Objective To analyze the relative factors of bone marrow suppression after chemotherapy with different-dose carboplatin and paclitaxel (TC) on the patients with ovarian cancer.Methods Sixty-two patients with ovarian cancer admitted in Beijing Obstetrics and Gynecology Hospital from January 2002 to December 2007, using TC regimen ,a total of 196 cycles of chemotherapy ,were divided into two groups by the doses of carboplatin [area under concentration-time curve(AUC) 4 -6 for low-dose,AUC >6 -7 for hight-dose, the carboplatin dose calculated with AUC] or by the doses of paclitaxel (135 -< 150 mg/m2 low-dose,150 - 175 mg/m2 hight-dose). After each TC cycle, the routine blood was test to determine the graduation of the marrow suppression, and then the correlation factors were analyzed with logistic regression. Results (1) The occurrence rate of bone marrow suppression:there were 159 cycles (81.1%) grade 0 - Ⅱ bone marrow suppression, while 37 cycles (18.9%) of grade Ⅲ - Ⅳ. (2) Factors related to bone marrow suppression:the results shown that there were not related to bone marrow suppression,which incluced cellular differentiation, tumor type, height, weight and paclitaxel dose(P>0.05). While,the different cycle, age, the later stages of tumor, serum creatinine concentration, endogenous creatinine clearance rate, AUC values were the relative factors of bone marrow suppression(P =0.000,0.000,0.018,0.033,0.001,0.000). Seven variables were conducted into the logistic regression and the results shown that the different cycles, the age, AUC grades were independent risk factors (P = 0.030,0.043,0.009).(3) When low-dose of paclitaxel was given, the occurrence of bone marrow suppression was related to the carboplatin dose AUC. The higher AUC values for carbopaltin were chosen, the higher of severe bone marrow suppression would happen. (4/14 vs 0,P=0.015). When the dose of high grade of paclitaxel was given, the occurrence of bone marrow suppression in cases with hight-dose carboplatin was statistically significant than that in cases treated with low-dose carboplatin [45.7%(16/35) vs 13.7% (17/124), P=0.000]. Conclusions The independent risk factors of myelosuppression after chemotherapy with TC regime on the patients with ovarian cancer including the cycles, age and AUC values. The carboplatin dose calculating with AUC is related to the occurrence of bone marrow suppression, the higher AUC values for carbopaltin would chosen,the higher of severe bone marrow suppression would be happen.

Objective To evaluate the efficacy of radiation therapy on primary vaginal cancer with high dose rate brachytherapy alone or in combination with external radiation Methods Fifty one cases with primary vaginal cancer who were treated with high dose rate brachytherapy alone or in combination with the external radiation in Cancer Hospital, Chinese Academy of Medical Sciences from 1989 to 1999 were retrospectively studied,including stage Ⅰ 10 cases,stage Ⅱ 13 cases,stage Ⅲ 23 cases and stage Ⅳ 5 cases WD HDR18 after loading equipment was used in the brachytherapy and 6 or 8 MV linear accelerator was used in the external radiation Results The overall 5 year survival rate with WD HDR18 was 58 8%, with 80 0% for stage Ⅰ,76 9% for stage Ⅱ,65 2% for stage Ⅲ,and 0 0% for stage Ⅳ The comparison of treatments with WD HDR18 and radium therapy showed the 5 year survival rates of the cases of each stage treated with WD HDR18 were higher Conclusion Treatment results obtained with high dose rate brachytherapy are at least similar to traditional radium therapy for primary vaginal cancer

Objective:To explore the influence of ADHD on academic achievement of undergraduates Method:104 undergraduates were randomly selected and divided into two groups by characteristics of adults with ADHD according to DSM-IV criteria Their academic achievements were also recorded SAS was used to assess their anxiety level Result:After controlled influence of anxiety and gender, academic achievement of undergraduates in ADHD group was significantly lower than that in non-ADHD group Conclusion:ADHD has negative influence on academic achievement of undergraduates

Endometrial carcinoma is the most common malignancy of the female genital tract. The traditional treatment of endometrial cancer is surgical excision supplemented by radiotherapy, chemotherapy or combined radio-chemotherapy. According to the individual condition of postoperative patients with endometrial carcinoma, choosing appropriate postoperative adjuvant therapy discreetly, which can effectively improve disease-free survival and long-term survival rate. But, for patients with endometrial carcinoma, how to choose the postoperative adjuvant treatment method is still controversial. The purpose of this article is to review of the research progress of endometrial carcinoma postoperative adjuvant therapy, and summariz.

Endometrial cancer is one of the malignant tumors of female reproductive system. The prognosis of advanced endometrial cancer is poor. How to improve the overall survival rate and improve the prognosis of patients with advanced endometrial cancer is still one of the clinical problems. In recent years, the research on tumor gene changes is increasing gradually. Epigenetics is the study of genetic changes in gene expression without changing the nucleotide sequence of genes. Epigenetics includes many phenomena, such as DNA methylation, microRNA expression and gene silencing, chromatin remodeling. These changes may be important factors in the occurrence and development of tumors, and may become new therapeutic targets for tumors. With the study on epigenetics of endometrial cancer in the future, new therapeutic targets may be found. Meanwhile, those study may provide new ideas for targeted therapy of endometrial cancer.

