Objective To investigate the efficacy and toxicity of thalidomide plus irinotecan and cisplatin treatment for recurrent small cell lung cancer.Methods 62 Patients with recurrent small cell lung cancer in the same period were randomly divided into observation group and control group according to the principle of minimum distribution imbalance index.The observation group patients were treated with thalidomide plus irinotecan and cisplatin chemotherapy,and the control group patients were treated with irinotecan and cisplatin chemotherapy.The efficacy and toxicity of the two groups were compared.Results The overall response rate in the group observation was 86.7％ compared with 63.3％ in the control group,and the difference had statistical significance (x2 =8.52,P ＜ 0.05).The major toxicities were hematologic toxicity and gastrointestinal symptoms,and the side effects differences were not statistically significant (x2 =0.18,P ＞ 0.05).Conclusion The treatment of recurrent small cell lung cancer with irinotecan and cisplatin in combination with thalidomide has high efficiency,and the toxicity can be tolerated.

Objective To summarize the nursing experience in patients with CT-assisted thoracoscopic surgery for small indeterminate pulmonary nodules.Method The data of 26 patients having undergone CT-assisted thoracoscopic surgery for small indeterminate pulmonary nodules were analyzed retrospectively for summarizing the nursing experience.Result The CT-assisted locations of nodules and the thoracoscopic resection of the pulmonary nodules in all the patients were successfully performed,without pneumatothorax,haematothorax and pneumorrhagia.Conclusion Such measures as setting the right time for locating,enhanced management of body position,accurate and safe punctuation and well performance of surgical cooperation are all critical for the success of the resection.

The successful separation of breast cancer stem cells (BCSCs) is the foundation of BCSC research.At present,people could gather BCSCs to some extent in a number of ways.However,as more and more biomarkers are found in BCSCs separation,the heterogeneity becomes a hot spot.How to gather BCSCs as much as possible and how to explain the heterogeneity could provide new insights in the treatment of breast cancer.

Objective:To investigate the correlation between preoperative blood platelet-to-lymphocyte ratio (PLR) and clinico-pathological features, as well as the effect of PLR on the prognosis of non-small cell lung cancer (NSCLC) patients after surgical resec-tion. Methods:Retrospective analysis was performed for 255 cases with histologically confirmed NSCLC that underwent curative re-section from January 2004 to December 2007. All patients were classified into two groups based on the median value of PLR. The rela-tionship between PLR and clinicopathological features was studied. Univariate and multivariate analyses were performed to assess the prognostic effect of preoperative PLR. Results:The median value of preoperative PLR was 130 (range:45.45 to 272.66). Based on the cut-off value of 130, all patients were divided into two groups:low PLR (≤130, n=127) and high PLR (>130, n=128). PLR was corre-lated with tumor site, T stage, and clinical stage. Five-year survival rates of low and high PLR patients were 49.6%and 33.6%, respec-tively, which indicated a statistically significant difference (χ2=12.577, P<0.001) between the two groups. Univariate analysis showed that smoking status, histological differentiation, clinical stage, T stage, N stage, postoperative adjuvant therapy and PLR were associat-ed with survival (P<0.05 for all). Multivariate analysis identified N stage, postoperative adjuvant therapy, and PLR as independent prog-nostic factors of all the patients. In addition, stratified analysis showed that the five-year survival rate of the low PLR group was higher than that of the high PLR group with or without lymph node metastasis, and the differences were statistically significant (P=0.020 and 0.037). Conclusion:An elevated blood preoperative PLR indicates poor prognosis in NSCLC patients. Preoperative PLR is an indepen-dent prognostic factor of NSCLC after curative resection.

Objective To evaluate the clinical significance of cytokeratin19(CK19) mRNA in the peripheral blood of patients with non-small cell lung cancer (NSCLC). Methods The expression of CK19 mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in the peripheral blood from 98 NSCLC patients (NSCLC group), 20 benign pulmonary lesion patients (benign pulmonary lesion group) and 20 healthy adults(control group). Results The positive rate of CK19 mRNA in peripheral blood of NSCLC group, benign pulmonary lesion group and control group was 77.55 % (76/98), 3.57% (1/28),0 (0/20) respectively,and there was significant difference among three groups ( x2 = 73.680,P ＜ 0.01 ). The positive rate of CK19 mRNA in different pathological types of NSCLC had no significant difference (x2 =0.414, P ＞ 0.05 ), but had significant difference in different lymphy node metastasis status( x2 = 17.523, P ＜0.01 ) and different clinical stage ( x2 =13.453,P ＜ 0.01 ). Conclusions The higher expression of CK19mRNA in peripheral blood of NSCLC may relate to cancer metastasis. Detection of CK19 mRNA has significance in early prediction of its prognosis.

BACKGROUNDPulmonary blastoma is a rare primary malignancy of the lung. It is now recognized in two forms: adult type pulmonary blastoma and childhood pleuropulmonary blastoma. The clinical characteristics, diagnosis and treatments of adult type pulmonary blastoma are discussed in this article.

METHODSThe clinical records of 5 patients with adult type pulmonary blastoma admitted in Cancer Center, Sun Yet-sen University from 1964 to 2004 were analyzed and the literature on pulmonary blastoma was reviewed.

