Varieties of chemotherapeutic regimens based on fluorouracil have been recently developed.This review summarized widely used regimens of fluorouracil based chemotherapy in this decade.The common side effects,their mechanisms and clinical prevention and symptomatic treatment for these adverse reactions were also discussed.Therefore,this review will provide guidance for regimen selections,and improve the efficacy and safety of chemotherapy.In addition,the detailed information and data presented in this paper may be helpful in the development of new chemotherapy regimens.

Objective: To study the protective mechanism of Donepezil on apoptosis of PC12 cells induced by amyloid beta protein. Methods: PC12 cells were cultured as previously,then amyloid beta protein and Donepezil were used to treat PC12 cells.Morphology observation,TUNEL and immunocytochemistry were employed to investigate the damage of PC12 cells induced by A?,protection of Donepezil on apoptosis of PC12 cells and the expression of Bcl2 and Caspase-3 in A?-treated group and Donepezil-treated group. Results: A? induced apoptosis of PC12 cells in a dose-dependent way;Compared to the group treated with A? only and the group post-treated with donepezil, the apoptosis index of PC12 cells(17.29?0.83)% and expression of Caspase-3(26.46?2.87)% were significantly downregulated in the group pretreated with donepezil(P0.05). Conclusion: This study demonstrated that Donepezil can protect PC12 cells against apoptosis induced with amyloid protein,which was closely related to the time of interference.The mechanism of protection was involved with the expression of Bcl-2 and Caspase-3.

BACKGROUND:Adult central nervous system lacks the ability to regenerate,so it is of great significance to find a new source of neural stem cells.OBJECTIVE:To investigate the differences between basic fibroblast growth factor(bFGF)and epidermal growth factor(EGF)in inducing bone marrow mesenchymal stem cells(MSCs)to differentiate into neurons in vitro.METHODS:MSCs were isolated from normal human bone marrow using density gradient centrifugation and cell attachment method.MSCs were plated in 96-well culture plates at a density of 0.25×108/L and cultured with 200 μL DMEM/F12 for 0,1,2,3,4,5,6,and 7 days,with 20 μL MTT(5 mg/mL)in 5 wells at each time point.The supernatant was removed and 100 μL dimethyl sulphoxide was added to each well for 4 additional hours of incubation.In addition,some cells were exposed to bFGF and EGF.Growth curve was determined with MTT method.Telomerase activity were examined by TRAP(PCR)-ELISA.Additionally,the functional differences of the two cytokines were checked by RT-PCR.RESULTS AND CONCLUSION:RT-PCR revealed that nestin,glial fibrillary acidic protein(GFAP)and neurofilament subunit M (NF-M)mRNA were expressed in un-induced MSCs of passage 4.Nestin expression reduced at 7 days.The expression of micro-tubule-associated protein-2(MAP2)mRNA was not detected until the induction,and increased thereafter.The expression of MAP2 mRNA was greater in bFGF+EGF and bFGF alone groups compared with EGF alone group,and the expression of GFAP in EGF alone group was greater than other groups.Results showed that MSCs can be cultivated,proliferated and differentiated into neural stem cells in vitro.The differentiated neural stem cells have the activity of proliferation,but not have the ability of infinite proliferation as tumor cells.

Objective To evaluate the factors which might affect the successful reopening of occluded subclavian artery. Methods During the period of Jan. 1998-March 2007, endovascular stent placement was performed in 20 patients with occluded subclavian artery, including 12 males and 8 females, aged 17-74 years (mean 53 years). The procedures were carried out by using super-slippery guide wire via anterograde or bilateral access. Results Successful reopening of occluded subclavian artery was obtained in 14 cases and the treatment ended in failure in 6 cases. In 14 patients with successful results, the mean length of diseased artery was 3.00 cm and the mean course of disease was 9.83 months, which were 2.13 cm and 27.6 months respectively in 6 cases of failure. The successful reopening rate was 80% in arthrosclerosis cases, while it was 50% in aorto-arteritis obliterans. The successful reopening rate was 100% in those cases whose occluded artery showing a sharp stump, while the successful reopening rate was 33% in those cases whose occluded artery showing a round stump, with a statistically significant difference between the two (P< 0.05). The successful rate in cases performed via anterograde access was 65%, and it was only 43% in cases performed via bilateral access. Conclusion The etiology, the duration of disease and the shape of stump bear a close relationship to the successful reopening rate, while no obvious correlation exists between the length of diseased artery and the reopening rate. Higher reopening rate can be achieved when the procedure is performed via anterograde access.

