0.05) . Cost-effectiveness ratios were 52.89 and 211.53,respectively. CONCLUSION:Low-dose prolonged gemcitabine infusion combined with cisplatin regimen is economical one in the treatment of advanced NSCLC.

BACKGROUND:The regional gene therapy of bone defect is to transfer genes capable of accelerating bone healing into target cells, which will transcript the genes into mRNA and translate them into proteins, then the target cells will be stimulated to differentiate under the role of protein, and finally reach the purpose of accelerating bone healing by means of autocrine or paracrine. With the development of cell recombination technique, more and more genes of growth factors involved in the bone repairing have been successfully cloned, which make it possible to treat bone defect with gene therapy. The present status for the regional gene therapy of bone defect is summarized.DATA SOURCES: An online search in Pubmed database was undertaken to identify articles about the regional gene therapy of bone defect published in English from January 1965 to January 2006 by using keywords of "gene therapy,bone defect". Meanwhile, Chinese relevant articles published from January 2000 to January 2006 were searched in Wanfang database by using the same keywords in Chinese.STUDY SELECTION: The data were primarily checked, and the references of each article were looked up. Inclusive criteria: related to the regional gene therapy of bone defect. Exclusive criteria: repetitive study or Meta analysis.DATA EXTRACTrON: Totally 237 articles were collected, 32 of them were in accordance with the inclusive criteria, and the other 205 were old or repetitive ones. Of the 32 articles, 4 were about the selection of destination genes, 3 about the selection of target cells, 7 about the selection of gene expression vector, 3 about the methods of gene transfer, 4 about gene therapy combined with tissue engineering in treating bone defect, 5 about polygenes in treating bone defects, and 2 about the problems and prospects in the gene therapy of bone defect.DATA SYNTHESIS: The regional gene therapy of bone defect is a new technique developed base on the basic theoretical cognition of bone regeneration and gene recombination technique, and provides ideal solving program for the treatment of bone defect caused by various reasons. The basic problems mainly include the selection of destination genes, selection of target cells, selection of gene expression vectors and the selection of the methods of gene transfer.The studies about the selection of target cells and methods of gene transfer become mature day by day, bone marrow stromal cells have become the target cells should be selected firstly, and it has been generally acknowledged that ex vivo gene transfer has more obvious advantages than in vivo one. The key problem at present is how to further explain the natural process of the repair of bone defect, and select the most effective component from the signal molecules involved in the process to apply in the gene therapy of bone defect, and further improve the gene expression vector, so as to ensure the safety of gene therapy. It is believed that with the continuously deepened theoretical cognition of bone regeneration and the continuous perfection of gene recombinant technique, the gene therapy of bone defect will finally go out of laboratory, and really serve the patients with bone defect.CONCLUSION: The regional gene therapy of bone defect can effectively activate the activity of bone regeneration at the site of bone defect, also can avoid the problems of immunologic rejection and systematic toxicity caused by the direct application of cytokines, and has good prospects of clinical application. At present, this technique is not completely perfect, and there are many problems to be deeply investigated in destination genes, gene vectors and transfection technique, etc.

The technology of bone tissue engineering has got rid from autologous bone implant and allograft bone. With the development in recent 20 years,the basic pattern of tissue engineered bone has already been constructed,consisting of related molecules to bone regeneration,active cells for osteogenesis and scaffold materials. The related molecule to bone regeneration is the dominant factor to determine the bio-activity of tissue engineered bone,and also is the key researches in the field of bone tissue engineering. As the molecule bio-mechanism of bone regeneration has been elucidated and molecule bio-techniques have been combined with bone tissue engineering,many achievements regarding the related molecules to bone regeneration are observed in bone induction mechanism,vector,gene therapy technology and the combined use,which all improve the effect of tissue engineered bone on repairing the bone defects.

