Background and purpose:Gastric cancer is one of the leading causes of cancer death throughout the world.When compared with optimal supportive care alone,combination chemotherapy yields a significant advantage in the management of advanced gastric cancer.However,no single regimen has emerged or been accepted as being clearly superior over another.Here we investigated the efficacy and safety of "docetaxel+ cisplatin + fluorouracil" 5-day combination chemotherapy as treatment in patients with advanced gastric cancer.Methods:Between 2004 January and 2005 July,we enrolled 30 patients [males 22,median age 53 years(range 28-72)] with advanced gastric cancer.The regimen consisted of docetaxel 75 mg/m~(2) on day 1,cisplatin 15 mg/ m~(2) on days 1-5,and fluorouracil 500 mg/ m~(2) on days 1-5,every 3 weeks.All patients received over two cycles of this regimen.Results:A total of 99 cycles were administered.Mean cycle number per patient was 3.3.The administered dose intensity of docetaxel was 23.5 mg/m~(2)/week,fluorouracil 735 mg/ m~(2)/week and cisplatin 14.7 mg/ m~(2)/week,which corresponded to 94%,97.5% and 92.3% of planned doses.Of these patients,16(53.3%) achieved a partial response,8(26.6%) stable disease,and 6 patients(20%) showed progressive disease.The median time to progression was 5.1 months.(95% CI 4.1-6.0 months).Median overall survival was 9.9 months.(95% CI 8.1-11.6 months).Leukopenia occurred during 36.7% of cycles(36 of 99 cycles);18.2% grade Ⅰ,10.1% grade Ⅱ,5.0% grade Ⅲ and 3.0% grade Ⅳ.Anemia occurred in 12.1%(12 of 99 cycles);7.1% grade Ⅰ and 5.0% grade Ⅱ.Thrombocytopenia was 15.2%(15 of 99 cycles) and all were grade Ⅰ or Ⅱ.Diarrhea,stomatitis and hypersensitivity occurred in 16.7%(5 out of 30 patients),respectively.Neutropenic fever occurred in two patients(6.7%) and myalgia in nine(30%).Conclusions:Docetaxel combined with fluorouracil and cisplatin is an active and tolerable regimen for the treatment of patients with advanced gastric cancer.

objective To evaluate the effect of intensive diabetes health education plus web-based follow-up program on metabolic control.Methods One hundred and fifteen patients with type 2 diabetes mellitus (DM) were assigned to receive intensive diabetes health education plus web-based follow-up (treatment group,n=57) or conventional education program (control group,n=58).Hemoglobin Alc(HbAlc),body mass index (BMI),lipid profile,and blood pressure were compared at 3 or 6 month with baseline.Results At 3 month.the patients with HbAlc<6.5% in the treatment group was increased from 26.32% to 80.79%.At 6 month.HbAlC was decreased by 2.10% and 1.13% in the treatment or control group.In contrast to the control group,in the treatment group,the patient with BMI<24 increased from 43.86% to 68.42%.Neither groups showed significant changes in blood pressure.Conclusion Intensive diabetes education may be more effective than conventional program in improving metabolic control.

Objective To know the influence of short-term hard health education combined with net-working fellow-up on diabetes related costs. Methods Divided 83 diabetes patients into the experimental group (41 cases) and the control group (42 cases) randomly. Short-term hard health education combined with networking fellow-up and traditional health education was used in the two groups respectively, and then evaluat-ed the diabetes related costs between the two groups on the time points of the third, the sixth and the dozenth month. Results The costs of health products in the control group was significant higher than that of in the experimental group from the first month to the third month after the intervention, while the inspection expenses in the experimental group was significant higher than that of in the control group from the fourth month to the sixth month after the intervention. Conclusions Short-term bard health education can not change the average level of diabetes related costs, but it can change the constituent ratio of costs.

