Objective To explore the mechanism of gefitinib in the treatment of non-small cell lung cancer (NSCLC) cell lines in vitro. Methods The effects of the gefitinib in five human NSCLC cell lines (A549, SPC-A-1, H460, H1229, 95D) were studied. The inhibition of cell proliferation in each group were measured by CCK8;The status of apoptosis cells were observed using flow cytometry after PI marked;invasion of lung cancer cell inhibited by gefitinib were assessed by transwell technique;The drug was detected by western blot on the proliferation-related signaling protein. Results The proliferation and invasive capacity of NSCLC cells were inhibited by gefitinib (P < 0.05). In gefitinib group, the apoptosis rates of A549 [(9.6±0.73) %]and SPC-A-1[(14.3±1.12) %]were higher than that of control group[(3.1±0.29) %](t =11.16,P =0.001;t =4.726, P =0.009). Expression of p-AKT, p-EGFR, p-MAPK protein levels were significantly down regulated in A549 cells when gefitinib was given after 72 hours (t =6.656, P =0.003;t =16.441, P =0.0001;t =3.736, P =0.020). Conclusion Gefitinib can inhibit the proliferation and invasion of lung cancer cell, also can induce apoptosis in vitro and most likely to contribute to the inhibition of key enzymes in EGFR signaling transduction pathway.

Objective To investigate the effects of ulinastatin on renal ischemia/reperfusion (I/R) in rats and assess the possible mechanism. Methods Seventy-five male SD rats weighing 210-250 g were randomly divided into three groups with 25 animals in each group : (Ⅰ) control group received sham operation; (Ⅱ)renal I/R group and (Ⅲ) ulinastatin + I/R group. The animals were anesthetized with intraperitoneal ketamine 50 mg?kg-1 . Bilateral kidneys were exposed through midline incision and bilateral renal pedicles were occluded with atraumatic mini-clamp. The kidneys turned pale. In control group the kidneys were exposed but their pedicles were not clamped, while in ulinastatin group (Ⅲ) ulinastatin 12 500 u was given i. v. 30 min before ischemia and at the beginning of reperfusion. Blood samples and kidneys were obtained at 0, 2, 6, 12, 24 h of reperfusion for determination of blood urea nitrogen (BUN) and serum creatinine (Cr) concentrations and the expression of heat shock protein 70 (HSP 70) and bcl-2 in kidney and for microscopic examination. Paller scoring system was used to evaluate the severity of histological changes ( the higher the score, the worse is the change) .Results BUN and serum Cr levels were significantly lower at 12 and 24 h of reperfusion in group Ⅲ than in group Ⅱ (P 0.05) . Conclusion Ulinastatin can reduce the risk of renal dysfunction and injury associated with renal I/ R. The protective effect of ulinastatin may be associated with the up-regulation of bcl-2 expression.

Objective To investigate the influence of preoperative training of pushing trachea and esophagus or not on cervical operation by anterior approach.Methods All patients were randomly divided into two groups:experimental group and control group (56 cases,respectively).Patients in the former group had no training of pushing trachea and esophagus,while patients in the latter group had,recording the data of surgery duration,operator's degree of satisfaction,blood loss,blood pressure,heart rate,and oxygen saturation during operation,hospital stay and cost.Meanwhile,we observed and compared the VAS scores and the complication rate etc.between two groups.Results There were no differences between two groups in surgery duration,operator's degree of satisfaction,blood loss,blood pressure,heart rate,and oxygen saturation during operation,hospital stay and cost,nor in the VAS scores and the throat-related complications rate.The hospital stay and cost of patients in experimental group were longer and higher than that of patients in control group,(7.3±1.6) d vs (5.8±1.4) d,(48 468.3±4 313.8) vs (45 228.4±4 124.6) yuan,t=5.280,4.062,P＜0.05.Conclusions Training of pushing trachea and esophagus has no influence in the throat-related complications rate,VAS scores and operator's degree of satisfaction.Instead,training of pushing trachea and esophagus increases hospital stay and cost and amount of nurse's work.So,it's not necessary to undertake the preoperative training before cervical operation by anterior.

Objective To investigate the effect of lovastatin on hyperlipemia of children with nephrotic syndrom.Methods 43 cases of nephrotic syndrome were randomly divided into treatment group (n=21) and control group (n=22), all of which were given prednisone.Lovastatin was added to the treatment group.Before treatment and one month after treatment liver function and serum lipide were measured.Results The levels of serum apolipoprotein B (ApoB),total cholesterol (TC), trigtycerides (TG), low density lipoprotein cholesterol (LDL C) and lipoprotein (a) (Lpa) were obviously decreased compared with that before treament (P

Objective To investigate the effects of autologous blood transfusion on serum neopterin and IL-2 concentrations after radical gastrectomy. Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes (33 male, 27 female) aged 40-65 yrs weighing 51-70 kg undergoing radical gastrectomy for stomach cancer were randomly divided into 2 groups (n = 30 each):homologous blood transfusion group (H) and autologous blood transfusion group (A). The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 5 ?g?kg-1, propofol 1 mg?kg-1 and vecuronium 0.12 mg? kg-1 and maintained with isoflurane inhalation (1 % -2 %) and intermittent i. v. boluses of fentanyl and vecuronium. In group H homologous blood 400 ml was infused during gastro-intestinal anastomosis. In group A 400 ml of blood was removed from radial artery after induction of anesthesia, before surgery. Blood volume was maintained by simultaneous infusion of succinylated gelatin 500 ml. The 400 ml autologous blood was infused also during gastrointestinal anastomosis. Venous blood samples were taken before operation (baseline) , at the end of operation and on the 5th postoperative day for determination of serum concentrations of neopterin and IL-2 (ELISA) Results The two groups were comparable with regard to sex (M/F ratio), age, body weight, duration of operation and total blood loss. The serum concentrations of neopterin and IL-2 were significantly decreased after operation compared to the baseline values before operation in group H (P

