Background and purpose:The majority of patients with gastric cancer are in advanced stage with either extensive invasion of tumor into the adjacent organs,lymph nodes or distant metastases when diagnosed.As a new anticancer drug of Taxanes,docetaxel has shown considerable promise in advanced gastric cancer through clinical study in these years.We conducted a clinical trial to compare the response and toxic reaction of weekly and 3-weeks'docetaxel /cisplatin/5-Fu treatment in advanced gastric cancer.Methods:80 patients were deviede into two groups.Ggroup A:Docetaxel 25 mg/m2 iv d 1,8,15,cisplatin 25 mg/m2 iv d 1-3,5-FU 500 mg/m2 iv d 1-5 q4w.Group B:Docetaxel 75 mg/m2 iv d 1,cisplatin 25 mg/m2 iv d 1-3,5-FU 500 mg/m2 iv d 1-5 q3w;The clinical responses were assessed after two cycles.Toxicity was assessed every cycle.Results:There was 1 CR in 40 cases,16 with PR,14 with SD in group A;there was 1 CR in 40 cases,17 with PR,14 with SD in group B.The overall response rates were 42.4% and 45.0% in group A and B,respectively.Grade Ⅲ/Ⅳ neatropenia were 32.5% and 77.5% in group A and B.The major non-hematologic toxicity was weakness.Grade Ⅲ/Ⅳ weakness were 22.5% and 42.5% in group A and B.Conclusions:The response rates were similar between groups A and B.The occurrence of hematological toxicity and weakness were lower in weekly treatment group.

Objective To explore the effect of non-operative management in the treatment of external pancreatic fistula(EPF). Methods 18 cases of EPF underwent non-operative treatment were analyzed retrospectively . The causes of EPF, the criteria of case selection were summarized respectively. the non- operative treatments methods and the change of drainage volume after the treatment were analyzed.Results After the non-operative treatment,the drainage volume reduced gradually,and all the 18 cases were curred in 1 to 8 (averaged 5.5) months.No recurrence happened after the drainage withdrawn.There were no other severe complications except 4 pancreatic pseudocysts formation. Conclusions Non-operative treatment plays an important role in the treatment of EPF.It could reduce patients' sufferings.The choice of the method should be according to patients' condition.

Objective To investigate the related risk factors referred to hematoma enlargement in acute stage of spontaneous cerebral hemorrhage.Methods 104 stroke patients were divided into the observation group(hematoma enlarged group) and control group (without hematoma enlarged group).The course of disease,mean arterial pressure,the bleeding amount of the first time,hematoma shape and mortality were compared between the two groups,and the risk factors of hematoma enlargement of cerebral hemorrhage patients were analyzed.Results (1) The course of disease,mean arterial pressure,hematoma shape and the bleeding amount were significantly different between the two groups(t =9.5431,11.4499,6.1847,10.7233,all P ＜ 0.05).(2) The multivariate logistic regression analysis showed that factors of influence on hematoma enlargement were mean arterial blood pressure,the course of disease and hematoma shape.(3)The mortality of the observation group was 36.53 ％,which was significantly higher than that of the control group (19.23 ％) (χ2 =3.8731,P ＜ 0.05).Conclusion High level of mean arterial blood pressure,short time of interval to onset,irregular shape of hematoma and frequent vomiting are main risk factors of hematoma enlargement in patients with intracerebral hemorrhage at acute stage.

Objective To study the anesthetic effect and influence to circulatory and respiratory function of target controlled infusion(TCI)and intravenous injection of propofol anesthesia in elderly patients undergoing colonoscopy.Method 50 patients above 55 years of age undergoing colonoscopy were randomly allocated to 2 groups.The TCI group received target controlled infusion of propofol with a target concentration of 3?g/ml.The injection group received intravenous injection of 2mg/kg propofol with addition of 20-50mg propofol for each time at intervals during anesthesia when necessary.BP,HR,SpO2,and limb motion were detected during colonoscopy operation,and the time of eye-open and word-response after colonoscopy were also recorded.Results No significant difference was found in colonoscopy time and limb motion response between the two groups.Patients in TCI group consumed more propofol and opening of eyes was delayed compared to those patients in the injection group(P

4cm) or involved the urethra、 vagina、 clitoris or anus. Pathologic grouping was 25 squamous carcinomas 3 adenocarcinomas and 2 undifferentiated carcinomas. Radiotherapy was given by angled radiation with wedge block. Dose was 65 to 70 Gy/6-7W. RESULTS Thirty patients completed their inductive chemotherapy within 30 days for 86 courses. The response rate was 86. 7% (26/30). CR was 30. 16%. 18 of 30 patients were followed-up for over 5 years. Five years survival rate was 72.2 (13/18). Major acute complications were vuvitis (23%). Late adverse effects were 1 patient with ure-throstenotic uroschesis, 1 patient with pathologic transcervical fracture. None of patients had radiation rectitis and cystitis. CONCLUSION Inductive chemotherapy consisting of modified VBP regimen was active in reducing the vulvar tumor volume. Radiotherapy used angled radiation with wedged block to treat advance vulvar cancer was fa-ciliated. Chemoradiotherapy was found to be an effective treatment for locally advanced vulvar carcinoma, with acceptable morbidity even in an elderly population. The technique allowed maintenance of normal anatomical and physiologic function that would have been compromised by primary surgical approach. It yielded survival rates comparable to those achieved with ultraradical surgery in younger patients. Life quality was improved significant-ly.

