OBJECTIVE:To observe clinical efficacy and safety of paclitaxel or 5-fluorouracil combined with nadaplatin in the treatment of advanced nasopharyngeal carcinoma(NPC). METHODS:42 patients with advanced NPC were randomly divided into observation group and control group(n=21). 2 groups of patients were treated with radiotherapy. Observation group received che-motherapy of paclitaxel(135 mg/m2,d1)and nedaplatin(80 mg/m2,d 2-4);control group received chemotherapy of 5-fluoroura-cil(500 mg/m2,d1-5)and nedaplatin(80 mg/m2,d1-3);a treatment course lasted for 3 weeks,and both groups received 2 courses of treatment. Clinical efficacy, survival rate and ADR were observed in 2 groups. RESULTS:The overall response rate was 95.2%in observation group and 90.5% in control group,with no significant difference between 2 groups (P>0.05). The 3-year overall survival rate and progression-free survival rate were 81.0% and 71.4% in observation group and 76.2% and 66.6% in control group,with no significant difference(P>0.05). The incidence of nausea and vomiting in observation group were lower than in con-trol group,while the incidence of oral mucosa inflammation was higher than control group,with statistical significance(P<0.05). CONCLUSIONS:The chemoradiotherapy of paclitaxel or 5-fluorouracil combined with nadaplatin have similar therapeutic efficacy for advanced NPC. ADR by chemoradiotherapy should be monitored closely and treated timely.

OBJECTIVE:To evaluate the use of narcotic analgesics in eight hospitals of Lianyungang,Jiangsu Province. METHODS:Consumption of narcotic analgesics in eight hospitals of Lianyungang was audited and analyzed in terms of variety,volume,sales value and DDDs.RESULTS:Narcotic analgesics as used in the eight hospitals of Lianyungang recorded year-on-year growths in both consumption volume and sales value,with their growth rates in sales value being significantly higher than those of other drugs.Consumption of Pethidine hydrochloride was on the down while that of Morphine was picking up year-on-year.The DDDs of Fentanyl patch remained small.CONCLUSIONS:The use of narcotic analgesics in the eight hospitals of Lianyungang tends to be rational in recent years.

Objective To observe the effect of RNA interference binding immunoglobulin protein (BiP) on expression of bone markers and keytranscription factors in osteoblast exposed to fluoride.Methods MC3T3-E1 cells were used as osteoblast model in vitro.The cell viability was test with cell counting Kit-8 after cells were administrated with varying concentrations of fluoride [0.0 (control),0.1,1.0,2.0,4.0,8.0,16.0,20.0,32.0 and 64.0 mg/L] for different duration.Cells transfected with small interfering RNA (siRNA) BiP were exposed to fluoride (2.0,8.0 and 20.0 mg/L) for 2 days.Real-time PCR and Western blotting technique were used to determine the gene and protein levels of BiP.Meantime,the mRNA expression of bone markers and key transcription factors was investigated by real-time PCR.Results The difference of all viability in fluoride-dose groups was statistically significant exposed for 1,3,7 and 14 days (F =46.7,118.6,214.6,325.6,all P ＜ 0.05).Expression of BiP significantly increased in cells exposed to 20.0 mg/L compared to that of control (11.22 ± 3.25 vs.7.94 ± 1.31,P ＜ 0.05).The expression of alkaline phosphatase (ALP) elevated in cells exposed to 2.0 mg/L of fluoride (12.81 ± 3.62 vs.6.86 ± 2.13,P ＜ 0.01);conversely,it significantly reduced in cells exposed to 20.0 mg/L of fluoride (0.89 ± 0.17 vs.6.87 ± 2.14,P ＜ 0.01).Cells transfected with siRNA BiP significantly decreased the ALP expression in cells exposed to fluoride compared to that of cells only exposed to the same concentration of fluorine (12.81 ± 3.62 vs.7.43 ± 2.06;5.92 ± 2.38 vs.3.96 ± 0.21,all P ＜ 0.05).Cells transfected with siRNA BiP and administrated with 2.0 mg/L significantly reduced the osteocalcin expression (4.29 ± 0.99 vs.1.29 ± 0.86,P ＜ 0.01).Similarly,expression of runt-related transcription factor 2 (Runx2) significantly increased in cells exposed to 2.0 mg/L.However,expression of Runx2 significantly decreased in cells transfected with siRNA BiP and administrated with fluoride.Cells transfected with siRNA BiP significantly decreased the Runx2 expression in cells exposed to 2.0 mg/L and 20.0 mg/L compared to that of cells only exposed to the same concentration of fluorine (1.13 ± 0.22 vs.6.61 ± 0.48;0.02 ± 0.02 vs.1.50 ± 0.38,all P ＜ 0.01).As the downstream of Runx2,the expression of osterix in cells treated with different concentrations of fluoride was similar to that of Runx2.Conclusion BiP is not directly involved in the process of osteoblast differentiation induced by fluoride;instead,it affects the expression of bone markers and key transcription factors in osteoblast exposed to fluoride.

