Glottis ; pathology ; Humans ; Laryngeal Diseases ; surgery ; Stents

ObjectivesTo compare clinical outcomes and safety of 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer. MethodsLiterature search were performed by key words,such as metastatic colorectal cancer,capecitabine,oxaliplatin,5-Fu on all randomized controlled trails reported on 5-Fu or capecitabine combined with oxaliplatin therapy for metastatic colorectal cancer before Jun.2011.Two authors drew the details of trail design,characteristics of patients,outcomes and so on from the studies included. Data analysis was performed by RevMan 4.2. ResultsAccording to the same screening criteria,6 clinical studies were included in this Meta-analysis. Sample volume in this Meta-analysis was 2189 colorectal cancer cases.The baseline characteristics of 5-Fu group were similar to those of capecitabine group.The short-term outcome such as response rate,RR was 0.92 [95 ％CI(0.82,1.02),P=0.12], and the long-term outcome such as median overall survival, median progression-free survival and the WMD was -0.19 [95 ％CI(-0.73,0.35),P=0.49],-1.91 [95 ％CI(-2.53,0.16),P=0.08],respectively,two groups weresimilar. In the comparison of Ⅲ-Ⅳ grade toxicity between the two groups, the incidences of neutropenic in 5-Fu group were higher than those in capecitabine group,and the RR was 0.24 [95 ％CI(0.11,0.55), P=0.0007]. However, the incidence of wand-foot symptoms in 5-Fu group was lower than those in capecitabine group, the RR was 2.83 [95％CI (1.66,4.82), P=0.0001]. ConclusionBoth 5-Fu and capecitabine were similarly effective in the therapy of metastatic colorectal cancer. And the Ⅲ-Ⅳ grade toxicity such as neutropenic was easier to happen in 5-Fu group,while the incidence of hand-foot symptoms was on the other hand.

ObjectiveTo explore the clinical significance of lymph node metastasis in gastrointestinal stromal tumor (GIST).Methods A literature search to identify studies relating to GIST cases reported between January 1998 and December 2010 was conducted.The associations between lymph node metastasis and GIST clinicopathological features, gene expression, GIST stage, and GIST prognosis were evaluated.Results 6063 literatures were screened and only 16 GIST patients (median age of 49.25 years,10females) with lymph node metastasis were enrolled in this study.Among them,12 tumors were located in the stomach, 3 in the small intestine, and 1 in the esophagus.Morphologically, 13 specimens were mainly characterized by spindle cells.Gene analysis was examined in 7 cases.Conclusions Lymph node metastasis in GIST might more frequently found in the stomach, tumor stage of high grade, and cellular morphology of spindle-shaped.Gene mutation may have a relationship with lymph node metastasis.However, its clinical significance remains unclear.

OBJECTIVE:To study the pharmacokinetics and pharmacodynamics of single dose of intramuscularly injected methotrexate(MTX)in the treatment of ectopic pregnancy so as to provide theoretical bases for the choice dosage regimen.METHODS:Serum concentration of MTX in 8 cases with ectopic pregnancy were determined by fluorescence polarization immunoassay after injected i.m with single dose MTX(50mg/m2);The ?-HCG was monitored both before and after treatment and the lump sizes of the ectopic pregnancy were determined by B ultrasound.RESULTS:The pharmacokinetics of single dose of intramuscularly injected MTX conformed to two-compartment open model;Cmax occurred at 1.9h after drug taking with 2.31 ?mol/L;The time for the recovery of ?-HCG to normal was(24.8?10)days,the patency rate of oviducts of those who demanding procreation was 75%.CONCLUSION:Injection intramuscularly with single dose of MTX 50mg/m2 is effective in the treatment of ectopic pregnancy.

Objective To explore the CT, MRI?PET features of Heroin Spongiform Leukoencephalopathy (HSLE).Methods CT and MRI of 29 patients, and PET of 4 patients were analysed.Results 1.CT and MRI showed extensive and symmetric lesions in white matters of bilateral cerebellum,posterior crus of internal capsule and parieto occipital region;2.Cerebral CT showed hypodense areas, MRI showed corresponding areas with decreased signal intensity on T1 weighted images and increased signal intensity on T2 weighted images, no edema, FLAIR and enhancing scan showed no destruction of brain blood barrier, PET imaging showed hypometabolism or non metabolism changes in corresponding areas; 3. PET imaging showed non metabolism areas in untreated patients' posterior limb of internal capsule, parietooccipital lobes and cerebellum, and the metabolism in corresponding areas of improved patients was low obviously; 4.PET imaging showed hypometabolism in grey matter of untreated and improved patients, and the metabolism in the grey matter remarkable improved patient was normal.Conclusion CT and MRI changes of HSLE sufferers almost limited in brain white matters, PET imaging showed hypometabolism or non metabolism changes in corresponding areas, the metabolism improvement in grey and white matters was very important to the improvement of HSLE sufferers, PET was more appropriate than MRI to the prognoses of HSLE sufferers.

