Purpose:To determine the efficacy and toxicity of gemcitabine plus cisplatin in anthracyclin- and taxane-pretreated patients with advanced breast cancer. Methods:Chemo-resistance was defined as no response while rece iving first-line and/or second-line chemotherapy. Patients with advanced and c hemo-resistant breast cancer, which was confirmed histologically, received gemc itabine 1,000 mg/m 2 on d1, 8 and cisplatin 25 mg/m 2 on d1-3, every 3 weeks.2 cycles were delivered at least. Results:30 female patients were enrolled in this trial. All pat ients were evaluable for response and toxicity. The median age was 46 years (ran ge, 34-58 years). After 2-4 (median, 3) cycles of chemotherapy, overall object ive response was 50.0%, with 5 CRs (Complete response 16.7%) and 10 PRs (Partial response 33.3%). Stable disease was seen in 13 patients (43.3%), and disease pr ogression in 2 patiens (6.7%). Toxicities included myelosuppression and gastroin testinal reaction mainly. Grade Ⅲ-Ⅳ toxicites developed in 50% patients. Ther e were no treat-related deaths. The median follow-up time was 12.5 (range: 2- 48) months. Median overall survival was 14 months, and median time to progressio n was 10 months. Conclusions:These data indicate that the combination of gemcita bine and cisplatin is an effective treatment for heavily pretreated breast cance r patients with manageable toxicity.

Purpose:To evaluate the effectiveness and safety of the second-line treatment in patients with advanced non small cell lung cancer(NSCLC). Methods:23 patients with histologically and /or cytologically confirmed advanced NSCLC were treated with docetaxel(taxotere) 75mg/m 2 on d1 every 3 weeks. All patients had received prior platinum-containing chemotherapy and relapsed or progressed after receiving one prior chemothergpy regimen. Results:23 patients were available for evaluation: partial response (PR) was 17% (4/23), stable disease(SD)and progressive disease(PD) was 57% (13/23) and 26% (6/23), respectively, there was no complete response (CR). The response rate was 17% (4/23) and the median survival of all patients was 9 months .one -year survival rate was 39% (9/23) . Hematologic toxicity was the main side effect, and they were well tolerated. Conclusions:Taxotere as second-line treatment of NSCLC is effective, and toxicity is tolerated.

0.05). For the toxicity,Neutropenia and anemia were common in the three regimens. Thrombocytopenia was significantly mild on the NP regimen. For the PC regimen,gastrointestinal toxicity and nephrotoxicity were mostly mild,and peripheral neurotoxicity was most common. Conclusions:Efficacy was not significantly different between the three investigated regimens. These regimens could be use as first-line chemotherapy in advanced NSCLC. Toxicities of these regimens were different,so clinicians should apply the chemotherapy according to individual characteristics of patients.

Objective To study the drug-time process of aurantiin in Rhizoma Drymariae in vivo.Methods By the optimization of the chromatographic condition,a reversed-phase HPLC was established to measure the content of aurantiin in the serum and the tissues of rats.Results After administration of total flavones of Rhizoma Drymariae to the rats by gavage,aurantiin started to be absorbed in 30 minutes and arrived at the peak in 90 minutes.The blood drug concentration decreased evidently 4 hours after gavage and maintained at a certain level in 8 hours.The drug concentration was highest in the stomach and bowels,but decreased quickly.The concentration in the liver,lungs and kidney came next and can be determined in the muscles and fat;however,it was very low or zero in the brain.Conclusion This method is convenient,sensitive,rapid and without the interference of other impurities.It is suitable for the determination of aurantiin content in the serum and tissues of rats.Administering total flavones of Rhizoma Drymariae to the rats by gavage,aurantiin is absorbed slowly and maintains for a long time and subsides slowly in the blood.

Objective: To study the mechanism of effect of total flavone of rhizoma drynariae in groups with different dosage on osteoblasts cultured in vitro. Methods: To culture osteoblasts with UMA-106-01 osteoblast strain and to observe the activity of ALP and the endosmosis of 3H-TdR. Results: The total flavone of rhizoma drynariae increased the activity of ALP in cells cultured with UMR-106-01 strain. The ALP activities correspondingly changed in the 24h, 48h and 72h, which related to dosage effect and time effect. Among them, the activity in the 48h is the most ideal one. And the amount of endosmosis of the total flavone of rhizoma drynariae to 3H-TdR increased more remarkably in the 48h than that in the 24h and it also related to the time effect. Conclusion: The total flavone of rhizoma drynariae can promote the differentiation and multiplication of osteoblasts.

Background and purpose:Neuropilin-1 (NRP1), a vascular endothelial growth factor (VEGF) receptor, plays an important role in tumor angiogenesis and tumor cell migration. The purpose of this study was to de-termine the correlation between NRP1 expression and sensitivity to ifrst-line platinum-based chemotherapy in patients with advanced non-small cell lung cancer (NSCLC), and between NRP1 expression and survival.Methods:NRP1 ex-pression in tumor tissues of 104 advanced NSCLC patients treated with ifrst-line platinum-based regimen was detected by immunohistochemisty.A chi-square test and logistic regression model were used to analyze the relationship between NRP1 expression and the chemotherapy response rate. Kaplan-Meier and Cox proportional hazard regression models were used to analyze the effect of NRP1 expression on patient survival.Results:Among the 104 patients, 56 (53.8%) had high expression of NRP1. High expression of NRP1 was not related to age, gender, histological type, degree of differentiation, performance status, and chemotherapy regimen. The chemotherapy response rate was significantly higher in patients with low NRP1 expression than in patients with high expression (43.8% vs23.2%,P=0.026). The low NRP1 expression was signiifcantly associated with longer progression-free survival (4.6 monthsvs3.0 months, P=0.001 for log-rank test,χ2=11.273) and overall survival (11.5 monthsvs9.2 months,P=0.000 for log-rank test,χ2=14.392) as compared with high NRP1 expression. Multivariate analysis showed that high expression of NRP1 was an independent predictor for the chemotherapy response rate and overall survival in patients with advanced NSCLC.Conclusion:NRP1 expression is associated with response rate and survival in advanced NSCLC patients treated with ifrst-line plati-num-based chemotherapy. NRP1 expression may be a potential biomarker for predicting chemosensitivity and prognosis in patients with advanced NSCLC.

