Objective To investigate the clinical and pathological features of prostate cancer with low level of serum prostate-specific antigen (PSA) in elderly patients.Methods Data of 328 patients with prostate cancer were retrospectively analyzed.Clinical and pathological data of 4 prostate cancer patients with low serum PSA level were analyzed.Potential risk factors and diagnostic methods of prostate cancer with low serum PSA level were discussed based on the clinical data combined with literatures.Results Mean age of the 4 patients was 71.3 years.Mean PSA value on admission was 1.96 μg/L.2 patients had abnormal digital anal examination results.2 patients were pathologically diagnosed as adenocarcinoma after puncture,among which 1 had duct adenocarcinoma,and the other 2 patients were pathologically diagnosed as neuroendocrine carcinoma after puncture.2 patients with neuroendocrine carcinoma of prostate were treated with endocrine therapy,and the other 2 patients were treated with radical prostatectomy plus auxiliary endocrine therapy.Conclusions Prostate cancer with low serum PSA level has an insidious onset,which is prone to miss the diagnosis.It should be paid sufficient attention for the diagnosis,and monitoring of prostate cancer is independent on PSA.Prostate cancer with low serum PSA level should be diagnosed in combination with some basic examinations such as serum free prostate specific antigen,prostate specific antigen density and digital rectal examination,et al.

Objective To evaluate the clinical value and safety of radiotherapy combined with tyrosine kinase inhibitors (TKI) in non-small cell lung cancer (NSCLC) with brain metastasis driven by epidermal growth factor receptor (EGFR) mutation.Methods A retrospective cohort of 21 non-small cell lung cancer (NSCLC) patients with EGFR mutation-driven brain metastasis was recruited.10 patients (treatment group) were randomly selected for radiotherapy combined with TKI treatment,and 11 patients (control group) were treated with radiotherapy.Tumor size was measured and clinical efficacy was evaluated by MRI in the four weeks after radiotherapy.Since then,a clinical response was evaluated every three months until disease progression,and the median overall survival time was calculated.Results The objective remission was 8 cases in treatment group and 4 cases in control group.The disease control was 9 cases in treatment group and 8 cases in control group.The median overall survival time of treatment and control groups was 11.2 months and 6.4 months,respectively.Adverse reactions in treatment group mainly contained nausea,diarrhea and rash,which all were tolerated.Conclusion Radiotherapy combined with TKI is superior to radiotherapy alone in effect and safety for treatment of NSCLC with EGFR mutation-driven brain metastasis.

model rats group. Conclusion Bushenhuoluofang increased the weight of ovary and uterus, follicular number and endomelrium area of ASR. By affecting the level of FSH and LH of the rat, improves its endocrine function and the growth of follicle, Bushenhuoluofang achieved the purpose of promoting ovulation.

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 observe the efficacy and toxicity of S -1 monotherapy in elderly patients with advanced non -small lung cancer (NSCLC).Methods Fifty-six patients aged 70 or over with stage IIIb-IV NSCLC were enrolled.S-1 was given orally twice a day according to body surface area on days 1 to 14 for 21-day cycle, the evaluation of efficacy and toxicity were performed on all patients after 2 cycles.Results For all 56 patients, CR 0, PR 15, SD 29 and PD 23 were observed.The objective response rate (ORR) and the disease control rate (DCR) were 26.8% and 78.6%,respectively.The 1-year survival rate was 30.9%, with a medi-an survival of 10.0 months.The myelotoxicity and gastrointestinal toxicity were major side effects .The major toxicity could be tolerated by the patients.Conclusions S-1 monotherapy is an effective chemotherapy for advanced NSCLC in elderly patients with moderate side effects and safety in clinical practice .

Objective To investigate the effect of Calponin-1 suppression on human myometrium cells through adenovirus mediated siRNA. Methods Human uterine smooth muscle tissues were digested with enzymes, cultured and confirmed with immunocytochemistry. Aadenovirus siRNA-Calponin-1 plasmid was transfected into primary cultured uterine smooth muscle cells in vitro. The expressions of Calponin-1 mRNA and protein were analyzed by RT-PCR and Western blot, respectively.Results The pAdEasy-pShuttle-U6-Calponin-1 siRNA plasmid was successfully constructed, and Calponin-1 siRNA mediated by recombinant adenovirus resulted in markedly reduced expression of Calponin-1 mRNA and protein in human myometrium cells. The gray values of Calponin-1 mRNA in the uterine smooth muscle cells in the experimental, blank control, and empty vector groups were 316.3±39.2, 1048.5±126.4 and 1027.2±127.5, respectively. The gray values of Calponin-1 protein were 323.3±43.2, 1021.5±143.4, and 1019.2±144.5,respectively. The difference between the experimental group and the blank control group as well as the empty vector group was significant (P< 0.05). There was no significant difference between the empty vector group and the blank control group (P>0.05).Conclusion The pAdEasy-pShuttle-U6-Calponin-1 siRNA plasmid can inhibit the expression of Calponin-1 in human myometrium cells in vitro,which may be a useful approach to determine the role of Calponin-1 in delivery.

