Objective To observe the protective effect of goserelin on ovarian function of premenopausal patients with breast cancer during chemotherapy. Methods Forty patients with breast cancer under 40 received adjuvant chemotherapy were randomly divided intotest group(20 cases) and control group (20 cases). Compared the recovery rate and time of menstruation between two groups. Results All the 40 patients finished the treatment. Recovery ratio of normal ovarian function in test group and control group was 75% and 50% (P =0.013) respectively, and the median menstrual recovery time in two groups was 4.65 months and 6.65 months (P = 0.046) respectively. Statistically significant differences were found between two groups. Conclusion Goserelin can effectively protect ovarian function during chemotherapy , increase the ratio of normal ovarian function, shorten menstrual recovery time, and shows good tolerance.

Objective To investigate the clinical significance of brain-derived neurotrophic factor (BDNF) from peripheral serum in patients of vascular cognitive impairment (VCI).Methods Forty VCI subjects (including 10 mild cognitive impairment vascular(MCI-V) and 30 vascular dementia(VD)),and the control group for the same period in 40 healthy persons.Enzyme-linked immunosorbant assay (ELISA) was used to measure the serum levels of BDNF,statistical analysis was performed.Results The peripheral serum levels of BDNF in VCI (0.175 ±0.056) ng/L were lower than those of control group (0.211 ±0.061) ng/L,and there were significant differences (t =-2.752,P ＜ 0.05).The levels of BDNF showed no significant difference between MCI and VD ((0.195 ± 0.067) ng/L vs.(0.168 ± 0.052) ng/L,t =1.310,P ＞ 0.05).But they were both significantly lower than the control group (F =4.590,P =0.013).No significant differences were observed in the levels of BDNF between subcortical small vessel dementia (0.178 ± 0.057) ng/L and big vascular dementia (0.154 ± 0.042) ng/L (t =1.278,P =0.212).Conclusion BDNF participate in pathophysiology of VCI,and the serum levels of BDNF may be a candidate marker for clinical diagnosis of VCI.But serum levels of BDNF could not reflect the severity or the type of the VCI.

Objective To determin and compare the significance of the expression of chemotactic cytokines in pleural effusions monocyte chemoattractant protein-1(MCP-1)and regulated on activation,normal,T-cell expressed and secreted(RANTES)levels in tuberculous and malignant pleural effusions.Methods The effusion and serum levels of MCP-1 and RANTES were measured in 37 patients with tuberculous pleural effusion and 35 patients with malignant pleural effusion,and selected 20 healthy people acting as control group.Results The effusion and serum levds of MCP-1 and RANTES in tuberculous effusion patients was significantly higher than that in malignant group(P＜0.01);In tuberculous group,the content of MCP-1 in serum was higher than control group,the serum level of RANTES was no statistic significant difference between control group and tuberculous group.The contents of MCP-1 and RANTES were not correlated with pathologic type of lung.cancer.Conclusion MCP-1 and RANTES technique has an important clinical value in diagnosis and differential diagnosis of tuberculosis and malignant pleural effusion.

Objective To design a quantitative criterion and grading system for injury from adverse drug reaction (ADR) in order to serve the compensation system of injury from ADR. Methods Based on the other grading system of injury cases, the independent scores and serial grades were given to the ADR injury of different organs or different levels through two turns of consultation to 27 experts from Shanghai. Results Injury from ADR was graded from stage 1 to stage 10 according to the damage degree, with 1 stand for death and 10 for slightest injury. Conclusion The grading method of ADR based on the characteristics of injury accords with the condition of China, and can provide reference for making up the compensation system of ADR injury.