Objective To observe the change of sinus heart rate turbulence (HRT) and its relation to left ventricular systolic function (LVSF) in patients with acute coronary syndrome (ACS). Methods The 103 ACS patients and 62 healthy subjects were enrolled in this study, all of them received 24-hour Holter monitor. And the values of turbulence onset (TO), turbulence slope (TS)and heart rate variability (HRV) SDNN were calculated according the Holter records. The clinical information, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were recorded. Then the ACS patients were divided into acute myocardial infarction (AMI)group and unable angina pectoris (UAP) group according to the cardiac enzymes and electrocardiogram. Results The value of TO was significantly higher in ACS group than in control group [(0.17±1.40)％ vs. (- 0.26±0.99)％, P＜0.05], and TS was significantly lower in ACS group than in control group [R-R interval:(0.88±2.51) ms vs. (2.60±2.76) ms, P＜0.01].There were significant differences in TS, LVEF and LVEDD between AMI group and UAP group (all P＜0.01), but there were no differences in HRV and TO between the two groups. TS was positively correlated with LVEF (r=0.21, P＜0.05), while TO was negatively correlated with LVEF (r=-0.26, P＜0.05) by Spearman correlation analysis. Conclusions HRT is significantly blunted in ACS patients and can evaluate cardiac autonomic function. It may be as a predictor of LVSF in ACS patients.

Objective: To investigate the effect of three different goals of blood glucose control by insulin therapy on protein metabolism in the patients with critically cerebral disease.Methods: We performed a prospective,randomized,controlled study.A total of 122 patients with critically cerebral disease were randomly divided into three groups according to the target glucose-control levels:Group A: 4.4-6.1 mmol/L(n=41),Group B: 6.1-8.3 mmol/L(n=42),and Group C: 10-11.1 mmol/L(n=39).The state of protein metabolism and ratio of hypoglycemia of three groups were compared.Results: The indicators of nitrogen balance,prealbumin and transferrin in group A and group B were significantly better than that in group C(P<0.05),but the ratio of hypoglycemia in group A was significantly higher than those in group B and group C(P<0.05).Conclusion: Maintaining the blood glucose level ≤8.3 mmol/L might improve the nutrition status in the patients with critically cerebral disease by decreasing catabolism and promoting synthesis of protein.

Objective To examine and evaluate the ability of spontaneous regeneration following various extent of incomplete injury in adult rats. Methods The quantities and reduplicated various extent incomplete injured model of adult rats optic nerve was established using different wounding time with constant wounding force produced by across action forceps at 2mm behind eyeball. GAP-43 (growth associated protein-43) and its mRNA expressions were detected with immunohistochemistry (IHC) and reverse transcription polymerase chain reaction (RT-PCR). All data were analyzed by ANOVA. Results GAP-43 and its mRNA expression levels revealed that there was negative response at the distal area contrast to the strong positive response at the proximal in earlier period after injury until half mouth. One mouth later, the increased GAP-43 and its mRNA expression levels became more and more high and reached the climax at second month post injury. Then it decreased gradually. The result of RT-PCR showed there are significant difference among the various extent incomplete injured models and different time after injury. Conclusion Spontaneous regeneration of adult rat’s optic nerve can be detected and identified following incomplete injury, and the extent of regenerating ability is correlated with the extent of injury.

The incidence of rectal cancer has been increasing in recent years .It leads to more attention of scholars at home and abroad ,which the efficacy of rectal cancer has been improved by using neoadjuvant therapy all over the world .It is included preoperative radiotherapy ,preoperative chemotherapy and preoperative chemora-diotherapy .Preoperative radiotherapy ,which can be divided into short radiotherapy and conventional radiotherapy , are evaluated by comparison of T drop rate ,sphincter preservation rate ,complete remission rate and other indica-tors of clinical effect .Although the experience of pure preoperative chemotherapy is not rich enough ,it still has an advantage in lowering the tumour stage and other aspects .Currently, preoperative chemoradiotherapy is a good choice for rectal cancer ,because it could make an obvious advantage in the treatment ,at the same time ,three-di-mensional radiotherapy can make target more evenly distributed and focus treatment more precise .However,neo-adjuvant therapy has insufficient support in clinical in our country.So it needs to get more information for clinical effectiveness of applying preoperative chemoradiotherapy .This study is to summarize the new adjuvant treatment of rectal cancer .

0.05), but after 21 days of different estrogen treatment when the different estrogen levels were stabilized there were significant differences in PWL among the 3 groups ( P