Objective To observe the efficacy and toxicity of 5 -Fluorouracil plus cisplatin (FP)and docetaxel plus cisplatin(DP)in the treatment of patients with metastatic esophageal cancer.Methods A total num-ber of 68 cases of metastatic esophageal cancer confirmed by histopathology and (or)cytological examination was ana-lyzed retrospectively.There were 33 cases in FP group(5 -Fu 500mg/m2 ,d1 -5;DDP 20mg/m2 ,d1 -5,28 days a cycle),and 35 cases were in DP group(DTX 75mg/m2 ,d1,DDP 20mg/m2 ,d1 -3,21 days a cycle).The evaluation of efficacy and toxicity were performed on all patients per 2 cycles.Statistics and analysis of the difference between the two groups was performed.Results For FP group,CR was in 1 case,PR ere in 12 cases,SD ere in 16 cases and PD ere in 4 cases,respectively.The corresponding value was 3,18,11 and 3 for DP group.The objective response rate (ORR)for DP group(68.57%)was significantly higher than FP group(36.39%)(χ2 =5.83,P =0.02),and the disease control rate (DCR)were similar with no significance between the two groups(P =0.71).The Ⅲ -Ⅳ degree myelotoxicity for DP group was higher than for FP group with statistical difference (χ2 =7.07,P =0.01),while the incidence of nausea,vomiting,diarrhea and liver toxicity was similar (P >0.05).Conclusion DP regimen was more effective than FP regimen for the metastatic esophageal cancer,and the patients can tolerate with the slightly higher incidence of myelotoxicity,it was worthy of further study and clinical application.

Objective To evaluate the diagnostic value of three-dimensional CT(3DCT)in atlantoaxial lesions.Methods The findings of 3DCT were analyzed and compared with conventional CT and radiography in 124 patients with atlantoaxial disease.Results 124 cases of atlantoaxial lesion included fracture in 42,atlantoaxial rotatory dislocation in 73,hypoplasia of the dens in 4,and congenital atlantoaxial deformity in 5.Among the 124 cases,89 cases were diagnosed by X-ray,109 cases by conventional CT,121 cases by MIP,122 cases by SSD,124 cases by MPR and VR.Conclusion 3DCT can find the slight rotatory dislocation,so it is the most effective means for the diagnosis of atlantoaxial rotatory dislocation.3D and MPR of spiral CT are useful in the diagnosis of atantoaxial fracture.Combining conventional CT and X-ray film with 3DCT can improve the acuracy of the diagnosis.

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Objective To investigate Enterococci resistance to glycopeptides and their genotypes. Methods MICs of antimicrobial agents to Enterococci were determined with agar dilution test and van genes were amplified with PCR. Results 298 E. faecalis and 42 E. faecium clinical isolates were collected from 13 University teaching hospitals around China. The resistant rates of E. faecalis to penicillins were 14.1%～17.8%, which was much lower than those of E.feacium. No glycopeptides resistant Enterococci strain was detected. 8 E. faecalis and 1 E. faecium were intermediate sensitive to vancomycin but sensitive to teicoplanin with MICs of 8～16 and 0.25～2 mg/L, respectively. PCR amplification of van genes gave rise to only vanC2/3 gene positive in E. faecalis B144. Conclusions Glycopeptide resistant Enterococci is not common in China and no vanA or vanB type Enterococci was detected in this study. Penicillins, vancomycin and teicoplanin could be employed in the treatment of Enterococcus faecalis infections. High attention should be paid to future development of vancomycin resistant Enterococcus (VRE) in China.

Objective To investigate the bacteriological features and the epidemiology of methicillin－ resistant Staphylococcus aureus (MRSA) in patients with impetigo, and provide evidence for selection of appropriate agents for treating impetigo and its complications. Methods Two hundred and forty－ six out- patients with impetigo were surveyed. Cultures were obtained from impetiginous lesions. Antibiotic susceptibility tests on 212 S.aureus isolates were performed by standard agar dilution testing (MIC). Results In a total of 246 isolates, 87.0％ yielded S.aureus alone, 2.0％ S.aureus and Group A beta－ hemolytic streptococcus (GABHS), 1.6％ GABHS alone, 4.1％ Staphylococcus epidermidis. Fifteen antimicrobial agents were used in the susceptibility tests. One hundred percent of S. aureus isolates were resistant to penicillin, 87.7％ were resistant to erythromycin, followed by clindamycin (75.5％ ), tetracycline (63.2％ ), chloramphenicol (54.2％ ), ampicillin－ sulbactam (44.8％ ), oxacillin (30.2％ ), ciprofloxacin (12.8％ ), cefotaxime (0.9％ ), fusidic acid (0.9％ ) and gentamicin (0.9％ ). None of the S.aureus isolates was resistant to vancomycin, cefazolin, cefuroxime and mupirocin. Sixty- four MRSA strains were isolated. No vancomycin resistant S.aureus strain was found. Conclusions Penicillin, erythromycin, clindamycin, tetracycline, chloramphenicol and ampicillin－ sulbactam prove to be no longer the appropriate therapeutic agents. Cephalosporin, mupirocin and fusidic acid might be the good choice for treatment of impetigo in our region.

