obvious cerebral sequela. The facial nerve was preserved both anatomically andfunctionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases,Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in4 cases who all had severe facial paralysis or nerve interruption before operation. 16 patients returned to workwithin 1～3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via thetranslabyrinthine approach, with good result of facial nerve function and minimum incidence of morbidity.