Objective To observe the clinical effect of maintenance chemotherapy by pemetrexed in advanced non-small-cell lung cancer. Methods 60 patients with advanced non-small-cell lung cancer (stage Ⅲb~ Ⅳ) were randomly divided into observation group and control group , all the patients showed complete or partial remission after receiving 4 cycles of induction chemotherapy. Observation group was given pemetrexed maintenance (500 mg/m2 on days 1 every 21 days) until first disease progression, control group was given best supportive care . Progression free survival ( PFS ) , overall survival ( OS ) and adverse reaction were observed . Results PFS and OS of observation group were significantly higher than control group, PFS was (7.3 ± 1.20) vs (3.5 ± 1.13) months, OS was (12.2 ± 1.14) vs (7.1 ± 1.23) months, the difference was statistically significant. The main side effects were fatigue and leucopenia which were tolerable. Conclusion Maintenance therapy with peme-trexed following initial therapy was feasible, and extended the PFS and OS, and shows a favorable toxicity profile.

Objective To explore the genetic characteristics, diagnosis, and treatment of hereditary spherical polycythemia (HS). Methods The clinical data of one case of HS was analyzed retrospectively, and related literatures were reviewed. Results The 5-year-old girl presented hemolytic anemia from 6 months old. Incubation of fragility tests was positive. Blood smears and red cell electron microscopy showed spherical red blood cells. DNA sequencing showed alterations in heterozygosity of stopgain SNV. The girl was diagnosed was HS, and was scheduled to undergo splenectomy at 6 years old. Conclusions HS is an autosomal dominant genetic disease, mainly manifested as anemia, hemolytic anemia, and splenomegaly. The early diagnosis depends on genetic testing.

AIM: To compare the efficacy of different locations scleral tunnel incision in phacoemulsification cataract on preoperative corneal astigmatism.
METHODS:Totally 90 patients (94 eyes) in our hospital who had undergone the phaco-surgery from March 2013 to October 2014 were divided into two groups. The group A was those with 3. 2mm scleral tunnel incision at the direction of 10:00 ~11:00 points. The group B was those with 3.2mm scleral tunnel incision at the steepest corneal meridian. Incision was not sutured. Corneal astigmatism status of preoperative and postoperative at different times were detected by corneal refractive. The impact of different surgical incision on postoperative corneal astigmatism was compared. In the two groups, patients with preoperative corneal astigmatism<1. 00D, 1. 00 ~2.00D and > 2. 00D were compared respectively. The changes of the uncorrected visual acuity and corneal astigmatism at postoperative 1wk, 1 and 3mo were observed.
RESULTS:The uncorrected visual acuity of the patients who were in the group B preoperative corneal astigmatism <1. 00D and 1. 00 ~ 2. 00D was better than that in the group A. The postoperative corneal astigmatism of the patients who were in the group B preoperative corneal astigmatism <1. 00D was lower than that in the group A.
CONCLUSION: On the basis of preoperative corneal astigmatism, 3. 2mm scleral tunnel incision at the steepest corneal meridian to some extent can correct preoperative corneal astigmatism < 1. 00D, and accordingly improve the uncorrected visual acuity.

Objective To survey and analyze characteristics of brucellosis epidemic in Dalian City for the purpose of setting up prevention and control measures for the disease. Methods In 2007, the basic situation of people of 7-60 years old and in close contact with livestock was surveyed in Dalian according to the "Surveillance standard for brucellosis"(GB 16885-1997). Blood was collected in brucellosis suspicious or high-risk groups for the laboratory examination, using rose bengal test for qualitative detection and test-tube agglutination test(SAT) method for quantitative detection of serum antibodies; At the same time, brucellosis cases found in the routine monitoring and confirmed in and this survey in the department of endemic disease prevention in the center for disease control and prevention of Dalian City underwent questionnaire surveys. Results All 1563 people were epidemiologically surveyed of brucellosis, 1310 were male, 253 female,livestock care givers accounted for 56.05% (876/1563). 240 blood samples were serologically surveyed, the detection rate was 3.75%(9/240). This survey confirmed 2 cases of brucellosis patients, 3 cases confirmed in routine monitoring. 3 cases were infected via contacting infected brucellosis cows, and the 2 cases were imported. Conclusions To strengthen the quarantine of livestock and timely treat the infected livestock should be the key of control of brucellosis. At the same time, professionals of livestock should be educated to protect themselves.

