Objective: To compare the efficacy and safety of different administration of pamidronate for relieving bone pain and to improve the living quality in Chinese patients with painful bone metastases due to lung cancer. Methods:96 patients with painful bone metastases due to lung cancer were randomly enrolled to group A (150 mg) or group B (90 mg). There were 53 patients receiving 150 mg of pamidronate(34 pts for 2 days and 19 patients for 5 days administration). 43 (patients) receiving 90 mg of pamidronate. Results:There were 84.9% of patients relieving bone pain in group A and (67.4%) in group B (P=0.043). The score measuring bone pain decreased from 6.47?1.45 to (3.28?)1.71 in group A and from 6.21?1.49 to 3.49?2.88 in group B after injection of pamidronate , and the mean duration for pain relief were 28.00 days and 21.00 days respectively(P

Raltitrexed is a specific inhibitor of thymidylate synthase,and has been confirmed that ralti-trexed has no cross tolerance with 5-fluorouracil.Studies have shown that raltitrexed-based combination chemo-therapy has a beneficial effect on the treatment of advanced gastric cancer,and well tolerance,which is worthy of clinical use.

Objective To know the advantages and disadvantages of problem-based learning from students'angle. Methods Interviewed 15 students by PBL scale and face to face interview,to know their ideas about problem-based learning,and then analyzed the results. Results PBL contributed to developing problem-solving skills,self-directed learning,team collaboration and extending professional knowl-edge. But it failed to show positive effect on students'learning motivation. Conclusions PBL has two sides on the outcomes of learning. Implementing PBL appropriately could gain the optimal effects.

Objective To detect and analyze nuclear factor kappa B (NF-κB),Helicobacter pylori (HP),Helicobacter pylori cytotoxin associated protein A (CagA),platelet (PLT) and platelet associated IgG (PA IgG) in 224 patients with idiopathic thrombocytopenic purpur(ITP) from three urban hospitals of Shaoxing,in order to explore the role of NF-κB and CagA in the pathogenesis of ITP,then to improve the prognosis of ITP.Methods SABC method was used to detect the NF-κB,13C breath test for the determination of the Hp infection.CagA and PA-IgG were tested by enzyme linked immunosorbent assay.Automatic blood cell analyzer was used to measure PLT.According to the test results,the patients were divided into Hp+cagA+NF-κB+,Hp+cagA+NF-κB-,Hp+cagA-NF-κB+,Hp+cagA-NF-κB-,Hp-NF-κB+,Hp-NF-κB-PLT groups,and PA-IgG,PLT of the six groups were statistically analyzed.Results Of 224 cases with ITP,175 cases of HP positive,the positive rate was 78.13%.CagA+ 91 cases in 175 cases of Hp+,accounting for 52%,overall 43.63%.NF-kappa B+ 108 cases,the positive rate was 46.21%,78 cases were found in Hp+cagA+,accounting for 85.71% in cagA+.In 84 cases of Hp+cagA-,there were 21 cases NF-κB+,the positive rate was 25%.In 49 of HP-,9 cases with NF-kappa B+,accounting for 18.37%.PLT and PA-IgG were compared among the groups.The count of PLT of group Hp+,group Hp+cagA+ and group NF-κB+ was lower than group Hp-,group Hp+cagA- and group NF-κB-.However,the level of PA-IgG of group Hp+,group Hp+cagA+ and group NF-κB+ was higher than group Hp-,group Hp+cagA- and group NF-κB-,the difference was statistically significant(P<0.05).Conclusion CagA maybe directly or through the activation of NF-kappa B take part in the immune response of ITP,cause PA-IgG increased and thrombocytopenia.

