Purpose:To study the efficacy and toxicity of g emcitabine/cisplatin(GP) and gemcitabine/carboplatin(GC) in patients with advanc ed non-small-cell lung cancer(NSCLC). Methods:patients for GP: gemcitabine 1 000 mg/m 2,days 1 a nd 8 plus cisplatin 30 mg/m 2 days 1-3 or GC:gemcitabine 1 000 mg/m 2 , days 1 and 8 plus carboplatin AUC=5 day 1. Cycles were repeated every 3 weeks. Results:54 patients to GP and 52 to GC. The objective response rate(CR+PR)was 48.1% for GP and 44.2% for GC. No significant differences between arms were observed in response rate. No significant differences between arms we re observed in median time to progression(6.8 months GP, 6.2 months GC).GP arm h ad a remarkably higher incidence of grade nausea/vomiting Ⅲ-Ⅳ than GC arm(P

Adult ; Aged ; Aged, 80 and over ; Blood Viscosity ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemorheology ; drug effects ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pulmonary Heart Disease ; blood ; drug therapy

Objective:To guide antithrombotic medication in the patients with PCI by GRACE and CRUSADE risk score. Meth-ods:The GRACE and CRUSADE score at the admission of 147 patients with ACS undergone PCI in one 3-level hospital were analyzed, and the two risk scores of the PCI patients and the correlation between the two scores were studied. Results:The risk factors in the two scores were part of the same, and the two scores had significant positive correlation. Conclusion: The GRACE score and CRUSADE score should be assessed at the same time in clinics to weigh the risk of bleeding and ischemia fully and then develop strategies for an-tithrombotic treatment.

Objective:Cholangioduodenal reflux is still an unresolved problem in interposed jejunal choledochoduodenostomy (IJC) yet.To settle this problem,we designed IJC with distal suspending (IJCDS).Methods:IJCDS is to insert and suspend the distal end of the 25 cm-ling interposed jejunum to the duodenal cavity,which is about 2.5 cm long.The pressure of the biliary tract and the biochemical composition or the bile were measured during and after the operation and the results were compared.Barium meal and cholangiography through T tube were performed after the operation.Follow-up surveys were also done.Results:The pressure or the biliary tract decreased distinctively after the operation.Barium meals found no cholangioduodenal reflux although the patients had changed many postures.Cholangiography through T tube showed parisaltic or the interposed jejunum and the contrast medium was continuously pushed into the duodenum.Noreflux cholangitis and stone recurrence were found in the follow-up survey in 14 patients.Conclusion:IJCDS has the powerful function on preventing cholangioduodenal reflux.On the other hand,it avods the shortcomings of other reflux-preventing operative pattern.So it had the good prospect to extend its clinical usage.

Objective:To investigate the effects of maternal malnutrition on the expression of the insulin signal transduction proteins in the liver of perinatal rats.Methods:(1)The dams were semi-starvation from the first day during pregnancy to build the animal model of intrauterine growth retardation(IUGR).On days 15,17,19,21(E15,E17,E19,E21)of gestation,the fetuses were delivered by cesarean section.The fetal rats,placenta,fetal liver and the fetal brain were weighed respectively.And the placenta weight to the body weight ratio(PWR),the liver weight to the body weight ratio(LWR),the brain weight to the body weight ratio(BWR)were calculated;The expressions of the hepatic insulin receptor(IR),insulin receptor substrate-1(IRS-1),insulin receptor subtrate-2(IRS-2),phosphatidyl inositol 3-kinse(PI3K)mRNA in the rats during perinatal period were detected by RT-PCR.Results:(1)The PWR of the IUGR fetus on E15 was lower than that in the control(P0.05).Conclusion:(1)In order to protect the development of brain,the fetus that suffered maternal malnutrition throughout the pregnancy had liver weight and body weight reduced much more than brain weight,which was known as "brain spare effects".(2)The expressions of hepatic IR mRNA and PI3K mRNA of the fetus were in normal ranges;But the expressions of the hepatic IRS-1 mRNA and IRS-2 mRNA of the IUGR fetus were decreased during the perinatal period.These may be related to the growth retardation and insulin resistance of the adult IUGR rats.

Objective:To investigate the expressions of the insulin receptor(IR),insulin receptor substrate-1(IRS-1),insulin receptor substrate-2(IRS-2),phosphatidyl inositol 3-kinase(PI3K) and insulin-like growth factor-1(IGF-1) of the livers of the male adult rats born with intrauterine growth retardation(IUGR),and to find out the relationship between IUGR and insulin resistance in their adult life.Methods:The foods were available ad libitum throughout the pregnancy to the control group and the rats in the experimental group were fed 50% of the control group to build the IUGR animal model.Liver samples were collected when the male offspring grew up to 12 weeks old.The mRNA expressions of hepatic IR,IRS-1,IRS-2,PI3K,and IGF-1 were detected by RT-PCR.The protein expressions of hepatic IR,IRS-1,and IRS-2 were analyzed by immunohistochemistry.Results:The mRNA expressions of hepatic IR in the adult male rats with IUGR were significantly lower than control group[(0.41?0.06) vs(0.62?0.11),P0.05] in both groups.The mRNA and protein expressions of the hepatic IRS-1[mRNA:(0.77?0.20) vs(1.32?0.42),P0.05].The expressions of hepatic IGF-1 mRNA of the rats with IUGR were significantly lower than those in control group [(0.55?0.12) vs(1.22?0.34),P

Eleven type 1 diabetic patients who received fixed regime of insulin Glargine were included in the study.The levels of fasting serum insulin were measured for each subject at 6:00 in three consecutive mornings.The variability of mean fasting serum insulin in each subject was 3.3%-41.5% (mean 15.4%).The variability did not correlate with the dose of Glargine statistically.

