Objective To evaluate the efficacy and toxicity of docetaxel combined with Cisplatin(DDP) and 5-fluorouracil(5-Fu) in the treatment of advanced gastric cancer. Methods 35 patients with advanced gastric cancer,which were confirmed by pathological diagnosis,were treated with docetaxel + DDP +5-Fu regimen:docetaxel 70 mg/m2 iv infusion for 4 hours on day 1, DDP 20 mg/m2 iv infusion on day 1 to 5,5-Fu 750 mg/m2 iv infusion for 6 hours on day 1 to 5 every 3 ～ 4weeks. Patients responsing to the chemotherapy finished at least 4 ～ 6 cycles or proceeded the therapy until progression of the disease (PD). Results 32 cases (91.4% ) were available for response evaluation with CR0;PR 15;SD7;PD 10. The rate of total remission( CR + PR) was 46.9% (15/32) ,and rates of CR and SD were 0 and 21.9% respectively. Leucopenia was seen in 40% patients,in which 13.6% cases were in grade III -IV. One patient had fever with neutropenia and improved after active treatment. There was no systemic infection or therapy-related death in all patients. Conclusion Docetaxel + DDP +5-Fu regimen has an assured response for advanced gastric cancer with tolerable toxicity and could be an effective candidate in clinical treatment.

Objective Randomly sampling survey was performed among the troops stationed in the monitoring sites during the period of 2006-2007 for understanding and analyzing the incidence,distribution and the epidemiological features of military training related injuries(MTRI).Methods Troops stationed in 9 monitoring sites were randomly selected for the survey,and soldiers participated in military training during the period of 2006-2007 served as the objects.The data concerning the military training injuries were collected and analyzed according to the "Diagnostic Criteria and Treatment Principle on Military Training Related Injury".Results 6262 out of 71836 soldiers who participated in assorted military training during the period of 2006-2007 suffered from military training related injuries.Among them 2455 out of 35582 soldiers who participated in military training in 2006 suffered the injuries,with an incidence of 6.9%;while 3807 out of 36254 soldiers who participated in military training in 2007 suffered the injuries,with an incidence of 10.5%.A significant difference existed in the incidence of military training related injuries between the years of 2006 and 2007(P

Objective: To investigate the clinical results of permanent implantation of radioactive 125 I seeds in treatment of advanced pancreatic adenocarcinoma.Methods:Eight patients with advanced pancreatic adenocarcinoma were treated with 125 I implantation from May 2002 to December 2002 and the data was retrospectively analyzed.Results: The mean number of 125 I seeds implanted was 22.8 with minimum of 19 to maximum of 38 each. The matched peripheral dose was 65 Gy.The postoperative courses were uneventful and no bone marrow suppression was recorded.The preoperative efractory abdominal and back pain in 2 patients were relieved completely (2/2).The postoperative CT scan which were done in four cases showed that tumor disappeared completely in 2 cases,were well locally controlled in 1 and slightly controlled in one.No acute pancreatitis and pancreatic leakage were encountered in all patients.Conclusion: The implantation of radioactive 125 I was effective in local control of the tumor and pain relief and is a safe alternative for the treatment of unresectable pancreatic adenocarcinoma.

AIM:To investigate the relationship of clinical efficacy,blood trough concentration and adverse reavtion,which in the treatment of methicillin-resistant Staphylococcus aureus infection with Vancomycin.METHODS:The clinical data of 82 hospital patients who were infected by methicillin-resistant Staphylococcus aureus and treated with Vancomycin from January 2008 to October 2009 were retrospectively analyzed the clinic efficacy,bacteriological treatment,adverse reaction were observed,and the blook trough concentration was detected.RESULTS:The treatment effective rate of Vancomycin-blood trough concentration which was less than 5 ?g/mL,in the range of 5-10 ?g/mL,and greater than 10 ?g/mL were 68.75%,72.73% and 81.82%.The bacterial clearance rates were 62.50%,68.18% and 72.73%.One case of blood trough concentration of 14.6 ?g/mL in patients with renal toxicity.CONCLUSION:Increasing the blood trough concentration of Vancomycin can improve the treatment of methicillin-resistant Staphylococcus aureus infection in the efficacy and bacterial eradication rates,but the probability of renal toxicity adverse reactions will also increase accordingly.

