Objective To study the level of serum vascular endothelial growth factor(sVEGF)in advanced non-small cell lung cancer(NSCLC) and its clinical significance.Methods Serum level of VEGF was detected by ELISA method in 96 patients with advanced NSCLC.sVEGF level was analyzed after giving 2-4 cycles of cisplatin-based chemotherapy.At the same time,serum level of VEGF in 50 healthy controls was detected.Results The level of sVEGF was significantly higher in patient with lung cancer than in control group (P＜0.01).No statistical significant defference was observed between sVEGF level of stage Ⅲ and Ⅳ NSCLC patients,the patients with squamocellular lung cancer and adenocarcinoma(P＞0.05);Descended sVEGF level was found in the patients with response to chemotherapy(P＜0.05).Conclusion sVEGF can be used to evaluate chemotherapy response and diagnoses in the patients with advanced NSCLC.

Major points: Zhongwan (CV 12), bilateral Zusanli (ST 36) and Neiguan (PC 6); for excessive cold-dampness, plus Pishu (BL 20) and Sanyinjiao (SP 6); for Liver-qi affecting stomach, plus Yinlingquan (SP 9) and Taichong (LR 3); for deficiency of both spleen and sto mach, plus Pishu (BL 20) and Weishu (BL 21). Forty-six cases of diabetic gastric disorder were treated with acupuncture and 30 cases got marked effect, 16 cases got effect and the total effective rate reached 100%.

Objective To investigate the effects of parecoxib pretreatment on the intrapulmonary shunt during one-lung ventilation in patients undergoing esophageal cancer resection.Methods Forty ASA Ⅰ or Ⅱ patients of both sexes,aged 25-64 yr,weighing 45-70 kg,with body height 156-178 cm,undergoing elective esophageal surgery,were randomly divided into 2 groups (n =20 each):normal saline group (group NS) and parecoxib group (group P).Parecoxib 40 mg (in normal saline 10 ml) was injected intravenously 30 min before anesthesia in group P,while the equal volume of normal saline was given instead of parecoxib in group NS.Anesthesia was induced with iv injection of propofol,fentanyl and rocuronium.Bronchial blocker was inserted after tracheal intubation and the correct position was confirmed by bronchoscopy.Anesthesia was maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of atracurium.HR,MAP,SpO2 and mean airway pressure (Pmean)were determined at 5 min of two-lung ventilation,at 40 min of one-lung ventilation,and at 30 min after re-expansion of the collapsed lung (T0-2).Blood samples were taken simultaneously from jugular vein and radial artery for blood gas analysis.Intrapulmonary shunt (Qs/Qt) was calculated.Results There were no significant differences in hemodynamic parameters and Pmean between the two groups (P ＞ 0.05).PaO2 was significantly lower,while Qs/Qt was significantly higher at T1,2 than at T0 in groups NS and P (P ＜ 0.05).PaO2 was significantly higher,while Qs/Qt was significantly lower at T2 than at T1 in groups NS and P (P ＜ 0.05).Qs/Qt was significantly lower at T1,2 and PaO2 was significantly higher at T2 in group P than in group NS (P ＜ 0.05).Conclusion Parecoxib 40 mg injected intravenously at 30 min before anesthesia can reduce the intrapulmonary shunt during one lung ventilation in patients undergoing esophageal cancer resection.

Endophytic fungi which reside in the tissue of mangrove plants seem to play an important role in the discovery of new biologically active substances. During the course of screening for the antimicrobial metabolites from the endophytic fugus Penicillium sp. FJ-1 of mangrove plant Avicennia marina, a new aurone glycoside (1) was isolated by repeated column chromatography on silica gel and recrystallization methods. The structure of 1 was elucidated as (Z)-7,4'-dimethoxy-6-hydroxy-aurone-4-O-β-glucopyranoside, on the basis of spectroscopic analysis. Compound 1 exhibited antifungal activity against Candida sp., with the potency comparable to amphotericin B and much better than fluconazole. Compound 1 can also inhibit extracellular phospholipase secretion in a concentration-dependent manner.
Antifungal Agents ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Benzofurans ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Candida ; drug effects ; Glycosides ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Molecular Structure ; Penicillium ; chemistry ; genetics ; isolation & purification ; metabolism ; Seawater ; microbiology

ObjectiveTo study the effects of intermittent subglottic secretion drainage(SSD)with an endotracheal tube on incidience of ventilator- associated pneumonia(VAP). MethodsWe searched computerized databases,including Cochrane library,Pubmed,EMbase,CBM,CNKI,Wanfang and some relevant databases from initializing to March 2012,extracting data about subglottic secretion drainage(SSD)with an endotracheal tube on incidence of VAP using RCT.The data had Meta- analysis by software RevMan5,and to those data which could not be conversed or merged,they underwent descriptive analysis. ResultsWeidentifled 5 randomized clinical trials that met the inclusion criteria with a total of 683 randomized patients.In Meta- analysis,the overall risk ratio for ventilator- associated pneumonia was decreased significantly by intermittent subglottic secretion drainage with an endotracheal tube.There was no significant difference on adverse events or on hospital or intensive care unit mortality.Databases,including ICU and hospital LOS,duration of endotracheal catheterization,bacteria concentration,which were difficult to be conversed and obtained full data,they underwent a descriptive research. ConclusionsCompared with the common endotracheal tubes,the use of endotracheal tubes with subglottic secretion drainage is effective for prevention of ventilatorassociated pneumonia.But it has no effect on adverse events or on hospital or intensive care unit mortality.So large sample RCTs with multiply- center should be carried out to assess the effect of the use of SSD.