Objective To evaluate dynamic CT and PET-CT features of normal dog liver after radiofrequency ablation(RFA)correlated with the time-related histopathological changes.Methods Fifteen hybrid adult dogs in good health condition were evenly divided into 5 groups(the immediate,1 st,2 nd,4 th and 8 th week group)according to random digits table methods.Twice RFA was performed for each dog liver.The dogs after RFA underwent CT and PET-CT scanning respectively at the time point defined for each group.All dogs were executed through intravenous injection of klorvess liquid after scanning.Liver samples were histologically examined.All images were assessed to determine the ratios(r_(p/p))which referred to the comparison of rimlike enhancement or tracer uptake in the periphery of the necrosis to that in normal liver parenchyma.Those imaging results were compared and correlated with histopathological findings.Results For the immediate group after RFA procedure,central ablation lesions appeared coagulation necrosis and surrounding sinusoids engorged with blood.On the images of enhanced CT,marked rimlike enhancement was noticed in peripheral ablation lesions.While PET-CT showed decreased ~(18)F-FDG uptake surrounded by homogeneous tracer distribution.For the 1 st-4 th week group,central necrosis was gradually getting more severe.Infiltration of the inflammatory cells,granulation tissue formation and fibrous tissue restoration were noticed in peripheral ablation lesions.Rimlike enhancement and increased glucose metabolism appeared surrounding the lesions on CT and PET-CT,especially in the 1st to 2nd week groups.For the 8 th week group after RFA,the enhancement or hypermetabolism metioned above disappeared when perilesional tissue regeneration became more obvious.From the dynamic curve of changes on enhanced CT,marked enhancement occurred in the immediate group after ablation(r_(p/p)=1.34±0.21),reached its peak at the 1st week group(r_(p/p)=1.39±0.20),and then declined gradually.The metabolic changes on PET-CT showed a typical single peak curve,with the peak at the 1st week group(r_(p/p)=1.19±0.09)and similar even metabolism at the immediate and 8 th week group.Conclusions Both CT and PET-CT imaging can well correlate with the histopathological changes after RFA in the normal liver.To avoid the interference of inflammatory reaction when differentiating normal liver tissue from residual tumor,it is better to take radiology examination immediately and 8 weeks after RFA.PET-CT probably has advantages over CT immediately after RAF.After 1 week,PET-CT and CT may have similar diagnostic efficacy.

OBJECTIVETo explore the molecular basis for an individual with a rare weak D phenotype.

METHODSRegular serological assaying and indirect antiglobulin testing (IAT) were performed to characterize the RhD blood group. Mutations of the RHD gene were screened by polymerase chain reaction (PCR), reverse transcription PCR and DNA sequencing. Amplified cDNA product was TA cloned and subjected to haplotype analysis.

RESULTSThe RhD blood group of the proband was determined as weak D. The result of PCR amplification showed that all of the 10 exons of the RHD gene were present. Heterozygote status of 101A/G and 845A/G were determined by gDNA and cDNA sequencing. After TA cloning and haplotype sequencing, two alleles 101A>G mutation (weak D 101G ) and 845G>A mutation (weak D type 15) were revealed.

CONCLUSION101A>G and 845G>A mutations are responsible for the low expression of RhD antigen on the red blood cells of the proband, which has resulted in a weak D phenotype.

Adult ; Female ; Haplotypes ; Humans ; Mutation ; Reverse Transcriptase Polymerase Chain Reaction ; Rh-Hr Blood-Group System ; genetics

ObjectiveTo evaluate the clinical effect of holmium laser lithotripsy combined with fiber choledochoscope in the treatment of intra- and extra-hepatolithiasis. MethodsSixty-four patients who were diagnosed with intra- and extra-hepatolithiasis in our hospital from January 2012 to July 2014 were assigned to receive fiber choledochoscope treatment (33 cases) or holmium laser lithotripsy combined with fiber choledochoscope (31 cases). The one-time stone removal rate and incidence of complications were compared between the two groups. Comparison of categorical data was made by chi-square test, while comparison of continuous data was made by t test. ResultsThe fiber choledochoscope group had a significantly lower one-time stone removal rate and a significantly higher incidence of complications compared with the combination therapy group (72.73% (24/33) vs 93.55% (29/31), χ2=4.868, P=0.027; 21.21%(7/33) vs 323%(1/31), χ2=4.728, P=0.030). ConclusionHolmium laser combined with fiber choledochoscope can effectively increase the one-time stone removal rate and reduce the incidence of complications in patients with intra- and extra-hepatolithiasis. This therapy holds promise for clinical application.

OBJECTIVETo explore the molecular mechanism for a case with para-Bombay phenotype caused by α-1,2-fucosyltransferase (FUT1) gene mutations.

METHODSBlood phenotype of the propositus was determined by standard serological testing. Polymerase chain reaction-sequence specific primer (PCR-SSP) and direct sequencing of PCR product were used to analyze its ABO genotype. The PCR product of FUT1 gene was sequenced and analyzed.

