Objective To investigate the effect of combination therapy of Gabapentin and Cobamamide in treatment of painful diabetic neuropathy (PDN).Methods A total of 96 patients with type 2 diabetes (T2DM) and PDN were enrolled in this study and randomly divided into control group (Con,n=32),Cobamamide group,(n=32),and Gabapentin+Cobamamide group,(n=32).FPG and HbA1c were actively controlled in each group.Con group was treated with vitamin B1.Clinical and biochemical data of all the subjects were collected.The degree of pain was assessed by visual analogue scale (VAS).The changes of median nerve,peroneal nerve motor nerve conduction velocity (MNCV),and sensory nerve conduction velocity (SNCV) were evaluated by EMG assessment.The assessment of sleep quality was done by Pittsburgh sleep quality index scale (PSQI).Results There was no significant differences of baseline MNCV,SNCV and the degree of pain among the three groups (P>0.05).After treatment,all the above index were improved in both Cobamamide group and Gabapentin+Cobamamide group.MNCV and SNCV were higher in Gabapentin+Cobamamide group than in Cobamamide group (P<0.05).There were no significantly improvement of MNCV and SNCV in Con group (P>0.05).Conclusion The combination therapy of Gabapentin and adenosine cobalt amine could reduce pain,improve nerve conduction velocity,and improve the quality of sleep.

Objective To study the method and effect of the combination treatment based on the minimally invasive surgery and radioactive seeds brachytherapy for lung cancer. Methods Entered the study there were 12 cases of lung cancer (4 cases of primary lung cancer, 3 cases of recurrent lung cancer, and 5 cases of metastatic lung cancer) between November 2001 and February 2002. All the 12 patients received thoracoscopic mini operations, including 5 cases of local wedge-shaped tumor resection combined with seeds implantation, 3 cases of radio frequency thermaerotherapy combined with seeds implantation, 3 cases of percutaneous radio frequency with seeds implantation, and 1 case of seeds implantation only. Postoperative combination treatment was conducted in accordance with the patient's general condition. Results All the patients were followed for (12～30) months. The local control rate in the study was 83%, and the survival time was more than 1 year. Two patients expired in the 18th and 21st postoperative months, respectively. No decreases of the white blood cell and platelet took place. Conclusions The combination treatment based on minimally invasive surgery and radioactive seeds brachytherapy provides high local control rate, high life quality and satisfactory survival time.

Objective To explore the effect of intracavitary therapy on acute pulmonary embohsm.Methods Fifteen patients were selected as our subjects,who suffered acute pulmonary embolism and received percutaneous catheter thrombus crashing and catheter directed thrombolysis in Beijing Military.Region General Hospital from January 2009 to June 2011.Local injection of Urokinase was performed with a total amount of 500 000 U in catheter directed thrombolysis.After thrombolysis,low molecular Heparin was administered to patients for 7-10 days and oral administration of Warfarin was performed for 3-6 months.Clinical symptoms,improvement of physical signs,complications,changes of mean pulmonary arterial pressure(mPAP) and arterial partial pressure of oxygen(PO2),and the opening of pulmonary artery were recorded.Results The pulmonary arteries of the 12 patients were completely opened,and partially opened in 3 patients.The effective rate was 100％ (15/15).mPAP was reduced from (40.07 ±5.97) mmHg to (20.00 ±4.66) mmHg (t =-1.128,P ＜ 0.05),PO2 was increased from (50.26 ± 9.30) mmHg to (80.49 ± 9.04) mmHg (t =1.246,P ＜ 0.05).Patients were followed-up for 3-6 months and no recurrence case was seen.Conclusion The interventional therapy is effective,safe and practicable in the treatment of acute pulmonary embolism.

