Objective To observe the protective effect of goserelin on ovarian function of premenopausal patients with breast cancer during chemotherapy. Methods Forty patients with breast cancer under 40 received adjuvant chemotherapy were randomly divided intotest group(20 cases) and control group (20 cases). Compared the recovery rate and time of menstruation between two groups. Results All the 40 patients finished the treatment. Recovery ratio of normal ovarian function in test group and control group was 75% and 50% (P =0.013) respectively, and the median menstrual recovery time in two groups was 4.65 months and 6.65 months (P = 0.046) respectively. Statistically significant differences were found between two groups. Conclusion Goserelin can effectively protect ovarian function during chemotherapy , increase the ratio of normal ovarian function, shorten menstrual recovery time, and shows good tolerance.

Purpose:To study the response rate and adverse reactions of gemcitabine and cisplatin in the treatment of advanced liver cancer and the disease related symptoms improvement(DRSI). Methods:16 patients of advanced liver cancer were treated from Dec. 1999 to Dec. 2001.Gemcitabine was used intravenously by infusion for 30 min with the dose from 1 000 mg/m 2 to 1 250 mg/m 2 on day 1,8,cisplatin was infused intravenously with a dose of 25 mg/m 2 on day 1,2,3.Twenty one days were counted as one cycle. After 2 cycles of the treatment the response rate and adverse reaction and clinical symptoms were evaluated. Results:Among these 16 patients,there was no complete response,PR 4(25%),MR 6(37.5%),SD 4(25%),PD 2(12.5%),and clinical benefit response(CR+PR+MR+SD)14(87.5%). DRSI could be observed in 31.3%(5/16) for 1 cycle and 68.8%(11/16) for 2 cycles.The main adverse reactions were hematologic toxicity(grade 3/4),which included leucopenia 15.4%(6/39),anemia 12.8%(5/39),thrombocytopenia 25.6%(10/39),and nonhematologic toxicity was mild.Conclusions:Combination of gemcitabine with cisplatin was an effective and new chemotherapy for advanced liver cancer,it has high DRSI and mild adverse reactions.

Objective To investigate whether genotypes of CYP3A5,MDR1 and cyclooxygenase-2 are associated with the sensitivity of vinorelbine-platinum to NSCLC.Methods The genotypes of CYP3A5(*3),MDR1 (2677G>T at exon 21 and 3435C>T at exon 26 and their haplotypes),cyclooxygenase-2 (-1 195G>A) were determined by RFLP-PCR and chemotherapy responses were analyzed in 69 non-small-celllung cancer (NSCLC) Chinese Han patients.They received a combination chemotherapy of vinorelbine-cispla-tin.Chi-square test was used to investigate the potential association of genotype with chemotherapy response.OR and 95% C1 were calculated.Results The 3435 CC genotype was associated with a significantly betterchemotherapy response compared with the combined 3435 CT and 1Tr genotypes(P=0.033).The 2677 GG genotype was also associated with a significantly better chemotherapy response compared with the combined 2677 GT and IT genotype(P=0.012).Moreover.patients with the 2677 G-3435 C haplotype seemed to have a better response to chemotherapy compared with those with the other haplotypes(P=0.063).CYP3A5*3 was not likely to correlate with sensitivity of vinorelbine-platinum to NSCLC.Cyclooxygenase-2-1195G>A was likely to have better response to vinorelbine but not statistically significant(P=0.067).Conclusion Polymor-Dhisms of MDR1 3435 C>T and MDR1 2677 G>A/T can be used for predicting treatment response to vinorel-bine-cisplatin chemotherapy in NSCLC patients.

