Objective:To evaluate the real-time fluorescent quantitative-polymerase chain reaction approach(fqRT-PCR) of cytokeratin 19(CK19)targets for its feasibility to estimate the number of circulating tumor cells(CTCs)in the patients with lung carcinoma during radiotherapy and to correlate our observation to clinical findings.Methods:Samples of 5ml peripheral blood were taken from each lung cancer patients(n=30)both before and after the radiotherapy course.Meanwhile tumour size was determined by chest X-ray or computed tomography.The blood samples were subjected to real time RT-PCR assay.All patients with lung cancer were treated with primary definitive and mediastinal radiotherapy.Results:Compared to with that before the-treatment,the value of CK19 mRNA in PB after therapy decreased dramaticall(y5.093 2?1.062 8 vs 4.249 3 ?0.832 3,t=3.192,P=0.007).The change of CK19 mRNA level before and after radiotherapy was closely related to the typ(esquamous cell cancer/adenocarcinoma vs.small cell cancer,0.538 9?0.903 0 vs 1.682 6?0.946 7,t=2.146 5,P=0.051).Meanwhile,there was a close link between the grade(Well/Mod vs Poor)and the change of CK19 mRNA(0.502 4 vs 1.527 1,t=2.017,P=0.065).The change of CK19 mRNA level in peripheral blood(PB)was related to variation of tumour burden during radiotherapy(r=0.057 5,P=0.025).Of the 30 cases studied,24 cases were positive before radiotherapy (24/30,80%).The positive rate was 53%(16/30)after radiotherapy,meaning that 8 cases were converted intonegative after radiotherapy. Conclusion:The disseminated cancer cells cannot be completely eradicated by radiotherapy,suggesting further more systemic adjuvant treatment should be conducted.Early assessment of the therapeutic response might be possible by serial quantitative of CTCs.Detection of tumour cells disseminated in peripheral blood can provide clinically important data that are of value for tumour staging and possibly for prognostication.

Objective: To investigate the clinical value of immature reticulocyte count in early monitoring the suppression of bone marrow function in patients with chest tumor during postoperative chemotherapy.Methods:Forty-one patients with chest tumor(22 with lung cancer?19 with esophagus cancer) received chemotherapy after radical operation.Several indexes including reticulocyte count and white blood cell(WBC) were detected with sysmex SE-9000 automated analyzer during the procedure of postoperative chemotherapy.Results:Compared with the value before chemotherapy,HFR+MFR was significantly lower than that at 7 days after chemotherapy(P

Objective To detect multidrug resistance gene(mdr1) transcription in peripheral blood lymphocyte(PBL) before and after chemotherapy and to determine its correlation with chemotherapeutic effect.Methods The peripheral blood sample was taken from each lung cancer patients(n=32) before chemotherapy and at 3rd week after chemotherapy and subjected to fluorescent quantitative real-time RT-PCR.Simultaneously the tumor size was determined by chest X-ray or CT.Results The mdr1 mRNA level in PBL after chemotherapy increased significantly as compared with that before chemotherapy [(4.316 6?0.923 1) vs(3.881 8?0.828 0),t=-4.207,P=0.000].There was an negative correlation between mdr1 mRNA level and the tumor size(r=-0.389,P=0.028).The level of mdr1 transcription in SCLC patients was significantly less than that of NSCLC patients before chemotherapy [(2.831 4?0.398 4) vs(4.231 9?0.603 4),t=6.101,P=0.000].Conclusion In terms of an anticancer drug resistant mechanism,there could be a difference between NSCLC and SCLC.Longitudinal study of mdr1 level in PBL is valuable for evaluating the treatment(response.)

OBJECTIVE:To investigate the characteristics and regular pattern of the adverse drug reactions (ADR) occurred in our hospital.METHODS:A total of 174 ADR cases reported by our hospital from May 2006 to June 2008 were categorized and analyzed statistically.RESULTS:The ADR were induced by 16 categories(83 kinds) of drugs,predominantly by the antimicrobial agents(12 kinds,60 cases) and Chinese drugs preparations(17 kinds,66 cases).The ADR of 57 cases(26.89%) manifested chiefly as lesions of skin and its appendages,followed by gastrointestinal lesion(39 cases,18.40%).CONCLUSION:Timely ADR reporting is conducive to ADR incidence reduction and clinical rational drug use.

OBJECTIVE: To implement the policy of New Medical Reform, and to promote pharmaceutical care of our hospital. METHODS: The policy of New Medical Reform was carried out and specific implementation methods for the improvement of pharmaceutical care of our hospital were analyzed. RESULTS & CONCLUSION: Prescription evaluation was applied to provide pharmaceutical care in the clinic indirectly. Clinical pharmacists went into the wards to provide direct pharmaceutical care. They supervised the utilization of antimicrobial drugs, carried out pharmacy propaganda and wrote Clinical Drug News. ADR monitoring was also carried out. The policy of New Medical Reform was implemented through above methods to promote pharmaceutical care of our hospital.