Objective To observe the k-ras mutation rate of colorectal cancer in China, and assess the effect and toxicity in advanced colorectal cancer (CRC) patients (pts) receiving chemotherapy combined with monoclonal antibody against Epidermal Growth Factor Receptor (EGFR). Methods The k-ras mutation of 139 samples collected from our hospital were tested by pyrophosphoric acid sequencing. Twenty-three advanced colorectal cancer patients were treated with chemotherapy combined with anti-EGFR monoclonal antibody, including 3 initial treated and 20 retreated. In the total 23 patients, 18 were treated with cetuximab and chemotherapy, and S were treated with nimotuzumab and chemotherapy. Cetuximab was taken with 400 mg/m2 first time, and then 250 mg/m2 every week. Nimotuzumab was taken with 400 mg first time, and then 200 mg every week. Eight patients of the total 23 received anti-EGFR monoclonal antibody combined with irinotecan, 12 with FOLFIRI, 3 with FOLFOX4. Results k-ras mutation type (mt) was detected in 39.6 % (55/139) of pts, k-ras wild type (wt) was 60.4 % (94/139). In 22 effect evaluable patients, 5 received PR and 9 SD, and RR and DCR were 22.7 % and 63.6 %, respectively. TTP was 124 days. Thirteen of the 22 patients tested k-ras mutation, of the 11 k-ras mt pts, 4 received PR, 4 SD and 3 PD. Two patients of k-ras mt received PD after 2 cycles treatment. Acneform eruptions were observed in 15 patients of 18 pts who received cetuximab and paronychia in 3 pts. Eruption or paronychia was not observed in all patients who received nimotuzumab. Grade 3 hypersensitivity were occured in 2 patients with cetuximab, and one of them alternated nimotuzumab in next cycle didn't get hypersensitivity any more. Conclusion The mutation rate of k-ras in Chinese colorectal cancer patients was similar with westerners. The effect of cetuximab combined with chemotherapy on advanced colorectal cancer was reliable. Nimotuzumab combined with chemotherapy worth to be studied further because of the promising effect and mild toxicity.

Objective To study the technology and the result of dual plane breast augmentation using nipple margin vertical incision of areola.Methods Totally 60 cases of augmentation mammaplasty were involved in this study.The nipple margin vertical incision of areola was applied obliquely into the breast through the pectoralis major fascia.The rib starting point of pectoralis major were cut off,medial to the side of the sternum.Under the pectoralis major the cavity was peeled according to the preoperative design range.Based on the different situation of the breast types Ⅰ,Ⅱ,Ⅲ,dual plane breast augmentations were stripped respectively.After implanting the breast prosthesis,the upper part of the prosthesis was under the pectoralis major and the lower part was under the mammary gland.Results The 60 patients were all after childbearing,20 of whom underwent type 2 dual plane breast augmentation,4 underwent type 3 double plane and the rest underwent type 1 double plane.After 3 months to 2 years follow-up,all cases got satisfactory results,except 1 case of postoperative hematoma and 1 case appeared capsular contracture.Conclusions The nipple margin vertical incision of areola can complete types Ⅰ,Ⅱ,Ⅲ dual plane breast augmentation operation,at the same time it can correct mild-to-moderate mastoptosis.

Objective To evaluate the homing molecules expression of CD49d, CCRg, CD62L on T lymphocytes in AIDS patients before and after treatment with HAART. Methods The study was per-formed in 42 cases of AIDS patients and 18 cases of healthy controls. The expression of CD49d, CCR9 and CD62L on T lymphocytes in AIDS patients and healthy controls were analyzed by flow cytometry. Software BD FACSDiva was used to calculate the percentage of expression. Results The number of peripheral CD4~+ T lymphocytes in group on-HAART was significantly increased compared with group pre-HAART (P<0.01) ; the frequency of CD3~+ CD49d~+, CD3~+CCR9~+, CD3~+CD62L~+, CD3~+CD4~+, CD4~+CD49d~+,CD4~+CCR9~+, CD4~+CD62L~+, CD8~+CD49d~+, CD8~+CD62L~+T lymphocyte in group pre-HAART were statistically decreased compared with group on-HAART and controls(P<0.05) ; The frequency of CD3~+ CD8~+ T lymphocytes was significantly increased compared with group on-HAART(P<0.05) ; the frequency of CD3~+ CCR9~+, CD8~+CCR9~+, CD8~+CD62L~+ T lymphocytes in group on-HAART were significantly de-creased than controls (P<0.001). Conclusion Not only the number of T lymphocytes sub-group, but the expression rate of gut homing molecules CD49d and CCR9, lymph node homing molecule CD62L on T lym-phocytes was changed in AIDS patients : the lower expression frequency of gut homing molecules CD49d and CCR9, lymph node homing molecule CD62L. Anti-virus therapy could partially reverse the immunologic pathological phenomena. CD49d, CCR9 and CD62L may be suggested to indicate the progression of AIDS and immunologic reeonstitution after HAART.