Objective To evaluate the levels of LDH in cerebrospinal fluid in patients with different types of central nervous sys‐tem diseases .Methods Cerebrospinal fluid LDH were detected by rate assay in control group and disease group(including patients with acute leukemia ,lymphoma ,brain neoplasms and meningitis) .Results In ptients with acute leukemia ,the cerebrospinal fluid LDH level of central nervous system leukemia(CNSL) group was (28 .68 ± 9 .29)U/L ,which was higher than that of non CNSL group ,and the difference were significance(P<0 .05) .In lymphoma patients ,cerebrospinal fluid LDH level of brain metastasis pa‐tients was (125 .20 ± 115 .24)U/L ,which was higher than that of lymphoma patients without brain metastasis ,the difference was significant(P<0 .05) .In patients with brain neoplasms ,cerebrospinal fluid LDH level of meningeal carcinomatosis group was (77 . 37 ± 128 .15)U/L ,which was higher than that of primary brain neoplasms group ,the difference was significant(P<0 .05) .In pa‐tients with meningitis ,cerebrospinal fluid LDH level of tuberculous meningitis group and purulent meningitis group patients were (54 .48 ± 84 .60U/L) and (43 .54 ± 32 .05)U/L respectively ,which were higher than those of viral meningitis group patients ,and the differences were significant (P<0 .05) .Conclusion LDH in cerebrospinal fluid can be used in early diagnosis of CNSL ,brain metastsisly of mphoma ,meningeal carcinomatosis and differential diagnosis of meningitis .

Objective To evaluate the influence of the placement of instant hand disinfectant in compliance and qualified rate of hand hygiene of clinicians.Methods Hand hygiene compliance of clinicians in departments of gyne-cology,obstetrics,and general surgery were observed after the placement of instant hand disinfectant at the door-way of wards,hand specimens were taken to check hand hygiene effectiveness.Results Before and after placement of instant hand disinfectant at the doorway of wards of above departments,hand hygiene behaviors of 300 person-times were observed.Hand hygiene compliance rate among clinicians in department of gynecology,obstetrics,and general surgery increased from 32.33% to 74.33%,33.67% to 85.67%,and 26.33% to 64.00%,respectively(all P <0.001).Each department selected 98 hand hygiene specimens,the qualified rate was 98.98%,100.00% and 94.90% respectively.Conclusion The placement of instant hand disinfectant at the doorway of each ward can effec-tively improve clinicians’hand hygiene compliance and hand hygiene effectiveness.

Objective To evaluate the role of O-GlcNAc protein modification in attenuation of brain damage by glutamine in septic rats.Methods Sixty male SD rata weighing 180-240 g were randomly divided into 4 groups:sham operation group(group S,n =12),sepsis group(group CLP,n =16),glutamine group(group G,n =16),an inhibitor of O-linked-N-acetyl glucosamine transferase Alloxan + glutamine group(group G + A,n =16).Rats were submitted to sepsis by cecal ligation and perforation(CLP).Glutamine(Gln)0.75 g/kg was injected iv after CLP in group G.Gln 0.75 g/kg was injected iv and Alloxan 90 mg/kg was injected ip after CLP in group G + A.Equal volume of normal saline was given in group S and group CLP.A1 24 h afler CLP,the neural reflex score was evaluated,then rat was sacrificed.The brain was removed for measurement of brain water content,observation of histopathology and determination of O-GlcNAc-modified protein expression.Results Compared with group S,neural reflex score and brain water content were significantly increased in groups CLP,G and G + A(P ＜ 0.05).Compared with group CLP,neural reflex score and brain water content were significantly decreased in groups G and G + A(P ＜ 0.05),and the expression of O-GlcNAc-modified protein was upregulated in group G(P ＜ 0.05),Compared with groups G,neural reflex score and brain water content were significantly increased,and the expression of O-GlcNAc-modified protein downregulated in group G + A(P ＜ 0.05).There was no significant difference in O-GlcNAc-modified protein expression among groups S,CLP and G + A.Conclusion Glutamine attenuates brain damage through O-GlcNAc protein modification in septic rats.

Migrant workers incur the challenges of linkage and compatibility of medical insurance systems for their migration across regions and change of identities. To identify a medical insurance system adaptable to their needs, the paper recommends the following: Take their medical insurance into the national account of medical insurance; build a linkage mechanism between cities and villages, and that between cities as well; make the medical insurance system more compatible and portable, in order to safeguard their right of health.

ObjectiveTo study the dose and time effects of X-ray radiation on the expression of Pokemon gene and protein in human lung adenocarcinoma cell line A549.MethodsA549 cells was exposed to different doses of X-ray (2,4,6 and 8 Gy),and the expression of Pokemon mRNA and protein of the cells was detected by using Quantitative real-time PCR and western-blotting at 2,4,8,12,24,and 48 h after irradiation. 3-( 4,5-Dimethylthiazol-2-yl )-2,5-diphenyltetrazoliumbromidewasused to detectthe proliferation of A549 cells at 1,2,3,4,and 5 d after 2 Gy X-ray irradiation.The mock treated A549 cells were used as the control.ResultsThe expression of Pokemon mRNA trended to decrease after irradiated with 4,6 and 8 Gy in the earlier period and increased in the later period with statistical difference at the most time points (t =3.40 -154.76,P =0.000 -0.041 ).The expression of Pokemon protein trended to increase and reached the peak at 8 h after irradiated of 2,4,6 and 8 Gy with statistical difference at the most time points ( t =4.18 - 89.64,P =0.000 - 0.039).Compared with the control,the proliferation of A549 cells was significantly inhibited during 3 to 5 d after irradiation of 2 Gy ( t =2.34 - 18.19,P =0.000 -0.040).ConclusionsX-ray irradiation may increase the expression of Pokemon mRNA and protein in A549 cells,which might be correlated with radiation-resistance of A549 cells.