Background and purpose: The prognosis of completely resected stage ⅢA(N2) non-small cell lung cancer (NSCLC) remains a significant concern. The 5-year overall survival (OS) rates range from 10% to 30%. This study aimed to analyze the patterns of first failure in completely resected stage ⅢA(N2) NSCLC and to assess the actuarial risk of developing metastasis at different sites and to guild standard clinical practice. Methods: Patients withⅢA(N2) NSCLC who had undergone radical surgery in our hospital from Jan. 2005 to Jul. 2012 were retrospectively reviewed. The progression-free survival (PFS), the OS, patterns of first failure, the actuarial risk were analyzed. The cumulative incidence of first failure was determined using the Kaplan-Meier analysis. Results: Among 357 patients who met the eligibility criteria with completely resected stage ⅢA(N2) NSCLC, 5-year OS was 36.9%. There were 284 (77.6%) patients experiencing disease failure: 61 with local failure, 197 with local and distant failures, and 26 patients with local recurrence as the first failure. Brain, bone and lung were the main sites of distant failure as the first failure, while brain was the most common site. There were 67 patients developing brain metastases (BM) as the first site of failure. The median time of local failure as the first site of failure was 13.6 months, and the time to develop distant recurrence was 15.1 months. 92.5% BM developed in 3 years after the complete resection. Conclusion: As the first failure, the rate of distant failure was much higher than that of local failure in completely resected stage ⅢA(N2) NSCLC. Brain was the most common site of distant failure as the first failure. These results can be helpful in guiding standard clinical practice and evaluating the outcome of comprehensive treatment.

?AIM: To evaluate the clinical effects, corneal surface shape and corneal thickness variation after treated by Danzhi Xiaoyao Capsule combined with hypromellose 2910, dextran 70 and glycerol eye drops for dry eye in menopausal patients.?METHODS: Eighty menopausal patients ( 160 eyes ) diagnosed as dry eye were randomly divided into groups A and B ( 40 patients each ) . Group A was treated with hypromellose 2910,dextran 70 and glycerol eye drops only and group B was treated with Danzhi Xiaoyao Capsule and eye drops. Before and 1mo after treatment, the clinical effects were evaluated by symptom scores, fluorescein staining ( FL ) , tear film breakup time ( BUT ) and Schirmer Ⅰ test. While the corneal surface regularity index (SRI), surface asymmetry index (SAI) and central corneal thickness ( CCT) were observed.? RESULTS: At 1mo after treatment, the symptoms scores and FL scores of the 2 groups decreased significantly( P<0. 05 ); BUT and SⅠt were significantly increased (P<0. 05). SRI and SAI gradually increased with dry eye exacerbations, after treatment the two parameters significantly reduced than those before treatment. SRI of group B improved significantly more than group A. CCT gradually got thinning with the dry eye condition worsened, which also significantly increased after treatment (P<0. 05);but there was no difference between 2 groups before and after treatment(P>0. 05).?CONCLUSION: Combination therapy of Danzhi Xiaoyao Capsule and hypromellose 2910, dextran 70 and glycerol eye drops for menopausal patients with dry eye is more effective than single eye drops, and can improve the symptoms and signs.

Acute Disease ; Adult ; Aged ; Aryldialkylphosphatase ; blood ; Female ; Humans ; Male ; Middle Aged ; Organophosphate Poisoning ; Young Adult

Acute Disease ; Adult ; Aged ; Female ; Humans ; Lipid Peroxidation ; Male ; Malondialdehyde ; blood ; Middle Aged ; Organophosphate Poisoning ; Oxidative Stress ; Superoxide Dismutase ; blood ; Xanthine Oxidase ; blood ; Young Adult

Objective To observe the changes of islet cell apoptosis and oxidation-antioxidation before the transplantation, and to explore the pathways of islet protection. Methods Fifteen human pancreases were perfused with the Hanks solution containing collagenase, then digested and isolated. During the procedure, islet cell apoptosis was detected by TUNEL, SOD and MDA in the pancreas were measured by colorimetric method, and the morphologic changes were observed by H-E staining and dithizone staining. Results In the procedure of human islet isolation, especially in the stage of digestion, the apoptosis of human islet cells occurred. In the stages of perfusion and digestion, the MDA contents reached the high levels (6. 18 ± 2. 38 and 9. 21 ± 2. 75 umol/mg protein respectively),and the structures of the islets and tissues around the islets were damaged. Conclusion In the stages of perfusion and digestion, apoptosis of islet cells can be caused by oxidation. It suggests that antioxidation is a pathway for protection of islets before transplantation.