Objective:In order to develop a new standard of curative effect,this study was designed to track the number of CTCs in patients with lung cancer during chemotherapy.Methods:Samples of peripheral blood was taken from each lung cancer patients(n=32) on the day before chemotherapy as well as the third week after the chemotherapy cycle.The samples were subjected to real-time fqRT-PCR.Meanwhile the tumour size was determined by chest X-ray or computed tomograghy. Results:Compared to that of pre-chemotherapy,the expression level of CK19 in the patients significantly declined after chemotherapy(t=4.659,P=0.000 1).The level of CK19 mRNA in patients with SCLC was higher than that of patients with NSCLC(t=1.944,P=0.041).The change of CK19 mRNA correlated well with the type during the treatment.Relatively the shift of SCLC is more obvious(t=6.073,P=0.000 1).Conclusions:The real-time fluorescent quantitative-PCR approach is useful for measuring the relative number of CTCs in a patients' peripheral blood to monitor the effectiveness of treatment,and for designing more comprehensive and reasonable therapeutic regimes at earlier dates for patients.

ObjectiveTo investigate the effect of psychological intervention on quality of life (QOL) of patients with mammary carcinoma.Methods64 patients with mammary carcinoma were divided into intervention group (n=36) and control group (n=28), and psychological status and QOL of patients of two groups were analyzed after treatment.ResultsThe psychological status and QOL of intervention group was better than that of control group (P<0.05～0.001).ConclusionThe psychological intervention in full stage being in hospital can improve QOL of patients with mammary carcinoma, and it is clinically significant to improve cure rate and survival rate of patients.

Objective To investigate the epidemiological characteristics of hemoglobin variability (Hb-Var) in dialysis patients,and to explore the factors related to Hb-Var and the relationship between Hb-Var and patients outcomes.Methods The study enrolled 178 hemodialysis and peritoneal dialysis patients in the Department of Nephrology,Peking University People's Hospital between October 2009 and March 2010.First six months were observation period,and then followed up for 12 months.The Hb-Var was described by residual standard deviation (Res-SD) and fluctuation across threshold of the Hb level.Non-fatal cardiovascular events and mortality were the primary endpoints.Results The Res-SD was (4.74±2.66) g/L in dialysis patients.Most patients fell into groups of high amplitude (HA) and low amplitude low (LAL),with frequency of 29.8％ and 33.1％ respectively.The related factors of Hb-Var were fluctuation of erythropoietin (EPO) dosage and hemodialysis.Kaplan-Meier survival curve and multivariable adjusted Cox regression indicated that Res-SD had no impact on the primary endpoints.Accumulative time to reach target hemoglobin level was an independent factor related to outcome.Conclusion Hb-Var occurs commonly in dialysis patients.The fluctuation of EPO dosage and dialysis style increase Hb-Var.Accumulative time to reach target hemoglobin level is an independent factor related to patients outcomes.

Objective To investigate the interaction of in vitro antibacterial activity between cefoperazone-sulbactam and imipenem against carbapenem-resistant Acinetobacterbaumannii.Methods The minimum inhibitory concentrations (MIC) of imipenem and cefoperazone-sulbactam against Acinetobacter baumannii were detected and the fractional inhibitory concentration (FIC) index of imipenem/cefoperazone-sulbactam combination was calculated by broth micro-dilution method.The interactions of imipenem and cefoperazone-sulbactam were assayed by K-B agar plate method.Results The MIC50 of cefoperazone-sulbactam and imipenem were both 16 mg/L,and MIC90 of the two drugs were both 64 mg/L.Among the 26 strains of Acinetobacter baumannii,16 strains had FIC indexes ≤0.5,and 10 had FIC indexes≥2.0.K-B agar plate assay showed that the cefoperazone-sulbactam/imipenem combination was synergistic for strains with FIC indexes≤0.5,and antagonistic for strains with FIC indexes ≥ 2.0.Conclusions Imipenem in combination with cefoperazone-sulbactam can be either antagonistic or synergistic against carbapenem-resistant Acinetobacter baumannii.The clinical use of cefoperazone-sulbactam/imipenem combination for the treatment of carbapenem resistance Acinetobacter baumannii infections should be cautious in case of antagonism.

Objective To observe the expression levels of 8 - hydroxy-deoxyguanosine (8-OHdG) in patients with different glucose metabolism and its relationship with islet dysfunction.Methods Based on the 75 g oral glucose tolerance test (OGTT), the patients were divided into 3 groups: normal glucose tolerance (NGT) group (30 patients), isolated impaired glucose tolerance (IGT) group (28 patients), type 2 diabetes mellitus (T2DM) group (28 patients), and 30 healthy subjects were selected as the healthy control group (healthy control, HC) . The triglyceride (TG) and total cholesterol (TC), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), insulin resistance index, insulin and c-peptide area under the curve (AUC) were detected, and compared between groups, and the correlation between 8-OHdG and these indexes was analyzed. Results There was no difference in FBG values between NGT group and HC group, the indicators of patients in other groups were higher than HC group,the difference was statistically significant (P<0.01). The values of FBG, 8-OHdG, HbA1C and HOMA-IR of patients in IGT group were higher than NGT group, the difference was statistically significant (P<0.01) . The values of FBG ,8-OHdG, HbA1C and HOMA-IR in T2DM group were higher than IGT group. There were no differences in insulin AUC between NGT group, IGT group and T2DM group (P> 0.05) . 8-OHdG was correlated with FBG, HbA1c, HOMA-IR, C peptide AUC, insulin AUC, and the correlation coefficients were 0.704, 0.713, 0.665, 0.825 and 0.653, respectively, the differences were statistically significant. Conclusions 8-OHdG levels can reflect the status of islet dysfunction,and can be used as an indicator of islet function for diabetic patients.