Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy (BMS-IMRT) for postoperative cervical cancer.Methods From January 2011 to June 2012,totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly.External whole pelvic intensitymodulated irradiation combined with chemotherapy was carried out for all patients.The planning target volume received a dose of 45 Gy/25 fractions in all patients.Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group:the pelvis V30 ≤ 50％.All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy.Results Treatment was completed in 67 patients,as the other 3 patients stopped chemotherapy because of myelosuppression.There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS),alimentary tract toxicity and urinary toxicity.IMRT group had more serious hematologic toxicity than BMS-IMRT group,with statistically significant difference (x2 =14.355,P ＜ 0.05).Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy,IMRT group has more serious hematologic toxicity than BMS-IMRT group.The short-term effect and other toxicities reaction are similar between two groups.

Bone Substitutes ; Facial Injuries ; surgery ; Fracture Fixation ; methods ; Humans ; Maxillofacial Injuries ; surgery ; Oral Surgical Procedures ; Surgical Flaps ; Tooth Injuries ; surgery

Objective To summarize the treatment experience of supraventricular tachycardia (SVT) after coronary artery bypass graft (CABG). Methods The clinical data of 136 patients who had occurred SVT after CABG between January 2008 and December 2009 were analyzed retrospectively. Results Among 136 patients,no perioperative mortality,atrial fibrillation (AF) occurred in 110 cases (80.88%),paroxysmal supraventricular tachycardia (PSVT) occurred in18 cases ( 13.24% ), atrial flutter occurred in 8 cases (5.88%),112 of 136 cases occurred in 1-3 days after surgery,accounting for 82.35% ,24 cases occurred in 4-7 days after surgery,accounting for 17.65%. Given amiodarone in the treatment of 105 cases,100 cases reverted to sinus rhythm (cardioversion rate of 95.24% ),given esmolol in the treatment of 11 cases, 9 cases reverted to sinus rhythm( cardioversion rate of 81.82% ), synchronous direct current cardioversion in 20 cases, all transferred to sinus rhythm, all patients with improved symptoms. The remaining failed to transfer to sinus rhythm, had got normal ventricular rate, and symptoms improved significantly. Conclusions It is necessary to take effective measures to prevent SVT within 3 days after CABG. Amiodarone, esmolol and synchronous direct current cardioversion can be used effectively and safely to control SVT after CABG.

Objective To discuss the expression and significance of platelet ultrastructure and platelet acti-vating factor(PAF)relationship in patients with acute cerebral infarction.Methods 40 patients with cerebral infarc-tion were chosen onset in 6-24 hours as the observation group,while at the same time 20 cases of healthy adults were selected as the control group.The observation group was given 1-7d of aspirin enteric-coated metformin hydrochloride 300mg,qd,and 8-14d had worship of aspirin enteric-coated metformin hydrochloride 100mg,qd.And before and 1,7, 14 days after treatment,control group and observation group respectively preclude the use of transmission electron microscopy ultrastructure of platelets,before and 1,14 days after treatment automatic blood cell analyzer test was used to analyze the average platelet volume (MPV),platelet count (PLT),platelet volume distribution width (PDW)of the two groups.And 1,2,3,7,14 days after treatment,enzyme-linked immunosorbent determination of double clamp method was used to test the concentration of PAF.Results Before treatment,MPV,PDW and PAF in peripheral blood of the observation group were (9.22 ±1.30)fL,(17.89 ±1.23)%,(211.31 ±11.22)pg/mL,which were sig-nificantly higher than those of the control group (8.68 ±1.03)fL,(16.06 ±1.03)%,(155.49 ±8.70)pg/mL(t =2.082,2.563,14.401,all P <0.05),while PLT was (173.22 ±63.40)×109 /L,which was significantly lower than that in the control group (231.22 ±56.76)×109 /L(t =3.048,P <0.05).After treatment in patients with acute cer-ebral infarction,the MPV,PDW of peripheral blood were (8.43 ±1.28)fL,(16.66 ±1.11)%,which were signifi-cantly lower than before treatment (9.22 ±1.30)fL,(17.89 ±1.23)% (t =1.937,3.320,all P <0.05),while PLT (195.33 ±61.45)×109 /L was significantly higher than before treatment (173.22 ±63.40)×109 /L(t =1.915, P <0.05).PAF peaked in the treatment of 3 days,which was (240.12 ±13.78)pg/mL,and gradually declined after 7 days,which was (215.33 ±16.43)pg/mL,and that after 14 days was(170.27 ±11.40)pg/mL,compared with before treatment (211.31 ±11.22)pg/mL,the difference was statistically significant (t =16.24,P <0.05).Before treatment,platelet shape had irregular,increased pseudopodia,several visible platelet aggregation,and was blend together.And after 14 days treatment in the observation group,platelet ultrastructure greatly recovered.Conclusion Monitoring of MPV,PDW,PAF and PLT in peripheral blood of patients with acute cerebral infarction before and after treatment has important clinical value for disease diagnosis and treatment.

