OBJECTIVE:To observe therapeutic efficacy and safety of nedaplatin combined with paclitaxel in the treatment of advanced cervical cancer. METHODS:Totally 100 patients with advanced cervical cancer were randomly divided into observation group(50 cases)and control group(50 cases). Both groups were given 6MV linear accelerator radiotherapy combined with intra-cavitary irradiation. Based on it,control group was additionally given Cisplatin injection 20 mg/m2,d1+Paclitaxel injection 35 mg/m2,d1 intravenously within 3 h. Observation group was additionally given Nedaplatin for injection 20 mg/m2,d1+Paclitaxel injection intravenously(same usage and dosage as control group). A treatment course lasted for a week,and both groups received 6 courses of treatment. Short-term efficacies of 2 groups were observed,and the levels of vascular endothelial growth factor A(VEGF-A), VEGF-C and VEGF-D,lymphatic microvessel density(LVD),microvessel density(MVD),toxic reaction were also observed be-fore and after treatment. RESULTS: Total response rate(52.00% vs. 32.00%)and disease control rate(86.00% vs. 66.00%)of ob-servation group were significantly higher than those of control group,with statistical significance(P<0.05). After treatment,the levels of VEGF-A,VEGF-C and VEGF-D,LVD,MVD in 2 groups were significantly lower than before treatment,and the obser-vation group was significantly lower than the control group,with statistical significance(P<0.05). The incidence of thrombocyto-penia in observation group was significantly higher than control group,and the incidence of nausea and vomiting was significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS: Nedaplatin combined with paclitaxel can im-prove short-term efficacy of patients with advanced cervical cancer,reduce gastrointestinal reaction,VEGF level and inhibit the generation of tumor vessel,but great importance should be attached to platelet toxic reaction.

AIM: To establish the determination of dihydromyricetin in stem,leaf of Ampelopsis grossedentata in different seasons from different habitat. METHODS : Novapak C_ 18 column (150mm?4.6mm,5?m) was selected as separation column at 25 ?C . Methanol-water-phosphoric acid (27∶73∶0.1) was used as a mobile phase at a flow rate of 1.0mL?min -1 . The peak of dihydromyricetin was detected at UV 290nm. RESULTS : The linearity of this method was good. The average recovery was 99.47%,RSD was 1.68%. The content of dihydromyricetin in leaf of Ampelopsis grossedentata collected in May was the highest and was three ～ four times the size of that in stem. CONCLUSIONS :The method is convient with a good separating degree and is useful basis for the develoment and utilization of Ampelopsis grossedentata.

Objective To evaluate how functional endoscopic sinus surgery(FESS)modifies patients symptom profiles and the quality of life and analyze the influential factors.Methods During 2010 to 2012,90 cases were investigated to evaluate the quality of life of different age groups to use SNOT-20.Results The quality of life after the surgery of different age groups were significantly higher than it before the surgery(P<0.05).The juvenile group:first dimension(nasal congestion,70%),the second dimension (memory,30%),the third dimension(worried about the condition,30%)and the fourth dimension(social influence,40%).The young aged group:first dimension(nasal congestion,73.3%),the fourth dimension(social influence,43.3%),second dimension (quality of sleep,20.0%)and the third dimension(irritability,16.7%).The middle and old aged group:first dimension(nasal con-gestion,66.7%),the third dimension(trepidation,20%),the second dimension(quality of sleep,20.0%)and the fourth dimension (financial burden,40.0%).Preoperative QOL related factors:complications,age,gender,disease duration and urban-rural;Postop-erative QOL related factors:complications,disease duration,age,perioperative management,gender and urban-rural.Conclusion The quality of life of different ages after FESS is improved in different aspects.To increase the level of perioperative compliance can improve the quality of life.

AIM: To observe the difference of cerebral injury following ischemia/reperfusion and mRNA expression of TGF-β1 between diabetic and non-diabetic rats.METHODS: At first, Wistar rats were divided into two groups,non-diabetes and diabetes, and then two groups followed by sham, middle cerebral artery occlusion(MCAO) 2h and reperfusion 24 h after MCAO 2 h respectively. TGF-β1 mRNA expression was measured by semi-quantitative reverse transcription polymerase chain reaction(RT-PCR); Cerebral damage was evaluated by histopathology.RESULTS: In the same condition of ischemia or ischemia/reperfusion, injuried area enlarged in DM groups; The expression level of TGF-β1 mRNA increased at the time of 2 h after MCAO in non-diabetic group and diabetic group, especialy significantly in non-diabetic group with MCAO 2 h, and decreased at the time of reperfusion 24 h after MCAO 2 h, but still higher than that in the sham group.CONCLUSION: Diabetes mellitus exacerbated brain lesion following ischemia/repefusion, increased TGF-β1 mRNA expresion after MCAO may be an anti-injury reaction,and anti-injury ability is decreased under diabetic condition

