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.

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.

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.

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs)and anti-angio-genic drugs have individually demonstrated clinical benefit in the treatment of patients with advanced non-small cell lung cancer (NSCLC).Recent studies demonstrate that the combination of anti-EGFR and anti-angiogene-sis can more significantly enhance clinical benefit,and even can remit EGFR-TKIs resistance in the treatment of advanced NSCLC.According to the different kinds of anti-angiogenesis drugs,recent clinical studies mainly include the combination of anti-vascular endothelial growth factor monoclonal antibody bevacizumab plus EGFR-TKIs and multi-targeted receptor anti-angiogenic tyrosine kinase inhibitor plus EGFR-TKIs,and the for-mer results show a more significant improvement in terms of safety and efficacy in the treatment of advanced NSCLC.Therefore,the combination of bevacizumab plus EGFR-TKIs can be used as a new treatment standard in the treatment of some patients with NSCLC.

Objective To observe the clinical characteristics and surgical methods of strabismus following external approach for retinal detachment,and explore the common factors related to deviation angles of strabismus.Methods Twenty-five cases of secondary strabismus following external approach for retinal detachment underwent strabismus surgery were recruited,and the follow-up time was from 5 months to 41 months.Ophthalmic examinations were performed before operation.Clinical characteristics of these cases were observed by intraoperative exploration,including preoperative and postoperative eye position and ocular movement (at 1 week and further followup).The preoperative and postoperative deviation angles of strabismus were evaluated according to the times of retinal detachment operation,postoperative BCVA and the surgery procedure of hang-back recession.Results Before strabismus operation,all cases underwent abnormal eye-movements,8 cases suffered from diplopia,and scar adhesions were observed in all involved ocular muscles during operation.Seven cases underwent weakening procedure of extraocular muscle,18 cases underwent weakening procedure plus strengthening procedure.Ten cases underwent hang-back recession among them.At 1 week and the final follow-up,the eyeball in21 cases and 15 cases were in position,4 cases and 9 cases were in undercorrection,5 cases and 7 cases were in limitation,and 2 cases and 1 case were in diplopia.The more operations were performed in retinal detachment,the more scar adhesions were presented,and statistical significance existed with the mean deviation angles before and after operation(in a week) between cases that had one-time and over-one-time of retinal detachment surgery (P =0.01,0.00).No difference of mean deviation angles was found at one week after operation and at follow-ups between the cases with and without hang-back recession (P =0.26,0.63).Conclusion Abnormal eyemovements,diplopia and scar adhesion are the most common clinical characteristics of strabismus following retinal detachment surgery.Times of retinal detachment operation and postoperative BCVA can influence the deviation angles of strabismus,and hang-back recession seems the safe and effective method of strabismus surgery.

Objective To compare the effects of epidural administration of different combinations of lidocaine, corticosteroids (dexamethasone, prednisolone) and vitamins(B 1,B 6,B 12 ) on epidural space adhesion and nerve root inflammation in rabbits Methods Forty eight adult Japannese white rabbits of either sex weighing (2 38?0 31)kg were anesthetized with intramuscular ketamine 15 mg?kg -1 and midazolam 0 2 0 3 mg?kg -1 A catheter was inserted into epidural space at L 2 when the ligamentum flavum was exposed by surgery and advanced caudally for 2 3cm Correct placement of the catheter in epidural space was confirmed by injecting 0 5% lidocaine 0 2 ml through the cathter when the animal was awake 24h after epidural cathter placement 0 2ml?kg -1 of normal saline containing talcum power 1mg?ml -1 was injected into epidural space 3 days later the animal were randomly divided into 8 groups: group Ⅰ received no treatment, group Ⅱ epidural normal saline 0 2ml?kg -1 , group Ⅲ epidural 0 5% lidocaine 0 2ml?kg -1 , group Ⅳ epidural compound lidocaine solution 1 (lidocaine 100mg +dexamethasone 10 mg in 20 ml normal saline) 0 2ml?kg -1 , group V epidural compound lidocaine solution 2 (lidocaine 100mg+prednisolone 50 mg in 20 ml normal saline)0 2 ml?kg -1 , group Ⅳ epidural compound lidocaine solution 3 (lidocaine 100mg+dexamethasone 10 mg+vitamin B 1 200mg in 20 ml normal saline) 0 2 ml/kg, group Ⅵ epidural compound lidocaine solution 4 ( lidocaine 100mg+dexamethasone 10 mg+vitamin B 6 200mg in 20 ml normal saline) 0 2 ml/kg, and group Ⅷ epidural compound lidocaine solution 5 (lidocaine 100mg+dexamethasone 10 mg+vitamin B 12 200mg in 20 ml normal saline) 0 2 ml/kg One week later animals were killed by intravenous injection of air Spinal column below L 1 was removed Epidural space and nerve root adhesion was checked first with naked eye then examined under microscope Epidural space adhesion was divided into 4 grades according to Rydell Results 1 Macroscopic examination of epidural space for adhesion: there was no significant different between group Ⅰ and group Ⅱ,Ⅲ, also between group Ⅱ,Ⅲ and group Ⅳ,Ⅴ,Ⅵ,Ⅶ,Ⅷ; there was significant different between group Ⅰ and groupⅣ,Ⅴ,Ⅵ,Ⅵ,Ⅷ (P

0.25)levels in the two groups.In the group treated with42mJ/cm 2 UVB irradiation followed by the addition of EGCG,the numbers of apoptotic and dead cells and Fas mRNA were decreased,but bcl-2protein was increased.Conclusions Low dosage of UVB irradiation could induce apoptosis of keratinocytes.High dosage of UVB irradiation might result in cell death.EGCG could reduce UVB-induced apoptosis of keratinocytes by increasing bcl-2protein and decreasing Fas mRNA.

To study in a systematic and dynamic manner the level, traits, and development tracks of scientific and technological achievements in medicine and health and related disciplinary fields in the past two decades, the paper conducted a statistical analysis of the winners of prizes awarded by the Ministry of Health for progress in science and technology from 1981 to 1999. The results showed that the number of prize winners presented the tendency of fluctuating increase with 4 to 5 years as a cycle; the quality of prize winners presented a downward tendency; and endocrinology, preclinical medicine, oncology and preventive medicine ranked in the first four places with their prize winners accounting for over half of the total. The academies of medical sciences, Shanghai Medical University, Shanghai, Beijing Medical University, Beijing, and the academies of preventive medical sciences won the most prizes in almost all the fields involved while the academies of medical sciences took the first place in one third of the disciplinary fields. The project index of institutions was 1.91. The study indicates the following musts: enhancing the quality of the bidding projects, reinforcing the strength of research, and implementing policies that favor key and brainstorm projects and key disciplines; supporting weak disciplines, intensifying the development of disciplines with unique features, and stepping up scientific cooperation; strengthening scientific and technological input and the construction of echelons of scientific and technological personnel and maintaining the continuity of research contingents and capabilities of various disciplinary fields.