Objective:To investigate the clinical efficacy of every 3-week regimen of oxaliplatin (OXA) plus 5-fluorouracil (5-FU)/leucovorin(CF)as postoperative adjuvant chemotherapy for colorectal cancer.Methods:Ninety eight patients with stage Ⅱ to stage Ⅲ colorectal cancer received every 3-week OXA plus 5-FU/CF adjuvant chemotherapy for six cycles after resection surgery. All the patients received a complete reexamination every 3 months after the end of adjuvant chemotherapy. The disease-free survival period and 1- and 2-year disease-free survival rates were observed.Results:The total 2-year disease-free survival rate was 74.5%. It was 87.0% for stageⅡpatients and 63.5% for stage Ⅲ patients. The main adverse reaction included peripheral neurotoxicity, neutropenia and diarrhea at grades Ⅰ to Ⅱ. Grades Ⅲ to Ⅳ adverse reactions occurred rarely.Conclusion:The every 3-week OXA combined with 5-FU/CF adjuvant chemotherapy regimen had definite efficacy and good tolerance, which was a rational choice of postoperative adjuvant chemotherapy for colorectal cancer.

Objective: To evaluate the impact of the number of negative lymph nodes on disease free survival (DFS) of patients with locally advanced gastric cancer. Methods: A total of 485 patients who underwent surgery for gastric cancer were enrolled in this study. We analyzed the data of these patients including complete information of follow-up and definite postoperative pathological results. The disease free survival of all patients was more than 6 months and was analyzed according to the pathological stage respectively. COX regression analysis was performed to screen the independent prognostic factors. Kaplan-Meier method was used to draw the disease free survival curve and the disease free survival rate was compared among subgroups. Results: Cox regression analysis showed that the disease free survival rate of gastric cancer patients with pathological stage T_3N_(0～2)M_0 was significantly associated with age, degree of tumor differentiation, tumor location as well as the number of negative lymph nodes. In the T_3N_0M_0 subgroup, when the number of negative lymph nodes was 1 to 4 and 5 or more, the 2-year disease free survival rate was 8.3% and 55.6%, respectively, and the 3-year disease free survival rate was 0 and 24.9%, respectively (P=0.025).In the T_3N_1M_0 subgroup, when the number of negative lymph nodes was 3 or less, 4 to 9, and 10 or more, the 2-year disease free survival rate was 17.3%, 39.1%, and 52.6%, respectively, and the 3-year disease free survival rate was 4.2%, 6.0%, and 17.1%, respectively (P<0.001). In the T_3N_1M_0 subgroup, when the number of negative lymph nodes was 7 or less and 8 or more, the 2-year disease free survival rate was 11.5% and 35%, respectively, and the 3-year disease free survival rate was 0.8% and 5%, respectively (P=0.015).Conclusion: For gastric cancer patients with pathological stage T_3N_(0～2)M_0, the number of negative nodes could reflect the level of regional lymph node dissection. The number of negative nodes can be an index for evaluation of the accuracy of pathological staging and is considered as an independent prognostic factor for disease free survival of gastric cancer patients.

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; pathology ; physiopathology ; Pituitary Gland ; pathology ; Pituitary Neoplasms ; pathology

OBJECTIVETo evaluate the long-time effect on allitridum and selenium in preventing cancer of digestive system.

METHODSPersons who were recruited into the intervention group and took allitridum and selenium to prevent gastric cancer in Qixia county of China from 1989-1991 were followed up to 2001 and data of deaths was collected. The long effect on allitridum and selenium in preventing cancer of digestive system was analysed.

RESULTSData were compared to placebo group five years (1992-1996) after the termination of intervention to have found that the accumulative mortality rate of all cancer, digestive system cancer and gastric cancer had decreased 45.5%, 41.2% and 63.3% in the intervention group respectively. By stratum analysis, accumulative mortality rate of all cancer, digestive system cancer and gastric cancer had decreased 51.5%, 51.5% and 67.7% in males of the intervention group, respectively. Relative risks for males in the intervention group were 0.48, 0.47 and 0.30 times more than the placebo group, respectively. All of them were statistically significant. Relative risks for females in the intervention group were 0.74, 0.92 and 0.70 times more than placebo group. Six to ten years later after the termination of intervention, the accumulative mortality rate and relative risk of all cancers in two groups became similar.

CONCLUSIONAllitridum and selenium had the effect of decreasing the incidence risk of digestive cancer with a protective rate more than 50% for five years after the termination of intervention program.

