Objective To compare the efficacy and resistance between S?1 combined with radiotherapy and S?1 alone in the treatment of elderly patients with locally advanced gastric cancer. Methods Fifty?eight elderly patients with unresectable locally advanced ( stage Ⅲ) gastric cancer were randomly and equally divided into S?1 combined with concurrent radiotherapy group ( experimental group ) and S?1 alone group ( control group ) . The experimental group received 4 cycles of S?1 treatment with each cycle containing two?week oral administration of S?1 at a dose of 40 mg/m2 twice a day followed by one?week drug withdrawal. Gastric intensity?modulated radiotherapy was performed concurrently with a dose of 45 Gy ( 1. 8 Gy per fraction) . The control group received the same dose of S?1 alone. Short?term outcomes and adverse reactions were evaluated in the two groups. Comparison was made by chi?square test. Results All patients completed the planning treatment. The experimental group had significantly higher objective response, disease control, and symptom remission rates than the control group ( 52% vs. 24%, P=0. 03;76% vs. 45%, P=0. 016;86% vs. 48%, P=0. 005) . There were no significant differences in the incidence of nausea and vomiting, anorexia, leukopenia, diarrhea, or thrombocytopenia between the two groups ( all P>0. 05) . Conclusions S?1 treatment combined with concurrent radiotherapy improves the short?term outcomes and causes tolerable toxicities in the treatment of elderly patients with locally advanced gastric cancer.

BACKGROUND: Microcirculation disturbance of pharynx may be one of the pathogenesis base caused recurrent attacks of chronic pharyngitis. The negative pressure can improve the microcirculation of inflammary target organs by biomechanical changes.OBJECTIVE: To explore the therapeutic effect of oral negative pressure on patients with chronic pharyngitis and nail fold microcirculation.DESIGN: A randomized single blind controlled observation.SETTING: Department of Pathophysiology of Hebei North University.PARTICIPANTS: A total of 65 patients with chronic pharyngitis and course of disease about 1-3 years admitted to Department of Neurology,First affiliated Hospital of Hebei North University from January to September 2002 were selected. They were randomly divided into treatment group (n=35) and control group (n=30), including 36 cases with chronic pharyngitis (18 cases from the treatment group, 18 cases from the control group), 29with chronic hypertrophied pharyngitis (17 cases from the treatment group,12 cases from the control group).METHODS: The Hices oral negative pressure instrument was used and the negative pressure exert equipment was put into the optimal position of the patients' mouth to keep the negative pressure of (0.05±0.01) Mpa, 10minutes once (the first therapy time was 5 minutes), once daily and the time was fixed, 5 days as a period of therapy for three periods. Patients in the control group were also given the negative pressure exerts equipment,but no negative pressure was exerted.MAIN OUTCOME MEASURES: ① Observation and evaluation of nail fold microcirculation: The nail fold microcirculation was observed by the XTL- Ⅱ microcirculation micro-television system, and the first row nail fold of the left ring figure was checked conventionally to record the state of microvessel, state of micro-bloodstream and peri-loop. The degree of microcirculatory disturbance was quantitatively analyzed according to Tian Niu's weighing integral method, the lower the scores, the better the microcirculation. ②The improvement of chronic pharyngitis after treatment of 3courses.RESULTS: Totally 65 patients with chronic pharyngitis entered the stage of result analysis. ①After 1 course of treatment, the symptoms of 1/3 of the patients in the treatment group were significantly improved; after 3 courses of treatment, except there was no obvious changes of hypertrophied morphology such as lymphatic follicle proliferation on posterior wall of throat and hypertrophy on side cable of throat, the pathological signs and prevalence of mucosa congestion were obviously lower than those before treatment and the control group (P ＜ 0.05-0.01) effective rate was 88.6%.②) Improvement of microcirculation disturbance with chronic pharyngitis was evident, restoring to basically normal from medium degree abnormality before treatment, the total score values reduced to 1.941 ±0.165 from 4.836±0.242 (P ＜ 0.01).CONCLUSION: Oral negative pressure can significantly release or eliminate the symptoms and signs of chronic pharyngitis, which may relate to improvement of microcirculation disturbance.

Establishing medical service payment system reform organization of diagnosis related groups and prospective payment system(DRGs-PPS) based on the theory of matrix management and learning organization.Firstly joint committee mechanism hasbeen established to guide the implementation of DRGs-PPS with the strong support of Beijing local government; Secondly series of related technical standards and organizational systems including AP-DRGs,AR-DRGs Group,Data Dictionary,ICD Group,International Classification of Surgical Operations Group,Pricing Classification Group,Training Group,Supervision Group,Support Group,Data Validation Group,BJ-DRGs Group have been created to support standard maintenance,project inspection and data analysis; Furthermore,learning organization has been realized by setting up various project groups and the establishment of DRGs-PPS platform help ensure performance evaluation of healtheare institutions and payment system reform.

The medical service payment system reform is one of core issues in medical and health system reform.The payment system can directly affect behavior of stakeholders and indirectly affect medical expense,quality of care,efficiency of medical services and efficiency of medical insurance funds.Through behavior analysis of stakeholders in fee for service,DRGs-PPS,global budget,DRGs-PPS is the best payment system that can control the irrational increase of medical expenses and ensure the level of health service and meets interest of stakeholders among three payment systems.In DRGs-PPS,stakeholders continuously make progress in filling in the front sheet of medical records,clinical pathway,construction of information system,cost calculation and restructure costs.