Objective To analyze the medical and audiological features of trauma induced stapes fracture ,and to summarize the key diagnostic points and to observe the effects of surgical treatment .Methods Five patients with trauma induced stapes fracture confirmed by the surgical exploration from January 1995 to October 2013 were retro_spectively reviewed .Ossicular chain reconstruction was performed on each patient .The preoperative and postopera_tive pure-tone thresholds were compared to judge the effects of surgical treatment .ResuIts The surgical explora_tion revealed 4 cases of stapes feet fracture ,1 case of stapes neck fracture with temporal bone fracture and peripheral paralysis of the facial nerve .Different types of ossicular reconstruction were performed according to the exploration results:2 cases with autogenous stapes remodeling ,1 case with allogenous stapes remodeling ,1 case with bone piece of external acoustic meatus ,and 1 case with artificial auditory ossicle(TORP) implanting .Additionally ,the case of peripheral paralysis of the facial nerve received facial nerve decompression .After the operation ,5 patients felt that their hearing was improved .The mean postoperative pure-tone threshold was 30 .7 dB HL ,and the mean ABG(air-bone-gap) was 18 dB HL while the mean preoperative pure-tone threshold was 61 dB HL(t=6 .725 ,P<0 .05) and the mean ABG was 38 .7 dB HL(t=3 .616 ,P<0 .05) .The facial nerve functions of the case with facial paralysis recovered to House-Brackmann Grade I three months after receiving facial nerve decompression .ConcIu_sion Stapes fractures are rare .Being different from the general conductive hearing loss ,patients with stapes fracture usu_ally have the acoustic stapedius reflex .Through ossicular reconstruction ,we can yield a satisfying hearing recovery .

Objective This study examined the effects of Midazolum-ketamine oral solution (MKOS) on the expression of N-methyl-D-aspartate receptor 1 (NMDAR1) and gamma-aminobutyric acid (GABA)A receptors (GABAAR) mRNA in the cerebral cortex of rat, in order to investigate the sedation mechanism of MKOS. Methods Fifty Sprague-Dawley(SD) rats were divided into ten groups according to the observed time after MKOS administration (0,5,10, 15,30,60,90,120,240 and 360 minutes, n =5 each). The 0 minute group(control group) received 0.9% saline instead. Immunohistochemical staining and in situ hybridization were used to detect the expressions of NMDAR1 and GABAAR mRNA in the cerebral cortex. Results Both GABAAR and NMDAR1 all expressed in the glial cells of cerebral cortex. The expression of NMDAR1 in control group was strong. The expression of NMDAR1 became weaker during 15 to 90 minutes after administration of MKOS (P＜0.05). The expression of GABAAR mRNA in control group was weaker,while became stronger during 30 to 90 minutes after administration of MKOS (P ＜0. 05). Conclusion MKOS may play sedation by strengthening the expression of GABAAR and suppressing the expression of NMDAR1 in the cerebral cortex.

The respective sense and antisense oligodeoxynucleotides and their phosphorothiods, targeting at the bcr/abl, were the hallmark gene of Chronic Myelogenous Leukemia( CML) and c-myb correlates with CML. K562 cells, derived initially from a patient of CML blast crisis, were incubated with bcr/abl antisense oligodeoxynucleotides asODN or c-myb asODN or with both asODN in combinalion. All kinds of asODN could not only significantly inhibit K562 cells survival with the highest inhibitory rate of 64.7%?3.2%, but also dramatically inhibit DNA synthesis and the highest inhibitory rate was 85. 8 %?4.1%, decrease bcr/abl mRNA level almost completely and induce apoptosis significantly. The inhibition effect of antisense oligodeoxynucleotides phosphorothiodes s-asODN was stronger than that of unmodified asODN. The inhibition of the combination of bcr/abl and c-myb asODN was stronger than that of anyone alnoe. All the inhibitions exhibited in sequence-and time-dependent manner. We concluded that bcr/abl in pathogenesis of CML not only increased CML cells proliferation rate, but also decreased CML cells apoptosis rate. c-myb may participate in CML mainly by regulating bcr/abl. Trie results indicated that the modified asODN and multiple asODN targeting several oncogenes may advance to antisense gene therapy.

