Objective This study assessed whether the best overall response rate(ORR) of cetuximab combined with oxaliplatin,leucovorin and fluorouracil/Xeloda was superior to that of this method alone as first-line treatment for metastatic colorectal cancer.The influence of KRAS mutation status was investigated.Methods Patients received cetuximab(400mg/m2 initial dose followed by 250mg/m2,wk thereafter)less than 2 times plus chemotherapy(oxaliplatin 130mg/m2 on day 1,plus leucovorin 200mg/m2 and fluorouracil as a 400mg/m2 bolus followed by a 600mg/m2 infusion during 22 hours on days 1 and 2) or chemotherapy alone.Treatment was continued until disease progression or unacceptable toxicity.KRAS mutation status was assessed in the subset of patients with assessable tumor samples.Results The confirmed ORR for cetuximab plus oxaliplatin,leucovorin and fluorouracil/Xeloda was higher than that with alone(42.86% vs 21.74%).A statistically significant increase in the odds for a response with the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda could be established.In patients with KRAS wild-type tumors,the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda was associated with a clinically significant increased chance of response(ORR 54.55% vs 21.74%) and a lower risk as compared with chemothrapy alone.Cetuximab plus oxaliplatin,leucovorin and fluorouracil/Xeloda was generally well tolerated.Conclusion The clinical effcacy of chemothrapy(oxaliplatin,leucovorin and fluorouracil/Xeloda) plus cetuximab is better than only chemothrapy.KRAS mutational status was shown to be a highly predictive selection criterion in the treatment decision regarding the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda for previously untreated patients with metastatic colorectal cancer.

In bone marrow transplantation (BMT), cytomegalovirus (CMV) interstitial pneumonitis (IP) is one of the most dangerous complications, which has been the first important cause to lead the failure of BMT. At present, there is no effective and specific therapy for CMV-IP, therefore how to prevent CMV infection effectively is a top task. From 1991 to 1996, we used comprehensive steps to prevent CMV-IP in BMT, and none of 14 patients developed CMV-IP. The preventing results that we achieved by using the steps were quite satisfied.

Objective To discuss the development and content of Chinese mental health assessment guideline.Methods Following literature review,initial assessment items were outlined by authors.A questionnaire survey concerniug assessment criteria was then conducted among the authorities in tbe field of psychology or psychiatry,A working group meeting was held to make the final decision.Results Ninety-five of 192 questionnaires were finally received,and those who knew much well about mental health accounted for 85.3％.Of 24 commonly used definition and criteria,5 assessment criteria and 15 essential items were agreed to use for mental health evaluation in Chinese populations.Conclusion The development of Chinese mental health assessment guideline is important to modify mental health evaluation and health care services in China.

Objective To make a survey on common cosmetic allergens, and to provide epidemiological data and clinical evidence for cosmetic allergy. Methods Patch test was performed by using 49cosmetic allergens from a European cosmetic series and 5 Chinese standard screening allergens on 89patients with suspected cosmetic allergic contact dermatitis. Test results were determined according to the International Contact Dermatitis Research Group (ICDRG) recommendation. Results Of the 89 patients, 61(68.5%) showed positive reactions to one or more cosmetic allergens. The most common allergens were fragrances (33.7%), followed by preservatives (30.3%), para-phenylenediamine (25.8%) and amerchol L 101(10.1%). Conclusion Fragrances, preservatives, para-phenylenediamine and amerchol L 101 are dominant causative allergens in patients with cosmetic allergic contact dermatitis.

Adult ; Barotrauma ; diagnosis ; surgery ; Hand Injuries ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Paint

The basic pain threshold and pain tolerance were measured by use of radiant heat stimulation in healthy volunteers, which were close to normal distribution. The stability was obtained by repeated determination for same individuals in different time. With this method, a clinical assessment of analgesic drugs was carried out among healthy volunteers. Acetaminophen-Codeine tablet ( 2 tablets ) was able to depress pain response by increasing pain threshold and tolerance of 23% and 12% ( P

Buprenorphine, a synthetic derivative of Thebaine, is a strong new analgesic agent. It was compared with pethidine in doudle-blind trial of 86 burn and plastic patients with severe or moderate pain. The result showed that the analgesic effect of Buprenorphine 0.3 mg I. M. appeared superior to Pethidine 50mg ( P