Objective: To investigate the expression of suppressor of cytokine signaling 2 (SOCS2) in breast carcinoma tissues and to discuss its relationship with clinical pathological data of breast carcinoma patients. Methods: The tissue microarray for 171 cases of breast carcinoma specimens, 18 adjacent tissues and 20 breast benign lesions were established. Then the expression of SOCS2, ER, PR, cerbB2, p53 and Ki-67 was detected by tissue microarray technique and S-P immunohistochemistry. Results: Positive rates of the SOCS2 protein in the breast carcinoma specimens, adjacent tissues and breast benign lesion were 57. 89% (99/171), 94. 44% (17/18), and 75% (15/20), respectively. The expression of SOCS2 was significantly different in breast carcinoma tissues of different TNM classification, different histological grades, and with or without Ki-67 expression and lymphatic metasrasis(P

Pathologic experiment teaching is special feature and stresses morphologic teaching,It is easy for stuents to learn passively.Problem-basedlearning ( PBL ) was introduced in pathologic experiment teaching in eight-year clinical medicine.program courses.In pathologic experiment class,questions was produced by analyzing various diseases,observing macroscopic and microscopic changes,discussed by clinical cases and solved by students themselves with bilingualistic teaching.In conclusion,PBL was significant in improving the quality of pathological experiment teaching,overcoming the shortage of morphologic learning,and making students more active in learning pathology.

Objective To evaluate the efficacy of liver grafts with warm ischemia and with different cold preservation time in liver transplantation.Methods The clinical data of 154 patients who received liver transplantation at the First Affiliated Hospital of Sun Yat-sen University from January 2006 to December 2007 were retrospectively analyzed.The warm ischemia time of the liver grafts obtained from the non-heart-beating donors was within 10 minutes.According to cold perservation time of the liver grafts,patients were divided into 3 groups:the cold preservation time of the liver grafts was within 8 hours,8-12 hours and above 12 hours in group I(n=58),group Ⅱ(n=62)and group Ⅲ(n=34),respectively.The peak level of alanine aminotransferase(ALT),primary graft dysfunction(PGD)after liver transplantation,acute rejection response,biliary complications,vessel complications,perioperative infections and the survival of liver grafts and recipients among the 3 groups were analyzed via chi-square test,t test and variance analysis.Results No PGD was detected in the 3 groups after liver transplantation.All patients were followed up for 8-32 months.The peak level of ALT,incidence of infection and biliary complication,survival of liver grafts and recipients were(482±357)U/L,12%(7/58),12%(7/58),86%(50/58)and 88%(51/58)in group Ⅰ,and were(1274±608)U/L,29%(10/34),26%(9/34),68%(23/34)and 71%(24/34)in group Ⅲ,with significant difference between the 2 groups(t=5.23,X~2=4.28,6.77,4.51,4.28,P<0.05).The peak level of ALT in group Ⅱ was(953±424)U/L,which was significant higher than(482±357)U/L in group Ⅰ(t=4.76,P＜0.05).Conclusions Liver grafts with a warm ischemia time shorter than 10 minutes could tolerate the injury caused by cold preservation with the maximum time of 12 hours.The incidences of biliary complications and postoperative infections are significantly increased and the survivals of liver grafts and recipients are decreased when the cold preservation time exceeds 12 hours.

