Objective To explore the application effect of paclitaxel combined with carboplatin neoadjuvant chemotherapy in patients with advanced cervical carcinoma.Methods Forty patients with stage Ⅱa and above cervical cancer who were treated between August 2015 and August 2016 were selected as the research objectives and all patients were diagnosed by pathological examination.They were divided randomly into experimental group(n=20)and control group(n=20).Patients in the experimental group were treated with intravenous chemotherapy before operation.This scheme included paclitaxel and carboplatin.It included 2 cycles,and the interval between the 2 cycles was 3 weeks.Extensive hysterectomy and pelvic lymphadenectomy were made in 14 days after chemotherapy.The patients in the control group were treated only with extensive hysterectomy and pelvic lymphadenectomy.The efficacy of neoadjuvant chemotherapy was evaluated according to WHO criteria,and observed the operation condition.Adverse drug reactions were evaluated according to WHO anti-cancer drug adverse reaction grade.The quality of life of the two groups was evaluated by the mos item short from health survey(SF-36).Results 20 patients completed chemotherapy,CR5 cases,PR11 cases,SD3 cases,PD1 cases,and the total effective rate(CR+PR)was 80％.At the same time,The paracervical tissue becomed soft in varying degrees,the gap widened,the invasive lesions were controlled in different degrees.Adverse reactions were mild and relieved without special treatment.There was no kidney and heart function damage.All cases were operated successfully after chemotherapy.There were no significant difference in operation time and blood loss between the two groups.The rate of lymph node metastasis,the infiltration rate of uterine tissue and the residual rate of tumor tissue in the vaginal margin were lower than those in the control group(P<0.01).The SF-36 scores of the two groups were higher than those before treatment,but the score of the experimental group was higher significantly than that of the control group,and the difference was statistically significant(P<0.01).Conclusion Paclitaxel combined with carboplatin in neoadjuvant chemotherapy of cervical cancer can reduce the tumor volume,increase the chance of surgery,has less toxic side effects,lower metastatic rate and improve the quality of life of patients.It is worthy of further clinical research and recommendation.

Objective To study the feasibility of re-operation of gynecological laparoscopy.Methods Clinical records of 47 patients with gynecological diseases undergoing a re-laparoscopy from December 1995 December 2003 were analyzed retrospectively.Results The re-operations of laparoscopy were successfully accomplished in 46 patients(97.9%) while a conversion to open surgery was required in 1 patient.The re-operation time was 30~80 min(mean,50 min),and the in-hospital stay was 2.5~5 days(mean,3.5 days).No long-term complications were noted in 44 patients on a postoperative follow-up for(1~4) years.Out of 19 patients with infertility, 1 patient had a natural pregnancy and 6 patients were pregnant with the help of artificial reproductive techniques.Supportive medical treatment had been given in patients with endometriosis postoperatively,3 of whom experienced symptomatic improvements and 1 of whom had a natural pregnancy.Conclusions For patients with a history of laparoscopy,a re-operation of gynecological laparoscopy is safe and feasible.

Objective To evaluate the effect of transitional care on the quality of life in patients with maintenance hemodialysis (MHD).Methods 101 MHD patients with symptoms of kidney ＜ 80 points were assigned into the interventional group (47 of 51 cases completed the study) and the control group (45 of 50 cases completed the study) by random number table method.The patients in the interventional group received transitional care for 6 months,while control group received routine care.The effects on function index,satisfaction index and clinical index were evaluated at the 3rd month and 6th month after intervention.Results 6 months after intervention,the scores of physical composite,mental composite,burden of kidney disease,symptoms/problems list,effects of kidney disease in the interventional group were 51.78±5.91,55.32±5.36,29.79±17.64,79.39±6.73,68.02±11.38,while the scores of the control group were 38.22±9.46,42.03±8.32,19.58±17.25,69.49±10.10,52.09±16.78,and the difference between the two groups was statistically significant (t=5.308-9.063,Z=-3.07,P ＜ 0.01).The scores of self-management behavior,health locus of control in the interventional group were 71.30-±5.42,25.74±2.42,while the scores of the control group were 65.0±8.74,22.47±3.97 (t=4.132,4.759,P ＜ 0.01).The nursing satisfaction in the interventional group scored 91.06±7.29,which was significantly higher than the control group scored 86.22±10.72 (Z=-2.45,P＜ 0.05).The level of serum phosphorus (PO4),Ca × PO4 products,parathormone (PTH) in the interventional group were (1.76±0.35) mmol/L,(51.02±10.04) mg2/dl2,464.56 ng/L,which were significanlty lower than (2.01±0.54) mmol/L,(57.41±17.38) mg2/dl2,625.78 ng/L in the control group (t=-2.691,-2.167,-2.000 in tum,P ＜ 0.01 or 0.05).Conclusions Transitional care achieves good effectiveness on the quality of life in patients with MHD.

