Objective To compare the short-term and long-term efficacy of chemotherapy with biotherapy and same chemotherapy followed by biotherapy on malignant melanoma in stage Ⅲ and Ⅳ.Methods 82 cases with malignant melanoma were treated with chemotherapy(dacarbazing,cis-platin and carmustine)or biotherapy(interleukin-2,interferon ? and dendritic cell vaccine)or biochemotherapy(chemotherapy plus biotherapy).Among them,32 cases were received biochemotherapy,26 for biotherapy and 24 for chemotherapy.Therapentic response was assessed every 3 cycles.The median time of follow up was 2 years(1-4 years).Results Response rate was 71.9% for biochemotherapy,46.2% for biotherapy and 54.2% for chemotherapy(P

Objective To establish an animal model of dog severe myocardial contusion (MC) .Methods 12 dogs with the body weight of (11 .36 ± 1 .50)kg were selected .The BIM‐Ⅱ type biological impact machine was adopted to directly impact the bare area of the left chest by the driving pressure of 800 kPa ,the impact area was 16 .61 cm2 and the chest wall was inward compressed within 4-6 cm ,the severe myocardial contusion model was established .The pathological examination was taken at 8 h after injury and grading was performed according to the Abbreviated Injury Scale (AIS ,update in 2005) .Results The scattered large area bleeding spots appeared in the epicardium and endocardium of wound area .No obvious abnormality was found in the non - wound area .The pathological examination was performed based on the coronal plane of the left ventricular cross section .The percentage of the section 8 h necrosis area to the total area was (39 .78 ± 9 .07)% .Conclusion The established dog severe myocardial contusion model is stable and reproducible ,which can accurately simulate the temporary MC mode .

Objective To detect the changes and clinical significance of the expression of anti‐GPⅡb/Ⅲa and anti‐GPⅠb/ⅠX on anti‐secreting B cells in patient with thrombocytopenia .Methods Expression of anti‐GPⅡb/Ⅲa and anti‐GPⅠb/ⅠX specific autoantibodies in thrombocytopenia were tested with (CBA) .Results There were significantly more circulating anti‐GPⅠ b/ⅠX and anti‐GPⅡb/Ⅲa antibody‐producing B cells in primary ITP(P<0 .05) for all comparisons .For diagnosing primary ITP ,the an‐ti‐GPⅠb/ⅠX had 43% sensitivity and 89% specificity ,whereas the anti‐GPⅡ b/Ⅲ a had 86% sensitivity and 83% specificity . When two tests were combined ,the sensitivity improved to 90% without a reduction in specificity .Conclusion The assay for detec‐ting anti‐GPⅠb/ⅠX is useful for identifying patients with ITP ,but its utility for diagnosing ITP is inferior to the anti‐GPⅡb/Ⅲa assay .

Abstract: The activities of four CYP450 enzymes (CYP3A, 1A2, 2El and 2C) and the mRNA expression levels of CYP1A2, 2El, 2Cll and 3A1 in rat liver were determined after Wistar rats were orally administered with brucine (BR) at three dosage levels (3, 15 and 60 mg.kg-1 per day) and the high dose of BR combined with glycyrrhetinic acid (GA, 25 mg.kg-1 per day) or liquiritin (LQ, 20 mg.kg-1 per day) for 7 consecutive days. Compared with the control, brucine caused 24.5% and 34.6% decrease of CYP3A-associated testosterone 6beta-hydroxylation (6betaTesto-OH) and CYP2C-associated tolbutamide hydroxylation (Tol-OH), respectively, and 146.1% increase of CYP2El-associated para-nitrophenol hydroxylation (PNP-OH) at the high dose level. On the other hand, (BR+GA) caused 51.4% and 33.5% decrease, respectively, of CYP2El-associated PNP-OH and CYP1A2-associated ethoxyresorufin-O-de-ethylation (EROD) as compared with the high dose of BR group. Meanwhile, (BR+LQ) caused 41.1% decrease of CYP2El-associated PNP-OH and 37.7% increase of CYP2C-associated Tol-OH. The results indicated that the co-administration of BR with GA or LQ had effect on mRNA expression and activities of the CYP450 enzymes mentioned above to some extent, and the in vivo antagonism of LQ on BR-induced CYPs adverse effects and the in vivo inhibitory action of GA on CYP2E1 and 1A2 might play an important role in the detoxification of Radix Glycyrrhizae against Strychnos nux-vomica L.