The learning theory of constructivism, formed by the development of cognitive psychology, shaped well thecognitive structure of medical students. It paid attention to the curriculum configuration and integration, and also thoughtmuch of the situated instruction. The theory embodied the main ideology of regarding medical students as the instruc-tional central and the principle of independent study. It offered the theoretical basis and a new view for the setting ofclinical integrate curriculum.

Objective To compare the therapeutic effect of Qingre Anchuang Tablets(QAT) processed by new or old technology on rabbit ear acne.Methods Experimental rabbit ear acne was induced by coal tar.After the modeling,the rabbits were administrated with QAT processed by new or old technology.The thickness,weight and PGE2 level of the acne ear were measured,and the pathological changes of the acne ear were also examined.Results QAT processed by new or old technology could decrease the thickness,weight and PGE2 level of the ear significantly,and relieve the pathological changes of the acne ear.The effects of QAT processed by new technology was better than that of QAT processed by old technology.Conclusion QAT processed by new technology has a better therapeutic effect on rabbit ear acne than QAT processed by old technology.

Objective To study the relationships between clinical and endoscopic findings of children with Henoch-Schoenlein purpura ( HSP). Methods All of the 51 cases with HSP from Aug 2000 to Apr 2004 were checked up by endoscopy, either gastroscopy and/or colonoscopy, and analyzed the relationship between clinical and endoscopic fingings. Results Fifteen out of 51 cases had no prominent changes in endoscopies, and 36 cases had different lesions in gastric, duodenal or colonic mucosa. There were 4 cases presented with simple lesion on stomach mucosa and 7 cases on colonic mucosa; and 25 cases had the lesions presented in gastrie, duodenal and/or colonic mucosa. The main findings in mucosa were exudates, erosion and hemorrhage. Conclusion There are obvious lesions in stomach, duodenum and /or colonic mucosa of HSP in children. Sometimes, these lesions happened before the appearance of skin purpura. There are close relationships between the lesions and the clinical manifestations of HSP in children, and therefore the endoscopic check up of HSP in children has very important significance in early diagnosis.

Objective To evaluate the indication,operation pattern and therapeutic effect of ano-saving surgery for lower rectal carcinoma. Methods Retrospective analysis on the clinical feature of 320 patients with lower rectal carcinoma (postoperative time ≥5 years)treated by ano-saving surgery, the 5-year survival rate, local recurrence rate, and mortality were compared in the various operations. Results The success performed rate of ano-saving operation for lower rectal cancer was 58.5%(320/547).Among them, anastomotic leakage after surgery occurred in 4 cases (1.25%), and 26 cases had anastomostic narrowness (8.13%) within 1 year after surgery.The defecation function after surgery, in patients received colonic J pouch or transverse coloplasty pouch was much better than that in patients received coloanal or colorectal anastomosis. 5-year survival rates, and anastomostic recurrence rates were as follows:In ultra-low anastomosis were 63.24% and 10.27%. Park′s operation 66.67% and 5.13%, local resection 89.46% and 10.71%, respectively. 5-year recurrence rate in the pelvic soft tissue was 3.44%(11/320).Two cases died after operation. Conclusions Lower or ultra-low colon-rectum anastomosis becomes the main operative pattern in preserving anal sphincter in lower rectal cancer.Local resection of lower rectal tumor might be considered if the indecation is selected strictly. Colonic-J-pouch or transverse coloplasty pouch is good for improving the defecation function after ano-saving surgery for lower rectal cancer.

Objective To explore the efficacy and safety of endovascular therapy in the treatment of symptomatic M1 stenosis of middle cerebral artery as well as the causes of perioperative complications.Methods Two hundred fifty-six patients with symptomatic M1 stenosis of middle cerebral artery (＞90％) confirmed by TCD,cerebral CT angiography and DSA was treated by endovascular intervention.The success rate,the changes of stenosis,longterm vascular patency rate,in-stent restenosis rate were analyzed.Results endovascular stent was successfully placed in 251 patients with the M1 part of symptomatic middle cerebral artery stenosis and the successful rate was 98.05％.Fifteen patients had complications (5.86％) which caused neurology deficits and deaths.The degree of vascular stenosis was significantly reduced after stenosis (Before vs After:92.26％±2.11％ vs 15.40％±2.60％).The mean mRS and NIHSS scores was decreased significantly.The average follow-up duration was (21.70±0.80) months,249 patients underwent a second DSA and the mean stenosis was (21.70％±0.80％).Twenty-three patients developed instent restenosis (ISR) and ISR rate was 9.24％.Recurrence ischemic stroke and transient ischemic attacks occurred in 5 patients and recurrence rate was 2.01％.Conclusion Endovascular therapy of symptomatic M1 stenosis of middle cerebral artery is safety and efficacy with low complications.The follow-up results reveal good patency rate and excellent prevention of anterior circulation ischemia.