BACKGROUND:Tetramethylpyrazine (TMP) can inhibit the expression of vascular endothelial growth factor (VEGF), but it is uncertain that TMP inhibit the growth and proliferation of HL-60 leukemic cells induced by VEGF.OBJECTIVE:To observe the effect of TMP on the proliferation of HL-60 leukemic cells induced by VEGF.DESIGN:Repetitive measurement and observation.SETTING:School of Medicine, Wuhan University of Science and Technology.MATERIALS:The experiment was carried out in the Molecular Biology Laboratory Center, School of Medicine, Wuhan University of Science and Technology from March to June in 2007. Human leukemic cell line HL-60 cells were purchased from Shanghai Institute of Cell Biology. TMP hydrochloride injection was produced by Wuxi Seventh Pharmaceutical Products Limited (Lot number:011014), protamine sulfate injection was produced by Shanghai First Biochemical Pharmaceuticals (Batch number:010302), and immunohistochemistry kit was purchased from Boster company.METHODS:①Human leukemic cell line HL-60 cells at log phase were used for the experiments. Cells were treated with 100 μg/L VEGF, and then TMP at final concentrations of 1.5, 15, 150 mg/L was added into culture medium. While the cells in medium without TMP were taken as blank control group, and the cells in medium with 20 mg/L protamine as positive control group. Meanwhile cells without treatment of VEGF were served as VEGF control group. After cells were incubated for 48 hours, the growth inhibiting rate of HL-60 cells was detected by MTT assay.②After HL-60 cells were treated with TMP at the final concentrations of 1.5, 15, 150 mg/L for 24 hours, the protein expression of VEGF in HL-60 cells was examined by SP immunohistochemistry.MAIN OUTCOME MEASURES:①Growth inhibiting rate of HL-60 cells.②Protein expression of VEGF.RESULTS:①Growth inhibiting rate of HL-60 cells:After HL-60 cells induced by VEGF were treated with 15 and 150 mg/L TMP, the absorbance value was significantly lower than that in VEGF control group (P < 0.05).②Protein expression of VEGF:After HL-60 cells were treated with TMP for 24 hours, the protein expression of VEGF was down-regulated with increasing TMP concentration in a dependent manner. Significant differences were observed in the protein expression of VEGF between cells treated by TMP and the controls (P < 0.01).CONCLUSION:TMP can inhibit the proliferation of HL-60 cells stimulated by VEGF and down-regulate the expression of VEGF.

Objective To study the protective effect of recombination human erythropoietin (rhEPO) on the apoptosis of retinal neurons induced by glutamate.Methods The primary retinal neurons of postnatal SD rats were cultured in vitro for 7 days and divided into 3 groups :control group ,glutamate group and rhEPO pretreatment group.The neurons in the rhEPO pre-treatment group were afterwards allocated to three subgroups in terms of different rhEPO treatments (0.15 ,0.30 or 0.50 U/mL rhEPO for 12 h).Those in glutamate group and rhEPO pretreatment group were treated with glutamate at the concentration of 20μmol/L for 30 min for establishment of the apoptosis model.Twenty-four h later ,the apoptosis index (AI) was assayed by TUNEL and the expressions of BCL-xL mRNA and protein was detected by RT-PCR and immunocytochemistry respective-ly.Results The AI was significantly higher in the glutamate group than in the control group (P<0.01).The AI was signifi-cantly reduced ,and the expression level of BCL-xL mRNA and protein was markedly dose-dependently increased in the rhEPO pretreatment groups compared with the glutamate group (P<0.01).Conclusion The rhEPO pretreatment can inhibit the glu-tamate-induced apoptosis of retinal neurons by up-regulating the expression of BCL-xL .

