Objective: To investigate the efficacy and adverse reaction of erlotinib as a single agent in 2nd and 3rd treatment of advanced non-small cell lung cancer (NSCLC) patients. Methods: Patients with advanced NSCLC (III B/IV stage) were recruited in this study. They had recurrence after receiving at least one or two regimens of platinum-based chemotherapy from October 2005 to September 2006. Erlotinib was given orally to the patients at 150 mg/d, once daily until disease progression. The clinical outcome and adverse reaction were observed. Patients were followed up. Kaplan-Meier method was used to perform survival analysis. Results: Fifty NSCLC patients were enrolled into the study and followed up until September 20, 2007. The median follow-up period was 17 months and the follow-up ratio was 100%. The clinical outcome could not be evaluated in 3 patients. There was no patient with complete response (0%, 0/47), 38.3% patients with partial response (18/47), 44.7% patients with stable disease (21/47) and 17.0% patients with progressive disease (8/47). Disease control rate was 83.0% (39/47). Median time to progression and median overall survival period were 7.0 and 13.7 months, respectively. One year progression-free survival rate and 1-year overall survival rate were 30% and 56%, respectively. Patients with II to III grade skin rash had higher response rate and disease control rate than those with 0 to I grade. The patients with partial response and stable disease obtained superior survival benefit than those with progressed disease. The occurence rate of skin rash over grade III was 4% (2/50). Conclusion: Erlotinib as a single agent is effective in the treatment of advanced NSCLC patients after failure of chemotherapy. The tolerance is well. The survival time is not dependent on gender, smoking status, and pathological classification. The patients with severe skin rash (> grade II) achieves better.

Objective: This study was designed to compare the effects of STI 571 on proliferation, cell phases, and apoptosis between A549 and cisplatin-resistant A549 cells (A549/DDP) and detect the expressions of STI 571-related receptors in non-small cell lung cancer (NSCLC) tissues. Methods: A549 and cisplatin-resistant A549 cells (A549/DDP) were cultured in vitro. The cell proliferation was measured by MTT assay. Cell cycle distribution and apoptosis induced by STI 571, cisplatin and their combination were detected by flow cytometry in NSCLC cell lines. The expressions of platelet-derived growth factor receptor (PDGFRs) -α and-β and c-KIT in the non-small cell lung cancer cell lines and tissues were investigated by immunocytochemistry and immunchistochemistry, respectively. Kaplan-Meier survival curves were used to compare the correlation of PDGFR-α and-β expression with total survival of NSCLC patients. Results: STI 571 inhibited proliferation of A549/DDP cells, sensitized them to cisplatin chemotherapy, increased the cell number in G2/M and S phase, and induced apoptosis. However, STI 571 at the concentration below 10 μmol/L had no effect on the proliferation of A549 cells. Both A549 and A549/DDP cells expressed PDGFR-α and-β, but c-KIT expression was only observed in A549/DDP cells. The expression rates of PDGFR-α and-β were 65.5% and 69% in pulmonary adenocarcinoma, similar to those in squamous carcinoma (70.4% and 74.1%). Only one case of squamous carcinoma expressed c-Kit (3.7%). The PDGFR-α or β-positive patients had similar 3-year survival rates and overall survival time with the PDGFRα or β-negative patients. Conclusion: ST1 571 could suppress proliferation of A549/DDP cells, induce apoptosis and increase the sensitivity of A549/DDP to cisplatin. The levels of PDGFRα and β expression did not correlate with the prognosis of NSCLC patients.

Objective: To investigate the correlation of CA-simple sequence repeat (SSR) polymorphismof epidermal growth factor receptor (EGFR ) gene with the clinical outcome of patients with advancednon-small cell lung cancer (NSCLC) after treatment with epidermal growth factor receptor tyrosinekinase inhibitors (EGFR-TKIs). Methods: The clinical outcome and the survival of 101 patients withadvanced NSCLC after treatment with EGFR-TKIs were measured. CA-SSR polymorphisim of EGFR intron1 from peripheral blood cells of NSCLC patients was detected by PCR and direct DNA sequencing. Thecorrelations of CA-SSR polymorphisim with the clinical outcome and the survival of NSCLC patientsafter treatment with EGFR-TKIs were analyzed. Results: Twenty-four patients reached a partial response(23.8%), 46 patients reached a stable disease (45.5%), and 70 patients reached a clinical benefit (69.3%).Median survival time (MST) in female or adenocarcinoma patients was longer than that in male or non-adenocarcinoma patients (P<0.05). Allele (CA)20 was the most frequent allele (68.7%, 68/99) in CA-SSR.Progression-free survival (PFS) in patients with short CA-SSR was longer than that in patients with long CA-SSR (P<0.039). The MSTs of patients with short CA-SSR and long CA-SSR were 15.7 and 14.4 months, respectively, and the difference in MST was not significant (P = 0.691). Conclusion: The MST of female or adenocarcinoma patients with NSCLC as well as the PSF of patients with short CA-SSR can be prolonged after treatment with EGFR-TKIs. Copyright© 2011 by Tumor.

