Objective:To observe the efficacy and safety of Qingpeng ointment in the prevention and treatment of chemotherapeutic phlebitis. Methods:Totally 72 patients with non-small cell lung cancer undergoing chemotherapy after pneumonectomy were randomly divided into control and observation groups. The control group was treated with the conventional therapy to prevent phlebitis, and on the basis of conrentional therapy the observation group was treated with Qingpeng ointment at the injection site and along with the vein be-fore the chemotherapy, at the beginning of the chemotherapy, during the chemotherapy and after the chemotherapy in the same day and on the next day. The treatment course was 3 days. The incidence of phlebitis, hierarchical cases, VAS score and pain duration between the groups were compared, and the adverse drug reactions were observed. Results:The pain degree and duration induced by phlebitis showed no significant differences between the groups(P>0. 05), while the pain degree and duration in the observation group were de-creased when compared with those in the control group. The incidence of phlebitis in the observation group was obviously lower than that in the control group with statistically significant difference (P <0. 05). No adverse reactions were found with the external use of Qingpeng ointment. Conclusion:Qingpeng ointment has certain efficacy with high safety in the prevention of tumor-chemotherapeutic phlebitis, which can improve patients’ compliance, and is worthy of promoted application in clinics.

Objective To compare the therapeutic efficacies and toxicities either of pemetrexed or paclitaxel combined with oxaliplatin as a chemotherapy in postoperative with non‐small‐cell lung cancer(NSCLC) .Methods The clinical data collected from 86 patients who admitted into the first affiliated hospital of Kunming medical university from January 2010 to December 2011 who had been diagnosed with non‐small‐cell lung cancer(NSCLC) were retrospectively analyzed .All of these patients received the radical resection of pulmonary carcinoma ,in which 65 patients received pemetrexed combined with oxaliplatin treatment(named as peme‐trexed combination group) .Another 40 patients were treated with paclitaxel combined with oxaliplatin (named as paclitaxel combi‐nation group) .Survival analysis was evaluated by Kaplan‐Merie .Single factor analysis and COX regression model were employed to analyze the relationship between the influencing factors and the prognosis of disease .Results We found that neither OS (χ2 =0 .648 ,P=0 .421) nor PFS(χ2 =0 .758 ,P=0 .384)was statistical different between two groups .However ,the incidence of leucope‐nia above Ⅲ degrees was 34 .8% in pemetrexed combination group ,and 60 .0% in paclitaxel combination group(χ2 = 5 .469 ,P=0 .019) .The incidence of of ALT increase above Ⅲ degrees was 12 .2% in pemetrexed combination group ,and 35 .0% in paclitaxel combination group(χ2 =7 .238 ,P=0 .007) .The incidence of AST increase rate above Ⅲ degrees was 13 .0% in pemetrexed combi‐nation group and 32 .5% in paclitaxel combination group(χ2 = 4 .706 ,P= 0 .030) .The incidence of neurotoxicity was 28 .2% in pemetrexed combined group ,65 .0% in paclitaxel combined group (χ2 = 11 .652 ,P= 11 .652) .The incidence of gastrointestinal tract reaction above Ⅲ degrees was 47 .8% in pemetrexed combined group ,57 .5% in paclitaxel combined group was ,(χ2 = 0 .803 , P=0 .370) .Cox regression analysis revealed that PS score(HR=0 .207 ,95% CI:0 .090-0 .479) and clinical stages(HR=0 .089 , 95% CI:0 .041-0 .191) had significant effects on survival of patients .Conclusion Two kinds of treatment in two groups showed the similar curative effects and promised to be first‐line chemotherapy strategy for postoperative patients with NSCLC .However , the pemetrexed combined group showed less drug toxicity compared with that of the paclitaxel combined group .

Objective By comparing the change of expression of AQP1 in vitro lung preserved by the continuous infusion of a heart‐lung machine ,continuous pressure perfusion and single low temperature ,to explore the best method of vitro lung preserva‐tion .Methods Thirty Mongrel dogs were randomly divided into 3 groups ,and both lungs were completely resected under the condi‐tion of keeping mechanical ventilation .The vitro lungs were preserved by the way of the continuous infusion of a heart‐lung ma‐chine ,continuous pressure perfusion and single low temperature ,and collecting specimens according to the time point .HE staining was used to observe the morphological changes of vitro lung tissue .Immunohistochemistry and Western blot were used to detect the expression of AQP1 in vitro lung .Results HE staining found that as the time went by alveolar structure gradually collapsed ,in‐flammatory cells increased ,alveolar interval also gradually broadened and exudation could be seen in the alveolar cavity ;at the same time point ,organization structure of extracorporeal circulation group changed lighter than pressure perfusion group and low‐temper‐ature preservation group .In each experimental group ,the expression of AQP1 showed a trend of decline;at each time point ,the ex‐pression of AQP1 in extracorporeal circulation group was higher than pressure perfusion group ,and pressure infusion group was higher than that of low‐temperature preservation group .Conclusion The protective effect of the continuous infusion of a heart‐lung machine on vitro lung was better than continuous pressure perfusion and single low temperature .