Adult ; Aged ; Allyl Compounds ; therapeutic use ; Antioxidants ; therapeutic use ; Female ; Follow-Up Studies ; Gastrointestinal Neoplasms ; prevention & control ; Humans ; Male ; Middle Aged ; Selenium ; therapeutic use ; Stomach Neoplasms ; prevention & control ; Sulfides ; therapeutic use

Objective To explore the tutorial system of biomedical engineering students in medical colleges and universities,and provide useful references for the implementation of undergraduate tutorial system in medical colleges and universities in China.Methods Based on the compulsory professional knowledge and skills of biomedical engineering students,the undergraduate tutorial system of biomedical engineering specialty was analyzed and summarized with thatof School of Biomedical Engineering of the Fourth Military Medical University taken as an example.Results The necessity,problems and new mode were pointed out for the undergraduate tutorial system of biomedical engineering specialty.Conclusion The implementation of undergraduate tutorial system is a new idea of deepening the reform of undergraduate education in biomedical engineering specialty,and is of important significance to improve the professional skills of students.

Gene therapy offers the promise of curing the HIV-infected patients. Specific, potent, and sustained short hairpin RNA (shRNA)-mediated gene silencing is crucial for the successful application of RNA interference technology to therapeutic interventions. To reduce the probability of viral escape mutants, in this study, we constructed lentiviral vector containing vpr and tat shRNA, respectively, furthermore the bispecific lentiviral vector harboring vpr and tat shRNA expression cassettes from U6 promotor and H1 promotor was cotransfected with recombinant plasmid expressing the vpr and tat gene. The result showed that the bispecific lentiviral vector plvx-vpr-tatshRNA could inhibit the vpr and tat effectively,with ratios of 89.20% and 62.00% respectively. When cotransfected with pNL4-3 in 293T cell, plvx-vpr-tatshRNA showed higher efficacy in down regulating the HIV NL4-3 packaging production than the plvx-vprshRNA or plvx-tatshRNA individually. MT4 cell clones transduced with recombinant lentiviral vectors were screened and challenged with HIV NL4-3. P24 ELISA test showed that MT4 transduced with the combinational lentiviral vector could inhibit virus replication efficiently.
Cell Line ; Down-Regulation ; Genetic Therapy ; Genetic Vectors ; genetics ; metabolism ; HIV Infections ; therapy ; virology ; HIV-1 ; genetics ; metabolism ; Humans ; Lentivirus ; genetics ; metabolism ; RNA Interference ; RNA, Small Interfering ; genetics ; metabolism ; therapeutic use ; tat Gene Products, Human Immunodeficiency Virus ; genetics ; metabolism ; vpr Gene Products, Human Immunodeficiency Virus ; genetics ; metabolism

This study was aimed to explore the expression of B cell-activating factor of TNF family (BAFF) and B cell lymphoma/leukemia-2 (BCL-2) in bone marrow mononuclear cells (BMMNC) of multiple myeloma (MM) and the significance of BAFF and BCL-2 for occurrence, development and prognosis of MM. The bone marrow of 40 cases of MM and 10 healthy persons was collected, the mononuclear cells (MNC) were isolated, the expression of BAFF and BCL-2 mRNA in BMMNC was detected by real-time PCR; the plasma was simultaneously collected and the β2-MG level was determined; the clinical staging of MM patients was performed according to Durie-Salmon (D-S) staging criterion. The results indicated that the expression level of BAFF and BCL-2 mRNA in MM patients increased, as compared with normal controls, the difference was statistical significant (p < 0.05); the expression level of BAFF and BCL-2 mRNA in plateau stage after treatment obviously decreased. The expression level of BAFF and BCL-2 mRNA in relapsed/refractory MM patients was significantly higher than that in normal controls and patients reached plateau stage (p < 0.05), there was no statistically significant difference between newly diagnosed and relapsed/refractory MM patients (p > 0.05). The expression of BAFF and BCL-2 mRNA related with D-S staging and β2-MG level. It is concluded that the expression levels of BAFF and BCL-2 mRNA increase, moreover the expression levels of BAFF and BCL-2 mRNA in newly diagnosed and relapsed/refractory MM patients are higher than those in patients reached plateau stage, which suggest the BAFF and BCL-2 may be involved in occurrence and development of MM; the relation of expression level of BAFF and BCL-2 mRNA to MM load is positive, which indicates the expression level of BAFF and BCL-2 mRNA may be a new indicator for evaluating the prognosis of MM patients.
Adult ; Aged ; B-Cell Activating Factor ; genetics ; metabolism ; Case-Control Studies ; Female ; Humans ; Lymphoma, B-Cell ; genetics ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; genetics ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; RNA, Messenger ; genetics

