Objective To evaluate the efficacy and toxicity of docetaxel combined with Cisplatin(DDP) and 5-fluorouracil(5-Fu) in the treatment of advanced gastric cancer. Methods 35 patients with advanced gastric cancer,which were confirmed by pathological diagnosis,were treated with docetaxel + DDP +5-Fu regimen:docetaxel 70 mg/m2 iv infusion for 4 hours on day 1, DDP 20 mg/m2 iv infusion on day 1 to 5,5-Fu 750 mg/m2 iv infusion for 6 hours on day 1 to 5 every 3 ～ 4weeks. Patients responsing to the chemotherapy finished at least 4 ～ 6 cycles or proceeded the therapy until progression of the disease (PD). Results 32 cases (91.4% ) were available for response evaluation with CR0;PR 15;SD7;PD 10. The rate of total remission( CR + PR) was 46.9% (15/32) ,and rates of CR and SD were 0 and 21.9% respectively. Leucopenia was seen in 40% patients,in which 13.6% cases were in grade III -IV. One patient had fever with neutropenia and improved after active treatment. There was no systemic infection or therapy-related death in all patients. Conclusion Docetaxel + DDP +5-Fu regimen has an assured response for advanced gastric cancer with tolerable toxicity and could be an effective candidate in clinical treatment.

ObjectiveTo investigate the influence of olsalazine on tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in patients with chronic ulcerative colitis.MethodsSixty patients with chronic ulcerative colitis(observation group),including 22 chronic recurrent cases and 38 chronic persistent cases,were enrolled and treated with olsalazine.Meanwhile,60 healthy volunteers without disease history of ulcerative colitis were selected as control group.The concentrations of TNF- α and IL-10 in serum of the two groups were detected by ELISA and compared.ResultsBefore treatment,the concentration of TNF- α in serum of the observation group was significantly higher than that of control group [ (57.2 ± 10.1 )ng/L vs.(27.2 ± 6.9) ng/L],while IL-10 was significantly lower than that of control group[ (9.2 ± 2.1 ) ng/L vs.(17.3 ±2.9) ng/L] (P ＜0.05).Before treatment,the concentration of TNF-α in serum in chronic persistent patients and chronic recurrent patients[ (56.9 ± 9.9),(57.3 ± 9.7) ng/L ] were significantly higher than that in control group,and serum IL-10 in chronic persistent patients and chronic recurrent patients [ (9.1 ± 2.3 ),(8.4 ± 2.5 ) ng/L ] was significantly lower than that in control group (P＜ 0.05 ).The concentration of TNF- α in serum in observation group after treatment was obviously lower than that before treatment [(28.1 ±8.9) ng/L vs.(57.2 ± 10.1 ) ng/L],and IL-10 was obviously higher than that before treatment [(13.4 ± 10.7) ng/L vs.(9.2 ±2.1 )ng/L] (P ＜ 0.05).The concentration of serum TNF-αand IL-10 in chronic persistent and chronic recurrent patients before and after treatment had statistical significance (P＜0.05 ).ConclusionsOlsalazine can significantly decrease the concentration of TNF- α and increase the concentration of IL-10 in serum in patients with chronic ulcerative colitis.It is worthy of application in clinic.

Aim To determine whether pranlukast (ONO-1078), a cysteinyl leukotriene receptor antagonist, possesses therapeutic effect when administered after focal cerebral ischemia in mice. Methods Persistent focal cerebral ischemia was induced by middle cerebral artery occlusion. Pranlukast and edaravone, a positive control drug, were ip injected 1, 6 and 24 h after ischemia. The neurological deficits were evaluated by neurological scores and inclined plane test 24 and 48 h after the surgery. Forty-eight h later, the brain slices were prepared for measurements of infarct volume and the ratio of ischemic/non-ischemic hemispheres. Brain sections were cut and examined for neuron densities in different regions of the brain. The effects of pranlukast and edaravone were evaluated by the changes of these variables. Results Pranlukast (0.1 and 0.2 mg?kg -1) and edaravone (3 and 10 mg?kg -1) significantly reduced the neurological deficits, infarct volume (maximally 82.3%), ratio of ischemic/non-ischemic hemispheres, and attenuated the reduction of neuron densities in hippocampal CA1 region, cortex and striatum. Conclusion Pranlukast possesses therapeutic effect on ischemic insults when administered after ischemia as effective as edravone, indicating a therapeutic potential in the treatment of ischemic stroke.