Objective:To establish a UPLC method for the determination of ginsenoside Rg1 , ginsenoside Re and ginsenoside Rb1 in Yi’ nianjin. Methods: The column was ZORBAX Eclipse Plus C18 (2. 1 mm × 50 mm,1. 8 μm), the flow rate was 0. 21 ml· min-1 , the column temperature was 30℃, the mobile phase consisted of acetonitrile-water with gradient elution, the detection wave-length was 203nm, and the sample size was 1μl. Results:The linear range of ginsenoside Rg1 was 0. 020 3-0. 303 9 mg·ml-1 ( r=0. 999 6), and the average recovery was 99. 05% (RSD=1. 3%, n=6). The linear range of ginsenoside Re was 0. 020 2-0. 302 7 mg·ml-1(r=0. 999 8), and the average recovery was 101. 31% (RSD=1. 1%, n=6). The linear range of ginsenoside Rb1 was 0. 020 3-0. 305 1 mg·ml-1(r=0. 999 8), and the average recovery of 100. 71% (RSD=0. 9%, n=6). Conclusion: The method is simple and accurate, and can determine the three components simultaneously. The method can be used in the quality control of Yi’ nianjin.

0. 05). Conclusion Chronic fluorosis has no obvious effect on myocardial collagen metabolism of rats and myocardial collagen is not likely the main target of fluoride.

Objective To investigate the expression of connexin CX43 using hybridization techniques after GABA restraining receptor gene was transferred into the supramammillary of hypothalamus in Kainic acid(KA) induced epileptic rats.Methods Twenty-four male Wistar rats were divided into four groups: control group(n=2),surgery group(n=2),KA group(n=10) and GABA restraining receptor gene transferred group(GABA group)(n=10).No treatment was given to the control group.Physiological saline(1 ?L) was injected into right amygdala of rat in surgery group.In KA group,KA(1 ?L,1 ?g) was injected into the amygdala of rat to build epileptic model.In GABA group,the GABA restraining receptor gene(400 nL,40 ng) was transferred into the supramammillary of hypothalamus by HVJ-liposome 48 h before KA was injected into amygdala.The expressions of CX43 mRNA and morphological changes different time(3 h,6 h,24 h,3d,7d) were observed by in situ hybridization in each group.Results In control group and surgery group,the morphological manifestations were normal,and the hippocampus structures were complete.In KA group,swell and degenerative hippocampus neurons were showed and deteriorated with time.In GABA group,the degeneration and necroses of hippocampus neurons were relatively alleviated.The positive expression of CX43 mRNA was few in control group and surgery group.And in KA group it increased with time.In GABA group,the positive expression of CX43 mRNA was fewer than that of KA group at every period.Conclusion The expression of CX43 mRNA in hippocampus can be decreased by transferring GABA receptor gene into hypothalamus.

Objective To determine the optimum dose of Oxycodone for anesthesia induction in patients undergoing laparoscopic cholecystectomy. Methods Ninety patients, ASA Ⅰ or Ⅱ , scheduled for elective LC, were randomly divided into 3 groups using random number table (O 1~O 3 groups, n = 30 each). Anesthesia was induced with iv Propofol 1.00~2.00 mg/kg, Oxycodone 0.20 mg/kg, 0.3 mg/kg and 0.4 mg/kg (O 1~O 3 groups, respectively), and Vecuronium 0.10 mg/kg. Before anesthesia induction ( T0 ), 1 min after Laryngeal Mask intubating ( T1 ), the instant of pneumoperitoneum ( T2 ), separation of the gallbladder ( T3 ), wake up immediately ( T4 ), leaving the recovery room ( T5 ), the heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. At T4, leaving the recovery room ( T5 ), 4 hours after the operation ( T6 ), 8 hours after operation (T7), the numeric pain rating scale (NRS) were recorded. The overall amount of remifentanil and Oxycodone were record. The wake up time, additional analgetic cases and the adverse reactions were recorded. Results The average HR, SBP and DBP fluctuations in the O 2 and O 3 groups were not more than 20.00% of the basal values. There was no significant difference in wake up time between the three groups. There were 22 cases of patients, the NRS> 4, in O1 group requires additional analgesics after they wake up, more than O 2 and O 3 group (7, 3 respectively, P < 0.05). The overall Oxycodone consumption of the three groups were O1: (18.93 ± 4.34) mg (0.90~2.60 mg),O2: (25.50 ± 4.49) mg (1.40~3.00 mg), O3: (26.10 ± 4.55) mg (1.80~3.40 mg) (F = 23.79, P = 0.000). There was no significant difference in adverse reactions between the three groups, but one patient had respiratory depression in O3 group. Conclusion The optimum dose of Oxycodone for anesthesia inducing in laparoscopic cholecystectomy were 0.30 mg/kg.

