In clinical practice, muscular atrophy is a common sign in children. Because of relatively thick subcutaneous fat in children, muscular atrophy is not easy to be discovered. In order to confirm the diagnosis earlier, it is very important to take history in detail, to observe the motor function, cry, the posture of sitting and standing carefully, to do the physical examination thoroughly, and to use the assistant test reasonably.

Objective To observe the clinical effects of pemetrexed chemotherapy combined with radiotherapy in brain metastases of lung adenocarcinoma patients.Methods The data of lung adenocarcinoma patients with brain metastases were conducted retrospectively diagnostic analysis,and they were stratified randomized divided into the observation group (26 cases) and the control group (25 cases).The observation group was treated with pemetrexed chemotherapy combined with radiotherapy; the control group was treated with radiotherapy alone.Brain metastases,quality of life,short-term efficacy,adverse reactions,and patients' survival period were observed.Results The efficacy and quality of life of patients in the observation group were improved significantly than those of the control group,and adverse reactions were mild,the survival period was not significant between two groups.Conclusions Pemetrexed in combination with radiation therapy for the treatment of brain metastases from lung adenocarcinoma can effectively improve the short-term efficacy and quality of life of patients,and the adverse reactions are mild,it possess great application value in the treatment of brain metastases of lung adenocarcinoma.

Objective:To study p16 methylation of BEP-2D cells during its malignant transformation.Methods:Normal BEP-2D cells and BEP-2D cells treated by cigarette smoke condensate(CSC) for 15 weeks(W-15),25 weeks(W-25),38 weeks(W-38) and 43 weeks(W-43)respectively were chosen to study the p16 methylation status by Nested methylation specific PCR (Nested-MSP).Results:The p16 methylation was found in W-15,W-25,W-38 and W-43 BEP-2D cells,but not in the normal BEP-2D cell.Conclusion:The p16 methylation may be considered as a kind of biology-marker of the early diagnosis of lung cancer because the p16 methylation occurs in the earlier period of lung cancer.

0.05);There are significant differences between treatment group and control group in moderate and severe patients(P

Objective:To study the phamacokinetics of Nalmefene hydrochloride. Methods:30 healthy Chinese volunteers were assigned to 3 groups according to randomized design, and each group were given respectively a single intravenous administration dose of 0.5 mg, 1mg and 2mg of Nalmefene hydrochloride. The electrospray ionization positive selected reaction monitoring detections for Nalmefene hydrochloride and allyln-oroxymorphone (the internal standard) in the plasma and in the urine were used. The pharmaceutical parameters were calculated by 3P87 software. Results: The limit of the detection for Nalmefene hydrochloride was 0.0008 ng/ml in plasma and 0.0003 ng/ml in urine. There were good linear relationship range from 0.04 to 625ng/ml in plasma and 0.2 to 625 ng/ml in the urine. The variation coefficient in day and days, and the recoveries fitted the clinical pharmacokinetic study requirements. After a single intravenous administration of 0.5 mg,1mg, and 2mg of Na-lmefene hydrochloride, the obtained pharmacokinetic parameters were respectively as follows:Cmax were(1.74?0.48)?g/L,(4.17?1.08) ?g/L,(7.88?2.89) ?g/L;t1/2? were(12.83?3.98) h,(12.6?6.4) h, (10.58?3.74) h;V were (3.45?0.16) L/kg;(4.11?0.0716)L/kg、(4.25?0.56)L/kg;CL were (0.81?0.11) L/(h?kg), (0.85?0.15)L/(h?kg), (0.87?0.11) L/(h?kg);AUC0-∞ were (21.62?9.34) (ng/L)*h,(24.89?8.52) (ng/L)*h, (35?11.2) ng/L)*h;the urine accumulatived exc-retory rate were (78?21)%,(71?29)%,(78?19)%. Conclusion: The determination method for Nalmefene hydro-chloride in the plasma and in the urine by the electrosprayionization positive selected reaction monitoring detections is exclusive, accurate, sensitive and suitable. Pharmacokinetic characteristics in 3 groups of human treated with intravenous administration were described by a two-compartment model. The pharmaceutical characteristics of doxycycline hydrochloride in human body were linear in the range of 0.5~2.0 mg.

To confirm a patient's muscular dystrophy is a motor neuron amyotrophy or not,we should take history in detail,physical examination completely,and assistant test reasonably.The history include the first onset symptom such as dysarthrosis,dysphagia,weakness and muscular dystrophy in the hand.We should pay attention to the fasciculation,insensibility,sphincter problem,the symptom progress,and family history.The lab tests include serum creating kinas,electromyogram,muscle biopsy,and gene(SOD1,SMA)analysis.It is important distinguish motor neuron amyotrophy from other muscular dystrophy with the cause of the spinal anterior horn cells damage clear.

