Objective To investigate the relationship between thyroid hormones and Lp(a) the pituitary-thyroid axis in elder patients with congestive heart failure(CHF). Methods 50 normal controls and 158 elder patients with CHF who had not thyroid gland illness were involved in this study. Levels of FT 3, FT 4, TSH and Lp(a) in serum were measured. Patients were divided into two groups according to the course of chronic heart failure: patients with the course of CHF

13.1mmol/L were treated by 2 weeks short-term intensive insulin treatment. FBS, Fasting blood insulin(FINS), glycosylated hemoglobin A1c (HbA1c), 2 hours postprandial blood sugar(PBS 2), Homa ? and Homa IR were measured and compared between pre-treatment and post-treatment. Results After 2 weeks short-term intensive insulin treatment, the excellent control of FBS, PBS 2 in 23 out of 27 patients were achieved respectively in (5.6?2.3)days and (8.5?3.5)days. Homa ? significantly increased, and HbA1c and Homa IR decreased comared with pre-treatment. Conclusions The excellent glycemia control and improvement of ?-cell function can be induced by short-term intensive insulin treatment in newly diagnosed type 2 diabetic patients with severe hyperglycemia.

Aim To evaluate the effects of R-Salbutamol(R-Sal)on the contraction of isolated tracheal strips and lung parenchyma strips in guinea-pig,induced by Histamine(His).Methods Tracheal strips and lung parenchyma strips of guinea-pig in vitro were prepared,and the dilatory effect on shrinkage reaction of isolating specimens induced by His were measured before or after the administration of R-Sal in doses of 10-8,10-7,10-6 mol?L-1,with fix-doses pharmacology methods.The inhibitory effect was compared with that of Sal(10-6 mol?L-1).Results His could induce the contraction of isolated strips in guinea-pig in a dose-dependent manner,and R-Sal could significantly inhibit this shrinkage of lung parenchyma induced by His.in a dose-dependent manner.R-Sal was much more efficient than Sal(P

Objective To investigate the current state of core competence of hospital clinical new nurses of different training mode so as to provide the basis for formulating targeted training mode . Methods Adopted order-form training mode that including internship and employment .Then using Competency Inventory For Registered Nurse to survey 104 new nurses who have registered in 2013 and analyzed the results . Results Total core capability score of new nurses was (158.40 ±25.95).And the dimensions score of critical thinking(27.81 ±3.72), clinical care (26.37 ±2.96), leadership ability (29.84 ±3.18), interpersonal relationships(26.05 ±5.47), legal/ethical practice(26.27 ±3.22), professional development (17.57 ±2.34) and education/consultation(20.43 ±3.14)among new nurses of order-form training was higher then that of non-order-form training nurses,and the differences between two groups showed statistically significance (t=6.207, 5.530,3.782,4.531,3.912,2.195,4.053,respectively;P<0.05).Conclusions Hospital should increase the proportion of order-form training, promote effective cooperation between institutions and hospitals and broaden the new ways of hospital talents construction .

Nowadays, lung cancer is the malignant tumor of the highest morbidity and mortality over the world, and non-small cell lung cancer (NSCLC) makes up about 80%. hTere is a great many NSCLC patients have been in advanced stage when diagnosed. As a result, people pay more attention to curing advanced NSCLC. hTe standard treatment to advanced NSCLC is platinum-based combined chemotherapy. However, chemotherapy drugs usually have limited effects on improving the survival of the patients. hTen exploring new therapies is extremely urgent to us. Now, molecular targeted therapy has been the most promising research area for the treatment of NSCLC with researches going deep into pathogenesis and biological behavior of lung cancer. Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have achieved a great suc-cess in the treatment of advanced NSCLC. hTeir representatives are erlotinib and geiftinib. hTe two drugs have been widely used to treat advanced NSCLCs worldwide, especially for the patients with EGFR activating mutations. However, atfer a period of treatment (median time is 6 to 12 months), most patients will develop drug resistance to EGFR-TKIs. Intense research in these NSCLCs has identiifed two major mechanisms of resistance to TKIs:primary and acquired resistances. hTe research about resistance mechanism of NSCLC to EGFR-TKIs is a hot one because of their excellent effects on improving overall and progression-free survival. hTe aim of this article was to summarize the development of the resistance mechanisms.