OBJECTIVEDue to its minimal-invasive approach, endovascular procedure had replaced surgery in treating Budd-Chiari syndrome (BCS). The interventional therapy was a safe and effective treatment in adults with BCS and the cure rate was high. However Budd-Chiari syndrome in children and adolescents is rare. Published literature on interventional procedure for Budd-Chiari syndrome in children and adolescents is scarce. The aim of the study was to present results of percutaneous transluminal angioplasty (PTA) and stents placement in children and adolescents with BCS and to evaluate the efficacy and safety in these patients of this approach.

METHODTwenty-five patients [16 boys and 9 girls; average age of (14.5 ± 3.4) years old; age ranged from 5 to 17 years] with Budd-Chiari syndrome who were hospitalized from December 1990 to August 2012 were presented. All of them were diagnosed by color Doppler ultrasound scan while 12 of them had magnetic resonance venography (MRV) scan. All of the patients had undergone angiographic examination. Four cases with membranous obstruction of the inferior vena cava (IVC) were treated with PTA. One case with segmental block of IVC was treated with PTA and stent placement. Five cases with membranous obstruction of IVC and hepatic vein (/and accessory hepatic vein) were treated with PTA. Among 8 cases with membranous obstruction of hepatic veins, 6 cases were treated with PTA and the others with PTA and stent placement. Among 4 cases with blocks of 3 hepatic veins (HVs), one was treated with PTA, one with PTA plus catheter thrombolysis plus PTA, one with PTA and stent placement and the other one was unsuccessful. Three cases with obstruction of HV and accessory HV (AHV) were treated with PTA. Totally, 24 patients were treated with interventional approach and followed up.

RESULTThe procedure was successful in 24 patients. The involved veins (hepatic veins or IVC) were patented after interventional procedure. The pressure of hepatic vein was (42.1 ± 4.2) cm H2O (37-50 cm H2O) (1 cm H2O = 0.098 kPa) before the interventional therapy, while it was (17.3 ± 3.3) cm H2O (14-26 cm H2O) after it. The pressure of IVC was (30.6 ± 2.9) cm H2O (26-36 cm H2O) before the interventional therapy, while it was (18.8 ± 4.2) cm H2O (15-26 cm H2O) after it. The symptoms and signs vanished instantly after interventional procedure. There were no procedure-related complications. The rate of overall initial cure was 96%. The patients were followed up for a mean of 25.8 months (range 6 months to 8 years). Seven cases developed restenosis after first procedure. Five of them were treated with PTA, one with PTA plus catheter thrombolysis plus PTA, one with PTA and stent placement. All of the involved veins were patented again. Clinical symptoms were relieved. There were no procedure-related complications as well.

CONCLUSIONThe interventional procedure in children and adolescents with BCS is the same as in adults. Radiological therapeutic intervention is efficacious and safe in children and adolescents with BCS.

Adolescent ; Angioplasty ; Budd-Chiari Syndrome ; diagnostic imaging ; surgery ; therapy ; Catheterization, Peripheral ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Hepatic Veins ; diagnostic imaging ; surgery ; Humans ; Liver ; blood supply ; diagnostic imaging ; Male ; Phlebography ; methods ; Radiography, Interventional ; Retrospective Studies ; Stents ; Thrombolytic Therapy ; Treatment Outcome ; Vena Cava, Inferior ; diagnostic imaging ; surgery ; Venous Thrombosis ; therapy

Based on a sufficient analysis of the theoretical framework of " transformation learning collaboration" ( TLC ) and " people-centered and integrated health care " ( PCIC ) mode, this article introduced the main practices and achievements of " Hangzhou characteristics" countywide medical alliances, centering on TLC mode.Hangzhou takes the countywide medical alliance construction as a pilot, refers to the TLC model, and takes growth-oriented collaboration as the guidance, to promote responsibility sharing, benefit sharing, service integration and management collaboration.Guided by the PCIC model proposed by the World Health Organization, the city has established an integrated service model of hierarchical medical system-prevention-rehabilitation-aging care.The countywide medical alliance system framework features " 5 fields, unified leadership, unified culture, 6 supports, 3 tasks and TLC teams " , which may provide references for the coordinated and integrated development of such alliances.