Background and purpose:Advanced and metastatic colorectal cancer is the second leading cause of cancer death. In the past ,the standard treatment for patients with advanced CRC was fluorouracil(5-FU) biochemically modulated by leucovorin(LV), which demonstrated a response rate of about 23% .In 1990s, a number of new treatment options have been available. In particular, one new cytotoxic agent ,irinotecan (CPT-11), which is a specific inhibitor of topoisomerase I, have been proven to have efficacy in the tretment of CRC .Furthermore, several first-line phase Ⅲ trials show a significant improvement in result with the addition of CPT-11 to FU-LV combination therapy (FOLFIRI).We observed the survival situation, efficacy and safety of irinotecan plus 5-FU/LV after first-line chemotherapy failure for Chinese patients with advanced or/and metastatic colorectal cancer. Methods:Twenty-four patients with metastatic colorectal cancer whose disease had progressed after treatment with first-line oxaliplatin or other chemotherapeutics were included to receive biweekly FOLFIRI regimen (irinotecan 180mg/m~ 2 on day 1,with LV 200mg/m~ 2 adiministrated as a 2-hour infusion before 5-FU 400mg/m~ 2 administrated as an intravenous bolus injection and FU⒉4g/m~ 2 as 46-hour infusion immediately after 5-FU bolus ).All the patients were planned to receive at least 6 cycles of chemotherapy .They were assessed on the basis of WHO evaluation standard of objective therapeutic effect for solid tumor.Results:24 patients were assessable to observe the efficacy and safety. No case was CR.5 case were PR, response rate was 20% (5/24). 17 case were SD , rate was 70% (17/24). 2 case were PD, rate was 8%(2/24). Median time to progression (TTP) were 6.6 months (6 to 24 months ),median overall survival was 10.7 months. The majority of adverse reaction were nausea, vomiting, anorexia, diarrhea, leucopenia, alopecie. Most of them were Ⅰ/Ⅱ degree, only 6 cases reached III/IV degree. 3 cases had diarrhea with leucopenia and fever.Conclusions:The biweekly regimen of irinotcan in combination with 5-FU/LV results in significant and clinically meaningful improvement in survival and quality of life among patients with metastatic colorectal cancer. Toxicity is manageable.

Background and purpose:The prognosis of high grade gliomas remains poor, and multidisciplinary treatment strategy has been much investigated recently. This study was to explore the efficacy of Temozolomide as first-line treatment combined with radiotherapy and followed by adjuvant chemotherapy for the treatment of newly diagnosed high grade gliomas. Methods:18 patients who had been pathologically proven to be high grade gliomas were enrolled into the study. The patients received 40 Gy/20fractions for the whole brain and followed by 20Gy/10fractions as a boost to tumor bed. All of the patients were given daily oral temozolomide 75mg/ m2 during radiotherapy. 4 weeks after radiotherapy, all of the patients received 6 cycles of Temozolomide, each cycle lasted 5 days with 28 days interval between each cycles. 150 mg/m2 of temozolomide was given for the first cycle for five days,followd by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed. Results:Median follow-up was 12.5 months, 11 cases had either recurrence or progression, 5 of them died from the disease. The median time for disease progression-free survival was 9.8 months (95% CI, 6.1~9.8months), the median time for overall survival was 14 months (95% CI, 8.5 ~ 19.5months), 1-year overall survival rate was 55.6% ,6-month progression-free survival rate was 81.8%. there were no severe temozolomide related toxicities. Conclusion: Concurrent temozolomide with radiotherapy and followed by 6 cycles of temozolomide in the treatment of high grade gliomas had better clinical efficacy, the patients tolerated the strategy well and no severe toxicities were observed.

Objective:To investigate the cognitive characteristics,dangerous factors and the syndromes in mild cognitive impairment(MCI).Methods: Memory and cognitive function were assessed with Mini-Mental State Examination(MMSE).The MCI cases and normal controls were assessed by the Delayed Paragraph Story Recall Examination(DPR).A syndrome scale was used to diagnose the syndromes of subjects.The diagnosis of MCI,AD was made according to Petersen’s criteria,NINCDS-ADRDA,respectively.Results: MMSE scores of MCI cases were higher than that of normal controls,a signifi cantly difference was found.Average education level of normal controls was higher than that of MCI cases,but average contractive pressure was lower.Defi ciency of kidney,defi ciency of qi and phlegm syndromes were popular in both MCI cases aormal controls,and MCI cases had increased percentage of combined syndromes.Conclusion:The cognition function of MCI cases was decreased.Cognitive impairment was related to hypertensive disease and low education.As the development of cognitive impairment,complex Chinese medical syndromes appeared.

