Objective To evaluate the recent effects of concurrent versus sequential chemo-radio-therapy in treatment for locally advanced non-small-cell lung cancer (NSCLC). Methods The clinical data of 39 patients with locally advanced NSCLC were analyzed retrospectively. The sequential therapy was 23 (sequential group) ,and the concurrent therapy (concurrent group)was 16. The total radiation dose was 60 ～ 65 Gy by conventional fractionation radiotherapy. In sequential group,the patients received induction chemotherapy for two cycles followed by conventional radiation therapy. In concurrent group,the patients re-ceived radiation therapy,at the same time the docetaxe was given every week. Results The recent efficien-cy(62.5%) of concurrent therapy was higher than that(43.5% )of sequential therapy. The clinical remission rate of the two groups was similar. Conclusion Concurrent chemo-radiotherapy in locally advanced NSCLC can increase the recent effect. The concurrent treatment method of docetaxel + three-dimensional conformal radiotherapy is advocated.

Objective To investigate the healthy adults in Heyuan area of serum N terminal pro brain natriuretic peptide (N‐proBNP) concentration distribution and the preliminary investigation on the normal reference range .Methods From 2010 Novem‐ber to 2012 November in the physical examination ,laboratory examination center of our hospital indicators ,ECG ,B ultrasound ex‐amination showed no abnormalities of the healthy people 1 017 ,according to the different gender and age :A group less than 25 years ,group B was 25- <35 years ,35- <45 years ,group C ,group D 45- <55 years ,55- <65 years of E group ,F group for over 65 years a total of 6 age groups ,content determination of serum N‐proBNP by Roche chemical instrument light .Results age ,gen‐der can affect the distribution of N‐proBNP level ,and with the increase of age ,adjacent to the age groups (except F group) to com‐pare the serum levels of N‐proBNP ,the difference was statistically significant (P<0 .05);Compared with the F group in each age group was significantly increased(P<0 .05) ,there was statistical significance compared with the group ;the serum N‐proBNP level of different sex ,the difference was statistically significant (P<0 .05) .Conclusion age ,gender and other physiological factors can affect the distribution of N‐proBNP levels ,should establish the corresponding reference interval according to the different age ,gen‐der ,provide the corresponding parameters for the diagnosis and treatment of related diseases .

Purpose To investigate the clinical effect of ultrasound guided drainage combined with different hardeners for simple breast cysts,and to further provide reference for individual treatment.Materials and Methods Clinical data of 117 cases breast simple cysts were analyzed retrospectively,of which 42 cases were routine ultrasound-guided puncture combined with fluid injection of hypertonic sugar (group A),40 cases were routine ultrasound guided drainage combined with ethanol injection therapy (group B),and 35 cases were routine ultrasound guided therapy alone (control group).The clinical efficacy and adverse reactions were compared among the three groups after treatment.Results The total effective rate of group A was 95.24％,group B was 97.50％,and control group was 82.86％.Total effective rate of group A and B had no significant difference (P＞0.05),which were both higher than control group (P＜0.05).The adverse reactions rate of group B was higher than group A and control group,which had statistical significance (P＜0.05).Conclusion Ultrasound guided injection of hypertonic sugar or ethanol after drainage treatment for simple breast cysts can both obtain satisfactory clinical results,but adverse reactions of the former one are mild,it should be widely applied.

Objective To investigate the relationship between infection of helicobaeter pylori(Hp) and iron deficiency anemia(IDA) and to explore effective clinical treatments for patients with Hp associated IDA . Method 1. The Hp infection ratio of 40 chronic gastritis with IDA and 42 patients without IDA were counted up respectively. 2. 36 patients with Hp-positive chronic gastritis were divided into two groups randomly. One group was treated by using Hp eradication therapy in conjunction with oral iron supplement and the other using iron supplement only. The hema-tological parameters before and after treatment are measured and the effectiveness of the treatment was evaluated. Re-sult The Hp infection ratio in chronic gastritis patients with IDA is |figher than that in patients without IDA and the difference is significant. After Hp eradication therapy in conjunction with iron supplement Hb. serum iron and serum ferritin level in Hp associated IDA patients are increased significantly while that for patients treated by using iron sup-plement only have no significant improvement. Conclusion It appears that Hp infection may be related to IDA. When iron supplement treatment has no obvious effect to an IDA patient,lt may suggest a ease of Hp associated IDA. The i-ton supplement treatment has positive effects to IDA patients after Hp eradication.