Objective To evaluate the clinical value of transesophageal echocardiography (TEE) on minimally invasive surgical closure of heart septal defects. Methods Thirty-four patients with atrial septal defect (ASD) and 38 patients with ventricular septal defect(VSD) were selected by transthoracic echocardiography (TTE) prepared for minimally invasive surgical closure. TEE was performed to choose appropriate occluder and guide occluder release during the procedure. The immediate closure effect also evaluated by using TEE. A week follow-up was done by using TTE. Results Successful occlusion was in 32 patients with ASD and 29 patients with VSD. On 1 week follow-up,neither displacement for the occluders nor residual shunt except minimal residual shunt in 3 patients. The ventrieular remodeling was improved, the valvular regurgitation and pulmonary arterial pressure decreased. Conclusions TEE is important in minimally invasive surgical closure of atrial, ventricular septal defects, especially in choosing the candidate for the procedure and occluder, guiding occluder released and evaluating the procedure.

Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography(RT-3D-TEE)in cardiac valvular diseases.Methods Preoperative and postoperative RT-3D-TEE studies were performed in 32 patients who had undertaken cardiac valve repair or valvular replacement using Philips iE33 with X7-2 probe,and quantitative analysed the mitral structure in cases of mitral valve prolapse by using online QLAB7.0 quantitative analysis software.Results RT-3D-TEE can demonstrate the anatomicsl structure clearly,evaluate the function of cardiac valves precisely,and reveal details of type,position and extent of lesions vividly in surgical view.RT-3D-TEE helped correct misdiagnose in 2 cases,revised surgical plans in 3 cases,and guided implementation of remedial surgery in 1 case.Conclusions RT-3D-TEE can present images lively,and it can provide adequate information for preoperative diagnosis,aid the formulation of surgical plan and evaluate surgical effect.

Objective To explore the association of lipid metabolism and bomocysteine with hypertensive disorders in pregnancy and observe the inflammatory reaction and the pathological change of placenta.Methods We conducted a prospective randomized placebo-controlled study.Seventy-four cases with hypertensive disorders in pregnancy were recruited as the experimental group and 77 cases of normal pregnant women were recruited as matched control group from Aug.2008 to Mar.2010.The relationship between lipid metabolism and homocysteine was analyzed.Results There was significant difference between the two groups in body-mass index before pregnancy(29.03±4.52 vs.23.99±5.90,t =5.88),cholesterol[(6.16±1.48)mmol/L vs.(5.01±1.05) mmmol/L,t =5.52],low density lipoprotein[(3.46±1.35) mmol/L vs.(2.26±0.86) mmol/L,t =6.54]and C-reactive protein[(29.04±14.90) mmol/L vs.(15.48±4.57) mmol/L,t =7.62](P ＜ 0.05).No significant difference was found on triglycerides[(3.29±1.03) mmol/L vs.(3.49±1.37) mmol/L],high density lipoprotein[(1.84±0.40) mmol/L vs.(1.88±0.35) mmol/L],homocysteine [(8.77±2.65) mmol/L vs.(8.40±2.03) mmol/L]and neonatal weight[(3547±519)g vs.(3431±461)g](P ＞ 0.05).Significant difference exists in placenta pathology of infarction(54.55％ vs.31.04％),villi dysplasia,fit nodules form and hypoxia(65.46％ vs.39.66％)(P ＜0.05).Conclusion We should detect lipid,homocysteine and C-reactive protein by dynamic combinational ways,pay more attention to women with high BMI before pregnancy,and value placenta pathology research on hypertensive disorders in pregnant women.This has high clinical significance in revealing the etiology of hypertensive disorders in pregnant women and improving pregnant outcomes.

