Objective Objective To evaluate the response,survival and toxicity of concurrent chemoradiotherapy for patients with inoperable esophageal cancer. Methods Eighty-eight patients with inoperable esophageal cancer were divided randomly into two groups, 43 patients in group R+C received chemoradiotherapy, while 45 patients in group R received radiotherapy only. For both groups, the same radiation technic was carried out by conventional fractionation, to a total dose of 60-65Gy/30-33Fr/6.0-6.5W. For group R+C patients, concurrent chemotherapy(5-Fu 500mg/d1-4,DDP 20mg/d1-4) was given. Results Complete response rate in group R+C was 33%,while in group R, it was 13% (P

Objective To evaluate the efficacy and safety of transurethral plasmakinetic resection for patients with superficial bladder tumor(SBT) complicated with benign prostate hyperplasia(BPH).Methods A total of 41 patients with SBT complicated with BPH were treated by transurethral plasmakinetic resection in our hospital.Various procedures were selected basing on the location,size,quantity of the bladder tumors,size of the prostate,and degree of adhesion around the gland.Results The opertion was completed in all of the 41 cases.The mean operation time was(67.2?25.3) min for resection of the bladder tumors and(72.3?23.2) min for the prostate.During the surgery,7 cases showed obturator nerve reflex and 2 developed bladder perforation.No patients died or had transurethral resection syndrome or rectal perforation.Six months after the operation,reexamination showed a mean IPSS of 6.2?3.7 and Qmax of(20.1?4.2) ml/s,which were significantly imporved compared with those detected before the surgery [25.3?4.1,(8.9?4.1)ml/s,t=22.209 and -12.174 respectively;and both P=0.000].The patients were followed up for 1 to 4 years,during which 9 cases showed recurent bladder tumor.Conclusions Transurethral plasmakinetic resection is safe and effective for patients with SBT complicated with BPH.The surgical procedure should be determined accordingly.

Background and Purpose:In recent years,along with marked rise in the incidence of lung cancer,the incidence of brain metastasis from lung cancer has increased year by year.The main treatment strategy of lung cancer with brain metastasis is irradiation,while so far there are only few researches concerning chemotherapy combined with radiotherapy for these patients.The aim of this study is to evaluate the therapeutic effect,survival rate and toxicity of chemotherapy with VM_(26)+DDP regimen given concurrently with whole-brain radiotherapy in lung cancer with brain metastasis.Methods:From Sep.2000 to Oct.2001,forty-one patients with lung cancer with brain metastasis were divided randomly into two groups: 20 patients(14 male,6 female) received concurrent chemoradiotherapy(chemoradiotherapy group),the other 21 patients(14 male,7 female) received only radiotherapy(radiotherapy group).In the chemoradiotherapy group,the average age was 50 years with range 40 to 70 years,16 patients were non-small-cell lung cancer,4 patients were small-cell lung cancer.In the radiotherapy group,the average age was 52 years with range 40 to 73 years and 19 patients were non-small-cell lung cancer,2 patients were small-cell lung cancer.For both groups,the same radiation technique was given with conventional fraction.Radiotherapy was delivered by 6MV.Fractionations of 3Gy/fraction/day was delivered 10Gy/5 factions/week.The total dose was 30Gy/10Fr/2W.For chemoradiotherapy group,the patients were also given concurrent chemotherapy(VM_(26) 60mg/m~(2)/ day iv on days 1-3,cisplatin 60 mg/m~(2) iv on the 1~(st)day).Results:The response rate and complete response in the chemoradiotherapy group was significantly higher than that in the radiotherapy group(75% ?? 38.10%,P

0.05).Conclusions:Concurrent chemoradiotherapy can be well tolerated even though the acute side-effects less than grade 2 were higher in concurrent chemoradiotherapy than other group.Immediate response was very encouraging in the concurrent group.There was no advantage in terms of survival rate in the concurrent group compared to the sequential group.

