Objective To evaluate the efficacy and toxicity of weekly docetaxel and cisplatin in previously untreated patients with advanced non-small-cell lung carcinoma. Methods Between January 2002 and December 2003 ,34 patients with pathologically comfirmed advanced non-small-cell lung carcinoma who had not received treatment were enrolled. The mean age was under 66 years. The patients received intravenous infusions of docetaxel(25 mg/m2,dayl ,8,15) with dexamethasone premedication and cisplatin(25 mg/m2,dayl ,8,15) ,followed by a week of rest. The remedies which were less than 6 regimens lasted to disease progression or severe toxicity. Therapeutic effect was evaluated by CT scan every two courses . The patients were followed up for 24 months. Descriptive statistics and SPSSIO. 0 software were used to analyse the results. Results 34 patients finished 90 courses. The mean was 2. 6 courses. All patients were followed up. Two patients achieved complete responses, ten patients achieved partial responses, ten patients achieved stable disease. An objective response rate of 35. 29% (95% confidence interval 19. 25%-51. 33% )was obtained. Patients life quality was significantly improved. The median time to progression was 4. 1 months, and median overall survival was 11 months. The 1-year survival rate was 47. 06% , the 2-year survival rate was 11.76% . Toxicities were mild. Grade 3 to 4 neutropenia (11.76%), anemia (5.88%), hyponatremia (5.88%), alopecie (17.64%) and nausea/vomiting (5. 88% ) were observed. Conclusion Weekly Cisplatin plus docetaxel is an effective and well-tolerated regimen in chemo-naive patients with advanced NSCLC. Well-designed clinical trials should be conducted.

Introduction:This paper describes the epidemiological, microbiological and environmental investigations conducted during an outbreak of Salmonella gastroenteritis in Singapore. Methods:A case-control study was undertaken to identify the vehicle of transmission. Microbiological testing was performed on faecal, food and environmental samples. Isolates of Salmonella were further characterized by phage typing and ribotyping. Results:There were 216 gastroenteritis cases reported from 20 November to 4 December 2007. The causative agent was identified as Salmonella enterica subspecies enterica serotype Enteritidis for 14 out of 20 cases tested. The vehicle of transmission was traced to cream cakes produced by a bakery and sold at its retail outlets ( P < 0.001, OR = 143.00, 95% Cl = 27.23–759.10). More than two-thirds of the 40 Salmonella strains isolated from hospitalized cases, food samples and asymptomatic food handlers were of phage type 1; the others reacted but did not conform to any phage type. The phage types correlated well with their unique antibiograms. The ribotype patterns of 22 selected isolates tested were highly similar, indicating genetic relatedness. The dendrogram of the strains from the outbreak showed distinct clustering and correlation compared to the non-outbreak strains, confirming a common source of infection. Discussion:The cream cakes were likely contaminated by one of the ingredients used in the icing. Cross-contamination down the production line and subsequent storage of cakes at ambient temperatures for a prolonged period before consumption could have resulted in the outbreak.

INTRODUCTIONSingapore's defense against imported novel influenza A (H1N1-2009) comprised public health measures in compliance with the World Health Organization's (WHO) International Health Regulations (IHR), 2005. We report herein on the epidemiology and control of the fi rst 350 cases notified between May and June 2009.

MATERIALS AND METHODSWe investigated the fi rst 350 laboratory-confirmed cases of novel influenza A (H1N1-2009) identified from the healthcare institutions between 27 May and 25 June 2009. Epidemiological details of these cases were retrieved and analysed. Contact tracing and active case finding were also instituted for each reported case, and relevant particulars including flight information were provided to WHO and overseas counterparts.

RESULTSThe fi rst 350 novel influenza A (H1N1-2009) cases comprised 221(63%) imported cases, 124 (35%) locally acquired cases and 5 (2%) cases with unknown source. The imported cases consisted of three waves involving the United States (US), Australia and Southeast Asia. In the fi rst wave, 11 (69%) of the 16 imported cases had visited the US within seven days prior to their onset of illness between 25 May and 4 June 2009. In the second wave, 20 (74%) of the 27 imported cases between 5 June and 12 June had travelled to Melbourne, Australia. In the third wave, 90 (51%) of the 178 imported cases between 13 June and 25 June were acquired from intra-regional travel in Southeast Asia. Specifically, 49 cases were from the Philippines and 40 (82%) of them had travelled to Manila. A total of 667 communications were effected through the IHR mechanism; a majority within 24 hours of disease notification.

CONCLUSIONSingapore experienced an unprecedented need for international cooperation in surveillance and response to this novel Influenza A (H1N1-2009) pandemic. The IHR mechanism served as a useful channel to engage in regional cooperation concerning disease surveillance and data sharing, but requires improvement.

Adolescent ; Adult ; Child ; Disease Notification ; Disease Outbreaks ; prevention & control ; Female ; Guideline Adherence ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; epidemiology ; prevention & control ; International Cooperation ; Male ; Singapore ; epidemiology ; Travel ; World Health Organization ; Young Adult

OBJECTIVETo investigate the effect of Astaxanthin on enhancing the function of anti-oxidative damage in osteoblast.