BACKGROUND: Whether antihypertesive remedy is given or not is not only according to the blood pressure grade, but also to its risk stratification. Recently the relation of syndrome types to hypertension grades and risk stratification in primary hypertension has been investigated at home. OBJECTIVE: To observe the relation of syndrome types to hypertension grades and risk stratification in primary hypertension by the method of syndrome differentiation in traditional Chinese medicine combining with achievements in modern medicine. DESIGN: Descriptive investigation. SETTING: Department of Traditional Chinese Medicine, Jing'an District Central Hospital of Shanghai City and Shanghai Dahua Hospital. PARTICIPANTS: Sixty-four patients, in different genders and ages, with primary hypertension from Department of Traditional Chinese Medicine of Jing'an District Central Hospital of Shanghai City METHODS: The primary hypertension was classified into four types of syndrome: up disturbing of wind-yang, up clouding of turbid phlegm, deficiency of qi and blood and yin deficiency of liver and kidney. The relation of syndrome type to hypertension grade and risk stratification in primary hypertension was investigated combining syndrome differentiation in traditional Chinese medicine (TCM) and disease differentiation in Western Medicine. MAIN OUTCOME MEASURES: The relation of syndrome types to the age, course, blood pressure grade and risk stratification in primary hypertension RESULTS: All 64 patients entered the result analysis. ① Relationship of syndrome type with the age, course and blood pressure grade: The age of patients in up-disturbing of wind-yang group was younger than those in both up-clouding of turbid phlegm and yin deficiency of liver and kidney groups [(59.0±10.9), (72.7±9.1), (71.6±10.1)years, P ＜ 0.01]; the disease course of patients in yin deficiency of liver and kidney group was longer than those in up-disturbing of wind-yang group and up-clouding of turbid phlegm group [( 160.50±143.51 ), (64.83±70.77), (80.56±108.69)months,P ＜ 0.05];the difference of systolic pressure among different syndrome types was not significant, but the diastolic pressure in up-disturbing of wind-yang group was higher than those in other groups [(99±8), (92±9),(89±11 ), (89±12)mmHg, P ＜ 0.05]. ② The relationship of syndrome type with blood pressure grade and risk stratification: The difference of blood pressure grades among patients with different syndrome types was not significant, but the risk stratification in up-disturbing of wind-yang group was lower than those in up-clouding of turbid phlegm and yin deficiency of liver and kidney groups (There were respectively 3, 7, 5 and 3 cases; 15, 1, 1and 1 cases; 16, 1, 2 and 1 cases at very high risk, high risk, medium risk and low risk, P ＜ 0.05). CONCLUSION: Different syndrome types in TCM may present differences in hypertension grade and risk stratification, which can provide basis for determining therapeutic principle.

Objective To compare the mast cells' property and the level of pelvic pain, urgency and frequency (PUF) scale in urinary bladder between interstitial cystitis (IC) patients and controls.Methods Eighteen cystoscopy biopsy specimens of interstitial cystitis patients and 12 controls were stained with 0.5% toluidine blue and immobilizated with Osmic Acid. Then the mast cells were observed and counted with light microscope and transmission electron microscope. The PUF scale and the number of mast cells between the 2 groups were compared. Results The mast cell's number of the interstitial cystitis samples(28-76 pieces/mm2) was significantly higher than that of the non IC persons' bladder tissues(7-15 pieces/mm2) (Z=3.927,P＜0.01). 75.3% mast cells were in a state of being activated degranulation. The PUF scale of IC patients( 17-35 scores)was significantly higher than that of the non IC persons' (0-8 scores) (t=14.736,P＜0.01). The PUF scale of the patient group did not have a linear IC relation with the mast cell's infiltrated number among the specimens (rs=-0.618,P=0.601). Conclusions Mast cell infiltration may be one of the characteristic pathological manifestations of IC. The association of mast cell infiltration and the PUF scale may be a new diagnosis criteria for IC.

Pharmaceutical excipients are implementing registration and approval management in our country. As the disadvantages of the registration system appearing continuously, the demand for reform is getting higher and higher. The cry for drug master files ( DMF) model instead of registration and approval management is becoming more prominent. Based on the understanding of DMF sys-tem, the article discussed the positive roles of the excipients standards and guidelines construction in DMF implementation using phar-maceutical excipients supervision experience in the United States as the reference and starting from the standards and guidelines system of excipients, which aimed to provide suggestions for the supervision and management of pharmaceutical excipients, and improve the quality and safety of pharmaceutical excipients and drugs.