Objective To evaluate the efficacy and safety of combination therapy of oxaliplatin and S-1 vs oxaliplatin and docetaxel for advanced gastric cancer (AGC)patients.Methods From April 201 1 to Janu-ary 201 3,62 cases of AGC were collected in the Fifth People′s Hospital of Qinghai Province.All cases were randomly divided into group A (31 cases)and B (31 cases)by random number table.In group A,oxaliplatin plus S-1 was administered,and in group B,oxaliplatin plus docetaxel was applied.The response rate (RR), time of diseases controlled rate (DCR),progression-free survival (PFS),overall survival (OS)and adverse reactions of the two groups were observed and compared.Results There were no statistically differences between group A and group B in RR (48.4% vs 54.8%),DCR (67.7% vs 77.4%),mPFS (5.4 months vs 6.2 months),mOS (9.0 months vs 9.8 months),and the statistical values were as follows:χ2 =0.26,P =0.71 1 ;χ2 =0.73,P =0.393;χ2 =0.51 ,P =0.473;χ2 =0.03,P =0.829.The incidence of degrees Ⅰ-Ⅱperipheral neuropathy (9.7% vs 22.6%),nausea and vomiting (1 2.9% vs 32.3%)in group A were signifi-cantly lower than those in group B (χ2 =5.78,P =0.002;χ2 =4.63,P =0.01 6).Conclusion Both the two chemotherapies are similar in therapeutic effect for patients with AGC.Oxaliplatin plus S-1 treatment may be better than oxaliplatin plus docetaxel in the tolerance of patients.

Objective To discuss the risk factors of C5 never palsy incidence after cervical open-door laminoplasty. Methods This study involved 254 patients with cervical spondylotic myelopathy, who underwent expansive open-door lam?inoplasty in our hospital between January 2009 and December 2012. Patients were divided into two groups according to the incidence of C5 palsy after operation. Group A included 20 patients with C5 palsy and group B included 234 cases without C5 palsy. The risk factors for postoperative C5 palsy were compared between two groups. The factors may affect the inci?dence of C5 palsy were analyze. Results All cases received follow-up with an average follow-up time (24.9±2.6) months. Values of cervical curvature index (CCI), lamina open angles and spinal cord shift were significantly greater in group A than those of group B (P<0.05). There were no significant differences in preoperative intramedullary high signal, ossification of posterior longitudinal ligament and intervertebral foramen stenosis between two groups (P>0.05). Results of Logistic regres?sion analysis of multiple factors showed that lamina open angles, the pathogenic factors of C5 palsy included the spinal cord shift and postoperative CCI [OR(95%CI):2.035(1.684-2.359), 3.542 (2.465-9.254) and 9.126(4.425-17.273). Conclusion The angle of open door too large, CCI and spinal cord shift are risk factors for postoperative C5 palsy.

Objective To study the effects of laparoscopic and open hepatectomy(LH and OH) on liver function of patients,and to evaluate patients′ traumatic reaction after LH.Methods Forty patients scheduled to undergo hepatectomy were divided into LH group and OH group randomly in PLA General Hospital from Jun.2004 to Feb.2005.Data of pre-and post-operative liver function of the two groups were compared.Results Postoperative mean value of ALT,AST and LDH in LH group and OH group elevated quickly,and the postoperative mean value of these markers was significantly different compared to that of the preoperative value,and the mean value in OH was higher than that in LH.There was no significant difference between postoperative and preoperative level of ALP and ?-GT in both groups,but postoperative mean value of them in OH was higher than that in LH.There was no significant difference between the 2 groups in TBIL and DBIL level,but their postoperative mean value in OH was higher than that preoperatively.Conclusions The effects of LH on liver function in patients are less than those of OH.This finding suggests that patients′ traumatic reaction after LH is less than that after OH and this is beneficial for the reduction of hepatic failure after LH.

