90% with better sparing of the surrounded normal tissue.However,the metastasis rate is still 20%-25%,which limits the improvement of overall survival(OS).To consolidate the local control rate and reduce the metastasis rate,it is necessary to combine chemotherapy with radiotherapy.According to clinical randomized studies and meta-analysis,chemotherapy can improve the OS of loco-regionally advanced nasopharyngeal carcinoma by more than 6% with radiotherapy alone as baseline.Concurrent chemo-radiotherapy is the most promising strategy to cope with the disease.This review has summarized the progress in the area of combination of chemotherapy and radiotherapy for the treatment of loco-regionally advanced nasopharyngeal carcinoma.

AIM: To study the signal transduction pathway of apoptosis initiation induced by homoharringtonine in HL-60 cells. METHODS: After establishing the model of apoptosis initiation induced by homoharringtonine in HL-60 cells, at the point of apoptosis initiation, molecular caspase-3, Bcl-2, Bax and Fas/FasL were measured with flow cytometry and transmission electron microscope. ERK2 and P38 expression in HL-60 cells were detected by using immunohistochemistry. RESULTS: The model of apoptosis initiation induced by homoharringtonine was established in HL-60 cells. At the point of apoptosis initiation, upregulation of caspase-3 and decrease in Bcl-2/Bax were observed. However, the expression of Fas/FasL did not significantly change. ERK2 expression decreased and P38 expression increased. CONCLUSIONS: Caspase-3, Bcl-2, Bax and mitogen activated protein kinase pathways were involved in signal transduction of apoptosis initiation induced by homoharringtonine in HL-60 cells. [

Objective To investigate the effects of propofol on myocardial nuclear factor kappaB(NF-κB)and inducible nitric oxide synthase (iNOS) during myocardial ischemia-reperfusion (I/R) in isolated rat hearts.Methods Twenty-four adult SD rats of both sexes weighing 200-300 g were randomly divided into 3 groups (n=8 each):group Ⅰ control (C) ; group Ⅱ I/R and group Ⅲ propofol + I/R (P).The animals were anesthetized with intrxperitoneal urethane 1.0 g/kg and their hearts were excised.The aorta was cannulated and the hearts were retrogradely pedused with oxygenated K-H solution in a Langandorff apparatus for 20 min.In group C the hearts were continuously perfused with K-H solution for 110 min.In I/R group after 20 min stabilization the hearts were made globally ischemic for 30 min followed by 60 rain reperfusion.In group P the hearts were peffused with K-H solution containing 50 μmol/L propofol for 20 min,the hearts were then made globally ischemic for 30 min followed by 60 min repedusinn with K-H solution containing 50 μmol/L propofol.Cardiac troponinI (cTnI) concentration in coronary effluent was measured at the end of 20 min stabilization before myocardial isobemia (baseline) and at 10 min(T1) and 60 min (T2) of reperfusion.Myocardial specimen was obtained frem left ventricle at 60 min of repeffusion for determination of MDA content,SOD and iNOS activity,the expression of NF-κB and IκB (by immuno-histochemistry).Results The cTnI concentration in coronary effluent was significantly higher at T1 and T2 in group I/R and at T2 in group P than in group C.The NF-κB expression was significantly higher while IκB expression was lower in I/R and P group than in group C.iNOS activity was higher in I/R group than in control group but there was no significant difference in iNOS between group P and C.Propofol administered before and after myocardial ischemia significantly attenuated I/R-induced changes listed above.Conclusion Propofol can attenuate myocardial ischemia-reperfusien injury through reducing the NF-κB activation and suppressing the iNOS activity.

Obesity is one of the major risk factors of primary hypertension,with the dramatic increase in obesity.Obesity-induced hypertension also gradually increases.Due to promoting the occurrence and development of high blood pressure,obesity has caused wide public concern.In recent years,the pathogenesis of obesity-induced hypertension has become the study hotspot.However,fat and blood pressure relationship is complicated.This review article emphatically reviewed the activation of the sympathetic nervous system,the renin-angiotensin-aldosterone system (RAAS) activation,insulin and insulin resistance,leptin and leptin resistance,the gastrointestinal tract anomalies in the pathogenesis of obesity hypertension of the latest research progress.

Objective We compared the effect of three anesthetic procedures on the establishment of and recovery effect on the young minipig models of skull defect,and explore an optimal anesthetic procedure for long-lasting surgical experiment in minipigs.Methods Thirty 3-month old Guizhou minipigs (male∶female=1∶1) were randomly divided into three groups,10 in each group.The group A was given with midazolam and ketamine i.p.,the group B received lumianning II i.p.,and the group C received midazolam combined with ketamine and lumianning II i.p.The induction time of anesthesia,the first anesthesia maintenance time,the first anesthesia maintenance period after additional use of anesthetics,the second time anesthesia maintenance period after additional use of anesthetics,the recovery period,the number of times of additional intraoperative use of anesthetics,cumulative amount of anesthetics used,and the adverse reaction and mortality rates of the animals after anesthesia were observed and analyzed.Results The anesthesia induction time in the group B was significantly longer than that in the groups A and C (P<0.05 for both).The anesthesia maintenance time and the anesthesia maintenance after first and second additional use of anesthetics in the groups A were significantly longer than those of the groups A and B (P<0.05 for both).The recovery periods in groups A and C were shorter than that of the group B (P<0.05 for both).The number of times of additional intraoperative use of anesthetics,the total dose of anesthetics,the adverse reaction and mortality rates in the group C were significantly lower than those of the groups A and B (P<0.05 for both).Conclusions The combination of midazolam with ketamine and lumianning II is a simple,easy to control the anesthesia depth,and a safe method to anesthetize young minipigs in long-lasting surgical experiment.