METHODSMC3T3-E1 osteoblasts were randomly divided into five groups, including control group, model group, Astaxanthin group [low-dose (1 x 10(-7) mol/L), middle-dose (1 x 10(-6) mol/L), high-dose (1 x 10(-5) mol/L)], in which the activity of cells, activity of superoxide dismutase (SOD), the content of reactive oxygen species (ROS), lipid oxygen (LPO) and membrane fluidity were tested and compared.

RESULTSCompared with Astaxanthin groups, the activity of cells, SOD activity and membrane fluidity in the model group were significantly decreased (P < 0.01). However, the contents of ROS and LPO were significantly raised (P < 0.01).

CONCLUSIONH2O2 can cause oxidative damage of MC3T3-E1 osteoblasts, but Astaxanthin can prevent or decrease its influence.

Animals ; Antioxidants ; chemistry ; pharmacology ; Cell Line ; Hydrogen Peroxide ; metabolism ; Lipid Peroxidation ; drug effects ; Membrane Fluidity ; drug effects ; Mice ; Osteoblasts ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism ; Xanthophylls ; chemistry ; pharmacology

OBJECTIVETo study the influence of canthaxanthin on D-galactose induced osseous changes of rat.

METHODSForty-five six-week-old Wistar male rats were randomly divided into model group, canthaxanthin group and young control group. In addition, 15 sixteen-month-old Wistar male rats were used as old control group. Model group and canthaxanthin group were given injections of D-galactose for 5 months (20 mg/kg/once per-day) to cause aging of rat. Then routine osseous parameters were tested and compared among the 4 groups.

RESULTSCompared with young control group, the BMD, parameters of structural mechanics and biomechanics, bone calcium, manganese, magnesium and the content of hydroxyproline in the model group decreased significantly (P < 0.01), however, the content of bone phosphorus, the activity of bone and serum ALP increased significantly (P < 0.01). Those changes of the model group were the same as the old control group,but the changes in the canthaxanthin group significantly differed with the model group (P < 0.01).

CONCLUSIONThe high does of D-galactose intake can cause aging and osteoporosis at the same time in rat, but canthaxanthin can prevent and inhibit D-galactose induced osseous changes.

Alkaline Phosphatase ; blood ; Animals ; Biomechanical Phenomena ; Bone Density ; drug effects ; Bone and Bones ; chemistry ; drug effects ; Calcium ; analysis ; Canthaxanthin ; pharmacology ; Galactose ; toxicity ; Male ; Malondialdehyde ; blood ; Rats ; Rats, Wistar ; Superoxide Dismutase ; blood

Objective To investigate the diagnostic value of internal septation for differentiating benign from malignant breast lesions.Methods A total of 26 patients were included in the study,in which 12 patients had 20 lesions of breast carcinoma and 14 patients had 25 lesions of fibroadenoma diagnosed either pathologically or clinically.The differential diagnoistic value of the hypointensive internal septation was analyzed.Results The signal intensity of fibroadenomas and malignant lesions on T_2-weighted fat- suppressed images could be classified as iso- to hyper- intensity,hypointensity and mixed intensity. According to the signal intensity classification,there were 5,11 and 4 cases in patients with breast carcinoma respectively,while 11,10,4 cases in patients with fibroadenoma respectively.There was no statistical difference in the distribution between the two patient groups(?~2=1.764,P=0.414).The shape of fibroadenomas and malignant lesions could be classified as irregular、roundish or lobulated.According to the morphological classification,there were 12,7 and 1 case in patients with breast carcinoma respectively, while 1,7,17 cases in patients with fibroadenoma respectively.There was statistical difference in the distribution between the two patient groups(?~2=23.262,P=0.000).The typical features of fibroadenomas were as follows:lobulated shape,hypointensive internal septations on T_2-weighted or postcontrast images. The diagnostic sensitivity of the three imaging features for fibroadenoma was 68%(17/25),52%(13/25), and 72%(18/25)respectively;and the diagnostic specificity was 95%(19/20),90%(18/20),95% (19/20)respectively.Conclusion The internal septation is a rather specific sign for diagnosis of fibroadenomas.

OBJECTIVETo investigate the influence of aqueous extract of Aralia echinocaulis Hand.-Mazz on the expression of fracture healing-ralated factor receptors.

METHODSSingle factor model was set up in SD rat. Selecting 14 and 28 days in the experiment. Immunohistochemistry was employed to determine the expression of Fibroblast growth factor receptor 2 (FGFR2), Fms-like tyrosine kinase (Flt-1) and Fetal licer kinase (Flk-1) at 14 and 28 days after model establishing.