Objective To explore the methodology of suturing the upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap to the levator aponeurosis,simulating the mechanism of fibers from the levator aponeurosis to the dermis in natural double-eyelid in blepharoplasty.Methods Pretarsal orbicularis myocutaneous flap was harvested.Dissection between the orbital septum and the levator aponeurosis was performed originating from the upper margin of the tarsi until to the levator muscle.The upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap was sutured to the levator aponeurosis.The lower skin margin to the orbital septum to the upper skin margin was sutured interruptedly.Patients with medial epicanthus were performed epicanthoplasty at the same time.Results 136 eyes in 68 patients were performed with double-eyelid blepharoplasty using this method.62 patients were followed-up for 1 month and 53 patients were followed-up for 3 months.They all reported satisfactory aesthetic results.Conclusions Double-eyelid blepharoplasty using this method accords with the physiological mechanism in natural double-eyelid.Postoperative double-eyelid is natural with little tumefaction.This method can avoid double-eyelid fold retraction and multi-fold occurrence.

Objective To observe the short-term efficacy and toxicity of HEPP regimen in treatment of refractory Non-Hodgkin's Lymphoma. Methods HEPP regimen: HCPT 8 mg/m2 iv gtt d1~ d5, VP16 100 mg/d iv gtt d1~d5, PDD 20 mg/d iv gtt d1~d5, PDN 60 mg/m2 po d1~d14. The chemotherapy was repeated every 4 weeks as a cycle.The clinical effect was evaluated after 2 cycles and toxicity was observed during every cycle. Results 25 patients were eligible for toxicity evaluation and 22 patients for clinical response evaluation. The objective response rate was 60.0 %, including three cases complete remission and ten cases partial remission. Six cases achieved stable disease and three cases progressive disease. The major toxicity was bone marrow suppression, including 24.0 % grade Ⅲ/Ⅳ leukopenia and 12.0 % grade Ⅲ/Ⅳ thrombocytopenia. The incidence of nausea/vomiting, mucositis and hepatic toxicity was low. Conclusion HEPP regimen can achieve a satisfy result in the treatment of refractory Non-Hodgkin's Lymphoma. It is low toxic and well tolerated.

AIM:To determine the contents of euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae and Semen Euphorbiae Pulveratun from different habitats.METHODS:A kromasil C_(18) column(150 mm×4.6 mm,5 μm)was used with methanol-water(68:32)as the mobile phase and UV detection was at 280 nm.RESULTS:The linear ranges of euphorbiasteroid and lathyrol diadetate benzozte were from 0.200 μg to 1.200 μg and 0.206 μg to 1.651 μg(r = 0.999 7,r = 0.999 9).The contents of euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae from different habitats ranged from 0.450 8% to 0.625 1 % and 0.692 3% to 0.752 9%.The contents of two kinds of compositions in Semen Euphorbiae Pulveratun ranged from 0.156 8% to 0.221 1% and 0.232 2% to 0.283 0%.CONCLUSION:The method for quantitating euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae is accurate and reliable,and can be used to control the quality of toxicity Semen Euphorbiae and Semen Euphorbiae Pulveratun.