Objective: This study was designed to identify the influence of age and comorbidity on the treatment strategies and survival time of the elderly patients(≥70 years) with advanced (stage III B or IV) non-small cell lung cancer (NSCLC). Methods: The clinical characteristics, treatment strategies and survival features of 127 elderly patients with a good performance status (PS≤1) were retrospectively analyzed. They were diagnosed as NSCLC and received chemotherapy in our oncological department between January 2005 and December 2005. These patients were stratified by age into two groups: 70-74 years group and ≥75 years group; and divided into three groups based on the degree of comorbidity: no comorbidity (0), mild comorbidity (1-2) and severe comorbidity (≥3) groups. Their relationship with clinical features, treatment strategies, and survival time was analyzed. Results: More than 50% patients in 70-74 years group (51.2%) were treated with cisplatin-based combination therapy, while only 20.6% patients in ≥75 years group received cisplatin-based combination therapy (P=0.003). There were 37.0% patients in the severe comorbidity group received palliative radiotherapy, which was significantly higher than that of the no or moderate comorbidity groups (21.7% and 11.7%, P=0.014). In 70-74 years group and ≥75 years group, the 1-year survival rate was 41.4% and 35.3% (log-rank, P=0.319). In no, mild and severe comorbidity group, the 1-year survival rate was 53.5%, 41.3%, and 20.8%, respectively (log-rank, P=0.071). In univariate and multivariate COX model analyses, age and mild comorbidity did not increase the risk of survival, but severe comorbidity was an independent risk factor for the survival of elderly patients with NSCLC; the relative risk ratio (95% confidence interval) was 2.09 (1.06-4.15) and 2.56 (1.18-5.76) (P=0.034 and 0.023). Conclusions: Different treatment strategies should be given to elderly patients with advanced NSCLC according to the age or the degree of comorbidity. Severe comorbidity is an independent risk factor for survival of elderly patients with advanced NSCLC.

Environmental Pollutants ; Humans ; Polychlorinated Biphenyls ; Population Surveillance

Objective To improve the understanding and diagnosis of primary hypertrophic os-teoathropathy(PHO).Methods A case of PHO was reported.The clinical data and the process of the diagno-sis and treatment was analyzed retrospectively,and the related literature were reviewed.Results The patient was a young man without family history of PHO.He had symptoms since age 16.He had clubbing fingers and toes,hypertrophic skin,joint swelling,hyperhidrosis and radiographic evidence of periostitis.Thus the disease was diagnosed as PHO.The patient was treated with NSAIDs and the symptoms relieved very quickly.Conclusion Radiographic examination should be taken in time when young males have the general characters of clubbing fingers and toes,hypertrophic skin changes.If the periostitis presents,the final diagnosis of PHO can be confirmed.

Objective To observe the clinical efficacy of acupuncture-moxibustion plusMEI Te-lan’s manipulations in treating lumbar intervertebral disc herniation (LIDH) due to blood stagnation.Method Totally 248 LIDH patients due to blood stagnation were randomized into a treatment group of 123 cases and a control group of 125 cases. The treatment group was intervened by acupuncture-moxibustion plusMEI Te-lan’s manipulations, while the control group was by acupuncture-moxibustion plus tuina at lower back. The short-form McGill Pain Questionnaire (SF-MPQ) and Oswestry disability index (ODI) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate and recovery-markedly effective rate were respectively 80.5% and 52.0% in the treatment group, versus 72.8% and 20.0% in the control group. There was a significant difference in comparing the recovery-markedly effective rate between the two groups (P<0.05). In the treatment group, the Pain Rating Index (PRI) score, Visual Analogue Scale (VAS) score, Present Pain Intensity (PPI) score, and ODI score were significantly changed after 3-day, 6-day, and 20-day treatment compared to the scores before treatment (P<0.05). After 20-day treatment, the PRI, VAS, PPI, and ODI scores of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Acupuncture-moxibustion plusMEI Te-lan’s manipulations is an effective method in treating LIDH due to blood stagnation.

Serum sialic acid (SA) levels were detected by neuraminidase method in 366 patients with malignant tumor, 40 patients with benign diseases and 40 healthy subjects.For 277 malignant tumor patients, serum SA levels were monitored before and after treatment.The serum SA levels in malignant tumor group were significantly higher than those in benign diseases and control groups (P ＜0.01 ), but there were no differences between normal and benign groups (P ＞0.05 ).Serum SA levels were decreased in malignant tumor patients with remission and stable disease after treatment.In remission or stable patients the decrease of serum SA levels occurred in the first three months and no changes were found from the fourth to sixth month; meanwhile SA levels were elevated in patients with instablc condition.

