Objective To evaluate the efficacy and toxicity of gimeracil and oteracil porassium capsules combined with nedaplatin in the treatment of the patients with distant metastatic nasopharyngeal carcinoma.Methods Fourty cases were randomly divided into the observation group and control group by random digital table.19 cases in the observation group were treated with oteracil potassium capsules combined with nedaplatin.21cases in the observation group were treated with gemcitabine combined with nedaplatin.The response rate,response rate(RR) and progression free survival(PFS),toxicity were evaluated according to response evaluation criteria in solid tumors (RECIST).Results The response rate were 52.6％,52.3％ respectively,the median progression-free survival were 5.5 and 5.2 months,respectively.Grade Ⅲ an Ⅳ platelet supression were 10.5％,38.0％ between the observation group and control group.It was statistically significant between the two group(x2 =4.89,P ＜ 0.05).Conclusion Oteracil porassium capsules combined with nedaplatin is similar with gemcitabine combined with nedaplatin in the distant metastatic nasopharyngeal carcinoma,the adverse reaction was lighter than that of the control group.

Objective: To observe the effect of warm needling therapy plus acupuncture on third lumbar vertebra transverse process syndrome.
Methods: Sixty cases of third lumbar vertebra transverseprocess syndrome were randomly divided into a warm needling groupor an acupuncture group, 30 cases in each group. Cases in the acupuncture group were treated by routine points and needle sticking manipulation, while those in the warm needling group were treated by moxibustion plus needling as same as the acupuncture group. Japanese orthopedic association scores (JOA) in the two groups were observed and compared after 2 treatment courses.
Results: After treatment, the JOA score in the warm needling group was higher than that in the acupuncture group (P<0.01); subjective symptom, clinical syndromes, activity of daily living (ADL) in the warm needling group were all higher than those in the acupuncture group (allP<0.05); the score of pain in the warm needling group was significantly lower than that in the acupuncture group (P<0.01); the total effective rate in the warm needling group was 76.7%, versus 70.0% in the acupuncture group, showing a statistically significant difference (P<0.05).
Conclusion: Warm needling therapy is more effective thannormal acupuncture in treating third lumbar vertebra transverseprocess syndrome.

Inherited metabolic disorder is a major class of clinical diseases with complexity and dififculty of being di-agnosed. Current clinical diagnosis has to rely on the metabolite analysis, gene analysis and enzyme activity (protein function) analysis of these three techniques. We analyse the features of the three diagnostic methods and clinical application of analysis, comparison and induction, to provide some experience and reference that help clinicians to better use of these three techniques. These three ways should be organically combined to form a diagnostic platform for inherited metabolic disorders.

Objective To investigate the clinical effect of early laparoscopic cholecystectomy in the treat -ment of elderly patients with acute cholecystitis .Methods 68 elderly patients with early acute cholecystitis were di-vided into the two groups according to the surgical procedures .33 cases in OC group were given traditional open sur-gery,while 35 cases in LC group received early laparoscopic cholecystectomy .The operative time,postoperative bowel recovery time and postoperative hospital stay time were compared between the two groups .Results The operative time,postoperative bowel recovery time ,postoperative hospital stay time in LC group were (43.7 ±5.8)min,(36.4 ± 3.9)h,(4.8 ±1.4)d,which were significantly shorter than (68.6 ±7.3)min,(65.2 ±4.5)h,(8.3 ±2.9)d in the OC group(t=3.317,3.862,3.029,all P<0.05).The incidence rate of postoperative complication of LC group was 14.29%,which of the OC group was 24.24%,the difference was not significant(P>0.05).Conclusion Early lap-aroscopic cholecystectomy in the treatment of elderly patients with acute cholecystitis can significantly shorten the operation time, promote postoperative recovery of gastrointestinal function and reduce postoperative hospital stay , reduce the burden of patients ,improve the quality of life and the incidence rate of complications is low .