Background and objective Small cell lung cancer (SCLC) is the most malignant neuroendocrine tu-mor and sensitive to chemotherapy and radiotherapy. However, most patients who receive ifrst-line chemotherapy will relapse within one to two years. Once recurrent, it indicates poor prognosis. Currently, the standard ifrst-line chemotherapy regimen of extensive-stage SCLC is platinum combined etoposide regimen while the standard second-line chemotherapy regimen is open to debate. hTe aim of this study is to analysis the prognostic factors of second-line chemotherapy in extensive-stage SCLC and to compare the differences of objective response rate, side effects and survival among different second-line chemotherapy regimens. Methods 181 patients who were diagnosed as extensive-stage SCLC and received second-line chemotherapy were collected.χ2 test was used to analysis the differences of enumeration data and between different groups. Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS). Univariate analysis and Cox regression analysis were used to detect the prognostic factors. Objective response rate was evaluated by RECIST criteria and side effects were evaluated by WHO criteria. Results hTe patients who received second-line chemotherapy can be divided into 6 groups, namly group A (CE/EP regimen) 27 cases, group B (regimens containing TPT) 44 cases, group C (regimens containing CPT-11) 33 cases, group D (regimens containing TAX/DXL) 20 cases, group E (regimens containing IFO) 28 cases and group F (other regimens) 29 cases. hTe median OS in second-line chemotherapy as 7.0 months and was relevant with smoking his-tory (P=0.004), ECOG PS (P<0.001), liver metastasis (P=0.019) and bone metastasis (P=0.028) independently. hTe median PFS in second-line chemotherapy as 3.0 months and was relevant with smoking history (P=0.034), ECOG PS (P=0.011) and bone metastasis (P=0.005). hTe response rate among six regimens was signiifcantly different (P=0.017);hTere was not statistical signiifcance between each group. As to side effects, the incidence of gastrointestinal reaction in group C was higher than any other group. hTe differences of OS and PFS between six regimens in second-line therapy were not statistically differ-ent (P=0.914, P=0.293). Conclusion hTe most signiifcant prognostic factor of extensive-stage small cell lung cancer patients who received second-line chemotherapy was ECOG PS. hTe most optimal second-line chemotherapy regimen with deifnite curatice effect was controversial.

Background and objective At present, surgery is advocated for stage IIIa non-small cell lung cancer (NSCLC), and the survival of them is determined by many factors. hTe aim of this study is to analyze the inlfuencing factors of prognosis for stage IIIa surgical patients. Methods Between March 2002 and October 2012, 151 surgical cases that have postoperative pathological ifnding of stage IIIa NSCLC with completed followed-up data were received in the Peking Union Medical College Hospital. According to different N stages, 151 patients were divided into T4N0/T3-4N1M0 and T1-3N2M0 stages. Kaplan-Meier survival method was used to calculate the overall survival (OS) and progression-free survival (PFS), and to proceed univariate analysis of survival. Cox regression analysis was used to conduct multivariate analysis. A p-value less than 0.05 was evaluated as statistically signiifcant. Results 151 stage IIIa NSCLC patients had 43 stage T4N0/T3-4N1M0 cases and 108 stage T1-3N2M0 cases. hTe median OS and PFS of the whole group were 38.9 and 12.9 months respectively. hTe median OS of stage T4N0/T3-4N1M0 and T1-3N2M0 were 48.7 and 38.9 months. hTe median PFS of them were 14.9 and 19.8 months respectively. hTere were no signiifcant differences of OS and PFS between two groups. Univariate and multivari-ate analysis indicated that postoperative chemotherapy had a signiifcant inlfuence on OS of the surgical patients with stage IIIa NSCLC (P=0.001), and family history of tumor had a signiifcant inlfuence on PFS (P<0.05). hTe maximum diameter of tumor had a signiifcant inlfuence on PFS only in univariate analysis. Conclusion For stage IIIa NSCLC, postoperative chemotherapy can increase OS and PFS, but postoperative radiotherapy have no beneift on them.