Objective To discuss the role of indoleamine 2, 3-dioxygenas e (IDO) and tryptophanyl-tRNA synthetase (TTS) mediated tryptophan catabolism in immune thrombocytopenia (ITP) patients treated with high doses of dexamethasone through the expressions of IDO and TTS in T cells , and the concentrations of plasma kynurenine and tryptophan. Methods 20 newly diagnosed or relapse ITP patients were treated with 40 mg/d × 4 d dose of dexamethasone. The heparin anticoagulant blood samples were obtained before treatment and the 5th day after treatment. 20 healthy subjects were selected as the control group. The IDO and TTS expressions in CD4+and CD8+ T cells were analyzed by flow cytometry. The concentrations of plasma kynurenine and tryptophan were detected by liquid-mass spectrometry system. Results Compared with healthy controls group, the plasma tryptophan and kynurenine concentration and the ratio of Kyn/Trp were significantly elevated in ITP patients (P <0.05); the IDO expressions of CD4+ and CD8+ T cells in ITP patients were significantly lower than those in healthy controls (P < 0.05), but the TTS expressions were significantly higher (P < 0.05). The concentration of tryptophan in effective group was significantly lower than before treatment (P < 0.05), in contrast, the kynurenine concentration and the ratio of Kyn/Trp were significantly higher than before (P < 0.05). The expression of IDO in effective group were significantly higher than that before treatment (P < 0.05), conversely, the expression of TTS in effective group were significantly decreased (P < 0.05). No significant difference can be found in ineffective group. Conclusion IDO/TTS-mediated tryptophan catabolism pathway could indicate the onset of ITP. The sensitivity of ITP patients with high dose of dexamethasone treatment can be observed through the level of IDO and TTS.

Objective To evaluate the validity and responsiveness of the Chinese version of the miniBalance Evaluation Systems Test(mini-BESTest).Methods A total of 208 stroke patients were evaluated by 2 professionals using both mini-BESTest and Berg balance scale (BBS).All data were analyzed using Pearson correlation,t-test and descriptive statistical analysis.Results Significant correlation was observed between each entry of the mini-BESTest and its domain,with correlation coefficients ranging from 0.78 to 0.93 (P ＜ 0.05).The scores of whole assessment and the three related domains were significantly correlated between mini-BESTest and BBS results,the correlation coefficients ranging from 0.68 to 0.87 (P ＜ 0.05).After 2 weeks of treatment,there was significant improvement in each domain and in the total assessment score (P ＜ 0.05).No floor or ceiling effects were observed in the total mini-BESTest scores,but there was a slight ceiling effect in the anticipatory and sensory orientation domains,and a slight floor effect in the reactive postural control domain.Conclusion The mini-BESTest has good validity and responsiveness,and can be applied to evaluate patients after stroke.

Objective To study the expression status of estrogen receptor-alpha36(ER-α36)in breast cancer tissue and its rela-tionships with the occurrence,development and clinical prognosis of breast cancer.Methods 653 cases of breast cancer tissues were selected in this study.The real-time reverse transcription polymerase chain reaction(RT-PCR)and immunohistochemistry were used to detect the expression of ER-α36,estrogen receptor-alpha66 (ER-α66),progesterone receptor(PR)and human epidermal growth factor receptor-2(Her-2).The relationships between the expression of ER-α36,ER-α66,PR and Her-2 and the pathological charac-ter were analyzed.Results The expression rate of ER-α36 in all cases was 40%.The expression rate of ER-α36 in Her-2 positive tissues(63%)was significantly higher than that in the Her-2 negative group(44%,P <0.05).The expression rate of ER-α36 in ER-α66/PR/Her-2 negative tissues(66%)was significantly higher than that in the non-three-negative group(35%,P <0.05).The differences of ER-α36 expression rate between ER-α66 positive samples and negative samples or between PR positive and negative samples showed no statistical significance(P >0.05).The expression rate of ER-α36 in stage Ⅲ+Ⅳ breast cancer tissues(54%) was significantly higher than that in stage Ⅰ+Ⅱ breast cancer tissues(28%,P <0.05).The expression rate of ER-α36 in breast cancer tissues with lymph node metastasis (55%)was significantly higher than that in breast cancer tissues without lymph node me-tastasis (23%,P <0.05).Conclusion The results indicate that ER-α36 may play a very important role in the occurrence,develop-ment and lymph node metastasis of breast cancer,and be associated with the expression of Her-2,breast cancer staging and lymph node metastasis.ER-α36 is expected to become a new tumor marker and clinical diagnosis and treatment target.