Aged ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Humans ; Male ; Middle Aged ; Pedigree ; Vertigo ; genetics

Objective? To investigate the status and influencing factors of nurses' evidence-based nursing ability in a tertiary general hospital in Beijing. Methods? A total of 463 nurses from a tertiary hospital in Beijing were selected for research by convenience sampling method. Evidence-based nursing practice ability rating scale was used to evaluate nurses' evidence-based nursing ability, and a self-designed influencing factor questionnaire was used to investigate and analyze the influencing factors. 463 questionnaires were collected and 463 were valid. Results? The total score of 463 nurses with evidence-based nursing ability was (43.05±24.25). The average score was (1.87±1.05). The score of the evidence retrieval and evaluation ability dimension was (1.72±1.18), the score of the evidence integration ability dimension was (1.54±1.21), the score of the evidence dissemination ability dimension was (1.89±1.22), and the score of situational evaluation and evidence application dimension was (2.20±1.04). Univariate analysis showed the scores of nurses' evidence- based nursing ability were different with 10 different characteristics:initial education, final education, working years, English level, whether received evidence-based training, knowledge of evidence-based nursing, and whether considered evidence-based nursing is helpful for clinical work, considered whether it is necessary to carry out evidence-based practice projects, whether to consult the literature, whether you have tried evidence-based nursing practice, the differences were statistically significant (P＜ 0.05). Multiple linear regression analysis showed years of work, whether to consult the literature, and considered whether it is necessary to carry out evidence-based practice projects, whether you have tried evidence-based nursing practice were the factors affecting the nurse's evidence-based ability score. Conclusions? In this study, the level of evidence-based nursing ability of nurses needs to be improved. The nurses, who are with longer working years, limited literature consulting, consider no need to carry out evidence-based practice, and have no evidence-based practice experience, have lower ability in evidence-based practice. It is suggested that nursing managers should pay attention to the cultivation of evidence-based nursing ability of senior nurses, organize literature review and evidence-based nursing training to increase knowledge, create an organizational environment for evidence-based nursing to change attitudes, give full play to leadership to support evidence-based nursing behaviors of nurses, and improve their evidence-based nursing ability.

OBJECTIVETo improve the diagnosis and treatment of testicular torsion (or spermatic cord torsion), and reduce its misdiagnosis and mistreatment.

METHODSOne hundred and thirteen misdiagnosed clinical cases of testicular torsion from 1994 to 2004 were reviewed and analysed.

RESULTSThe error rate of initial diagnosis was 84.3%, among which 81 cases (71.7%) were misdiagnosed as acute epididymitis or testis, 10 (8.8%) as hydrocele of the tunica vaginalis, and 7 (6.2%) as acute enteritis. The lengths of time between the income and diagnosis of the disease varied from 2 hours to 2 months, averaging 6.3 days. Hand replacement succeeded in 3 cases, surgical examination was carried out in 92, resection of the testis or epididymis was performed in 64, testis atrophy occurred in 26, and the total testis impairment rate was 79.6%.

CONCLUSIONThe key to the reduction of misdiagnosis is to improve the diagnostic methods, which can be achieved by the combined use of case history, physical signs and color ultrasonography. Surgical examination of the scrotum is the best option for both the diagnosis and the treatment of testicular torsion.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Diagnostic Errors ; Epididymitis ; diagnosis ; Humans ; Infant ; Male ; Middle Aged ; Orchitis ; diagnosis ; Retrospective Studies ; Spermatic Cord Torsion ; diagnosis

Objective To explore the effects of application and management of the standardized training system for newly graduated registered nurses. Methods A total of 238 newly graduated nurses in Peking University First Hospital were selected by purposive sampling method. The 138 nurses who were enrolled in August 2015 were assigned into control group, adopting the traditional training program for new nurses. The 100 newly enrolled nurses in August 2016 were assigned into observation group, adopting the new standardized training program for new nurses. After training, the nurses of both groups were evaluated with the Transition Shock of Newly Graduated Nurses Scale (TSNGNS), the New Nurse Standardized Training Satisfaction Questionnaire, and the comprehensive examination paper. Results The total scores of TSNGNS, physical dimension, psychological dimension, social culture and development of nurses in the observation group were lower than those in the control group after training, and the differences were statistically significant (P＜0.01). After training, the total score and each dimension score of nurse satisfaction questionnaire in the observation group were higher than those in the control group, and the differences were statistically significant (P＜0.05). After the training, the comprehensive examination score of the nurses in the observation group was higher than that in the control group, and the difference was statistically significant (P＜ 0.01). Conclusions The implementation of the new training scheme can effectively relieve the new nurses' transition shock and improve their satisfaction and comprehensive evaluation score during training.