Background and purpose:Neoadjuvant chemotherapy has become a major therapeutic strategy for the treatment of locally advanced breast cancer.Randomized trials comparing this approach to adjuvant chemotherapy have demonstrated that neoadjuvant chemotherapy was as efficacious as adjuvant chemotherapy and allowed for a higher rate of breast conservation.This study was to evaluate the efficacy and toxicity of docetaxel plus capecitabine in the neoadjuvant chemotherapy of locally advanced breast cancer(LABC) .Methods:Fifty-two patients with LABC were treated with docetaxel 75 mg/m2,d1;Capecitabine 2 000 mg/m2,d1-14.The chemotherapy was repeated every 3 weeks.Effi cacy and toxicities were reviewed after 3 to 4 cycles of chemotherapy.Results:The CR+PR rate was 80.7%.A pathological complete response in the breast was achieved in 5.8% of patients after 4 cycles of docetaxel/capecitabine.The adverse reactions were neutropenia,alopecia and hand-foot syndrome.Conclusion:The combination of docetaxel and capecitabine was well tolerated and effective in LABC for neoadjuvant chemotherapy.

Objective To investigate the correlations between ambulatory arterial stiffness index and intracranial/extracranial arterial stenosis.Methods One hundred and twenty-eight cases of ischemic cerebrovascular disease were collected in our hospital from January 2010 to March 2012.Joint diagnosis of cranial computer tomography(TCD) and magnetic resonance angiography (MRA) and,or CT angiography (CTA) were used to detect the degree and number of intracranial arteries,and in accordance with the lesions level,patients were divided into stenosis group,the mild stenosis group,the moderate stenosis group and severe stenosis group.24 h ambulatory blood pressure was monitored and ambulatory arterial stiffness index (AASI) was calculated and statistically analyzed.Results (1) Age,sex,hypertension proportion of diabetes,body mass index(BMI) of different Intracranial arterial stenosis in four groups did not have significant differences (P ＞0.05),but in AASI the without stenosis group is 0.48 ± 0.15 ; the mild stenosis group 0.62 ± 0.16,the moderate stenosis group 0.61 ± 0.17,severe stenosis group 0.64 ± 0.15,and there was significant difference (F =3.955,P =0.001).(2) Age,sex,hypertension proportion of diabetes,BMI of different extracranial arterial stenosis in four groups did not have significant differences (P ＞ 0.05),but in AASI the without stenosis group was 0.48 ± 0.01 ; the mild stenosis group 0.57 ± 0.11,the moderate stenosis 0.59 ± 0.12,and severe group 0.60 ±0.15,and there was significant difference (F =3.643,P =0.002).In comparison between any two group:light,moderate and severe stenosis AASI were significantly higher than those without stenosis,and there was significant difference (P ＜ 0.05).And there was significant different in AASI among different intracranial and extracranial arterial lesions (F =7.395,P ＜ 0.001).Compared to 0 branch pathological changes,1 branch,2 branch,3 branch and above,there was was significant difference(P ＜ 0.05).Conclusion Based on a 24-hour ambulatory blood pressure monitoring indicators,AASI was mainly reflecting the impact of atherosclerosis on blood pressure,associated with intracranial and extracranial artery stenosis.AASI would play a major role in clinical diagnosis and treatment of ischemic cerebrovascular and forecast.

OBJECTIVE To investigate the generation of beta-lactamases from Klebsiella pneumoniae(KPN) which is only susceptible to imipenem.METHODS Sixteen kinds of beta-lactamase genes were detected in a KPN strain by PCR.The genes included TEM,SHV,LEN,OKP, CTX-M-1 group,CTX-M-2 group,CTX-M-9 group,OXA-1 group,OXA-2 group,OXA-10 group,PER,GES,VEB,CARB,DHA,and ACT-1.RESULTS The assay showed six positive genes including TEM,SHV,CTX-M-1 group,CTX-M-9 group,OXA-1 group,and DHA.CONCLUSIONS The KPN strain carries six kinds of beta-lactamase genes simultaneously.

