Stage Ⅲ A non-small cell lung cancer (NSCLC) has high heterogeneity and there are some controversies over the treatment of this disease,especially for patients with stage ⅢA-N2 NSCLC.This article investigates whether preoperative or postoperative radiotherapy can improve the survival of patients with stage ⅢA-N2 NSCLC and evaluates the effect of surgical treatment.

Most epidemiological investigations and basic studies have demonstrated that estrogen has neuroprotective effects,and the application of estrogen in cerebrovascular disease has a positive attitude.However,large clinical trials of the application of estrogen have indicated that harms outweigh benefits,and even have the risks of stroke.This article reviews the related studies about the neuroprotective effects of estrogen from the positive and negative aspects.

The concept and important role of associative memory neural network are introduced.The development of associative memory neural network is also summarized along with other neural networks such as the Hopfield neural network,the neural network composed of FitzHugh-Nagumo neuron model,the neural network composed of Hodgkin-Huxley neuron model.

Objective To study the signal pathway of apoptosis of renal proximal tubular cells (RPTC) caused by cisplatin for prevention of toxic effects of cisplatin on kidney. Methods pcDNA3.1/Hygromycin vector and pEGFP-C3 vector including Bcl-2(Bcl-acta,Bcl-cb5 and Bcl-nt) were co-transfected in RPTC.After treated with cisplatin, Bax was activated,cytochrom C release and apoptosis were analyzed with confocal microscope and immunofluoresence technique. Apoptotic cells stained with Hoechst33258 were also counted and statistically analyzed. Results The percent of cytochrom C release (35.74%) in Bcl-cb5 transfected group was higher than those in Bcl-nt group (18.7%) and Bcl-acta group(24.6%)(P

To investigate the role of ERC,6 gene in the growth rate and antifungal susceptibility,Aspergillus fumigatus strain with extra copies of ERG6 gene was constructed.Open reading frame (ORF) of putative ERG6 gene was searched in A.fumigatus genome.A PCR fragment, ERG6 ORF sandwiched by its flanking sequences (about 1 kb respectively),was amplified and was then subcloned into vector pRG-AMA1- NotI to produce a recombinant plasmid pERG6,which was further transformed into uracil auxotroph A.fumigatus strain AF293.1 to produce the transformant AF-pERG6.In the same time,empty plasmid pRG-AMA1-NotI was also transformed into A.fumigatus strain AF293.1 to produce the transformant AF-empty as a control.Radial growth of the transformants was tested on minimal medium (MM) and YAG medi- um.Antifungal susceptibilities of these resahing transformants,AF-pERG6 and AF-empty,to the common antifungal agents were performed by using both disk diffusion and broth microdillution methods.A.fumigatus genome contains a ERG6 gene,of which the ORF size is 1 256 bp.Comparing to Candida albicans and Sacchromyces cerivisiae sterol methyltransferase,A.fumigatus Erg6p had 57% and 50% identity, and had 70% and 63% similarity in amino acid sequences,respectively.Radial growth of transformant AF-pERG6 was slower than that of transformant AF-empty.The antifungal susceptibilties of transformant AF-pERG6 to the antifungal drugs itraconazole,voriconazole,terbin- aline,amphotericin B,caspofungin and grisefolvin were same to that of transformant AF-empty.In A.fumigatus,extra copies of ERG6 gene have no effect on antifungal susceptibilities to itraconazole,voriconazole,terbinafine,amphotericin B,caspofungin and grisefolvin.Radial growth of A.fumigatus harboring extra copies of ERG6 gene becomes slower compared to the control.

Objective To determine the key points in surgical treatment of Mirizzi syndrome in the olderlys. Methods Clinical data of 12 cases of Mirizzi syndrome treated in our hospital from 1995 to 2004 were retrospectively analyzed. Results Only 6 cases were definitely diagnosed by ERCP and ultrasounography before operations. Three cases were treated with cholecystectomy, 7 cases with cholecystectomy and T-tube drainage of common bile duct, 2 cases with cholecystectomy and Roux-Y hepaticojejunostomy. Conclusions It is still difficult to diagnose Mirizzi syndrome preoperatively. Appropriate operative patterns should be selected according to different types of Mirizzi syndrome.No patient death during operations.The patients were followed 1-10 years, average was 3.2 years. No bile duct stricture was found.

