Objective To analyze the efficacy and safety of erlotinib associated conformal intensity modulated radiotherapy in treatment (IMRT) of locally advanced pancreatic carcinoma. Methods The clinical data of 23 patients with locally advanced pancreatic carcinoma were retrospectively analyzed. The patients′ therapeutic methods: erlotinib was taken continuously and orally at 100 mg/time, 1 time/d until disease progressed or serious adverse reactions happened; intensity modulated radiotherapy (IMRT) was used combined with erlotinib at 50.4 Gy, 1 time/d, 1.8 Gy/time, 5 times/week, total 28 times. Tumor response was evaluated at the end of radiotherapy after 4 weeks. Results In 23 patients, there was partial response in 10 cases, stable disease in 9 cases and progress disease in 4 cases. The objective response rate was 43.5%(10/23), and the median survival time was 11.3 months. Adverse reactions included fatigue, rash, bone marrow suppression, nausea and diarrhea. The adverse reactions were mostly tolerable with grade 1-2. Conclusions Erlotinib combined with IMRT is safe and effective in patients with locally advanced pancreatic carcinoma, which is worthy of further study.

Objective To investigate the risk factors for colorectal cancer adjuvant chemotherapy induced leucopenia. Methods The basic clinical data of 108 patients with colorectal cancer who had received radical operation and adjuvant chemotherapy were retrospectively evaluated. The patients were divided into two groups: normal white blood cell group (39 patients) and leucopenia group (69 patients). The data were analyzed with SPSS 22.0 software, t test, χ2 test , univariate analysis and multifactor Logistic regression analysis, and analysis of variance to investigate the risk factors for colorectal cancer adjuvant chemotherapy induced leucopenia. Results Univariate analysis revealed that the female patients and the ones who received radiotherapy were more prone to leucopenia (P<0.01), while hypertension, the levels of white blood cell, neutrophil counting and serum creatinine before chemotherapy were protective factors for leucopenia (P<0.05 or<0.01). Multifactor Logistic regression analysis revealed that the level of serum creatinine before chemotherapy was an independent risk factor for leucopenia, OR = 0.950 (95% CI: 0.906- 0.996, P<0.05). The further analysis showed the lower the level of serum creatinine, the more severe the leucopenia would be (P = 0.04). Conclusions The level of serum creatinine before chemotherapy was an independent risk factor for colorectal cancer adjuvant chemotherapy induced leucopenia.

Objective To compare the clinical outcomes of gonadotropin-releasing hormone (GnRH) antagonist (GnRH-ant) fixed protocol with GnRH agonist (GnRH-a) long protocol in infertile patients with normal ovarian reserve function in their first in vitro fertilization-embryo transfer (IVF-ET) cycle,and to explore the feasibility and advantage of GnRH antagonist protocol performed in normal responders.MethodsFrom January 2011 to June 2011,771 infertile women with normal ovarian reserve function underwent their first IVF or intracytoplasmic sperm injection (ICSI) cycles in Peking University Third Hospital,which were divided into 245 cycles in GnRH-ant fixed protocol group ( GnRH-ant group) and 526 cycles in GnRH-a long protocol group ( GnRH-a group).The data of general demographic,treatment and clinical outcome were compared between two groups.ResultsAge,infertile duration,body mass index (BMI),baseline serum follicle-stimulating hormone (FSH) and estradiol levels between two groups did not reached statistical difference (P ＞ 0.05 ).The level of estradiol was (12 289 ± 6856) pmol/L in GnRH-ant group and (14934±8007)pmol/L in GnRH-a group at day of hCG injection.The mean length of stimulation was ( 10.3 ± 1.2) days in GnRH-ant group and ( 12.8 ± 1.6) days in GnRH-a group.The dose of gonadotropin was (2013 ± 607 ) U in GnRH-ant group and (2646 ± 913 ) U in GnRH-a group.The number of ovum was 15 ± 7 in GnRH-ant group and 17 ± 8 in GnRh-a group.Those clinical parameter all reached statistical difference (P ＜0.05 ).The number of embryo was 7 ±4 in GnRH-ant group and 8 ± 5 in GnRH-a group,the rate of clinical pregnancy was 40.9％ (94/230) in GnRH-ant group and 45.6％ (216/474)in GnRH-a group,the rate of implantation was 26.1％ (128/490)in GnRH-ant group and 30.9％ (307/994) in GnRH-a group,the rate of continuing pregnancy was 38.7％ ( 89/230 ) in GnRH-ant group and 42.6％ (202/474) in GnRH-a group,those parameter did not reach statistical difference (P ＞ 0.05).The rate of moderate or severe ovarian hyperstimulation syndrome was 2.4％ ( 6/245 ) in GnRH-ant group and 4.2％ (22/526) in GnRH-a group,which did not show significant difference ( P ＞ 0.05 ).ConclusionIn the first IVF or ICSI cycle of the patients with normal ovarian reserve function,the fixed GnRH-ant protocol could get the same satisfied clinical outcome,and it is more economic,convenient and safer compared with low dose depot GnRH-a long protocol.

