Objective To study clinical manifestations and imagine features (CT and MRI) on toxic encephalopathy after inhaling heroin. Methods 13 patients with toxic encephalopathy induced by inhaling heroin were observed and analyzed on its clinical and imagine features (CT and MRI).Results 13 patients all were male, and were intoxicated by way of inhaling heroin vapour. Nine cases had appearances of clinical manifestations during abrupt abstinence. The main clinical manifestations of the disease were of the sub-acute diffuse cerebral lesions, especially of early mental symptoms and cerebellum ataxia. The CT of all 13 cases showed multiple white matter lesions involving in the frontal, parietal, occipital,temporal, and cerebellum hemisphere dentate nucleus. There was no occupational mass shown in general. The MRI of 6 cases showing focus was the same as of the CT. Conclusion The diagnosis of HTE should be dependent on the definite inhaling heroin vapour and their clinical features and neuroradiological appearance. CT should be valuable for the diagnosis of HTE, and the MRI as well. Corticosteroids show less therapeutic effect on such diesease.

Objective To evaluate the efficacy and safety of induction chemotherapy and three-dimensional conformal radiation (3D-CRT) combined with endostar in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods Thirty patients with locally advanced NSCLC were enrolled and divided into observation group (15 cases) and control group (15 cases).In the observation group,the patients received induction chemotherapy and 3D-CRT combined with endostar.Chemotherapy:Vinorelbine 25mg/m2 on day 1 and 8,DDP 30mg/m2 on day 2 to 4.Endostar 7.5mg/m2 on day 1 to 14,which was used again after 7 days for 2 to 4 cycles.In the control group,the patients received induction chemotherapy and 3D-CRT at the same dosage.All patients were treated with 3D-CRT and the prescription dose was 60 ～ 68Gy per fraction.The responses were evaluated according to WHO criteria.The shortterm efficacy between the 2 groups was compared.Results The overall effective rate of the two groups were 66.7％ and 60.0％,respectively (P ＞ 0.05).The median progression-free survival time was 12 months in the observation group and 10 months in the control group.The median survival time was 20 months in the observation group and 18 months in the control group.The 1 year overall survival rate was 80.0％ in the observation group and 73.3％ in the control group(P ＞ 0.05).The main toxicities in the two groups were marrow suppression,gastrointestinal symptoms,acute radiation pneumonitis and acute radiation esophagitis.There was no significant difference between the two groups (P ＞ 0.05).Conclusions The combination of endostar with induction chemotherapy and 3D-CRT can improve the short-term efficacy rate of locally advanced NSCLC,the adverse events of which are tolerable,but the improvement is not significant in both groups.The result pending further randomized multi-center phase Ⅲ clinical study.

Objective To study in targeted therapy of cancer drug endostar combined with radiotherapy and chemotherapy in the treatment of newly diagnosed patients with advanced non-small cell lung cancer, and find an effective combined treatment mode of advanced non-small cell lung cancer, so as to improve the survival rate and quality of life of patients with advanced lung cancer. Methods 18 patients with newly diagnosed advanced non- small cell lung cancer admitted to our hospital from July 2009 to February 2010 were randomly divided into 2 groups and treated with induction chemotherapy and 3D-CRT,9 cases in the experimental group (including Endostar), 9 cases in the control group, All of the patients'clinical symptoms, efficacy and toxicity in the two groups were observed. At the same time, nursing of radiotherapy, chemotherapy and targeted therapy was given to paients. Results The efficacy of the experimental group and the control group were 77.8% and 66.7%, the clinical remission rates of the experimental group and the control group showed no significant difference, both of the patients in the two groups had varying degrees of toxicity, but all of the them completed the treatment well under the holistic nursing and systematical health education by nurses. Conclusions Endostar combined with induction chemotherapy and three-dimensional conformal radiotherapy (3D-CRT) in the treatment of advanced non-small cell lung cancer can improve the efficacy and survival rate, and the quality of life, although there are some side effects, but can be alleviated by symptomatic treatment and care.

BACKGROUND: The occurrence and severity of acute high-altitude disease(AHAD) are determined by the speed entering the highland, the altitude of highland and seasons. The association between obesity and AHAD has not been fully investigated.OBJECTIVE: To investigate the association between obesity and acute high-altitude in people exposed rapidly to the highland.DESIGN: Comparative observation.SETTING: Department of Cardiology, General Hospital of Chinese PLA and Department of Cardiology, Tibetan General Hospital of Chinese PLA.PARTICIPANTS: The experiment was conducted at the Department of Cardiology, General Hospital of Tibetan Military Area Command of Chinese PLA in August 2006. Totally 82 Henan subjects aged 28-45 years were selected from the male workers constructing the Qinghai-Tibet Railway and their managers with acute high-altitude exposure. They had never been to the highland before, and all agreed to the detection.METHODS: ①Every subject completed the AHAD self-report questionnaire at sea level and 12 hours and 24 hours after ascending high-altitude. The items in the questionnaire included symptoms of headache, gastrointestinal symptoms,fatigue or weakness, dizziness, and insomnia. Each symptom was graded from 0-3 with 0 as no symptoms, 1 as mild symptoms, 2 as moderate symptoms, and 3 as severe symptoms and a total score of 15. A score of 4 or more could by identified as AHAD. ②The height and body mass were measured to calculate the body mass (BMI). Those with BMI≥28 kg/m2 served as the obesity group [n =39, mean age (35±8) years], and those with BMI of 18.5-23.9 kg/m2 as the normal body mass group [n =43, mean age (35±8) years]. ③Arterial blood was taken to evaluate arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude. ④The measurement data was compared by t test.MAIN OUTCOME MEASURES: BMI, vital capacity of lungs, SO2, PaO2 and PaCO2 levels of obese and normal people.RESULTS: Totally 39 obese people and 43 normal people were involved in the result analysis. ①AHAD score: No symptom was reported at sea level in all participants (scored 0), but the AHAD scores in the obesity group were significantly higher than those in normal group 12-hour and 24-hour after ascending high-altitude. ②Blood gas analysis:At sea level, there were no statistical differences in the levels of SO2, PaO2, and PaCO2 between two groups (P ＞ 0.05).But 24 hours after ascending high-altitude, SO2 and PaO2 of the obesity group were much lower than in the normal group (P＜ 0.01), and PaCO2 was significantly higher than in the normal group (P＜ 0.01).CONCLUSION: Obese men are more vulnerable to high-altitude hypoxia than people with normal body mass. Obesity is an important risk factor for the development of acute high-altitude disease.