Objective To study techniques and effects of laparoscopic repair for peptic ulcer perforation. Methods A total of 23 cases of peptic ulcer perforation (the duodenum, 17 cases; the anterior wall of the gastric antrum, 5 cases; the lesser curvature of stomach, 1 case) underwent laparoscopic repair and abdominal drainage. Results All the operations were successfully accomplished without complications. Gastroscopy at 3 months after operation showed visible threads in 13 patients with silk suture sewn, and no threads in 10 patients with absorbable suture sewn. Follow-up for 6~27 months (mean,18 months)found a mild belching and acid regurgitation in 3 cases of duodenal bulb perforation. No re-perforation occurred. Conclusions Laparoscopic repair is a safe and reliable method for peptic ulcer perforation. Postoperative standard medical treatment is required for satisfactory outcomes.

Objective:To assess the role of EGFR mutations on pemetrexed response in patients with advanced lung adenocarcino-ma. Method: Forty pulmonary adenocarcinoma patients with evaluable lesions were retrospectively screened .They had been treated with pemetrexed-included chemotherapy and had EGFR gene test results. The evaluation endpoints were overall response rate,disease control rate and progression free survival. Result:No significant statistical difference was seen in overall response rate(ORR) (44.4%VS 31.8%, respectively) and disease control rate(DCR) (88.9%VS 81.8%, respectively ) between EGFR wild group and EGFR muta-tion group, but patients in EGFR wild group had longer progression free survival(PFS) ( 8.9 months VS 5.3 months;P=0.046). Conclu-sion:EGFR mutation status can influence the efficacy of pemetrexed.

Objective To evaluated the efficacy of biomarker?guided concurrent chemoradiotherapy in unrescetable esophageal squamous cell carcinoma patients. Methods 54 cases of unrescetable esophageal squamous cell carcinoma were enrolled in the prospective non?randomized clinical study and divided into study group and control group. All cases were treated with concurrent chemoraditherapy. Intensity?modulated radiation therapy was used with a dose of 60?66 Gy. Chemotherapy was perfromed on day 1 and d29. In the study group the selection of the chemotherapy drug was based on the excision repair cross?complementation 1 ( ERCC1) ,thymidylate synthetase ( TYMS) ,ribonucleotide reductase M1( RRM1) ,and theβ?tubulin isotypeⅢ( TUBB3) mRNA expression levels. In the control group,the regiment for chemotherapy was Cisplatin plus Fluorouracil. The objective response rate and overall survival ( OS ) were calculated using Kaplan?meier method and log?rank test was used for between?group comparison. The survival rate was calculated using Kaplan?Meier method and analyzed using log?rank method, other comparison was performed by χ2 test. Results The follow?up rate was 100% in the study group and 96% in the controll group. The objective response rate of the study group and the control group were 85% and 86 ( P=0. 483 ) , respectively. The median survival time ( MST) in the study group was 35. 5 months and that in the control group was 25. 8 months. The 1?,2?,and 3?year OS rates of the study group and the control group were 84%,68%,46% and 71%,59%,28% respectively (P=0. 047).No significant differences were observed in the incidence of side?effects in the two groups. Conclusions Selecting the chemotherapy drug according to biomarker,combined with radiation therapy,could improve survival.in unrescetable esophageal squamous cell carcinoma. The value needs further investigation.

reproducible, and may cover the major circulating strains in China.

Objective To compare postoperative three-dimensional conformal radiotherapy (3DCRT) and conventional radiotherapy (CR) in patients with non-small-cell lung cancer (NSCLC). Methods From Nov. 2002 to Mar. 2006,162 patients with stage ⅠB～ⅢB NSCLC receiving postoperative radiotherapy in our department were restrospetcively analyzed. Among them,86 received 3DCRT and 76 re-ceived CR. The survival outcome, pattern of failure and treatment-related side effects in both groups were an-alyzed. Results The median follow-up was 29.4 months in the 3DCRT group and 24 months in the CR group. The 1-,2- and 3-year local-regional free survival was 97.5% ,83.2% and 83.2% in 3DCRT group, and 84.3% ,76.0% and 65.6% in CR group(χ2= 5.46, P = 0.019), respectively. No statistically signifi-cant difference was found in the overall survival, disease-free survival or distant metastasis-free survival be-tween the two groups. The local-regional failure rate was statistically different between the two groups (14.5% vs 33.3% ,χ2 =7.70,P =0.006). The incidence of distant metastasis in the two groups was simi-lar. Radiation pneumonitis of NCI CTC grade 2-3 occurred in 10 patients(11.6%)in 3DCRT group and 18 (23.7%) in CR group,which was statistically different(χ2 =4.10,P=0.043). Conclusions Postopera-tive 3DCRT for NSCLC provides a better local-regional control and lower incidence of radiation pneumonitis compared with CR.

Lung cancer displays the highest morbidity and mortality worldwide. Non-small cell lung cancer (NSCLC) is the most com-mon type of lung cancer. In-depth research was performed on the pathogenesis and biological behavior of lung cancer and the im-provement of genetic testing level. The discovery of drugs targeting epidermal growth factor receptor and anaplastic lymphoma kinase plays a significant role in individual treatment of advanced NSCLC. BIM is a protein in the Bcl-2 family that promotes apoptosis, which leads to cell death. The BIM expression level and polymorphism can influence the therapeutic effect of targeted therapy and chemo-therapy on advanced NSCLC. Therefore, this review summarizes BIM and its effects on targeted therapy and chemotherapy for ad-vanced NSCLC.