After more than3 years of pilot (since 2010), standardized training of resident physicians in Shanghai has made great progress, however, it still needs to be improved. Cerebral and spinal vascular diseases are main types of neurological diseases and they seriously influence people's life and health. Interventional neuroradiology plays an important role in the diagnosis and treatment of cerebral and spinal vascular diseases. However, in the current residency training system in Shanghai or other provinces of China, the training of interventional neuroradiology is not included. In this paper, the authors analyzed the important role of interventional neuroradiology in diagnosis and treatment of cerebral and spinal vascular disorders and discussed the feasibility, method, and time arrangement of including interventional neuroradiology curriculum into the schedule of neurology standardizedresidency training and hoped to provide reference for the relevant departments to formulate a future policy.

Following the wishes of volunteer patients,316 cases of type 2 diabetics of our community center in 2008 carried out a three-year intervention from 2008 to 2011 on the basis of rational drug therapy plus the interventions of health education,regular review and lifestyle strengthening.And regular monitoring and recording were performed on the parameters of body mass index (BMI),blood pressure,blood lipids,fasting glucose,2 h postprandial blood glucose,glycosylated hemoglobin (HbA1c) and liver & kidney function.After intervention,some indicators changed:BMI (25.2 ±3.5) vs.(25.0 ±3.3) kg/m2,systolic blood pressure (129.1 ± 11.8) vs.(126.2 ±7.9) mm Hg(1 mm Hg=0.133 kPa),fasting glucose (7.80 ±2.81) vs.(7.25 ± 1.96) mmol/L,2 h postprandial blood glucose (11.04 ±4.60) vs.(9.83 ±3.60) mmol/L,HbA1c (7.39 ± 1.61) vs.(7.17 ± 1.65)％,total cholesterol (5.08 ±1.21) vs.(4.74 ± 1.35) mmol/L,low density lipoprotein cholesterol(LDL) (3.09 ± 0.87) vs.(2.85 ±0.83) mmol/L,high density lipoprotein cholesterol (HDL) (1.27 ± 0.33) vs.(1.41 ± 0.32) mmol/L,serum creatinine 65 vs.72 μmol/L,uric acid 300 vs.317 μmol/L.And the differences were statistically significant (P ＜ 0.05).After intervention,blood pressure compliance rate increased from 72.5％ to 88.0％,LDL-C compliance rate improved from 27.2％ to 38.6％,HDL-C compliance rate of 54.9％ increased to 66.9％.And the differences were statistically significant (P ＜ 0.05).The pre-intervention combined compliance rate of 11.4％ (n =36) rose to 17.7％ (n =56).And there was significant difference (P =0.024).

Animals ; Education, Medical ; trends ; Humans ; Medicine, Chinese Traditional ; methods ; trends