Objective: This study was to observe the changes of IL-6 gene expression in acute repetitive hypoxia. Method: When the ratio of living cells was more than 95%, nerve cells cultured were passed through with mixed gases of 95% N_2+5%CO_2 for 3 min followed by another gases mixture of 95% O2+5% CO_2 for 10 min. After repeated the experiment as above, the alteration in the expression of IL-6 gene was measured using the RT-PCR method. The prod ucts of PCR were analyzed with computer Gel imaging and image analysis instrument. Result: After the first hypoxia IL-6 gene expression enhanced, and after the second hypoxia, it was still stronger than baseline although it declined slightly. There was no significant RNA disintegration. Conclusion:The IL-6 involves in the cellular defense in hypoxia adaptation.

The clinical data of 380 patients undergoing loop electrosurgical excision procedure(LEEP) conization for cervical intraepithelial neoplasia grade 3(CIN3) at the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2019 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the risk factors of positive margin and residual lesions following conization. One hundred and twelve cases (29.5%) had positive margins, and the risk factors for positive margins were positive high-risk human papillomavirus ( OR=4.92, 95% CI: 1.81-13.36), high-grade lesions on thin cytologic test (TCT)screening ( OR=3.95, 95% CI: 2.42-6.42), and glandular involvement ( OR=3.58, 95% CI: 1.93-6.63). The hysteretomy was performed following conization in 169 hundred and sixty-nine patients who had difficulty in follow-up or no fertility intension, among whom 51 (30.2%) had residual lesions; logistic regression analysis showed that positive margins on LEEP were a risk factor for residual lesions at the time of hysterectomy ( OR: 2.83, 95% CI: 1.44-5.59). The study indicates that positive HR-HPV, high-grade TCT lesions, and lesions involving glands are risk factors for positive margins in CIN3 patients undergoing LEEP conization; and positive margins is risk factor for residual lesions following conization,to which more attention should be paid in clinical practice.

Objective To evaluate the clinical value of different radiotherapy protocols in the treatment of advanced cervical cancer. Methods From 1976 to 2006,763 patients with stage Ⅲ cervical cancer(722 with squamous cell carcinoma and 41 with adenocarcinoma)were treated by radiotherapy in our hospital. 113 patients were treated by two-field whole pelvic irradiation in conventional fractionation plus brachytherapy (CF group), 44 by four-field whole pelvic irradiation in accelerated hyperfractionation plus brachytherapy( AHF group), and 606 by concomitant four-field unconventional fractionation radiotherapy and brachytherapy(FRT group). Sixty-one patients were treated by radiotherapy and chemotherapy. Among 350 patients who had complete data, the short-term efficacy and toxicities were compared. Results For patients in CF,AHF and FRT groups, the 3-year overall survival rates (OS) were 65.7%, 66.8% and 44.3%, respectively (P=0.000), and the 5-year OS were 65.7 % ,66.8 % and 36.3 %, respectively (P=0.000). The 10-year OS were 43.3% and 31.9% in CF and FRT groups(P=0.200). For squamous cell carcinoma,the OS was higher of patients with chemotherapy than those without. In 350 patients who had complete data,the local control rates of CF, AHF and FRT groups were 83.0% ,93.2% and 86.1%, respectively(X2=2.70, P=0.259);AHF group had the lowest side effect rate, especially skin reaction (9.1%,X2=20.25,P=0.002) ;CF group had the lowest acute bone marrow suppression rate(X2=25.95,P=0.000);for squamous cell carcinoma, the OS was higher in patients with chemotherapy than those without;the acute bone marrow and intestinal toxicities were more in patients with chemotherapy than those without. Conclusions CF and AHF groups have similar 5-year OS of patients with advanced cervical cancer. AHF group has less toxicities, shorter treatment course and a trend of better local control. Concurrent chemoradiation could improve survival and local control of the patients with advanced squamous cell cervical cancer while increase the side effects. The individual condition should be considered to choose the treatment protocol.

Objective To sum up the experience on diagnosis and treatment of blunt bronchial injuries .Methods From January 2002 to December 2009 ,18 patients with blunt broncheal injuries were admitted .The definitive diagnosis was confirmed by fibro-bronchoscopy .Twelve patients suffered from main bronchial injuries and the remaining 6 patients from lobe bronchial injuries .All patients managed with surgical therapies .Emergent operation was performed in 15 patients and elective operation in 3 patients .End to end bronchial anastomosis was performed in 15 patients and primary repair in 3 patients .Results There was no death in this group .One patient after emergent primary repair developed ischic necrosis in the repair site on 3 the postoperative day and under-went resection of the necrotic tissue followed by end to end anastomsis .Thirteen patients had no complications and were able to take part in normal activities .Anastomotic stricture occurred in 5 patients and managed with granulation tissue resection and cryothera-py .Four patients were healed but one patient underwent lobectomy 6 months later as a result of recurrent stricture and severe dysp-nea .Conclusion Fibrobronchoscopy is able to define the blunt bronchial injuries immediately .Early surgery after trauma can im-prove the successful rate of treatment .

ObjectiveTo observe the effects and safety of early high-loading-dose clopidogrel in treatment of patients with acute coronary syndrome.Methods178 patients with STEMI were divided into two groups randomly.96patients were treated with clopidogrel 600 mg immediately when they came to the hospital, and then were treated with clopidogrel 75mg daily for 1 year;82 patients were treated with clopidogrel 300mg immediately when they came to the hospital,and then were treated with clopidogrel 75mg daily for 1 year.The attacks of postinfarction angina pectoris,events of heart failure and the composite of death,reinfarction or stroke were observed.ResultsCompared with control group, the high-loading-dose group had obvious reduction in the attacks of postinfarction angina pectoris and the composite of death, reinfarction or stroke (all p ＜ O.05).There were no major and minor bleeding events in the two groups.ConclusionEarly treatment with high-loading-dose of clopidogrel in ACS could significantly improve its prognosis,and was safe and well tolerated.