AIM: To study the effects of different process methods on the content of total flavonoids and the aqueous extract from Rhizoma Drynariae. METHODS: The contents of total flavonoids of Rhizoma Drynariae processed in different ways were assayed by polyamide chromatography and ultraviolet spectroplotometry; the contents of the aqueous extract were assayed by extraction in water. RESULTS: The contents of total flavonoids and the aqueous extract in Rhizoma Drynariae increased after it was processed and purified. The contents of total flavonoids and the aqueous extract in Rhizoma Dyrnariae hotted in sands, at constant temperature oven and microwave process were not influenced, but easier to be extracted in water by these methods. CONCLUSION:Microwave processis better than the other methods.

Background and purpose:At present,the treatment of metastatic breast cancer has remained diff icult for patients who have failed after the use of anthracycline and taxane,so the treatment options for those with advanced metastatic breast cancer are very limited.Therefore,pemetrexed combined with cisplatin in the treatment of anthracycline and taxane failed advanced metastatic breast cancer patients,its effi cacy and adverse reactions were studied.Methods:10 patients with advanced metastatic breast cancer patients received pemetrexed and cisplatin chemotherapy,pemetrexed 500mg/m2 intravenous infusion,cisplatin 75mg/m2 intravenous drip,repeated every 3 weeks.Evaluation of response and adverse reactions were practiced every 2 cycles.Results:10 patients were evaluable,CR 1 patient,PR 4 patients,SD 2 patients,PD 3 patients.With a median follow-up of 6 months(4-18 months),8 patients survived and 2 patients died.The median time to progression was 4 months(3-14 months),the median survival time was 8 months(4-18 months).The most common adverse reaction was fatigue,white blood cells decrease and the digestive tract reactions,followed by oral ulcers.Conclusion:Pemetrexed combined with cisplatin in the treatment of anthracycline and taxane treatment failed patients with advanced metastatic breast cancer could improve survival,adverse reactions could be tolerated.

Objective To investigate the effect of neuropeptide Y (NPY) on the osteoblastic differentiation of murine MC3T3-E1 cells and its mechanism related to the Wnt signaling pathway.Methods The murine MC3T3-E1 cells were divided into 4 groups according to the stimulators added:phosphate buffered saline (PBS) (control) and different concentrations of NPY (10-8 mol/L,10-10 mol/L and 10-12 mol/L).The cellular proliferation was detected with MTT assay after 1,3,5,7 and 9 days.The cells were identified with cell immunochemistry and Western Blot to find out the most effective concentration of NPY at different time points under osteoblastic condition.The cells were then divided into 4 groups:PBS,NPY,NPY + NPY receptor antagonist,and NPY + DKK1.Western blot was used to determine the expression of β3-catenin and p-GSK-3β in each group.Nuclear signaling activity of β3-catenin was observed using immunofluorescence staining.Results NPY significantly improved the proliferation of MC3T3-E1 cells at 7 and 9 days (P ＜0.05).NPY (10s mol/L and 10-10 mol/L) groups and NPY (10-10 mol/L and 10-12 mol/L) groups significantly improved the ALP activity at 4 and 14 days respectively (P ＜ 0.05).At 4 days,the expression of ALP protein was significantly decreased in the NPY + DKK1 group and the NPY + NPY receptor antagonist group compared with that in the NPY group (P ＜ 0.05).Although the expression levels of [β-catenin and p-GSK-3β protein were uninfluenced in either case,NPY significantly stimulated the nuclear signaling activity of β3-catenin.Conclusions NPY may significantly increase the expression of ALP protein in MC3T3-E1 ceils during osteoblastic differentiation.This effect might be mediated through the canonical Wnt signaling pathway.