Objective: To discuss the predictive value of liver and spleen stiffness detected by transientelasticity imaging technology on esophageal varices bleeding (EVB) of patients with hepatitis B cirrhosis. Methods: 100 patients with hepatitis B cirrhosis (18 cases were no EV, 30 cases were mild EV, 28 cases were moderate EV and 24 cases were severe EV) were selected. In these patients, 52 cases were no bleeding, 28 cases were single hemorrhage and 20 cases were multiple hemorrhage. As the Child-Pugh grading, there were 34 cases were A grade, 30 cases were B grade and 36 cases were C grade. All of the liver and spleen stiffness of these patients were detected by instantaneous elasticity imaging technology, and to compare different Child-Pugh grading of patients, different EV degree, and liver and spleen stiffness on different EVB situation. Results: The liver and spleen stiffness of patients in Child-Pugh C stage were significantly higher than that in Child-Pugh A stage and B stage, respectively (t=21.13, t=12.04, t=11.24, t=9.741; P<0.05). With the aggravating of the severe degree of EV, the liver and spleen stiffness were significant increasing, and there were significant differences between different EV degree patients for liver stiffness and spleen stiffness, respectively (F=7.494, F=8.129, P<0.05). The liver and spleen stiffness of multiple hemorrhage group were significant higher than that of no-hemorrhage group and single hemorrhage group, respectively (t=13.13, t=18.14, t=12.15, t=17.46; P<0.05). Conclusion: By using instantaneous elasticity imaging technology to detect liver and spleen stiffness can predict EVB of patient with hepatitis B cirrhosis and it has higher clinical value, therefore, it is a sophisticated noninvasive examination with simple operation and better repeatability.

ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.

Objective To understand the clinical characteristics of Acinetobacter baumannii infections in elderly patients in intensive care unit (ICU)and investigate its drug susceptibility. Methods Bacterial identification was carried out by VITEK?32 automatic micro?analyzer(Bio?Merieux Company of French). Data processing was performed with WHONET5.6 software. Results Totally 259 strains of Acinetobacter baumannii were isolated from 220 infected elderly patients. The detection rate of Acinetobacter baumannii was 71.43%(185 strains),13.13%(34 strains), 6.18%(16 strains )and 9.26%(24 strains)from sputum,drainage fluid,blood and other specimens,respectively . Drug resistance of Acinetobacter baumanniito antibiotics was relatively high. Resistance to tigecycline of Acinetobacterbaumanniistrains was the lowest(0%?23.38%)while the sus?ceptibility was the highest(70.13%?80.85%)in all kinds of antibiotics in this study. Conclusion Acinetobacter baumannii varied in drug resis?tance to different antibiotics. It is necessary to choose susceptible antibiotics for clinical anti?infection treatment on the basis of in?vitro antibiotics sus?ceptibility testing for isolated strains from local regions.

