Purpose:To observe the response and tolerance to the regimen of etoposide,folinic acid and fluorouracil (ELF) in advanced gastric cancer. Methods:Thirty two patients with advanced gastric cancer received chemotherapy of ELF regimen(VP 16 100 mg iv d 1—3 ,CF 100—300 mg iv d 1—3,5 FU 750 1 000 mg iv d 1—3 Results:The overall response rate was 37.5% (12/32) and complete response rate was 3.1% (1/31), the partial response rate was 33.4% (11/32). The main toxicity was myelosuppression and alopecia. Leukopenia was observed in 81.6% of the patients, but grade 3 and 4 in only 12.5%. Anemia and throbopenia was observed in 21.8% and 35.1% of the patients respectively, alopecia in 100%. Other side effects were uncommon. Conclusions:This study shows that the regimen of ELF is effective and tolerable for treatment of advanced gastric cancer. [

Objective To evaluate the effect of community systemic management on quality of life in patients with hypertension.Methods A cross-sectional study was used to survey 224 patients with essential hypertension systemically managed in community and 205 non-management patients using the questionnaire including demographic information,behaviour,years of hypertension,treatment,Chinese version SF-36 short form of quality of life and the symptom distress checklist.Student-t test,?2-test,and covariance analysis was used in data analysis.Result The managed patients' mean score of knowledge(6.40?1.31)was significantly higher than that in non-managed patients'(5.02?1.82,t=8.82,P

ObjectiveTo investigate the disruption of blood-brain barrier (BBB) after brain trauma in rats using IgG immunohistochemical staining.MethodsAn impact-acceleration head injury model was established with rats. Histological changes of rats' brains were observed by HE staining and light and electron microscopes at 1 h, 6 h, 24 h and 7 d after injury, and BBB permeability was analyzed semi-quantitatively by IgG immunohistochemical staining at the same time points.ResultsThe spot bleeding and brain edema was present in the damage region after brain trauma and endothelial cell damage and astrocyte swelling could be found under electron microscope. The extravasations of IgG was detected in the injured hemisphere of rats at 1 h, and achieved the peak at 6 h, remained a high level up to 24 h, and decreased at 7th d.ConclusionThe disruption of BBB function occurs after brain trauma in rats, and detection of IgG extravasations tested by immunohistochemical staining is a simple and sensitive way to investigate BBB permeability.

Objective To assess the effects of zinc protoporphyrin (ZnPP), an inhibitor of the heme oxygenase (HO), on the colonic interstitial cells of Cajal (ICC) of diabetic rats with colonic slow transit. Methods Diabetes mellitus (DM) model was induced by intraperitoneal injection of streptozotocin (STZ) in Sprague-Dawley rats. Twenty four successfully established DM rats were selected, and 16 healthy rats were served as controls. Six weeks later, gastrointestional (GI) dysfunction was observed by charcoal propulsion experiment in 8 DM rats and 8 controls. The rest rats in DM group were divided into 2 groups: DM rats intraperitoneal injected with PBS (n=8) or with 10 μmol/kg of ZnPP (n = 8) every other day for 3 weeks. The rats in control group (n = 8) were intraperitoneally injected with PBS. The levels of HO and c-kit (the special receptor of ICC) expression were detected by Western blotting. The distribution of ICC was observed by immunohistochemistry and the area of c-kit positive cells was counted. Results The GI propulsion rate in DM rats interfered with PBS was significantly declined compared to that in the controls (63.0%± 1.2% vs 71.8%±2.0%, P<0.05). But it was improved in DM rats interfered with ZnPP (72.5± 2.6%, P<0.05), which showed no significant differentee with that in control group (P>0.05). The expression of HO-1 in close and distant colon of DM rats interfered with ZnPP was decreased (P< 0.05). The expression of HO-2 in close colon and the area of c-kit positive cells of DM rats interfered with PBS was reduced compared with that in controls (P<0.05), but both were improved in DM rats interfered with ZnPP (P<0. 05). Conclusion Administration of ZnPP might be able to protect ICC by its blockage of HO-1 in DM rats with gastrointestinal dysfunction.

To explore the measures of nursing management in the treatment of large number of infants with urinary calculi. The nursing management measures included launching the preparedness and response project for sudden public health events, formulating scientific and standardized nursing management system,optimizing work flow,strengthening nurse training,focusing on the details in nursing management,implementing disinfection and isolation system seriously,and paying close attention to health education for the parents of minority infants. Scientific nursing management can ensure the treatment effectiveness and nursing safety for the infants with urinary calculi.