Programmed death-ligand 1 (PD-L1 ),which is highly expressed in NSCLC,can be divided into two categories:membrane PD-L1 and soluble PD-L1 .PD-L1 participates in tumor immune escape through combining with its receptor.PD-L1 immune checkpoint inhibitors have entered the phase Ⅰ studies and showed a good application prospect.It is also found that the sensitivity of PD-L1 immune checkpoint inhibitors is strongly associated with the expression of PD-L1 in tumor.Therefore,PD-L1 can be used as a biomarker to pre-dict its curative effect.

Objective To observe MSCT and clinical features in patients of laryngocarcinoma combined with other primary carcinomas. Methods Five patients of laryngeal cancer combined with multiple primary cancer were enrolled in the study. Three paitents had long-term smoking history more than 20 years. Three paitents had various degree of radiotherapy, chemotherapy and immunotherapy. The second primary cancer located in right upper lung lobe in 2 patients of synchronous cancer and 1 patient of metachronous cancer. The others located in soft palate, uvula and the left side of zone Ⅱ and zone Ⅳ in the neck, respectively. MSCT and clinical characteristics were analyzed. Results Five patients of multiple primary cancers included 2 patients of synchronous cancer and three patients of metachronous cancer. MSCT found the appearances of malignant tumors in various parts in all 5 patients and cervical lymph nodes metastasis in 2 patients. Conclusion The possibility of prime laryngocarcinoma combined with other primary cancers should be considered when other organ malignant tumor was detected in patients with laryngeal carcinoma, especially in patients with history of long-term smoking, radiotherapy and chemotherapy and immunotherapy. Long-term following-up of cervix and other organs should be taken for the postoperative patients of laryngocarcinoma.

B-Raf kinase (BRAF) gene is a driver mutation,and is an effective target in the treatment of non-small cell lung cancer (NSCLC).Studies have shown that BRAF inhibitors are effective for treatment of NSCLC with BRAF mutant.It is important to understand the clinicopathologic features and the research progress of BRAF inhibitors for the individual treatment of NSCLC.

Objective To study the diagnosis and treatment of testicular cancer in cryptorchids. Methods The data of 10 patients with cryptorchid tumor treated at our hospital between 1986 and 2003 were retrospectively analyzed.Their average age was 40 years (range,32~55 years).Of these patients,1 had the testis in the inguinal area;3,in the scrotum (with a history of inguinal cryptorchidism) and 6,in the abdomen.Cryptorchidism occurred on the left in 2 cases,on the right in 5 and bilaterally in 3.Three patients presented with stage Ⅰ A disease,5 with stage Ⅰ B,and 2 with stage Ⅱ D. Results All the 10 patients received surgical treatment including radical tumor resection,radical tumor resection with retroperitoneal lymph node dissection (RPLND),and palliative operation.Pathology showed that 9 cases had seminoma and 1 had seminoma accompanied by embryonic carcinoma.Radiotherapy was performed in 8 cases,and radiotherapy plus chemotherapy,in 2 (including 1 with embryonic carcinoma).Postoperatively,6 patients were followed up for 6 months to 14 years with a mean of 5.2 years;these patients showed no evidence of tumor recurrence and metastasis. Conclusions Cryptorchid testes have a greater risk of malignant change than do normally descended testes,and early intervention is advocated to prevent malignant canceration.Even treated with orchidopexy or orchiectomy,the patient should be followed up lifelong.Most of cryptorchid tumors are seminomas, and the ideal treatment strategies are tumor resection and radiotherapy.

Objective To investigate the value of magnetic resonance (MR) imaging for diagnosing typeⅠ congenital choledochocele and its complications. Methods The MR imaging data of 13 cases with proved typeⅠ congenital choledochocele associated with complications were retrospectively reviewed and compared with operative findings. MR imaging sequences included axial T2W and T1W plain scan, true-FISP coronal images, 2D-MRCP, and Gd-enhanced T1W images. Results All patients had cystic dilatation of the common bile ducts to various degrees. In 6 patients complicated with stone and infection, the bile duct showed uniform wall thickening with marked enhancement, and calculus were depicted within the duct lumen with dilatation of the proximal biliary duct. In 7 cases complicated with carcinoma of biliary duct, a polypoid soft tissue mass or nodule was seen inside the ductal lumen in 3 cases, or the duct wall was irregularly thickened in 4 patients. Six cases received curative operation, but one patient with extensive local infiltration, vascular encasement and lymphadenopathy had only palliative treatment. MR imaging observations were verified by surgery findings in all 13 patients. Conclusion MR imaging is very valuable not only in diagnosing typeⅠ congenital choledochocele, but also in revealing its complications.