Objectives To understand the susceptible factors for tobacco use among doctors in Henan province.Methods A random multilevel cluster sampling method was conducted.2 990 subjects were studied with an inquiry and self-reported questionnaire.Results The total smoking rate was 27.5%.The current smoking rate was 22.3%.Daily smoking rate was 13.3%.The main reasons for smoking were social needs,pressure relief,getting refreshing.About 21.4% subjects smoked in front of patients.Majority doctors understood the relationship between smoking and some diseases.The multivariate analysis showed that the doctors'smoking behavior was related with his gender,age,education background,monthly revenue,working section,hospital administration level,knowledge scale of tobacco being harmful on health,knowledge scale on the relationship between smoking and illness,doctors'social norm attitude for smoking.Conclusions The smoking behavior of doctors was complex,which was related to personal,social environment factors.Only comprehensive smoking prevention interventions could be stressed to produce lasting behavior change.

Objective To investigate the effect of different concentrations of heparin in the cold preservation solution on blood coagulation after reperfusion during orthotopic liver transplantation ( OLT) . Methods Forty ASA Ⅱ or Ⅲ patients with end-stage liver disease (31 males, 9 females) weighing 51-82 kg undergoing OLT were randomly divided into 3 groups according to the concentrations of heparin in the liver preservation solution: group Ⅰ 2 000 U?L-1( n = 14); group Ⅱ 8000 U?L-1(n= 12) and group Ⅲ 20 000 U?L-1(n = 12) .Anesthesia was induced with propofol, fentanyl and rocuronium and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyl. Body temperature was maintained at 35.5-37.5℃ and Hct at 22%-35% . Blood samples were taken from central vein at 15 min before reperfusion (T0,baseline) and 5, 30, 60, 120 and 180 min of reperfusion (T1-5) for determination of ACT, CR and platelet function (PF) using Sonoclot platelet function and coagulation analyzer (U.S.A.). Blood concentration of heparin was determined in 3-4 patients in each group at T0-5 ( HPLC) . Results The 3 groups were comparable with respect to age, body weight, ASA physical status and Child classification. The glass ball activated coagulation time (gbACT) was significantly prolonged at T1-4 in group Ⅲ and at T1,2 in group Ⅱ as compared to the baseline values at T0 ( P

Objective In order to understand situation of the passive smoking in public places and provide scientific basis for formulating a policy of tobacco control and implement FCTC. Methods Observation on site and investigation by questionnaire in 45 public places, including service halls of government, medical and health units, schools, waiting room of communication, markets in the provincial capital, prefecture cities, county town. Results In 45 public places, there was 53.3% being smoking forbidden sites, 31.1% having no -smoking regulations and 68.9% having ban -smoking signs. It was common that people smoking in public places. Investigation by interception showed that it was easy to find out smoker in public paces. 93% persons investigated were exposed to passive-smoking every day over half hour, over 40% were never against on smoking in front of themselves, over 70% smoker never to ask if other persons agreed on their smoking in front of other people. 64.2% student's fathers were smokers and 44.7% of them exposed to passive-smoking at home in a week. 59.3% students saw his teachers smoking at schools. Conclusions It was a serious problem of public health that smoking in public places. It is necessary to strengthen the construction of rulers and law and strictly implement it, while strengthen propaganda and education in order to reduce passive-smoking and promote FCTC implement.

OBJECTIVE:To evaluate the efficacy and toxicity of docetaxel plus xeloda in the treatment of advanced gastric cancer. METHODS: Forty patients with advanced gastric cancer were treated with docetaxel 75 mg?m-2 on day 1 and xeloda 2 000 mg?m-2 (in two divided oral doses) for the first 14 days. The chemotherapy repeated every 3 weeks. Efficacy and toxicities were reviewed after 3 to 4 cycles of chemotherapy (1 cycle = 21 days). RESULTS: Among the 40 evaluable patients, 1 (2.5%) showed complete remission, 23 (57.5%) partial remission, 13 (32.5%) stable and 3 (7.5%) disease progression, and the overall response rate was 60.0%. The main adverse reactions were myelosuppression, alopecia, diarrhea, and hand-foot syndrome. CONCLUSION: The combination of docetaxel and xeloda is well tolerated and effective in the treatment of advanced gastric cancer.

