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.

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.

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 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 .

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 discuss the method of surgery treatment for nodular goiter,Graves disease,Hashimoto thyroiditis and differentiated thyroid carcinoma. Methods:A retrospective analysis of the clinical records of 76 patients undergoing total thyroidectomy was analyzed for the method of surgery treatment for thyroid diseases from resection extent,operative techniques,intraoperative and postoperative complications. Results:Five patients(78.4%)of all the patients accepted total thyroidectomy in first operation had transient or short-term completely recovered hypocalcemia postoperatively,and there were no cases with injury of recurrent laryngeal nerve. 4 patients(33.3%) had one-sided recurrent laryngeal nerve injury and temporary hypoparathyroidism in recurrent patient,and one of the cases had permanent hypoparathyroidism. Conclusion:Total thyroidectomy could be served as the routine operative method for multinodular goiter,Graves disease,Hashimoto thyroiditis and differentiated thyroid carcinoma.

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.

Objective To search for an effective acupuncture-moxibustion therapy for high fever in common cold. Methods According to the randomized and multi-central trial principle, 276 cases enrolled were randomly assigned to observation group of 138 cases and control group of 138 cases. The observation group were treated by electroacupuncture at Dazhui and the control group were treated by Antondinie injection coordinating pathogeny therapy to observe the prompt effects in 24 hours. Results After treatment, the temperature of every time point of the observation group was lower than that of the control group (P 0.05). Conclusion The method of electroacupuncturing at Dazhui has a definite therapeutic effect on high fever in common cold.

Objective To explore the anticoagulating active components in water extraction, alcohol sedimentation and fraction separated by gelfiltration chromatography of Bombyx Batryticatus. Methods Anticoagulating active fractions were prepared by the methods of water extraction, 70% alcohol sedimentation and gelfiltration chromatography. Components (such as porteins or polypeptide, amino acids, oxalic acid ammonium) in each fraction were determined by chemical reaction indentification, Kjeldahl method, conductance, UV and HPLC. Results Polypeptide, amino acids and oxalic acid ammonium were the main components in anticoagulating active fractions, content of which reached more than 80%. The content of oxalic acid ammonium decreased about 52% processed by alcohol sedimentation, while the content of polypeptide and amino acids only decreased about 8%. The content of peptides and amino acids increased about 28% purified by gelfiltration chromatography compared with the one in water extraction and about 39% compared with the one in alcohol sedimentation. The content of oxalic acid ammonium was the same as the one in alcohol sedimentation, but decreased about 1 time compared with the one in water extraction. The content of 15 kinds of amino acids were 40%～50% in the solids of each fractions, which maked up to 60%～76% of the content of proteins determined by Kjeldahl method. Molecular weight range of peptides is 1.0～4.4 kDa. Conclusion This study provides a experimental basis for further separation and purification of anticoagulating active components from Bombyx Batryticatus.

Thirty-two patients with comminuted proximal humerus fractures(Neer Ⅲ or Ⅳ) were admitted to Department of Orthopedics,First Hospital of Jilin University from March 2001 to April 2006.The patients consisted of 19 males and 13 females,aged 19-70 years,including 15 of 19-49 years and 17 of 50-70 years.All patients underwent treatment of cloverleaf plate-screw fixation.During the follow-up for 8 months,union time and scores from Constant & Murley functional scale were similar between male and female groups.Compared with patients aged 50 years,and the scores from Constant & Murley functional scale were significantly lower(P 50 years old is relatively longer with unfavorable functional recovery in the shoulder joint.