RESULTSThe phenotype of the propositus was initially detected as para-Bombay A type. Direct sequencing of ABO gene showed that the genotype of the proband was A101/O01 (261G/del), which was consistent with the result of PCR-SSP. Two homo-mutations, 35C>T and 658C>T, were detected in the FUT1 gene by sequencing, and the genotype was determined as h(35T+658T)/h(35T+658T).

CONCLUSIONh(35T+658T)/h(35T+658T) is responsible for the para-Bombay phenotype of the propositus. The genotype is rare even in para-Bombay populations.

ABO Blood-Group System ; genetics ; Base Sequence ; DNA Mutational Analysis ; methods ; DNA Primers ; Fucosyltransferases ; genetics ; Genotype ; Homozygote ; Humans ; Male ; Phenotype ; Point Mutation ; Polymerase Chain Reaction

OBJECTIVE: To study the relationship between nasal anatomic abnormalities and the bacteria infection status of maxillary sinus. METHOD: The anatomic abnormalities of 115 cases of maxillary sinuses were detected with the CT images and confirmed with chronic infection, which were divided into two groups: high anatomic abnormality group and low anatomic abnormality group. The sinusal contents were sent to bacteria culture, compare the bacteria infection rate and the distribution of bacteria between the two groups. RESULT: The bacteria positive rate of the high anatomic abnormality group and low anatomic abnormality group was 90.32% and 56.60% (P < 0.01) respectively. The contribution of gram-positive bacteria and gram-negative bacteria are 47.76% and 52.24% in high anatomic abnormality group, 62.16% and 37.84% in low anatomic abnormality group. CONCLUSION Nasal anatomic abnormalities can improve the bacteria infectious rate of maxillary sinuses. High anatomic abnormality may more induces gram-negative bacteria infections,while low anatomic abnormality may more induces gram-positive bacteria infections.
Adult ; Aged ; Aged, 80 and over ; Bacterial Infections ; etiology ; Chronic Disease ; Humans ; Middle Aged ; Nose ; abnormalities ; Sinusitis ; microbiology ; Young Adult

Objective To observe the pathological response in the tumor tissue and the changes of serum level of vascular endothelial growth factor ( VEGF) in esophageal cancer patients receiving concurrent chemoradiotherapy, in order to study the impacts of these two factors on the prognosis of patients. Methods One hundred pathologically confirmed esophageal cancer patients were treated with radiotherapy including 72 patients with concurrent chemoradiotherapy. After 4 weeks, gastroscopy was performed to collect tumor biopsies for examination of pathological changes. The responses to radiotherapy were classified into three degrees: mild, moderate and intensive. Moreover, serum samples were collected from the patients prior to, at the fourth week during radiotherapy, and one week after radiotherapy, and serum VEGF level was determined. The changes of serum VEGF were classified as increased, unchanged and decreased. Serum samples from 30 healthy subjects were collected and represented as VEGF healthy control. Results Among the eighty?nine patients evaluable, the 1? and 3?year overall survival ( OS) rates were 70.8% and 33.3%, respectively;1?year and 3?year progression?free survival ( PFS) rates were 61.8% and 28.2%, respectively;and 1?year and 3?year local control ( LC) rates were 76.9% and 50.0%, respectively. The 1?year OS rates in the patients with mild, moderate and intensive pathological responses were 50. 0%, 76. 9% and 78. 0%, respectively. The 1?year OS rate in the mild response group was significantly lower than that in the intensive response group ( P<0.05) . The 1?year and 3?year PFS rates in the three groups were 36.4%, 73.1%, 68.3%, and 0. 0%, 40.0% and 38. 9%, respectively, showing that the rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . The PFS rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . Moreover, the 1?year local control ( LC) rates in the three groups were 52.9%, 83.3%and 83.8%, and the three?year LC rates were 0. 0%, 64. 3% and 64. 0%, respectively, showing that the lowest LC rates in the mild response group were significantly lower than that in the moderate and intensive response groups (P<0.05 for both). The average serum VEGF levels in the patients prior to, during and after radiotherapy were (109.6±33.7) ng/L, (101.2±24.3) ng/L and (99.5±22.9) ng/L, respectively, all significantly higher than that in the healthy subjects [(79.6±39.2) ng/L, P<0.05 for both]. The level of serum VEGF was decreased during and after radiotherapy compared with that before radiotherapy ( F=6.124, P=0.004). The 1?year OS rates in the VEGF?increased, unchanged and decreased groups were 50.0%, 67.4% and 86.7%, respectively, and the 3?year OS rates in these three groups were 15. 4%, 27. 0% and 50.0%, respectively. The OS rates in the increased group were significantly lower than that in the VEGF?decreased group (P<0.05). Moreover, the 3?year PFS rates in the three groups were 7.7%, 21.6% and 46.4%, respectively, and the rate in the VEGF?increased group was significantly lower than that in the VEGF?decreased group ( P<0.05) . The multi?variate analysis showed that TNM stage, pathological response and serum VEGF were independent factors affecting the survival in the non?surgical patients with esophageal cancer (P<0.05 for all). Conclusions Tumor tissue pathological response and variation of serum VEGF level in response to chemoradiotherapy can be used to predict the efficacy of chemoradiotherapy in non?surgical patients with esophageal cancer. Hence, monitoring the pathological response and VEGF changes during the course of therapy is of utmost importance to evaluate and perform an individualized therapy in clinical practice.

