ObjectiveTo evaluate the clinical efficacy,untoward reaction of bruceolic oil emulsion combined GP program in treatment of advanced non-small-cell lung cancer(NSCLC).MethodsOne hundred and thirty-six patients with NSCLC were divided into observation group and control group with 68 cases each by random digits table,the two groups were received GP program,the observation group added bruceolic oil emulsion( 1 time a day).The effective rate and untoward reaction between two groups were compared.ResultsThe objective effective rates of observation group and control group were 32.4％(22/68)and 17.6％( 12/68 ),the subjective effective rates of observation group and control group were 52.9％(36/68 )and 32.4％ (22/68),there were significant differences between two groups(P ＜0.05).There was no significant difference in CD3+,CD4+,CD8+,CD56+ between two groups before treatment (P＞ 0.05 ).CD3+,CD4+,CD8+,CD56+ in observation group were better than those in control group after treatment(0.552 ± 0.072 vs.0.468 ± 0.080,0.368 ± 0.062 vs.0.288 ± 0.061,0.268 ± 0.052 vs.0.212 ± 0.044,0.226 ± 0.044 vs.0.168 ±0.042),there were significant differences between two groups (P ＜ 0.05).There was no statistical difference in Ⅲ+ Ⅳ degree untoward reaction between two groups(P ＞ 0.05).ConclusionBetter therapeutic efficacy and less untoward reaction are expected by combined bruceolic oil emulsion with GP program in treatment of advanced NSCLC.

BACKGROUND:Pedicle screw fixation is the mainstream type of spine operation currently. The key point of the fixation is to make the screw pass through the center of pedicle. The angle of pedicle screw implantation is a key factor for repair quality. In previous literatures, angle of pedicle screw is determined according to the patient body, and is easily disturbed by factors such as position of the body. OBJECTIVE:To determine the inserting angle of pedicle screw of lower lumbar spine taking local anatomic landmark as a reference using digital technology. METHODS:3D-CT data of 100 patients were selected. The fourth and fifth lumbar vertebrae received three-dimensional reconstruction, and the operation was simulated using digital technology to achieve optimal placement. After simulation, the angle of pedicle screw was measured. The angle of the planes of the midline of the screw and the midline of the spine served as coronal angle. The angle of the planes of the midline of the screw and the upper surface of the vertebral body served as sagittal angle. RESULTS AND CONCLUSION:Measure results suggest that each angle was bigger than the angle in previous studies, which might be induced by different reference markers. Standard deviation of each angle was also big. These findings verify that the anatomical differences of pedicles were apparent. Thus, we should insert the pedicle screws individual y. Method of locating reference using anatomic landmarks of a single vertebral body can maximize to avoid interference posture. The combination with preoperative three-dimensional reconstruction is more in line with the requirements of pedicle screw, and can effectively improve the accuracy of pedicle screws.

Objective To compare the efficacy of XELOX and FOLFOX4 in the treatment of locally advanced unresectable gastric cancer. Methods The clinical data of 72 patients with gastric cancer who were admitted to the Shandong Provincial Hospital from July 2006 to October 2009 were prospectively analyzed. Of all the patients, 3 lost follow-up, and 69 patients with locally advanced unresectable gastric cancer were randomly divided into XELOX group ( n = 36 ) and FOLFOX4 group ( n = 33 ) according to the random number table.All patients received chemotherapy for six weeks. The efficacy of the two regimens were evaluated by the multidiscipline team six weeks later. The cell cycle of patients with complete or partial remission and received surgical treatment was detected by flow cytometry. All data were analyzed using the Pearson chi-square test, Levene test or t test. Results The curative rates of XELOX and FOLFOX4 were 53% (19/36) and 52% (17/33), respectively,with no significant difference between the two groups ( x2= 0. 01 , P ＞ 0. 05 ). The incidences of nausea and vomiting, phlebitis and hand-foot syndrome were 25% (9/36), 6% (2/36) and 19% (7/36) in the xELOX group, and 55% ( 18/33), 39% (13/33) and 3% (1/33) in the FOLFOX4 group, respectively, with significant difference between the two groups ( x2 = 6.31, 11.59, 4.53, P ＜ 0.05 ). Nineteen patients in the XELOX group and 17 patients in the FOLFOX4 group received surgical resection of the gastric cancer, and no complications such as anastomotic leakage and hemorrhage occurred postoperatively. In the XELOX group, the s-phase fraction (SPF),proliferation index (PI) and G2/M of the gastric cancer cells were 5.89% ± 0.79%, 9.22% ± 1.99% and 5.19% ± 1. 66% after neoadjuvant chemotherapy, which were significantly lower than 6.76% ± 1.21%, 10.44% ±2.12% and 6. 04% ± 0. 57% before neoadjuvant chemotherapy, while the ratio of gastric cancer cells in the G0/G1 phase after neoadjuvant chemotherapy was 90.39% ±4.78%, which was significantly higher than 87.54%±6.34% before neoadjuvant chemotherapy (x2 =3.61, 2.52, 2. 15, 2.91, P ＜0.05). In the FOLFOX4group, the SPF, PI and G2/M of the gastric cancer cells were 6.09% ± 0.96%, 10.65 % ± 2.47% and 4.88% ±0.87% after neoadjuvant chemotherapy, which were significantly lower than 7.15% ± 1.45%, 11.87% ± 2.33%and 5.67% ± 1.03% before neoadjuvant chemotherapy, while the ratio of gastric cancer cells in the G0/G1 phase after neoadjuvant chemotherapy was 91.45% ± 5.22%, which was significantly higher than 88.01% ± 4.23%before neoadjuvant chemotherapy ( x2 = 3.50, 2.06, 3.37, 2.94, P ＜ 0.05 ). There was a significant difference in PI between XELOX group and FOLFOX4 group after neoadjuvant chemotherapy ( x2 = 2.66, P ＜ 0.05 ).Conclusions XELOX and FOLFOX4 are safe and effective in the treatment of locally advanced unresectable gastric cancer, and they can significantly restrain the proliferation of gastric cancer cells. XELOX regimen is more effective than FOLFOX4 regimen.

