Stage Ⅲ A non-small cell lung cancer (NSCLC) has high heterogeneity and there are some controversies over the treatment of this disease,especially for patients with stage ⅢA-N2 NSCLC.This article investigates whether preoperative or postoperative radiotherapy can improve the survival of patients with stage ⅢA-N2 NSCLC and evaluates the effect of surgical treatment.

Most epidemiological investigations and basic studies have demonstrated that estrogen has neuroprotective effects,and the application of estrogen in cerebrovascular disease has a positive attitude.However,large clinical trials of the application of estrogen have indicated that harms outweigh benefits,and even have the risks of stroke.This article reviews the related studies about the neuroprotective effects of estrogen from the positive and negative aspects.

The concept and important role of associative memory neural network are introduced.The development of associative memory neural network is also summarized along with other neural networks such as the Hopfield neural network,the neural network composed of FitzHugh-Nagumo neuron model,the neural network composed of Hodgkin-Huxley neuron model.

Objective To study the signal pathway of apoptosis of renal proximal tubular cells (RPTC) caused by cisplatin for prevention of toxic effects of cisplatin on kidney. Methods pcDNA3.1/Hygromycin vector and pEGFP-C3 vector including Bcl-2(Bcl-acta,Bcl-cb5 and Bcl-nt) were co-transfected in RPTC.After treated with cisplatin, Bax was activated,cytochrom C release and apoptosis were analyzed with confocal microscope and immunofluoresence technique. Apoptotic cells stained with Hoechst33258 were also counted and statistically analyzed. Results The percent of cytochrom C release (35.74%) in Bcl-cb5 transfected group was higher than those in Bcl-nt group (18.7%) and Bcl-acta group(24.6%)(P

Objective To determine the key points in surgical treatment of Mirizzi syndrome in the olderlys. Methods Clinical data of 12 cases of Mirizzi syndrome treated in our hospital from 1995 to 2004 were retrospectively analyzed. Results Only 6 cases were definitely diagnosed by ERCP and ultrasounography before operations. Three cases were treated with cholecystectomy, 7 cases with cholecystectomy and T-tube drainage of common bile duct, 2 cases with cholecystectomy and Roux-Y hepaticojejunostomy. Conclusions It is still difficult to diagnose Mirizzi syndrome preoperatively. Appropriate operative patterns should be selected according to different types of Mirizzi syndrome.No patient death during operations.The patients were followed 1-10 years, average was 3.2 years. No bile duct stricture was found.

To investigate the role of ERC,6 gene in the growth rate and antifungal susceptibility,Aspergillus fumigatus strain with extra copies of ERG6 gene was constructed.Open reading frame (ORF) of putative ERG6 gene was searched in A.fumigatus genome.A PCR fragment, ERG6 ORF sandwiched by its flanking sequences (about 1 kb respectively),was amplified and was then subcloned into vector pRG-AMA1- NotI to produce a recombinant plasmid pERG6,which was further transformed into uracil auxotroph A.fumigatus strain AF293.1 to produce the transformant AF-pERG6.In the same time,empty plasmid pRG-AMA1-NotI was also transformed into A.fumigatus strain AF293.1 to produce the transformant AF-empty as a control.Radial growth of the transformants was tested on minimal medium (MM) and YAG medi- um.Antifungal susceptibilities of these resahing transformants,AF-pERG6 and AF-empty,to the common antifungal agents were performed by using both disk diffusion and broth microdillution methods.A.fumigatus genome contains a ERG6 gene,of which the ORF size is 1 256 bp.Comparing to Candida albicans and Sacchromyces cerivisiae sterol methyltransferase,A.fumigatus Erg6p had 57% and 50% identity, and had 70% and 63% similarity in amino acid sequences,respectively.Radial growth of transformant AF-pERG6 was slower than that of transformant AF-empty.The antifungal susceptibilties of transformant AF-pERG6 to the antifungal drugs itraconazole,voriconazole,terbin- aline,amphotericin B,caspofungin and grisefolvin were same to that of transformant AF-empty.In A.fumigatus,extra copies of ERG6 gene have no effect on antifungal susceptibilities to itraconazole,voriconazole,terbinafine,amphotericin B,caspofungin and grisefolvin.Radial growth of A.fumigatus harboring extra copies of ERG6 gene becomes slower compared to the control.

Objective To discuss the diagnostic value of soluble scavenger receptor(sCD163)for the patients of malignant tumor associated with fever in early infection .Methods Collect 102 cases of patients confirmed with malignant tumor in this hospi-tal since January to December 2014 ,all the patients were examined with blood culture .102 patients were divided into two groups ac-cording to the results of blood culture :infection group (60 cases) and uninfected group (42 cases) .ELISA ,electrochemical lumines-cence and immune transmission turbidimetric methods were used to detect the levels of sCD163 ,PCT and CRP in serum ,to compare the differences in the above indicators between two groups .The receiver-operating characteristic curve (ROC curve) was applied to evaluate the application value of sCD163 in diagnosing of malignant tumor associated with fever in early infection .Results The lev-el of sCD163 ,PCT and CRP had statistically difference in two groups(P< 0 .05) ;the critical values of sCD163 、PCT and CRP were 110 .80 ng/mL ,0 .45 ng/mL ,15 .60 mg/L respectively which can suggest the patients with malignant tumor complicated with fever in early infection .The area under the curve were 0 .894 ,0 .835 ,0 .743 respectively ,among that sCD163 area was the largest ;The corresponding sensitivity were 88 .9% ,77 .9% and 88 .0% ;specificity were 77 .0% ,74 .0% and 50 .0% respectively .Conclusion Compared with PCT ,CRP ,sCD163 has more value for diagnosing the patients of malignant tumor associated with fever in early in-fection .

