Objective To analyze the treatment and prognosis of lung cancer patients with brain metastases.Methods The clinical data of 352 lung cancer patients with brain metastases were retrospectively reviewed.According to the treatment modalities,patients were divided into palliative therapy group(n=28),simple whole brain radiotherapy(WBRT)or chemotherapy group(n=49)and comprehensive treatment group(n=275).Comprehensive treatment group was subdivided into WBRT plus chemotherapy group(n=192),stereotactic radiosurgery(?knife)plus chemotherapy/WBRT group(n=72,n=16 for?knife plus chemotherapy and n=56 for?knife plus WBRT and chemotherapy)and neurosurgical resection plus chemotherapy/WBRT group(n=11).In comprehensive treatment group,111 patients received chemotherapy≤3 cycles,and the other 164≥4 cycles.Survival curves of each group were drawn respectively,and both survival time and survival rates were compared among groups.Results The median survival time of palliative therapy group,simple WBRT or chemotherapy group,WBRT plus chemotherapy group,?knife plus chemotherapy/WBRT group and neurosurgical resection plus chemotherapy/WBRT group was 1.7,3.2,9.0,11.6 and 17.1 months,respectively.It was revealed by survival analysis that WBRT plus chemotherapy group was better than simple WBRT or chemotherapy group (P=0.0000),?knife plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group(P=0.0000),and neurosurgical resection plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group and WBRT plus chemotherapy group(P=0.0001,P=0.0229).There was no significant difference in survival rates between neurosurgical resection plus chemotherapy/WBRT group and?knife plus chemotherapy/WBRT group(P=0.2543),and there was no significant difference in survival rates between those with?knife plus chemotherapy and those with?knife plus WBRT and chemotherapy(P=0.3804).In comprehensive treatment group,the survival rates of those with chemotherapy≥4 cycles was significantly higher than that of those with chemotherapy≤3 cycles(P=0.0000). Conclusion Both WBRT plus chemotherapy and?knife plus chemotherapy and WBRT are effective modalities for the treatment of lung cancer patients with brain metastases,and the latter has the tendency to gain more survival benefit.There is no significant difference in the survival time between patients receiving?knife with WBRT and those without.It is proper for the patients to have no less than 4 cycles of chemotherapy.

OBJECTIVE:To provide reference for continuous improvement of drug counseling and pharmaceutical care. METH-ODS:220 cases of drug counseling answered by inpatient general pharmacist were collected from our hospital during 2012-2013, and the contents of drug counseling were classified and analyzed. RESULTS:Among consultants,73.18% of them were physi-cians;the type of drug involved mainly were antibiotics,accounting for 42.73%;main contents of drug counseling included drug selection,usage and dosage,accounting for 47.27%. CONCLUSIONS:Pharmacists provide drug counseling for physicians and nurses,answer various questions about usage,and guide rational drug use so as to enhance the communication between pharma-cists and physicians,nurses,and promote rational drug use in the clinic.

Objective To explore the feasibility of dual-source CT virtual scan replace conventional scan in the CT peritoneography. Methods Prospective enrolled 29 cases who accepted peritoneal dialysis (PD) treatment and were highly suspected with PD-related complications. The patients were firstly underwent CT conventional in the fasting state by applied the dual-source CT (single energy pattern), and then 2 L dialysate which mixed with contrast medium was infused into peritoneal cavity, and the CT scan was performed again after 30 min (dual-energy pattern). Scaning data were processed by virtual post-processing software to obtain virtual CT scan imaging. Subjective evaluation (including lesions and image quality score) and objective evaluation (including the CT value, noise and signal to noise ratio) were performed on the conventional scan and virtual scan, and recorded the radiation dose. Wilcoxon test was used to analyse the differences of lesions revealing and image quality score of conventional scan imaging and virtual scan imaging, and paired t test was applied to compare the differences of radiation dose and the other quality objective evaluation index. Results There was no significant difference between conventional CT scan and virtual CT scan in the cyst, calcification, calculus, hematoma and catheterization (P>0.05). The image quality score of conventional CT scan and virtual CT scan was 5.0±0.0 and 4.9±0.4, and there was no significant difference (Z=-1.6,P=0.10). There was no statistically significant difference in CT value of muscle, kidney, subcutaneous fat, urine in bladder and intraperitoneal fluid between the two groups (P>0.05), and the CT value of liver in the virtual CT scan was higher than that in the conventional CT scan (P<0.05), but the value of bone in the virtual CT scan was lower than that in the conventional CT (P<0.05). The noise of conventional CT was significant higher than that of invirtual CT, but the SNR was significant lower than virtual CT scan (P<0.05). The effective radiation dose in the conventional CT scan and virtual CT scan were(9.6±1.4)and(15.9±4.9)mSv, and showed significant difference. Furthermore, the effective radiation dose decreased by 39.6%(6.3/15.9). Conclusion Dual-energy CT scan can replace conventional CT scan in the CT peritoneography, which can guarantee the accuracy of diagnosis and reduce radiation dose.

