Chemotherapy and molecular targeted therapy are the main treatments in unresectable gastric cancer. In recent years,due to the adjustment and optimization of chemotherapy regimens which are consist of fluorouracil,platinum and taxane,the survival time of gastric cancer patient has been prolonged and the quality of life has been improved. The molecular targeted therapy in gastric cancer arouses more and more concern,and there are many phrase Ⅲ clinical trials which are used to assess the efficacy of molecular targeted therapy. The advances of chemotherapy and molecular targeted therapy bring new hope to advanced gastric cancer patients.

Gastrectomy ; methods ; Humans ; Laparoscopy ; Stomach Neoplasms ; surgery

The risk of stroke increases significantly after transient ischemic attack (TIA). TIA is an independent risk factor for cerebral infarction. This article review s the advances in prediction models of stroke risk after TIA in order to conduct rapid and accurate risk assessment and stratification in patients w ith TIA and develop timely reasonable treatment strategies, thereby reducing the risk of stroke.

AlM:To observe clinical effects between the laser in situ keratomileusis ( LASlK ) surgery and the laser subepithelial keratomileusis ( LASEK ) surgery as the second operation after an unsuccessful LASlK surgery.METHODS:Forty-nine patients (98 eyes) with refractive regression after LASlK operation received the second surgery. All patients were divided into two groups:group A and B. Group A (48 eyes of 24 patients) received LASlK surgery and group B ( 50 eyes of 25 patients ) received LASEK surgery. lnspect the main parameters included visual acuity, refraction, corneal curvature, and the total value of high-aberration after 1wk, 1mo and 1a, t-test of groups was used as statistical analysis method.RESULTS: There was statistically significant (P<0. 05) between the two groups in visual acuity after 1wk. There was no statistically significant between the two groups in visual acuity after 1mo, and there was also no statistically significant between the two groups in visual acuity, average spherical equivalent refractive degree, average corneal curvature, and the total value of high-aberration after one year (P>0. 05). There developed one case of epithelium in growth after LASlK surgery, and one case of haze Ⅱ after LASEK surgery.CONCLUSlON: Both LASlK and LASEK surgery can obtain satisfactory therapeutic results after an unsuccessful LASlK surgery.

Objective To compare the osseo-induction and biodegradation performances of three types of injectable and degradable calcium phosphate cement (CPC) so as to find out a better bone substitute. Methods Three types of injectable and degradable CPC were respectively implanted into the bilateral tibias of 24 New Zealand rabbits: pure CPC (Group A), CPC added with Zinc and Strontiumions (Group B), and CPC with composite rhBMP-2 (Group C) . Their systematic and local reactions in implanted region were closely observed. The degra- dation and osseo-induction performances were compared macroscopically, microscopically and by CT scan to find out the one that could best meet clinical needs. Tissue slices were sampled and photographed four, eight and 16 weeks after operation. Five photographs were selected in each group and at each time points for computer software (Image Pro Plus 5.1) processing to calculate the percentages of bone in the images of postoperative slices. Results In Groups A and B, new bone was found to form slowly and little by little, and the ossification was not synchronous with the material degradation. In Group C, however, new bone was observed to form early and massively, and the os- sification was almost synchronous with the material degradation. In Groups A, B and C, the percentage of bone in the images of postoperative slices was (41.7?16.6)%, (31. 2?12.2)% and (71.7?21.0)% respectively. The bone percentage in CPC with composite rhBMP-2 was significantly higher than that in the other two types of CPC (P＜0.01 ). Conclusion The injectable and degradable CPC with composite rhBMP-2 is more suitable for clinical use, because it can induce early new bone formation and synchronous biodegradation.

UNLABELLED: The patient with long history of alcohol was admitted because of intermittent right nasal bleeding for two days,and treated by nasal packing. After 3 days,the patient exhibited auditory hallucinations and immediately showed rage, mania, sweating and fever. CT examination showed calcification in the right frontal lobe, brain atrophy and sinusitis. DIAGNOSIS epistaxis and alcohol withdrawal syndrome, deviated septum, sinusitis.
Alcohol-Induced Disorders ; complications ; Epistaxis ; complications ; Humans ; Male ; Middle Aged ; Substance Withdrawal Syndrome ; complications

The general system of clinical engineering professional certification in Germany was introduced from the aspects of history, certification authority, requirement of certification, skills and knowledge points, methods of implementation and so on. Through comparative study, some suggestions were proposed to promote clinical engineering staff technology level assessment and certification, which might provide some references for the further improvement of clinical engineering certification system in China.