Objective To explore the optimal treatment options of Stanford type B aortic dissection. Methods A to?tal of 51 patients with Stanford type B aortic dissection who visited the General Hospital of Tianjin Medical University from May 2008 to March 2013 were analyzed retrospectively. Survival and recovery of patients were evaluated by follow ups. Pa?tients were divided to TEVAR group(40 cases)and conservative group(11 cases)according to the treatment they recieved. Results Operations were successful in all 40 patients. There were two cases of perioperative death(5%). And none of pa?tients died in TEVAR group during follow-up. One case among 11 patients who received conservative treatment dead in hos?pital(9.1%)while other 7 cases died during follow-up(63.6%). Kaplan-Meier survival curve showed that two-year survival rate of TEVAR group was significantly higher than that of conservative group. In TEVAR group, the maximum diameter of the aorta presented a decreasing trend and thrombosis was seen in artificial lumen with time going after operation. Conclu?sion For patients with Stanford type B aortic dissection, TEVAR presented a high success rate and promoted remodeling of the aortic genuine and aritificial lumen. What’s more, it can significantly improve patient’s survival rate and recovery in short or mid-term period compared with effect of traditional conservative treatment.

Objective To evaluate the correlation between plasma D dimer levels and ovarian cancer, as well as its pathologic staging.Methods According to the inclusion and exclusion criteria , articles published about the correlation between plasma D dimer levels and human ovarian cancer were searched by means of PubMed , Embase, CNKI and WanFang Data from their inception to December 31th , 2013.In addition , references′list of the included articles and their related citations in Pubmed were also reviewed for additional articles.After quality assessment of all studies , Meta-analysis and ANOVA were performed with RevMan 5.2 and SAS 9.1 for statistic analysis.Results A total of 13 articles were identified, including 679 cases of ovarian cancers , 685 cases of benign controls and 477 cases of healthy controls.Meta-analysis revealed that:(1) Plasma D dimer levels in ovarian cancer groups were higher than that in benign control groups ( Z =8.61, P <0.000 01 ) and healthy control groups ( Z =6.76, P <0.000 01);(2) Plasma D dimer levels in benign control groups were higher than that in healthy controls (Z=3.15, P=0.002); (3) Plasma D dimer levels in advanced ovarian cancer FIGO (Ⅲ-Ⅳ) were higher than that in early cancer FIGO (Ⅰ-Ⅱ) (Z=3.38, P=0.000 9);(4)But there were no difference between relapse groups and remission groups (Z=1.19, P=0.23).ANOVA revealed that:(1) There were significant difference of D dimer levels among ovarian cancer groups or benign groups , healthy control groups; ( 2 ) Significant increasing of D dimer levels was revealed by Pairwise ANOVA from healthy controls, benign controls to ovarian cancer.Conclusions Plasma D dimer levels were high in patients with ovarian cancer , especially in FIGO (Ⅲ-Ⅳ) ovarian cancer.No difference of D dimer levels were investigated between relapse phase and remission phase.

Objective To evaluate the clinical features and renal morphological changes of the patients with urinary tract infection associated ureteral stent.Methods From Oct.2012 to May.2013,21 patients were divided into three groups depending on the different conditions:Group A (n=7):patients who had febrile urinary tract infections associated with ureteral stents; Group B (n =7):patients with ureteral stents but no fever; Group C (n=7):patients who had febrile urinary tract infections but no ureteral stent.The clinical data,laboratory data and 99Tcm-dimercaptosuccinic acid (DMSA) renal scintigraphy results were recorded prospectively and analyzed.Results In Group A,there were two patients had flank pain and positive costovertebral angle percussion tcnderness.The mean value of white blood cells and Hs-CRP of Group A and Group C were obviously higher than Group B (P＜0.05).The ratios of pyuria were 100.0％,71.4％ and 100.0％ in Group A,B and C.The ratios of positive urine bacteuria culture were 100.0％,42.9％ and 100.0％ in Group A,B and C.The results of 99Tcm-DMSA renal scintigraphy demonstrated the decreased uptake in the different portion of the kidneys on the sides of ureteral stents inserted in all the patients in Group A but no such changes in Group B and Group C.Conclusions 99Tcm-DMSA renal scintigraphy can be used to judge the status of urinary tract infection associated ureteral stent.The febrile urinary tract infection associated with ureteral stents always means pyelonephritis occurs and prompt treatment must be given.