Objective To evaluate the efficacy and toxicity of concurrent chemoradiotherapy for unresectable stage Ⅲ non-small-cell lung cancer. Methods Fifty-two patients with unresectable stage Ⅲ non-small-cell lung cancer were randomized into group A and B. The method of radiotherapy was the same. All patients were irradiated 2.0 Gy/per fraction, five fractions a week, the total radiation dose was 60～ 64 Gy in tumor. Group A received chemotherapy with 45 mg/m2 of paclitaxel on every Monday. Group B received 30 mg/m2 of cisplatin on days 2 to 4 and 23 to 25 and 135 mg/m2 of paclitaxel on days 1 and 22 concomitant with the radiotherapy. Results The CR (complete response) rates were 22 % and 14 % respectively(P<0.05). Local tumor control time of group A was longer than group B(P=0.0493). Survival rate of group A was higher than group B (P=0.0532). The difference between the toxicity was not statistically significant in both groups (P>0.05). Conclusion The efficacy of low-dose every week was more effective than high-dose every three weeks and it's local tumor control time and survival was longer than later.

Objective To study the operating approaches of laparoscopic resection of ovarian benign cystic teratomas. Methods 67 patients underwent operative laparoscopy for ovarian cystic teratomas(23 ovarian cystectomies,44 oophorectomies or adnexectomies),including 27 patients who had cysts more than 8cm in diameter.In operation, a plastic bag was used and the abdominal cavity was abundantly flushed with warm physiologic saline.The larger cysts were aspirated to reduce the cysts and extracted through abdominal wall incision. Results Cyst rupture occurred in 17 cases (17/44) when cystectomy was performed. No cyst spillage occurred in all the oophorectomies and adexectomies.The mean operating time was (34?19)min.Blood loss was 3ml～7ml.No complications occurred and none of the patients needed conversion from laparoscopy to laparotomy.chemical peritonitis wes not seen in any of the patiants. Conclusions Laparoscopic surgery is safe and feasible for ovarian benign cystic teratomas and allows the removal of larger ovarian cysts.

Objective To explore a reasonable treatment for intertrochanteric hip fractures in the aged patients by comparing the fixation effects of cannulated compression screws and intramedullary fixation nails. Methods From January 1998 to December 2004, in our department 123 old patients with intertrochanteric hip fracture were fixed with cannulated compression screws or intramedullary nails. They were followed up and their complete clinic data kept. According to the Evans classification, of the 51 patients who received treatment with cannulated compression screws for their anterograde intertrochanteric hip fracture, 14 were type Ⅰ , 24 type Ⅱ , 10 type Ⅲ and three type Ⅳ , while of the 72 patients who received treatment with intramedullary nailing, 10 were type Ⅰ , 12 type Ⅱ , 28 type Ⅲ , 14 type Ⅵ , and eight retrograde intertrochanteric hip fractures. A retrospective comparison was made between the old patients treated with the two different fixation devices in terms of operative time, blood loss, transfusion, average hospitalization time, intraoperative and postoperative complications, functional recovery one year postoperatively and treatment expenses. Results The differences between the two groups in operative time, blood loss, transfusion, treatment expenses were of statistical significance (P0.05). Conclusions Cannulated compression screws should be chosen for old patients with anterograde intertrochanteric hip fractures of Evans types Ⅰ & Ⅱ or of Evans types Ⅲ & Ⅳ who are at a high risk, in a poor health or severely osteoporotic state. For patients with unstable Evans types Ⅲ & Ⅳ or with retrograde intertrochanteric hip fractures, intramedullary nails are suitable.

Objective To screen specific mutations on extracellular regions of membrane proteins ( extracellular membrane protein mutations ) in tumor cells and provide the reference information for target searching in cancer precision medicine .Methods Somatic mutations on extracellular regions of membrane proteins of 7042 tumor samples were collected to screen all specific extracellular membrane protein mutations, and the overall distribution of these mutations were obtained by statistical analysis.Genes, gene site and cancer types occured high frequency of extracellular membrane protein mutations were identified.Results 97193 specific extracellular membrane protein mutations were obtained from 4938362 somatic mutations in 7042 tumor samples (30 cancer types), the statistical analysis showed that 4347 genes and 65532 sites were involved in these specific mutations.The study further analyzed five genes (MUC16、LRP1B、CSMD3、RYR2、USH2A), one site (17:37868208) and six cancer types (including colorectal cancer, melanoma, uterine cancer, brain lower grade glioma, lung adenocarcinoma and stomach adenocarcinoma) which occured high frequency of extracellular membrane protein mutations.Conclusion An information library of specific mutations on extracellular regions of membrane proteins was established and the distribution of these specific mutations was obtained which can provide reference information for target detection in targeted cancer therapy and immunological therapy.

