Objective To observe the clinical efficacy and prognosis of nimotuzumab combined with intensity modulated radiotherapy(IMRT) in the treatment of advanced local nasopharyngeal carcinoma.Methods 82 patients with advanced nasopharyngeal carcinoma were selected, and they were randomly divided into observation group(40 cases) and control group(42 cases) according to the digital table.The observation group was treated with nimotuzumab plus IMRT plus cisplatin, and the control group was treated with IMRT plus cisplatin.After 7 weeks of treatment, the clinical efficacy, adverse reactions and T cell subsets were observed.And the patients were followed up for 1 year, 2 years and 3 years to evaluate the survival rate.Results In the observation group, the total remission rate was 75.00%,which was higher than that in the control group(59.09%),the difference was statistically significant(x2=35.81,P<0.05).The CD+4,CD+8 and CD+4/CD+8 levels in the observation group were similar to those in the control group(tCD+4=0.59,P=0.56;tCD+8=1.70,P=0.01;tCD+4/CD+8=0.13,P=0.89).The incidence rates of Ⅰ degree and Ⅱ degree mucosal reaction and dermatitis in the observation group were 35.00%,40.00%,40.00%,35.00%,respectively,which were higher than 9.09%,9.09%,9.09%,9.09% of the control group,the differences were statistically significant(x2Ⅰmucous membrane=4.18,P=0.04;x2Ⅱmucous membrane=5.52,P=0.02;x2Ⅰdermatitis=5.52,P=0.02;x2Ⅱdermatitis=4.18,P=0.04).The 2-year and 3-year survival rates in the observation group were 65.50%,60.00%,respectively,which were significantly higher than 31.82%,27.27% in the control group, the differences were statistically significant(x2=4.11,P=0.04;x2=4.58,P=0.03).Conclusion Nimotuzumab combined with IMRT in the treatment of advanced nasopharyngeal carcinoma has good short-term clinical efficacy, good long-term efficacy and controllable adverse reactions.It is worthy of clinical application.

Objective Patients with Alzheimer dementia often display poor sleep. Given that the disease is often associated with low endogenous levels of melatonin, exogenous melatonin administration may lead to improvements in sleep. Methods Randomized, placebo controlled study was carried out in 41 patients with probable Alzheimer disease. Melatonin (8. 5 mg immediate release and 1. 5 mg sustained release) (n =24) or placebo (n = 17) administered at 22:00 P. M. for 10 consecutive nights. The protocol sleep was measured continuously using actigraphy. Results There were no significant effects of melatonin,compared with placebo,on sleep and circadian rhythms. Conclusion This study failed to find a beneficial effect of exogenous melatonin.

Objective To explore the correlation between 18F-FLT SUVmax and intratumoral microvessel density (MVD) in NSCLC patients.Methods From January 2008 to December 2010,68 patients (48males and 20 females; age ranging from 36 to 84 years) with NSCLC underwent 18F-FLT PET/CT followed by surgery within two weeks.Tumor proliferation was evaluated in terms of Ki67 labeling index (LI) with SP.MVD was determined using anti-CD31 mAb (CD31-MVD),anti-CD34 mAb (CD34-MVD) and anti-CD105 mAb (CD105-MVD) for each resected tumor.Linear correlation analysis was used to analyze data.Results The mean values of CD31-MVD,CD34-MVD and CD105-MVD were 159.6,166.1,and 38.0 per view field,respectively.Tumor SUVmax was 4.1±2.9,and Ki67 LI was (37.0± 14.5) ％,both of which had significantly correlations with CD105-MVD (r=0.550,0.633 ; both P＜0.05),but there was no significant relationship between SUVmax and CD31-MVD,CD34-MVD (r=0.228,0.235; both P＞0.05).Conclusion 18F-FLT PET/CT imaging has a positive relationship with CD105-MVD of NSCLC,and it could reflect the ability of tumor angiogenesis.