Objective To investigate the distribution and drug resistance of bacteria in 1 -6 months infants with lower respiratory infection(LRI).Methods Induced sputum was extracted from 326 infants with LRI who were 1 -6 months.Antibiotic susceptibility tests were performed after bacteria had been identified.Results 61 cases were detected pathogenic bacteria and the detection rate of bacteria was 18.71%.5 cases were detected two kinds of bacte-ria.66 bacterial strains were isolated among which gram -positive bacteria(33 strains)accounted for 50.00% and gram -negative bacteria(33 strains)accounted for 50.00%.Staphylococcus aureus was the most common gram -pos-itive bacteria and Streptococcus pneumoniae was the second.13 strains were methicillin -resistant Staphylococcus au-reus(MRSA).Hemophilus influenzae was the most common gram -negative bacteria,followed by Klebsiella pneumo-nia and Escherichia coli among which ESBL positive Klebsiella pneumonia were 5 cases and ESBL positive Escherich-ia coli were 4 cases.The common gram -positive bacteria had higher rate of penicillin resistance.MRSA had higher rate of penicillin,oxacillin,erythomycin and clindamycin resistance.Resistant strains to vancomycin and rina thiazole amine were not found.The common gram -negative bacteria had higher rate of ampicillin,ampicillin/shu tan,cefazo-lin and ceftriaxone resistance and had lower rate of cefepime,ceftazidime,piperacillin/he azole temple and imipenem resistance.Conclusion The common pathogenic bacteria in 1 -6 months infants with lower respiratory infection were Staphylococcus aureus,Hemophilus influenzae,Streptococcus pneumoniae,Klebsiella pneumonia and Escherichia coli. We should pay attention to the common antibiotic resistance.MRSA and ESBL positive bacteria were the common mul-tiple drug resistant bacterias.Reasonable selection of antibiotics should be based on susceptibility results earlier.

AIM: To observe the difference of cerebral injury following ischemia/reperfusion and mRNA expression of TGF-? 1 between diabetic and non-diabetic rats.METHODS: At first, Wistar rats were divided into two groups,non-diabetes and diabetes, and then two groups followed by sham, middle cerebral artery occlusion(MCAO) 2h and reperfusion 24 h after MCAO 2 h respectively. TGF-? 1 mRNA expression was measured by semi-quantitative reverse transcription polymerase chain reaction(RT-PCR); Cerebral damage was evaluated by histopathology.RESULTS: In the same condition of ischemia or ischemia/reperfusion, injuried area enlarged in DM groups; The expression level of TGF-? 1 mRNA increased at the time of 2 h after MCAO in non-diabetic group and diabetic group, especialy significantly in non-diabetic group with MCAO 2 h, and decreased at the time of reperfusion 24 h after MCAO 2 h, but still higher than that in the sham group.CONCLUSION: Diabetes mellitus exacerbated brain lesion following ischemia/repefusion, increased TGF-? 1 mRNA expresion after MCAO may be an anti-injury reaction,and anti-injury ability is decreased under diabetic condition.

AIM: To study forms of cell death following cerebral ischemia/reperfusion in diabetic rats. METHODS: Based on the modles of diabetes and middle cerebral artery occlusion(MCAO), characteristics of cell death after ischemia/reperfusion were evaluated synthetically by the pathological, flow cytometry(FCM), TUNEL and the DNA agarose electrophoresis.RESULTS: The occurrence of cerebral injury after ischemia/reperfusion were accompanied by cell necrosis and cell apoptosis. And cell apoptosis was mainly located in ischeamic penumbra(IP) zone around the densely ischemic focus. Ischemic centre(IC)was characterized by cell necrosis. At the same time, the results showed that the process of ischemic cerebral injury worsen by diabetes mellitus was related to inducing cell apoptosis in IP and Mid zone.CONCLUSION: Neuronal damage following focal cerebral ischemia/reperfusion included cell necrosis and apoptosis, IC zone was mainly characterized by the former, however IP zone by the latter, and there had close internal relationship between them. Brain damage following cerebral ischemia/reperfusion was worsen instinctly under diabetic condition.