Objective:To explore the effects of treadmill training during pregnancy on the development of dendritic spines and the expression of brain-derived neurotrophic factor (BDNF) in hippocampal neurons of offspring rats.Methods:According to the random number table, the natural pregnant healthy SPF female rats were divided into control group (CON group) and treadmill training group (TE group), with 6 rats in each group. The pregnant rats in CON group were fed quietly, while those in TE group were given treadmill exercise intervention 60 minutes a day with 5 days a week for 3 weeks. The setting parameters of treadmill training: the slope of electric flat plate was 0°, the track transmission speed was 8 m/min in the first 5 min, 10 m/min in the middle 25 min, and 12 m/min in the last 30 min.The body weight changes of pregnant rats in the two groups were recorded every two days from gestation of 0 day (G0). On day 21 of gestation (G21), the pregnant mice were placed in a quiet environment for labor. The expression of BDNF in hippocampus was detected by Western blot at 0, 7, 14 and 28 days after birth (P0, P7, P14, P28) respectively. The density of dendritic spines in hippocampus was detected by Golgi staining on P28. SPSS 19.0 software was used to analyze the data. Repeated measurement ANOVA was used to analyze the body weight of pregnant rats. t-test was used to analyze the data of neuronal dendritic spines. Results:Golgi staining showed that at P28, the density of dendritic spines in hippocampal CA1 area of TE group(11.330±0.558) was significantly higher than that of CON group (9.667±0.422), and the difference was statistically significant ( t=2.384, P<0.05). Compared with CON group, the relative expression level of BDNF protein in the hippocampus of offspring rats of TE group was significantly higher at P0: ((1.001±0.206), (2.027±0.240), t=3.244, P<0.05), P7: ((1.003±0.152), (2.077±0.172), t=4.669, P<0.05), P14: ((1.005±0.160), (1.562±0.178), t=3.329, P<0.05) and P28: ((1.004±0.196), (1.790±0.191), t=2.875, P<0.05), and the differences were statistically significant. Conclusion:Treadmill training during pregnancy can promote the development of dendritic spines in hippocampal neurons of offspring rats, which may be related to the promotion of BDNF expression in hippocampus.

Objective: To investigate the relationship between daily outdoor activity time both on and off campus and respiratory symptoms of junior middle school students, then to provide evidence for the prevention of respiratory diseases in adolescents. Methods: In 2016, two middle schools were selected in Wuhan，in which a total of 860 eighth grade students were surveyed, generalized linear analysis was conducted by SAS 9.4 software. Results: Average outdoor activity time out of campus during weekdays in boys and was (1.84±2.30) hours, which was higher than in girls (1.51±1.99) hours (t=2.19, P<0.05). Average outdoor activity time in campus in boys was (1.74±1.50) hours, which was significantly higher than that of girls (1.49±1.20) hours (t=2.68, P<0.05). According to the results of generalized linear analysis, after controlled for gender, age and self-perceived physical condition, the longer the time adolescents spent outside the classroom during weekday, the less likely they were to have symptoms of throat and nasal cavity(estimated value=-0.06,-0.07, P<0.05). Conclusion Adolescents who spend more time outside the classroom during weekday can effectively prevent the occurrence of respiratory related diseases.

Objective:To explore the inhibitory mechanism of herb cake-partitioned moxibustion on tumor growth in colitis-associated colorectal cancer(CAC)based on histone lysine demethylase 4D(KDM4D). Methods:Inbred male Sprague-Dawley rats were randomly divided into a normal group,a CAC group,a herb cake-partitioned moxibustion group,and an inhibitor group.Except the normal group,rats in the other three groups were treated with azoxymethane(AOM)combined with dextran sulfate sodium(DSS)to make CAC rat models.Rats in the normal group and the CAC group did not receive interventions;rats in the herb cake-partitioned moxibustion group received moxibustion at Qihai(CV6)and bilateral Tianshu(ST25),2 cones for one point each time,once a day for 30 d with 1-day rest every week;rats in the inhibitor group received intraperitoneal injection of KDM4D inhibitor,5-chloro-8-hydroxyquinoline(5-c-8HQ),once a day for 30 d.After intervention,the general condition,colon length,tumor number and volume,and histopathological colon changes were observed.The expression of adenomatous polyposis coli(APC),axis inhibitor(Axin),cyclin D1,matrix metalloproteinase(MMP)-7 and MMP-9 mRNAs were detected by real-time quantitative polymerase chain reaction.The proliferating cell nuclear antigen(PCNA),cleaved caspase3,KDM4D,APC,and Axin proteins were detected by immunohistochemistry. Results:Compared with the normal group,the general condition was poor,the colon length was significantly shortened(P<0.01),the number and volume of colonic tumors were increased(P<0.01),the structure of glandular duct was obviously disordered with"back-to-back"and cowall phenomenon,and also high-grade adenocarcinoma formed;the protein expression levels of PCNA and KDM4D were significantly increased(P<0.01),while cleaved caspase3,APC,and Axin were significantly reduced(P<0.01);the mRNA expression levels of cyclin D1,MMP-7,and MMP-9 were significantly increased(P<0.01),while APC and Axin were significantly reduced(P<0.01)in the CAC group.Compared with the CAC group,the general condition was improved,the length of colon was significantly increased(P<0.01),the number and volume of the colonic tumors were reduced(P<0.05),and the colon tissues showed epithelial cell proliferation with enlarged and deep staining nuclei,dysplasia and inflammatory cell infiltration;the protein expression levels of PCNA and KDM4D were significantly reduced(P<0.01),while the cleaved caspase3,APC,and Axin were significantly increased(P<0.01);the mRNA expression levels of cyclin D1,MMP-7,and MMP-9 were reduced(P<0.05),while the APC and Axin were increased(P<0.05)in the colon tissues of rats in the herb cake-partitioned moxibustion group and the inhibitor group. Conclusion:Herb cake-partitioned moxibustion regulated abnormally expressed KDM4D in CAC rats,activated APC and Axin,the upstream molecules of Wnt/β-catenin pathway,inhibited abnormally activated downstream molecules of Wnt/β-catenin pathway.This may be a key mechanism of herb cake-partitioned moxibustion in inhibiting CAC tumor growth.