Objective To evaluate the efficacy and safety of disodium cantharidinate injection combined with transcatheter arterial chemoembolization(TACE) compared with TCAE alone in the treatment of hepatocellular carcinoma(HCC) by meta-analysis.Methods Databases of Pubmed, CNKI,Wangfang and VIP were searched electronically, and the randomized controlled trials about disodium cantharidinate injection combined with TACE in the treatment of HCC were included.Meta-analyses were conducted after the quality of the included studies was assessed.Results Seven eligible studies that included a total of 562 HCC patients were identified in the present meta-analysis.The combined results showed that disodium cantharidinate injection combined with TACE in the treatment of HCC, compared with TACE alone, could increase effective rate ( RR =1.31, 95%CI 1.10-1.56) and clinical benefit rate (RR =1.20, 95%CI 1.04 -1.39), improve the life quality (RR =1.60, 95%CI 1.26 -2.03) and improved the 1, 2 year survival (RR =1.57 with 95%CI 1.28 -1.93 and RR =2.08 with 95%CI 1.46 -2.97, respectively).Conclusion Meta-analysis indicates that the efficacy of disodium cantharidinate injection combined with TACE is superior to TACE alone for the patients with HCC.

Objective To eraluate the methods and results of endoscopic mucosal resections for colonic laterally spreading tumors with early malignant degeneration. Methods The pit pattern was studied with magnitying colonoscopy and mucosal staining technique for colonic laterally spreading tumors (LST) undergoing early earcinatous degeneration. They were removed with endoscopic mucosal resection techniques. A follow-up study was made. Results Eight patients suffering from early carcinoma on top of colonic laterally spreading tumors were followed-up. ① 75% of the lesions were situated in the rectum, sigmoid colon and decending colon. ② 75% of the lesions were larger than 30mm in diameter. ③ 75% of the lesions belonged to Ⅳpit pattern. ④ 62.5% of the lesions were Villous adenomas and 75% of the onalignant change involved the mucosa only. ⑤ All the lesions were completely removed by EMR, ⑥ No local residual lesion, recurrence or metastasis was discovered in all the patients after a mean follow-up period of 20.7 months. Conclusions Most of the early carcinomas originated from colonic LST involved the mucosa only. Endoscopic mucosal resection may be a curative method for the early cancer arising from colonic LST.

OBJECTIVE: To provide reference for the management of central pharmacy in our hospital. METHODS: In daily work, performance score of a job was related with quality evaluation using grouping work model and management method of allocating a specific responsibility to a specific person. RESULT & CONCLUSION: The work process of central pharmacy is clear and plays a great role in economizing on resources relatively.

Objective: To develop the native Chinese Affective Picture System (CAPS) for future research on emotion. Methods: 852 pictures were screened out to make up of CAPS. 46 Chinese university students were collected to rate the valence, arousal and dominance by self-report in a 9-point rating scale for CAPS. Results: The standard deviations of scores on valence and dominance were greater than that on arousal. Scatter plot showed that the score distribution on the dimension of valence and arousal was wide in CAPS. Conclusion: Though IAPS (International Affective Picture System) is highly internationally-accessible, there are still significant differences between the two sources. The native Chinese Affective Picture System is necessary.