Objective To evaluate the accuracy of an expiratory resistance device assisting pulse pressure variation (PPV) in predicting volume responsiveness in the spontaneously breathing patients.Methods Forty spontaneously breathing patients of both sexes,aged 22-61 yr,weighing 51-73 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective operation,were enrolled.Before induction of anesthesia,mean arterial pressure (MAP),heart rate (HR),central venous pressure (CVP),cardiac index (CI) and pulse pressure variation (PPVB) were recorded after haemodynamics were stable.Then the expiratory resistance device was used,and MAP,HR,CVP,CI,and PPVA were recorded.The device was then removed.Volume expansion was carried out.6％ hydroxyethyl starch 130/0.4 6 ml/kg was infused over 10 min.MAP,HR,CVP,CI and PPVB were recorded within 3 min after volume expansion.The device was used again,and 1 min later MAP,HR,CVP,CI and PPVA were recorded.The device was then removed.The patients were divided into 2 groups according the percentage of increase in CI after volume expansion (△ CI):△ CI≥ 15％ considered to be a positive response group (group P),and ACI＜15％ considered to be a negative response group (group N).A receiver-operating characteristic (ROC) curve for PPV was plotted.According to the ROC curve,the diagnostic threshold,sensitivity,specificity,area under the curve,and 95％ confidence interval of the expiratory resistance device assisting PPV in predicting volume responsiveness were determined.Results The area under the curve (95％ confidence interval) of PPVA was 0.880 (0.70-0.98),the diagnostic threshold was 13.5％,and the sensitivity and specificity in determining volume responsiveness were 87％ and 88％,respectively.Compared with the value before administration of the loading dose,the CVP and CI were significantly increased,and PPVB and PPVA were decreased after volume expansion in group P,and the CVP and CI were significantly increased after volume expansion in group N (P＜0.05).Compared with group P,the PPVA was significantly decreased before volume expansion,and the CI was increased after volume expansion in group N (P＜0.05).Conclusion The expiratory resistance device can assist PPV in predicting volume responsiveness in the spontaneously breathing patients.

Ferula sinkiangensis K.M. Shen is a kind of endangered national plant medicine in the northern of Xinjiang,China. It mainly contains sesquiterpene coumarins,sulfides,polysaccharides,aromatic compounds and other effective chemical constitu-tions;Chromatography is used to build the fingerprint and to control the medicine quality in most cases. Both raw plant medicine and specific compounds possess pharmacologic activities such as antibacterial,insecticidal,anti-allergic,and antitumor properties. The present paper summarizes the resource distribution,chemical constituents,fingerprints and pharmacological activities of F. sinkian-gensis,to provide reference for its systematic research,effective quality control and efficient development and utilization.