ObjectiveTo guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.MethodsThirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.ResultsEVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P ＜ 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P ＜ 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P ＜ 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P＜0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.ConclusionEVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.

Objective To investigate the value of volume reconstruction ( VR ) in showing the ear lesions and to compare with otherpost-processed methods.Methods 15 patients with hearing loss underwent MSCT ultra-high resolution scan with collimation 0.5 mm,pitch 0.5~0.875 and increment 0.1mm.An additional enhanced CT was performed in 10 of 15 cases. The various reconstructions including VR , MPR, SSD, VE, Ray Sum and MIP/MinIP were performed for the comparison of their ability in showing the ear lesions and the invasion of the auditory ossicals and the inner ear of the adjacent tumors. Results VR was the most optimal way, in showing the ear lesions,successionally in descending order was VR, MPR, SSD, MIP/MinIP. Ray Sum and VE were only suitable for showing the lesions of the inner ear and auditory ossicles respectively.Conclusion The data acquired from the scan of MSCT using 0.5 mm collimation can be used in various reconstruction methods including VR, MPR, SSD and MIP/MinIP to display the lesions of the ear and the invasion of the ear fine structures from the plane and three-dimensional view. VR is the best way, which can display the relationship between tumor and facial/auditory nerve, labyrinth .

Objective To investigate the effect of video-based teaching in the training of nursing operation for newly-contracted nurses. Methods One hundred and twenty one nurses newly recruited in September 2011 to September 2012 were set as the control group, another 128 in October 2012 to October 2013 were set as the experiment group. The former were trained and assessed with traditional training method and the latter were trained for 1 year in video-based teaching methodology. After training, both groups were examined about their operation skills and meanwhile a survey on video-based teaching was conducted. Result After training, the results in operating skills evaluation in the experiment group were significantly better those of the control group (Z=2.82, P<0.05). Conclusion Compared with traditional training method, the video-based teaching can raise the level of nursing operation skills and significantly improve the quality of nursing, thus worthy of popularization and application.

Objective To investigate the inhibitory effects and mechanisms of a nature product derivate oridonin on in?vasion of human lung cancer. Methods Human lung cancer A549 and PC-9 cell lines were treated with oridonin. MTS as?say was used to determine cell proliferation. Transwell assay was used to determine the cell invasion, and adhesion assay to determine the cell adhesion. Flow cytometry was used to determine cell cycle. Western blotting and realtime-PCR were used to detect expression levels of CDK1, mTOR, p53, p21, E-cadherin, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src. The luciferase reporter assay was used to detect the NF-κB promoter activity. Results In vitro proliferation, invasion and adhesion of A549 and PC-9 cells were significantly inhibited by oridonin. The cell cycle was halted by G2/M phase, and ex?pressions of E-cadherin, p53 and p21 were promoted, while expressions of CDK1, mTOR, CD44,β-catenin, uPA, MMP-2/9, p-AKT and p-Src and promoter activity of NF-κB were down-regulated. Conclusion Oridonin is able to inhibit the in vitro invasion of human lung cancer A549 and PC-9 cell lines, which might be correlated with its abilities to regulate the ty?rosine kinase activity.

AIM: To compare the measurement of anterior chamber depth(ACD) inclusive of corneal thickness using intrao-cular lens(IOL) master and ultrasound biomicroscopy (UBM) and evaluate the repeatability of each method.METHODS: Two consecutive measurements of ACD were prospectively performed using IOL master and UBM in 60 eyes in 60 individuals. Mean values were compared using the paired t test. For each individual, ACD measure-ments was performed 5 times to estimate the repeatability of each method by a coefficient of variation(CV).RESULTS: The mean ACD was 2.95±0.25mm with the IOL master and 2.96±0.22mm with the UBM. This diffe-rence was not statistically significant (P=0.631).The coefficient of variation (CV) was 0.56%±0.26% and 0.65%± 0.36% in IOL master and UBM, respectively.CONCLUSION: The mean ACD of IOL master was the same as UBM. The repeatability of IOL master is better than UBM.

