Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

OBJECTIVE:To prepare Lornoxicam for injection and to study its stability.METHODS:The formular and pre paration technology of Lornoxicam for injection was optimized with the index of contents,the related substances and pH value;3batches of samples'stability was investigated.RESULTS:The best formula was found to be the following:4.0g of lornoxicam,4.0g of propylene glycol,100g of mannitol and sufficient quantum of1mol/L caustic soda,3batches of sample preparations man ufactured under this formula were found to be stable in quality in the accelerated,room temperature storage test under the condition of commercial packing.CONCLUSION:The formula design was reasonable and the preparation technology was feasible.

3' Untranslated Regions ; genetics ; 5' Untranslated Regions ; genetics ; Enterovirus B, Human ; genetics ; Genome, Viral ; genetics ; Humans ; Poly A ; genetics

OBJECTIVE:TO summarize the treatment of complicated proximal humeral fracture with artificial shoulder replacement.METHODS:A computer-based online search of VIP was performed for related articles published between January 1998 and October 2009 with the key words"shoulder joint,prosthesis replacement,proximal humeral fracture".Articles with high correlation were included.and repetitive studies were excluded.The data were firstly collected,the references of each article were reviewed.RESULTS:A total of 18 articles were included The treatment of complicated proximal humeral fracture remains controversial.Early semi-shoulder ioint replacement is an appropriate method.Shoulder replacement includes humeral head replacement and total shoulder replacement.Neer and Biligani type are typical artificial humeral head.The fixation patterns of humeral head prosthesis shaft include cemented and cementless.Bone cement includes total bone cement and proximal cement fixation,and cementless includes pressure fixation and compaction bone grafting.Complications following shoulder replacement involve prosthesis instability,nodule heterotopia,heterotopic ossification,prosthesis loosening,periprosthetic fracture,infection and nerve injury.CONCLUSION:Majority of complications can be prevented by appropriate location of prosthesis,reconstruction of greater and lesser tubercle.and in combination with postoperative rehabilitation treatment.

Objective To study the application value of serum umbilical cord blood bilirubin and hemolysis three test in the prediction of neonatal hyperbilirubinemia.Methods 1 200 cases of healthy newborn were selected,whose mothers were type O blood and fathers were not type O blood.According to the situation of maternal and infant blood type,they were divided into the same maternal and child blood type group with 539 cases and different blood type group with 661 cases;According to the umbilical cord blood bilirubin concentration range was divided into five groups,and analyzed umbilical cord blood bilirubin and hemolysis three test in the prediction of neonatal hyperbilirubinemia.Results (1) The concentrations of umbilical cord blood bilirubin,the incidence of ABO-HDN,the incidence of hyperbilirubinemia in the maternal-fetal blood(O-A/B) group were (38.1 ± 10.3) μmol/L,47.35％,26.02％,respectively,which were all significantly higher than (33.4 ± 7.9)μmol/L,15.21％,14.66％ in the maternal blood type (O-O) group (t =5.8,x2 =120.7,x2 =20.1,all P =0.000) ; (2) When the concentrations of umbilical cord blood bilirubin was higher,the incidence of hyperbilirubinemia was higher,but the sensitivity and the specificity both were bad; (3) According to the result of hemolysis three to predict the neonatal hyperbilirubinemia,when the concentrations of umbilical cord blood bilirubin was less than 21μmol/L or more than 55μmol/L,the positive predictive value and the specificity both were 100.00％,and the sensitivity was not low(75.00％ and 86.96％).Conclusion Detection of umbilical cord blood bilirubin and hemolysis three test in the maternal-fetal blood group incompatibility could predict early hyperbilirubinemia of newborn,which had certain clinically practical value.

AIDS-Related Opportunistic Infections ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; Sarcoma, Kaposi

Objective To study the effect of DNA damage induced by H2 O2 on the micronucleus frequency in lymphocytes. Methods Resting lymphocytes were treated with different levels of H2 O2 (10,50,100,1 000 μmol/L).1 000 μmol/L H2 O2 was added into mitogen-stimulated lymphocyte cultures at different time intervals.Then micronucleus rate was examined by the conven-tional culture method.Results There was no significant change of the micronucleus frequency in the experimental groups.Conclu-sion H2 O2 could induce lymphocyte DNA damage rapidly,but exerts no effect on the formation of micronuclei,which may be relat-ed to the type of DNA damage and rapid DNA repair.