Objective To evaluate the prevention and treatment of massive bleeding complicated by severe acute pancreatitis(SAP).Methods From 1999 to 2008,massive intraabdominal bleeding was encountered in 65 cases out of 790 SAP patients admitted in pancreas surgery center,Union Hospital.Results From 1999.1 to 2003.12.44 out of 387 SAP cases(11.37%)suffered from massive bleeding,among them there were 12 cases of gastrointestinal bleeding and 32 cases of intra-abdominal bleeding.19 cases died of hemorrhage(4.91%);From 2004.1 to 2008.12,severe hemorrhage occurred in 21 out of 403 SAP cases(5.21%),including 8 cases of gastrointestinal bleeding,and 13 cases of intra-abdominal bleeding.5 cases(1.24%)died.The difference of bleeding related morbidity and mortality was statistically significant between these two periods(P<0.01).Conclusions Early and timely enteral nutrition and immunotherapy,effective peritoneal drainage,and appropriate surgical laparotomy were effective measures to decrease the risk of massive bleeding related morbidity and mortality in SAP cases.

Objective To describe the association between age and the sex-based outcome difference and analyze the potential mechanism responsible for sex-based outcome difference in severe trauma patients.Methods A retrospective analysis derived from the Emergency Intensive Care Unit of the acute trauma center of the Shanghai Municipal Sixth People's Hospital during the 2010-2013 period was performed to identify sex-based outcome differences after severe blunt trauma.The study cohort of patients was then stratified by age:(1) 18 years ≤ age ＜45 years,(2) 45 years ≤ age ≤ 55 years,and (3) age ＞55 years.Crude and adjusted odds ratios (ORs) were calculated to evaluate the association between gender and the hospitalized mortality,both overall and subgroups according to age categories.Results A total of 987 severe trauma patients met our inclusion criteria were enrolled in this study.Crude mortality was higher in male severe trauma patients (male 9.1％ vs.female 5.0％,P ＜ 0.05).Multiple logistic regression revealed that females had a 79％ decrease in hospitalized mortality compared with males (OR =0.21,95％ CI:0.07-0.64,P =0.006).This difference was most distinct in patients with age ＜ 45 years,(OR =0.15,95％ CI:0.04-0.67,P =0.012).There is no significant difference between genders in mortality of trauma patients with 45 years ≤ age ≤ 55 years and age ＞ 55 years.Conclusions The present study revealed a statistical significant association between gender and mortality among severe blunt trauma patients,particularly in patients with age ＜ 45 years.These results may highlight the importance of sex hormones in outcomes of severe trauma.

AlM:To investigate the expression transforming growth factor-β1 (TGF-β1) and heat shock protein 47 (HSP-47), in pterygium and normal conjunctiva tissues, in order to study the roles of these cytokines played in the pathogenesis in human pterygium.
METHODS:The expression difference of TGF-β1, HSP-47 between human pterygium and normal conjunctive tissues were compared by immuno - histochemistry technique.
RESULTS:The positive expression of TGF-β1, HSP-47 was stronger than in normal conjunctive tissues ( P <0. 05), the TGF-β1 expressed in all layers of pterygium, especially in the squamous epithelium, in the inflammation cells and vascular endothelial cells also expressed. The HSP-47 showed higher expressed in the lamina propria layer of pterygium, and weakly expressed in epithelial layer, no obvious expression in normal conjunctive tissues.
CONCLUSlON:Over-expression of TGF-β1 and HSP-47 in pterygium compared to the normal conjunctiva tissues may play a critical role during the occurrence, development and invasion of the pterygium.

Objective Subject To summary the port placement and system set-up for robotic minimally invasive heart surgery using da Vinci S system in China. Methods 400 patients accepted selective robotic minimally invasive heart surgery from January 2007 to January 2011. We conducted a retrospective review of port placement and system set-up for all the surgeries. During the surgery 3-4 ports were made in the lateral thoracic wall and the position of ports were modulated according to the types of diseases, the procedure and patients' habitus. The surgeon completed the procedure before the surgeon console.The arms of da Vinci S system was adjusted according to surgery procedure. Results The right lateral ports were suitable for the intracardiac operation with extracorporeal circulation. And the left lateral ports can be used in the inner thoracic artery harvesting and coronary bypass graft on beating heart. Except for 1 case changed to sternotomy because of sever pleural adhesions,no arms collision and mechanical malfunction during the surgery that leaded to surgical conversion. Conclusion Robotic minimally invasive heart surgery can be safely applied to partial cardiac surgeries. The port position and system set-up should be adjusted according to the habitus of patients and surgical requirement.