Objective To obtain better insights into transmission dynamics of macrolide resistance genes between human and animal Enterococcus strains.Methods The antimicrobial susceptibility to 8 anti-bioties of 52 Enterococci isolated from animal and 55 Enterococci isolated from human was determined.PCR was used to detect the macrolide resistance genes ermB and mefA,tetracycline resistance genes tetM,and the integrase gene int of Tnl545 of the total 107 strains.Forty-nine ermB positive strains were chosen to be se-quenced.Filter mating experiments were taken.Results The resistance rate to erythromycin were 89.09% and 80.77%for isolates from human and animal:and resistance rate to tetracycline were 80.00%and 67.3l%for isolates from human and animal.respectively.All isolated Enterococci strains were found sensi-tive to vancomycin ermB was detected in 61.82% human Enterococci and 53.85% porcine ones.Identical er-mB gene sequences were found in animal and human Enterococci.Transfer of the ermB gene from porcine E.faecalis to human E.feacalis was successful.and the transfer frequency is 1.2×10-5.Conclusion En-terococci have a high resistance rate to erythromycin and some other antibio tics,especially in pediatric iso-lates:but still very sensitive to glycopeptide.ermB was the predominant genes for macrolide and tetracy-cline.Identical ermB gene sequences were present in animal and human Enterococci and that transfer of the ermB gene from porcine E.faecalis to human E.faecalis and vice versa is possible.but probably occurs at a low frequency.

Objective To study the antimicrobial susceptibility of Staphylococcus aureus isolated from children with infectious skin diseases in Beijing area and to investigate the prevalance of community acquired methicillin-resistant S.aureus (MRSA).Methods S.aureus was isolated from 600 outpatients with infectious skin diseases in Beijing Children's ospital.The susceptibility of these isolates to 14 antimi crobial agents was determined by agar dilution method according to the guidelines from Clinical and Laboratory Standards Institute (CLSI).Results Totally，451 S.aureus strains were isolated.Of them,93.8% were resistant to penicillin,87.6% to erythromycin,71.6% to lindamycin,37.3% to etracycline,13.3% to chloramphenicol,6.4% to gentamicin,1.6%to oxacillin,2.2% to ciprofloxacin,0.4% to cefazolin,0.2% to cefuroxime and mupirocin.No resistance was found to vancomycin,ceffriaxone or fusidic acid.Conclusions The results suggest that penicillin and erythromycin are no longer the appropriate agents for the treatment of S.aureus.The prevalance of MRSA iS 1.6% in children with infectious skin diseases in Beijing area.Oxacillin and cephalosporin are recommended for systemic treatment of community acquired MRSA,and mupirocin or fusidic acid for its topical treatment.

Objective To investigate the epidemiology of 10 000 patients with mammary gland disease.Methods 10 000 mammary gland disease cages during 1987～2006 in Yangquan Tumor Institute were collected,all patients had integrity case files and were diagnosed by molybdenum target radiography,near infrared ray,sonography,aspiration-needle biopsy or polyrrhea smear examination.Results In 8919 outpatient treated cases,7493 suffered cyclomastopathy(84%).1081 cases were inpatient cared(11%),the top five mammary gland disease are:breast cancer 342 cases,cyclomastopathy 252 cases,adenofibroma 104 cases,intraductal papilloma 86 cases and ductal ectasia 76 cages.For breast cancer patients,there were 125 cases during 1987～1996,3 were 21～30 years old and 23 were 31～40 years old.The number during 1997～2006 was 217,24 were 21～30 years old and 69 were 31～40 years old.Conclusion In 10000 cases,there are 7745 cyclomastopathy patients(77.45%)which takes the first place.Especially for 342(3.42%)breast cancer cases,the incidence grew up and patients age was much younger.

Objective: To investigate the effect of carcinoma-associated fibroblasts (CAFs) conditioned medium on the expression of survivin gene in human intrahepatic cholangiocarcinoma HCCC-9810 cells. Methods: The effect of CAFs conditioned medium on the proliferation of HCCC-9810 cells was detected by MTT assay. The effect of CAFs conditioned medium on the cell cycle distribution of HCCC-9810 cells was detected by FCM. The effects of CAFs conditioned medium on the expression levels of survivin mRNA and protein were detected by realtime fluorescent quantitative PCR and Western blotting, respectively. Results: CAFs conditioned medium significantly promoted the proliferation of HCCC-9810 cells (P < 0.05). The percentage of HCCC-9810 cells at G0/G1 phase in CAFs conditioned medium group was lower than that in the control group (cultured with RPMI 1640 medium) (P < 0.05), while the percentage of HCCC-9810 cells at S phase was opposite (P < 0.05). The percentage of HCCC-9810 cells at G2/M phase had no difference between CAFs conditioned medium group and the control group (P > 0.05). The expression levels of survivin mRNA and protein in HCCC-9810 cells were up-regulated by CAFs conditioned medium (both P < 0.05). Conclusion: CAFs conditioned medium can promote the proliferation and cell cycle progression of HCCC-9810 cells. This effect is related to the up-regulaion of survivin mRNA and protein expressions.

Objective To observe the effect of Fujian Tablets(FT),a prescription with the actions of nourishing liver and kidney,on the expression of microtubule-associated protein 2(MAP-2) in cerebral infarction rats at different time points,and to explore its mechanism on promoting nerve cell differentiation.Methods A total of 240 male Sprague Dawley rats were divided into normal control group,sham-operation group,model group and FT group.Focal cerebral ischemia models were established by occlusion of the middle cerebral artery according to the reformed Longa method in rats,and were subdivided into 3-,7-,14-,28-,and 42-day cerebral infarction subgroups.FT group was given FT in the dose of 9 g?kg-1?d-1,and the other groups were given the same dose of distilled water.Results In the model group,MAP-2 expression in the hippocampus increased and reached a peak on day 3,which were notably different from that in the normal control group(P0.05).In FT group,MAP-2 expression increased on day 3,reached a peak on day 7,remained high level till day 14,and then decreased,the difference being significant compared with the model group(P