Objective To understand teicoplanin concentration in cerebrospinal fluid (CSF)during intravenous in-fusion in patients following neurosurgery operation,and evaluate whether drug concentration can be increased if blood-brain barrier was damaged, and effect of continuous pump of drug on drug concentration in CSF. Methods The post-neurosurgical surgery patients with surgical site/ventricular drainage were enrolled in the study, patients were divided into routine administration group(a dose of teicoplanin of 400 mg/12 h was administered for 30 min)and continuous administration group (a dose of 400 mg teicoplanin was administered for 30 min followed by a continuous infusion of 200 mg/6 h).CSF specimens were collected at respective time points of administration, teicoplanin concentration in specimens was measured.Results For routine administration group,drug concentration in CSF was (0.004 ± 0.0123 )mg/L immediately after teicoplanin was bumped,the peak concentration was (0.712 ± 1.028)mg/L after 1-hour bumping,then concentration decreased gradually,which were (0.254 ±0.222),(0.173 ± 0.152),and (0.355±0.207)mg/L at 12,18,and 24 hours of bumping respectively.For continuous administration group, drug concentration in CSF was(0.017±0.020))mg/L immediately after teicoplanin was bumped,the peak concentration reached (0.587±0.255)mg/L after 4-hour bumping,then concentration were (0.429±0.416),(0.325±0.254),(0.476 ±0.686),and (0.318 ±0.464)mg/L at 6,12,18,and 24 hours of bumping respectively,teicoplanin concentration was relatively stable 6 hours later,which were (0.318±0.464)mg/L-(0.476±0.686)mg/L.The area under the curve during 24 hours (AUC0-24 )in routine administration group and continuous administration group were 5.590 mg/L·h and 9.082 mg/L·h respectively.For two groups of patients,teicoplanin concentration only at the area near peak value a-chieved 50% minimum inhibitory concentration(MIC50 )for coagulase negative staphylococcus (CNS),but the time for a-chieving concentration higher than CNS MIC50 was far less than 50% of total administration time;teicoplanin concentration in CSF of both groups of patients didn’t achieve MIC50 for Staphylococcus aureus .Conclusion After continuous infusion of teicoplanin,drug concentration in CSF can be increased compared with routine administration group,but still can’t achieve the effective MIC;the increase of blood drug concentration is benefit to drug concentration in CSF,it is necessary to in-crease the dose appropriately to achieve clinical effectiveness.

Objective To investigate the optimal time of termination of pregnancy for patients with hemolysis elevated liver enzymes and low platelet (HELLP) syndrome Methods 57 patients with HELLP syndrome admitted from October 1992 to September 2001 were enrolled According to the length from the time diagnoses confirmed to the time of delivery,patients were divided into 3 groups; group Ⅰ,within 24 hours, group Ⅱ,24 to 48 hours and group Ⅲ,over 48 hours Complications,maternal and perinatal mortality were analyzed retrospectively between different groups Results Maternal and perinatal mortality were 7% and 11% in group Ⅰ, 16% and 21% in group Ⅱ, 64% and 73% in group Ⅲ with significant differences between group Ⅲ and group Ⅰ or group Ⅲ and group Ⅱ ( P

Objective To analyze the data from Online Mendelian Inheritance in Man (OMIM) to understand more about it, and provide reference to researchers using this database.Methods 19414 mutations which have definite relevant phenotypes from OMIM were obtained, then these mutations with three databases (1000 Genome Project,GO-ESP,ExAC) which record the mutation frequency in different population were compared.Results Most of the phenotype-related mutations from OMIM are rare mutations whose mutation frequency is less than 1%:18866 in 1000 Genome Project, 18981 in GO-ESP, 18979 in ExAC.The number of mutation whose frequency is more than 1% is 548433435 in 1000 Genome Project, GO-ESP, ExAC, respectively.And there are 320 mutations whose frequency is more than 1% in all databases.In all phenotypes, there are 127 polymorphism phenotypes, 584 susceptibility phenotypes, while in 320 ( 1.6%) phenotypes with common mutations, there are 62 polymorphism phenotypes, 88 susceptibility phenotypes and occupies 48.8%, 15.1%, respectively.Conclusion Approximately 97.5% mutations in OMIM are rare mutations.Polymorphism and susceptibility enrich in common mutations, especially in the mutation whose frequency is more than 10%.