BACKGROUND:A large amount of apicocoronal and buccolingual bone resorption occur in alveolar bone after tooth extraction, leading to the distinct shortage of bone mass of alveolar bone in tooth-missing area, which has a certain effect on the stability of early implantation and postoperative aesthetic outcomes and greatly affects the long-term success rate of denture implantation. Therefore, immediate-delayed implantation can shorten the time of repair. OBJECTIVE:To evaluate the effect of implant repair after immediate-delayed implantation and application of guided bone regeneration technique in anterior maxila area. METHODS:Nineteen patients (28 teeth lost) with maxilary anterior tooth loss and labial one-waled bone defects were selected. Twenty-eight OSSTEM implants were implanted at 4 weeks after tooth extraction. Guided bone regeneration technique was applied concurrently in labial bone defect area. The secondary repair was performed after 6 months. RESULTS AND CONCLUSION:The success rate of these 28 implants was 100% at 24 months after denture implantation. The peri-implant bone height loss at 6, 12 and 24 months was 0.1, 0.6 and 0.11 mm, respectively. Red aesthetic scores were satisfactory. Immediate-delayed implantation combined with application of guided bone regeneration technique for treatment of maxilary anterior tooth loss and mild bone defect can restore the height and width of peri-implant bone and acquire stable vertical bone resorption and satisfactory gingival aesthetic outcomes .

Objective To retrospectively study the clinical features in elderly patients with epilepsy.Methods Clinical data of 72 elderly patients with epilepsy aged over 60 years from outpatients and inpatients were studied.Results In the 72 cases,cerebrovascular disease associated with epilepsy occurred in 52 cases (72.2％),with partial seizures in 50 cases (69.4％),and with generalized seizures in 22 cases (30.6％).In 38 cases with epilepsy secondary to cerebral infarction,the cerebral cortex infarction occurred in 26 cases (68.4％).In 14 cases with epilepsy secondary to cerebral hemorrhage,cerebral cortex hemorrhage occurred in 11 cases (78.6％).In interictal electroencephalogram (EEG) of the 72 cases,8 cases had normal EEG (11.1％),64 cases had abnormal EEG (88.8％).31 cases (48.4％) presented with sharp wave,spikes wave or tip--slow composite wave,33 cases (51.6％) presented with low amplitude of slow wave activity,which were non-specific abnormalities.Conclusions The main cause of seizures in the elderly is cerebrovascular disease.Partial seizures is the main type of seizure.Most of seizures caused by cerebrovascular disease occur in the region near the cortex.

Objective To detemine the value of cardiac troponin in early diagnosis of severe myocardial contusion in the dog.Methods Twelve dogs weighing (11.4 ± 1.5) kg were subjected to severe myocardial contusion by impacting the chest area with BIM-Ⅱ biological impact machine.Electrocardiogram,cTnT and cTnI were measured before,immediately,and 2,4,6 and 8 hours after injury.Animals were then killed and the serum was separated for gross examination and triphenyl tetrazolium chloride (TTC) staining.Results Supraventricular tachycardia,ventricular tachycardia,ventricular premature beat,myocardial ischemia,atrial fibrillation,and ventricular fibrillation were seen on the electrocardiogram 2,4,6 and 8 hours after the injury,which suggested a high sensitivity but low specificity.cTnT and cTnI levels revealed no specific changes at postoperative 2 and 4 hours,but cTnT and cTnl were significantly increased to (0.130 ± 0.052) ng/ml and (1.615 ± 0.371) ng/ml at postoperative 8 hours,significantly higher than that immediately after operation (P ＜ 0.01).Sensitivity and specificity of cTnT and cTnI were both 100％,while the specificity of the TTC staining was (39.78 ± 9.07)％.Conclusion Cardiac troponin is of high sensitivity and specificity in early diagnosis of severe myocardial contusion and has good correlation with pathological changes,which exhibits great potential in clinical application.

