Objective To evaluate short -term clinical efficacy and adverse effects of brucea javanica oil emulsion(BJOE)combined with TP regimen in treating malignant pleural effusion(MPE)of non -small cell lung cancer(NSCLC)by double -way chemotherapy.Methods Totally 91 patients with MPE of NSCLC diagnosed by pathology were builted into the central venous catheter.The patients were assigned to group A,B and C according to therapies.Group A(21 cases)accepted infusion of BJOE 60mL into thoracic cavity twice a week.Group B(33 cases) accepted TP regime therapy,which included paclitaxel(TAX)intravenous chemotherapy at a dose of 150mg/m2 and cisplatin(DDP)injecting into thoracic cavity at a dose of 60mg +0.9% sodium chloride injection 30mL in first day, the therapy was repeated every 3 weeks.Group C(38 cases)combined the therapies of group A′s and B′s.Clinical efficacy and adverse effects were evaluated after 6 weeks.Results The objective response rate(81.6%)for group C was higher than group A or B(χ2 =8.605,P <0.05),the same result were in CR ratio(55.3%)(χ2 =10.384,P <0.05)and PD ratio(5.3%)(χ2 =8.649,P <0.05).There were no serious adverse effects in the three groups.The occurring rate of white blood cell reduction in group A was lower than those of group B and C,there was statistically significance(χ2 =8.999,P <0.05).Conclusion The efficacy of BJOE combined with TP regimen in treating MPE of NSCLC by double -way chemotherapy is better than that of single chemotherapy or alone intrathoracic treatment, and the adverse effects could be well tolerated.

Objective To observe the efficacy and safety of preoperative concurrent chemoradiotherapy or radiotherapy alone in patients with T3,T4 or lymph node-positive rectal cancer.Methods 141 rectal cancer patients with locally advanced or node-positive based on imaging from 2000 to 2009 were retrospective analyzed.Ninety-seven patients received preoperative concurrent chemoradiotherapy and 44 received preoperative radiotherapy alone.Two-dimensional or three-dimensional radiation technique and four types of chemotherapy regimens were used.Results The following-up rate was 91.5％.106 patients were followed up for at least 3 years and 68 patients for at least 5 years.The 3-and 5-year overall survival rates were 85.8％ and 65.7％,respectively.The 3-and 5-year local recurrence rates were 9.2％ and 14.1％,respectively.The 3-and 5-year metastasis rates were 33.8％ and 45.8％,respectively.The downstaging rate was up to 59.0％ (82/139) and the rate of sphincter preservation was 65.5％ (91/139).The median disease-free survival in patients treated with preoperative concurrent chemoradiotherapy was superior to radiotherapy alone (51 months vs 31 months,x2 =12.88,P =0.000).The time to metastasis in patients with downstaging was significantly delayed than that in patients without downstaging (60 months vs 29 months,x2 =14.65,P =0.000).Most acute toxicity was grade 1 and grade 2.The incidence of delayed wound healing and anastomotic leakage was very low.Conclusions Preoperative concurrent chemoradiotherapy or radiotherapy alone has excellent tumor downstaging effect and helps in sphincter preservation,with tolerable side effects.

Objective To investigate the factors of lifestyle associated with the mild cognitive impairment (MCI). Methods A 1∶ 2 matched case-control study investigated 120 patients of MCI and 240 healthy controls with lifestyle factors associated with MCI. Results Multiple factors analysis confirmed that, participate in social activities (OR=0.562, 95%CI: 0.359~0.723), playing chess or joke (OR=0.603,95%CI: 0.323~0.884), travelling (OR=0.683, 95%CI: 0.467~0.912), continue to work after retirement (OR=0.531, 95%CI: 0. .326~0.724),reading (OR=0.272, 95%CI: 0.174~0.428), using computer (OR=0.536, 95%CI: 0.427~0.869), regular physical exercise (OR=0.437, 95% CI: 0.316~0.732), friendship (OR=0.583, 95%CI: 0.385~0.765), meeting children (OR=0.464, 95%CI: 0.316~0.745), intaking unsaturated fatty acids (OR=0.524, 95%CI: 0.368~0.787), often eating fish and seafood (OR=0.224, 95%CI: 0.171~0.383), daily consumption of fruits and vegetables (OR=0.485, 95%CI: 0.316~0.665) were protective factors for MCI. Conclusion A positive, leisure lifestyle, health reasonable diet and avoiding risk factors could effectively reduce the risk of MCI.

