Objective To evaluate RR,DCR,PFS,OS and toxicities in a population affected by NSCLC using gefitinib as maintenance therapy after the first line chemotherapy.Methods From January,2006 to January,2008,seventy-one patients were enrolled with stable disease or partial response after firstline chemotherapy.They were divided into the observing group and the control group.Gefitinib was administered at the dose of 250 mg in observing group;placebo was also administered everyday in control group.Results Of 71 assessable patients ,overall response rate was 36.1% (13/36) in observing group and 14.3 % (5/35) in control group respectively (x 2 = 4.633,P = 0.036),and one patient (2.8 %) was observed complete response (CR) in observing group.The disease control rate was 83.3 % (30/36) in observing group and 42.9 % (15/35) in control group,respectively,(x2 = 14.782,P ＜ 0.001).The median PFS (progression free survival time) was 13 weeks in observing group and 11 weeks in control group respectively (x2 = 10.401,P =0.001).The median overall survival time (OS) was 13.2 months in observing group and 10.4 months in control group respectively (x2 = 7.696,P= 0.006).The median OS was 18.5 months in women and 11.2 months in men(x2 =22.864,P=0.011) .The median OS was 15.3 months in non-smokers and 10.3 months in smokers (x2 =10.389,P =0.007).The median OS was 16.0 months in adenocarcinoma and alveolar cell carcinoma patients and 10.2 months in squamous cell carcinoma patients (x 2 = 4.638,P = 0.001).The most common toxicity was rash ,diarrhea,fatigue and dry skin itching,and most of them were 1 or 2 grade.Conclusion Maintenance therapy with gefitinib after first-line chemotherapy may improve overall survival time and progression free survival time in patients with NSCLC,and it is effective and safe.

Human insulin gene(PCMV.INS) is successfully transferred and expressed into N1H3T3 cell by chitosan mediation.This is helpful in the research of the gene therapy of type 1 diabetes.

Objective To observe the morphologic change in rats with pulmonary fibrosis induced by bleomycin through antisense-human tissue inhibitor of metalloproteinase-1(hTIMP-1)transfection.Methods Thirty rats were divided into five groups randomly(six rats in each group),namely,hTIMP-1 transfection group,anti-sense hTIMP-1 transfection group,empty retroviral vectors transfection group,pulmonary fibrosis group,and the normal group.On the 1st,3rd,7th,14th,28th,60th,90th day of BLM administration to the hTIMP-1,anti-sense hTIMP-1 and retroviral vectors transfection group,the hTIMP-1 cDNA retroviral vectors containing sense and anti-sense ones and the empty vectors were conducted into the lungs of rats with pulmonary fibrosis,which were sacrificed on the 28th days.The pulmonary fibrosis group was given just BLM for the same period of time.The rats in the normal control groups were sacrificed on the same day.Observe the role of anti-sense hTIMP-1 transfection and the change of hydroxyproline.Results The degree of fibrosis and content of HYP were extenuated by antisense hTIMP-1 transfection on 1st and 3rd day after BLM exposure compared with the same time of fibrosis and transfection by empty retroviral vectors group,morphologically.Conclusion Transfection with antisense-TIMP-1 on the first and third day can suppress the process of pulmonary fibrosis induced by BLM to some extent.

Objective To explore the main pathogenic bacteria and antibiotic resistance patterns in children with bacterial diar‐rhea from Guangzhou region .Methods Regular bacterial culture of stool samples from children with suspicious bacterial diarrhea was performed to isolate the pathogen during 2011 to 2012 ,followed by the analysis of its composition and serum type ,ward distri‐bution characteristics and drug resistance to 12 antimicrobacterial drugs .Results 416 strains of pathogenic bacteria were isolated from diarrhea children during 2011-2012 ,in which salmonella ,enteropathogenic E .coli ,Campylobacter jejuni and Candida albicans isolates accounted for 53 .61% ,37 .98% ,5 .29% and 1 .68% respectively .Drug resistance rate of the main strains to 12 antimicrobi‐al agents was 85 .25% to ampicillin ,54 .28% to compound sulfamethoxazole ,44 .70% to cefotaxime ,42 .53% to ceftriaxone , 40 .66% to chloramphenicol ,23 .55% to ceftazidime ,23 .36% to aztreonam ,14 .88% to ciprofloxacin ,8 .07% to cefepime ,7 .99% to cefperazone/sulbactam ,7 .42% to piperacillin/tazobactam respectively ,and no resistance to imipenem was detected .Conclusion The pathogenic bacteria causing diarrhea mainly includes salmonella ,pathogenic e .coli ,campylobacter jejuni in children from guang‐zhou region ,the top five sensitive antimicrobial reagents for the main strains includes imipenem ,piperacillin/tazobactam ,cefpera‐zone/sulbactam ,cefepime and ciprofloxacin .

