Purpose:To study the clinical response and the toxic-side reactions of patients with gastric cancer treated with continuous infusion of fluorouracil (5-FU) lasting 240 hours.Methods:35 cases of gastric cancer were treated with continuous infusion of 5-FU lasting 240 hours.32 cases of gastric cancer were treated with traditional infusion of 5-FU on days 1 to 5. The clinical response and the toxic -side reactions were observed.Results:35 cases were treated with continuous infusion of 5-FU regimen with a response rate of 51.4%. 32 cases were treated with traditional infusion of 5-FU regimen with a response rate of 25.0%,thus between them,there was a significant difference in curative effects. The toxicities in traditional infusion of 5-FU group were more severe than in continuous infusion of 5-FU group. They included myelosuppression nausea et al.Conclusions:Continuous infusion of 5-FU regimen is preferable in the treatment of gastric cancer.

Objective To introduce surgical repair methods of cross-bridge transplantation of free latissimus dorsi muscular flap and free fibula for complex lower leg defect and discuss its clinical feasibility.Methods The study included 12 patients with tibial defect larger than 8 cm (range,9-12 cm) combined with soft tissue defect of 17 cm × 12 cm to 20 cm × 18 cm treated from May 2008 to May 2012.Cross-bridge transplantation of free latissimus dorsi muscular flap and free fibula was performed at the first phase.The flap pedicled with subscapular vessel was anastomosed to posterior tibial artery and vein of normal lower leg.The flap pedicled with anterior serratus muscle of distal thoracodorsal artery was anastomosed to peroneal vessel of fibular flap.External fixators were used to immobilize the bilateral lower legs postoperatively.Results All patients were followed up for 13-32 months (mean 21 months).According to Enneking system,mean leg function was scored 23 points after tandem transplantation of free latissimus dorsi muscle and free fibula,with recovery rate of 77％.Conclusions Cross-bridge transplantation of free latissimus dorsi muscular flap and free fibula tackles the problem of recipient vessel limitation.Further,the technique is effective in repair of large area of complex defect in lower legs.

Objective To investigate the effect of gravity and lung volume on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).MethodsMagnetic resonance imaging of lung perfusion was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner(GE medical system).Five sequentially coronal slices with the gap of 3cm from dorsal to ventral(labeled as P3,P6,P9,P12,P15,respeectivly)were obtained on end respiration and the relative pulmonary blood flow(rPBF)was measured.Another coronal perfusion-weighted image of P3 slice was obtained on end inspiration.Tagging efficiency of pulmonary parenchyma with IR(⊿SI%),the rPBF and area of the P3 slice were analyzed.respectively.Paired Student's t test was used for statistical analysis.Results(1)In the direction of gravity,an increase in rPBF of the gravity-dependent lung was found.rPBF of right lung from dorsal to ventral were 100.57±18.22,79.57±12.36,61.65±11.15,48.92±9.96,41.20±9.88,respectively；and that of left lung were 106.61±26.99,78.89±11.98,64.00±13.64,51.27±8.95,43.04±12.18.No statistical differences between P12 and P15,there were significant statistic differences of any other two coronal planes.But along an isogravitational plane,no statistical difference was observed.Regression coefficients of right and left lung were -4.98 and -5.16,respectively.This means the rPBF of right lung falls by 4.98 for each centimeter above the dorsal and that of left lung falls by 5.16.(2)For(⊿)SI%,rPBF and area,there were significant statistic differences at different respiratory phases(P＜0.05).(⊿)SI%,rPBF,area at expiration phase vs.inspiration phase were 1.12±0.31 vs 0.71±0.18,90.78±17.35 vs 52.85±8.75,(12.59±3.23)×103mm2 vs (17.77±4.24)×103mm2 for right lung;and 1.01±0.24 vs 0.70±0.11,91.08±18.68 vs 54.58±10.70,(12.34±3.08)×103mm2 vs(17.34±4.98)×103mm2 for left lung.Greater (⊿)SI%and increased perfusion were observed on end expiration than on end inspiration.The area was larger on end inspiration than on end expiration.ConclusionsThe FAIR is sensitive to perfusion changes in the gravity-dependent lung.Pulmonary blood flow is less in a state of high lung inflation than in a low state(inspiration vs.expiration).Positioning the patient so that the area of interest is down-gravity and breath-hold on end expiration may improve visibility of perfusion defects.

