Objective To investigate the expression of Circulating tumor cells ( CTCs ) in peripheral blood cells of patients with different stages of Small-Cell Lung Cancer ( SCLC) ,and to evaluate its significance in early diagnosis of lung cancer metastasis.Methods Thirty-five patients with SCLC ( 12 in limited stage and 23 in extensive stage ) and 25 patients with benign lung disease were recruited at the Shanghai Changhai Hospital from April 2011 to April 2013.Samples were prepared from 7.5 ml peripheral venous blood and collected in CellSave tubes.The CTC counts were determined using CellTracks AutoPrep fluorescence scanning system according to the manufacturers′instructions.The expression of CTCs in peripheral blood of SCLC patients and benign lung disease patients were analyzed.The expression of CTCs in different stages of SCLC was measured and compared.Furthermore, samples were prepared from 2 ml peripheral venous blood by centrifugation.The serum levels of NSE Neuron specific enolase were measured.The relationship between the expression of CTC and NSE was analyzed.Results CTCs positive rates in SCLC were significantly higher than in benign lung disease controls [ Positive rates of CTC≥1 were 80.0%and 12.0%(χ2 =27.003,P<0.000 1),CTC≥5 were 51.4%and 0 (χ2 =18.367,P<0.000 1), CTC≥10 were 34.3%and 0(χ2 =10.714,P<0.001),CTC≥50 were 17.1 and 0(P=0.036,P<0.05), respectively ].CTCs positive rates in SCLC extensive stage were significantly higher than limited-stage [Positive rates of CTC≥1 were 58.3% and 91.3%(P=0.033,P<0.05), CTC≥5 were 65.2% and 25.0%(P=0.035,P<0.05), respectively].The expression of CTCs was significantly correlated with NSE (r=0.743 7, P<0.000 1).Conclusion The expression of CTC in SCLC patients is significantly higher than those in control group , and is closely related to clinical stages , which may provide new clues to early predicting of SCLC metastasis and deterioration.

Objective To assess the chemotherapeutic protection management among nurses who exposed to chemotherapy drug .Methods A cross-sectional survey was conducted among nurses who worked in oncology and non-oncology department in 5 Class-3 general hospitals in Wuhan .492 nurses were investigated by a self-designed questionnaire .Results 94.2% nurses from non-oncology department had the experience of preparing chemotherapy drugs , which was more than the proportion of nurses ( 66 .9%) from the oncology department.There was significant difference between groups (χ2 =62.825,P<0.01).The proportions of non-oncology specialized nurses who reported that the hospitals or departments they worked in were equipped with chemotherapy drugs dispensing center , arranged someone to manage and prepare chemotherapy drugs were 19.2%,28.8% and 31.7%, respectively, which were lower than those of oncology specialized nurses (68.0%,53.5% and 57.7%).There were significant differences between groups (χ2 =117.774,28.735, 38.344, respectively;P<0.01).The proportions of the nurses reporting that the hospitals or departments they worked in were equipped with separate dispensing room , biological safety cabinets , separate dispensing desk , special chemotherapy waste container were 16.3%,20.2%,27.4% and 40.4%, respectively in non-oncology department, which were also lower than those of oncology specialized nurses (51.4%,49.3%,53.2% and 52.1%).There were significant differences between groups (χ2 =76.582, 53.297, 39.542, 6.970, respectively;P<0 .01 ) .Conclusions Nurses working in whether oncology or non-oncology departments have many opportunities to exposure to chemotherapy drugs . Hospitals should strengthen and improve chemotherapeutic protection management .Besides , oncology nurses or non-oncology nurses who are possibly expose to chemotherapy drugs should be focused as the groups needed chemotherapeutic protection .