Objective To investigate the effect and significance of early coronary artery bypass grafting (CABG) on the expression level of nerve-related factor at infracted border zone (IBZ) in dogs with acute myocardial infarction (AMI).Methods The anterior descending coronary artery of all thirty dogs randomly assigned into experimental group(n =22) and control group(n =8)were ligated into MI model.The experimental group included those undergoing CABG 1(n =6),2 week(n =4),4 week(n =6)and 6 week (n =6) after MI,and control group(n =2) was established for every experimental group.We detected the local expression level of nerve-related factor such as GAP43 mRNA,NGF mRNA and SYN mRNA at normal myocardium and infracted border zone myocavdium by means of RT-PCR through thoracotomy at eight weeks after surgery.Results Four dogs of every experimental group and all dogs of control group survived to the end of the study.The local expression level of GAP43 mRNA,NGF mRNA and SYN mRNA in control groups was significantly higher than that in normal and experimental groups (P ＜0.01 ).The local expression level of GAP43 mRNA,NGF mRNA and SYN mRNA in 4 and 6 weeks bypass groups was significantly higher than that in normal and 1,2 weeks bypass groups (P ＜0.05).There was no statistically significant the expression level of SYN mRNA among all experimental groups (P ＞ 0.05 ).Conclusions Early CABG surgery for AMI in dogs could lessen the expression level of nerve-related factor and the sympathetic remodelling at IBZ.Especially CABG surgery two weeks after MI could lessen the sympathetic maximacily.

Objective To investigate the anti-atherosclerosis effect of apocynum venetum(AV)by observing the influence of AV extract on early inflammatory factor TNF-αexpression.Methods Human U937 monocytes were differentiated to macrophages by the phorbol myristate acetate(PMA)induction and acted with 100 mg/L ox-LDL to form the foam cells for establishing the early atherosclerosis model(ox-LDL group).The different concentrations(0.2,0.4,0.8 mg/L)of AV were added to co-culture for 48 h (AV1,AV2,AV3 groups).The expression level of TNF-αin the supernate was detected by ELISA and RT-PCR respectively.Re-sults Compared with control group,the expression level of TNF-αin the ox-LDL group was significantly increased,the expression level of TNF-αin various AV medication groups(AV1,AV2,AV3 groups)was significantly decreased compared with the ox-LDL group(P<0.05).The AV concentration increase was negatively correlated with the TNF-αexpression level(P<0.05).Conclusion TNF-αis an important inflammatory factor in early atherosclerosis,AV could play the anti-atherosclerosis role by inhibiting the inflammatory factors.

Objective To study the clinical characteristics of tuberculosis in oral and maxillofacial region,and to provide reference in early diagnosis and early treatment. Methods The clinical data of 132 patients were analyzed retrospectively. ResultsIn all cases, male to female ratio of 1∶1.69, the average age of 38.7 years, the group of 15 ～40year-old had higher incidence. Al1 parts of oral and maxillofacial region could be involved. In all 132 cases,107 cases were treated by surgery and drugs,25 cases by drugs only. Conclusion The local sign of tuberculosis in oral and maxillofacial region was atypical ,so it was likely to misdiagnosis. Definitive diagnosis relied on pathological examination. Operations played an important role in the cases of unifocal lymph nodes tuberculosis,oral mucosal tuberculosis, multifocal concentrated lymph nodes tuberculosis and salivary tuberculosis, while the therapy of multifocal sporadic lymph nodes tuberculosis and osseous tuberculosis should be relied on the medicine.

