Objective To investigate the short-term efficacy and safety of gefitinib combined with dendritic cells-cytokine induced killer (DC-CIK) cells in the treatment of advanced lung adenocarcinoma.Methods Fifty patients with lung adenocarcinoma who in previous had underwent radiotherapy and first-line chemotherapy failure received DC-CIK in combination with gefitinib treatment,blood count changes,imaging data,carcinoembryonic antigen and changes in the quality of life before and after treatment were compared and evaluated.Results DC-CIK could improve effectively and relieve bone marrow suppression response after chemotherapy and significantly increase the WBC content of blood (P ＜ 0.01).After treatment,the tumor carcinoembryonic antigen (CEA) was significantly lower in patients (P ＜ 0.01).Fifty cases of patients in complete remission (CR) were 0 cases,partial remission (PR) were 24 cases,stable disease (SD) were 17 cases and progression (PD) were 9 cases,and the response rates (RR) were 48％;The quality of life of patients was significantly improved (P ＜ 0.05).Common adverse reactions were rash,diarrhea,chill and fever,but mild symptoms could be relieved after symptomatic treatment.Conclusions Gefitinib with autologous DC-CIK cell infusion second-line treatment of advanced lung cancer have a certain short-term efficacy,without significant adverse reactions.Gefitinib with autologous DC-CIK cell therapy can mitigate the response of bone marrow suppression in patients with advanced lung cancer and improve the quality of life of patients.Long-term effect remains to be investigated.

BACKGROUND: The pathological characteristics of pulmonary interstitial fibrosis are the proliferation of a large number of fibroblasts and the increasing deposition of matrix collagen that takes the place of normal lung structure. Fluvastatin can inhibit the proliferation of fibroblasts and many other cells.OBJECTIVE: To investigate the effects of fluvastatin in inhibiting the proliferation of rat lung fibroblasts cultured in vitro and its influence on bleomycin-induced pulmonary fibrosis and ventilation function.DESIGN: A randomized controlled trial.SETTING: Department of Respiratory Diseases, Xijing Hospital, Fourth Military Medical University of Chinese PLA; Teaching and Research Section of Pathology, Department of Basic Medicine, Fourth Military Medical University of Chinese PLA; Research Institute ofOrthopedics, Xijing Hospital,Fourth Military Medical University of Chinese PLA.PARTICIPANTS: The study was conducted in the laboratory of Department of Respiratory Diseases, Xijing Hospital of Fourth Military Medical University of Chinese PLA from January to December 2001. Thirty-one healthy adult male Sprague-Dawley(SD) rats of grade Ⅰ were selected in this study.INTERVENTIONS: The fibroblasts derived from the lung normal of one rat were cultured in vitro in media containing fluvastatin. The effect of fluvastatin on the growth curve and the effect of its different concentrations(0, 1 × 10-7,1 ×10-6, 1 ×10-5, 1 ×10-4, 1 ×10 3and 1 ×10-2 mol/L, fluvastatin of 0 mol/L was taken as the blank control group) in inhibiting the cultured cells were observed with MTT colorimetry. The effect of fluvastatin on the division index of the fibroblasts was analyzed by direct cell counting Hydroxyproline colorimetry was used to detect the influence of fluvastatin on the collagen secretion in the media. The other 30 SD rats were divided into six groups: normal control group, bleomycin-induced group and fluvastatin-treated groups(TH 1,TE1, TH15 and TL15 groups) named according to the date of giving fluvastatin,i. e. the 1st day and the 15th day, after the rats were given bleomycin A5. All the rats were killed 28 days later. The number of fibroblasts, the thickness of alveolar wall and the area of mesenchyma in lung tissue were measured by HE staining. The extracellular matrix and collagen in lung tissue were observed by Masson and sirius red staining, and hydroxyproline in lung tissue homogenates was measured.MAIN OUTCOME MEASURES: Fibroblast growth curve and division index of rat lung, hydroxyproline in the media and lung tissue homogenates,number of fibroblasts and the thickness of alveolar wall, the area of mesenchyma, extracellular matrix and collagen contents in lung tissue.RESULTS: Fluvastatin could inhibit the proliferation of the rat lung fibroblasts cultured in vitro(t=4.20 to 17.52, P < 0.01), and its inhibitory effect was increased with the increased dose of fluvastatin, which showed a dose-dependent effect. The 1 × 10-4 mol/L fluvastatin could completely inhibit the proliferation of the cultured cells, and the A490 value from the 2nd day on the fibroblasts by MTT colorimetry was not insignificantly different from those on the 1st day( P > 0.05) . The division index of the fibroblasts and secretion of collagen were obviously decreased by fluvastatin( t = 8. 037,P <0.01; t =3.99 to 10. 84, P <0.05 or P <0.01). In vivo, the number of fibroblasts, the thickness of lung alveolar wall, the area of mesenchyma and the content of hydroxyproline in lung tissue were significantly higher in bleomycin group than in control group( t =4. 62 to 11.93, P < 0. 01), while those in the fluvastatin-treated groups were lower than those in bleomycin group in different degrees( t = 2.69 to 7.65, P < 0.05 to 0.01 ) . The distribution of extracellular matrix and types Ⅰ and Ⅲ collagen in lung tissue were obviously increased in bleomycin group as compared with that in control group, but decreased in different degrees in fluvastatin-treated groups.CONCLUSION: Fluvastatin can significantly inhibit the proliferation of rat lung fibroblasts in vitro, suggesting that it may be an effective drug for pulmonary fibrosis. Treatment at earlier stage is more effective than at advanced stage.