Objective To evaluate the effects of dexmedetomidine used to supplement analgesia with sufentanil on the stress response and inflammatory response after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-four patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into sufentanil analgesia group (group S,n =20) and dexmedetomidine supplementing sufentanil analgesia group (group DS,n=24) using a random number table.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated.Combined intravenous-inhalational anesthesia was used to maintain anesthesia.Dexmedetomidine was infused at 0.3 μg · kg-1 · h-1 from closure of the chest to the end of surgery in group DS,while the equal volume of normal saline was given instead in group S.The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline in group S,or sufentanil 2 μg/kg plus dexmedetomidine 3 μg/kg in 100 ml of normal saline in group DS.The PCIA pump was set up with a 0.5 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 1.5 ml/h.Visual analogue scale score was maintained ≤ 3.When visual analogue scale score ≥ 4,morphine 0.1 mg/kg was injected intravenously.The occurrence of analgesics-related respiratory depression,bradycardia and hypotension was recorded.At the end of surgery (T0),and 12,24,48 and 72 h after surgery (T1-4),blood samples were collected from the central vein for determination of serum cortisol,β-endorphin,C-reactive protein,interleukin-2 (IL-2),and IL-6 concentrations by enzyme-linked immunosorbent assay.Results No analgesics-related adverse events were detected in the two groups.Compared with group S,the requirement for morphine was significantly decreased,the serum cortisol concentration was decreased at T2-4 and the serum β-endorphin,C-reactive protein concentrations were decreased at T1-4,the serum IL-2 concentrations were increased at T1-4,and the serum IL-6 concentrations were increased at T3 in group DS (P＜0.05).Conclusion Dexmedetomidine used to supplement analgesia with sufentanil can alleviate the stress response and inflammatory response after cardiac valve replacement with CPB.

Objective To investigate the clinical value of combined test of prealbumin (PA),total bile acid(TBA)and liver bi-opsy in chronic hepatitis.Methods 172 patients hospitalized with chronic hepatitis in the Affiliated Hospital of Yan’an Uni-versity Medical College from October,2013 to March,2014 was collected as the chronic hepatitis group;and 45 cases of nor-mal healthy control of the corresponding period was collected as the control group.Prealbumin,TBA was detected respec-tively in the two groups.Immunoturbidimetry was adopted in PA,Enzymatic cycling assay was employed in TBA,and at the same time percutaneous puncture of liver histology was detected in the chronic hepatitis group.Results The PA in the chro-nic hepatitis group (179.12±8.46 mg/L)was lower than the control group (257.34±6.38 mg/L),and the difference was statistically significant (P <0.05).The TBA in the chronic hepatitis group (30.58±9.37 μmol/L)was higher than the con-trol group (8.16±1.59 μmol/L)and also the difference was statistically significant (P <0.05).PA was negatively correla-ted with the pathological grades (rs =-0.617,P <0.05),and TBA was positively correlated with pathological grades (rs =0.724,P <0.05).The separate diagnostic positive rate of PA was 58.7% (101/172),while the TBA was 93.6% (161/172).The combined diagnostic positive rate of the two was 93.6% (161/172),it was higher than the separate rate and was statistically significant (P <0.05).Conclusion The serum levels of PA and TBA can reflect the extent and degree of hypo-hepatia and hepatic inflammation,and the combined detection of the two will be much sensitive to the diagnosis of chronic hepatitis,and compared with histological detection,it is convenient,simple,and easy to operate.

Objective To explore the value of apparent diffusion coefficient (ADC)in differentiating brain tuberculomas from me-tastases.Methods Conventional and enhanced MRI as well as diffusion weighted imaging (DWI)were performed in 24 cases of brain tuberculomas(immature in 18 cases and mature in 6 case)and 36 cases of metastases.The mean ADC values and relative ADC (rADC)values were calculated from the enhanced and non-enhanced regions of mass and the peripheral edema regions of brain le-sions.Results The mean ADC values and rADC values in the enhanced,non-enhanced and the peripheral edema regions were 796.90×10 -6 mm2/s and 1.1 6,864.85×10 -6 mm2/s and 1.27,1 531.60×10 -6 mm2/s and 2.24 for the immature brain tuberculo-mas;791.95×10 -6 mm2/s and 1.1 6,61 1.80×10 -6 mm2/s and 0.87,and 1 488.45×10 -6 mm2/s and 2.10 for the mature tubercu-lomas;421.95×10 -6 mm2/s and 0.61,961.00×10 -6 mm2/s and 1.36,1 545.00×10 -6 mm2/s and 2.18 for the brain metastases, respectively.There were significant differences in the mean ADC values (H =42.293,P ≤0.05)and rADC values (H =42.575, P ≤0.05)for the enhance regions in the three groups .There were also significant differences in the mean ADC values (H =33.100, P ≤0.05)and rADC values (H =1 7.867,P ≤0.05)for the non-enhance regions.No significant difference in the mean ADC values (H =1.550,P ≥0.05)and rADC values (H =5.511,P ≥0.05)were found for the peripheral edema regions.Conclusion The ADC values of DWI can help to differentiate brain tuberculomas from metastases,when combining with the conventional and enhanced MRI.