Background and purpose: The prognosis of completely resected stage ⅢA(N2) non-small cell lung cancer (NSCLC) remains a significant concern. The 5-year overall survival (OS) rates range from 10% to 30%. This study aimed to analyze the patterns of first failure in completely resected stage ⅢA(N2) NSCLC and to assess the actuarial risk of developing metastasis at different sites and to guild standard clinical practice. Methods: Patients withⅢA(N2) NSCLC who had undergone radical surgery in our hospital from Jan. 2005 to Jul. 2012 were retrospectively reviewed. The progression-free survival (PFS), the OS, patterns of first failure, the actuarial risk were analyzed. The cumulative incidence of first failure was determined using the Kaplan-Meier analysis. Results: Among 357 patients who met the eligibility criteria with completely resected stage ⅢA(N2) NSCLC, 5-year OS was 36.9%. There were 284 (77.6%) patients experiencing disease failure: 61 with local failure, 197 with local and distant failures, and 26 patients with local recurrence as the first failure. Brain, bone and lung were the main sites of distant failure as the first failure, while brain was the most common site. There were 67 patients developing brain metastases (BM) as the first site of failure. The median time of local failure as the first site of failure was 13.6 months, and the time to develop distant recurrence was 15.1 months. 92.5% BM developed in 3 years after the complete resection. Conclusion: As the first failure, the rate of distant failure was much higher than that of local failure in completely resected stage ⅢA(N2) NSCLC. Brain was the most common site of distant failure as the first failure. These results can be helpful in guiding standard clinical practice and evaluating the outcome of comprehensive treatment.

Objective To compare the anti-aging effect of polysaccharides from crude and processed Cornus Officinalis on the mice with deficiency of kidney.Methods The mice were given the drugs by gastric perfusion. The effect of polysaccharides on the time of weight-loading swimming, anti-hypoxia time , and serum SOD activity and MDA content in mice with kidney deficiency was observed. Results Compared to the crude Cornus Officinalis, the polysaccharides from the processed product can markedly prolong the time of weight-loading swimming, anti-hypoxia time, promote the activity of SOD and decrease the content of MDA. Conclusions Polysaccharides from Cornus Officinalis have certain anti-aging effect on the mice with deficiency of kidney, and the effect of the processed is superior to that of the crude.

Background and purpose:Radiotherapy (RT) is one of the most important therapeutic tools for esophageal cancer. Because tumors are heterogeneous, including for18F-FDG uptake and, most likely, for radioresistance, selective boosting of high FDG uptake zones within the tumor has been suggested. Therefore, it is critical to know whether the location of these high FDG uptake patterns within the tumor remains stable during RT.Methods:Twenty-two patients with esophageal squamous cell carcinoma treated with concurrent chemo-radiation underwent repeated18F-FDG PET-CT scans before RT and after 20 fractions of RT. On all scans, the high and low FDG uptake regions were auto-delineated using several standard uptake value (SUV) thresholds, varying from 40% to 70% of SUVmax on the pretreatment scan [gross tumor volume (GTV)40%pre, GTV50%pre, GTV60%pre, GTV70%pre] and from 70% to 90% of SUVmax on the dur-treatment scan (GTV70%dur, GTV80%dur, GTV90%dur) and ifxed thresholds of 2.5 and 5 (GTV2.5pre, GTV5pre). The volumes and overlap fractions (OF) of these delineations were calculated to demonstrate the stability of the high FDG uptake regions during RT.Results:The high uptake regions within the tumor during RT largely corresponded (OF>70%) with the 50% SUVmax high FDG uptake area (GTV50%pre) of the pretreatment scan. The hotspot within the residual area (GTV90%dur) was completely within the GTV and pre-radiotherapy high uptake regions (OF=100%). Although the location of the high FDG uptake patterns within the tumor during RT remained stable, the delineated volumes varied markedly.Conclusion:The location of the high FDG uptake areas within the tumor remained stable during RT. This knowledge may enable selective boosting of high FDG uptake areas within the tumor.