Objective To observe the pathological response in the tumor tissue and the changes of serum level of vascular endothelial growth factor ( VEGF) in esophageal cancer patients receiving concurrent chemoradiotherapy, in order to study the impacts of these two factors on the prognosis of patients. Methods One hundred pathologically confirmed esophageal cancer patients were treated with radiotherapy including 72 patients with concurrent chemoradiotherapy. After 4 weeks, gastroscopy was performed to collect tumor biopsies for examination of pathological changes. The responses to radiotherapy were classified into three degrees: mild, moderate and intensive. Moreover, serum samples were collected from the patients prior to, at the fourth week during radiotherapy, and one week after radiotherapy, and serum VEGF level was determined. The changes of serum VEGF were classified as increased, unchanged and decreased. Serum samples from 30 healthy subjects were collected and represented as VEGF healthy control. Results Among the eighty?nine patients evaluable, the 1? and 3?year overall survival ( OS) rates were 70.8% and 33.3%, respectively;1?year and 3?year progression?free survival ( PFS) rates were 61.8% and 28.2%, respectively;and 1?year and 3?year local control ( LC) rates were 76.9% and 50.0%, respectively. The 1?year OS rates in the patients with mild, moderate and intensive pathological responses were 50. 0%, 76. 9% and 78. 0%, respectively. The 1?year OS rate in the mild response group was significantly lower than that in the intensive response group ( P<0.05) . The 1?year and 3?year PFS rates in the three groups were 36.4%, 73.1%, 68.3%, and 0. 0%, 40.0% and 38. 9%, respectively, showing that the rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . The PFS rate in the mild response group was significantly lower than that in the moderate and intensive response groups ( P<0.05 for both) . Moreover, the 1?year local control ( LC) rates in the three groups were 52.9%, 83.3%and 83.8%, and the three?year LC rates were 0. 0%, 64. 3% and 64. 0%, respectively, showing that the lowest LC rates in the mild response group were significantly lower than that in the moderate and intensive response groups (P<0.05 for both). The average serum VEGF levels in the patients prior to, during and after radiotherapy were (109.6±33.7) ng/L, (101.2±24.3) ng/L and (99.5±22.9) ng/L, respectively, all significantly higher than that in the healthy subjects [(79.6±39.2) ng/L, P<0.05 for both]. The level of serum VEGF was decreased during and after radiotherapy compared with that before radiotherapy ( F=6.124, P=0.004). The 1?year OS rates in the VEGF?increased, unchanged and decreased groups were 50.0%, 67.4% and 86.7%, respectively, and the 3?year OS rates in these three groups were 15. 4%, 27. 0% and 50.0%, respectively. The OS rates in the increased group were significantly lower than that in the VEGF?decreased group (P<0.05). Moreover, the 3?year PFS rates in the three groups were 7.7%, 21.6% and 46.4%, respectively, and the rate in the VEGF?increased group was significantly lower than that in the VEGF?decreased group ( P<0.05) . The multi?variate analysis showed that TNM stage, pathological response and serum VEGF were independent factors affecting the survival in the non?surgical patients with esophageal cancer (P<0.05 for all). Conclusions Tumor tissue pathological response and variation of serum VEGF level in response to chemoradiotherapy can be used to predict the efficacy of chemoradiotherapy in non?surgical patients with esophageal cancer. Hence, monitoring the pathological response and VEGF changes during the course of therapy is of utmost importance to evaluate and perform an individualized therapy in clinical practice.