RESULTSThree patients were male and two were female with the ages ranged from 22 years old to 70. Their symptoms consisted mainly of cough, hemoptysis and chest pain. The pulmonary blastomas were mainly manifested as a solitary parenchymal mass of the lung on chest radiograph and CT. None of these patients was diognosed by fibrobronchoscopy nor sputum cytology. Three patients underwent lobectomy, one underwent pneumonectomy, and these four patients underwent mediastinal lymph node resection also. The fifth one received wedge resection and postoperative chemotherapy. At the end of follow-up, three patients died and two was alive, and the survival time was from 6 months to 11 years.

CONCLUSIONSPulmonary blastoma is difficult to be diagnosed before operation. Surgery is the best therapeutic choice up to now. It has poor response to radiotherapy and chemotherapy. The prognosis of patient with pulmonary blastoma is variable.

Objective To investigate the effects of EMP exposure to male BABL/c mice on the reproduction and its sex ratio.Methods Thirty-three male BALB/c mice were randomly divided into sham-exposed group,10 000 pulses/d exposed group,and 100 000 pulses/d exposed group with 50 Hz static magnetic field of 35 kV/m for 2 weeks consecutively,then the male mice were mated with unexposed females (1 male vs.2 female).Mated males were sacrificed to examine the exposure effects on sperm number and testis index after 7 days of mating.The sex ratio of embryos collected from unexposed mated females was investigated by PCR.Results The sex ratio of offspring was 0.298 (14/47) in the 10 000 pulses/d exposed group,significantly lower than 0.871 (27/31) in the sham-exposed group.No statistical changes were observed in the sex ratio of offspring,sperm number,the weights of testis and testis index after 100 000 pulses/d exposure.Conclusions The exposure of male mice to 35 kV/m EMP at 10 000 pulses/d for 2 weeks consecutively may change the sex ratio of mice's offspring.

In the process of MPH graduates education in medical universities , there are three problems such as lack of initiative subjective of postgraduate, uneven level of tutors and monitoring defi-ciency of education. The main reasons are the low quality of MPH graduates, lack of quality consciousness for graduates education and graduates’ value tending to be utilitarian. Facing the problems, we suggest establishing guarantee mechanism for MPH graduate education quality, strengthening the tutors’ construc-tion and framing an eliminating system.

Background:Despite numerous previous studies, the consideration of tumor location as a prognostic factor in resectable non–small cell lung cancer (NSCLC) remains controversial. The present study analyzed the association between tumor location and clinical outcome in patients with resectable NSCLC who had undergone lobectomy with systematic lymphadenectomy and who had presented with varying nodal statuses.
Methods:The data from a cohort of 627 eligible patients treated in Sun Yat?sen University Cancer Center between January 2000 and December 2008 were retrospectively collected, and the nodal statuses of patients with different tumor locations were compared. Cox proportional hazards regression model was used to determine the independent factors related to cancer?speciifc survival (CSS).
Results:Multivariate analysis demonstrated that left lower lobe (LLL) tumors [hazard ratio (HR): 1.465, 95% conif?dence interval (CI) 1.090–1.969,P= 0.011], lymph node metastasis (HR: 2.742, 95% CI 2.145–3.507,P < 0.001), and a tumor size of >4cm (HR: 1.474, 95% CI 1.151–1.888,P= 0.002) were three independent prognosticators in patients with resectable NSCLC. However, LLL tumors were associated only with CSS in node?positive patients (HR: 1.528, 95%CI 1.015–2.301,P= 0.042), and a tumor size of >4cm was the only independent risk predictor in the node?negative subgroup (HR: 1.889, 95% CI 1.324–2.696,P < 0.001).
Conclusions:Tumor location is related to the long?term CSS of NSCLC patients with lymph node metastasis. LLL tumors may be upstaged in node?positive patients to facilitate an optimal treatment strategy.

Objective: To explore the status of lymph node metastasis of middle third thoracic esophageal squamous cell carcinoma and its influence on the prognosis and to seek the reasonable range of lymphade-nectomy. Methods: A total of 129 patients who underwent curative esophagectomy with modern two-field lymphadenectomy of middle third thoracic esophageal squamous cell carcinoma were reviewed. Results: The lymph node metastasis rate was 56.6% and the upper mediastinal lymph node metastasis rate was 43.4%. The lymph node metastasis ratio (positive nodes/total dissected nodes, LMR) was 11.3%. Paraesophageal lymph nodes, lymph nodes near the right recurrent nerve, the left gastric and infracadnal lymph nodes were most commonly involved when the tumor was located in the middle thoracic esophagus. Tumor differentiation, the depth of tumor invasion and the length of tumor were influencing factors for lymph node metastasis. The 5-year survival of N_0, N_1 (LMR≤20%) and N_1 (LMR>20%) patients were 50.4%, 31.0% and 6.8%, respective-ly, with a significant difference among the three groups (P=0.000). Conclusion: LMR was one of the key fac-tors affecting the prognosis, of esophageal cancer. Patients with middle third thoracic esophageal carcinoma should be treated with radical surgery with modern two-field lymphadenectomy.