OBJECTIVE To investigate the time of aerosol inhalation using Budesonide Suspension and Mucosolvan drived by oxygen on prevention of pharyngeal and oral mucosa damage induced by radiotherapy in nasopharyngeal carcinoma (NPC). METHODS All 108 cases with NPC were divided into 4 groups, each group 27 cases. In 3 treatment groups,aerosol inhalation using Budesonide Suspension and Mucosolvan drived by oxygen were began at the initial , after 5 times, after 10 times radiotherapy respectively. In control group, aerosol inhalation was not used. The rates of third degree of pharyngeal and oral mucosa injury during different dose of radiotherapy were compared among the 4 groups. RESULTS At the dose below 30 Gy, there were no case of third degree of pharyngeal and oral mucosa injury occurred in 3 treatment groups, one case in control group. At the dose of 30 to 40 Gy, third degree injury occurred in all groups, there was no statistical difference among the 4 groups. At the dose over 40 Gy, the patients of third degree injury in group 1 and 2 were less than that in control group. There was no difference between group 3 and control group. CONCLUSION The right time of aerosol inhalation using Budesonide Suspension and Mucosolvan drived by oxygen for prevention of pharyngeal and oral mucosa complication induced by radiotherapy in NPC is at 5 to 10 times after radiotherapy.

Objective To evaluate the clinical efficacy and toxicity of paclitaxel liposome combined with cisplatin chemotherapy in NSCLC with brain metastasis. Methods Twenty-eight patients were newly diag-nosed NSCLC with brain metastasis(confirmed by pathology or cytology). The patients were treated with pacli-taxel liposome(135 mg/ m2 )on day 1 intravenous drip for 3 hours,cisplatin,25 mg/ m2 on day 1-3. The course of treatment was 21 days. The patients accepted the anti-allergy treatment before chemotherapy. Results Twenty-eight patients could be evaluated,and 101 treatment cycles were completed( 3. 6 cycles per patient). General lesion assessment presented that no patient got complete remission( CR),13 patients (46. 43% )got a partial response(PR),11(39. 28% )had a stable disease(SD)and 4(14. 29% )had a progressive disease( PD). The objective response rate( RR)was 46. 43% ,and the disease control rate (DCR) was 85. 71% . Local cerebral response assessment showed that no patient got CR,6 patients (21. 43% )got a PR,15(53. 58% )had a SD and 4(14. 29% )had a PD. The RR was 21. 43% ,and the DCR was 85. 71% . There was a significant difference in the RR(χ2 = 3. 90,P = 0. 03)but not in the DCR (χ2 = 0. 15,P = 0. 3)between the local cerebral disease and the general lesion. The median time to disease progression(TTP)for general lesion and local cerebral were 7. 2 months and 6. 2 months,respectively(χ2 =6. 43,P < 0. 05). The adverse reactions included bone marrow suppression,gastrointestinal reactions,elevated transaminases,alopecia,neurotoxicity,etc. All of these could be well controlled. Conclusion Paclitaxel liposome combined with cisplatin regimen demonstrates a higher efficacy and well tolerable against main metas-tasis of NSCLC,and the adverse effects are minor.

Objective To investigate the effects of remffentanil pretreatment on myocardial ischemiareperfusion (I/R) injury in rabbits. Methods Thirty healthy rabbits, aged 12-18 months, weighing 2.5-3.5 kg,were randomly divided into 3 groups (n = 10 each): I/R group, low-dose remifentanil pretreatment group (group R1 ) and high-dose remifentanil pretreatment group (group R2 ). Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 6 h of reperfusion in the 3 groups. Remifentanil was infused intavenously at 1.65 and 3.30 μg· kg - 1 · min- 1 for 30 min before ischemia in group R1 and R2 respectively, while equal volume of normal saline was infused instead in group I/R. Blood samples were taken for determination of serum cardiac troponin-Ⅰ (cTnI) and creatine kinase-MB isoenzyme (CK-MB) concentrations before administration (baseline), after administration, at 30 min of ischemia and at 6 h of reperfusion. The rabbits were then sacrificed and hearts removed. Myocardial tissues were obtained for microscopic examination. Results Serum cTnI and CK-MB concentrations were significantly lower in group R1 and R2 than in group I/R and serum cTnI concentration lower in group R2 than in group R1 ( P ＜ 0.01). Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil pretreatment provides protective effect against myocardial I/R injury in rabbits and it is related to the dose.