Objective To study the application value of preoperative medical adhesive locating in performing thoracoscopy for small pulmonary nodules (SPN).Methods The clinical data of 41 patients with solitary SPN,who received thoracoscopy with the help of preoperative locating procedure,were retrospective analyzed.The preoperative locating methods included medical adhesive locating (n=22,medical adhesive group) and Hook-wire locating (n=19,Hook-wire group).The locating effects,complications,the time of engagement stage and the time used for pulmonary wedge resection were determined,and the results were compared between the two groups.Results The locating of SPN was successfully accomplished in all patients of both groups.The incidences of pneumothorax,pulmonary hemorrhage and chest pain in the medical adhesive group were 18.2％,9.1％ and 4.5％ respectively,which were lower than those in the Hook-wire group;among them the difference in the incidence of pulmonary hemorrhage between the two groups was statistically significant (P＜0.01).No-complication rate in the medical adhesive group (63.6％) was higher than that in the Hook-wire group (21.1％),and the difference was statistically significant (P＜0.05).The time of engagement stage for patients in the medical adhesive group was (16.32±8.83) hours,which was longer than (3.29±4.21) hours in the Hook-wire group,the difference between the two groups was statistically significant (P＜0.01).The time used for puhnonary wedge resection in the medical adhesive group and in the Hook-wire group was (21.14±7.01) min and (18.58±5.22) min respectively,the difference between the two groups was not statistically significant (P＞0.05).Conclusion Preoperative medical adhesive locating for the performance of thoracoscopy for SPN is safe and effective,it carries less complications when compared with Hook-wirelocating method and can obtain a longer interwal period,therefore,this technique has high application valuein clinical practice.

Objective To establish an effective and stable rat model of skin-infection for evaluating the therapeutic effects of topical anti-infection drugs.Methods SD rats were subcutaneously injected with cyclophosphamide to induce immunosuppression,and then surgical incisions were made on both sides of the spine.The rat model of skin-infection was established by applying methicillin-resistant Staphylococcus aureas suspension to the incisions for two consecutive days,and evaluated by analyzing infection status,pathological changes and healing time.Results The development of pyogenic infection was detected in all of the rats.Compared with the non-cyclophosphamide treated group,the cyclophosphamide treated group showed a more severe infection both from the visual inspection and the microscopic observation,moreover,its healing time was delayed more than 10 days.Conclusion The skin-infection model was successfully established in immunosuppressed rats induced by cyclophosphamide,which could be applicable to the efficacy evaluation of anti-infection drugs for external use on skin infection.

Objective To analys hyperinsulinemia in Bartter syndrome. Methods Twenty-three cases of Bartter syndrome [age (27 ±9) years;fasting serum potassium(2. 8 ±0. 5)mmol/L], 20 patients of aldosterone-producing adenoma [APA, age (45 ± 11 ) years, fasting serum potassium ( 3.0 ± 0. 4 ) mmol/L], 20 patients of idiopathic hyperaldosteronism [IHA, age (51 ± 11 ) years, fasting serum potassium (3.4 ±0. 2)mmol/L] were diagnosed in Peking Union Medical College Hospital from September 2003 to May 2008. All patients underwent 3-hours oral glucose tolerance test(3hOGTT), postural stimulation test and calculated HOMA-insulin resistance ( HOMA-IR ) and HOMA-insulin sensitivity ( HOMA-IS ) by Homeostasis model.Results The insulin area under curve-(229.0±162.4)mIU·L-1·h] was singnificantly higher than APA group [(227.7±158.6)mIU·-1·h].But HOMA-IR in Bartter group were similar to APA group( 1.96 ± 1.14 vs 1.41 ± 0. 91 ), and HOMA-IR in APA group was lower than IHA group ( 1.96 ± 1.14 vs 2.40 ± 1.60, P ＜ 0. 05 ). There was no deference in HOMA-IS among three groups,but APA group had lower level. In all three groups, the peak of insulin secretion was delayed. Conclusion Bartter syndrome patients commonly present with hyperinsulinemia.

