Purpose:To evaluate the efficacy and toxicity of the biweekly regimen of high dose leucovorin (CF), continuous central venous infusion(ccvi) of fluorouracil (5 FU) and oxaliplatin (OXA)for advanced and refractory colorectal cancer.Methods:28 patients (12 in rectum,16 in colon) received biweekly CF/5 FU/OXA (CF: 200 mg/m 2,ccvi 2 hour,days 1～2;5 FU:400mg/m 2,iv.,day 1; 5 FU: 1.6 g/m 2,ccvi.22 hours, days 1～2; OXA: 135 mg/m 2,ccvi.4 hour,day 1,every two weeks).Four treatment courses were carried out with an interval of one month.Results:The overall response rate was 39.28%.The response rates of rectal,colonic cancers were 33.33%% and 43.13%, respectively.Median duration of 11 partial responses were 5.0 months.Median survival of all patients was 7.0 months. Median survival of responsive patients,and non responsive was 11.0 and 7.0 months,respectively( P

Objective To evaluate urodynamic diagnosis of intrinsic sphincter deficiency (ISD) in female stress urinary incontinence. Methods Leak-point pressures (LPP) and maximum urethra close pressures (MUCP) were detected in 30 patients with female stress urinary incontinence,among whom there were 11 cases with type Ⅲ,19 type Ⅱ/Ⅲ. Results Of type Ⅲ incontinence the LPP was less than 50 cmH 2O in 10 out of 11 and in 17 out of 19 type Ⅱ/Ⅲ incontinence the LPP 50～100 cmH 2O ( P

Objective To evaluate the effects of different surgical treatments on severe polycystic liver disease (SPLD). Methods A total of 22 patients with SPLD were surgically treated in our Department from December 1989 to July 1999. Of the patients, 5 were treated with the partial hepatic resection in combination with cyst fenestration (group A), 7 with laparotomic fenestration (group B), 4 with laparoscopic fenestration (group C) and 6 with puncture under the guidance of ultrasonography B (group D). The surgical outcome and long term follow up results were retrospectively analyzed. Results After the treatments, all the patients experienced immediate relief of symptoms. However, the follow up for an average of 3 years showed that 10 patients developed recurrence of the disease. The recurring rates were 0, 28.5%, 65.5% and 100% in groups A, B, C and D, respectively. Conclusions The approach of partial hepatic resection in combination with cyst fenestration is the most effective treatment for SPLD. Laparoscopic fenestration may not be an appropriate surgical way for treatment of SPLD.

Objective To obeserve the effects of acute hypervolemic hemodilution(AHH) with hypertonic .sodium chloride hydroxyethyl starch 40(HSH 40) on hemodynamics and fluid balance in patients under general anesthesia.Methods Fifty patients undergoing radical surgery for gastral cancer under general anesthesia were randomly divided into 2 groups with 25 patients each.Acute hypervolemic bemodilution (AHH) was performed with HSH 40 6 ml/kg in group A or with hydroxyethyl statch(HES) 6 ml/kg in group,which was infused within 30 minuts.HR,MAP,CVP were recorded before(T_0),at 30 min (T_1),60 min (T_2) after infusionand and the end of operation (T_3).The amounts of bleeding,HSH 40 and HES and urine output were recorded as well.Results There were no significant diferences in HR and MAP between two groups at all time points.CVP was sighificantly higher at T_1-T_3 than that at To in two groups.The urine output was more in groups A than that in group B(P<0.05).Conclusion AHH with HSH 40 can effectively expand blood vlume and increase urine output in surgical patients under general anesthesia.

Objective To investigate the relationship between genetic polymorphisms of ERCC1 and survival rate in advanced non-small cell lung cancer (NSCLC) patients treated with platinum based chemotherapy.Methods A total of 204 patients with advanced NSCLC were routinely treated by platinbased chemotherapy.The polymorphic genotypes were analyzed by MALDI-TOF-MS nethod using DNA samples isolated from peripheral blood before treatment.Besides,5 ％ samples werc extracted randomly for sequencing to test the accuracy of this method.To explored the association between SNP of ERCC1 (118) and prognosis to platinum-based chemotherapy in advanced NSCLC patients.Results Among 204 patients,61 achieved partial response,116 achieved stable response,and 27 achieved progressive disease.The overall response rate was 29.9 ％ (61/204).The effective rates of patients with the ERCC1 (118) C/C genotype,C/T + T/T genotype were 24.0 ％ (29/121) and 38.6 ％ (32/83),respectively,with significant difference (P ＜ 0.05).The response rate of ERCC1 (118) C/T allele carriers was 1.992-fold than that of C/C allele carriers (95 ％ confidence interval:1.083-3.650,P =0.025).MST,1-year survival and 2-year survival rates of patients with the ERCC1 (118) C/C genotype,C/T + T/T genotype were 9.0 months,34.7 ％ (42/121) and 4.1％ (5/121) vs 12.0 months,60.2 ％ (50/83) and 12.0 ％ (10/83),respectively,with significant difference (P ＜ 0.05).Conclusions Polymorphisms of ERCC1 might be associated with overall survival period in patients with advanced NSCLC after treatment with platin-based chemotherapy,which might be the predictive markers for overall survival.