Objective To probe the surgical approach and effect on upper abdominal malignant tumor infiltrating pancrea. Methods Thirty patients with upper abdominal malignant tumor infiltrating pancreas or tissue around pancrea were treated by radical resection on primary tumor combined pancreaticoduodenectomy. Results Three patients died in 1 month after operation due to multiple organ failure. The patients with gallbladder cancer and metastatic lymph nodes fixed behind caput pancreatis were followed up averaged 35 months. The patients with gastric antrum carcinoma infiltrating caput pancreatis were followed up averaged 31 months. The patients with recurrent gastric cancer infiltrating caput pancreatis were followed up averaged 13 months. The patients with pancreatic and duodenal invasion by cancer of hepatic flexure of colon were followed up averaged 41 months. The patients with hilar cholangiocarcinoma and metastatic lymph nodes fixed behind caput pancreatis were followed up averaged 11 months. Conclusion The patients with upper abdominal malignant tumor infiltrating pancreas should be operated by radical resection on primary tumor combined pancreaticoduodenectomy, which can increase the rate of tumor resection, and be expected to prolong the survival period.

Aim To study the content and clinical significance of serum endothelin-1(ET-1)in patient with malignant tumors. Methods The contents of serum ET-1 in 85 patients with malignant tumors,30 patients with benign diseases and 30 normal indivaduals were detected by radioimmunoassay. Results (1)The mean concentrations of serum ET-1 in normal individuals and in non-tumor patients were (46.9± 23.1)μ g/L and (51.1± 30.9)μ g/L,respectively, while in patients with malignant tumors it was (190.1± 135.2～ 382.4± 190.1)μ g/L. (2)There was no significant difference between the mean serum contents of ET-1 in normal individuals and non-tumors pstients(P∧ 0.05),but the level of serum ET-1 in patients with malignant tumors were significantly higher than that in above two groups(P∨ 0.001). (3)When the mean content plus twice standard deviation of serum ET-1 in normal individuals was as a threshold value,that is ,the value was defined as the positive clinical value to diagnose cancer, the positive rates of patients with different malignant tumours were 72％ ～ 100％ . Conclusion Serum ET-1 contents could be used as a better tumor index for maligant tumor screening and accessory diagnosis.

Objective To evaluate the efficacy and safety of sorafenib in the treatment of advanced renal cell carcinoma.Methods The clinical date of 33 patients with advanced renal cell carcinoma from September 2007 to April 2012 was reviewed retrospectively.26 were males and 7 were females,with an average age of 69 years.Pathological diagnosis showed 30 clear cell RCCs,2 papillary RCCs,and 1 unclassified RCC.These patients were treated by sorafenib 400 mg twice a day until intolerable toxicity or disease progression.The primary end points were objective response rate,clinical benefit rate,median survival time,median progression-free survival and the incidence of adverse reaction.Results All patients were evaluable for response and toxicity,with 8 patients (24％) of partial remission,19 cases (58％) of stable disease,and 6 cases (18％) of disease progression.The disease control rate was 82％,the median progression-free survival was 10.2 months,while the median survival time was 16.5 months.The common adverse reactions included hand-foot skin reaction (61％),diarrhea (46％),hypertension (21％).Most adverse reactions occurred around the second week after drug therapy,with the duration unequal.The majority of adverse reactions could be released by symptomatic treatment,which did not affect the medication.Conclusion Sorafenib has good short term efficacy for patients with advanced renal cell carcinoma,and most adverse reactions were tolerable.