With the development of medical theory and technology, the traditional teaching patterns have fallen behind the requirements for the training of medical students. Recently, virtual reality techniques have been proved to be effective in the practice of medical education. Through sum-marizing the experience of building simulation systems of eye anatomy, clinical features of eye and simulation practice, the author has elaborated the role of virtual reality technology in ophthalmology teaching theory and practice, which is of profound significance to improve the overall level of ophthal-mology teaching.

Objective To study the clinical effect of Zhenqifuzheng granule combined with Tegafur gimeracil oteracil potassium capsule in treating advanced carcinoma of gastric cardia in aged patients.Methods 52 cases of aged patients with advanced carcinoma of gastric cardia were randomly divided into the observation group and the control group.The observation group was treated with zhenqi fuzheng granule combined with tegafur gimeracil oteracil potassium capsule,and the control group was given Tegafur gimeracil oteracil potassium capsule only.The curative effect,adverse reaction and cellular immune function were evaluated after two treatment cycles.Results There was no statistically significant difference in the objective efficacy rate between observation (46.2％) and control group (50.0％) (P＞0.05).The rate of adverse reaction was higher in the control group than in observation group (P＜0.05).The rate of gastrointestinal adverse reactions in the control group was 50.0％,but 15.4％ in observation group.The rate of bone marrow suppression was 26.9％ in control group,but 11.5％ in observation group.The cellular immune function was better in observation group than in the control group (P＜0.05).Conclusions Zhenqifuzheng granule can improve immune function and reduce toxic side effects when combined with Tegafur gimeracil oteracil potassim capsule in treating advanced carcinoma of gastric cardia in aged patients.

Accurate imaging of lymphoma is essential for optimal management. Positron emission tomography(PET-CT),by providing both anatomic and functional information,is fundamentally altering staging,monitoring of response,response assessment,and choice of treatment modality for lymphomas, including Hodgkin lymphoma. This imaging technique, when used carefully in conjunction with standard testing,increases the sensitivity of lesion detection, provides an opportunity to monitor the quality of response during treatment, permits separation of fibronecrotic scartissue from viable tumor, and adds prognostic information.PET-CT has become integral to modern lymphoma management, but as a relatively new diagnostic technique,it is still being studied and neither its full potential nor its major limitations are fully understood. Discussed herein are recent observations from clinical trials and single-center experiences with PET-CT to explore its advantages and limitations from a clinician’ s point of view.

Objective To investigate the clinical effect of minimally invasive plate fixation in the treatment of calcaneal fractures.Methods 68 patients with calcaneal fractures were selected as the research subjects,they were randomly divided into the control group and observation group,34 cases in each group.The control group received open reduction and plate internal fixation,while the observation group was treated with minimally invasive plate fixa-tion.The clinical results and complications of the two groups were observed.Results The excellent and good rate was 94.1 2% in the observation group,which was significantly higher than 79.41 % in the control group,the difference was statistically significant(χ2 =9.397 6,P <0.05 ).The Bohler angle and Gissane angles in the control group were (28.67 ±2.04)°,(1 21 .87 ±8.23 )°after treatment,which were significantly higher than (6.45 ±1 .21 )°, (1 01 .65 ±8.56)°before treatment.After treatment,the Bohler angle and Gissane angles of the observation group were (32.56 ±3.25 )°,(1 29.45 ±1 2.86)°,which were significantly higher than (6.36 ±1 .26)°,(1 01 .54 ± 8.27)°of the control group,the differences were statistically significant(P <0.05),and the increase of Bohler angle and Gissane angle of the observation group was more obvious than the control group.The incidence rate of complica-tion in the observation group was 2.94%,which was lower than 8.82% in the control group,the difference was statis-tically significant(χ2 =3.923 7,P =0.047 7).Conclusion Minimally invasive plate fixation in the treatment of cal-caneal fractures has significantly smaller incision,and can reduce the incidence of complications,it is worthy of clini-cal application.