Objective To determine activity concentrations of natural and artificial radionuclides in the surface soils in Huhhot city,measure environmental radiation level,and evaluate risks to residents health.Methods Radionuclides in 48 surface soil samples were determined by means of the high purity germanium γ spectrometer;environmental radiation level was measured using an environment γ dose rate meter;comparison was made of average activity concentrations in soils between domestically and globally;and the radiation dose to the local residents was estimated by using the methods recommended by UNSCEAR and reported in the related literatures.Results The average values for specific activity of 238U,232Th,226 Ra,40K and137 Cs in the surface soil samples in Huhhot city were (29.29 ± 12.95),(39.33±4.34),(29.77 ±3.21),(650.49 ±62.21) and (1.62 ± 1.53) Bq/kg,respectively;the measured air absorbed dose rate was (86.32 ± 11.92) nGy/h;the annual effective dose to local residents from outdoor γ radiation was 79.27 μSv/year.Conclusions The specific activities of radionulcides in soils and the environmental radiation in surface soil in Huhhot city were at a normal background level,with low risks to health of the local residents.

Objective To investigate the clinical characteristics,diagnosis and treatment for Graves' disease associated with papillary thyroid microcarcinoma(PTMC) by retrospectively analyzing domestic and foreign literatures.Methods 32 patients of Graves' disease associated with PTMC treated at the Department of Thyroid Surgery,the First Bethune Hospital of Jilin University from Jun.2008 to Jun.2013 were collected.32 cases of PTMC with normal thyroid function were randomly selected by a random number table method from the same period as control.Results The experimental group had 32 patients aging from 24 to 71 years old,among whom 3 were males,and 29 were females with the male to female ratio was 1∶9.7.15 cases in the experimental group had positive central lymph node metastasis and the other 17 cases were negative,while in the control group 7 cases were positive and 25 cases were negative.The mean number of positive lymph nodes was 3 ± 2.88 in the experimental group and 1.71 ± 1.25 in the control group.The ratio of positive lymph node metastasis(the number of positive lymph nodes/the total number of lymph nodes,and the total number of central lymph nodes was ＞3)was (50.34 ±27.09) ％ in the experimental group and(33.5 ±30.79)％ in the control group.For the above 3 values of central lymph node metastasis,the experimental group were all higher than those of the control group (P =0.035,0.039,0.018 respectively).Conclusions Compared with patients of PTMC,patients of Graves' disease associated with PTMC are more likely to have central lymph node metastasis,more number of positive lymph node and higher metastasis ratio.In order to prevent the postoperative recurrence of Graves' disease and thyroid carcinoma local lymph node,total thyroidectomy plus central lymph node dissection should be the ideal operation method.

