Hemodialysis is the most important and effective treatment for patients with chronic renal failure. It provides the opportunity for patient to lead a meaningful and long life. The author analyzed the present state of hemodialysis for patients with chronic renal failure in China and put forward some concrete proposals to the improvement of hemodialysis.

OBJECTIVE:To investigate release characteristics of sirolimus liposome in vitro.METHODS:The concentration of sirolimus was determined by RP-HPLC.In vitro release rate of sirolimus liposome within 24 h was investigated by the reverse dialysis method with 20% ethanol 500 mL as medium.Release curve of sirolimus was fitted with drug release model equation.RESULTS:The linear range of sirolimus were 0.5～20 ?g.mL-1(r=0.999 8)with an average recovery of 99.42%(RSD=1.23%).At the first 4 hours of release,sirolimus liposome released rapidly with accumulative release rate of 50%.After that release rate of liposome was slowed down with accumulative rate of 80% in 24 h.The in vitro release curve conformed to the first order equation.CONCLUSION:Sirolimus liposome has delayed release capability,and in vitro drug release of sirolimus liposome is in concentration dependant manner.

As one of the five senses of human beings, taste is inseparable from our lives. It is vulnerable to radiotherapy-induced injury for head and neck malignant tumors, which in turn affects the patients′ quality of life and clinical prognosis. In this article, the epidemiological characteristics, pathogenesis, influencing factors, evaluation and prevention and treatment of radiotherapy-related taste disorders were reviewed, aiming to explore the research progress on the radiotherapy-induced taste disorders and provide novel ideas to improve the quality of life in the whole process of radiotherapy for patients with head and neck malignant tumors.

Renal transplantation is the best method for end-stage renal diseases in clinic. With the development of immunosuppressive agents, renal transplantation has been quite successful. Various complications after renal transplantation still threaten the function of graft and the life of patients. Some medical complications are difficult to prevent, but surgical complications are effective to prevent. The article comprehensively analyzes the etiology, diagnosis, treatment and prevention of some common urological complications such as urinary fistula, ureteral obstruction and ureteric reflux. The urological complications as the common complication are correlated to surgical skill. It has been an important link in improvement of transplantation quality to reduce incidence of urological complications and to diagnose and manage.

Background and purpose:The mechanism of vinorelbine is inhibition of microtubule protein assembly and inducetion of the disaggreation of microtubles;where as docetaxed promotes the assembly of microtuble protein and inhibits normal physiological disaggreation of tubulin.We studied the curative effect and toxicity of combination of chemotherapy with navelbine(NVB) plus paclitaxel in the treatment of advanced breast cancer.Methods:Forty-two pathologically and cytologically proved cases of advanced breast cancer were treated with intravenous infusion of navelbine 25mg/m~2 on d1 and d8,paclitaxel 175mg/m~2 by 3-hour continuous infusion on d1.Interval between each cycle was 21 days and the clinical response and the toxicity were assessed after 2~4 cycles.Results:The overall response rate(RR) for the whole group of patients was 66.7% with 16.7% complete response(CR).In the first time chemotherapy patients,the RR was 72.2% with 27.2% CR;while in those with prior chemotherapy,an RR as high as 62.5% with 8.3% CR was also obtained.The 2-and 4-year survival rates was 40.5% and 21.4%,the median remission period was 8 months,the median overall survival duration was 18 months.The major side effects include leukopenia,hairloss,milieu phlebitis.Conclusions:The combination chemotherapy with navelbine and paclitaxel in treatment of advanced breast cancer is effective and the side effects could be tolerated.

[Objective]To compare the short term outcome in treatment of degenerative lumbar stenosis with Coflex implant versus laminectomy and posterior interbody fusion along with pedicle screw system. [Methods]Thirty patients with degenerative lumbar stenosis were randomly divided into two groups.Fifteen patients in the control group were treated with laminectomy and posterior interbody fusion along with pedicle screw system. The other 15 patients in the experiment group were treated with Coflex implant. The parameters for assessment included operation time,intraoperative blood loss,hospital stay,pre- and postoperative JOA score,improvement rate and complication rate.[Results]Compared to the control,significant reduction was found in terms of operation time,intraoperative blood loss,and hospital stay in the experiment group.No significant difference was found regard to the improvement rate and postoperative JOA score. In addition ,there was no complication in the Coflex group during the follow-up.[Conclusion]Coflex implant is an effective,save and minimally invasive surgical method for the treatment of degenerative lumbar stenosis.

