Objective To explore the efficacy and toxicities of S-1 in the maintenance treatment of advanced esophageal cancer. Methods A total of 52 advanced esophageal cancer patients who benefited from the first-line treatment were randomly divided into experimental group (26 cases received S-1 orally as maintenance treatment) and control group (26 cases received placebo orally) by means of coin toss. After treatment, the efficacy and toxicities of the two groups were observed comparatively. Results The overall response rates (ORR) in experimental group and control group were 84.6% (22/26) and 76.9% (20/26), respectively, and there was significant difference between the two groups (χ2=3.885, P=0.049). The median progression free survival (PFS) time of experimental group was 14.4 months, and that of control group was 12.5 months (χ2= 3.885, P= 0.049). The main adverse reactions of the two groups were grade 1-2, and grade 4 adverse reactions did not appear in all patients. Conclusion S-1 is effective and well-tolerated in the maintenance treatment of advanced esophageal cancer.

Objective To investigate the preventive effects of Buyang Huanwu Decoction (BYHWD) and its recipe composition (BYJJF) in focal ischemic brain injury condition in vivo/in vitro. Methods In vivo studies, SD rats were divided into sham-operation group, MCAO group, BYHWD group and BYJJF group based on rat weight, 10 rats in each group. The body weight, infarct area and brain water contents were determined. In vitro studies, H2O2 was used to damage PC12 cells, and the vitro oxidative stress cell model was established. PC12 cells were divided into normal group, blank control group, BYHWD and BYJJF groups with different concentrations (0.1, 0.2, 0.5, 1.0, 2.0, 3.5 mg/mL). MTT method was employed to determine the protective effects of BYHWD and BYJJF on model cells.Results Vivo studies showed that after 7 days of treatment with BYHWD and BYJJF, those determinated quotas were all significantly improved compared with MCAO model rats (P<0.05), and there were no differences between BYHWD and BYJJF (P>0.05).Vtiro studies showed that the protective effects of BYHWD and BYJJF took place 2 hours later, and it was obvious in oxidative stress injury caused by H2O2, with statistical differences with model group (P<0.05). BYHWD and BYJJF could increase cell viability, and there was no difference between the groups with same concentration (P>0.05).Conclusion The research confirmed that BYJJF plays a significant role in improving the cerebral ischemia injury, which is the same performance as BYHWD, and BYJJF can save TCM resources under the precondition of TCM efficacy.

Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.

Objective To evaluate the feasibility of catheter ablation of Para-Hisian Atrial Tachycardia guide by CARTO. Method Catheter ablation guided by CARTO was performed after activation map in three patients with Para-Hisian Atrial Tachycardia. Result Successful ablation was got at right atrial in two patients and at non-coronary in one patient. Conclusion Catheter ablation guided by CARTO is safe and efficient for Para-Hisian Atrial Tachycardia.

Objective To investigate the expression and relationship of livin and mutant p53 in hepatocellular carcinoma (HCC). Methods The expression of livin and mutant p53 were evaluated using the SP immunohistochemistry in 80 HCC tissue, 39 hepatic cirrhosis tissue, 33 normal tissue beside the hemangiomas of liver. Results The integrated A average results showed that the intension of positive expression of livin aligned by turns was HCC tissue (Median=5.09; P25～P75=3.06～8.28), hepatic cirrhosistissue(Median=3.05; P25～P75=2.49～4.25), normal liver tissue(Median=1.99; P25～P75=1.54～2.54) (P<0.001), respectively. It also showed that the intension of positive expression of p53 in HCC tissue (Median=43.13; P25～P75=20.41～78.53) was higher than that in hepatic cirrhosis tissue (Median=20.30;P25～P75=14.90～28.08), as well as in that of normal liver tissue (Median=15.52;P25～P75=12.81～21.80) (P <0.001), but it made no sense in statistics between hepatic cirrhosis tissue and normal tissue of liver. The expression of livin was obviously correlated with p53 in HCC tissue(r=0.241, P<0.05). Conclusion The overexpressian of livin and p53 and their positive correlation showed that livin may play a crucial role in the origin and development of HCC in coordination with p53.

Objective:To determine the effects of enforced expression of Foxp3 in lung cancer cell with regards to proliferation and tumorgeneity. Methods: A stable subline NCIH-hFoxp3 was established by liopfectamin-mediated pcDNA plasmid transfection carrying exogenous hFoxp3. The growth curve and secrection of IL-8 and IL-10 of NCIH-hFoxp3 were evaluated using MTT and ELISA, respectively. The in vivo tumorigeneity was assessed as well by inoculation of NCIH-hFoxp3 subcutaneously in nude mice. Results:Lung cancer cell NCIH-hFoxp3 with enforced expression of Foxp3 proliferated slowly but exihited increased in vivo tumorgeneity compared with corresponding control subline. In addition,increased expression of hFoxp3 in NCIH-hFoxp3 augmented secretion and at-tenuated secretion of IL-8 and IL-10,respectively. Conclusion:Increased expression of Foxp3 may promote progression of lung cancer cell by change of cellular microenvironment and evasion of immune surveillance.