The development of clinical pathways must "start and end up with education" as put by the authors. The article discussed the objectives, significance and contents, as well as approaches in the education of clinical pathways. It recommended a tiered education for hospital leaders, medical care workers, office staff, patients and their family members, and different target groups and contents in the education for clinical pathways application.

Objective To establish the carotid fusiform aneurysm model in rabbits carrying similar characteristics of human intracranial aneurysms by using induction method with porcine pancreatic elastase. Methods Twenty-five New Zealand white rabbits were randomly divided into normal control group (n=5), saline control group (n = 5) and study group (n = 15). The rabbits of the study group were randomly and equally subdivided into 7-day subgroup, 14-day subgroup and 21-day subgroup. By using induction method with porcine pancreatic elastase to digest right common carotid the fusiform aneurysm model was established in all the rabbits of the study group. DSA examination , HE staining and elastic fiber staining pathologic examination were carried out at 7, 14 and 21 days after the procedure to observe the imaging and pathologic changes of the fusiform aneurysm models. Results DSA angiography showed that the mean vascular diameters of the normal control group and the saline control group were (1.64 ± 0.17) mm and (1.66 ± 0.24) mm respectively. The mean length and width of the fusiform aneurysm of the 7-day subgroup, 14-day subgroup and 21-day subgroup were (19.33 ± 1.65) mm and (2.86 ± 0.21) mm, (19.66 ± 1.18) mm and (3.95 ± 0.54) mm, and (19.84 ± 0.82) mm and (4.03 ± 0.95) mm, respectively. Pathologically, rupture of internal elastic membrane, disordered structure of tunica media smooth muscle and distortion of cell shape were observed in the rabbits of 7-day subgroup. Gradually stabilized aneurysmal lumen intimal hyperplasia was seen in the rabbits of 14-day subgroup. Remarkable structure changes at the aneurysmal neck-cavity junction were found in the rabbits of 21-day subgroup. Elastic fiber staining demonstrated that strikingly thinned elastic layer was observed in the rabbits of 7-day subgroup, gradually thinning elastic layer at the aneurysmal neck-cavity junction was seen in the rabbits of 14-day subgroup, and the thinned elastic layer became stable in the rabbits of 21-day subgroup. Conclusion Using simple surgical method combined with porcine pancreatic elastase to digest vascular wall, carotid fusiform aneurysm models can be reliably established in New Zealand white rabbits which carry similar morphologic and pathologic characteristics of human intracranial aneurysms.

OBJECTIVE To improve the quality of venous infusion and reduce the incidence of hospital infection.METHODS We analyzed the factors of hospital infection resulted from venous infusion.RESULTS The main factors were pollution or degeneration of the liquid,over standard of the bacterial number in prepared or infused environment,disobeying the operating instruction of venous infusion and unsuitable operating method.CONCLUSIONS The measures to prevent hospital infection are holding the key step of venous infusion,constructing and executing the management system of sterilization and isolation,reducing the chance of bacterium pollution,paying attention to the sterile operation through venous infusion,fostering the well working style and improving the links of infusing operation.We reduced the infusion reaction and the incidence of hospital infection effectively.