Objective To detect circulating CD4 + CD25 + regulatory T cells (Treg) and Toll-like receptor(TLR)2 and TLR4 expression on the peripheral blood mononuclear cells (PBMCs) of patients with HBV-related liver cirrhosis (LC), and to explore the correlation between them. Methods PBMCs isolated from 30 LC patients, 21 chronic hepatitis B (CHB) patients and 16 normal controls(NC) were stained with fluorescent labeling anti-TLR2-PE, anti-TLR4-APC, anti-CD14-FITC monoclonal antibodies and anti-CD4-PerCP, anti-CD25-FITC, anti-CD127-PE. Samples were detected by flow cytometry. Statistic analysis be-tween groups was performed by Kruskal-Wallis H test. Spearman rank correlation was used to analyze the correlation of Treg and TLR2, TLR4. Results The expression of TLR2 and TLR4 were significantly up-reg-ulated in patients with LC than those in the controls (TLR2 : 200.3 ± 96.8 vs 94.1 ± 17.6, P < 0.05 ; TLR4:32.1 ±7.2 vs 17.8 ±3.9, P<0.05). The expression of TLR4 was significantly increased in pa-tients with LC than those in patients with CHB (TLR4 : 32. 1 ± 7.2 vs 25.2 ± 8.3, P < 0.05), but there were no differences of TLR2 expression between LC and CHB(200.3 ± 96.8 vs 214.0 ± 72.6, P > 0.05). Treg/CD4+ T cells were 5.07% ±1.43%, 5.88% ±1.66%, 4.21% ±1.24% in patients with LC, CHB and NC, respectively. Treg/CD4+ T cells were significantly increased in patients with CHB than those in pa-tients with NC(P<0. 05) and LC(P <0.05), but there were no differences between LC and NC(P > 0.05). TLR4 expression and Treg were positive correlation (r = 0. 469, P = 0. 032) and TLB2 expression were negative correlation in patients with LC (r = -0.428, P = 0.021). Conclusion The expression of TLR2 and TLR4 were up-regulated on PBMCs in patients with LC. It seems to be expression of TLR2 and TLR4 in-volved in the pathogenesis of LC.

In this study, Escherichia coli BL21 (DE3) was used as the host to construct 2 recombinant E. coli strains that co-expressed leucine dehydrogenase (LDH, Bacillus cereus)/formate dehydrogenase (FDH, Ancylobacter aquaticus), or leucine dehydrogenase (LDH, Bacillus cereus)/alcohol dehydrogenase (ADH, Rhodococcus), respectively. L-2-aminobutyric acid was then synthesized by L-threonine deaminase (L-TD) with LDH-FDH or LDH-ADH by coupling with two different NADH regeneration systems. LDH-FDH process and LDH-ADH process were optimized and compared with each other. The optimum reaction pH of LDH-FDH process was 7.5, and the optimum reaction temperature was 35 °C. After 28 h, the concentration of L-2-aminobutyric acid was 161.8 g/L with a yield of 97%, when adding L-threonine in batches for controlling 2-ketobutyric acid concentration less than 15 g/L and using 50 g/L ammonium formate, 0.3 g/L NAD+, 10% LDH-FDH crude enzyme solution (V/V) and 7 500 U/L L-TD. The optimum reaction pH of LDH-ADH process was 8.0, and the optimum reaction temperature was 35 °C. After 24 h, the concentration of L-2-aminobutyric acid was 119.6 g/L with a yield of 98%, when adding L-threonine and isopropanol (1.2 times of L-threonine) in batches for controlling 2-ketobutyric acid concentration less than 15 g/L, removing acetone in time and using 0.3 g/L NAD⁺, 10% LDH-ADH crude enzyme solution (V/V) and 7 500 U/L L-TD. The process and results used in this paper provide a reference for the industrialization of L-2-aminobutyric acid.
Aminobutyrates ; metabolism ; Escherichia coli ; genetics ; Formate Dehydrogenases ; metabolism ; Leucine Dehydrogenase ; metabolism ; NAD ; metabolism

Objective: To explore the feasibility and advantage of the drones in a county emergency medical service system. Methods: The study was conducted in Changxing County, Zhejiang Province from January to September 2018. The Changxing County People's Hospital and the health centers within its radius of 25 km were included in the study. Three types of indicators were obtained by using commercial drones to transfer simulated first-aid medical supplies from health centers to county people's hospitals: (1)The flight time of the drone; (2) The road traffic time measured by Baidu map and Tencent map software of the above-mentioned route at midnight; (3) The road traffic time measured by Amap software of these routes at 0: 00, 8: 00, 10:00, 12:00, 14:00, 16:00, 18:00, 20:00. The road traffic time at different time points measured by map softwares and drones flight time were compared. Wilcoxon symbolic rank test was used for statistical analysis, and P value of < 0.05 was considered statistically significant. Results: (1) A total of 10 health centers were involved in this study, the air straight-line distance between them and the county people's hospital was (10.97±3.59) km, and the road traffic distance was (13.61±4.95) km. (2) The flight time of drone was (16.35±5.15) min, less than road traffic time measured by Amap, Baidu and Tencent map software, which were (21.40±5.15) min, (22.50±6.11) min, (22.00±5.23) min, respectively (P< 0.01). (3)The road traffic time measured by Amap software was longer than that of drones from 0:00 to 20:00 (P< 0.01), with the maximum time of (27.80±6.12) min at 18:00, and the minimum time of (21.40±5.15) min at midnight. Drones could save up 14.07 min at most and 2.8 min at least, with an average save of (7.98±1.32) min. Conclusions Drone might be used to transfer first aid medical supplies between health centers in a county area, which is faster than road transportation. It has a better application prospect and is worth to further study.