Objective To investigate the association between left ventricular hypertrophy and peritoneal transport properties in Peritoneal Dialysis patients.Methods Sixty-nine Continuous Ambulatory Peritoneal Dialysis (CAPD)patients were enrolled in current study.All patients underwent echocardiography for left ventricular mass index (LVMI).Transport status was categorized as high transport,high average transport,low average transport and low transport based on modified peritoneal equilibration test (PET).The data collected included hemoglobin,albumin,blood urea nitrogen,creatinine,urea clearance (Kt/V) and creatinine clearance rate (Ccr),dialysis vintage,systolic blood pressure,diastolic blood pressure.Results Patients with high transport status were 41 cases,more than those with low transport status(28 cases).The dialysis age of high transport,high average transport,low average transport and low transport vintage were (39.2 ± 21.8),(26.6 ±15.6),(28.6 ± 14.4),(45.7 ± 35.0) years old respectively,and the difference was significant (F =4.128,P ＜ 0.05).The dialysis age in the higher transport group was longer than that in high average transport group and low average transport group (P ＜ 0.05).LVMI has significant positive correlations with D/Pcr at 4th hour,SBP and DBP (r =0.339,0.351,0.316,P ＜ 0.01) and the negative correlation with albmin (r =-0.292,P ＜0.05).Left ventricular hypertrophy(LVH) in all patients was 63.8％,ant it was higher in high transport group than that low average transport and low transport group (x2 =5.455,5.091,P ＜ 0.05) Conclusion High transport status is the most common in CAPD patients.There is high incident rate of LVH in this population.LVH has significant positive correlations with D/Pcr,higher SBP,DBP,and lower albumin.

Objective To observe the extracellular content of dopamine (DA)and expression of D1 receptors in hippocampal dentage gyrus (DG)in the model rats with vascular dementia (VD),and to investigate the relationship between them.Methods 12 male SD rats were randomly divided VD group and sham-operation group,and the VD model was prepared by permanent bilateral carotid occlusion.The extracellular content of DA in the DG was determined by in vivo microdialysis and HPLC,and the expression of D1 receptors was measured by immunehisto-chemistry.Results The DA content in the DG of the rats in VD group was lower than that in sham-operation group (P <0.05).The number of D1 receptor-positive cells in the DG hilus in VD group was increased compared with sham-operation group (P < 0.05),whereas the expression of D1 receptor in DG granule cell layer did not change (P > 0.05).Conclusion The DA content in the hippocampal DG is decreased in the VD rats,and its function may be compensated by the up-regulation of D1 receptors in the DG hilus.

OBJECTIVE: To investigate the clinical effect of nasal packing of pulmicort respules combined withnasopore after endoscopic sinus surgery. METHOD: A total of 30 CRSwNP and CRSsNP patients with bilateral functional endoscopic sinus surgery and finished following up visit were randomly choosed, conventionally select the left nasal cavity as the experimental group, the right nasal cavity as the control group. Experimental group to pack the nasal cavity with pulmicort respules union nasopore after surgery and control group to pack the nasal cavity with only nasopore after surgery. The differences were observed in patients with subjective symptoms and recovery of mucosa of operative cavity between the two groups after two weeks, one month and three months. RESULT: (1) The postoperative VAS symptoms score about nasal obstruction, nasal secretion, headache, dizziness and distending pain after two weeks,one month and three months in the experiment group were significantly better than those in the control group(P<0.05). (2) The postoperative Lund-Kennedy endoscopic mucosa morphology score after two weeks, one month and three months in the experiment group were significantly better than those in the control group(P<0.05); (3) After three months, the experiment group had 28 cases with clinic symptoms cured(93. 3%), Total effective rate was 96. 6%; The control group had 22 cases with clinic symptoms cured (73. 3%), total effective rate was 93. 3%. The cure rate of the experiment group was significantly higher than the control group(P<0.05), but there was no statistic difference between the two groups in the total effective rate (P>0.05). CONCLUSION The application of nasal packing of pulmicort respules combined with nasopore after functional endoscopic sinus surgery can effectively relieve postoperative uncomfortable symptoms, promote recovery of mucosa of perative cavity, which deserves clinical promotion.
Anti-Inflammatory Agents ; administration & dosage ; Bandages ; Budesonide ; administration & dosage ; Endoscopy ; Epistaxis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Paranasal Sinuses ; surgery ; Postoperative Period