AIM:To confirm the action of the light transmission method in evaluating focal ischemic cerebral infarction on persistent focal cerebral ischemia in mice. METHODS:Persistent focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO). Bederson's neurological scores, climbing board and hanging test were performed 24 h after ischemia, and infarct volume, brain hemisphere area, neuron density of cortex and subcortex were measured with computer-assisted imaging. Pranlukast ( 0.1 mg?kg -1) or nimodipine ( 0.4 mg?kg -1) were injected ip once daily for 3 days and to 1 h before MCAO assess the neuroprotective effect. RESULTS:The infarct volumes measured by light transmission closely correlated with that measured by TTC staining and neuron densities. The infarct volumes measured by light transmission well correlated with the neurological scores measured by integrated graded approach, too. Both pranlukast and nimodipine significantly attenuated infarct volumes and the ratio of ischemic/non-ischemic hemispheres, and reduced neurological deficits and neuron death. CONCLUSION:Light transmission and integrated graded approach can be used not only for qualitative analysis of focal cerebral ischemia, but also for evaluating the neuroprotective effect of drugs.

Objective To investigate the rate of hippocampus injury during whole brain radiotherapy for intracranial metastasis and explore the effect of whole brain radiotherapy in reducing the radiotherapy induced neurocognitive dysfunction of hippocampu and provide reference for the treatment of intracranial metastatic tumors. Methods The intracranial metastases in 123 patients from January 2015 to December 2016 were enrolled in this study. The MRI image data before and after radiotherapy were analyzed retrospectively.The anatomical position of tumor and the hippocampus in patients with intracranial metastasis was outlined.According to outlined position, the relationship between location of intracranial metastatic tumor and the hippocampus was analyzed, and the probability of the hippocampal damage by tumor radiotherapy was calculated in the treatment of intracranial metastatic brain. Neurocognitive dysfunction improvement by protective irradiation of hippocampus was compared between different radiotherapy methods. Results Four hundred and seventeen intracranial metastatic tumors were observed in 123 patients, among which the sites of 15 tumors(3.60%) were within the 5mm of hippocampus, the sites of 146 tumors(35.01%)were 5-10 mm from the hippocampus, and the sites of 256 tumors(61.39%) were beyond 10 mm of hippocampus. The distribution of 417 metastatic tumors in the brain was as followings: 137 tumors (32.85%) were in frontal lobe, 98 tumors(23.50%) were in temporal lobe, 59 tumors(14.15%)were in parietal lobe, 46 tumors(11.03%)were in occipital lobe, 41 tumors (9.83%) were in cerebellum and 36 tumors (8.63%) were in basal ganglia. Using helical tomotherapy, intracranial metastasis radiotherapy and volumetric modulated arc radiotherapy, the rate of patients with cognitive dysfunction induced by hippocampal injury was 1.96%(1/51), 10.26%(4/39)and 18.18% (6/33), and there was significant difference (χ2= 6.595, P = 0.000). Conclusions The hippocampus injury possibility is very small, when whole brain radiotherapy is used in the treatment of intracranial metastatic tumors. Avoiding the hippocampus in radiation therapy of intracranial metastasis has high feasibility, among which the helical tomotherapy can effectively reduce hippocampus injury and improve patients'cognitive function.