Objective The purpose of this study was to observe the distribution of CD3+T lymphocyte in the tissue of bladder cancer and epithelium of paracancer area, and analyze the significance. Methods Biopsy was performed in 28 patients with bladder cancer, and the distribution and number of CD3+T lymphocyte in tissue of bladder cancer and epithelium of paracancer area were observed and compared using immunohistochemistry. Results Many of CD3+T lymphocytes could be observed in the epithelium of paracancer tissues, but CD3+T lymphocytes in cancer nests was few. The average number of CD3+T lymphocytes in every 5 typical microscope visual fields of paracancer tissues and cancer nests was 15 ±4.5 and 4 ±2.2, respectively, and the difference was significant ( <0.05) . Conclusion Distribution of CD3+T lymphocytes in bladder cancer nests and paracancer tissues was different, which may be related to the immune escape and prognosis of bladder cancer. It is worthy of further research.

Objective To analyze of CD4+ CD25high regulatory T cells(Treg)in peripheral blood of chronic HBV patients and its correlation with multiple clinical indicators.Methods Thirty-five hepatitis B virus(HBV)infected patients in this study were divided into four different clinical types:HBsAb+group(n=5),inactive hepatitis group(n=8),chronic hepatitis group(n=12),and immune tolerance group(n=10).The number of CD4+CD25high Treg and related T cells subgroup in CD3/CD4/CD8 was thoroughly examined by flow cytometry in peripheral blood of HBV infected patients and the healthy contrast group(n=12).Serum HBV markers were determined by commercial ELISA kits.Serum HBV DNA was quantified by commercial real-time PCR kit.Statistical differences were studied to investigate the correlations between CD4+CD25high Treg and different clinical types of HBV infection and clinical indicators.Results The absolute counts of CD25high Treg and its frequency in CD4+ T cells were similar between HBV infected patients [(12.35±6.48)/μ,(1.82±0.87)%]and health controls[(8.91±3.11)/μl,(1.35±0.39)%],P＞0.05.The frequency of CD25high Treg in CD4+ T cells from the immune tolerance group was significantly higher than that of the HBsAb+ group,chronic hepatitis group,and the healthy contrast group(P＜0.05).The absolute counts of CD25high Treg from the immune tolerance group were significantly higher than the healthy control group(P＜0.05),and the frequency of CD25high Treg in CD4+ T cells is negatively correlated to the ALT level(r=-0.418,P=0.038),positively correlated to CD4/CD8 ratio(r=0.344,P=0.021),no correlation to the HBV DNA level(r=0.118,P＞0.05).The absolute counts of CD25high Treg were positively correlated to CD4/CD8 ratio(r=0.360,P=0.015),no correlation to ALT level and HBV DNA level(r=-0.211,r=0.060,P＞0.05).Conclusion CD4+ CD25high Treg may play a role in immunopathogenesis of chronic HBV infection.

Objective To evaluate the therapeutic efficacy and treatment-related toxicity of stereotactic body radiation therapy(SBRT)in patients with medically inoperable stage Ⅰ/Ⅱ non-small cell lung cancer(NSCLC). Methods SBRT was applied to 30 patients, including clinically staged T1 ,T2(≤5cm)or T3(chest wall primary tumors only), N0, M0 ,biopsy-confirmed NSCLC. All patients were precluded from lobotomy because of physical condition or comorbidity. No patients developed tumors of any T-stage in the proximal zone. SBRT was performed with the total dose of 50 Gy to 70 Gy in 10 - 11 fractions during 12 - 15 days. prescription line was set onthe edge of the PTV. Results The follow-up rate was 100%. The number of patients who completed the 1-, and 2-year follow-up were 15, and 10, respectively. All 30 patients completed therapy as planned. The complete response(CR), partial response(PR)and stable disease(SD)rates were 37%, 53% and 3%, respectively. With a median follow-up of 16 months(range,4-36 months), Kaplan-Meier local control at 2 years was 94%. The 2-year overall survival was 84% and the 2-year cancer specific survival was 90%. Seven patients(23%)developed Grade 2 pneumonitis, no grade ＞ 2 acute or late lung toxicity was observed. No one developed chest wall pain. Conclusions It is feasible to deliver 50 Gy to 70 Gy of SBRT in 10 - 11 fractions for medically inoperable patients with stage Ⅰ / Ⅱ NSCLC. It was associated with low incidence of toxicities and provided sustained local tumor control.The preliminary investigation indicated the cancer specific survival probability of SBRT was high. It is necessary to perform similar investigation in a larger number of patients with long-term follow-up.