Objective To explore the clinical characters, diagnosis and treatment methods of placenta accreta. Methods A retrospective analysis was made of 47 cases of placenta accreta admitted during May 1997 to May 2007 into Peking Union Medical College Hospital. They included 17 cases in the second trimester and 30 cases in the third. Results Among all the patients, the incidence of placenta accreta was 0. 262% ( 47/17 918 ). Most of these cases ( 81%, 38/47 ) experienced a uterine procedure.30% (14/47) of the cases were found with placenta previa and 11% ( 5/47 ) with myoma in the current pregnancy. 11% (5/47) of all the cases suffered postpartum hemorrhage. In the 17 cases in the second trimester, 12 were diagnosed by uhrasonography and 5 by clinical evidence . While in the 30 cases in the third trimester, 8 were diagnosed by biopsy, 2 by uhrasonography, and 20 by clinical evidence. 45 cases were cured by conservative treatment, which included dilatation and curettage, uterine artery embolization (UAE) with or without methotrexate (MTX), tamping B-lynch suture, singly with MTX, and mifepristone. Only 2 cases received cesarean hysterectomy. Conclusions The incidence of placenta accreta seems on the rise. The incidence in the second trimester is higher than that in the third. In the second trimester, most cases can be diagnosed by uhrasonography after labor, and presently UAE is the best conservative management. While in the third trimester clinical evidence is the most frequent diagnostic approach. A majority of the cases could be cured by conservative therapies, which help them avoid a hysterectomy.

Objective To investigate whether the presence of infection in a case series with coma would predict sepsis associated encephalopathy(SAE).Methods From Jan 2013 to Oct 2014,we used the criteria of systemic inflammatory response syndrome (SIRS)positive sepsis with encephalopathy and retrospective diagnosed a comatose case series with infection and from a tertiary teaching hospital intensive care unit (ICU).Results Among 6 comatose patients with evidence of infection,3 cases were secondary infection after hemorrhagic stroke,1 case was secondary infection after trauma,and the other 2 cases were primary infection.All patients met the diagnosis of SIRS -positive sepsis with encephalopathy.Among them,the presence of SIRS 3 criteria was in 2 cases,four criteria in 4 cases. All patients with severe brain failure (100%),in addition to 5 cases with acute respiratory failure caused by lung injury,one case with acute liver failure.Brain imaging confirmed that the delayed vasogenic edema was in two cases (33.3%),the cerebral ischemic lesions in four cases(66.7%).The ischemic lesion included 1 patient with minor infarcts and 1 case with mild white matter lesions,and with a good prognosis.The other two ischemic cases included multifocal leukoencephalopathy with central pontine myelinolysis in 1 case and extensive white matter lesions in 1 case,eventually with a poor prognosis.Conclusion SAE is a common critically illness,the use of the new classifi-cation criteria of sepsis is helpful in the diagnosis of sepsis associated encephalopathy.

OBJECTIVE:To establish a method for content determination of astragaloside in Danggui buxue formula granule, and investigate the influence of different conditions of dissolution on the content. METHODS:HPLC was performed on the column of Aglient C18 with mobile phase of acetonitrile-water(28:72,V/V)at flow rate of 1.0 ml/min,column temperature was 25 ℃,and the injection volume was 10 μl. RESUITS:The linear range of astragaloside was 2.91-17.46 μg;RSDs of precision,stability were lower than 2%,and reproducibility tests was 3.63%,recovery was 95.76%-98.20%(RSD=1.03%,n=6). The optimized use method was mixing the two granules with 80 ℃ hot water and keeping heat preservation for 5 min successively before taken. CON-CLUSIONS:The method is simple and reproducible,and can be used for the content determination of astragaloside in Danggui bux-ue formula granule.