Objective To clone fliH, fliⅠ, fliY and fliN genes that encoding flagellum-associated proteins of L. interrogans for construction of their prokaryotic expression systems, and to determine the loca- tions of Flirt, FliⅠ, FIiY and FIiN. Methods The fliH, fliⅠ, fliY andfliN genes were amplified by PCR and sequenced after T-A cloning. Prokaryotie expression systems of the target genes were constructed subsequently. Expression of target recombinant proteins were demonstrated by SDS-PAGE and BioRad Gel Image Analyzer, and Ni-NTA affinity chromatography was performed to extract the target expression prod- ucts. Rabbits were subcutaneously immunized with the four recombinant proteins respectively to obtain anti- sera. ELISA was performed to measure the titers of antisera and Western blot assay was used to determine the immunobinding abilities among the antisera and their antigens. Immunoelectron microscopy was selected to locate the position of FliH, FliⅠ, FliY and FIiN. Results Segments of fliH, fliⅠ, fliY andfliN genes with 924, 1365, 1065 and 318 bp in size were successfully obtained by PCR. Similarities of nucleotide and puta- tive amino acid sequences from the four genes were 100% compared with the reported sequences. The con- structed prokaryotic systems efficiently expressed rFliH, rFliⅠ, rFliY and rFliN with the outputs of approxi- mate 20% of the total bacterial proteins. The rabbits immunized by rFliH, rFliⅠ, rFliY or rFliN could pro- duce antibody. The antisera had the titers above 1:100 000, and could recognize the corresponding recombi- nant proteins and membrane proteins of L interrogans to display positive Western hybridization bands. Flirt, FliⅠ, FliY and FliN were found to distribute on the external surface of inner envelope, the internal surface of outer envelope or the interspaces between the two layers of L. interrogans envelope. Conclusion The pro- karyotic expression systems was successfully constructed in this study, which could efficiently express flagel-lum-associated proteins FliH, FliⅠ, FliY and FliN of L. interrogans. The antisera with high titers to recognize their protein antigens were also obtained. Flagellum-associated proteins Flirt, FliⅠ, FIiY and FIiN are the inner envelope proteins and/or outer envelope proteins of L. interrogans.

Castleman Disease ; complications ; metabolism ; pathology ; surgery ; Dendritic Cell Sarcoma, Follicular ; complications ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Receptors, Complement 3b ; metabolism ; Thoracic Diseases ; complications ; metabolism ; pathology ; surgery ; Thoracic Wall ; Vimentin ; metabolism

BACKGROUND: Morphine is the first choice for the pain of medium and advanced degrees due to cancer. This is advocated in the Pain Relieving Guide of the WHO. Controlled-release morphine sulfate tablets(CRM) and sustained-release morphine sulfate tablets (SRM) all belong to oral long-acting morphine. It plays an important role in relieving cancer pain effectively and improving their quality of life(QOL).OBJECTIVE: To observe the analgesic effect of CRM and SRM and to observe how they improve the QOL of the cancer patients with severe cancer pain.SETTING: Department of oncology, department of surgery, department of internal medicine and department of traditional chinese medicine in the first affiliated hospital of a university.PARTICIPANTS: During October 1995 to June 1998, all inpatients that were pathologically proved to suffer from malignant tumor with severe pain were recruited into our study.METHODS: There were 182 patients with severe pain due to advanced cancers pathologically proven. They all met the entry criterion of the study. Totally 95 patients were treated with CRM, of which 12 cases were lost in follow-up due to side effects, death, or discharge from the hospital, and the rest 83 cases entered the stage of clinical trial. Eighty-seven patients were treated with SRM. Of them 25 cases were lost in follow-up due to side effects, death, or discharge from the hospital, and the rest 62 cases entered the stage of clinical trial. The recommended initial dosage of CRM or SRM was 30 mg every 12 hours for all patients, and then the dosage was regulated according to the effects until the ideal anesthesia was achieved.MAIN OUTCOME MEASURES: Assessments included pain severity, the effective rate, complete remission rate, remission time, adverse reactions, and the QOL before and after the treatment.RESULTS: The effective rates of CRM and SRM were 95% and 94%respectively. The complete remission rates were 82% and 80% respectively, and the remission time was(9.1 ±4.1) hours and (8.7±4.4)hours respectively. Statistically, there was no significant difference in analgesic effect and remission time between CRM and SRM. QOL was elevated for a higher degree in 62(75% ) and 47(76% ) patients after the treatment. QOL scores of CRM were (34.6 ± 11.5 ) points before treatment and (52.6 ± 13.0) points after the treatment( P = 0. 000), while QOL scores of SRM were(37.7 ± 9.7) points before the treatment and points (49.8 ± 12.9) points after the treatment (P = 0. 000). There was significant difference in QOL after the treatment. They could relicve osteocope,visceral pain, soft tissue infiltrative pain more effectively than they do about neurological pain.CONCLUSION: Oral treatment with CRM and SRM for the patients with server cancer pain shows a similar analgesic effect. They are effective, safe,and convenient, and can improve the QOL.