This study was to investigate the chemical constituents from pseudobulbs of Pleione yunnanensis, one of the source of traditional Chinese medicine "Shancigu". The chemical constituents were isolated by various chromatography methods, including silica gel, ODS, Sephadex LH-20, and semi-preparative HPLC. Fourteen compounds were isolated and identified from the EtOAc fraction of 90% ethanol extract, including five dihydrophenanthrenes, four bibenzyls, two triterpenoids, and three phenylacrylic acids. Their structures were identified on the basis of the spectral data as 4, 7-dihydroxy-2-methoxy-9,10-dihydrophenanthrene (1), 4, 7-dihydroxy-1-(p-hydroxybenzyl)-2-methoxy-9,10-dihydrophenanthrene (2), (2,3-trans)-2-(4-hydroxy-3-methoxyphenyl) -3-hydroxymethyl-10-methoxy-2,3,4,5-tetrahydro-phenanthro[2,1-b]furan-7-ol (3), pleionesin B (4), blestriarene A (5), batatasin III (6), 3, 3'-dihydroxy-2-(p-hydroxybenzyl) -5-methoxybibenzyl (7), 3', 5-dihydroxy-2-(p-hydroxybenzyl) -3-methoxybibenzyl (8), 3,3'-dihydroxy-2,6-bis(4-hydroxybenzyl) -5-methoxybibenzyl (9), triphyllol (10), pholidotin (11), (E) -p-hydroxycinnamic acid (12), (E)-ferulic acid (13), and (E)-ferulic acid hexacosyl ester (14). Compounds 5,10-14 were separated from this plant for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Molecular Structure ; Orchidaceae ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Constitution of TCM is based on the study of individual constitution and physical health,and it has also drawn attention from the medical profession in the world.This commentary has reviewed about the development of constitution of TCM over the past few years,summed up the past 30 years,especially analysis the new research fruits during 2005-2006,expounded the important status of Chinese medical constitution in the development of Chinese medicine and the significance in socio-economic sustainable development,and put forward the direction of development and research for Chinese medical constitution.

Objective:To access the feasibility and safety of application of flexible laryngeal mask air-way ( FLMA) in oral&maxillofacial day surgery. Methods:Retrospective study was conducted of 40 oral& maxillofacial day surgery patients (3 to 61 years of age) using FLMA under general anaesthesia in De-partment of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology. All the patients were with American Society of Anesthesiologists ( ASA ) physical status Ⅰ -Ⅱ, including 19 males and 21 females. The patients' vital signs were recorded at five different time points:baseline before anesthesia ( T0 ) , time right after the FLMA insertion ( T1 ) , time at incision ( T2 ) , 15 min after incision ( T3 ) and time at the end of the operation ( T4 ) . The first attempted FLMA insertion successful rate and the number of timed of changing to endotracheal intubation were recorded. During operation, frequencies of movement, hypoxia and obstruction of airway were noted and the operation time, anesthesia time, time from the end of the operation to extubation, movement and coughing following extubation and sore throat within 24 h were taken down. Operation-related complications of bleeding, hematoma and injury of local nerves were recorded within 24 h as well. Results:The operations of all the 40 patients were successfully done under general anaesthesia. The 36 ( 90%, 36/40 ) patients using FLMA successfully were under steady process, including 16 males and 20 females. The first attempted successful rate of FLMA insertion was 80% (32/40), and the second 50% (4/8). Three out of the 4 failed FLMA patients were changed to endotracheal intubation after the second attempt failed. The other patient was changed to endotracheal intubation before operation because of leak. The average operation time was (46. 58 ± 22. 57) min, the anesthesia time was ( 77 . 97 ± 26 . 82 ) min and the time from the end of operation to extubation was (8. 31 ± 3. 33) min. All the patients were recorded without obvious body movement during the operation procedure. There were 4 patients (11. 11%, 4/36) with slight body movement during extubation. The incidence of sore throat was 13. 89% (5/36) within 24 h postoperatively. There were no complications of bleeding, hematoma and injury of local nerves. The vital signs of baseline T0 were significantly different from those at other time points T1, T2, T3, and T4 (P<0. 01). As to the hearts rate after anesthesia, the values at T1, T2, T3 and T4 for two-two comparison, there was no statistical difference (P>0. 05). As to the values of systolic blood pressure and diastolic blood pressure after anesthesia at T1 and T4 , T2 and T3, for two-two comparison, there was no statistical difference (P>0. 05). As to the respiratory rate from the start of the surgery, the values at T2, T3 and T4 showed no statistical difference (P>0. 05). Conclusion:Flexible laryngeal mask airway is a supraglottic airway management method. It is suitable and safe for securing the airway in oral & maxillofacial day surgery. The advantages of fewer haemody-namic changes and postoperative complications are confirmed.