Objective:To investigate the clinical value of serum cystatin C(Cys C) and neutrophil gelatinase associated lipocalin(NGAL) combined with cardiac biomarkers in the evaluation of sepsis with renal injury in children.Methods:The clinical data of 130 children with sepsis(67 cases in sepsis non AKI group and 63 cases in septic AKI group)admitted to pediatric intensive care unit(PICU) at Hunan Children′s Hospital from May 2018 to December 2019 were retrospectively analyzed.The differences of serum Cys C, NGAL and cardiac related biomarkers between sepsis and septic kidney injury were analyzed and compared.Results:The levels of serum Cys C, NGAL and amino-terminal pro-brain natriuretic peptide(NT-proBNP) in children with septic AKI were significantly higher than those in children of sepsis non AKI group(all P<0.01). There were no significant differences in creatine kinase isoenzyme(CK-MB)and high-sensitivity troponin T(cTnT-hs) between two groups (all P>0.05). The levels of CK-MB, cTnT-hs, NT-proBNP, Cys C and NGAL in the dead children were significantly higher than those in the surviving children ( P<0.05). In terms of predicting of AKI, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.724, 0.759 and 0.747, respectively.Regarding predicting the survival and death of sepsis, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.719, 0.722 and 0.769, respectively.In predicting the prognosis of children with sepsis and kidney injury, the area under the ROC curve of NGAL, Cys C and NT proBNP were 0.683, 0.651 and 0.682, respectively.The binary Logistic regression equation was established by Cys C, NGAL and NT-proBNP, Y=0.970 NGAL+ 0.9441 BNP+ 1.815 Cys C-2.944.In predicting kidney injury, evaluating prognosis of sepsis and predicting prognosis of sepsis with kidney injury, the area under ROC curve of new variable Y were 0.882, 0.802 and 0.808, respectively. Conclusion:NGAL, Cys C and NT-proBNP can be used to judge sepsis and sepsis with kidney injury alone.The evaluation value of combined detection of three indexes is better than that of single index.Therefore, the combined use of the three indicators may be better to judge the condition of children with sepsis and kidney injury.

Purpose To investigate the clinicopathologic features,molecular changes,treatment and prognosis of pulmo-nary artery intimal sarcoma.Methods Ten cases of pulmonary artery intimal sarcoma were collected and the clinical features analyzed,by using HE,immunohistochemistry EnVision meth-od,FISH,and review of relevant literature.Results There were 4 males and 6 females,with a male to female ratio of 1∶1.5.The patients were 33-75 years old with an average age of 55.7 years.The main clinical symptoms were chest tightness,shortness of breath(6/10),chest pain(5/10)and cough(3/10),hemoptysis(2/10),syncope(1/10),heart murmur(1/10).1 patient had a history of bilateral breast cancer,bilateral papillary thyroid carcinoma and invasive lung adenocarcinoma,1 patient had bilateral breast cancer and 1 patient had pulmonary embolism and cardiac myxoma.Preoperative imaging showed pulmonary embolism or lung tumor.Histological morphology showed that the tumor cells were fusiform or epithelioid,with ob-vious atypia.Some tumors differentiated into rhabdomyosarco-ma,angiosarcoma and leiomyosarcoma,and giant cells were seen in 2 cases.The tumor lacked specific immune markers,and the tumor cells expressed vimentin,Fli-1,SMA,MyogD1,Myoglobin,BCL-2,ERG,etc.Ki-67 proliferation index was a-bout 30％-70％.Fluorescence in situ hybridization was used to detect MDM2(4/5)and CDK4(1/1).All cases received surgical treatment,7 cases were followed up from 1 month to 17 months,and 4 cases of them had recurrence or distant metasta-sis.Conclusion Pulmonary artery intimal sarcoma is rare,without specific immune markers and with complicated gene changes.There is no standard treatment,and the prognosis is poor.

Review article is an important part of medical journals. It provides readers with the latest progress and cutting-edge ideas of medical research, which is of great interests for medical workers. An excellent review is not a simple literature listing. The author not only needs to summarize the important findings and highlights in the literature, but also needs to make a fair evaluation of the current research situation, deeply analyze the deficiencies and put forward his/her own unique views. The purpose is to enable readers to fully and accurately understand the research progress in this field, and inspire the readers to explore ideas, grasp the future direction and carry out innovative research. This paper will focus on how to improve the writing level of medical literature review in the process of topic selection, literature collection and screening, data analysis and evaluation.