Objective:To quantitively assess the mental status of patients with severe acute respiratory syndrome(SARS) for correct diagnosis of those have serious mental crisis,providing scientific basis for the psychological intervention. Methods:The mental status in 46 SARS patients were analyzed with the Mental Status Scale in Non psychiatric Settings(MSSNS, by Department of Psychology, Second Military Medical University )and compared with that of the common pneumonia patients and the norm of common inpatients. Results:The scores of SARS patients and those of the other pneumonia patients and the norm of common inpatients had no significant difference. The psychological reactions of SARS patients were related significantly with the patient's age, marital status, occupation and the duration of fever. Conclusion:The psychological reactions of SARS patients were accordant with those of the common patients. The results indicated that the patient's personality, such as the emotional stability, was the essential impact factor on the patient's mental status. The level of negative emotional reactions in SARS patients are influenced by whether the patients are young, single, lack of medical knowledge and fever duration. So the effective psychological intervention to the SARS patients should be based on the scientific assessment and influencing factors analysis.

This article was aimed to study effects and mechanisms of Gymnema sylvestre on protein kinase B (PKB) and its phosphorylation in adipose tissues of KKAy mice which were mainly characterized by insulin resistance (IR). A total of 18 KKAy mice were randomly divided into the diabetes model (DM) group and Gymnema sylvestre (GS) group according to body weight levels. And 9 normal C57BL/6J mice were used as the normal control (NC) group. Intragastric administration of medication was given to mice for 8 weeks. At the end of the experiment, all animals were tested for fasting plasma glucose (FPG) and fasting insulin level (Fins) for evaluation of insulin sensitivity index (ISI). Expressions of phosphoinositide-dependent kinase-1 (PDK1), PKB, P-PKB (Ser473), P-PKB (Thr 308) in adi-pose tissues of epididymis were determined. The expression of phosphatase and tensin homolog (PTEN) mRNA was also determined. The results showed that compared with the DM group, the GS group showed lower FPG and Fins, higher ISI. The expression of P-PKB (Ser473) phosphorylation and P-PKB (Thr 308) were increased, and the PDK1 and PTEN mRNA were decreased. It was concluded that GS can improve insulin sensitivity of KKAy mice through activating PKB by up-regulate the expression of P- PKB (Ser473) and its phosphorylation ratio and P- PKB (Thr 308) in adipose tissues.

Nitric oxide (NO), which is involved in the regulation of the cardiovascular system, nervous system, immune system, reproductive system, digestive system and other physiological activities, is an important biological substance with activity. Under normal physiological conditions, neuronal nitric oxide synthase (nNOS) can precisely regulate the nervous system NO production, release, diffusion and inactivation processes. But an excess of NO associates with the development of cerebral ischemia, Alzheimer's and Parkinson's psychosis nervous system diseases, while inhibition of nNOS activity can regulate the content of NO in vivo, and produce a therapeutic effect on some of the nervous system diseases. This review mainly describes the structure and regulation of nNOS and recent developments of small molecule inhibitors of nNOS.

Objective:To evaluate the effect of different dietary pattern and soybean oligosac-charides supplementation on the amount and proportion of short-chain fatty acids (SCFA). Method: Twelve healthy students aged 20 to 25 years old were selected in the medical college. The study included 3 periods. In every period the students accepted different dietary patterns in 1st week [1. low animal food diet (LAFD),2. balanced food diet (BD), 3. high animal food diet (HAFD)]. Soybean oligosaccharides (5g/d) were added to different diets in 2nd week. The diet in 1st week was recovered in 3rd week. The study lasted for 9 w. Feces were collected once a week and SCFA was measured by capillary gas chromatography. Results: The total SCFA in feces were increased after taking LAFD, more prominent in acetic acid and butyric acid (P

Objective To determine the si gnificance of plasma level of B-type natriuretic peptide (BNP) in patients with congestive heart failure (CHF) for differential diagnosis of their acute dyspne aMethods Totally, 130 patients with acute dyspnea were selected, including 78 patients diagnosed as CHF with left ventricular ejection fraction less than 040 and 52 patients without CHF Plasma level of BNP was m easured by a rapid, point-of-care quantitative immunofluorescent assay Results Plasma level of BNP was(732?53)ng/L in patients wit h CHF, much higher than that in those without CHF(71?34)ng/L(P

Objective To explore the effect of enhanced physical therapy with integrated traditional and western medicine on muscularweakness after selective posterior rhizotomy. Methods 44 children with muscular weakness after selective posterior rhizotomy were dividedinto the treatment group (n=28) and the control group (n=16). Exercise therapy, physical therapy, electroacupuncture and Chinese massagewere applied to the treatment group, while exercise therapy was applied to the control group only. The muscle strength of the leg of childrenwere compared right after the surgery and 2 weeks after the surgery. Results The muscle strength of the leg of children in treatment group recoveredbetter than the control group 2 weeks after the surgery (P<0.05), and it was almost at the same level with that before surgery (P<0.05). Conclusion The enhanced physical therapy with integrated traditional and western medicine method could rapidly recover the musclestrength of the leg of children after SPR.