Objective To investigate the development and dynamic changes of host immune response in DBA/2 mice infected with Plasmodium yoelii 17XL. Methods Female DBA/2 mice were infected by intraperitoneal ( i. p. ) injection of 106 P. yoelii 17XL parasitized erythrocytes ( PRBC). Levels of IL-12, IFN-γ, IL-4, IL-10 and P. yoelii 17XL-specific antibody in sera were measured by ELISA. Concentrations of NO in cell supernatants were measured by the Griess reaction. Parasitemia,percentage of mononuclear-macrophages of individual mice were monitored daily, and phagocytosis of mononuclear macrophages was also observed. Results Primary parasitemia in vein blood was developed on day 3 postinfection, which peaked with a level of 46. 9% on day 9. Most mice cleared the infection and survived by day 20 postinfection. From day 6 to day 16, the phagocytosis of PRBC by rodent macrophages was observed on the blood smear. Infected mice had a continuously increased level of IL-12 in serum from day 1 postinfection. Accordingly, high level of IFN-γ was also detected in sera from day 1 postinfection,which peaked on day 6. Infected mice produced higher level of IL-4 and IL-10 in serum on day 6 postinfection, which peaked on day 9 and day 15 postinfection respectively. In addition, splenocytes from infected mice produced significantly higher level of NO on day 6 and 20 postinfection. Level of P. yoelii 17XL-specific IgG was determined in the sera of infected mice with a steadily increased trend after infection, which peaked on day 70 postinfection. Conclusions Effective polarizing of Thl cells is significant in inhibition of parasitemia and eventual clearance of the Plasmodium parasites. Activated mononuclear-macrophages play a key role in inhibiting parasitemia in the early phase of infection with P. yoelii 17XL.

Objective To evaluate the effects and toxicities of the hyperthermic peritoneal peffusion with oxaliplatin (L-OHP) and interleukin-2 (IL-2) combined with chemotherapy for treatment malignant asci-tes. Methods 42 patients with malignant aacites from assimilation system tumor were catheterized,drained and flushed with L-OHP 85 mg/m2 in 2 000 ～2 500 ml of 5 % glucose and IL-2(2 MU),NRL-001 Double RF tumor hyperthermia system was applied to heat the abdominal part for 60 ～ 120 minutes at an intraperitoneal temperature of 41 -43 ℃ ,next day,all the patients were treated with calcium folinate(CF)0. 2 g/m2 by 2 hours intravenous infusion,5-fluorouracil (5-FU) 0. 4 g/m2 intravenously, followed by 46 hours continuous infusion of 5-FU (1 600 mg/m2), 2 weeks a cycle. Results The overall response rate was 66. 67%, including CR : 6 cases, PR:22 cases, NC:6 cases, and PD:8 cases. MST is 5.6 months. The main toxicity was impatient abdomen ache,paralysis intestinal obstruction. Conclusion Hyperthermic peritoneal perfusion with oxaliplatin and inter-leukin-2 combined with chemotherapy is efficient and safe in the treatment malignant ascites and can improve the quality of life. It is worthing wildly using and research.

Background and purpose: Protein kinase P1k3 could increase the transcriptional activity of p53. However, the effect of P1k3 on the transcriptional activity of p73 is still unknown. Our study was to investigate the effect of P1k3 on the transcriptional activity of p73. Methods: Luciferase reporter assay, RT-PCR and colony formation assay were adopted to study the effect of P1k3 and kinase-deficient P1k3 (K52R) on the transcriptional activity of p73 in p53-deficient human lung carcinoma H1299 cells. Results: Luciferase reporter assay showed that p73 increased the luciferase activities induced by p21~(WAF1) and Bax promoters (P<0.05). After co-transfection with p73 and P1k3, the luciferase activities induced by p21~(WAF1) and Bax promotors were significantly decreased in a dose-dependent manner as compared with the group that transfected p73 only (P<0.05). However, kinase-deficient Plk3 (K52R) had no significant effect on the luciferase activities induced by p21~(WAF1) and Bax promoters (P>0.05). RT-PCR showed that p73 increased the mRNA expressions of p21~(WAF1) and BAX (P<0.05). P1k3 decreased the expressions of p21~(WAF1) and Bax induced by p73 (P<0.05). Kinase-deficient P1k3 (K52R) had no significant effect on the expressions of p21~(WAF1) and Bax induced by p73 (P>0.05). Colony formation assay revealed that p73 decreased the colony formation of H1299 cells (P<0.05). P1k3 decreased the inhibitory effect of p73 on the colony formation of H1299 cells (P<0.05). Kinase-deficient P1k3 (K52R) had no significant effect on the inhibitory effect of p73 on the colony formation of H1299 cells (P>0.05).Conclusion: P1k3 can inhibit the transcriptional activity of p73, where as kinase-deficient P1k3 has no effect on the transcriptional activity of p73.