Objective To investigate the changes in metabolic indexes and anesthesia administration during perioperation in patients undergoing orthotopic liver transplantation. Methods Eleven patients who underwent orthotopic liver transplantation were selected. Their pH, BE, HCO 3 -, K +, Ca 2+, blood glucose, PT, APTT and FIB were assessed at 60 min of pretransplantation, 20 min and 40 min of liver transplantation, 20 min and 40 min of new liver reperfusion. Results The pH, BE, HCO 3 -, K +, Ca 2+ during 20 min and 40 min of liver transplantation decreased more significantly than those during pretransplantation 60 min, PT and APTT extended markedly, the level of blood glucose did not change markedly; pH, BE, HCO 3-, K +, Ca 2+ and the level of blood glucose during new liver reperfusion 20 min and 40 min increased significantly compared to those during liver transplantation 20 min and 40 min; PT, APTT and FIB did not change markedly. Conclusion Metabolic indexes during liver transplantation change more markedly than those during pretransplantation or new liver reperfusion.

Objective To explore the value of coronary flow reserve(CFR) evaluating myocardial ischemia measured by adenosine triphosphate (ATP) stress transthoracic Doppler echocardiography (TTDE),and the feasibility of CFR to predict coronary stenosis.Methods Fifty-four patients suffering chest pain with known or suspected coronary artery disease were performed ATP stress TTDE to measure resting and maximum expansion coronary blood flow velocity and calculate CFR.all patients were performed by coronary angiography (CAG) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging.Results ① To evaluate myocardial ischemia,there was not statistical significant difference between non-invasive CFR and SPECT myocardial perfusion imaging(P ＞0.05).CFR≤2.0 was the best cutoff value for evaluating myocardial ischemia which yielded a sensitivity of 93.3 ％ and specificity of 89.7％.②Coronary artery stenosis was negatively correlated with CFR (P ＜0.001).ROC curve analysis demonstrated that CFR≤ 1.60 yielded a sensitivity of 92.3％ and specificity of 73.3％ to predict coronary stenosis significantly.Conclusions CFR measured by ATP stress TTDE can evaluate myocardial ischemia of coronary artery disease and predict LAD significant stenosis before CAG.Using CFR and CAG has important clinical value for choosing treatment of stable coronary artery disease.

Objective To evaluate the effects of ulinastatin postconditioning and combination of ulinastatin preconditioning and postconditioning on myocardial apoptosis in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Eighty New York Heart Association (NYHA) class Ⅱ or Ⅲ patients of both sexes,aged 21-59 years,scheduled for cardiac valve replacement with CPB,were randomly divided into four groups (n =20 each):normal saline control group (group C),ulinastatin preconditioning group (group U1),ulinastatin postconditioning group (group U2) and ulinastatin preconditioning plus postconditioning group (group U3).In group U1,uinastatin 20000 U/kg was infused via the central vein at 500-1000 U·kg-1 · min-1 after endotracheal intubation until 10 minutes before blocking the ascending aorta.In group U2,ulinastatin 10000 U/kg was infused via the aortic root at 4000-5000 U· kg-1 · min-1 at 5-7 minutes before opening the aorta.In group U3,ulinastatin preconditioning and postconditioning were performed as described in groups U1 and U2.In group C,the same volume of normal saline was infused instead of ulinastatin.Blood samples were taken from the radial artery at 10 minutes before blocking the ascending aorta,40 minutes after blocking the ascending aorta,45 minutes after opening the aorta and at the end of operation for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α) and soluble tumor necrosis factor receptor 1 (sTNF-R1).Myocardial tissues were obtained from the right atrial appendage at 45 minutes after opening the aorta for determination of the expression of TNF-α,bcl-2,bax,caspase-3,and apoptosis.The bcl-2/bax ratio and apoptotic index were calculated.Results Plasma concentrations of TNF-α and sTNF-R1 and the expression of TNF-α,bax,caspase-3 and apoptotic index were lower and the expression of bcl-2 and bcl-2/bax ratio were higher in groups U1,U2 and U3 than in group C and they were lower in group U3 than in groups U1 and U2 (P ＜ 0.05).Conclusion Ulinastatin postconditioning can inhibit myocardial apoptosis in patients undergoing cardiac valve replacement with CPB,and the efficacy of combination of ulinastatin preconditioning and postconditioning is stronger than that of ulinastatin postconditioning.The mechanism is involved in balancing the expression of bax and bcl-2 and down-regulating the expression of TNF-α and its receptor.