Objective To establish the subcutaneous transplantation tumor models with Lewis lung adenocarcinoma in C57BL/6 mice, and to observe the influence of oHSV2, DDP and drug combination on tumor volume, median survival time and weight of tumor-burdened mice.Methods Subcutaneous transplantation tumor models were established with Lewis lung adenocarcinoma in tumor-burdened mice.Tumor-burdened mice were randomly divided into the control group, oHSV2 group, DDP group, oHSV2/DDP sequential group, DDP/oHSV2 sequential group and oHSV2+DDP combination group with 12 rats in each group using the random number table method.The tumor size and weight of mice were measured every 3 days.Results On the 21st day, the tumor size of tumor-burdened mice in every group was as follows: control group (1.82±0.06)cm3, oHSV2 group (0.63±0.05)cm3, DDP group (0.58±0.03)cm3, oHSV2/DDP sequential group (0.49±0.05)cm3, DDP/oHSV2 sequential group (0.42±0.04)cm3, and the difference was statistically significant (F=1 359.01, P=0.000).The data in oHSV2+DDP group were put away because of premature death in mice.The differences were statistically significant between control group and oHSV2 group (P=0.000), control group and DDP group (P=0.000), control group and oHSV2/DDP sequential group (P=0.000), control group and DDP/oHSV2 sequential group (P=0.000), oHSV2 group and DDP group (P=0.017), DDP group and DDP/oHSV2 sequential group (P=0.000), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (P=0.001).The weight of tumor-burdened mice in every group was listed as follows: control group (21.64±0.40)g, oHSV2 group (21.34±0.37)g, DDP group (15.96±0.43)g, oHSV2/DDP sequential group (19.04±0.31)g, DDP/oHSV2 sequential group (16.34±0.30)g, and the difference was statistically significant (F=588.67, P=0.000).The difference was not statistically significant between control group and oHSV2 group (P=0.076).However, the differences were statistically significant between control group and DDP group (P=0.000), control group and oHSV2/DDP sequential group (P=0.000), control group and DDP/oHSV2 sequential group (P=0.000), oHSV2 group and DDP group (P=0.000), oHSV2 group and oHSV2/DDP sequential group (P=0.000), DDP group and DDP/oHSV2 group (P=0.013), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (P=0.000).The median survival time of tumor-burdened mice in every group was displayed as follows: control group 23 d , oHSV2 group 32 d, DDP group 30 d, oHSV2/DDP sequential group 37 d, DDP/oHSV2 sequential group 39 d, oHSV2+DDP combination group 16 d, and the difference was statistically significant (χ2=120.81, P=0.000).The differences were statistically significant between control group and oHSV2 group (χ2=10.88, P=0.001), control group and DDP group (χ2=10.69, P=0.001), oHSV2 group and DDP/oHSV2 sequential group (χ2=10.09, P=0.001), DDP group and DDP/oHSV2 sequential group (χ2=9.67, P=0.002).However, the differences were not statistically significant between oHSV2 group and DDP group (χ2=0.00, P=0.996), oHSV2/DDP sequential group and DDP/oHSV2 sequential group (χ2=2.70, P=0.100).Conclusion On the premise of that the weight of mice is no affected, oHSV2 can inhibit the tumor size and prolong the median survival time of tumor-burdened mice effectively, and the effect of DDP/oHSV2 sequential group is the most significant.This article provides an experimental basis for exploring therapeutic methods of lung adenocarcinoma.

Objective To explore the value of transthoracic echocardiographic suprasternal view in　the diagnosis of the subtype of the patent ductus arteriosus(PDA).Methods Sixty-five cases with PDA were examined by transthoracic echocardiographic suprasternal view and parasternal great artery short axis view respectively before closure therapy.The diameters of both the aotic and pulmonary side were detected,and subtype diagnoses were made.The results were compared with those from digital subtraction angiography (DSA).Results The demonstrated rates of PDA were 100％ on the parasternal great artery short axis and suprasternal views.Of the 65 cases,12 cases,19 cases and 19 cases were the funnel type of PDA checked on the parasternal great artery short axis view,suprasternal view and DSA respectively.The demonstrated rate of the parasternal great artery short axis view was lower than that of the suprasternal view (x2 =5.14,P ＜0.025 ).The diameter of the aotic side of PDA was (8.31 ± 2.76)mm,(10.87 ± 3.26) mm and (11.15±3.29)mm and the diameter of the pulmonary side of PDA was (5.69± 2.82)mm,(5.75 ± 2.63)mm and (6.09 ± 2.78) mm respectively on the above two views and DSA.Conclusions The diameter of the aotic side of PDA can be accurately detected by using superasternal view,which would be helpful for the diagnosis of PDA subtype.

Objective To assess the clinical efficacy of minimally invasive internal fixation combined with percutaneous kyphoplasty (PKP) in treatment of thoracolumbar burst fractures in the elderly.Methods Twenty-one cases of neurologically intact thoracolumbar burst fractures treated by PKP between January 2007 and December 2008 were included in this study.There were 8 males and 13 females at age of 65-78 years (means,70.6 years).Mean period from injury to operation was (3.7 ± 1.1) days (range,3-7 days).The injured segments included Ti1 in two cases,T12 in six,L1 in eight and L2 in five.Kphosis Cobb' s angle,correction degree of kyphosis angle,correction loss of kyphosis,perioperative indicators,visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated after operation.Results All the cases were followed up for a period of 26-56 months (mean 34.2 months).Operation averaged 98.7 minutes (range,80-120 minutes) and showed mean blood loss of 32.8 ml (range,30-85 ml).Ambulation started at mean 18.2 hours after operation (range,8-19 hours).VAS averaged (0.9 ± 0.6) points at postoperative one week.Postoperative X-ray films revealed mean 10.4° correction of kyphotic Cobb angle,followed by mean 1.8 °of loss in the follow-up longer than 24 months.According to hyperextension and hyperflexion radiographies,there was no abnormal activity of fixed segments,implant loosening and breakage or adjacent vertebral fractures.Conclusion Minimally invasive internal fixation combined with PKP can relieve pain and restore function in a short time and is thought to be a preferable treatment option for thoracolumbar burst fractures in the elderly.