10.3969/j.issn.2095-4344.2013.23.007

Objective To evaluate the clinical effect and safety of retroperitoneal laparoscopic partial nephrectomy in treatment of patients with T1b renal carcinoma.Methods Fourteen patients (11 males and 3 females) with T1b renal carcinoma were retrospectively performed.The age of patients was (54.5 ± 9.2)years old,with 8 cases on the left side and 6 cases on the right side.Tumor diameter was (5.1±1.3) cm.All the patients received retroperitoneal laparoscopic partial nephrectomy.Results None of the 14 cases was converted to open surgery.The operation time was (112.0 ± 24.7) min,the intraoperative blood loss was (64.6 ± 15.9) ml,the warm ischemia time was (26.5 ± 9.3) min.The 14 patients were not blood transfusion in intraoperative and postoperative.Postoperative negative pressure drainage placement time was (3.1 ± 1.5)d,lying in bed time was 72 h.Serum creatinine increase was found in 1 case postoperative 12 h,others were no severe complications.Postoperative pathology:the incisal margin of 14 cases were all negative,clear cell carcinoma was in 13 cases,the pathology stage was T1bNoM0;angiomyolipoma of kidney was in 1 case.All the patients were follow-up 3-16 (21.4 ± 9.6) months,all the patients had normal renal function and had no tumor recurrence or metastasis.Conclusion Retroperitoneal laparoscopic partial nephrectomy is safe and reliable for treatment of patients with T1b renal carcinoma.

Objective To investigate the correlation between ankle-brachial index (ABI) and early neurological deterioration (END) in patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset from January 2014 to December 2014 were enroled. Bidirectional Doppler flow detector was used to detect ABI. END was defined as the increased National Institutes of Health Stroke Scale score ≥2 or the increased motor score ≥1. The demographic characteristics, vascular risk factors, laboratory parameters, and the incidence of END were identified and analyzed. Results A total of 210 patients with acute ischemic stroke were enroled, including 51 had END and 159 did not have END. Univariate analysis showed that the proportion of patient with ABI ≤0. 9 of the END group was significantly higher than that of the non-END group (43. 1% vs. 22. 0% ; χ2 = 8. 714, P =0. 003). Multivariable logistic regression analysis showed that ABI ≤0. 9 (odds ratio 2. 688, 95% confidence interval 1. 265 - 5. 052; P = 0. 009) was independently associated with END in patients with ischemic stroke after adjusting for the confounding factors, such as age, sex, baseline systolic blood pressure, and ischemic heart disease. Conclusion The low ABI was associated with the occurrence of END in patients with acute ischemic stroke.

Objective To investigate the effect of chronic intermittent hypoxia (CIH) on myocardial tissue pathology,oxidative stress and apoptosis in rat fed a high-fat diet,and to explore the possible mechanism of CIH induced cardiomyocyte injury.Methods A total of 24 male Wistar rats were randomly divided into 3 groups (n=8 each).The control group was fed common rat forage,the high-fat group was fed high-fat forage,and the high-fat plus intermittent hypoxia group was fed high-fat forage combined with a 7h/d intermittent hypoxia treatment.The changes of myocardial tissue pathology and ultrastructure of cardiomyocyte,and the activities of apoptosis regulating factor cysteine-containing aspartate-specific proteases-3 (caspase-3) and oxidative stress marker myeloperoxidase (MPO) were observed in the 3 groups after 4 weeks of treatment.Results There were significant differences in the activities of caspase-3 and MPO among the three group (F=89.94,71.24,both P＝0.001).The activities of caspase-3 and MPO were lower in the control group than in the high-fat group and in high fat plus intermittent hypoxia group [(0.21±0.06) vs.(0.80±0.11),(1.15±0.21),(3.20±0.58) vs.(10.87±1.96),(13.17±2.22),P＜0.01].The activities of caspase-3 and MPO were higher in the high-fat plus intermittent hypoxia group than in the high fat group[(1.15±0.21) vs.(0.80±0.11),(13.17±2.22) vs.(10.87±1.96),P＜0.01].No abnormal findings in the structure of cardiomyocyte were observed in the control group,while multiple pathologic damages in cardiomyocyte were detected in the high-fat group,and more obvious injuries in the high-fat plus intermittent hypoxia group.Conclusions The pathologic damages to cardiomyocyte are more serious in high fat and intermittent hypoxia group than in the high-fat group.Apoptosis induced by oxidative stress may play an important role in the pathogenesis of these injuries.