Objective To search the literature of randomized controlled trials on the treatment of anterior vaginal wall prolapse with adjuvant materials and compare the efficacy and safety of anterior vaginal wall prolapse repair with and without adjuvant materials.Methods Searches were made in the databases of Pubmed,Embase and Ovid for randomized controlled trials from 1980 to 2012 on the treatment of anterior vaginal wall prolapse with adjuvant materials.Comprehensive meta-analyses were conducted with Revman 5.1 analysis software to compare vaginal wall anatomy failure rate,operative duration,intraoperative bleeding volume,postoperative visceral injury,pelvic pain,urinary infection,material exposure,material erosion,de novo urinary incontinence and de novo dyspareunia in the adjuvant materials repair and repair without adjuvant materials groups.Results A total of 20 randomized controlled trials including 2313 participants were retrieved.The shortest average follow-up period was 3 months and the longest 36 months.Compared with repair without adjuvant materials,the application of adjuvant materials in anterior vaginal wall repair reduced vaginal front wall prolapse anatomy failure rate lower anatomy failure rate,had a longer operating duration,more peri-operative bleeding and lower urinary tract infection rate.The comprehensive effects were as follows:P＜0.01,RR =0.51,95％CI:0.41-0.64;P ＜0.01,weighted mean differenece (WMD) =16.25,95％ CI:8.07-24.43;P =0.01,WMD =35.00,95％ CI:6.90-63.11 ;P =0.03,RR =0.51,95％ CI:0.28-0.93,respectively,but the comparison of two groups around in visceral injury,postoperative pain,de novo stress urinary incontinence and de novo dyspareunia had no significant differences (P =0.07,0.58,0.54 and 0.67) and the average materiale exposure and rosion rate were 4.37％ (27/618) and 7.69％ (24/312) respectively.Conclusions The application of adjuvant materials in anterior vaginal wall repair can improve the postoperative recurrence.But no obvious differences exist in the incidence of complications in anterior repair with adjuvant materials and repair without adjuvant materials.

Objective To explore the clinical significance of Slug expression in papillary thyroid carci-noma(PTC). Methods Employed Ventana immunohistochemistry assay to determine the expression of Slug in 107 cases of PTC and para-tumorous normal tissue. The relationship with Slug expression in PTC and clinico-pathology data were also analyzed. Results Expression of Slug in PTC (65.4%, 70/107)and para-tumorous nor-mal tissue (14.0%,15/107)were statistically different (P < 0.001). Overexpression of Slug in PTC was signifi-cantly associated with capsular invasion and lymph node metastasis (P < 0.05). Conclusion Overexpression of Slug in PTC is associated with capsular invasion and lymph node metastasis , these may suggest some clinical significance of Slug expression in PTC in predicting lymph node metastasis and prognosis.

Objective To investigate the role of PPAR-γ in the gene expression of T-bet/GATA-3 in Jurkat T cells,and to explore the mechanisms underling this sensitizing effect of the change of TH cell subpopulation group.Methods Jurkat T cells were stimulated with PPAR-γ agonist pioglitazone.TH cell related cytokine IFN-γ and IL-10 was detected by ELISA,and the expression of transcription factors(T-bet and GATA-3)mRNA was detected by RT-PCR.To prove the PPAR-γ-dependent effect.the PPAR-γ-specific antagonist GW9662 was used.Results Stimulated with agonist PPAR-γpioglitazone.the concentration of IFN-γ and IL-10 and the expression of transcription factor T-bet and GATA-3 mRNA were both significantlY decreased in Jurkat T cells obviously,and these actions were dependent on the time and the concentrations of pioglitazone.Added with antagonist GW9662 at the same time,such inhibitory actions of IFN-γ and T-bet expression were recovered.but not IL-10 and GATA-3.Conclusion Pioglitazone can inhibite T cells proliferation and their secretion of cytokines.Pioglitazone can inhibit TH1 cells from secreting cytokines,and it is a PPAR-γ-dependent effect related to T-bet.The inhibition on TH2 is not a PPAR-γ-dependent effect and it is GATA-3 related.

Objective To determine the genetic background and evolutional route of macrolideresistance Streptococcus pneumoniae(MRSP)strains in Shanghai.Methods Forty-seven MRSP clinical isolates were genotyped by pulse field gel electrophoresis(PFGE)to detect the donal relationship of therm.Serotyping and muhilocus sequence typing(MIST)on 6 multi-resistant strains wag used to investigate the evolutional relationship between serum types and international epidemic strain among MRSP strains in Shanghai.Results There were 2 epidemical clones(type A 45%,type B 17%)in MRSP clinical isolates containing both the ermB and the mefE genes in Shanghai.MIST analysis showed that all 6 multi-resistant strains whose PFGE pattern was A type belonging to Asia clonal complex-CC236(Taiwan19F-14 clone).There was a novel ST-ST2116,which might derived from CC236 due to the recombination with alldic change.Conclusion,The high prevalence of erythromycin-resistant Streptococcus pneumoniae containing both the ermB and the mere genes in Shanghai is partly due to the clonal spread of a few mtdtidrng-resistant clones.