Objective The incidence of pancreatic cancer is increasing worldwide, and also in china. The characteristics of the cancer are: short course, rapid progress and high mortality, with median survival time of about 6 months. Unfortunately, the early symptoms of patients are not peculiarity. There are not simple, direct and effective methods of early diagnosis. When the patients have jaundice and abdominal pain, probably they are the advanced disease (stage Ⅲ-Ⅳ) ,with unresectable tumours,and have to perform biliary bypass operation for alleviative treatment. Furthermore, the most of all patients exhibit advanced disease, which is often associated with a reduced performance status, malnourished condition, immune function deficiency, all of which severely limit patients tolerance for toxic chemotherapy regimens. These may result in physiological problems that can alter the metabolism and distribution of cytotoxic drugs and therefor lead to an increase in treatment-related toxicity. Purpose To explore the effect of TPN in the post-palliative operations, Roux-en-Ycholedceho-jejunostomy, of advaneed pancreatic carcinoma patients receiving chemotherapy. Methods From Jan. 1996 to Jan. 1999, 40 cases had receiving combination chemotherapy after palliative operations for relief of jaundice by biliary hypass, and surgical biopsy for histologically cemented. The patients were randomly divided inter 2 groups: (1) treatment group (chemotherapy + TPN), 12 men and 8 women had a median age of 57.8 years old. (2) Control group (chemotherapy + routine treatment), 13 men and 7 women had a median age of 58.2 years old. All the patients received combined chemotherapy, the regimen was 5-Fu+ CF + MMC + DDP/EPI (5-fluorouracil + Calcium folniate + Mitomycin C + Cisplatin or Epirubicin ) or IFN-γ (interferon-γ). Dosages of drugs were modified for bone marrow toxicity, stomatits and declining performance status. After 28 days, the regimen performed once again. The regimen of TPN was: total caloric value (NPC) 20 Kcal/kg·d, nitrogen 0.2kg/kg·d, N/Q = 1g: 125Kcal, Glucose/Fat=6:4. The nutritional & immunological parameters, quality of life, effects of treatment wrer monitored. Results Treatemnt group is superior to control group. After TPN, serum pre. albumin, transferrin concentration, retinol-binding protein, total lymphocyte count, natural killer cells activity, IL-2R+ cells (CD25) percentage of peripheral blood, grades of quality of life and survival time increased significantly (P<0.05, P<0.01 respectively). However, no significant difference was observed in IFN-γ application group (P>0.05). Conelusions The nutritional support can improve nutritional and immune situation and quality of life, and prolong the survival time of the patients, but no relapse-free survival.

Objective To investigate the down stage effect and long-term results of preoperative chemoradiotherapy for locally advanced lower rectal adenocarcinoma. Methods From Jan. 1989 to Jul 1999, 103 patients suffering from lower rectal carcinoma were treated. Criteria entry: 1. Distance between anal verge and centre of tumor 4-8?cm(median 6.2?cm), 2. Uncertainty in decision of preservation of anus before admission, 3. Lesion belonged to locally advanced type, 4. definitive pathology, clinical stage and presence of objective observation of tumor extent, 5. Performance status proposed by Eastern Cooperative Oncology Group 0-2, 6. Age0.05), 25.5% and 48.5% (P

OBJECTIVE To assess the correlation between the steady-state minimal concentration （cmin） and 24 h area under the drug concentration-time curve （AUC24）/minimal inhibitory concentration （MIC） ratio （AUC24/MIC） of vancomycin in pediatric patients， and analyze independent risk factors for treatment failure. METHODS Data of hospitalized children treated with vancomycin and receiving therapeutic drug monitoring in our hospital from January 2021 to July 2024 were retrospectively collected and divided into success group and failure group according to whether the treatment was successful or not. Spearman correlation analysis was used to analyze the correlation between cmin and AUC24/MIC of vancomycin， and one-way and multifactorial Logistic regression analyses were used to screen the independent risk factors for vancomycin treatment failure. RESULTS A total of 59 children were included， with 41 in the success group and 18 in the failure group. Compared with the failure group， AUC24/MIC of vancomycin was significantly higher in the success group （P＝0.038）， but there was no statistically significant difference in the cmin of the two groups （P＞0.05）； cmin of vancomycin was significantly positively correlated with AUC24/MIC （r＝0.499， P＜0.001）， but it has a certain efficacy in predicting the achievement of the AUC24/MIC standard （≥400） （area under the receiver operator characteristic curve＝0.696）， with an optimal cutoff value of 6.05 mg/L determined by the Youden index. The efficacy of AUC24/ MIC in predicting treatment failure was superior to cmin （areas under the receiver operator characteristic curve were 0.671 vs. 0.523， P were 0.038 vs. 0.684）， with higher sensitivity （83.3% vs. 66.7%）. Hypoproteinemia and AUC24/MIC≤369.1 were independent risk factors for vancomycin treatment failure （P＜0.05）. The incidence of nephrotoxicity was 3.4%. CONCLUSIONS There is a significant positive correlation between cmin and AUC24/MIC of vancomycin in pediatric patients； hypoproteinemia and AUC24/MIC≤369.1 are independent risk factors for vancomycin treatment failure in children.