Actins ; metabolism ; Adult ; Antigens, Neoplasm ; metabolism ; Diagnosis, Differential ; Epithelioid Cells ; chemistry ; pathology ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Melanoma-Specific Antigens ; Mesenchymoma ; metabolism ; pathology ; surgery ; Neoplasm Proteins ; metabolism ; Uterine Neoplasms ; metabolism ; pathology ; surgery

Objective:To investigate the expression of wild type estrogen receptor(wER)and the ex-on-5 deleted ER(variant ER,vER)in human hepatocellular carcinoma(HCC)samples,and thereafteranalyze the possibility of HCC treatment by endocrine therapy.Methods:The mRNA expressions of wERand vER were analysed from 28 cases of HCC by RT-PCR.The expression of ER at the protein level wasdetected by immunohistochemistry(IHC).Results:IHC results showed that 39.3% of the HCC speci-mens expressed ER.The mRNA of wER was detected in 89.3%(25/28)of the HCC specimens whilethat of vER was detected in 96.4%(27/28).Twenty four out of 28 HCC cases(85.7%)expressedboth wER and vER.One out of 28 patients(3.5%)expressed only wER whereas 3 patients out of 28(10.7%)expressed vER only.Conclusion:Ninety six percent(27/28)of the HCC patients expressedvER,which suggests that the expression of vER is an important event in the development of HCC.

Objective To study the effect of interventional treatment of iliac and femoral vein stenosis concomitant with deep venous thrombosis. Method Fifty-three patients were divided into 5 groups. In group A after placing into inferior vena cava a filter,11 patients adopted Amplatz Trombectomy Device for thrombolysis or ORSIS thrombolysis and persistent thrombolysis through popliteal vein. In group B thrombus was taken out through guiding catheter and then persistent thrombolysis through popliteal vein after placing into inferior vena cava filters in 9 cases. In group C 13 patients adopted persistent thrombolysis through femoral arteries. In group D 8 patients received persistent thrombolysis through popliteal vein. In group E persistent thrombolysis through foot veins was carried out in 12 patients. Seventeen patients received implanted stents and balloon-expansion in iliac and femoral veins. Results Symptoms disappeared in 26 patients(49.0%), significantly improved in 21 patients (39.6%), improved in 3 patients (5.7%), did not improve in 3 patients (5.7%), respectively. The repatency of iliac and femoral vein was achieved in more than 80% of the 17 patients. Complications developed in 3 cases in the course of thrombolysis. Conclusion The effect of mechanical removal of thrombus, persistent thrombolysis through catheter and transluminal angioplasty is safe and satisfactory.

Objective To evaluate the effect of hyperbaric oxygen therapy (HBOT) in patients with severe traumatic brain injury (STBI) after craniotomy,and evaluate the difference of HBOT effects on the patients whose Glasgow coma score (GCS) were 6-8 scores and 3-5 scores.Methods Using case-control study,61 neurosurgical in-patients with STBl from February 6,2009 to November 25,2010 were divided into two groups by random digits table,30 in HBOT group and 31 in control group.Their GCS at the periods on admission,before HBOT and when they finished HBOT were recorded,as well as the Glasgow outcome score (GOS) before HBOT,finished HBOT,and 3 months after admission (GOS3M).Results The GCS finished HBOT were (12.63 ±2.70) scores in HBOT group and (11.64 ±2.50) scores in GCS 3-5 subgroup,there were statistically differences than those in control group [ (10.61± 3.01 ),(8.44 ± 1.67)scores] (P ＜0.05).The mean rank of GCS finished HBOT improvement (△GOSf) and GOS scores 3months after admission ( △ GOS3M) in HBOT group was 35.37 and 35.87,which were significantly higher than those in control group (26.77 and 26.29) (P ＜0.05).Meanwhile,the mean rank of △GOSf and △ GOS3M in GCS 3-5 subgroup was 12.14 and 13.09,which were significantly higher than those in control group (8.05 and 7.33) (P ＜ 0.05 ).In GCS 6-8 subgroup,there was no significant difference in △ GOSf and △ GOS3M between HBOT group and control group (P ＞ 0.05).Conclusion Early HBOT is effective to improve the recovery of consciousness and prognosis of the postoperative patient with STBI,especially of the patients with the special STBI (GCS 3-5 scores ).