Objective To determine if aquaporin1 ( AQP1) and aquaporin5 ( AQP5) are expressed in the alveolar-capillary membrane in rats, and to investigate the changes of AQP1 and AQP5 expression in the rat with acute lung injury.Methods The distribution of AQP1 and AQP5 in alveolar capillary membrane was investigated by immunohistochemistry and immunoelectron microscopy with affinity-purified antibodies to human AQP1 and AQP5.The possibility that alveolar capillary membrane AQP1 and AQP5 undergo altered regulation was studied by a rat model established using intra-tracheal instillation of lipopolysaccharide (LPS).Results Immunolabelling showed that AQP1 was stained primarily in the microvascular endothelium of normal lungs, while AQP5 was expressed in type I pneumocytes. Immunohistochemical analysis showed a significant decrease in the expression of AQP1 and AQP5 in injured lungs at 4 -48 h after LPS instillation.AQP1 protein was resumed partly at 24 h after LPS instillation and steroid administration, whereas AQP5 was unchanged.Conclusions The decreased expressions of AQP1 and AQP5 in injured lungs suggest that both of them may play a role in abnormal fluid transportation.

Objective Thoracic cavity fistula following esophagus carcinoma resection is a serious complication with a high mortality.This study aims at a better therapy for thoracic cavity fistula following esophagus carcinoma resection by summarizing the ex-perience with the four-tube strategy ( jejunal fistula tube, stomach tube, chest drainage tube, and nasal fistula tube) in the treatment of the complication. Methods We retrospectively analyzed the clinical data about 62 cases of thoracic cavity fistula following esopha-gus carcinoma resection, 35 treated with the four-tube strategy ( treatment group) and the other 27 with the three-tube ( stomach tube, chest drainage tube, and nasal fistula tube) method ( control group) .We compared the hospital days, wound healing time, mortality, and incidence of anastomotic stenosis at 6 months after operation between the two groups of patients. Results Compared with the controls, the treatment group showed remarkable decreases in the hospital days (P<0.05), wound healing time (P<0.05), and mortality (P<0.05), but no statistically significant difference was observed in the incidence rate of anastomotic stenosis at 6 months after operation between the two groups of patients ( P >0.05 ) . Conclusion Compared with the three-tube method, the four-tube strategy has the advantages of shorter healing time and lower mortali-ty, and therefore is preferable for the treatment of thoracic cavity fis-tula following esophagus carcinoma resection.

Objective To explore the roles of vascular endothelial growth factor (VEGF) and P38MAPK in the pathogenesis of Alzheimer's disease(AD) rats,and the effects of butyIphthalide on the influence of VEGF and P38MAPK in hippocampus of AD rats.Methods SD rats were randomly divided into blank group,AD model group,butylphthalide low-dose group and high dose group (n =8 rats per group).Aggregated Aβ1-42 was injected into the bilateral hippocampus of rats by stereotaxic coordinates method to induce AD.Morris water maze test was used to determine the abilities of learning and memory.Western blotting combined with Gel Doc imagine systems were used to investigate the expression of VEGF and P-P38MAPK in hippocampus of AD rats.Results The result of Morris water maze experiment showed that one week after modeling,escape latency was different(F =66.658,P ＜ 0.05),and either dose the frequency of crossing platform (F =6.884,P ＜0.05).Compared with the blank group,the other three groups'latent period of escape was extended significantly(P ＜ 0.05),and frequency of crossing platform was significantly less (P ＜ 0.05).After drug intervention for 4 weeks,the expression of VEGF was difference(F =171.064,P ＜0.05),it was decreased obviously in the model group than blank group(P ＜=0.05),but it was increased in the drug intervention groups than model group (P ＜ 0.05),and increased more significantly in the high dose group than low dose group (P ＜ 0.05).The expression of P38MAPK had no obvious change among four groups (P ＞ 0.05),however,the expression of P-P38MAPK showed difference(F =104.395,P ＜ 0.05),it was increased in drug intervention and model group than blank group (P ＜ 0.05),it was increased in drug intervention and model group than blank group (P ＜ 0.05),reduced significantly in drug intervention groups than model group (P ＜ 0.05),and decreased more significantly in high dose groups than low dose group (P ＜ 0.05).Conclusions Butylphthalide could obviously enhance the expression of VEGF,reduce the expression of P-P38MAPK in hippocampus of AD rats.