RESULTSThe expression of Flt-1 and Flk-1 at 14 days (the latter was more remarkable) were obviously promoted in High dose group of aqueous extract of Aralia echinocaulis Hand.-Mazz, and higher than that in normal group and model group. The expression of FGFR2 in the high dose group of Aralia echinocaulis Hand -Mazz was also promoted visibility, close to that in the compare group (traditional Chinese medicine), but higher than than in the model group. There was no significant difference among them. At 28 days, the expression of FGFR2, Flt-1 and Flk-1 in all groups decreased except normal group, and got higher expression in model groups than each control groups.

CONCLUSIONAqueous extract of Aralia echinocaulis Hand.-Mazz can promote angiogenesis in fracture healing, improve the activity and aggregation of fibroblasts, osteoblasts and chondrocytes. It also helps to quicken ossification in the cartilage and promote fracture healing.

Animals ; Aralia ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; therapeutic use ; Female ; Fibroblast Growth Factors ; metabolism ; Immunohistochemistry ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism ; Wound Healing ; drug effects

OBJECTIVETo investigate the expression of human epidermal growth factor receptor 2 (HER-2/neu) in hepatocellular carcinoma (HCC) patients and its clinical significance.

METHODSThe expressions of HER-2/neu were detected by SP immunohistochemistry method in 30 patients with HCC, 10 with portal cirrhosis of the liver and 10 with normal liver.

RESULTSThe positivity rate of HER-2/neu was markedly higher in HCC patients than in those with portal cirrhosis and normal liver (Chi(2)=6.482, P=0.032). The expression of HER-2/neu was closely correlated to portal cirrhosis of the liver (P=0.041), tumor invasion (P=0.028) and Edmondson grades (P=0.012). The average survival time was significant shorter in patients with HER-2/neu-positive tumor than in those with HER-2/neu-negative tumor (P=0.036).

CONCLUSIONThe expression of HER-2/neu may play a role in the invasion, metastasis and progression of HCC. The patients positive for HER-2/neu in the HCC tissues have generally poor prognosis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; genetics ; metabolism ; Female ; Humans ; Liver Neoplasms ; genetics ; metabolism ; Male ; Middle Aged ; Neoplasm Metastasis ; Prognosis ; Receptor, ErbB-2 ; genetics ; metabolism

OBJECTIVETo identify potential mutation of apolipoprotein E (apoE) gene in a male patient affected with lipoprotein glomerulopathy (LPG), his mother and his sister.

METHODSThe patient and his mother both had histologically confirmed LPG. His sister and his father were asymptomatic. Genomic DNA was extracted from peripheral blood samples. PCR products of the coding region of exons 3 and 4 of the apoE gene were cloned into a pTA2 vector and sequenced. Genetic variations of the apoE gene were detected using PCR and restriction fragment length polymorphism (RFLP).

RESULTSAn apoE gene mutation was identified in the patient's family. Sequence analysis confirmed a 9-bp deletion in the exon 4 of apoE gene from nt 484 to 492. The 9-bp deletion resulted in loss of 3 amino acids at positions 143-145. The sister of the propositus carried the same mutation, though she had neither proteinuria nor elevated plasma apoE. Sequence analysis of exon 3 showed no abnormality. No abnormalities were found in the father's apoE gene sequence. Analysis of genetic variations of the apoE gene by PCR and RFLP confirmed a 57 bp fragment consistent with the 9-bp deletion in exon 4. The father had a normal ε 3 ε 3 genotype.

CONCLUSIONThe 9 bp deletion of apoE may be associated with the pathogenesis of LPG.

Adolescent ; Apolipoproteins E ; blood ; genetics ; Exons ; Female ; Genetic Predisposition to Disease ; Genetic Variation ; Humans ; Kidney Diseases ; blood ; genetics ; Kidney Glomerulus ; metabolism ; pathology ; Lipoproteins ; blood ; Male ; Mutation ; Pedigree

Objective To explore the effectiveness and safety of intravenous metoprolol by two injection methods in treatment for patients of atrial fibrillation anti rapid ventricular rates complicated with heart failure.Methods Patients of atrial fibrillation and rapid ventricular rates complicated with heart failure were administrated regular drug therapy for their heart failure,and then they were observed for half an hour.If their ventricular rates were above 100 beats/min and blood pressure equal to or above 100/60 mm Hg (1 mm Hg=0.133 kPa),they were randomly divided into three groups,the first one administrated with metoprolol 10 mg by minipump in an hour,the second one administrated with metoprolol 5 mg in 10 minutes by direct injection,and repeated by 5 mg 10 minutes later if their heart beats were still above 100 beats/min and blood pressure equal to or above 100/60 mm Hg,and the third one administrated with normal saline as control group.As either ventricular rates were equal to or lower than 60 beats/min or blood pressure lower than 90/60 mm Hg,drug administration would be terminated.Symptoms,physical signs, heart rate,blood pressure,rale on auscultation of the chest,parameters of haemodynamics,serum levels of brain natrium peptide (BNP) and atrial natrium peptide (ANP) were observed at 0 h and 1 h after drug injection.Results Clinical symptoms and physical signs of heart failure were improved significantly,heart rates and serum levels of BNP (F=15.929,14.534,all P