Objective To investigate the predictive value of cervical length (CL) measured by transvaginal ultrasound for preterm birth<32 weeks,＜34 weeks in twin pregnancies in the second and the third trimester of pregnancy. Methods A total of 490 twin pregnant women with CL measured by transvaginal ultrasound during the second trimester of pregnancy (20-24 weeks) and the third trimester of pregnancy (28-32 weeks) delivered in Peking University Third Hospital, and Tongzhou Maternal and Child Health Hospital from January 2014 to December 2017 were collected, and 161 cases out of which were measured by CL during both the second trimester and the third trimester of pregnancy. Based on the measured gestational weeks, 427 cases were in the second trimester group and 224 cases in the third trimester group. The predictive value of CL for preterm birth was evaluated by calculating the optimal cut-off point with sensitivity and specificity. Logistic regression analysis was used to assess the relationship between CL and preterm birth after adjusting for confounding factors (age of pregnant women, chorionic status, mulipara, assisted reproductive pregnancy and pre-pregnancy body mass index). Results (1) The median CL of pregnant women in the second trimester group and the third trimester group were 36 mm (33-40 mm) and 28 mm (18-33 mm) respectively. In the second trimester group, 151 cases (35.4%, 151/427) were preterm birth and 276 cases (64.6%, 276/427) were full-term birth; the median CL of preterm and full-term pregnant women were 34 mm (30-37 mm) and 37 mm (34-40 mm), respectively, with significant difference (P<0.01). In the third trimester group, 100 cases (44.6%, 100/224) were preterm birth and 124 cases (55.4%, 124/224) were full-term birth; the median CL of preterm and full-term pregnant women were 22 mm (15-30 mm) and 31 mm (23-34 mm), respectively, with significant difference (P<0.01). (2) Prediction of preterm birth<32 weeks and<34 weeks was performed with CL in the second trimester group. The area under the receiver-operating characteristics curve were 0.78 (95% CI : 0.70-0.86) and 0.71 (95% CI : 0.64-0.79), respectively. The optimal cut-off points were 36.5 mm and 33.5 mm, respectively. After adjusting for confounding factors, CL was inversely associated with preterm birth<32 weeks and<34 weeks of gestation. (3) Prediction of preterm birth <32 weeks and <34 weeks were performed with CL in the third trimester group. The area under the receiver-operating characteristics curve were 0.86 (0.75-0.96) and 0.75 (0.67-0.84), respectively. The optimal cut-off points were 17.5 mm and 18.5 mm, respectively. After adjusting for confounding factors, CL was inversely associated with preterm birth at<32 weeks and<34 weeks of gestation. Conclusions CL measured by transvaginal ultrasound in the second and the third trimester is a good predictor for preterm birth of twin pregnancy. CL≤36.5 mm and≤33.5 mm at 20-24 weeks of gestation could predict preterm birth<32 weeks and<34 weeks respectively. CL≤17.5 mm and≤18.5 mm at 28-32 weeks of gestation could predict preterm birth<32 weeks and<34 weeks respectively.