Objective To discuss the diagnostic value of soluble scavenger receptor(sCD163)for the patients of malignant tumor associated with fever in early infection .Methods Collect 102 cases of patients confirmed with malignant tumor in this hospi-tal since January to December 2014 ,all the patients were examined with blood culture .102 patients were divided into two groups ac-cording to the results of blood culture :infection group (60 cases) and uninfected group (42 cases) .ELISA ,electrochemical lumines-cence and immune transmission turbidimetric methods were used to detect the levels of sCD163 ,PCT and CRP in serum ,to compare the differences in the above indicators between two groups .The receiver-operating characteristic curve (ROC curve) was applied to evaluate the application value of sCD163 in diagnosing of malignant tumor associated with fever in early infection .Results The lev-el of sCD163 ,PCT and CRP had statistically difference in two groups(P< 0 .05) ;the critical values of sCD163 、PCT and CRP were 110 .80 ng/mL ,0 .45 ng/mL ,15 .60 mg/L respectively which can suggest the patients with malignant tumor complicated with fever in early infection .The area under the curve were 0 .894 ,0 .835 ,0 .743 respectively ,among that sCD163 area was the largest ;The corresponding sensitivity were 88 .9% ,77 .9% and 88 .0% ;specificity were 77 .0% ,74 .0% and 50 .0% respectively .Conclusion Compared with PCT ,CRP ,sCD163 has more value for diagnosing the patients of malignant tumor associated with fever in early in-fection .

Objective To explore the optimal treatment options of Stanford type B aortic dissection. Methods A to?tal of 51 patients with Stanford type B aortic dissection who visited the General Hospital of Tianjin Medical University from May 2008 to March 2013 were analyzed retrospectively. Survival and recovery of patients were evaluated by follow ups. Pa?tients were divided to TEVAR group(40 cases)and conservative group(11 cases)according to the treatment they recieved. Results Operations were successful in all 40 patients. There were two cases of perioperative death(5%). And none of pa?tients died in TEVAR group during follow-up. One case among 11 patients who received conservative treatment dead in hos?pital(9.1%)while other 7 cases died during follow-up(63.6%). Kaplan-Meier survival curve showed that two-year survival rate of TEVAR group was significantly higher than that of conservative group. In TEVAR group, the maximum diameter of the aorta presented a decreasing trend and thrombosis was seen in artificial lumen with time going after operation. Conclu?sion For patients with Stanford type B aortic dissection, TEVAR presented a high success rate and promoted remodeling of the aortic genuine and aritificial lumen. What’s more, it can significantly improve patient’s survival rate and recovery in short or mid-term period compared with effect of traditional conservative treatment.

Objective To evaluate the value of preoperative spiral CT (SCT) scanning in the diagnosis and staging of middle-late stage rectal carcinoma. Methods The results of SCT scanning of 34 patients with middle-late stage rectal carcinomas were compared with the pathological examination results and the findings of surgical operation. Results SCT could display the manifestations of middle-late stage rectal carcinoma, such as rectal wall thickening, local tumor mass, tumor invasion of rectal circumference, narrow rectal cava, lymph node enlarging (diameter≥10mm) and tumor distant metastasis. According to Duke's staging, the overall accuracy of SCT staging was 70.6%, and for the stages B1, B2, C, and D the sensitivity was 83.3%, 50%, 66.7%, 78.5%, and the specificity was 62.5%, 44.4%, 57.1%, 100%, respectively. According to TNM staging, the overall accuracy of SCT was 73.5%, and for the stages T2, T3, T4 the sensitivity was 85.7%, 61.5%, 78.6%, and the specificity was 54.5%, 66.7%, 100%, respectively. Conclusion Preoperative SCT could display the invasive range of middle-late stage rectal carcinoma and the tumor lymph nodes metastasis, especially distant metastasis, and had a definite diagnostic value.

Objective To investigate the value of pro-adrenomedullin (pro-ADM) levels for severity as-sessment of community-acquired pneumonia (CAP).Methods 214 CAP patients who were admitted to the emer-gency department were prospectively studied.The levels of plasma pro-ADM were determined using a new sandwich immunoassay.At the same time, procalcitonin, C-reactive protein, interleukin-6 levels, leukocyte count, clinical varia-bles and the pneumonia severity index (PSI) were measured.Results Pro-ADM levels,in contrast to procalcitonin,interleukin-6 levels, increased with increasing of the severity of CAP, which was classified according to the PSI score (P<0.05).In patients who died during follow-up, pro-ADM levels on admission were significantly higher than that in survivors [2.08 vs.4.94 μg/L,Z=-4.081 ,P<0.001].In a receiver operating characteristic (ROC) analysis for survival, the area under the ROC curve (AUC) for pro-ADM was 0.79, which was significantly higher than that for procalcitonin(0.72), C-reactive protein (0.58), interleukin-6 (0.64 ), and total leukocyte count (0.50) and sim-ilar to the AUC of the PSI (0.75).Conclusion Pro-ADM is a useful biomarker for the risk stratification of CAP patients.