Objective To investigate influence of cisplatin (DDP) on the tumor inhibition rate,transcriptional levels of CyclinB1 and CyclinD1 of CNE-1 xenograft in nude mice.Methods Tumor mode of nude mice CNE-1 xenograft was established.Then mice were divided into control arm,DDP arm,high speed irradiation arm,simulated intensity modulated radiation therapy (IMRT) arm and simulated IMRT + DDP arm,with 12 mice in each arm.Irradiation dose was 20 Gy with a single fraction.DDP was 15 μg/g weight.The maximum diameter of tumor base was measured every other day.The growth curve was drawn and tumor inhibition rate werevcalculated after 40 days.The transcriptional level of CyclinB1 and CyclinD1 of xenograft was measured by RT-PCR.The results of different groups were compared with one-factor analysis of variance.Results Tumor inhibition rates of the control arm,DDP arm,high speed irradiation arm,simulated IMRT arm and simulated IMRT + DDP arm were-129.1％,-71.2％,42.5％,35.3％ and 47.1％,respectively.There was significant difference between the high speed irradiation arm and simulated IMRT arm (P =0.034),but not between the high speed irradiation arm and simulated IMRT + DDP arm (P =0.222).The transcriptional levels of CyclinB1 in the arms were 0.429,0.386,0.322,0.354 and 0.268.There were significant differences between the high speed irradiation arm and the simulated IMRT arm or the simulated IMRT + DDP arm (P =0.007 and 0.000).The transcriptional levels of CyclinD1 in the arms were 0.716,0.583,0.348,0.495 and 0.296,respectively.There was significant difference between the acute irradiation arm and the simulated IMRT arm (P =0.000),but there was no significant difference between the high speed irradiation arm and the simulated IMRT + DDP arm (P =0.072).Conclusions Irradiation of 20 Gy single fraction,or combined with DDP are effective on the CNE-1 xenograft in nude mice,but DDP alone can only lower the tumor growth speed.Irradiation of 20 Gy single fraction,or combined with DDP,or DDP alone can reduce the transcriptional levels of CyclinB1 and CyclinD1.As the single therapeutic time is prolonged in IMRT mode,the tumor inhibition rate is reduce,and the reduce of the transcriptional levels of CyclinB1 and CyclinD1 is depressed,while combined DDP can compensate the decline of the biological effect.

Objective To discuss the nursing care for patients with advanced hepatocellular carcinoma (HCC) who are receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib. Methods A total of 23 consecutive patients with advanced HCC who met the inclusion criteria were enrolled in this study. TACE was carried out in all patients. Three-five days after TACE the patients started to orally take sorafenib. During the treatment course, the patients were kept under close observation for adverse reactions and complications. After leaving the hospital the patients were followed up by the extended care team members, and health education as well as appropriate nursing intervention was carried out. Results All patients with advanced HCC took sorafenib orally after TACE. The major adverse events and complications were gastrointestinal adverse reactions (n = 22) and transient liver dysfunction (n = 23). After leaving the hospital all the patients received regular follow- up examination and extended nursing care. Conclusion Usually, the incidence of adverse reactions is higher in patients with advanced HCC after TACE combined with sorafenib treatment. Careful in-hospital observation and extended out-hospital nursing can reduce the incidence of adverse reactions and thus improve the patient’s quality of life.

Objective To evaluate the effect of community management of diabetic patients with hypertension in Beijing Cuigezhuang community in last three years.Methods A community diabetic management program was started from 2007 in Beijing Cuigezhuang community.Three hundred and seventy six patients who participated in the program for more than 3 years were enrolled in the study, including 196 with type 2 diabetes mellitus (T2DM) only (DM group) and 180 with T2DM and hypertension (DMH). The control rate of blood glucose, blood pressure, lipids and the comprehensive control rate were compared between two groups after 3-year intervention.Results There were no significant differences in age, gender ratio, course of diabetes, education background, monthly income and the history of stoke between two groups;while prevalence of dyslipidemia in DMH group was significantly higher than that in DM group [41.7%(75/180) vs.24.5%(48 196),χ2 =11.938,P=0.001].Compared with the baseline data, the types of antidiabetic drugs used were not significantly changed in two groups after 3-year intervention ( DM group:1.32 ±0.81 vs.1.31 ±0.93, t=-0.155, P=0.877, DMH group:1.43 ±0.72 vs.1.48 ±0.82, t=0,831, P =0.407) .The types of antihypertensive drug in DMH group were significantly decrease. (1.12 ±0.77 vs.1.25 ±0.45, t=2.484, P=0.014), while the rate of statins usage in DM group was significantly increased [13.3%(26/196) vs.5.1%(10/196),χ2 =7.830, P=0.005].The hemoglobin A1c (HbA1c) levels in DM group was decreased [(7.4 ±1.5)% vs.(7.8 ±2.1)%, t=2.586, P=0.011].The systolic pressure [(129 ±12) mmHg (1 mmHg=0.133 kPa) vs.(133 ±16) mmHg, t=3.503, P=0.001] and the diastolic pressure [(80 ±8) mmHg ratio (82 ±10) mmHg, t=2.436, P=0.016] in DMH group were significantly declined. The average LDL-C level [ DM group: ( 3.0 ± 0.9) mmol/L vs.(3.2 ±1.0) mmol/L, t =2.165, P=0.032; DMH group (2.9 ±1.0) mmol/L vs. (3.2 ±1.1) mmol/L, t=3.210, P=0.002] were also significantly decrease.Compared with the baseline, the comprehensive control rates of blood glucose, blood pressure and lipid level were increased in both groups [DM group:9.7% (19/196) vs.6.1%(12/196),χ2 =1.716, P=0.190, DMH group 13.9%(25/180) vs.5.0%(9/180),χ2 =8.315, P =0.004] .Conclusions The community management program is effective for improvement of comprehensive control rates of blood glucose, blood pressure and blood lipids in diabetic patients with hypertension in Beijing Cuigezhuang community.