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.

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 investigate the predictive value of red cell volume distribution width RDW),RDW to platelet ratio (RPR),aspartate aminotransferase (AST) to platelet ratio index APRI),fibrosis index based on the 4 factor (FIB-4) and aspartate-alanine aminotransferase ratio (AAR) in assessing esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between December 2013 and July 2015,a total of 190 patients with HBV-related cirrhosis and no previous history of endoscopic therapy for EV hospitalized at the Department of Hepatology,Tianjin Third Central Hospital were enrolled.Upper gastrointestinal endoscopy were conducted in all patients to diagnose EV.According to the morphology and degree of EV as well as bleeding risk,patients were categorized into mild,moderate and severe stages.RDW,platelet counts,alanine aminotransferase,aspartate aminotransferase were tested,and RPR,APRI,FIB-4,AAR were calculated.Spearman correlation was used to evaluate the association between EV and these indexes.Receive operating characteristic (ROC) curves were generated and the areas under the curves (AUC) were calculated to assess the performance of these indexes in predicting esophageal varices bleeding (EVB).Results RDW ([16.78±2.27]％),RPR (0.41±0.18),FIB4 (8.99±5.91),APRI (2.09[1.35,2.90]) in patients with EVB were all significantly higher than those ([14.37±1.86]％,t=-7.449;0.19±0.09 [t=-8.132];5.72±3.92 [t=-3.658];1.29 [0.70,2.39;z=-2.996]) without EVB (all P＜0.05).However,AAR had no statistical significance between two groups (t =1.216,P=0.226).Both of EV and EVB had positive correlation with RDW,RPR,FIB-4 and APRI (all P＜0.05) and no correlation withAAR(P＞0.05).RDW (F=9.604),RPR (F=47.530),FIB-4 (F=18.071) and APRI (H=12.320) showed statistically significant differences among patients with different stages of EV (all P＜0.05),whereas AAR showed no difference (F=1.177,P=0.320).The AUC of RPR (0.896) for EVB was highest,followed by RDW (0.824,P＜0.05).AUC of FIB-4 and APRI was 0.690 and 0.642,respectively,with no statistical difference (P＞0.05).The optimal cut-off levels of RDW,RPR,FIB-4 and APRI were 14.450 (sensitivity:88.24％,specificity:64.03％),0.209 (sensitivity:96.10％,specificity:69.10％),6.912 (sensitivity:66.67％,specificity:73.38％) and 1.338 (sensitivity:76.47％,specificity:51.08％),respectively.Conclusions RPR and RDW are closely correlated with EV in HBV-related cirrhotic patients,which are of clinical importance in predicting EVB.Both of them can be used as clinical screening methods and RPR may be superior to RDW.Although FIB-4 and APRI are correlated with EV,their predictive value of EBV are low.

Aim: To establish a method for the determination of pantoprazole sodium and its related substances. Methods: A column packed with octadecylsiance bonded silica gel (250 mm × 4. 6 mm, 5 pjn) was used. The 0. 01 mol/L monopotassium phosphate solution( adjusted with phosphoric acid to pH 7. 0) -acetonitrile were adopted as the mobile phase, a gradient elution was programmed as follows: 0→30 min(90:10-60:40), 30→45 min(60: 40→15: 85); the detection wavelength was 289 nm; the column temperature was 40 ℃; the flow rate was 1. 0 mL/min. Results: Pantoprazole sodium, the intermediates and its related substances could be well separated. A good linear relationship was obtained over the range of 6. 96-48. 72 μg/mL( r =0. 999 9). The limit detection and quantisation of pantoprazole sodium were 8.51 ng and 17.0 ng, respectively. Conclusion: This method can be applied to control the related substances of pantoprazole sodium and determine pantoprazole sodi-um.

BACKGROUND:The Notch signaling pathway is evolutionarily highly conserved and mediated by cel-cel interactions, which is widely involved in cel differentiation, proliferation and apoptosis. This critical transduction system participates in coordinating various functions of vascular endothelial cels, thus playing a vital role in the formation and remodeling of vascular network. OBJECTIVE: To elucidate the components of Notch signaling pathway and its impact on angiogenesis. METHODS: A computer-based online search of PubMed and CBM databases was performed. High-quality articles related to mechanism of angiogenesis regulated by Notch signaling were included, and repetitive studies were excluded. RESULTS AND CONCLUSION:Totaly 31 literatures were selectively included in this review. Angiogenesis is a complicated and muti-stage biological event and has been delicately regulated. Notch signaling participates in the regulation of every stage of angiogenesis directly or indirectly via the crosstalk with vascular endothelial growth factor, BMP-SMAD signaling and extracelular matrix molecules. Furthermore, consistent output of Notch signaling is essential for maintaining the stability and integrity of adult vascular system. This review wil thoroughly clarify the latest progress on angiogenesis regulated by Notch signaling and provide theoretical basis and a potential target for designing therapeutic methods against vascular disease.

Objective To investigate the levels of interleukin 1? (IL 1?) and tumor necrosis factor ? (TNF ?) in both serum and CSF in patients with Alzheimer's disease Methods Eleven patients with Alzheimer's disease,13 patients with vascular dementia (VD) and 13 healthy controls were analyzed by using commercial ELISA kits Results The average serum level of IL 1? was found higher in AD patients(60 13?17 81 pg/ml) than in VD patients(38 51?14 39 pg/ml) and in healthy controls(33 98?16 31 pg/ml)( P

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.

Objective To explore the occurrence, clinical feature and the associatrd factors of Sjogren' s syndrome(SS) complicated with Idiopathic Pulmonary Fibrosis(IPF) to build up knowledge for early diagnosis. Methods The clinical characteristics of 160 cases damitted SS patients collected from January 2002 to August 2008 were retrospectively investigated including RF, chest - X, ESR, blood -gas analysis,pulmonary function tests,chest HRCT,ANA and so on. Results The patients with IPF accounted for 33.12% of total SS patients, including 12 cases of male. These patients presented strongly positive ANA,strongly positive RF etc,especially in the male. Conclusion The occurrence of SS - IP was related to the disease' s activity. FHRCT and pulmonary function test should taken early in order to get early diagnosis and treatment.