Objective:To investigate the influence of lung inflation on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).Methods:Coronal perfusion-weighted images were obtained at different respiratory phases from 10 healthy volunteers on a 1.5T whole body scanner(GE medical system)using FAIR sequence.The changes of tagging efficiency of pulmonary parenchyma(?SI %),pulmonary blood flow and area of the scanning slice of different respiratory phases were analyzed.Results:(1)Significant difference was found in ?SI% between different respiratory phases(right lung P=0.021 5,left lung P=0.008 4),with that at end expiration greater than that at end inspiration.(2)Significant difference was also found in pulmonary blood flow at different respiratory phases(right lung P=8.92?10-5,left lung P=0.000 2),with that at end expiration higher than that at end inspiration.(3)The areas of the scanning slice were also significantly different at different respiratory phases(right lung P=2.94?10-5,left lung P=0.000 5),with that at end inspiration larger than that at end expiration.Conclusion:Pulmonary blood flow during expiration is higher than that during inspiration,which might be due to the decreased lung volume and increased vascular density during expiration.

Object To investigate the effects of Heart-benefitting Recipe (HBR) on the histopathological changes of Alzheimer's disease (AD) rats after unilateral amyloid-?_ 25-35 protein (A?_ 25-35 ) injection into the amygdala. Methods The experimental rat models with dementia,spatial learning,and memory impairment were induced by unilateral amyloid ?_ 25-35 protein (A?_ 25-35 ) injection into the amygdala of rats. The spatial learning and memory ability and the function of cholinergic system were observed by the means of Morris water maze and radioligand binding assay. The protein expression of A?_ 1-40 ,AT_8 was estimated with immunohistochemistry. The expression of mRNA related to APP was observed by RT-PCR. Results HBR significantly alleviated the spatial learning and memory impairment induced by A?_ 25-35 and remarkably increased the activity of ChAT and Rt of M-receptor binding sites of these models. The expressions of A?_ 1-40 protein and APP mRNA in cortex and hippocampus of AD rats were decreased remarkably by HBR. The results of immunohistochemistry showed that the expression of hyperphosphorilated tau AT_ 8 in cortex and hippocampus of AD rats was inhibited significantly by HBR. Conclusion HBR can effectively improve the spatial learning and memory impairment,decrease the deposition of A?_ 1-40 ,and alleviate the hyperphos-phorylation of tau of AD rats induced by A?_ 25-35 .

Objective To compare the clinical effect between CO2-1aser assisted and cold instrument assisted suspension laryngoscopic surgery for vocal fold cyst.Methods From January, 2011 to December, 2014, 72 patients with vocal fold cyst, which diagnosed by strobolaryngoscopy, were randomly divided into CO2-1aser assisted group and cold instrument group.Strobolaryngoscopy, acoustic analysis and perceptual voice analyses were performed on each patient before surgery, 1 month, and 3 months after surgery, respectively.Results All operations were successfully completed.The complete vocal fold cyst resection rate of CO2-1aser assisted group was significantly higher than cold instrument group (29/36, 80.5％ vs 21/36, 58.3％, P ＜ 0.05), especially the left vocal fold cyst (13/16, 81.3％ vs 9/19, 47.4％, P ＜ 0.05).The complete right vocal fold epidermoid cyst resection rate was significantly higher than retention cyst (17/19, 89.4％ vs 11/18, 61.1％, P ＜ 0.05).Two recurrent cases were found in cold instrument group but no recurrent cases in CO2-laser assisted group (0/36, 0％ vs 2/36, 5.6％, P ＞ 0.05).Correlation analysis showed that vocal fold cyst recurrence was related to complete resection rate and has no relation with surgical methods, histopathological types and position.Subjective and objective assessment of voice quality in preoperative, 1-month postoperative and 3-month postoperative were similer between CO2-1aser assisted group and cold instrument group (P ＞ 0.05).Conclusion The CO2-laser assisted suspension laryngoscopic surgery for vocal fold cyst, can increase the surgical precision, reduce the left hand impact, improve the complete resection rate and reduce the recurrence rate.