Boronic Acids ; therapeutic use ; Bortezomib ; Humans ; Male ; Middle Aged ; POEMS Syndrome ; therapy ; Peripheral Blood Stem Cell Transplantation ; Pyrazines ; therapeutic use ; Transplantation, Autologous

OBJECTIVETo investigate the effects of FTY720, a new immunosuppressive agent, on apoptosis and autophagy in multiple myeloma(MM) cell line U266 and to clarify its molecular mechanism.

METHODSU266 cells were treated with 0, 2.5, 5.0, 10.0 and 20.0 µmol/L FTY720 for 24 hours, and the cell viability was assayed by CCK-8 method. Then U266 cells were treated with 20.0 µmol/L FTY720 for 0, 2, 6 and 24 hours, the cell viability was tested. The apoptotic rates induced by different doses and time points of FTY720 were tested by flow cytometry separately. The expression of LC3B was detected by Western blot after U266 cells treated with different doses of FTY720 to see autophagy. U266 cells were treated with FTY720 ± Bafilomycin A1, an inhibitor of autophagy, for 24 hours, then the cell viability and apoptotic rates were tested. Meanwhile the expression of survivin, anti-apoptotic factors, were tested by Western blot.

RESULTSThe cell viability and the apoptotic rates were inhibited significantly by FTY720 (P < 0.05) in time-dependent and dose-dependent manner. The expression of LC3B-II increased significantly in a dose-dependent manner, it indicated that the autophagy was induced by FTY720. Bafilomycin A1 could rescue the cell viability and apoptotic rates in U266 cells treated with FTY720, and it could also rescue the expression of survivin decreased by FTY720.

CONCLUSIONSFTY720 can cause apoptosis and autophagy of U266 cells. The autophagy promote the apoptosis, which maybe due to the degradation of anti-apoptotic factors such as survivin or their upstream factors in lysosomes through autophagy.

Apoptosis ; drug effects ; Autophagy ; drug effects ; Cell Line, Tumor ; Fingolimod Hydrochloride ; Humans ; Multiple Myeloma ; pathology ; Propylene Glycols ; pharmacology ; Sphingosine ; analogs & derivatives ; pharmacology

Objective To explore a sensitive method and index to evaluate renal functional reserve (RFR) in patients with early diabetic nephropathy (DN) using protein loading-scintirenography.Methods Fifty subjects were studied and divided into 3 groups.Group one (G1) consisted of 14 healthy volunteers;Group two (G2) consisted of 15 patients with type 2 diabetes mellitus (DM) and normoalbuminuria; Group three (G3) consisted of 21 patients with type 2 DM and microalbuminuria.All subjects underwent baseline and protein loading-99 Tcm-DTPA scintirenography within one week.RFR was calculated as the difference between stimulated and baseline glomerular filtration rate (GFR), time of peak ( Tb ), time of half excretion ( C1/2 ), residual rate at 20 min ( C20/b ) .Variance analysis and t-test were used to analyze the group differences.Results ( 1 ) The RFR in terms of GFR had statistical difference between any two groups (t=14.884, 32.180, 16.042, all P＜0.01).After protein-loading, the GFR of G1, G2 and G3 increased 20.1, 10.9 and 2.2 ml·min-1·1.73 m-2 respectively.Therefore, the RFR decreased before microalbuminuria in type 2 DM patients.(2)There was statistical difference between the RFR of G1 and G2 in terms of C1/2 (t = 5.505, P＜0.05 ), and between G1 and G3 ( t = 8.914, P＜0.01 ).(3) There was statistical difference of the RFR in terms of TP between G1 and G3 (t = 5.690, P ＜ 0.01 ).(4) There was statistical difference of the RFR in terms of C20/b between G1 and G3 (t= 4.376, P＜0.05 ).Conclusions 99Tcm-DTPA protein loading-scintirenography is an effective method for measuring RFR to evaluate early DN in type 2 DM patients.