Tumor metastasis is the dominant cause of death in cancer patients. However, the molecular and cellular mechanisms underlying tumor metastasis are still elusive.The identification of protein molecules with their expressions correlated to the metastatic process would help to understand the metastatic mechanisms and thus facilitate the development of strategies for the therapeutic interventions and clinical management of cancer. Proteomics is a systematic research approach aiming to provide the global characterization of protein expression and function under given conditions. Proteomic technology has been widely used in biomarker discovery and pathogenetic studies including tumor metastasis. This article provides a brief review of the application of proteomics in identifying molecular factors in tumor metastasis process. The combination of proteomics with other experimental approaches in biochemistry, cell biology, molecular genetics and chemistry, together with the development of new technologies and improvements in existing method ologies will continue to extend its application in studying cancer metastasis.

OBJECTIVETo observe the therapeutic effect of rhubarb and Sanchi Powder (RSP) in treating patients with hemorrhagic fever in nephrotic syndrome (NS) complicated with digestive tract bleeding.

METHODSSixty patients clinically diagnosed as hemorrhagic fever in NS complicated with digestive tract bleeding were randomized into 2 groups. Fine ground rhubarb (3g) and SP (2g) were given orally to the patients in the treated group 3 - 4 times daily. Dicynonum (2g) was given by intravenously dripping to the patients in the control group.

RESULTSIn the treated group, 17 patients were cured, 5 markedly effective and 6 effective, with the markedly effective rate of 70.97% and the total effective rate of 90.32%. The corresponding number in the control group was 10, 3, 6, 44.83% and 65.52%, respectively, significant difference was shown in comparison between the two groups (P < 0.05 or P < 0.01). The average hemostatic time was (2.32 +/- 0.82) h, the platelet count was (8.84 +/- 1.13) x 10(9) /L, and the platelet aggregation rate was obviously improved in the treated group, which were significantly different to those in the control group [(4.15 +/- 0.69) h, (6.22 +/- 0.89) x 10(9)/L, respectively, P<0.01).

CONCLUSIONRSP has the action of promoting vasoconstriction, shortening the bleeding time and blood arresting, it can increase the platelet count and improve the platelet aggregation.

Adult ; Aged ; Araliaceae ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Gastrointestinal Hemorrhage ; drug therapy ; etiology ; Hemorrhagic Fever with Renal Syndrome ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Rheum

Objective To improve the level of early detection and treatment of pyonephrosis. Methods This study included 41 cases(17 men and 24 women;mean age,49 years)of pyonephrosis.A variety of examinations,including urinary analysis,blood analysis,kidney nuclear medicine scan,ultrasonog- raphy,intravenous urography(IVU),and CT were used for the early diagnosis of pyonephrosis.Pereutaneous nephrostomy(PCN)drainage was done for the interim management of pyonephrosis,then phase 2 operation was performed in 28 cases.The double-J tube was placed in ureter by ureteroscope for drainage,and then phase 2 operation was done in 2 cases.Emergency operation was done in 10 cases.The remaining 1 case un- derwent ESWL after anti-infective therapy.Results Definite diagnosis of pyonephrosis before operation was made by invasive examinations in 31 cases(75.6%),and by percutaneous drainage in 4 cases;the other 6 cases were detected during operation.Only 6 cases(14.6%)underwent nephrectomy;the other 35 cases (85.4%)underwent kidney-sparing operation.Follow-up of 3 months to 9 years was available in 37 cases. No nephrectomy was needed in 33 cases with spared kidney.Serum creatinine was normal in the 4 cases un- dergoing nephrectomy.Conclusions The key to the treatment of pyonephrosis by kidney-sparing surgery is early diagnosis,timely drainage and relief of obstruction.Ultrasonography plays an important role in the early diagnosis of pyonephrosis,and CT has a high sensibility in the diagnosis.Pereutaneons nephrolithotomy (PCNL)secondary to drainage through pereutaneous nephrostomy was beneficial to the patients with kidney stones or upper ureter stones.