Objective To observe the effect of ulinastatin in the treatment of children with severe pneumonia. Methods 86 children with severe pneumonia were divided into two groups according to the hospital card number:treatment group(n=45) and control group(n=41).All of them were given routine treatment,while the patients of the treatment group were given ulinastatin(5 000 U· kg-1 · time-1 ,1-2times/d,7d) in addition.The time of tem-perature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay were observed.Then,the therapeutic effect was evaluated after treatment for 7 days.Results The treatment group had 21 cases excellence,21 cases improvement and 3 cases failure, the total effective rate was 93.33%,the control group had 17 cases excellence,15 cases improvement and 9 cases failure,the total effective rate was 78.04%,there was significant difference between the two groups(χ2 =4.17,P<0.05).The time of temperature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay in the treatment group were (3.37 ±1.51)d,(3.12 ±1.72)d,(7.15 ±2.45)d,(10.75 ±2.47)d, respectively,which in the control group were (5.02 ±1.78)d,(4.82 ±1.51)d,(9.08 ±2.85)d,(13.22 ±2.85)d, there were significant differences between the two groups(t=4.71,4.91,3.42,4.41,all P<0.01).Conclusion Ulinastatin has good effect on children with severe pneumonia.It has value in application.

To explore evaluation of echocardiography (ECG) for early change of right ventricular function in aged patients with chronic obstructive pulmonary disease (COPD).Methods :A total of 45 aged patients with mild‐moderate stable COPD were selected as COPD group , and another 45 healthy volunteers were regarded as healthy control group .Two‐dimensional ultrasound and Doppler ultrasound indexes were measured and compared be‐tween two groups ,and their correlation were analyzed .Results :Compared with healthy control group ,there were significant rise in right ventricular transverse diameter [RVTD ,(28.03 ± 2.83) mm vs.(37.55 ± 5.44) mm] ,right ventricular wall thickness [RVWT ,(4.79 ± 0.44) mm vs.(5.04 ± 0.66) mm] ,right ventricular myocardial per‐formance index [RVMPI , (0.38 ± 0.06 ) vs .(0.54 ± 0.12 )] , tricuspid regurgitation pressure gradient [TRPG , (9. 50 ± 1. 93) vs.(36.87 ± 6.27 )] , tricuspid diastolic peak E／tissue Doppler tricuspid annular diastolic e′[E／e′, (4. 24 ± 0. 72) vs.(6.48 ± 1. 51)] and significant reductions in right ventricular fraction area change [FAC ,(53. 35 ± 5.41)% vs.(40.21 ± 7.24)%] ,tricuspid annular plane systolic excursion [TAPSE ,(20. 78 ± 2.64) vs.(14. 15 ± 2.44)] ,tricuspid early／late diastolic peak flow velocity [E／A , (1.17 ± 0.19 ) vs.(0.73 ± 0.14 )] , and tissue Doppler tricuspid annular systolic peak velocity [DTIs′,(13. 71 ± 1.25) vs.(12.92 ± 1. 70)] in COPD group , P＜0.05 or ＜0.01. Pearson correlation analysis indicated that TRPG was significant positively correlated with RVTD , RVMPI and RVWT ( r＝0. 440～0.830 , P＜0. 01 all) ,and significant inversely correlated with FAC ,TAPSE and DTIs＇( r＝ －0.615～ －0.561 , P＝0.001 all).Conclusion :RVTD ,FAC ,TAPSE ,tricuspid E／A ,E／e＇,RVMPI and TRPG etc .can be used to assess early change of right ventricular function .

OBJECTIVETo delineate the clinical features and potential mutation of the ATP7A gene in a family affected with Menkes disease.

METHODSClinical data of a patient and his family members were analyzed. Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) assays were performed to detect the mutation of the ATP7A gene.

RESULTSThe patient was admitted at the age of 5 months due to severe epilepsy and marked delayed psychomotor development. Significantly light complexion, pudgy cheeks and sparse fuzzy wooly hair were noted. Cranial magnetic resonance imaging and angiography revealed cortical atrophy, leukoencephalopathy and circuitous of intracranial vessels. The plasma ceruloplasmin was decreased. MLPA has identified a deletion spanning exons 8 to 12 of the ATP7A gene. His mother was found to be a heterozygous carrier of the same mutation.

CONCLUSIONThe clinical features and a novel mutation of the ATP7A gene of the family have been delineated.

Adenosine Triphosphatases ; genetics ; Adult ; Asian Continental Ancestry Group ; genetics ; Cation Transport Proteins ; genetics ; China ; Copper-transporting ATPases ; DNA Mutational Analysis ; Exons ; Female ; Heterozygote ; Humans ; Infant ; Male ; Menkes Kinky Hair Syndrome ; genetics ; Mutation ; Pedigree