Objective To investigate the expression of CD8 and CD28 lymphocytes in peripheral blood of patients with breast cancer before and after operation and explore its clinical significance.Method Flow cytometry was applied to test the expression of CD8,CD8+CD28+and D8+CD28-in the peripheral blood of both 40 patients with breast cancer and 25 healthy controls. Results The expression levels of CD8 in patients with breast cancer were significantly higher than those in healthy controls [(30.4±3.3)%VS. 30.4±3.3)%,P<0.05] . The expression levels of CD8+CD28+in patients with breast cancer were significantly lower than those in healthy controls [(10.4 ± 1.7)%VS. (14.3±2.6)%,P<0.05] . The expression levels of CD8+CD28-in patients with breast cancer were significantly higher than those in healthy controls [(25.1 ±2.8)% VS. (19.6 ±2.3)%, P<0.05] . After operation, the expression levels of CD8, CD8+CD28+and CD8+CD28-[(31.9 ±4.3)%, (15.4 ±2.7)%and (20.4±2.8)%, respectively] in peripheral blood of patients with breast cancer had no significant change compared with the healthy controls. The expression levels of CD8, CD8+CD28+and CD8+CD28-in peripheral blood of patients with breast cancer had significant difference between before and after operation. Conclusions After surgical operation, the immune defence and immune surveillance of cytotoxic T lymphocytes can be enhanced, immune suppression and tumor escape can be reduced. The assays of cell phenotypes CD8 and CD28 might be useful for evaluating the immunal state and prognosis of patient s with breast cancer.

OBJECTIVE To analyze the clinical cases of fungal infections and drug resistance to provide a basis for the treatment of mycotic infection.METHODS A total of 215 cases of fungal strains were identified by API 20C AUX.Drug susceptibility was determined by Rosco slip diffusion.RESULTS In 215 fungal strains of specimens,Candida accounted for 87.9%,of which C.albicans accounted for 37.2%.The yeast-like fungi sensitivity rate to amphotericin B,nystatin and ketoconazole respectively was 100.0%,97.9% and 93.5%.CONCLUSIONS Candida are the most common pathogens in the 215 fungal stains.Yeast-like fungi is sensitive to amphotericin B,nystatin and ketoconazole.

Objective To study the correlation between human papillomavirus(HPV) infection and cervical immune function.Methods A total of 209 women with HPV positive results in HPV-infected group,40 women with HPV negative results in control group,cervical samples were detected and genotyped with HPV GenoArray Diagnostic Kit.Concentrations of cytokines including interleukin(IL)-2,IL-4,interferon(IFN)-γ,and transforming growth factor(TGF)-β in cervical specimens were measured by ELISA.Results IL-2,IL-4 and IFN-γ levels in the HPV-infected group were different with those of the control group(P=0.000 1,0.001 0,0.000 1),TGF-β in HPV-infected group and control group showed no significant difference(P=0.680 0).IFN-γ in high-risk HPV group was significant lower than that in the low-risk HPV group(P=0.007 0).Conclusion HPV infection might be one of the main reasons of cervical local immune dysfunction.

Objective To assess the different methods and their outcomes of interventional therapy for stenosis or occlusion in superior vena cava and its branches. Methods Sixty patients with stenosis or occlusion of SVC and its branches were retrospectively analyzed after interventional therapy. Among them, 38 were males and 22 were females, with age range from 15 to 72 years old(mean age 58). Seventeen patients were treated by thrombolysis, and the rest 43 patients accepted percutaneous angioplasty and stenting. Before and after that, the pressures within the vein were measured at the inflow side. The paired-t test was used for statistical analysis. Results After treatment, the pressure at the inflow side dropped from (24.8±2.3)mm Hg to (7.1±1.5)mm Hg(1 mm Hg=0.133 kPa), with a significant difference(t=3.232,P＜0.01). The clinical outcomes included complete relief in 27 patients, partial relief in 28 patients and non-relief in 5 patients. No major complications occurred. During 6 months follow up, restenosis occurred in 10 patients, among whom 6 received repeat intervention with good results. The other 4 patients turned to surgery .Conclusion Interventional therapy for stenosis or occlusion in SVC and its branches could recanalize the vessels, restore the blood flow and relief the clinical symptoms.