General education is the quality education of higher education , which includes the humanities , so-cial science and natural science .It point out the present status of medical colleges and universities to carry out the general education of humanities and the existing problems which based on the current China 's higher medical colle-ges and universities to strengthen the urgency of the general education of humanities .It main including:the lack of humanistic concept of general education and human general curriculum is not reasonable ;the human general educa-tion hasn't dived into the medical professional education which lead to the students attention degree is not enough ;Human general education methods is single , practical link is weak .To solve these problems should be set up a med-ical humanities general education organization and management agencies , build reasonable medical humanities gen-eral course system , strengthen the construction of teaching staff of a curriculum , improve education curriculum teaching methods and many other countermeasures and suggestions .

Objective:Tiapride has been used effectively in the clinic for the treatment of dyskinesias and tic disorders including Tourette syndrome. The purpose of the retrospective study is to evaluate the effectiveness of tiapride with the horn of saiga tatarica in treatment of hemifacial spasm. Method:Twenty-eight patients with idio-pathic hemifacial spasm, who were previously treated with carbamazepine, or acupuncture, or botulinum toxin injection, but refused to continue the previous therapies, were treated with tiapride, at a dosage of 50 mg /time once to thrice per day, combined with the horn of saiga tatarica at a dosage of 0. 15 g to 0. 30 g/time once per day. The dosage of tiapride can been up to 100 mg/time once to thrice per day in some cases if necessary. The effectiveness of the therapy was evaluated from the time of three months after the beginning of the treatment. The main efficacy parameter was the degree of spasm reduction, that is, the classification of spasm before versus after the treatment. Result:The duration of following up is between 3 months and 12 months. Twenty-five cases out of 28 patients have demonstrated a significant reduction of spasm. Of which, eight cases were completely relieved, 12 cases marked relieved and 5 cases partially relieved. The effective rate is 89. 29%. Conclusion:Tiapride combined with the horn of saiga tatarica was effective and safe in reducing hemifacial spasm. However, further data from blinded trials and long-term following up are required before this treatment can be considered to be one of the main medical treatment options for hemifacial spasm.

Objective To study the effect of new dressing combined with ostomy appliances for treating intestinal fistula .Meth-ods 50 patients with intestinal fistula from September 2009 to September 2012 were taken as the experimental group and treated by the new dressing combined with ostomy appliances .Contemporaneous 29 cases of intestinal fistula as the control group were treated by traditional drainage method .The peristomal skin healthy state in the two groups′patients was evaluated by DET scoring before intervention ,on 5 ,10 ,15 d after intervention .The following indexes on 15 d after intervention were compared between the two groups ,including the infection rate of wound ,times of change dressings and costs of change dressings .Results The DET scores at each follow -up timepoint in the experimental group were significantly lower than those before intervention and those in the control group ,the difference had statistical significance (P<0 .05) .Compared with the control group ,,infection rate of wound were lower ,times of change dressings were fewer ,costs of change dressings was less in experimental group significantly (P<0 .05) at 15 days after treatment .Conclusion New dressing combined with ostomy appliances for treating intestinal fistula could get bet-ter clinical effect .

Objective　To probe the relationship of differentiation degree with spread or survival prognosis in retinoblastoma　(RB).　Methods　Clinical data, follow up status and eyeball specimens in 156 RB cases were investigated retrospectively. The tumors were divided into differentiated and undifferentiated groups.Conditions of the tumor invasion of ocular or surrounding tissues were reviewed. The fatality rate was obtained from the follow-up materials of 82 cases of RB. The fatality rate and the invasion rate between the two types were compared statistically by Chi-square test. In addition, the relation between the tumor invasion and death ,and the average survival time for dead people after surgery were explored.　Results　Local invasion of tumor cell was found in 8　eyes among 17 eyes with differentiated RB (47.06%),and in 66 eyes among 139 eyes with undifferentiated RB　(47.48%).There was no significant difference with regards to the local invasion between the two types (P>0．05). The fatality rate of cases of differentiated RB was 27.27%,and 22.54% in undifferentiated RB, and there was no statistical difference between the two types .The fatality rate for patients with orbital and scleral extension was 100%,optic nerve invasion (grade Ⅳ) was 62.50%,and uveal invasion was 22.22%.The survival time for the dead victims were from 5 months to 41 months and averaged to 21.92 months.　Conclusion　There was no significant difference both in survival prognosis and local invasion between the two types. The survival prognosis of metastatic RB was dependent on the degree of spread and the efforts of treatment and regardless of the types of differentiation of RB cells.