OBJECTIVETo investigate the clinicopathologic features, immunophenotyping, differential diagnoses and prognosis of histiocytic sarcoma (HS).

METHODSThe clinical and pathologic findings of 4 cases of HS were reviewed. The samples were used for paraffin section, HE stain, immunohistochemistry stain by EnVision method, electron microscope observation. Follow-up information was available in all patients.

RESULTSThe age of patients, 2 males and 2 females, ranged from 22 to 65 years old (median, 43.25 years). The sites of involvement included lymph node (2 cases), skin or soft tissue (1 case) and colon (1 case). The tumor cells were widespread infiltration, diffused distribution, no adhesion to each other. Tumor cells were middling and large, round, orbicular-ovate, polygon, epithelium appearance, plentiful cytoplasm and acidophilia, cystose. Nucelus was round, orbicular-ovate, dissymmetry. Nuclear chromatin was vacuole appearance, basophilia nucleolus, caryocinesia and pathological mitotic figure. Three of the cases showed conjugate nuclei, increased pleomorphism with multinucleated tumor giant cell formation. Focal cytoplasmic with foamy appearance was identified in 2 cases. One case demonstrated foci of spindly sarcomatoid appearance. Hemophagocytosis was identified in 2 cases. The tumor cells of 4 cases were often accompanied by various numbers of inflammatory cells. Immunohistochemical study showed that all cases were diffusely positive for α-1-ACT, CD68, CDl63 and lysozyme. Three of 4 cases also expressed CD45, CD45RO. The electron microscope results of 4 cases showed that the tumor cells were plentiful cytoplasm and a few cytolysosome in the cytoplasm, and no birbeck cytorrhyctes, cell-cell junction and digitation. Amongst the 4 patients with follow-up information available, three died of the disease 6-13 months after diagnosis. One patient, whose lesion was localized at the skin and soft tissue, survived at the present time.

CONCLUSIONHS was a scarce malignant tumor with mature histiocyte morphology and immunophenotype character. The diagnosis should be based on tissue morphology, immunohistochemistry and electron microscope observation to exclude other disorders.

Adult ; Aged ; Diagnosis, Differential ; Female ; Histiocytes ; pathology ; Histiocytic Sarcoma ; diagnosis ; pathology ; Humans ; Immunohistochemistry ; Immunophenotyping ; Male ; Microscopy, Electron ; Middle Aged ; Young Adult

OBJECTIVETo observe the regulatory effects of psoralen, oleanolic acid, and stilbene glucoside, three active components of psoralea fruit, glossy privet fruit and tuber fleeceflower root respectively, on Aβ25-35induced self-renewal and neuron-like differentiation of neural stem cells (NSCs).

METHODSEmbryonic NSCs werein vitro isolated and cultured from Kunming mice of 14-day pregnancy, and randomly divided into the control group, the Aβ25-35 group, the Aβ25-35 +psoralen group, the Aβ25-35 +oleanolic acid group, and the Aβ25-35 + stilbene glucoside group. The intervention concentration of Aβ25-35 was 25 µmol/L, and the intervention concentration of three active components of Chinese medicine was 10(-7)mol/L. The effect of three active components of Chinese medicine on the proliferation of NSCs was observed by counting method. The protein expression of Tubulin was observed by Western blot and immunofluorescence. The ratio of Tubulin+/DAPI was caculated. Results Compared with the control group, the sperical morphology of NSCs was destroyed in the Aβ25-35 group, the counting of NSCs, the expression of Tubulin protein, and the ratio of Tubulin /DAPI all decreased (P <0.01, P <0.05). Compared with the Aβ25-35 group, the counting of NSCs, the expression of Tubulin protein, and the ratio of Tubulin + /DAPI all increased in the three Chinese medicine treated groups (P <0. 01, P <0. 05).

CONCLUSIONS25 µmol/L Aβ25-35 could inhibit self-renewal and neuron-like differentiating of NSCs. But psoralen, oleanolic acid, and stilbene glucoside could promote self-renewal of NSCs and neuron-like differentiation.

Amyloid beta-Peptides ; physiology ; Animals ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Embryo, Mammalian ; Female ; Mice ; Neural Stem Cells ; Neurogenesis ; drug effects ; Neurons ; cytology ; Peptide Fragments ; physiology ; Pregnancy