Objective To evaluate the technique of transpancreatic septum precut for cannulation of inaccessible common bile duct in endoscopic retrograde cholangiopancreatography (ERCP). Methods Data of 109 patients with difficult biliary cannulation in ERCP, of whom 56 underwent transpancreatic septum precut and 53 had needle-knife sphincterotomy from January 2006 to July 2008, were analyzed retrospectively, and the success rate of cannulation and the occurrence of complications were compared between the two methods. Results Of 109 patients accepted precut papillotomy, common bile duct cannulation was successfully achieved in 97. The success rates of transpancreatic septum precut group and needle-knife sphincterotomy group were 96.4% (54/56) and 81.1% (43/53) respectively, which was significantly different (P<0.05). Complications occurred in 11 cases, including bleeding(n =4), acute pancreatitis(n=5), cholangitis(n=2). The tolal frequency of complications of the transpancreatic septum pre-cut papillotomy group was lower than that of needle-knife sphincterotomy group(3.6% vs. 17.0%, P<0.05). Conclusion In patients with inaccessible bile ducts, transpancreatic septum precut is a safe and effective procedure in cannulation, exhibiting a higher success rate and lower occurrence of complication when compared with needle-knife sphincterotomy.

Objective To evaluate the influence of different cannulation technique in endoscopic retrograde cholangiopanereatography (ERCP) on success rate, risk of post-ERCP complication and operation time of the procedure. Methods The data of 120 patients who underwent ERCP from June 2000 to June 2008 because of biliary duct disorders were retrospectively studied. Conventional carmulation technique was applied in 60 patients and guide-wire eannulation was used in other 60. The success rate, total time of ERCP operation and the incidence of post-ERCP complications including acute pancreatitis and biliary system infec-tion within 7 days were assessed. Results Compared with conventional carmulation technique, selective can-nulation with a standard ERCP catheter under the assistance of guide-wire proved a higher success rate and a shorter operation time (P<0.05). Incidences of postoperative pancreatitis and infection with conventional cannulation were 10.0% (6/60) and 23.3% (14/60), respectively, while with guide-wire assisted cannu-lation were 3.3% (2/60) and 10.0% (6/60), respectively. No complication of bleeding was observed in either group. Conclusion Guide-wire assisted cannulation in ERCP can shorten operation time, improve success rate and reduce post-ERCP complications. Further evaluations are warranted.

Anxiety disorder is one of the most common mental disorders and seriously impairs the physical and mental health of patients. Due to the efficacy of acupuncture for tranquilization, acupuncture displays its unique advantage on the treatment of anxiety disorder, but the relevant biological mechanism has not been elaborated. The modern medicine study has proved that the heart and brain have their own independent natriuretic peptide (NP) system. The dysfunction of ANP and its receptor are closely related to the occurrence of anxiety disorder. The ANP acts on anti-anxiety. Hence, focusing on the three aspects, named the anti-anxiety effect of acupuncture based on its tranquilizing effect, the anti-anxiety effect of ANP and the positive regulation of acupuncture on NP, the mechanism on ANP and its receptor was explored in anti-anxiety with acupuncture based on tranquilizing effect, and the idea was put forward on that the anti-anxiety effect of acupuncture was possibly based on its action of tranquilization through regulating the ANP and its receptor. As a result, it is expected to provide the theoretic support for the mechanism study on anti-anxiety with acupuncture based on its tranquilizing effect.
Acupuncture Therapy ; Animals ; Anti-Anxiety Agents ; metabolism ; Anxiety ; metabolism ; therapy ; Atrial Natriuretic Factor ; metabolism ; Humans ; Receptors, Atrial Natriuretic Factor ; metabolism

Teachers are principal parts in the innovation and implementation of teaching.Along with the deepening transformation of new medical teaching mode,higher demands have been set for the construction of teachership and for the education and training of teachers.The article gives an analysis on several issues that should be given attention to in the teacher training.

Objective To investigate the MR imaging technique and features of acute radiation- induced hepatic injury with superparamagnetic iron oxide(SPIO)enhancement in a rabbit model.Methods On the 10th day after half-liver single 40 Gy X-ray irradiation,MR imaging before and after SPIO administration and pathologic study of 12 adult rabbits were performed.Results On the 10th post-irradiation day,TSE T_2 WI before SPIO enhancement,the irradiated liver of two rabbits showed relatively higher signal, and 1 showed slightly lower signal.With SPIO enhancement,the irradiated livers of 9 rabbits were found to be abnormal,manifesting as higher or slightly higher areas on multiple MR imaging sequences,especially the TFE T_1 WI sequence.Histological specimen with HE stain under light microscopy revealed occlusive injury of central veins(veno-occlusive disease,VOD)in each irradiated liver to some extent.Electron microscopy investigation of the irradiated liver disclosed intracellular edema,fibrin deposition,and widening of the Disse-space.Conclusion The early pathologic feature of the irradiated liver is occlusive injury of the central vein.MR imaging with SPIO enhancement is effective to valuate the early irradiation-induced liver injury.