Background and objective Nowadays, comprehensive treatment, including surgery, chemotherapy and radiotherapy is advocated for stage III non-small cell lung cancer (NSCLC). However, many researchers have questioned the effectiveness of surgery. The aim of this study is to evaluate the effect of surgery for stage III NSCLC. Methods Between March 2002 and October 2012, 310 cases that have completed followed-up data with stage III NSCLC were received in the Peking Union Medical College Hospital. They were divided into surgical and non-surgical groups according to whether received surgery when diagnosed. In TNM staging, stage III NSCLC includes stage IIIa and IIIb, and stage IIIa NSCLC can be grouped into stage T4N0/T3-4N1M0 and T1-3N2M0 according to different N stages. Analyzed the enumeration data by Chi-Square test. Kaplan-Meier survival method was used to calculate the overall survival (OS) and progression-free survival (PFS), and to draw the survival curves. AP value less than 0.05 was evaluated as statistically significant. Results Three hundred and ten stage III NSCLC patients include surgical group 189 cases and non-surgical group 121 cases. One hundred and eighty-eight stage IIIa NSCLC patients include surgical group 152 cases and non-surgical group 36 cases. In stage IIIa, stage T4N0/T3-4N1M0 had 57 patients with 44 surgical and 13 non-surgical patients, and stage T1-3N2M0 had 131 patients with 108 surgical and 23 non-surgical patients. Thirty-seven out of 121 stage IIIb NSCLC patients received surgery. They had 22 stage T4N2M0 cases and 15 stage T1-4N3M0 cases. The patient whose performance status was 0 and staging was stage IIIa was more inclined to undergo surgery. For stage IIIa NSCLC patients, the median OS of surgical and non-surgical groups were 38.9 and 21.8 months, and the median PFS of them were 19.2 and 11.9 months respectively. The difference of OS between the two groups was significant (P=0.041), but the PFS of them had no significant difference (P=0.209). For stage T4N0/T3-4N1M0 which belongs to stage IIIa, the median OS of surgical and non-surgical groups were 48.7 and 20.1 months, and the median PFS of them were 14.6 and 10.5 months respectively. There were no significant differences of OS and PFS between the two groups (P>0.05). For stage T1-3N2M0 which also belongs to stage IIIa, the median OS of surgical and non-surgical groups were 38.9 and 30.8 months, and the median PFS of them were 19.8 and 12.7 months respectively. There were also no significant differences of OS and PFS between the two groups (P>0.05). The maximum diameter of tumor and auxillary chemotherapy had significant influences on OS and PFS of stage IIIa-N2 NSCLC patients, while the histology of tumor only influenced the OS of them (P<0.05). Conclusion The patient whose performance status is 0 and staging is stage IIIa is more inclined to undergo surgery. Surgery can prolong OS of patients with stage IIIa, especially for stage T4N0/T3-4N1M0. However, it has no benefit on PFS. The maximum diameter of tumor and auxillary chemotherapy have significant influences on OS and PFS of stage IIIa-N2 NSCLC patients, while the histology of tumor only influence the OS of them.