Objective To investigate the clinical treatment of infective endocarditis with vegetations in pregnant women and the outcomes of the gestation. Methods Nine cases of pregnant women diagnosed as infective endocarditis with vegetations in Beijing Anzhen Hospital, Capital Medical University from January 2001 to October 2015 were enrolled in retrospective analysis. Consultations were held by doctors from department of obstetrics, anesthesiology, cardiology, cardial surgery and extracorporeal circulation to decide the individualized treatment plan for the 9 cases of pregnant women after admissions. Clinical treatments including general treatment, anti-infection treatment, cardiac surgery, and termination of pregnancy surgery were completed through collaboration among related departments. The clinical characters, therapeutic regimens, maternal and neonatal outcomes of the 9 cases were analyzed. Results (1)Clinical characters: the ages of the 9 cases of pregnant women were from 25 to 36 years old. The onset gestational ages were from 19 to 36 weeks. Clinical symptoms: fever, cough, sputum and progressive anemia were the main symptoms. Patients had cyanosis of lips, could not lie on the back or even be orthopnea, when heart failure happened. Heart murmur was audible and splenomegaly was touched in physical examination. Blood cultures were positive. Basic heart disease types: 7 cases of congenital heart diseases included 2 cases of aortic insufficiency, 1 case of mitral insufficiency, 1 case of patent ductus arteriosus, 1 case of right ventricular outflow tract stenosis and 2 cases of ventricular septal defect.Two cases of rheumatic heart diseases included 1 case of mitral stenosis, 1 case of mitral stenosis after artificial disc changed and jammed. According to endocardial vegetations attached position there were 3 cases of mitral valve vegetations, 2 cases of pulmonary valve vegetations, 3 cases of aortic vegetations and 1 case of right ventricular outflow tract neoplasm. Preoperative heart function classification:1 case of levelⅡ, 3 cases of levelⅢ, 5 cases of levelⅣ.(2)Treatments:general treatment included oxygen uptake, rest in bed, cardiac strengthen and diuretic therapy, etc. Combined and adequate antibiotics were applied in anti-infection treatment according to drug sensitive test. Nine cases of pregnant women were all performed surgical treatment of heart diseases and removal of the endocardial vegetations. Caesarean sections were performed for 2 cases in second trimester and for 7 cases in last trimester. Cardiac surgery and caesarean section were operated in 6 cases at the same time among 22-34 weeks of pregnancy. Cardiac surgery were respectively operated in 2 cases 11 days and 32 days after the caesarean section at 33, 37 weeks of pregnancy. While Cardiac surgery was operated (at 26 weeks of pregnancy) before the caesarean section (at 37 weeks of pregnancy) in another 1 case. (3) Maternal and neonatal outcomes:7 cases of pregnant women were rescued successfully, while 2 cases of pregnant women were death. Postoperative heart function classification: 1 case of level Ⅰ, 2 cases of levelⅡ, 4 cases of levelⅢand 2 cases of levelⅥ. Neonatal survivals were 6 cases including 2case of full-term infants, 4 cases of preterm infants. Stillbirth or neonatal death were 3 cases, which included 2 cases performed caesarean section in second trimester and 1 case of very low weight infant who was given up treatment by family because of severe asphyxia. Followed up periods were from 1 to 7 years with an average time of (2.0 ± 1.6) years. Infants and young children grew and developed well during the period of follow up. Conclusions The risk is extremely high of pregnancy with infective endocarditis with vegetations. But there is still a way to save the maternal and neonatal life by using a multidisciplinary collaboration formulation and implementation of individualized treatment plan and selecting the appropriate time for heart surgery and the termination of pregnancy.

Aim To investigate the expression pattern of secretory clusterin ( sCLU) in lung tissues and plas-ma of rats with pulmonary arterial hypertension ( PAH) induced by monocrotaline ( MCT ) . Methods Thirty male SD rats were randomly divided into control group ( n=6 ) and MCT group ( n=24 ) , and were intraper-itoneally injected 60 mg·kg-1 MCT for MCT group or equal volume normal saline for control group. Real time PCR and Western blot were performed to investi-gate the expression pattern of sCLU mRNA and protein in rat lungs 1 ( n=6 ) , 2 ( n=6 ) , 3 ( n=6 ) and 4 (n=6) weeks after MCT injection, respectively. Im-munohitochemistry was performed to determine the lo-calization of sCLU in rat lungs. Enzyme linked immu-nosorbent assay was performed to detect the concentra-tion of sCLU in rat plasma. Results Expression of
sCLU mRNA and protein elevated significantly in time-dependent manners in rat lungs of MCT group, and sCLU mainly localized in the cytoplasma and extracel-lular matrix of cells in pulmonary arterioles. Further-more, sCLU plasma levels were significantly elevated with the progression of PAH and had positive correla-tions with pulmonary hemodynamic indices and right ventricular hypertrophic index. Conclusion sCLU was significantly elevated in MCT induced PAH rat lungs and plasma, and it may participate in the pulmo-nary vascular remodeling process. Moreover, plasma sCLU may be a potential biomarker for PAH.