Objective To compare the clinical efficacy of posterior pedicle screw fixation through Wiltse paraspinal approach and posterior traditional open approach in the treatment of thoracolumbar fracture and dislocation.Methods A retrospective case control study was performed based on the clinical data of 40 patients with thoracolumbar fracture and dislocation admitted between January 2013 and January 2016.All the surgeries were performed through posterior midline incision,and they were divided into two groups according to different approaches.Patients in Group A received pedicle screw fixation through Wiltse paraspinal approach while Group B received fixed pedicle screw through open surgery.Group A was composed of 12 males and 8 females,aged 21-60 years [(41.5 ±9.6)years].Group B was composed of 13 males and 7 females,aged 18-58 years [(39.1 ± 13.1) years].The same surgical procedures were adopted in spinal decompression,reduction,and the spinal vertebral interbody bone graft and fusion surgery in the two groups.Operation duration,intraoperative blood loss,postoperative drainage volume,visual analogue scale (VAS),spinal canal patency at the last follow-up,percentage of postoperative injury of vertebral height recovery,and Cobb angle were compared.CT and MRI were used to evaluate postoperative paravertebral muscle atrophy,and American spinal injury association (ASIA) impairment scale was used to evaluate neurological function assessment.Results All patients were followed up for 9-33 months,with (19.3 ± 5.6) months for Group A and (22.5 ± 4.9) months for Group B (P ＞ 0.05).The operation duration was (240.5 ± 38.3) min in Group A and (258.5 ± 43.7) min in Group B (P ＞ 0.05).The intraoperative blood loss was (525.0 ± 168.2) ml in Group A,less than (770.0 ± 269.2) ml in Group B (P ＜ 0.05).Postoperative drainage volume was (190.1 ± 78.9) ml in Group A,less than (281.7 ± 122.3) ml in Group B (P ＜ 0.05).VAS score 24 hours after operation and at the last follow-up in Group A was (6.4 ± 1.0) points and (1.6 ± 0.5) points,respectively,better than those in Group B [(7.8 ± 0.7) points and (2.2 ± 0.4) points] (P ＜ 0.05).No significant differences were observed in terms of spinal canal patency at the last follow-up,percentage of postoperative injury of vertebral height recovery,and Cobb angle [Group A:(85.3 ± 3.7) ％,(85.5 ± 2.7) ％,and (4.7 ± 1.2)°;GroupB:(85.8±1.8)％,(88.8 ±1.3)％,and (5.3 ±1.5)°] (P＞0.05).In terms of MRI evaluation score of postoperative paravertebral muscle atrophy,Group A reported better results than Group B [(2.1 ± 0.6) points vs.(1.2 ± 0.6) points] (P ＜ 0.05).At the last follow-up,there were 7,5,6,1 and 1 patients in Group A,while 6,6,5,2 and 1 patients in Group B at ASIA grades A,B,C,D and E (P ＞ 0.05).Within the same group,significant difference was observed between the preoperative data and that at the last follow-up in terms of postoperative VAS score,spinal canal patency,percentage of injury of vertebral height,Cobb angle,and ASIA impairment scale (P ＜ 0.05).Conclusion For thoracolumbar fracture and dislocation,compared with traditional open approach,posterior pedicle screw fixation through Wiltse paraspinal approach can effectively restore the vertebral body height and spinal canal patency and can reduce the intraoperative bleeding,postoperative drainage,postoperative back pain,and paravertebral lesion.