ObjectiveTo investigate the effects of combination of dexmedetomidine and sufentanil preconditioning on ischemia-reperfusion (I/R) injury in isolated rat hearts.MethodsForty male SD rats weighing 180-220 g, aged 8-10 weeks, were anesthetized with intraperitoneal 3％pentobarbital 60 mg/kg and heparin 3000 U/kg.The hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95％O2-5％CO2 at 36.5-37.5 ℃.Forty isolated rat hearts were randomly divided into 5 groups ( n =8 each):control group (group C),I/R group,dexmedetomidine preconditioning group (group DP),sufentanil preconditioning group (group SP),and dexmedetomidine + sufentanil preconditioning group (group DS).I/R injury was induced by 30 min of ischemia followed by 120 min of reperfusion.Groups DP,SP and DS received 30 min of perfusion with K-H solution containing dexmedetomidine 2.3 ng/ml,sufentanil 3.77 ng/ml and dexmedetomidine 2.3ng/ml + sufentanil 3.77 ng/ml respectively at 30 min before ischemia.Coronary flow (CF),left ventricular developed pressure (LVDP),± dp/dtmax and HR were measured at 15 min of equilibration,immediately before ischemia,at 30 min of ischemia and at 120 min of reperfusion.The superoxide didmutase (SOD) and myeloperoxidase (MPO) activities and the malondialdehyde (MDA) content in myocardial tissues and infarct size were determined at 120 min of reperfusion.Results Compared with group C,CF,LVDP, ± dp/dtmax,HR and SOD activity were significantly decreased,and MPO activity,MDA concent and infarct size were significantly increased in the other 4 groups ( P ＜ 0.05).Compared with group I/R,CF was significantly decreased in groups DP and DS,HR was significantly decreased in groups SP and DS,and LVDP, ± dp/dtmax and SOD activity were significantly increased,and MPO activity,MDA content and infarct size were significantly decreased in groups DP,SP and DS ( P ＜0.05).Compared with group DS,CF was significantly decreased and HR increased in group DP,and SOD activity was significantly decreased,CF,MPO activity,MDA content and infarct size were significantly increased in group SP (P ＜ 0.05 ),and no significant change was found in SOD and MPO activities,MDA content and infarct size in group DP ( P ＞ 0.05).Conclusion Dexmedetomidine combined with sufentanil preconditioning can reduce I/R injury in isolated rat hearts,but the myocardial protection is not further enhanced.

Objective To investigate the consistency of M RI detecting posterior ligamentous complex (PLC) injury associated with thoracolumbar factures.Methods MRI data of 170 cases of thoracolumbar fractures were reviewed retrospectively.Each case underwent MRI around one week postinjury.MRI data were analyzed and compared by three physicians respectively to discuss the consistency in MRI detection of PLC injury and the severity of PLC injury.Results Kappa coefficient was 0.846 between observer 1 and 2,0.768 between observer 1 and 3,and 0.793 between observer 2 and 3.Interobserver reliability was high and overall Kappa coefficient was 0.803.Severity of PLC injury was interrelated with spinal cord nerve injury (P ＜ 0.05).Conclusions Accurate detection of PLC injury in thoracolumbar fractures is beneficial to clear the mechanical stability of the spine.MRI detection of PLC injury is of high consistency and hence deserves wide use.

Objective Degenerative lumbar scoliosis is frequent clinic spine malformation ,and it is complicated by lumbar inter-vertebral disc ,joint of lumbar vertebra cataplasia and lumbar spinal stenosis .The aim of this paper is to study surgical therapeutic regimen for analyzing clinic feature of degenerative lumbar scoliosis .Methods We comprehended symptom and analyzed imageology feature for lumbar spinal stenosis through reviewing 48 cases of operation from August 2003 to August 2010 ,and then approached its therapeutic principle and regimen .Results There were good therapeutic effect on the basis of comprehending degenerative lum-bar scoliosis and designing different treatment plan by different case feature .Conclusion Ii is need to know degenerative lumbar scoliosis again ,in order to work out individual therapeutic regimen based on clinic feather ,process segment ,state of spinal stenosis , angle of lumbar scoliosis ,degree of vertebra rotation and lumbar destabilizing .