Objective:To investigate the efficacy and the clinical value of magnetic resonance elastography(MRE) in diagnosis of hepatic fibrosis with Meta-analysis, and to provide basis for clinical treatment of hepatic fibrosis.Methods:The studies published before February 2, 2017 about MRE and staging of hepatic fibrosis in Chinese or English were retrived in the databases including PubMed, EMBase, Web of Science, Cochrane Library,CNKI, CBMDisc,VIP, Wanfang data, and supplemented by manual retrieval for relevant literatures.The inclusion and exclusion criterions were used to select and extract the literatures.The literatures qualitie were valuated based on QUADAS-2 tool.The sensitivity(SEN), specificity (SPE), diagnostic odds ratio (DOR), positive likelihood ratio (+LR), negative likelihood ratio (-LR) on the groups of F0 vs F1-F4,F0-F1 vs F2-F4,F0-F2 vs F3-F4, F0-F3 vs F4 and heterogeneity were combined and tested with Stata software respectively.HSROC and AUROC were also implemented.Results:A total of 1 332 studies were searched, and 22 were included.21 of them were in English and 1 in Chinese.The results of Meta analysis showed that the SENp, SPEp, +LRp,-LRp, DOR and AUROC in F0 vs F1-F4 group were 88.8%(85.0-91.7),95.9%(91.5-98.0),21.435(10.215-44.979),0.117(0.086-0.159),183.187(72.533-462.650) and 0.96(0.94-0.98) ,respectively;the SENp, SPEp, +LRp,-LRp, DOR and AUROC in F0-F1 vs F2-F4 group were 93.3%(89.2%-35.9%), 94.1%(90.2%-96.5%),15.839(9.344-26.848),0.072(0.044-0.117),221.224(100.980-484.648) and 0.98(0.96-0.99),respectively;the SENp, SPEp, +LRp, -LRp, DOR and AUROC in F0-F2 vs F3-F4 group were 92.9%(88.9%-95.5%),94.6%(91.2%-96.8%),17.348(10.496-28.671),0.075(0.048-0.119),230.434(111.482-476.317)0.98(0.96-0.99), respectively;the SENp, SPEp, +LRp,-LRp, DOR and AUROC in F0-F3 vs F4 group were 97.7%(93.0%-99.3%),93.2%(90.3%-95.2%),14.337(9.910-20.742),0.025(0.008-0.075),580.405(144.871-2325.307) and 0.98(0.96-0.99),respectively.Conclusion:MRE,as a new and noninvasive imaging method, has high diagnostic value in all stages of hepatic fibrosis, which can provide a reliable reference for clinical precise treatment of hepatic fibrosis.

Objective To evaluate the clinical and radiological outcomes of skip-level anterior cervical discectomy and fusion(ACDF) for the treatment of two-level noncontiguous cervical spondylotic myelopathy(CSM).Methods There were 34 patients with two-level noncontiguous CSM underwent skip-level ACDF in our department from January 2014 to December 2016.The clinical outcome including surgery time, intraoperative blood loss,Japanese Orthopaedic Association(JOA) scores,Neck dysfunction index(NDI),the improvement rate of JOA,segment lordosis,fusion rate and Odom's criteria were evaluted.Results The surgery time was from 92 minutes to 125 minutes,mean operative time 103.28 minutes;the intraoperative blood loss was 50 to 150 mL,with average blood loss of 90 mL.The cervical spine lateral radiographs showed that the cervical physiological curvature had restored.The patients were followed up for average 6 months.The fusion rate of was 94.1％ at the lastest follow-up.No cages subside,implant failure or migration and infection occured.The JOA and NDI scores at the latest follow-up were(14.21±0.732) and (3.26±1.14),respectively,the JOA scores improvement rates was 58.62％.The segmental lordosis before surgery was(10.75±1.132)°,the one after surgery was(15.61±1.312)°,the difference was significant(P<0.05).The Odom's criteria at the lastest follow-up showed that excellent in 21 patients,good in 9 patients and fair in 4 patients,with excellent and good rate of 88.2％.Conclusion Skip-level ACDF can achieve good clinical and radiological outcomes including a high fusion rate and well maintainence of spinal curvature and intervertebral height for patients with two-level noncontiguous CSM.