OBJECTIVE To identify the pop strain of Staphylococcus aureus hospital acquired infection by random amplification of polymorphic DNA(RAPD),and to study the molecular mechanism of antibiotic(resistance),so as to reduce the occurrence of drug resistance and infection acquired in hospital.METHODS 1.DNA from 21 strains of S.aureus were extracted by the phenol-chloroform method and analyzed by using arbitrary(primer) polymerase chain reaction(AP-PCR).2.Amplifying mecA,GyrA and GrlA by PCR,and testing the(variation) of these genes by using Hinf Ⅰ-digested analysis.RESULTS Twenty one S.aureus strains were divided into 3(genetic) types.Type Ⅰ is the pop strain in our hospital which including 12 strains.Fourteen from 17 clinical stains were resistant to meticillin and quinolones,of which 13 strains had mecA except isolate 13064.And they all had(variation) in(GyrA) and/or GrlA.CONCLUSIONS RAPD provides markers for the typing of clinical strains and is suitable for(molecular) epidemiologic studies with high type ability,powerful discrimination,simplicity and(rapidness). Type Ⅰ is the pop S.aureus strain in hospital-acquired infection of our hospital.The majority of these strains are multi-(resistant) to meticillin,quinolones and other antibiotics.

OBJECTIVE To study the molecular mechanism of antibiotic resistance in hospital acquired(Staphylococcus) epidermidis infection,so as to reduce the occurrence of drug resistance and infection(acquired) in hospital.METHODS DNA from 18 strains of S.epidermidis were extracted by the phenol-chloroform method,and mecA,gyrA and grlA were amplified by PCR,then the variation of gyrA and grlA was tested by Hinf Ⅰ-(digested)(analysis).RESULTS Fifteen from 18 S.epidermidis strains were resistant to meticillin,and all of them had mecA gene. Eleven from 18 S.epidermidis strains were resistant to meticillin,quinolones and other(antibiotics).And they all had a mutant in gyrA and/or grlA.The mutated spots were gyrA Ser84(TCA→TTA) and GrlA Ser80(TCC→TTC).CONCLUSIONS The majority of hospital acquired S.epidermidis strains are multi-resistant to meticillin,quinolones and other antibiotics,which are caused by acquirement of drug-resistance gene or(mutation) of drug-targeting genes.Medical institutions must strictly standardize the application of antibiotics to(reduce)(development) of drug resistance.

ObjectiveTo investigate the association of phosphorylation of mammalian target protein of rapamycin (pmTOR) expression with glioma malignancy grades,and the correlation of pmTOR expression with Survivin and Ki-67,which represent tumor cell anti-apoptosis ability and reproductive activity.MethodsImmunohistochemistry EliVision method was employed to detect the expression of pmTOR,Survivin and Ki-67 in paraffin tissues from 87 patients with glioma (grade Ⅰ - Ⅱ 27 cases,grade Ⅲ24 cases and grade Ⅳ 36 cases).The association between positive expression rate,level of pmTOR and malignancy grades,and the correlation of its expression level with Survivin and Ki-67 were further evaluated.Results There was no significant difference in the positive expression rate of pmTOR among grade Ⅰ - Ⅱ(77.8％,21/27),grade Ⅲ(75.0％,18/24) and grade Ⅳ (72.2％,23/36) (P ＞ 0.05).However,the significant association between pmTOR expression level and malignancy grades was observed.The expression from 87 patients with glioma was significantly positively correlated with Survivin and Ki-67 expression level (r =0.858,P ＜ 0.01 ;r =0.708,P ＜ 0.01 ).ConclusionsThe expression level of pmTOR is associated with malignancy grades,tumor cell anti-apoptosis ability and reproductive activity.pmTOR may be served as a useful marker for predicting the biological behavior of glioma and a useful target for gene therapy.

Objective To investigate whether HSP90α could be a sensitive and specific serum biomarker for the diagnosis and progression of lung cancer. Methods In the present study, different secretomic analy-ses on the two human lung adenocarcinoma cell lines CL1-0 and CL1-5 with low and high metastatic poten-tial, respectively, were performed using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and ma-trix-assisted laser desorption/ionization time-of-flight mass spectrometry. The candidate biomarker was con-firmed by Western blotting, and was further analyzed in 224 serum samples including 141 lung cancer, 37 benign pulmonary diseases, as well as 46 healthy individuals using ELISA assay. Results HSP90α was sig-nificantly upregulated in the CM of CL1-5 cells. It was found that the levels of HSP90α were specifically ele-vated in the sera of non-small cell lung cancer compared with other groups. At the cut-off point 0.535 on the receiver operating oharacteristie curve, HSP90α could comparatively discriminate lung cancer from benign lung disease and healthy control groups with sensitivity of 0. 817, specificity 0. 919 and total accuracy 80. 14%. Conclusion HSP90α may be a potential useful serum biomarker for discriminating lung cancer from benign lung diseases and healthy individuals and staging of non-small cell lung cancer.