OBJECTIVETo compare therapeutic effects between patella replacement and patella osteotomy in total knee arthroplasty.

METHODSFrom April 2004 to April 2011, 52 patients (54 knees) were enrolled in the clinical trail of total knee arthroplasty, who received patella replacement (24 knees, including 13 males and 11 females,ranging in age from 53 to 78 years old or patella osteotomy (30 knees,including 16 males and 12 females,ranging in age from 55 to 79 years old. The average follow-up period was 56 months,ranging from 20 to 80 months. The American HSS Score for knee, the Feller score for patella, range of motion (ROM) for knee, patient satisfaction and complications related to the patella were used to evaluate therapeutic effects.

RESULTSIn the patella replacement group,the preoperative and final follow-up HSS scores of patients were 38.4 +/- 8.2 and 91.2 +/- 8.6 respectively; Feller scores were 13.6 +/- 6.2 and 25.2 +/- 4.2; scores of anterior knee pain were 3.9 +/- 3.2 and 11.2 +/- 3.7; ROM were (78 +/- 26) degrees and(108 +/- 18) degrees. In the patella osteotomy group,the preoperative and final follow-up HSS scores of patients were 39.5 +/- 8.4 and 91.0 +/- 8.5 respectively;Feller scores were 13.4 +/- 6.5 and 25.6 +/- 4.0; scores of anterior knee pain were 3.7 +/- 3.1 and 11.3 +/- 3.6; ROM were (76 +/- 27) degrees and (110 +/- 19) degrees. In the patella replacement group,patient's satisfaction was 91%, and complication related to the patella was 16.7%; in the patella osteotomy group, patient's satisfaction was 89%, and complications related to the patella was 10.0%. There were no statistically significant differeneces in final follow-up HSS scores, Feller scores, scores of anterior knee pain and ROM between the two groups. However,there was no significant difference of patient's satisfaction between them. There was statistically significant differenece of patella-related complications between the two groups, and the complication rate in the patella replacement group was higher than that in the patella osteotomy group.

CONCLUSIONTotal knee arthroplasty with patella replacement or patella osteotomy dramatically relieves pain and improves the knee function. Patella-related complications are associated with its treatment methods, but post-operative anterior knee pain and patient's satisfaction are not related to treatment methods of the patella.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Case-Control Studies ; China ; Female ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Osteotomy ; adverse effects ; Pain, Postoperative ; epidemiology ; etiology ; Patella ; surgery ; Treatment Outcome

A rapid and sensitive liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method for quantification of sitagliptin in human plasma and urine had been developed. This method was applied to the pharmacokinetics study of sitagliptin tablet after single- and multiple-dosing in Chinese population. Plasma samples were prepared by a liquid-liquid extracted method, and urine samples were diluted. Compounds were analyzed by multiple reaction monitoring (MRM) mode with a electrospray ionization (ESI) interface. Mobile phase consisted of methanol and water (85 : 15, v/v). The linear concentration range of calibration curve was 0.5-1 000 ng.mL-1. and 0.2-100 µg.mL , intra-run/between-run accuracy was 98.98%-103.69% and 97.63%-102.29%, intra-run/between-run precision was <5.51% and 4.26% for plasma and urine sample, respectively. The stability of sitagliptin stock solution was tested for 55 days at -30 °C. Sitagliptin was stable when stored under the following conditions: 24 hours in the autosampler after sample preparation; 24 hours at room temperature, after 3 freeze and thaw cycles (from -30 °C to room temperature), 40 days at -30 °C for plasma and urine samples. The absolute recovery in plasma was 71.1%, and no matrix effect was founded. This method was proved simple, specific, sensitive, rapid and suitable for pharmacokinetics study of sitagliptin in human being.
Calibration ; Chromatography, Liquid ; Humans ; Liquid-Liquid Extraction ; Sitagliptin Phosphate ; blood ; pharmacokinetics ; urine ; Tandem Mass Spectrometry

Objective To evaluate the feasibility,safety and accuracy of endoscopic ultrasonography guided fine-needle aspiration(EUS-FNA) in patients with mediastinal benign and malignant lesions.Methods A linear array scanning endosonography (Pentax-EG3630U) and a 22-guage (Wilson-CooK) needle were used to perform EUS-FNA in 22 patients with mediastinal lesions.Results EUS-FNA revealed 15 patients with carcinoma and 6 cases with benign tumors,which were confirmed by mediastinoscopy.One patient was not diagnosed because of inadequate specimen.None of the patients had complications caused by any procedures.Conclusion EUS-FNA is safe,reliable and accurate in diagnosis of mediastinal benign and malignant lesions.