Background and purpose:The gastric cancer is the highest incidence of malignant tumors in the world. The main treatment methods for gastric cancer are operation and chemotherapy. But the effect is not good. With the rapid development of economy and molecular biology, early diagnosis and molecular targeted therapy for gastric cancer has become a research hotspot. The oncogene overexpression and the anti-oncogene lower expression are closely related with gastric cancer.CDC4/FBXW7 is an anti-oncogene, butc-Myc is an oncogene. The previous research showed that CDC4 affected the expression of many oncogenes, such as Cyclin E. This study aimed to investigate the expression of CDC4 and c-Myc in gastric cancer and to elucidate the potential relationship between their expressions and clinical pathological characteristics.Methods:Semi-quantitative reverse transcription polymerase chain reaction (sRT-PCR), immunohistochemistry and Western blot method were used to determine the mRNA and protein expressions of CDC4 and c-Myc in 40 specimens of gastric carcinoma tissues, corresponding adjacent tissues and normal mucosal tissues. The expressions of CDC4 and c-Myc and the clinical pathological characteristics were analyzed.Results:The protein expressions of CDC4 in gastric cancer tissues were signiifcantly lower than those in adjacent tissues and normal mucosal tissues (P<0.05), whereas the protein expression of c-Myc in gastric cancer tissues was signiifcantly higher than that in adjacent tissues and normal mucosal tissues (P<0.05). The protein and mRNA expression of CDC4 and c-Myc were correlated with differentiation, TNM stage, lymph node metastasis, inifltration, but not with patients’ gender, age and site of cancer (P<0.05). There was a signiifcant negative correlation between CDC4 and c-Myc at the mRNA and protein expression levels (P<0.05).Conclusion:The lower expression of CDC4 is correlated with differentiation, TNM stage, lymph node metastasis and inifltration. c-Myc overexpression is likely to be the CDC4 loss. It suggests that the loss of CDC4 may be a valuable marker for assessing the diagnosis and treatment and the prognosis of gastric cancer.

Objective To evaluate the effect of monosialoganglioside (GM-1) on hippocampal protein kinase B (Akt) /glycogen synthase kinase 3β (GSK-3β) signaling pathway in the rats undergoing cardiopulmonary bypass (CPB).Methods Eighteen healthy male Sprague-Dawley rats, aged 6 months, weighing 400-500 g, were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C), CPB group and GM-1 group.GM-1 20 mg/kg was added to the priming solution in group GM-1, while the equal volume of normal saline was given in group CPB.At 3 h after termination of CPB, blood samples were taken from the jugular vein for determination of plasma neuron-specific enolase (NSE) and S-100β protein concentrations using enzyme-linked immunosorbent assay.After blood sampling, the rats were sacrificed, and the hippocampi were isolated for microscopic examination of the ultrastructure of the hippocampal neurons (with electron microscope), and for detection of neuronal apoptosis (with light microscope) and phosphorylation of Akt and GSK-3β (by Western blot).Results Compared with group C, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly increased in CPB and GM-1 groups, the phosphorylation of Akt and GSK-3β was decreased in group CPB, and the phosphorylation of Akt and GSK-3β was increased in group GM-1 (P＜0.05).Compared with group CPB, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly decreased, the phosphorylation of Akt and GSK-3β was increased (P＜0.05), and the pathological changes were reduced in group GM-1.Conclusion GM-1 can reduce apoptosis in hippocampal neurons through activating Akt/GSK-3β signaling pathway, thus mitigating CPB-induced brain injury in rats.

Objective To reproduce and validate the hexokinase reference method for glucose detection and compare other 5 routine glucose kits with this reference method. Methods The CDC hexokinase reference method for glucose detection was established and the performance was validated through testing a standard reference material (SRM) and participating in the IFCC ring-trial for reference laboratories for glucose evaluation. The CLSI EP 9-A2 protocol was used to compare the 5 routine glucose kits with the hexokinase reference method. Forty serum samples were analyzed by 5 routine kits and the hexokinase reference method. Results When SRM 965a was determined by the reference method,the bias of level 2 and level 3 were 0. 93%, -0. 23% respectively. The results for IFCC ring trial were within the accepted range. For the 5 routine kits, the confidence intervals of the predictive bias at the medical decision point Xc (Xc = 6. 11 mmol/L) were all within the range of defined acceptable error (10%) and the range of biological variation bias (6.9%). Conclusions The hexokinase reference method for serum glucose was reproduced in our lab. The serum glucose results measured with 5 routine kits were different from results detected with the reference method, but the bias was acceptable,and it will not affect the detection results.