Background and purpose:The majority of patients with gastric cancer are in advanced stage with either extensive invasion of tumor into the adjacent organs,lymph nodes or distant metastases when diagnosed.As a new anticancer drug of Taxanes,docetaxel has shown considerable promise in advanced gastric cancer through clinical study in these years.We conducted a clinical trial to compare the response and toxic reaction of weekly and 3-weeks'docetaxel /cisplatin/5-Fu treatment in advanced gastric cancer.Methods:80 patients were deviede into two groups.Ggroup A:Docetaxel 25 mg/m2 iv d 1,8,15,cisplatin 25 mg/m2 iv d 1-3,5-FU 500 mg/m2 iv d 1-5 q4w.Group B:Docetaxel 75 mg/m2 iv d 1,cisplatin 25 mg/m2 iv d 1-3,5-FU 500 mg/m2 iv d 1-5 q3w;The clinical responses were assessed after two cycles.Toxicity was assessed every cycle.Results:There was 1 CR in 40 cases,16 with PR,14 with SD in group A;there was 1 CR in 40 cases,17 with PR,14 with SD in group B.The overall response rates were 42.4% and 45.0% in group A and B,respectively.Grade Ⅲ/Ⅳ neatropenia were 32.5% and 77.5% in group A and B.The major non-hematologic toxicity was weakness.Grade Ⅲ/Ⅳ weakness were 22.5% and 42.5% in group A and B.Conclusions:The response rates were similar between groups A and B.The occurrence of hematological toxicity and weakness were lower in weekly treatment group.

OBJECTIVE:To control scientifically the limits of stock drugs in Hospital.METHODS:The method of setting the upper and lower limit of stored drugs through Hospital Information System(HIS)and the influencing factors were discussed by taking the outpatient pharmacy of our hospital as an example.RESULTS&CONCLUSION:Working out scientific and reasonable upper and lower limit for stock drugs is helpful for the improvement of the management quality of hospital pharmacy.

OBJECTIVE:To improve hospital's drug control level.METHODS:Quantized medicine provision management aims like stock limit,conformity rate of object-account of single category,medicine loss,mistake rate of recipe preparation,etc.were made and enforced.RESULTS:Through the above aims,medicine stock has been reduced effectively;the conformity rate of object-account has been increased;the medicine loss and incidences of mistakes in recipe preparation have been decreased.CONCLUSION:Working out feasible medicine provision management aims is an effective way to strengthen drug control.

Objective To explore the relationship of red blood cell distribution width (RDW) with severity and prognosis in children with sepsis. Methods The RDW, clinical features and prognosis of 494 sepsis children were retrospectively ana-lyzed. Results The RDW was increased in 305 sepsis children (61.74%) among whom 49.30%in sepsis group, 60.27%in sever sepsis group and 83.46%in septic shock group. The difference was signiifcant (P<0.001). The mortality of RDW increased children among three groups was 1.89%, 20.45%, 67.57%, and it was signiifcantly different (P<0.001). The rates of increased RDW was 56.15%in 374 survived cases and 79.17%in 120 died cases, and the difference was signiifcant (P<0.001). Pediatric critical illness score (PCIS) was negatively correlated with RDW (P<0.001), while mortality was positively correlated with RDW (P<0.001). Conclusions The rate of increased RDW is high in children with severe sepsis and septic shock and the level of RDW is closely related to the prognosis of patients.

ObjectiveTo assess the reliability and validity of Chinese version of tools in measuring yangsheng.MethodsChinese version of tools in measuring yangsheng was administered to 706 elderly citizens and evaluated for the reliability and validity.ResultsThe fittingness of the both exiting model were unidentified.A model of six factors and twenty-six items was determined using exploratory factor analysis.The fitness of such model was perfect ( RMSEA =0.050,AGFI =0.871,GFI =0.902,NFI =0.903,CFI =0.953 ) and all the construct reliability were more than 0.6 while the average variance extracted were higher than 0.5 except the diet yangsheng factor.The Cronbach's α of Chinese version of tools in measuring yangsheng was 0.918 and Cronbach's α of factors were all above 0.7.ConclusionThe Chinese version of tools in measuring yangsheng appears to have good validity and reliability to estimate the Yangsheng of elderly citizens in China.

ObjectiveTo investigate the social and family support in the recrudescent schizophrenia. MethodsThe Social Support Scale and The Family Environment Scale were adopted in the 71 patients with recrudescent schizophrenia. Other 49 non-recrudescent patients were adopted as control. ResultsAs compared with controls, the scores of recrudescent schizophrenia in external support, social support, familiarity and expressiveness were obviously lower, while the scores of the conflict and the control were higher. Logistic regression showed the familiarity was the protective factor, while conflict and control were risk factors of recrudescence. ConclusionThe patients with recrudescent schizophrenia get lower social and family support which might play an important role in the recrudesce of the schizophrenia.