Objective To investigate the clinical characteristics of tuberculosis (TB) first presenting as fever of unknown origin (FUO). Methods The clinical data of 100 cases of FUO, diagnosed as TB finally, among in-patients in Peking Union Medical College Hospital were analyzed retrospectively.Results ( 1 ) Sites of TB: there were 39 patients with merely pulmonary TB, 28 patients with merely extrapulmonary TB, and 33 patients with both pulmonary and extrapulmonary TB. (2) Clinical manifestations: depending on the different sites of tuberculous lesion, the clinical symptoms varied accordingly. The common laboratory findings included anemia, hypoalbuminemia, elevation of the level of ESR and C-reactive protein (CRP). (3) Methods for diagnosis: 34 cases were diagnosed by sputum smearor cultivation-positive for acid-fast bacilli; 8 cases by histopathology; 49 cases by clinical diagnosis of TB with an effective anti-TB therapy; and 9 cases by effective diagnostic anti-TB therapy. (4) Responses to treatment: among 73 cases with complete follow-up data, only 2 cases (2. 7% ) died and the other cases were cured or alleviated. Fifty-five cases (77.5%) showed marked efficacy after less than 4 weeks of regular anti-TB therapy, 37 cases ( 52. 1% ) suffered adverse effects of anti-TB agents, and all of them had improved after modifying anti-TB therapy and supporting treatment. Conclusions The diagnosis of TB that presents as FUO is quite difficult, and the median interval time for making diagnosis is 14 weeks (3-77weeks). Investigating clinical manifestations comprehensively, reviewing radiology data carefully, and eliciting microbiological and pathologic evidence of TB, are extremely important for making the correct diagnosis. In some cases, a therapeatic trial of anti-TB therapy is necessary.

A method was developed for determination of thirteen amines including seven aliphatic amines, two heterocyclic amines and four aromatic amines in atmospheric particulate matter (PM) by gas chromatography-mass spectrometry (GC-MS). Samples were ultrasonically extracted with ultra-pure water and derivatized with benzenesulfonyl chloride (BSC) under alkaline conditions. The derivatives were extracted with dichloromethane and then detected by GC-MS using DB-5MS chromatographic column. The method detection limit (S/N=3) and quantitation limit (S/N=10) were 0.00008-0.017 μg/mL and 0.00026-0.0565 μg/mL respectively, and the correlation coefficients were 0.9903-0.9996, which indicated that the standard curve had good linear correlation. In addition, the relative standard deviation was less than 30％ and the average recovery was 54.4％-159.7％ except for methylamine and benzylamine at spiked level of 1.0 μg/mL, showing high precision and accuracy. 9 kinds of amines were detected in the PM2.5 samples collected in Guangzhou city by this method, among which dimethylamine and butylamine accounted for 90％ of the total nine amines, which indicated that they were primary amines in PM2.5; while propylamine exhibited the lowest level in PM2.5 with the concentration less than 1.0 ng/m3.

Objective To compare the clinical effects and adverse effects of microwave ablation (MWA) with sorafenib and sorafenib monotherapy in the treatment of advanced-stage hepatocellular carcinoma (HCC).Methods Medical records and follow-up information of 57 patients with advanced-stage HCC were retrospectively reviewed.25 patients were treated with MWA combined with sorafenib (combined group),and 32 patients were treated with sorafenib monotherapy (monotherapy group).The end points were therapeutic effect,progression-free survival (PFS),overall survival (OS) and adverse reactions.Results The objective response rate in the combined group was similar to the monotherapy group (16.0％ vs.3.1％,x2 =1.521,P =0.217).The disease control rate in the combined group was significantly higher than that in the monotherapy group (80.0％ vs.50.0％,χ2 =5.429,P =0.020).The median PFS in the combined group was longer than that in the monotherapy group (6.0 months vs.3.2 months,x2 =7.675,P =0.006),but the median OS was similar (11.5 months vs.8.5 months,x2 =2.480,P =0.115).The serious adverse reactions were similar between the two treatment groups (44.0％ vs.34.4％,x2 =0.549,P =0.459).Conclusion MWA plus sorafenib is superior to sorafenib alone with respect to PFS in patients with advanced-stage HCC,although it may not improve OS,with no increased risk of serious adverse reactions.