Objective To evaluate the efficacy and application value of retroperitoneal laparoscopic nephroureterectomy for localized and poor differentiated renal pelvic carcinoma by comparing with open nephroureterectomy.Methods Thirty-three pelvic carcinoma patients underwent radical nephroureterectomy were retrospeetively analyzed.All tumors were confirmed to be localized,stage T1-T3 and grade 3.Retroperitoneal laparoscopic nephroureterectomy was performed in 12 patients,the ureteral orifice was resected in traditional way through a small incision in lower abdomen.Open radical nephroureterectomy was performed in 21 cases.Clinical outcomes of the patients were compared between the 2 surgery groups.Results Mean operative time was 232 vs 212 min(P=0.100)and blood loss volume was 162 vs 233 ml(P=0.001)in the laparoscopic and open nephroureterectomy groups.Mean postoperative hospitalization was 7.6 vs 9.8 d(P＜0.001)for the laparoscopic and open groups.During the followup for 7-67 months,all the 33 patients survived.There was no recurrence or metastasis in laparoscopic group.While there was 1 retroperitoneal recurrence,and 3 cases suffering from superficial bladder cancer in open surgery group.Conclnsion Retroperitoneal laparoscopic nephroureterectomy may be performed safely in local renal pelvic carcinoma patients with poor differentiated tumors,with less intraoperative blood loss and early recovery.

Objective To test the hypothesis that p53 gene therapy combined with endostatin can enhance tumor response to radiation therapy of RM-1 mouse xenograft prostate cancer and to investigate its mechanism. Methods A mouse prostate cancer model was established. Then mice with xenograft tumor were randomly divided into group A (control), B (radiation), C (radiation and rAdp53), D (radiation and rh-endostatin) and E (radiation and rAdp53 and rh-endostatin). On day 1, rAdp53 was injected intra-tumorously with 1 × 1010 vp per animal to group C and E. From day 1 to 14, rh-endostatin was given 15 mg/kg intraperitoneally daily to group D and E. On day 4 single fraction of 15 Gy was given to tumors in groups B, C, D and E. Normal saline was injected intra-tumorously or intraperitoneaUy accordingly as control. No treatment was done to group A. Tumor volume was measured daily. Samples were collected on Days 5, 10 and 15. Ki67, CD31, p53 and VEGF were detected by means of immunohistochemistry. Results (1) Radiation alone, radiation combined with intra-tumorous injection of Adp53 and/or intraperitoneal injection of rh-endostatin resulted in tumor growth arrest of RM-1 cells in vivo (P = 0.000). Radiation combined with both rAdp53 and rh-endostatin was the most effective treatment (P < 0.05). (2) All the four treatment groups had a decreased expression of mutant type P53 (P = 0.000). The expression of Ki67 in groups B and C were equal (P 0.05) and increasing (P = 0.000), respectively. Group D had a up-down-up curve (P < 0.05), but group E had a up-down one. On day 5 the expresion of VEGF in group E was the lowest (P < 0.05). An increased expression of MVD compared with the control was shown, and MVD in groups C, D and E were always higher than that in the control (P < 0.05). Conclusions The limitation of radiotherapy could be overcome by combination with beth p53 gene therapy and endostatin on the growth of mouse prostate cancer cell. Radiation, rAdp53 and endostatin have their own role but they can be interacted with each other.

Objective To explore the application of Monte Carlo simulation in optimizing and adjusting the reimbursement scheme with regard to the New Rural Cooperative Medical System (NCMS)to scientific steering practice. Optimization of the reimbursement scheme in rural areas of China was also studied. Methods A multi-stage sampling household survey was conducted in Sihui county,with 4 433 rural residents from 1 179 households from 13 towns in Guangdong province surveyed by self-designed questionnaire. Probit Regression Model was applied in fitting data and then estimating the own-price elasticity and cross elasticity of healthcare demand for both outpatients and inpatients. Monte Carlo simulation model was constructed to estimate the reimbursement effects of various alternative reimbursement schemes,by replicated simulation for one thousand times and each sampling on five hundred households. In this way,optimization of the implemented reimbursement scheme in Sihui county was conducted. Results Own-priced elasticity of demands for outpatient visit,inpatient visit in the township hospital center,secondary hospital and tertiary hospital were-0.174,-0.264,-0.675 and -0.429,respectively. Outpatient demand was affected by the per-visit price of township hospital center and secondary hospital. The cross-priced elasticity of demands for outpatient visit appeared to be 0.125 and 0.150. The reimbursement effects of Scheme B7 showed that the efficiency of NCMS fund was 17.85%,the reimbursement ratio for healthcare was 25.63%,and the decreased percentages of poverty caused by illness was 18.25%,more than 9.37%, from the implemented scheme A. So the implemented scheme was in need for optimization. Conclusion Monte Carlo simulation technique was applicable to simulate the effects of the optimized alternative reimbursement scheme of NCMS and it provided a new idea and method to optimize and adjust the reimbursement scheme.