Because of ignoring the basic knowledge training, the medicine graduates lack ba-sic knowledge of clinical pathology, which has seriously affected their improvement of medical skills. The paper analyzes the status of pathology teaching in clinical medicine graduates and the necessity to strengthen clinical pathology general education. Then it proposes measures about enhancing clinical pathology general education, so as to increase the basic clinical pathology knowledge of medical grad-uates.

Objective To retrospectively analyze the perioperative complications of posterior lumbar interbody fusion (PLIF) for recurrent lumbar disc herniation and identify potential risk factors that correlate with those complications.Methods All of 71 patients with recurrent lumbar disc herniation were treated surgically with PLIF,discharged from our department between January 2008 and December 2014.Demographic and operation data were collected and perioperative complications were recorded.We analyzed whether the clinical factors (age,gender,BMI,co-morbidity,smoking,time of recurrence,blood loss,operation segment,operation time) were in correlation with perioperative complication by univariate analysis.Then we integrated the statistically significant indicators into Logistic regression equation to determine the related risk factors for complication.Results The study group consisted of 71 cases,including 42 males and 29 females.The age was 19 to 64 years old with an average of 50.6 years old,and the average BMI was 23.6 kg/m2.26 cases had perioperative complications,while there were two or more complications in 5 patients,and no mortalities.Neurologic deterioration or neuropathic pain (10 cases,14.1％) and dural tears (6 cases,8.5％) were the most common intraoperaitive complications.The other complications included nerve root or cauda equine injury,deep or superficial wound infection,urinary tract infection,respiratory system complication,cardio-vascular complication and delirium.Univariate analysis suggested that age,gender,co-morbidity,smoking,time of recurrence,operation segment,operation time were not associated with perioperative complication.The multivariate Logistic regression analysis showed BMI and blood loss were closely related to perioperative complication.Conclusion Complications of posterior spinal fusion surgery for recurrent lumbar disc herniation are affected by many factors.The most common complications are transient neurologic deterioration or neuropathic pain and dural tears.BMI and blood loss are independent risk factors.

ObjectiveTo explore the risk factors for the prognosis of respiratory failure in neonates with gestational age≥34 weeks. MethodsA total of 143 hospitalized neonates with respiratory failure who had gestational age≥34 weeks were enrolled from Jan. 2011 to Jun. 2013. According to the outcome, the neonates were divided into good prognosis group and poor prognosis group. The risk factors for the prognosis of respiratory failure were screened by univariate analysis and mul-tivariate binary logistic regression model.ResultsAmong the 143 neonates, 105 neonates had good prognosis and 38 neonates had poor prognosis. Univariate analysis showed that the mode of delivery, small for gestational age, 5 minutes Apgar score <7, and with primary disease being pneumonia/sepsis were associated with a poor prognosis. The differences were statistically signif-icant (P<0.05). Furthermore, the multivariate binary logistic regression model showed that, small for gestation age (OR=23.87, 95%CI:3.149-180.9) and pneumonia/sepsis (OR=2.996, 95%CI:1.514-5.928) were the independent factors of poor prognosis. ConclusionsSmall for gestation age and primary diseases being pneumonia/sepsis are the independent factors inlfuencing prog-nosis of respiratory failure in neonates born at a gestational age≥34 weeks.

Objective To investigate the apoptosis induction of Bullatacin on A549 cell line of pulmonary adenocarcinoma. Methods The MTT assay was used to detect the growth inhibition rates of A549 cells cultured with Bullatacin in different concentrations (6.25, 12.5, 25, 50, 100μg/mL). 25μg/mL Bullatacin was used to culture A549 cells for 0, 12, 24, 48 h. The cell cycle distribution and apoptosis were measured by flow cytemetry. The protein expressions of ERK, JNK, and p38 were studied by Western blot. Results Dosage dependence was obviously showed after the different concentrations of Bullatacin were used to A549, and 25 μg/mL;Bullatacin blocked A549 cell in G0/G1 periods and induced its apoptosis. Compared with the blank group, protein expressions of P-ERK, P-JNK, and P-p38 were all increased by different degrees. Conclusion Bullatacin significantly inhibits the proliferation and induces the apoptosis of A549 cell. Its mechanism is related to activity of MAPK pathway thought the phosphorylation of the three protein kinases by Bullatacin.