Objective To detect the expression of Beclin1 and Bcl2 in invasive pituitary adenomas and to explore the relationship of Beclin1 and Bci2 in invasive pituitary adenomas and the relativity between the 2 genes.Methods 61 specimens were classified into invasive group (32 cases) and non-invasive group (29 cases) according to the comprehensive evaluation of invasive pituitary adenomas.lmmunofluorescence analysis and RT-PCR were adopted respectively to detect the protein and mRNA expressions of Beclinl and Bcl2.The difference and relativity of Beclin1 and Bcl2 expression in invasive group and non-invasive group were analyzed.Results 32 specimens of pituitary adenoma were invasive and 29 were non-invasive.Beclin1 protein and mRNA expressions were lower in the invasive group than in the non-invasive group (P ＜0.01 ).Bcl2 protein and mRNA expressions were higher in the invasive group than in the non-invasive group (P ＜0.01 ).Pearson related analysis showed that Beclin1 mRNA expression was negtively correlated with Bcl2 mRNA expression in the invasive group ( r =-0.42,P =0.028 ).Conclusions Beclinl expression is decreased in invasive pituitary adenomas.The invasiveness of pituitary adenoma is closely related to the high expression of Bcl2 protein and mRNA,and the low expression of Beclin1 protein and mRNA.The inhibition of the autophagy may lead to the enhancement of the invasiveness of pituitary adenomas and that inhibition may come from the interaction of Beclin1 and Bcl2.

Objective To analysis the relationship of primary aldosteronism to insulin resistance and abnormal glucose metabolism in patients with primary aldosteronism.Methods One hundred and three patients were diagnosed as aldosterone-producing adenoma(APA),75 cases as idiopathic hyperaldosterenism(IHA),56 patients as metabolic syndrome(MS)in Peking Union Medical College Hospital from September 2003 to December 2005.All patients were accepted 3 h oral glucose tolerance test and calculated HOMA-insulin resistance index (HOMA-IR)by Homeostasis Model.Results The Insulin area under curve[INS_(AUC) 270.8(192.7,370.4)mU?L~(-1)?h~(-1)]、HOMA-IR[3.2(2.4,4.7)]and prevalence of insulin resistance(64.3%)were significantly higher in patients with MS as compared with APA[113.2(81.5,193.6)mU?L~(-1)?h~(-1),1.4(1.0,2.2),16.5%]and IHA[186.9(116.6,243.3)mU?L~(-1)?h~(-1),2.0(1.4,3.1),32.0%]groups (all P＜0.01);The INS_(AUC), HOMA-IR and prevalence of insulin resistance were significantly higher in patients with IHA than those with APA (P＜0.05 or P＜0.01).There was no difference between the prevalence of impaired glucose regulation(41.7%, 34.7%),diabetes mellitus(15.5%,16.0%)in patients with APA,IHA and those with MS(41.1%, 26.8%).Conclusion Insulin resistance is present in primary aldosteronism patients,and the prevalence of insulin resistance is higher in patients with IHA.

Background The hearing of Chinese young adults is far less sensitive than 0 dB defined by international standards, with the threshold values mostly being at double digits, which is worthy of investigation. Objective To study the influencing factors of hearing threshold measurement. Methods The hearing measurements were conducted in two different ways, one was a standard method performed in a specialized audiometry experiment room, and the other one was an on-site audiometry test which included a daily examination of hearing and an onsite hearing test. From the workers who participated in the occupational health examination, 300 people were randomly selected as experimental subjects, and their hearing was measured in the hearing examination room of the Occupational Disease Prevention and Treatment Institute according to standard methods. A total of 9 766 workers from the General Motors factory were included in the daily group, and their hearing thresholds were measured in the hearing examination room in the factory. There were 4 617 people in the onsite group, and their hearing was measured in the test chamber of our mobile medical vehicle in their factories. The hearing threshold data of the three groups, i.e. experiment, daily examination and on-site, was compared and analyzed. In addition, the environmental noise in the hearing examination room and the mobile test chamber was measured. Results The hearing threshold value of the experimental group was the lowest. Despite this, its dB value remained at double digits at any frequency band. The hearing value of the daily group was in the middle. The onsite group had the highest hearing threshold, which was 58.2% higher than that of the experimental group. As the hearing data was not normally distributed, Kruskal-Wallis non-parametric test was conducted for statistical analysis. It was found that the hearing threshold difference among the three groups was statistically significant at all the frequency band (P< 0.01). The ambient noise level was 23.9-28.3 dB(A) in the hearing examination room, and 32.5 - 67.9 dB (A) in the mobile test chamber. Age and gender were not confounding factors to the results. Conclusion The hearing test method and its environmental noise were able to make the threshold measurements shift up significantly. The environmental noise of the mobile test chamber in the examination vehicle has exceeded the standard and needs to be improved.