ObjectiveTo study the effects of chemotherapy on growth development and endocrine function of long-survived children with acute lymphoblastic leukemia (ALL). Methods30 ALL patients who were received standard chemotherapy and survived more than five years were enrolled in this study. Their growth and development data and endocrine function examination were investigated. ResultsThrough testing,except two cases of height more than two standard deviation above,the others were all within the normal range; BMI exceeded bid in 1, and the rest were in the normal range;The results of sex hormones examination were consistent with age and Tanner installment, the girls appeared secondary sex characteristics in 9 years old or so,menstruation in 13 years old. Boys appeared sec-ondary sex characteristics around 10 years old;Cortisol and promote adrenal cortical hormone with 2 cases of obese children were in the normal range,but c-peptide and insulin were elevatory;The results of IGF-1 were in the normal range. ConclusionChemotherapy had no significant effect on growth development and endocrine function for patients with ALL.

Objective To investigate the clinical features and the gene mutation of patients with spinocerebellar ataxia type3 and type7.Methods The trinucleotide repeat mutations were detected by polymerase chain reaction (PCR),agarose gel electrophoresis method,and DNA sequencing in 13 patients,4 related members and 4 common members from 3 spinocerebellar ataxia families.Results Among the 13 patients,four patients had SCA3/MJD(CAG) n expansion mutation(n = 65 ～ 74),nine patients had SCA7 allele expansion for 40 ～ 52 times.Patients with type 3 or 7 showed significant difference in nervous system injury.Conclusion The difference of clinical feature might be used in diagnosis of SCA3/MJD and SCA7,but genotype determination would be the only method of definite diagnosis.

Objective To evaluate the clinical significance of telomerase in the diagnosis of lung cancerusing SROC curve method.Methods Looking“telomerase”and“lung cancer”as keywords,retrieving journalspublished within past 20 years in order to incorporate into literatures and to collect data .To conduct the SROC analysisusing Meta -DiSc 1.4 software.Results 1.Twenty -two documents were sampled as tissue specimensand the heterogeneity was relatively large (P =0.017).To analyze the data with random effective models ,thecombined sensitivity and specificity were 0.788(0.761 -0.814)and 0.955(0.936 -0.969),respectively.TheSROC AUC area under the curve was 0.9515,SE(AUC) =0.0145.2.There was no heterogeneity(P =0.633)amongthe 10 lavaged literatures.By use of fixed effects model for data analysis ,the combined sensitivity and specificitywere 0.777(0.734 -0.816) and 0.922(0.888 -0.948),and SROC AUC area under the curve was0.9369,SE(AUC) =0.0141.Conclusion Telomerase is a ideal tumor marker,and the detection of telomeraseactivity in lavage fluid is stable and accurate in clinical diagnosis .