Objective To evaluate the clinical effect of interspinous H-shaped bone grafting and bilateral facet interbody fusion in treatment of thoracolumbar fracture with severe disc injury and posterior ligamentous complex (PLC) injury after posterior pedicle screw fixation and its role in prevention of delayed kyphosis.Methods The study involved 19 cases of thoracolumbar fractures with severe disc injury and PLC injury,including 11 males and 8 females,at age of 23-59 years (mean 43.8 years.All cases were treated with posterior pedicle screw fixation (including 11 cases treated with unilateral laminectomy decompression) and C-arm X-ray showed favorable fracture reduction.For prevention of postoperative delayed kyphosis,the interspinous H-shaped bone grafting plus bilateral facet interbody fusion by using the iliac autografts was done.Neurologic recovery was assayed by using Frankel scale and lumbar and iliac pain by visual analogue scale (VAS).Cobb angle was detected as well.Results All cases were followed up for 24-64 months.At final follow-up,all cases showed neurological improvement for at least 1 to 2 Frankel grades except for two cases with Frankel Grade A,with mean Cobb angle of (2.0 ± 3.7) ° (range,-4.9°-8.1 °),mean VAS of lower back pain of (1.1 ± 1.2) points (range,0-4 points) and insignificant angle loss or kyphosis.The thin layer CT scan indicated complete integration of the transplanted bone grafts,with no complications like implant loosening or breakage.Conclusion Interspinous H-shaped bone grafting and bilateral facet interbody fusion is a good choice for prevention of delayed kyphosis after posterior pedicle screw fixation of thoracolumbar fracture with severe disc injury and PLC injury.

Objective To investigate the efficacy of holmium laser coagulation under choledochoscope for the treatment of intrahepatic hemobilia.Methods The clinical data of 55 patients with intrahepatic hemobilia who received holmium laser coagulation under choledochoscope at the General Hospital of Chengdu Military Area from June 2003 to August 2011 were retrospectively analyzed.After the hemobilia was confirmed with choledochoscopy,an optical fiber of holmium laser was inserted into the intrahepatic bile duct from the hole of choledochoscope.The top of the optical fiber was posed close to the bleeding region,and then the laser was stimulated for coagulation under direct vision.If the observation of the bleeding area was influenced by the bleeding,the porta hepatis was temporarily occluded with a rubber hose combined with pressurized liquid injection bag.For patients with distal bile duct stenosis and bleeding,the narrow area was first expanded by biliary balloon or laser,then hemostasis was completed after the flow of bile duct was restored.Results The hemorrhage of the 55 patients was controlled,with an average time of 5.5 minutes (range,2-15 minutes).Temporary hepatic portal clamping was applied for 16 patients (27 times),and the average blocking time was 2.2 minutes (range,1-4 minutes).Biliary rehaemorrahagia occurred after operation in 2 patients,and they were cured by non-surgical treatment.All patients were discharged after successful hemostasis.The time of follow-up was 35-49 days.The epithelium of the bile duct coagulated by intraoperative holmium laser restored flat in 41 patients,and new biliary stricture was not found in the other 14 patients.Conclusion Holmium laser coagulation under choledochoscope for intrahepatic hemobilia is simple and effective.