Purpose:To investigate the therapeutic effect a nd toxicity of combination chemotherapy with navelbine (NVB) and epirubicin (E- ADM) in treating metastatic breast cancer. Methods:37 patients with metastatic breast cancer were treated with combination chemotherapy of vinorelbine 25 mg/m2 d 1.8, E-ADM 60 mg/m2 d 1, 21 days for a cycle, a total of 2-4 cycles, made tracks for 6-37 months. Results:Among 27 patients with 37 metastatis, CR was 37.84%(14/ 37), PR 16.22%(6/37), SD 37.83%(14/37), SD≥6 months,21.62%(8/37), PD8.11%(3/37) , ORR(CR+PR) 54.05%, (CR+PR+SD≥6 months) 75.68%, and TTP was 6-9 months. Th e peak value of the efficiency to the lymph metastasis above the clavicle was 90 .9%. The toxicity was leukopenia,losing hair,milieu phlebitis. 74.07% of cases was in Grade Ⅲ and Grade Ⅳ leukopenia , 11.11% of cases was phlebitis. Conclusions:The combination chemotherapy with navelbine(NVB) an d epirubicin (E-ADM) in treating metastatic breast canser is effective and has acceptable tolerance.

Purpose: To observe the efficacy of combined chemotherapy of navelbine( NVB) and cisplatin ( DDP) plus concurrent palliative local radiotherapy in the treatment of stage M, nasopharngeal carcinoma( NPC). Methods: 21 cases of stage M, NPC received combined chemotherapy of NVB 25 mg/m2 on dl, d8 and DDP 30 mg/m2 on day 1-3. The therapy was repeated every 28 days. All patients were concurrenly treated with palliative radiotherapy for to the distant metastases areas. The radiotherapy dose varied from 15 to 60 Gy. Results: 1.The 1-, 2- and 3- year survival rates of the patients were 71.43%, 14.29% and 9.25% respectively. The median survival time ( MST) was 17 months. 2.The Cox Regression analysis showed that the effect of treatment and the liver invasion are significant prognostic factors. The survival rate is the highest in the patients with lung metastases. Conclusions: This scheme combined chemotherapy of NVB and DDP plus concurrent palliative local radiotherapy can improve the MST of the patients with stage M1 of NPC.

Objective To explore a therapeutic method for repairing the avulsion injury of total hand skin. Methods Bilateral chest navel flaps with nerves were used to repair the avulsion injury of total hand skin. Two nerves of the right lateral flap were anastomosed with the first and third common palmar digital nerves respectively; two nerves of the left lateral flap were anastomosed with the dorsum manus of ulnar nerve and cutaneous branch of radial nerve respectively. Results Postoperative follow up of 12 to 15 months showed that two cases were successful. The injured hands regained thalposis and thigmesthesia; the ulnar hand had sensitive thigmesthesia when touching a table; and the grasping function of the hand recovered partially. Conclusion Bilateral chest navel flaps with nerves are recommendable to all kinds of hospitals for repairing the avulsion injury of total hand skin.

BACKGROUND: Present existed procedure protocol for urinary fistula has some limitations, which can not reflect diseased region, pathological change, or severe condition of patients, OBJECTIVE: To establish the procedure protocol for urinary fistula diagnosis and treatment following renal transplantation, in addition, to investigate its significance in clinical practice. METHODS: A total of 102 cases with urinary fistula, including 67 male and 35 female, range in age from 21 to 57 years. According to the business management mode, we have designed the "five-step procedure protocol" for the diagnosis and treatment of urinary fistula after renal transplantation. Four diagnosis steps consisting of qualitative, located, quantitative and classified, as well as one treatment step. Among 102 cases of urinary fistula, 34 were adopted conservative treatment, including 24 cases with drainage tube and retention type catheter, 10 cases with indwelling ureteric stents at tubal bladder. Other 68 cases received surgical treatment. In 47 cases with simple fistula, 36 cases received ureter/bladder replantation, 11 cases with ureteral anastomosis. Twenty-one cases with complex fistula were treated with surgical prosthesis using omentum majus after repairing. RESULTS AND CONCLUSION: Among the 34 cases receiving conservative treatment, 2 got urinary tract infection repeatedly, and 5 got the stenosis of ureterovesical anastomotic stoma. Among the 68 cases receiving surgical treatment, 2 had ureteral stoma stricture, 1 ureterovesical anastomotic stoma stricture, and 1 ureteral countercurrent. In the surgical treatment series, 3 cases died from severe pulmonary infection elicited by urinary fistula. 77 cases were available for long-term follow-up, 22 were dropped out. In the 57 cases with simple fistula were followed up for 1-10 years, the transplanted renal function was normal in 40 cases, and 17 cases suffered from chronic rejection. 20 cases with complex fistula treated with surgical prosthesis using omentum majus were followed up for 1-7 years, 19 cases were normal, 1 patient had increased creatinine, which was returned to normal after intravenous glucocorticoid therapy. The design of "qualitative, located, quantitative and classified" standard for urinary fistula diagnosis following renal transplantation, and the establishment of "five-step procedure protocol", make urinary fistula diagnosis and treatment more ordered and standard, which is more feasible for selecting optimal therapeutic scheme.