Objective To analyze the clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis.Methods From Apr.2013 to Aug.2015,120 feet with severe hallux valgus were treated by operation in Beijing Friendship Hospital,Capital Medical University.Before operation,measured some angles,such as hallux valgus angle,intermetatarsal angle,proximal articular surficial intrinsic angle and so on in the two groups.And evaluated the patients condition by Maryland scale at the same time.Through the date,we make sure that there was no significant difference between the two groups before operation.According to the order of hospitalization,all patients were randomly divided into experimental group (n =60) and control group (n =60).The cases of experimental group were treated by Ludloff osteotomy and artificial joint replacement.The cases of control group were treated by Ludloff osteotomy and Akin osteotomy.We used the visual analogue scale,the core quality of life scale-36 and Maryland scale to record the date,such as pain,the range of motion and appearance of the metatarsophalangeal joint and the ability of daily life and sports before and after operation.Compared above categorical variables using paired T-test between before and after operation and using T-test between the two groups.Compared the rate of operative complications by Fisher's exact test between the two groups.Results Through the Maryland scale,the total excellent rate of the experimental group (91.7％) was higher than the total excellent rate of the control group (75.0％),with statistically significant (P ＜ 0.05).The operative complication rate of experimental group (1.7％) was lower than the control group (8.3％),but without statistically significant (P ＞0.05).The scores of quality of life of the experimental group after treatment were significantly higher than those of the control group,with statistically significant (P ＜ 0.05).The visual analogue scale pain score (1.61 ± 0.12) of the experimental group was significantly lower than the control group (3.68 ± 0.58),with statistically significant (P ＜ 0.05).Conclusion The clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis is better,high safety,less trauma and faster recovery.It is worthy of promotion and use.

Objective: The main objective of the present study is to develop the risk-adjusted capitation pay-ment standards to compensate health service providers. Methods:Descriptive statistical analysis was conducted to an-alyze the insured's enrollment and visit conditions, and the two-part model was conducted to obtain the appropriate compensation standard using data retrieved from information system of social health insurance for the period of 2014 to 2015 in Shenzhen City. Results:The estimated value of total expenditure per insured person per month is 6. 17 yuan. Age,sex,insurance level and with or without chronic disease or catastrophic disease were elicited as risk adjustors. The whole number insured people were divided into 52 groups by this four risk-adjustment factors whereby the rele-vant payment standards for each group was calculated. Conclusions:By adjusting capitation fee on the grounds of risk of disease and expected expense of medical services of the insured, the capitation payment standards can be calculat-ed virtually. This method will promote the process of capitation payment system reform and also lay a solid foundation for further research.

Objective:A novel tuberculosis DNA vaccine integrating siRNA,fusional antigen and hIL-12 triple expression units was constructed in our laboratory.Methods:To evaluate the independent expression of the three expression units,two eukaryotic expression plasmid pVAX1-siRNA-PVAE[EGFP]-hIL12 with TB fusional gene Ag85B-ESAT6(PVAE) and enhanced green fluorescent protein(EGFP),and pVAX1-siEGFP-PVAE[EGFP]-hIL12 with siRNA coding sequence targeting EGFP instead of Mcl-1L were constructed.Then two plasmids were used to transfer human embryonic kidney 293 cells.Based on EGFP report gene,it was demonstrated that siRNA expression unit and fusional antigen gene were independently expressed.Results:The hIL12 expression at 48h and 72h post transfection were also detected by ELISA analysis up to 1571.63pg/ml and 2392.25pg/ml respectively in the cell culture fluid.Conclusion:The results demonstrated that the novel DNA vaccine with siRNA,TB fusional antigen and hIL12 three expression units in the same plasmid frame is successfully constructed and independently expressed in eukaryotic cells.It laid a foundation for further animal model study on anti-tuberculosis effects of this novel DNA vaccine.

OBJECTIVETo reveal the relation between endogenous hormones and the flower bud differentiation in Schisandga chinensis.

METHODTop buds of extremely short branch and axillary buds of long branch in the same plant of S. chinensis were used as material and the contents of endogenous hormones were measured during different periods of the flower bud differentiation with HPLC.

RESULTThe result showed that flower bud differentiation and the formation of female flower were inhibited by high concentration of GA3 and were promoted by high concentration of ABA or ZT. Low ratio of GA3/ABA has the same result.

CONCLUSIONThere was a correlation between endogenous hormones and the flower bud differentiation of S. chinensis.

Abscisic Acid ; metabolism ; Flowers ; growth & development ; Germination ; Gibberellins ; metabolism ; Plant Growth Regulators ; metabolism ; Plants, Medicinal ; growth & development ; metabolism ; Schisandra ; growth & development ; metabolism ; Zeatin ; metabolism

Objective To validate a new standardized training program for urological surgeons to improve their laparoscopic surgical skills. Methods The laparoscopic surgical training program was carried out by using the traditional mechanical simulators and animal models. Thirty-three trainees participated the urological laparoscopic surgical training program. Initially, the novices were assigned to practise basic laparoscopic skills step by step on the simulator with fixed trocar positions. After a period of basic training, they were allowed to practise on animal models for some particular proce-dures. Results All trainees (33/33, 100.0%) participated were able to perform all basic techniques skillfully and completed laparoscopic anastomosis accurately after the training. The time required for performing the partial nephrectomy, dismembered pyeloplasty and ureteral reimplantation on animal models declined from 64.0±18.4, 127.54±17.5 and 75.84±11.6 min at the beginning to 30.94±3.8, 65.2±7. 5 and 37.7±7.2 min after practicing these procedures 8 times (P<0.01). They could un-derstand the crucial procedures of the laparoseopic surgeries after 6 to 8 special trainings on animal models. Fifteen trainees (15/33, 45.5%) had started to carry out laparoscopic surgeries after-finish- ing the training program. Conclusions Our program enables the participants to improve their techniques in complicated laparoscopic surgeries. The challenging parts of reconstructive laparoscopic surgeries such as laparoscopic dismembered pyeloplasty can be taught by using animal models. This program could be incorpo-rated easily by all urological departments developing a laparoscopie surgical training program.