Objective Sirolimus is a new, potent immunosuppreasant considered to be nonnephrotoxic. There is limited experience with the use of sirolimus in liver transplant recipients. This study was to investigate the clinical experience of conversion from tacrolimus-based to sirolimus-based immunosuppression in liver transplant recipients. Patients switched to cyclosporine-based immunosuppression during the same period were also enrolled as controls. Methods This retrospective study examined liver transplant recipients who had been switched from tacrelimus-based to sirolimus-based or cyelosporine-based immunosuppressive therapy between January 2004 and January 2008 in the First Affiliated Hospital of Sun Yat-sen University. Patients were divided into 2 groups: those switched to sirolimus-based immunosuppression (group A; n=32); and those switched to cyclosporine-based immunosuppression (group B; n=15). Results The rate of successful conversion was 34.5% in group A (10/32) compared with 45.5% in group B (7/15); this difference was not statistically significant (P>0.05). After conversion, renal function in patients in group A remained normal, while the renal function in patients in group B become abnormal 4 months after conversion (P<0.05). In group A, some simlimus-associated adverse effects occurred but were mild and easy to control. Conclusion Sirolimus can be used safely in place of tacrolimus in liver transplant recipients.

Objective To investigate the effects of ischemic preconditioning on the cholesterol content and the activity of Na+-K+-ATPase of hepatocytes following cold preservation in rats.Methods Twenty-five rats were randomly divided into five groups,including control group (C),cold preservation group (Ⅰ),ischemic preconditioning group (ⅠP),atorvastatin (30 μmol/L) treatment group (A30),and atorvastatin (100 μmol/L) treatment group (A100).The cholesterol content and the activity of Na+ -K+ -ATPase were assessed.Results The cholesterol contents on the rat liver tissue cell membrane in the C group,Ⅰ group,ⅠP group,A30 group and A100 group were (310.4 ± 27.5),(187.7±13.1),(394.3±25.9),(201.8±14.6) and (122.6±7.7) nmol/mg protein,and activity of the Na+ -K+ -ATP enzyme was (46.55 ± 3.20),(27.4 ± 2.81),(52.71 ± 3.02),(30.67 ±2.78) and (19.64 ± 2.11) μmol Pi/hr mg protein,respectively (P＜0.05).There was no significant difference in the plasma membrane phospholipid content among the five groups (P＞0.05).Conclusion Reduction of cholesterol content and Na+ K+ -ATPase activity on the liver cytoplasmic membrane is one of the factors causing donor liver cold preservation injury,but ischemic preconditioning can significantly improve cell membrane Na+ -K+ -ATPase activity and increase cytoplasmic membrane cholesterol content. Use of atorvastatin statins can reduce cytoplasmic membrane cholesterol synthesis,and significantly decrease Na+ -K+ -ATPase activity,thereby alleviating the donor liver cold preservation injury.

BACKGROUND: Tumor recurrence in liver transplant recipients greatly affects prognosis of liver transplantation with hepatocellular carcinoma (HCC). How to prevent tumor recurrence has aroused increasing attention. Arsenious acid chemotherapy is considered effective on treating moderate or advanced liver cancer, but its utilization following liver transplantation remains few. OBJECTIVE: To explore the role of arsenious acid on tumor recurrence in liver transplant patients with primary HCC extending Milan criteria. RESULTS AND CONCLUSION: All patients were routinely followed up for 3-32 months. Thirty recipients were presented with tumor recurrence, 16 in the chemotherapy group and 14 in the non-chemotherapy group. Tumor recurred in lung, liver graft and bones in most cases. The total recurrence rate was similar in these two groups, but chemotherapy could delay recurrence after transplantation (P=0.026). There was no significance in 6-month, 1-year survival rate between two groups, but the 2-year survival in the chemotherapy group was higher (P=0.037); 6-month tumor-free survival rates in the two groups had no significance, 1-year and 2-year tumor-free in the chemotherapy group were significantly higher than those in the non-chemotherapy group (P=0.030, 0.023). Intravenous arsenious acid chemotherapy can delay tumor recurrence and prolong survival in liver transplant patients with HCC extending Milan criteria.