Objective To investigate the relationship between the change of pre-ablative TSH after thyroid hormone withdrawal(THW) and the response of subsequent 131I therapy in patients with low to intermediate risk DTC after total or near total thyroidectomy.Methods A total of 120 DTC patients (38 males,82 females,age (40.8±10.9) years) were enrolled in this retrospective study.Serial TSH levels determined on the day of THW and on the day of receiving 131I ablative therapy were monitored,which were marked as TSH1 and TSH2 accordingly.The THW duration (t) was recorded,the change of TSH was defined as △TSH and the change rate of TSH was calculated (V=△TSH/t).The responses to 131I therapy were classified as excellent response (ER),indeterminate response (IDR),biochemical incomplete response (BIR) and structural incomplete response (SIR) according to ATA guideline.According to the TSH2(mU/L) levels,patients were divided into G1 group (30≤TSH2＜60),G2 group (60≤TSH2＜90),G3 group (90≤TSH2＜ 120),G4 group (120≤TSH2＜150) and G5 group (TSH2 ≥ 150).Clinical and pathological features,THW duration,the change rate of TSH,residual thyroid,131 I dose and follow-up time were compared among these groups.In order to evaluate the relationship between response to 131I ablation and change rate of TSH,patients were divided into V1 group (V≤2.5),V2 group (2.5＜V≤5.0) and V3 group (V＞5.0),and their responses to 131I ablation were compared.Patients were classified into RI group (including ER and IDR)and R2 group (including BIR and SIR),the differences of clinical and pathological features,131I doses between the two groups were explored.Furthermore,logistic regression was performed to identify factors associated with BIR and SIR.Results Patients with male gender (x2=11.863),younger age (F =4.975),and faster TSH change rate (H =44.911) and lower thyroid residue (H =18.159) achieved a higher value of TSH2(all P＜0.05).G3 group presented the highest rate of ER (83.8％,31/37).The percentage of ER + IDR in V2 group was higher than those in V1 group and V3 group,which was 92.4％ (61/66),85.7％ (18/21) and 5/7,respectively,but the difference was not significant (U=407.5,P＞0.05).TSH2 level (OR=0.835) and pre-ablative Tg level (OR =1.196) were independent factors in predicting BIR and SIR (both P＜0.05).Conclusions The changing rate of TSH before 131 I ablation may not be associated with the response to 131I therapy in patient with low to intermediate risk DTC,while the level of TSH2 does.Patients with TSH2 ranging from 90 to 120 mU/L could be of help in achieving a better clinical response.

OBJECTIVE:To investigate the effects of glutamine on neurological and gastrointestinal function of severe organo-phosphate poisoning patients. METHODS:46 patients with severe organic phosphorus poisoning in our hospital were enrolled and ran-domly divided into control group and observation group,with 23 cases in each group. Control group was given antidote atropine,en-ergy recovery agent pralidoxime chloride,blood perfusion and other symptomatic treatment. Observation group was additionally given Glutamine dipeptide injection 0.5 g/kg,ivgtt,qd,on the basis of control group. Both groups received the treatment for consecutive 3 d. The time of poisoning symptom disappearance,the time of blood cholinesterase recovery,hospitalization time,neurological and gastrointestinal function indexes were compared between 2 groups. RESULTS:The time of poisoning symptom disappearance,the time of blood cholinesterase recovery and hospitalization time of observation group were significantly shorter than those of control group,with statistical significance (P<0.05). After treatment,serum diamine oxidase and lactulose/mannitol of observation group were significantly lower than those of control group,while the serum content of citrulline was higher than in control group,with sta-tistical significance (P<0.05). After treatment,MCV and SCV of observation group were significantly higher than those of control group,while F wave latency was significantly shorter than control group,with statistical significance(P<0.05). CONCLUSIONS:Glutamine dipeptide is helpful to promote remission,improve gastrointestinal and neurological function.

Objective To investigate the effects of target-controlled confusion of propofol with different concentrations on ventricular repolarization after prophylactic infusion of cefuroxime sodium. Methods Sixty ASA physical status Ⅰ or Ⅱ female patients,aged 18-65 years,undergoing elective gynecological surgery were randomly divided into three groups:group P2 (n =20)with TCI 2 μg/ml, group P3 (n =1 9)with TCI 3 μg/ml and group P4 (n =20)with TCI 4 μg/ml.Firstly,they were re-hydrated;secondly,the patients in groups P2,P3 and P4 were intravenous infused with cefuroxime sodium 2.5 g (in 100 ml normal saline)and then target-controlled infused of propofol 2 μg/ml,3μg/ml and 4 μg/ml in target plasma concentration,respectively.At three pionts of time:after rehy-dration before intravenous antibiotics (T0 ),after intravenous antibiotics before TCI of propofol (T1 ), after TCI of propofol (T2 ),QT interval,QTc interval,Tp-e interval were measured and recorded, respectively.Results Compared with T0 ,QTc [(469.9 ± 34.0)ms vs.(451.2 ± 24.9)ms],Tp-e [(107±25)ms vs.(94±20)ms]and Tp-e/QT (0.260±0.058 vs.0.236±0.043)in group P4 were sig-nificantly prolonged at T1 (P < 0.05 ).Compared with T1 ,QTc of groups P2 [(437.4 ± 24.4)ms vs. (453.3±28.0)ms]and P4 [(438.8±29.9)ms vs.(469.9±34.0)ms]were shortened significantly at T2 (P <0.05).Conclusion Propofol could improve ventricular reporlarization heterogeneity caused by cefu-roxime sodium.