Objective:To investigate the inhibitory effect of RNA interference (RNAi) on the expression of multidrug resistance (MDR1) gene and analyze the altered sensitivities of human renal carcinoma cell line to cisplatin.Methods:Three small interfering RNA (siRNA) sequences targeted MDR1 gene were synthesized and transfected into renal carcinoma A498 cells. The expression level of MDRl mRNA was measured by RT-PCR to identify the most effective siRNA sequence. The recombinant plasmid was packed by lentivirus and transfected into A498 cells. RT-PCR was used to screen the A498 cells with the optimal silencing efficacy. The MDR1 protein expression level in the cloned cells was verified by Western blotting. The inhibitory effect of cisplatin on the proliferation of A498 cells was assessed by MTT assay and the IC_(50) value was calculated. Results:The 3 siRNA sequences suppressed MDR1 gene expression at different degrees. The siRNA 1 sequence silenced MDR1 gene more effectively with a significant reduction of 67%. The MDR1 protein expression greatly decreased in screened A498 cells compared with non-transfected cells (P<0.01), and the IC_(50) value of cisplatin on screened A498 cells was significantly decreased by 83.37% (P<0.01). Conclusion: The RNAi could effectively inhibit the expression of MDR1 gene and increase the sensibility to cisplatin in human renal carcinoma A498 cell line, which make it possible to reverse the resistance of renal carcinoma to chemotherapy.

Objective To compare clinical outcome of microvascular decompression (MVD) and percutaneous balloon compression (PBC) by using a prospective cohort study in order to provide a reliable evidence for the clinical decision-making. Methods Patients with trigeminal neuralgia hospitalized at Hangzhou First People′s Hospital in 2010 were chosen as database for cohort study. The patients were divided into MVD group (30 cases) and PBC group (30 cases). The clinical efficacy was followed by independent observers for 36 months after surgery. Chi-square test for hierarchical data, t test for quantitative data, and Kaplan-Meier plot for clinical outcomes were applied in the research. The endpoint was follow-up accomplishment or severe occurrence. Results Sixty patients were included in the research till the endpoint. The general records before surgery were almost the same with the literature records. By comparing painless period, mild and severe relapse, MVD group was superior to PBC group (P < 0.05). As for the painless survival period, MVD group was 96.7% of pain free after 1 year, 93.3% after 3 years, while PBC group was 90.0% after 1 year and 83.3% after 3 years. Regarding 3 years of follow-up, the relapse seemed occurred after 1 year in both groups. Conclusions As a curative and nondestructive procedure , MVD is more effective and has longer lasting pain free period , which should be considered as the first choice of treatment for trigeminal neuralgia in healthy people.

Objective To establish a practicable and easily mastered emergency department overcrowding (EDO) assessment system suitable for domestic ED setting by determining the validity and usefulness of the national emergency department over-crowding study (NEDOCS) tool in a 2000-bed tertiary care academic institution in China in comparison with visual analogue scale (VAS) in order to address the worldwide grave concern of EDO.Methods In a period of 6 months,data of subjective and objective EDO assessed simultaneously three times a day (1:00,9:00,17:00) were collected.The data were analyzed by using Bland-altmann method and Kappa test to determine the coincidence between VAS and NEDOCS assessments.Results The VAS-p value evaluated by physicians was significantly lower than VAS-n value evaluated by nurses [(6.49 ± 1.82) vs.(7.12 ± 1.78),P ＜ 0.01].The reliability analysis showed that Kappa value was as low as 0.112 (P ＜0.01) suggesting there was a great discrepancy between VAS-p value and VAS-n value.VAS-m (average value of VAS-p and VAS-n) was taken for comparing different evaluation systems.The significant correlation was found between the VAS-m and NEDOCS (r =0.7l4,P ＜0.01).However,the Bland-Altman plot showed the 95％ limit of coincidence was in an extensive range (-32.47 to 71.42) suggesting discrepancy existed between two methods.Conclusions The present study suggested there was a significant discrepancy between the two subjective assessments of ED crowding (VAS-p vs.VAS-n).There might be a fatal flaw existed in the assumptions of the original VAS method for EDO measurement.Using the Bland-Altman plot analysis,the results showed that NEDOCS did not authentically reflect the staff' s sense of overcrowding in the ED.It is very important and urgent to establish an objective and effective EDO evaluation system for ED management.