OBJECTIVE To study the influence of focused ultrasound on the morphology of nasal mucosa in sheep. METHODS A model CZB ultrasound therapeutic system for rhinitis, developed and produced by Chongqing Haifu(HIFU)Technology Co.,Ltd.,Chongqing China,was used in this study. Linear scans were performed on bovine liver in vitro under different scan parameters, and the biologic focal field(BFF)was detected to evaluate if it met the requirements of designed. The nasal mucosa of inferior turbinate of sheep was exposed with the same scan parameters under the observation of nasal endoscope, and morphological changes of the nasal mucosa were observed by gross examination, light and electron microscopes. RESULTS This study revealed that the designed biological focal field in bovine liver in vitro could be obtained under the scan parameters mentioned above. Linear scan with the same condition,there was no obvious change in appearance and color of the treated nasal mucosa in the inferior turbinate of the sheep. However,3 days after treatment,there was an increased secretion in the nasal cavity,which recovered 7 days post-treatment. Light microscopic examination 3 days after exposure showed that the epithelia of the nasal mucosa was intact and there was diffused distribution of spot coagulated necroses in the subepithelia layer of treated nasal mucosa. Degeneration of vascular endothelial cells and thrombosis of blood vessels were found in the coagulated necrosis region. Besides,degeneration or necrosis of nerve cells was induced,and glandular cells werepartially or completely damaged. The structure of epithelial goblet cells and ciliated cells in the treated nasal mucosa appeared to be normal under the observation of electronic microscope. At the seventh day after treatment,signs of tissue regeneration such as hyperplasia of collagen fiber were found in the coagulated region,and the necrosis tissue began to dissolve and was absorbed at the 14th day post-treatment. CONCLUSION Under the above scan parameters,the energy of focused ultrasound could be deposited specifically at the subepithelia layer,and to ablate the targeted nasal mucous tissues which are rich in blood vessels,nerves and glands. There were no damage to the non-target area such as epithelial layer,which could maintain the normal structure and biological function of mucociliary of nasal mucosa.

Objective To explore the diagnostic value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in diagnosis of different pathological types of lung cancer.Methods 45 patients were performed traditional MR and multi-b value DWI scan by GE discovery 750 MR.The values of Slow-ADC,Fast-ADC and ffast measured on a AW4.5 workstation were analyzed between the different pathological types of lung cancers.The correlations between these IVIM-DWI parameters and the serum tumor markers of lung cancer were analyzed.The diagnostic efficiency of these parameters were evaluated by receiver operator characteristic curve (ROC).Results 27 cases NSCLC(13 cases squamous carcinoma;14 cases adenocarcinoma )and 18 cases SCLC were finally included in this study.There were significant differences in Slow-ADC values between SCLC group and NSCLC group (P =0.00),the adenocarcinoma group (P=0.03),the squamous carcinoma group(P=0.01).There were no significant difference in Fast-ADC as well as ffast value between any two groups.The AUC of Slow-ADC value was 0.874.There existed negative correlation between squamous cell carcinoma antigen(SCC-Ag)of squamous carcinoma group and Slow-ADC(r=-0.730).Conclusion The Slow-ADC of IVIM-DWI parameters is useful in differential diagnosis of NSCLC and SCLC,which has the largest diagnostic efficiency.The correlation between SCC-Ag and Slow-ADC value has a certain meaning in diagnosing different pathological types of lung cancers.

Objective To explore the relationship between serum albumin (ALB) combined with red blood cell distribution width (RDW) in progression and prognosis of children with heart failure. Method A total of 144 children with heart failure were divided into light, medium, and heavy group according to the modified ROSS score; another aspect, they also were divided into survival group and death group. ALB, RDW, and modified ROSS score were measured to assess the relationship between the factors and the death by logistic regression analysis. Results There are 73 boys and 71 girls. The cases of mild, moderate, and severe group were 78, 39, and 27, respectively. Age and gender difference in three groups were not statistically significant (P>0.05). The ratio of high RDW was 54.86% (79/144), the ratio of low serum ALB was 33.33% (48/144). Chi-square analysis indicated that a severer status of the disease correlated with a lower ALB level (P <0.05) and a higher RDW. The analysis of rank correlation indicating the degree of heart failure was negatively correlated with the related trends of ALB and RDW (P<0.05). Logistic regression analysis indicating a higher risk of death of the disease correlated with a lower ALB level (P<0.05, OR=0.839)and a higher modified ROSS score(P<0.05,OR=1.324).Conclusions The ALB,RDW,and the modified ROSS score are closely related to the severity in heart failure children. The ALB and the modified ROSS score have important clinical prognostic significance in evaluating the prognosis.

Tacrolimus (FK506) is a 23-membered macrolide with immunosuppressant activity that is widely used clinically for treating the rejection after organ transplantation. The research on tacrolimus production was mainly focused on biosynthesis methods, within which there are still some bottlenecks. This review summarizes the progress made in tacrolimus biosynthesis via modification of metabolic pathways and control of fermentation process, with the hope to address the technical bottlenecks for tacrolimus biosynthesis and improve tacrolimus production by fermentation engineering and metabolic engineering.
Tacrolimus ; Immunosuppressive Agents ; Fermentation ; Macrolides ; Anti-Bacterial Agents