Background and objective Small cell lung cancer (SCLC) is the most malignant neuroendocrine tumor but highly sensitive to chemotherapy and radiotherapy. At present, the standard ifrst-line chemotherapy regimen of extensive-stage SCLC is platinum combined etoposide regimen. However, most patients who receive ifrst-line chemotherapy will relapse within one to two years. Once recurrent, it indicates poor prognosis. In this study, we analyzed the survival among all extensive-stage SCLC and patients who received ifrst-line chemotherapy and determined prognostic factors. Methods Total of 394 patients who were diagnosed as extensive-stage small cell lung cancer from February 2001to December 2011hospitalized in Peking Union Medical College Hospital were collected. Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS). Univariate analysis and Cox regression analysis were used to detect the inlfuence factors of survival. Results hTe median OS of all extensive-stage small cell lung cancer was14.8 months;1-year, 2-year and 5-year survival rates were 58.9%, 27.2%and 7.8%, respectively. According to the results of univariate and Cox multivariate analysis, OS of extensive-stage SCLC was closely associated with age (P=0.006), ECOG PS (P=0.021), liver metastasis (P<0.001), bone metastasis (P<0.001) and chemotherapy (P<0.001). hTe mortality risk of patients who didn’t receive chemotherapy was 4.919 times higher than that who received;the mortality risk of patients without liver, bone metastasis was reduced by approximately 50 percent. hTe ifrst-line chemotherapy was mainly EP (DDP+VP-16) or CE (CBP+VP-16) regimens (accounting for 82.8%) with 4-6 cycles. hTe median OS and PFS in ifrst-line chemotherapy were15.1months and 7.5 months, respectively. hTe result of Cox regression analysis indicated that OS in ifrst-line chemotherapy was remarkably related to smoking history (P=0.041), liver metastasis (P<0.001), bone metastasis (P<0.001), chemotherapy cycle number (P<0.001);PFS was relevant with smoking history (P=0.003), liver metastasis (P=0.001), bone metastasis (P<0.001), chemotherapy cycle number (P<0.001). hToracic radiotherapy was not an independent inlfuence factor of OS and PFS in extensive-stage small cell lung cancer. Con-clusion hTe patients who were younger than 60-year old, with good KPS, absence of liver and bone metastasis had better prognosis. Patients should receive chemotherapy with ifrst-line standard regimen (CE/EP regimen). It was beneifcial to sur-vival if the effect of ifrst-line chemotherapy was SD or PR-CR and the proper chemotherapy cycle number was 4-6 cycles. hTe role of thoracic radiotherapy in extensive-stage small cell lung cancer needed to be investigated further.

Objective To investigate the relationship between single nucleotide polymorphism(SNP)of the peroxisome proliferator activated receptor γ (PPARγ) gene Rs1801282 and brick-tea type fluorosis. Methods From 2012 to 2013, this cross-sectional study was performed in 16 endemic fluorosis areas of brick-tea type in Inner Mongolia Autonomous Region,Qinghai and Xinjiang Uygur Autonomous Region of China,to select adults>18 years old as subjects, who were diagnosed as skeletal fluorosis by X-ray. All of the subjects filled in demography survey questionnaire; the survey contents included general characteristic s, and average daily brick tea intake. Drinking tea samples and urine samples of each subject were collected, and fluoride content of urine and brick-tea was determined via the ion selective electrode method (WS/T 89-2006). X-ray scintigraphy was used to diagnose skeletal fluorosis, according to the "Diagnostic Criteria of Endemic Skeletal Fluorosis" (WS/T 192-2007); the subjects were divided into skeletal fluorosis group (case group) and non-skeletal fluorosis group (control group). To collect venous blood 5 ml, whole blood DNA was extracted, and polymorphism at Rs1801282 of PPARγ was detected by MassARRAY time-of-flight mass spectrometry, to calculate odds ratio (OR) and 95% confidence interval (CI). Results There were 1 414 people included in this study,including 347 in case group and 1 067 in control group. By the Hardy-Weinberg balance test, the PPARγ gene Rs1801282 genotype was representative in case group, control group and each nationality (P > 0.05). The difference of PPARγ gene Rs1801282 genotype in case group and control group was not statistically significant (OR was 0.991, 95%CI: 0.704 - 1.395, the adjusted OR was 1.026, 95%CI: 0.707-1.489).The difference of PPARγ gene Rs1801282 genotype(CC,CG+GG)in case group and control group in different nationality was not statistically significant (Tibetan: OR was 1.400, 95%CI: 0.576 - 3.404, the adjusted OR was 1.258, 95%CI: 0.474 - 3.340; Kazak: OR was 0.898, 95%CI:0.516 -1.562,the adjusted OR was 0.936,95%CI:0.532 -1.648;Mongolia: OR was 1.148,95%CI:0.508-2.594, the adjusted OR was 1.644, 95%CI: 0.683 - 3.956; Han: OR was 1.058, 95%CI: 0.451 - 2.482, the adjusted OR was 0.959, 95%CI: 0.388 - 2.371; Russian: OR was 0.000, 95%CI: 0.000 - 0.000, the adjusted OR was 0.000, 95% CI: 0.000 - 0.000) with binary Logistic regression analysis. Conclusion We have found no association between SNP of PPARγ gene Rs1801282 and skeletal fluorosis of brick-tea type fluorosis in China.