Objective To explore the application value of fiberoptic bronchoscopy in the diagnosis and treatment for refractoriness pneumonia in children.Methods Sixty-two cases of refractoriness pneumonia who had not been cured with normal anti-infective therapy for 2 weeks in Guiyang Children′s Hospital from Jun.2005 to Jun.2009 were selected.Fiberopic bronchoscopy Olympus BF-3C30 or BF-P40 examination was applied after routine local infiltration anesthesia to diagnose and local treat refractoriness pneumonia in 62 children.Results There were 27 cases(43%) of simple inflammation,20 cases(32%) of foreign bodies with concurrent infection,7 cases(11%) of dndobronchial tuberculosis,4 cases(6%) of dysplasia with concurrent infection,2 cases(3%) of bronchiectasis,and 2 cases(3%) of pulmonary hemosiderosis,among them,dysplasia were diagnosed on children under 1 year old,foreign bodies with infection on 1-3 years old,and tuberculosis and bronchiectasis on school age.Eleven cases(40%) of simple inflammation were identified various pathogen by bronchoalveolar la-vage fluid culture,mycoplasma PCR test and bronchial brushing and microscopic examination.Forty-seven cases of bronchi obstruction and stenosis caused by inflammation were irrigated and treated by drug and achieved satisfactory,among them,15 cases(79%) of pulmonary atelectasis were recovered with the treatment of fiberoptic bronchoscopy within 2 weeks,14 cases(70%) of foreign bodies were succeed in taking choked thing from bronchus with fiberoptic bronchoscopy.Conclusion The fiberoptic bronchoscopy play an important role in the etiological diagnosis and therapy of refractoriness pneumonia in children.

Objective: To investigate the association between body mass index ( BMI ) and mortality risk among older Chinese based on the China Health and Retirement Longitudinal Study ( CHARLS ). Methods: The demographic features, BMI, prevalence of chronic diseases and mortality among the elderly at ages of 60 years and greater were captured from the CHARLS database from 2011 to 2018. A multivariable Cox proportional hazards regression model was used to examine the association between BMI and the risk of death. Results: Totally 6 023 subjects were enrolled, including 3 006 men ( 50.09% ) and 3 017 women ( 49.91% ), and 68.69% of the participants ( 4 137 subjects ) were at ages of 60 to 69 years. There were 637 subjects ( 10.58% ) with underweight, 1 544 ( 25.63% ) with overweight, and 557 ( 9.25% ) with obesity. During the follow-up period ( 35 091 person-years ), 1 035 subjects died. Multivariable Cox proportional hazards regression analysis revealed an increased risk of mortality among the underweight elderly ( HR=1.496, 95%CI: 1.261-1.775 ) and a reduced risk of mortality among the obese elderly ( HR=0.671, 95%CI: 0.511-0.881 ) relative to the elderly with normal weight, after adjustment for age, gender, smoking, household registration, administration of anti-diabetic drugs, administration of anti-dyslipidemia drugs, and administration of anti-hypertensive drugs. Conclusion It is found that the risk of mortality among the Chinese elderly correlatives with BMI through the analysis of CHARLS data.

This experiment aimed to explore and research the process of preparing baicalein and wogonin through liquid fermentation with Bacillus natto. Active enzymes of produced by B. natto was used for the biological transformation of baclin and wogonoside, in order to increase the content of the haicalein and wogonin in the scutellaria. With the content of the baicalein and wogonin as evaluating indexes, the effects of carbon source, nitrogen source, the types and suitable concentration of inorganic salt, medium pH, granularities of medical materials, liquid volume in flask, shaking speed, liquid-to-solid ratio, fermentation time on the fermentation process were studied. The optimal process conditions for liquid fermentation of scutellaria were 1.0% of peptone, 0.05% of NaCl, pH at 6, the granularities of medical materials of the scutellaria screened through 40-mesh sifter, 33% of liquid, shaker incubator speed at 200 r x min(-1), liquid-to-solid ratio of 5:1, temperature at 37 degrees C, fermentation for 6 days, baclin's conversion rate at 97.6% and wogonoside's conversion rate at 97% in the scutellaria. According to the verification test, the process was stable and feasible, and could provide data reference for the industrial production.
Bacillus subtilis ; metabolism ; Biotransformation ; Fermentation ; Flavanones ; metabolism ; Flavonoids ; metabolism ; Glucosides ; metabolism ; Soy Foods ; microbiology

Keratoconus (KC) is a common cornea ectatic disorder characterized by myopia,irregular astigmatism and other visual impairment caused by corneal thinning and cone-shaped protrusion.With a wide range of effects,the etiology of this disease is unknown,and genetic factors may be involved in its pathogenesis.This paper summarizes the research progress on KC genetic etiology for reviewing the selected candidate genes and loci based on traditional/genome-wide linkage studies,genome-wide association studies and central corneal thickness in recent years.Genetic studies on KC pathogenesis will advance our understanding of this disease and further promote the development of potential therapies.