Objective To analyse distribution and antibacterial resistance status of pathogenic bacteria isolated from blood cul‐tures of hospitalized infants ,in order to provide references for rational use of antimicrobial agents in the treatment of bloodstream infection .Methods A total of 299 strains of pathogenic bacteria isolated from positive blood culture specimens from infants(3 or less than 3 months of age) suspected with bloodstream infections in this hospital from January 2011 to May 2015 were collected ,the bacteria identification and drug sensitivity test were carried out by using the VITEK 2 Compact automatic microorganism analyzer . The composition and antibacterial resistance of these isolates were analyzed .Results Among the 299 strains of pathogenic bacteria , there were 169 strains of gram‐positive cocci(accounted for 56 .5% ) ,including 95 strains of coagulase negative Staphylococcus (ac‐counted for 31 .8% ) which was the main isolates ,and followed by 28 strains of Staphylococcus aureus(accounted for 9 .4% );there were 120 strains of gram‐negative bacilli (accounted for 40 .1% ) and mainly were Escherichia coli (53 strains ,accounted for 17 .7% );otherwise ,there were 8 strains of fungi (accounted for 2 .7% ) and 2 strains of gram‐positive bacillus (accounted for 0 .7% ) .The results of drug susceptibility test indicated that the gram‐positive cocci had multiple drug resistance to antibacterial a‐gents except for vancomycin and linezolid;the gram‐negative bacilli shown multiple drug resistance except for amikacin ,imipenem and meropenem .The fungus ,however ,displayed high sensitivty to all antifungal drugs .Conclusion Gram‐positive and gram‐nega‐tive bacteria are the main pathogens of hospitalized infants with bloodstream infection ,and are severely resistant to antibacterial a‐gents .Rational use of antimicrobial agents should be recommend for improving clinical efficacy and prohibiting the emergence of drug‐resistant strains .

Objective To make a comparison of transthoracic echocardiography (TTE) and cardiac multi-slice spiral computed tomography (MSCT) in the diagnosis of partial anomalous pulmonary venous connection (PAPVC) in children.Methods One hundred and one patients admitted from February 2008 to April 2014 in Guangdong General Hospital primarily diagnosed with PAPVC with or without other congenital heart diseases were analyzed retrospectively,all the cases underwent routine TTE,which 74 cases underwent cardiac MSCT examination,and the TEE and cardiac MSCT diagnosis results were compared with final surgical findings,then the TTE and cardiac MSCT diagnosis accuracy was calculated.SPSS 13.0 software was used to analyze the data.Results All the patients underwent TTE examination,meanwhile,74 cases received cardiac MSCT examination.Ninety-three cases were confirmed by surgical findings,while 8 cases were misdiagnosed with PAPVC.Sixty-eight cases diagnosed by TTE coincided with surgical findings,and the diagnosis accuracy was 73.12％ (68/93 cases);65 cases diagnosed by cardiac MSCT coincided with surgical findings,and the diagnosis accuracy was 94.20％ (65/69 cases).Among the patients who received both TTE and cardiac MSCT examinations,66 cases were confirmed through final surgical operation,2 cases were mis-diagnosis,so the diagnosis accuracy was 97.06％ (66/68 cases).Conclusions In terms of the diagnosis accuracy of PAPVC,cardial MSCT examination is superior to TTE,as almost all of the cases could be diagnosed by TTE combined with cardial MSCT.In consideration of the acoustics window of children,apart from the conventional parasternal approach of detecting pulmonary veins,the importance of suprasternal and subcostal views should also be attached.

Objective To study the relationship between bisphenol A and precocious puberty in 6-8 years girls. Meth-ods Atotal of 103 girls aged 6-8 years with precocious puberty in our Endocrine clinic from August to December 2012 were se-lected. According to the classiifcation standard of precocious puberty, girls are divided into idiopathic central precocious puberty (ICPP) group (n=47) and permature thelarche (PT) group (n=56), 53 girls with no puberty development were chosen as control group. BPA concentrations were determined with HPLC-MS-MS, sex hormones were determined with chemiluminescence meth-od and Kisspeptin concentrations were determined with ELISA, then the differences among the three groups were compared and the relationships between bisphenol A and sex hormones and Kisspeptin were analyzed. Results The BPA relevance ratio and concentration in ICPP group were higher than those of PT group and control group (P<0.05). The peak concentration of LH and LH/FSH in ICPP group were higher than those of PT group (P<0.05). The concentration of E2 in ICPP group and PT group were higher than that of control group (P<0.05). The concentration of Kisspeptin in ICPP group was higher than that of PT group and control group (P<0.05). There were no relationship between the concentrations of bisphenol A and Kisspeptin and FSH peak con-centration (P>0.05). There were correlations between the concentrations of BPA and E2 and LH peak concentration and LH/FSH (P<0.05). Conclusions There is a certain correlation between the concentrations of BPA and ICPP.