OBJECTIVE:To evaluate the current situation and trend of narcotic analgesics used in our hospital.METHO-DS:The data of narcotics used in our hospital during 2003～2006 were analyzed statistically.RESULTS:Narcotic analgesic used in our hospital during 2003～2006 showed an upward trend year-on-year in both consumption quantity and consumption sum,much as in the consumption of morphine preparation.Consumption of Pethidine was decreasing year on year.However,the consumption of fentanyl injection had been ranking at the first place.CONCLUSION:The use of narcotic analgesics tended to be rational in variety,dosage form and route of administration.

OBJECTIVE To observe the clinical efficacy of cefminox for the treatment of bacterial liver abscess. METHODS Totally 118 patients with bacterial liver abscess were treated with cefminox 2 g iv drip 12 h or 8 h for(5-10 d),then with cefminox 1 g in drip 12 h for 21-35 d. RESULTS The total cure rate was 89.4%,the overall efficacy rate was 97.6%,and side effect rate was 2.4%. CONCLUSIONS Cefminox is an effective antibiotic in treating bacterial liver abscess.

Objective:To explore the correlation betWeen deceleration capacity of heart rate (DC)and heart rate var-iability (HRV)in patients With essential hypertension (EH)complicated coronary heart disease (CHD).Methods:DC and HRV Were monitored in 81 patients With EH + CHD (EH + CHD group)and 80 healthy volunteers (healthy control group)respectively.Results:Compared With healthy control group,there Were significant decrease in DC [(11.99±4.93)ms vs.(6.62±1.83)ms],standard deviation of normal to normal RR intervals calculated o-ver the 24 h period [SDNN,(129.94±15.22)ms vs.(63.66±12.13)ms],root-mean square of differences be-tWeen successive normal to normal intervals [rMSSD,(55.52±9.03)ms vs.(28.25±8.81)ms]and adjacent nor-mal RR interval difference > 50ms stroke accounted for a percentage of 24h total RR interval [PNN50,(13.99± 5.63)% vs.(7.29±1.11)%]of HRV in EH + CHD group,P <0.05 all;Pearson correlation analysis indicated that DC Was positively correlatedWith SDNN,rMSSD and PNN50 in EH+CHD patients (r =0.571,0.662,0.763, P <0.05 all).Conclusion:There is positive correlation betWeen deceleration capacity of heart rate and heart rate variability in patients With hypertension complicated coronary heart disease,Which can be jointly used as evidence for diagnosis and treatment.

Objective To investigate the influence of discontinuance of methimazole (MMI) and propylthiouracil (PTU) on 24 h radioactive iodine uptake(RAIU) in normal rats.Methods A total of 66 female SD rats were randomly divided into 3 groups by simple random sampling method.MMI group (30 rats) received MMI with a dose of 0.6 mg·ml-1·d-1 orally for 2 weeks, PTU group (30 rats) received PTU with a dose of 6 mg·ml-1·d-1 orally for 2 weeks.At 1, 3, 5, 7 and 9 d after MMI or PTU was discontinued, 6 rats were sacrificed to measure 24 h RAIU respectively.The control group (6 rats) received normal saline with a dose of 1 ml/d orally for 2 weeks, and then they were sacrificed to measure 24 h RAIU too.Data were analyzed with two-sample t test or t′ test.Results Thyroid 24 h RAIU in normal rats was (14.6±4.3)%.The 24 h RAIU on 1, 3, 5, 7 and 9 d was (4.6±0.7)%, (24.2±7.2)%, (13.1±2.9)%, (14.1±2.6)%, (16.1±3.7)% respectively after MMI withdrawal.The 24 h RAIU was significantly lower than that in control group at day 1 (t′=5.55, P<0.01), higher at day 3 (t=-2.83, P<0.05), and returned to the normal level at day 5, 7, 9 (t=0.68, 0.24,-0.67, all P>0.05).The 24 h RAIU on 1, 3, 5, 7 and 9 d was (1.9±0.8)%, (3.3±1.2)%, (7.7±2.4)%, (29.0±4.0)%, (17.1±4.8)% respectively after PTU withdrawal.It was lower than that in control group (t=7.01, 6.10, 3.40, all P<0.05) at day 1, 3, 5, and higher at day 7 (t=-5.97, P<0.01).The 24 h RAIU of 9 d showed no difference when compared with that in control group (t=-0.95, P>0.05).Conclusions MMI and PTU can inhibit the iodine uptake of thyroid, the 24 h RAIU returns to normal level at day 5 after withdrawal of MMI and at day 9 after withdrawal of PTU in euthyroid rats.

Objective To evaluate the feasibility of transfection of Sonic hedgehog gene (SHH)into bone marrow mesenchymal stem cells(BMMSC).Methods After the SHH gene was transfected into BMMSC by electroporation apparatus,the transfection rate was evaluated by fluorescence inverted microscope.The growth curves of untransfected and transfected BMMSC were drawn,respectively,to observe the influence of transfection on cells.The expression of SHH gene in the BMMSC was detected by PCR,RT-PCR,Western-blot analyses.Results Through fluorescence inverted microscope,the observed transfection rate was appropriately 30％,PCR showed a obvious increase of SHH expression in transfected cells than that in untransfected cells,and it is quantified by qPCR for appropriately 7 times.Western-blot further demonstrated that the SHH protein expression in transfected cells had a distinct increase.However,it was observed that the exponential phase of BMMSCSHH growth curve delayed.The growth curves of both overlap 12 days after transfection.Conclusions This electroporation method can transfect exogenous SHH gene into BMMSC sufficiently with the effective protein expression in BMMSCSHH.It is the foundation of further research of genetic therapy for ischemic heart disease.