Objective To evaluate the safety and efficacy of induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapywith capecitabine in patients with locally advanced pancreatic cancer (LAPC).Methods A total of 42 patients with locally advanced pancreatic cancer were enrolled.All patients received seven cycles of induction chemotherapy of gemcitabine 1 000 mg/m2,once a week.Concurrent chemoradiotherapy began 1 week after completion of induction chemotherapy.Radiotherapy was delivered with a median dose of 54 Gy (34-64 Gy) with 1.8-2.0 Gy in a fraction.The radiotherapy was combined with capecitabin at a dosage of 825 mg/m2 twice daily,5 d/week.Results Twenty patients (47.6％) were evaluated as clinical benefit response (CBR).Two cases were observed with complete remission (CR),8 with partial remission (PR),27 with stable disease (SD),and 5 with progressive disease (PD).The median overall survival was 10.1 months (range of 4-36 months).The 1-,2-year overall survival rate was 38.2％ and 18.2％,respectively.Myelosuppression was recorded in 20 patients with grades 1-2,and 5 patients with grade 3.Twenty-two patients suffered from grade 1-2 gastrointestinal toxicities,while 4 patients suffered from grade 3.Conclusions The preliminary results showed that induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapy with capecitabine in patients with LAPC might achieve encouraging efficacy with better tolerance.

Objective To study the effect of plant Coleus forskohlii active elements Isoforskolin(ISOF)and CT-E(analogs mixture of Isoforskolin)on human neutrophill(PMN)in vitro in order to uncover the mechanism of their properties of mitigating acute lung injury(ALI).Method The effects of ISOF and CF-E on PMN aggregation induced by N-formyl-methiony-leucyl-phenylalanine(fMLP)was performed by using a 4-channel platelet aggregometer.Cytometry Was applied to analyze the effect of tested samples on adhension between PMN and endothelial cells(ECV-304)activated by using lipopolysaccharides(LPS).Expression of LPS-induced PMN adhension molecules was determined with flow cytometry.Radioimmunoassay Was applied to detect the level of TNT-α liberated bv PMN and intracellular cyclic adenosine monophosphate(cAMP)level of PMN.Results It was found that ISOF(25,50,100 μmnol/L)and CF-E(1.25,2.5,5 mg/ml)inhibitted PMN aggregation induced by fMLP,PMN adhemion to ECV-304 indeed by LPS,expression of PMN adhesion molecules,and TNF-α level released by PMN.ISOF and CF-E also increased intracellular cAMP level of PMN.Condusions ISOF and CF-E inhibit PMN aggregation,adhension and adhension molecules,and TNF-α released by PMN,while they increase intracellular cAniP level of PMN.It suggests that their specific alleviating the ALI by the mechanism of the modulation of PMN function.

Objective: To discuss the surgical treatment of carcinoma of the pancreas with superior mesenteric artery (SMA) invasion. Methods: Vascular resection and reconstruction of the portal vein and hepatic artery were performed in 2 cases. Results: The portal vein (PV), superior mesenteric vein (SMV) and superior mesenteric artery (SMA) were involved. During surgery, the invaded superior mesenteric vessels were localized. Case 1 underwent pancreaticoduodenectomy with vascular resection, SMA partial resection and reconstruction. Case 2 was submitted to total pancreatic resection with simultaneous vascular resection of spleen artery and SMA reconstruction. No perioperative mortality occurred. Conclusion: Regional pancreaticoduodenectomy with superior mesenteric artery resection is a safe and effective surgical treatment for pancreatic carcinoma.

Objective To develop a promising type of radiation dosimeter based on doped hydroxyapatite,and to study the stability of dosimetric characteristics indepth.Methods The samples prepared by stereotyping techniques were stored under different temperatures,humidity and illumination conditions after 60Co γ-ray irradiation.Electron spin resonance (ESR) technique was used to quantitatively measure the radiation-induced free radical signal.Results The signal change was less than 3% when the dosimeter was preserved at 4℃ or room temperature within 3 months in the experiment.At 40℃,the signal changed by about 13%,but at room temperature with the humidity less than 36%,the signal changed less than 2%.The change rose to about 8% when humidity was 76%.However,no significant decay of signal strength occurred at relatively high temperatures and under high humidity conditions.When the samples were stored under average illumination of 1600 lux or in a light-resistant container,the signal changes were less than 3.8% or 3.4% respectively.Long-term stability inspection at room temperature suggested a signal change within 4.8%.Conclusion The dosimetric properties of the material don't change significantly below room temperature in a natural environment and exhibit good stability over long-term storage.The free radical signal is not influenced drastically by relatively strong light exposure.However,a high temperature or a highly humid environment may have some effect on the measurement process,which should be taken into consideration in further applications.