Objective:To study the use of left renal vein as a graft vessel in reconstruction after portal vein/superior mesenteric vein (PV-SMV) resection in pancreaticoduodenectomy.Methods:A retrospective study was conducted on 5 of these patients who underwent surgery from July 2008 to December 2017 at Chinese PLA General Hospital. The operative, complication and follow-up data were analysed.Results:There were 4 males and 1 female, with an average age of 57 (33-72) years. The mean operative time was 6.8 (5.4-9.1) h and the mean tumor size was 3.8 (2.8-4.8) cm. The average length of the PV-SMV defect left after resection was 3.8 (3.2-4.6) cm. The average length of the left renal vein used was 3.4 (3.0-4.1) cm. The operations were carried out in 3 patients with pancreatic cancer and in 2 patients with colon cancer pancreatic metastasis. The average postoperative hospital stay was 12 (10-25) days. Perioperative complications included 1 patient each with ascites, diarrhea and delayed gastric emptying. The creatinine levels ranged from 70-98 μmol/L preoperatively, with a transient creatinine rise to 80-156 μmol/L after operation and became 62-107 μmol/L upon discharge from hospital. The follow-up time was 4.3-17.8 months. Two patients died of recurrence/metastasis at 14.2 and 17.8 months after surgery.Conclusions:The left renal vein has the appropriate diameter and rich collateral branches. It has a sufficient length and it is conveniently located in the surgical field. This study showed that there was a minimal effect on renal function after its excision, and it can be used as a graft vessel for reconstruction in pancreaticoduodenectomy after PV-SMV resection.

Objective To demonstrate the origin of the right inferior phrenic artery(RIPA) in normal and hepatocellular carcinoma(HCC) patients and provide valuable anatomical information for angiographers before and after transcatheter arterial chemoembolization(TACE).Methods Four hundred and forty consecutive patients including 133 HCC cases who had biphase abdominal CT were assessed in this study.The routine abdominal enhanced CT scan(GE,LightSpeed16) was performed with 120 kV,200—240 mAs,10 mm collimation,1.375 pitch,and 10 mm reconstruction interval at 22—25 seconds for arterial phase triggered by timing bolus,60 seconds for portal venous phase after injection of 100 ml contrast material(300 mg I/ml) at a rate of 3.5 ml/s.Multiplanar reconstruction(MPR) and maximum intensity projection(MIP) images were generated using 1.25 mm images reconstructed with 1 mm interval in arterial phase and reviewed by two radiologists.An enhanced artery medial-posterior to the IVC,originated from aorta or its branches to the diaphragmatic dome was interpreted as the RIPA.Results The RIPA was showed in all(440 patients)(100%).Among 218(49.5%) RIPAs originated from the aorta,140 were from the right side of the aorta,22 from the left side of the aorta,56 from the anterior wall of the aorta,36 RIPAs had the same origin with the left inferior phrenic artery.Among 138(31.4%) RIPAs from the celiac artery,10 RIPAs had the same origin with the left gastric artery,and 33 RIPAs had the same origin with the left inferior phrenic artery.78(17.7%) were from the right renal artery,6(1.4%) were from the left gastric artery(the left gastric artery from aorta).The dilatation of the RIPA was demonstrated in 16 of(133 hepatocellular) carcinoma patients.Conclusion Multislice helical CT could demonstrate the origin of the RIPA in arterial phase and provide useful anatomical information for angiographer before and after TACE.

Objective To compare 16-slice multi-detector spiral computed tomography (MDCT) and breathhold 3D magnetic resonance (MR) coronary angiography in the visualization of coronary arteries and the accuracy of detecting significant (＞ 50%) coronary stenoses in patients with suspected coronary artery disease. Methods Forty patients were examined by 16-slice CT (GE, Lightspeedl6)and MR (GE,Twinspeed) within 3 days; 31 of them underwent conventional coronary angiography (CAG) within 2 weeks after CT and MR scan. CT was performed with 16× 1.25 mm detector collimation, 0.5 s rotation time and images were reconstructed at 60%-75% of the cardiac cycle. MR was performed with breath hold 3D FIESTA (TR4.0 ms, TE1.7 ms, flip angle 65, slice thickness 3 mm, FOV 280 mm, matrix 256× 192). Mean heart rate was 63 ± 5.8 bpm and β-blocker was used in 24 patients. MR and CT image quality was evaluated in 9 coronary segments (RCA1, RCA2, RCA3, LM, LAD1, LAD2, LAD3, LCX1, LCX2) using a four-point grading scale.Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for detection of significant stenosis using CAG as the gold standard. Results 16-slice CT showed higher image quality in most coronary segments except RCA2.Forty-three segments were diagnosed as significant stenosis by CAG, 36 and 27 of these were correctly detected by CT and MR respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of 16-slice CT and MR for detecting significant stenosis were 83 %, 84 %, 49 %, 97 % and 63 %, 90 %, 55 %, 93 %, respectively. Conclusion Sixteen-slice CT showed higher image quality in most coronary segments excepted for middle RCA. 16-slice CT had higher sensitivity than MR for detection of coronary significant stenosis, whereas MR had higher specificity than CT. Both CT and MR showed high negative predictive value,which is useful for excluding coronary stenosis in symptomatic patients.