Summarized in the paper are the practices and experiences of hospitals across China,in their optimization of medical resources under the Healthcare Improvement Initiative to meet medical needs.Namely rationally allocating medical resources to strengthen emergency rescue,introducing new technologies to improve procedures and efficiency,introducing day surgery and day-care units,and innovating resource sharing among others.The author also recommended on further optimization of medical resources.

Objective To investigate the impact of using antithrombotic drugs (anticoagulants or antiplatelet aggregation drugs)before the onset of cerebral infarction on hemorrhagic transformation after acute cerebral infarction. Methods The consecutive patients with acute cerebral infarction from Chengdu Stroke Registry Project admitted to the Department of Neurology,West China Hospital,Sichuan University from January 1,2004 to January 1,2014 were enrolled. The baseline data on admission,previous usage of anticoagulants and anti-platelet aggregation drugs,as well as CT/ MRI and other imaging data of all patients were collected. According to the results of CT/ MRI reexamined at 72 h after admission,the patients with hemorrhagic transformation were enrolled into a hemorrhagic transformation group;the patients with non-hemorrhagic transformation were enrolled into a non-hemorrhagic transformation group according to the ratio
of 1 ∶ 1. Their gender and age were matched with the hemorrhagic transformation group. The baseline data and drug used of the patients in both groups were compared. The differences of risk factors between the two groups were analyzed with multivariate Logistic regression analysis. The relationship between hemorrhagic transformation and premorbid use of antithrombotic drugs were observed. Results A total of 6 916 patients with acute cerebral infarction were enrolled,including 433 (6. 3%)hemorrhagic transformation (hemorrhagic transformation group)and 433 non-hemorrhagic transformation. (1)There were significant differences between the patients of the two groups on admission in the National Institutes of Health Stroke Scale (NIHSS)score,atrial fibrillation,previous cerebral infarction,and blood glucose levels on admission (all P < 0. 05). (2)The proportions of using anticoagulants and antiplatelet aggregation agents in the hemorrhagic transformation group were higher than those of the non-hemorrhagic transformation group (anticoagulants:14. 1% [n = 61]vs. 3. 9% [n = 17];P < 0. 01,OR,4. 01,95% CI 2. 303 -6. 993;anti-platelet aggregation drugs:14. 3% [n =62]vs. 8. 3% [n = 36];P = 0. 005,OR,1. 84,95% CI 1. 194 -2. 846). (3)The results of multivariate Logistic regression analysis showed that the use of anticoagu-lants,anti-platelet aggregation drugs,NIHSS score on admission,and random blood glucose on admission were the independent risk factors for hemorrhagic transformation (OR [95% CI]3. 302 [1. 860 -5. 862], 2. 081 [1. 281 -3. 382],1. 047 [1. 026 -1. 069],and 1. 055 [1. 011 -1. 100],respectively (all P <0. 05). Conclusion The NIHSS score and blood glucose levels on admission are the independent risk factors of hemorrhagic transformation. Using anticoagulants or anti-platelet aggregation drugs before symptom onset is independently associated with hemorrhagic transformation,however,its relationship with the long-term prognosis of acute cerebral infarction need to be further studied.

Objective] To observe the clinical effect of Shaoyao Gancao Decoction on treating children functional abdominal pain to offer reference for further observation. [Method] Choose 200 children patients in pediatric outpatient department of Changxing County TCM Hospital, randomly divide them into treatment and control groups in order, n=100. The treatment one was administered revised Shaoyao Gancao Decoction, the control one orally took Medilac-Vita; both for 4 courses, then observe the cure effects. [Result] In treatment group, total effective rate 94.00%; for control one, it was 86.00%. The comparison of both had difference of statistical meaning( P<0.05). On comparing their abdominal pain relieve, in treatment group, there's more in first 2w and showed marked summit value in the first week; while in control one, there's no marked summit value; so the treatment group was more obvious than other one on relieving pain in the first 2w(P<0.05). The side effect occurrence rate of treatment group was less than other one, the difference between them had statistical meaning(P<0.05). [Conclusion] The revised Saoyao Gancao Decoction has marked cure effect on children functional abdominal pain, worth clinical promotion.

Objective:To compare the changing trends and differences of bed numbers,doctor numbers and medical service utilization in the US.and China so as to provide polity implication for the health care reform in China from the supply side.Methods:The data of beds,doctors,hospitalization and outpatient service utilization from the website of OECD and CDC of the United States as well as Chinese Statistical Yearbook of Health and Family Planning were used to describe the trends.Results:The beds per 1000 people in China had exceeded that of the US,while the doctors per 1 000 people in China was less than the US.Both the two countries had yearly increasing trend of outpatient visits.However,the hospitalization was decreasing in the US,while the growth rate of hospitalization was even higher than the outpatient visits in China.Conclusion:The decrease of bed amount and the increase of outpatient amount were the main changing trend of medical resources and service utilization in the US.The imbalanced structure of medical resource supply in China resulted the overuse of hospitalization services.In the supply side reform of medical reform in China,it suggested to promote the cooperation of medical insurance,drug and health care,adjusted the reform thought from resource amount into the promotion of service quality,changed the health management system from disease centered into health centered.