Objective To investigate the expression of LKB1 and p53 in human gastric tissues and their correlation with clinical pathological factors.Methods The expression of LKB1 and p53 in 115 cases of gastric carcinoma and 20 cases of normal gastric tissues were detected by immunohistochemistry method,and the relation between the expression and the clinicopathological parameter of gastric carcinoma was analyzed.Results The positive rates of LKB1 in gastric carcinoma and normal tissues were 20.9 ％ (24/115) and 95.0 ％ (19/20),respectively (P ＜ 0.01).The positive rates of p53 in gastric carcinoma and normal tissues were 45.2 ％ (52/115) and 5.00 ％ (1/20),respectively (P ＜ 0.05).The analysis revealed that the high expression of LBK1 was associated with tumor lymph node metastasis,stage,Lauren classification and worse survival (P ＜ 0.05).The expression of p53 was associated with tumor lymph node metastasis,stage,distant metastasis and worse survival (P ＜ 0.05).Conclusions LKB1 protein expression may play an important role in the development and progression of gastric cancer.LKB1 may be used to assess the malignant biological behavior and prognosis of gastric cancer.

Rupture and bleeding of accessory hepatic aneurysms is clinically rare. Computed tomography angiography (CTA) or multislice reconstruction can provide reliable basis for clinical diagnosis. Interventional surgery is the main treatment method. A successful case of interventional embolization of ruptured accessory hepatic aneurysm in our hospital was reported. The accessory hepatic artery variation of this patient belongs to Michels type 4. The bleeding site of the variant artery was identified by CTA and digital subtraction angiography. Satisfactory results were obtained after interventional embolization and follow-up.

OBJECTIVETo explore the molecular biology mechanism of acupuncture on improving immune function damage induced by chemotherapy in cancer-bearing mice.

METHODSSeventy-two mice (36 mice in 3-day treatment and 5-day treatment, respectively) which were successfully made into cancer-bearing model were divided into a blank group, a model group, an acupuncture group and a moxibustion group by stratified randomization method, 9 mice in each one. Except for the mice in the blank group, the remaining mice were treated with intra-peritoneal injection of cyclophosphamide (CTX, 150 mg/kg), to establish the cancer-bearing mice of CTX. The mice in the blank group were treated with intraperitoneal injection of 0.9% NaCl (identical dose as other groups). After 4 h, the mice in the acupuncture group and moxibustion group were treated with acupuncture and moxibustion at "Dazhui" (GV 14), "Geshu" (BL 17), "Shenshu" (BL 23), "Zusanli" (ST 36), once a day. The mice in the blank group and model group were treated with immobilization and fixation during the same time. On the next day of the end of 3-day and 5-day treatment, the sample was collected. The ELISA method was applied to measure the contents of IL-12 and TNF-α in spleen of all the mice.

RESULTSAfter 3-day and 5-day treatment, compared with the blank group, the contents of IL-12 and TNF-α in spleen in the model group were reduced (all P < 0.05); compared with the model group, the contents of IL-12 and TNF-α in spleen in the acupuncture group and moxibustion group were increased (all P < 0.05), but the content of IL-12 and TNF-α in the acupuncture group was not different from that in the moxibustion group (both P > 0.05).

CONCLUSIONAcupuncture and moxibustion could effectively increase the contents of IL-12 and TNF-α in spleen of CTX cancer-bearing mice, which could relieve chemotherapy-induced immune function damage to improve immune function.

Acupuncture Therapy ; Animals ; Cyclophosphamide ; adverse effects ; Humans ; Interleukin-12 ; genetics ; metabolism ; Male ; Mice ; Moxibustion ; Neoplasms ; chemically induced ; genetics ; metabolism ; therapy ; Spleen ; metabolism ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Objective To evaluate the effectiveness of management for patients with chronic obstructive pulmonary disease (COPD) in stage Ⅰ at new rural cooperative medical facilities.Methods A quasi-experiment design was used for the evaluation of patients registering at Dongcun and Fangyuan subdistrict offices in Haiyang.And 79 COPD cases from Dongcun sub-district offices were selected into the management group while 76 cases from Fangyuan the control group.The measures at the new rural cooperative medical facilities included smoking-free publicity,avoiding a hazardous environment,application of influenza vaccines and training of patients and local general practitioners in essences of COPD prevention and treatment.Except for routine treatment,no special measures were taken for the control group.ResultsSixty-one patients in the management group and 60 in the control group completed a 3-year follow-up.Fifteen patients were smokers during their initial visits in the management group and 13 quitted smoking after a 3-year management.Meanwhile 19 patients were smokers during their initial visits in the control group and 3 of them quitted smoking within the same period.The decrement of BODE index between post-management at year 2&3 and between pre-management was higher in the management group versus the control group within the same period (P ＜ 0.01).The annual average frequencies of common cold,acute attack and physician consultation were obviously lower post-management at year 3 than those pre-management and the control group within the same period ( P ＜ 0.05 ).Lung functions of two groups deteriorated as compared with those 3 years before ( P ＜ 0.05).But no statistical difference existed between two groups (P ＞ 0.05).ConclusionThe management of COPD patients in stage Ⅰ at new rural cooperative medical facilities can improve their quality of life and reduce their frequencies of common cold,acute attack and physician consultation.

Objective To observe the efficacy and adverse events of L-asparaginasum plus DICE regimen in the treatment of relapsed and refractory non-Hodgkin's lymphoma (NHL). Methods Thirty-one patients with relapsed and refractory NHL were treated with L-asparaginasum plus DICE regimen. Each patient was scheduled to receive 2 to 6 cycles.Results Among the 31 assessable patients,11 (35.5 ％) achieved a complete remission (CR),14(45.2 ％) got a partial remission (PR),2 were stable,4 were progressive.The overall response (CR + PR) rate was 80.7 ％.The median survival was 8 months (rang:2-38 months).The 1-year survival rate was 43.3 ％,the 2-year survival rate was 32.5 ％.The main adverse events were myelosuppression,digestive tract reaction,allergy and edema.No treatment-related death was observed.Conclusion The L-asparaginasum plus DICE regimen is effective and safe for the relapsed and refractory NHL.