Objective To quantitatively detect CA125 with self-designed synthetic gold nanoparticle probes by the colorimetric immunoassay and to initially investigate the feasibility of clinical application .Methods The capture antibody of detective CA125 was conjugated to the gold nanoparticle surface for preparing the gold nanoparticle probes .The gold nanoparticle aggregation was formed by the antigen-antibody immunoreaction .CA125 was quantitatively detected by the colorimetric immunoassay .Results The gold nanoparticle probes was successfully prepared ,which could detect the serum CA125 content rapidly and conveniently ,the de-tection results were coincident with the pathological diagnosis .The lowest limit of quantitation was 0 .5 U/mL ,which was far lower than that in ELISA .Conclusion This gold nanoparticle probes are simple to be prepared ,rapid and easy to operate with low cost , and have the important application value in clinical early detection of ovarian cancer marker CA 125 ,especially in the primary hospi-tals .

Objective To investigate and analyse the status and influential factors of nurses' palliative care knowledge in Shanghai city.Methods Using cluster sampling method,a questionnaire survey using Palliative Care Quiz for Nursing (PCQN) was conducted on 973 nurses in 9 hospitals of Shanghai city.Results 939 nurses completed the survey whose scores were 8.88±2.51.The status quo of palliative care knowledge of Shanghai nurses were not very desirable.The scores of palliative care philosophy and principles and psychological,social and spiritual support were 0.376±0.009 and 0.310±0.008.The scores of knowledge of the pain and symptomcontrol was 0.496±0.005,which was better than the other two aspects.There were differences between dimension 1 and dimension 2,3 (t=-1 1.78,5.465,P＜0.01),and also between dimension 2 and 3 (t=19.673,P＜0.01).Conclusions Lacking of education and training,insufficient recognition of related institutions and the limit of traditional ideas caused the defect in the knowledge structure of palliative nursing.

Objective:To explore if the therapeutic effect can be enhanced, the dose of levodopa-like medications can be decreased and the complications can be reduced by acupuncture treatment in the patients with Parkinson's disease (PD) who took levodopa-like medications for a long time. Methods: thirty cases of the patients, most of whom were noticed with the decreased therapeutic effect and drug-induced complications, were treated by puncturing Shuigou (GV 26) and Baihui (GV 20), by reduction of Madopa dose, and the patients' conditions and complications were evaluated six months later. Results:After treatments for six months, the physiological functions were improved and the dose of Madopa was reduced and the total effective rate was 66.7%. Conclusion: After acupuncture treatments in PD patients, the therapeutic effects of levodopa were enhanced, with its dose and complications reduced.

Treated 50 cases of renal colic with electroacupuncture and compared the results with those in two control groups. Total effective rate in the treatment group, control group Ⅰ and control group Ⅱ was 98.0%,90.0% and 92.0% respectively.

Corneal graft melting after keratoplasty is rare to happen.However,once corneal graft melting had happened,it is difficult to manage.It would be precluded effectively by confirming the risk factors and pathogenesis for corneal graft melting.Progression of graft melting also can be well controlled using immune depressant,heparin,or collagenase inhibitor at the early stage.Those patients with melted graft can be treated with repeat keratoplasty

The involution of female Swiss mouse thymus induced by estradiol (Es_2) were studied by morphological methods.The involuting thymuses of 2-month-old mice increased greatly in weight after ovariectomy. Treated with Es_2, the thymuses of immature mice not only stopped growing, and also involuted apparently. The regeneration of thymuses was impeded in the mice whose thymuses had already involuted induced by hydrocortisone when treated with Es_2. These results proved the obvious inhibiting and involution-inducing effects of Es_2 on thymus. The pattern of the thymus involution induced by Es_2 was different from that by hydrocortisone. Es_2 had no lethal effect on thymocytes either in vivo or in vitro, but it reduced the proliferative rate of thymocytes slowly and caused the thymus involution gradually. Es_2 made no remarkable changes in weight and histology of adrenal glands. Thymus involution induced by Es_2 was also detected in adrenalectomized mice. These results indicated that thymus involution induced by Es_2 was adrenal independent. Accompanying the thymus involution, the number of type Ⅰ thymic epithelial cells decreased, which were considered to produce thymic hormones actively, and the structure of thymic epithelial cells denatured. These morphological degenerative alterations suggest that Es_2 can result in some changes or decline of the hormone secretory activity of thymic epithelial cells, and then the proliferation of thymocytes will reduce and thymus involution will take place.