Objeetive To evaluate the protective effects of decorin on the inner blood-retinal barrier function under high-glucose plus hypoxia conditions,and explore its potential mechanism.Methods The human umbilical vein endothelial cells (HUVEC) were cultured,and the effect of decorin with different concentrations on HUVEC viability was determined by using the cell counting kit-8 assay (CCK-8).At different hours after incubation under high-glucose plus hypoxia conditions (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),the suppression effects of various concentrations of decorin on the vascular endothelial growth factor (VEGF) expression of HUVEC was detected by enzyme-linked immunosorbent assay (ELISA).HUVEC were divided into normal control group (5.5 mmol · L-1 D-glucose),high-glucose plus hypoxia group (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),mannitol control group(5.5 mmol· L-1 D-glucose +19.5 mmol · L-1 mannitol) and decorin treatment group (25 mmol · L-1 D-glucose+ 100 μmol · L-1 CoCl2 + 100 nmol · L-1 decorin).HUVEC barrier function was evaluated by detecting transepithelial electrical resistance (TER) and permeability of fluorescein isothiocyanate-dextran (FITC-dextran).The content of tight junction proteins (claudin-5,occludin,and ZO-1) and p38 mitogen-activated protein kinase (MAPK) phosphorylation were examined by Western blotting.Results According to the results of CCK-8,the survival rates of HUVEC in all groups were more than 90％,different concentrations of decorin showed no significant effect on HUVEC survival (all P ＞ 0.05).According to the results of CCK-8 and ELISA,the stimulation of hypoxia for 48 hours and 100 nmol · L-1 decorin was taken as the condition of further experiment.At 14 days,TER of HUVEC reached its peak of (170.67 ±9.07) Ω.TER of high-glucose plus hypoxia group (97.33 ±6.11)Ω was significantly lower than that of decorin treatment group (157.67 ± 11.72)Ω (P ＜0.05).The FITC-dextran permeability of high-glucose plus hypoxia group increased to (2.12 ±0.07) times of normal control group(P ＜0.05).Decorin reversed this effect to (1.16 ± 0.03) times of normal control group (P ＜ 0.05).The expression of claudin-5,occludin and ZO-1 in high-glucose plns hypoxia group were 0.38 ±0.05,0.43 ±0.02,0.25 ± 0.02,compared to the normal control group (0.72 ±0.05,0.90 ±0.01,0.75 ±0.02),there were statistical differences (all P ＜0.05).The expression of claudin-5,occludin and ZO-1 m decorin treatment group were 0.65 ±0.08,0.87 ±0.03,0.60 ±0.01,there were statistical differences compared with high-glucose plns hypoxia group (all P ＜0.05).The ration of p-p38 MAPK/p38 MAPK in high-glucose plus hypoxia group (0.88 ± 0.02) was increased,while the decorin treatment group (0.58 ± 0.04) reached the level of the normal control group (0.56 ±0.02),there was statistical difference compared with high-glucose plns hypoxia group (P ＜0.05).Conclusion Decorin can protect the HUVEC barrier function under high-glucose plus hypoxia conditions and inhibit the activation of p38 MAPK signaling pathway.So it may be used to treat diabetic retinopathy.

Objective:To study the effects of PRF and recombinant hPDGF-AB,TGF-β1 and VEGF on the proliferation and adhe-sion of rat adipose tissue-derived stem cells(ADSCs)in vitro.Methods:ADSCs were cultured with PRF membrane and various do-ses of PDGF-AB,TGF-β1 and VEGF,cell adhesion was examined by adhesion assay after 2 culture,cell proliferation was examined by CCK-8 kit after 1 -7 d culture.Results:Cell adhesion assay showed that the adhesive numbers of rat ADSCs in PRF group were significantly higher than those in the negative group(P <0.05).The adhesive numbers of the ADSCs treated by PDGF-AB showed no significantly difference among different concentration groups(P >0.05).The adhesive numbers of the ADSCs treated by VEGF or TGF-β1 at different concentrations showed significant difference(P <0.05).CCK-8 kit assay showed that at different time points, the A values of ADSCs in PRF group were significantly higher than those of the negative control group(P <0.05).The A values of ADSCs in VEGF or PDGF-AB groups at different concentrations showed significant difference(P <0.05).The A values of rat AD-SCs in TGF-β1 group at different concentrations were lower than those in the negative control group(P <0.05).Conclusion:PRF as a combination of growth factors may stimulate the proliferation and adhesion of rat ADSCs in vitro.PDGF-AB and VEGF may stim-ulate the proliferation of rat ADSCs.TGF-β1 and VEGF may stimulate the adhesion of rat ADSCs in a dose-response manner to some degree.