Objective To investigate the effect of anisodamine on oxygen metabolism and organ function in dogs with sepsis.Methods Twenty beagles were divided into sepsis group (n =8) and anisodamine-treated group (n =12) according to the random number table.The sepsis model was established by cecal ligation and puncture.Changes in thrombomodulin (TM),arterial oxygen partial pressure (PaO2),oxgen uptake rate (ERO2) and lactate were mearsured before and 1,3,8 and 24 h after operation.Wet/dry ratio of lung tissues and incidence of multiorgan dysfunction syndrome (MODS) were detected 24 h after operation.Results Level of TM was increased progressively after operation,which was significantly higher in sepsis group than in anisodamine-treated group at 3,8 and 24 h [(28.7±15.9) vs (19.5 ±10.6)ng/ml,(36.5±20.8) vs (21.9±12.8)ng/ml,(52.6±32.7)vs (31.3 ± 18.4)ng/ml respectively] (P ＜ 0.05).The PaO2 decreased slowly after operation,with the decrease more significant in sepsis group than in anisodamine-treated group at 24 h [(65.6 ± 14.5) vs (83.3 ± 16.3)mmHg] (P ＜0.05).The ERO2 had a rise-and-fall trend after operation,with the level lower in sepsis group than in anisodamine-treated group at 24 h [(16.7 ± 3.1) ％ vs (21.7 ± 2.9) ％] (P ＜ 0.05).Level of blood lactate increased gradually,with the level higher in sepsis group than in anisodamine-treated group at 24 h [(4.4 ± 1.2) vs (3.1 ± 0.8) mmol/L] (P ＜ 0.05).Wet/dry ratio of lung tissues in sepsis group was (510 ± 80) ％ versus (370 ± 50) ％ in anisodamine-treated group at 24 h (P ＜ 0.05).Incidence of MODS in sepsis group was 38％ versus 17％ in anisodamine-treated group at 24 h (P ＜ 0.05).Conclusion Anisodamine may ameliorate the injury to vascular endothelial cells and oxygen metabolism disorder after sepsis and hence contributes to the reduction of sepsis-induced MODS.

Objective To study the effect of ING5 gene on growth inhibition of gastric cancer. Methods ING5 expressing plasmid was transfect?ed into SGC?7901 cells. The cell viability was assessed by CCK?8,cell apoptosis and cycle was detected by flow cytometry analysis,the migration and invasion was evaluated by scratch and transwell,the expressions of mRNA and protein were determined by real?time quantitative PCR and West?ern blot respectively. Nude mice were implanted subcutaneously with SGC?7901 cells and tumor size and related protein were analyzed. Results After transfection of pEGFP?N1?ING5,the proliferation of gastric cancer SGC?7901 cells was significantly inhibited(P<0.05),the apoptosis was decreased(P<0.05),the percentage of G1 phase was increased and G2 phase was decreased(P<0.05),the ability of migration and invasion was reduced(P<0.05),the expression of NF?κB,PI3K,p?Akt1/2/3,Bcl?2,XIAP,β?catenin,c?myc mRNA,and protein levels were significantly in?creased(P<0.05),and the expression of Akt1/2/3、MMP9 mRNA and protein levels were significantly decreased(P<0.05). Conclusion The ING5gene inhibits the SGC?7901 cell proliferation,induces G1 arrest,inhibits the migration and invasion,and effectively regulates the related genes and proteins about cell proliferation,cell cycle and adhesion,but reduces apoptosis. ING5 can inhibit the evolution and development of gastric can?cer.

The service capabilities and sustainable development of community doctors' first contact are undoubtedly the critical factors to promote the construction of grassroots clinics and tiered health care system.Based on the review of motivation-related concepts and its development, as well as the analysis of the current conditions of community first contact and characteristics of community doctors in China, this paper puts forward and defines the concept and connotation of service motivation for community doctors' first contact by logically summarizing the concept of force in physical sciences ,motivation in service science, Based on analyzing the extrinsic motivations to form community doctors' first contact such as attraction, support, constraint, and stress the intrinsic motivations produced by professional identity, self-efficacy and achievement,as well as the interactions and relationships between them, this paper contructs a formation mechanism of the service motivation for community doctors' first contact, which is visual and intuitive.This paper provides a logical path and basis for scientific governance and upgrade of the service motivation for community doctors's first contact to effectively promote community first contact system in China.

Objective To explore the effects and molecular mechanisms of suberoylanilide hydroxamic acid (SAHA) on ovarian carcinoma. Methods (1)Two groups of ovarian carcinoma cell lines (SKOV3 and SKOV3/DDP, HO8910 and HO8910-PM) were exposed to SAHA (1, 3, 5 and 7μmol/L SAHA,group 1-group 4). CCK-8 method was employed to eval-uate the inhibitory effects of SAHA.(2)Ovarian cancer cell lines treated with SAHA (2 or 5μmol/L SAHA) were used as 1 and 2 groups. Flow cytometry was performed following staining with Annexin V-FITC and PI for cell cycle and apoptosis.(3) Reverse transcription polymerase chain reaction (RT-PCR) and Western blot assay were used to assess the mRNA and pro-tein expression levels of phenotypic correlation factor. Results (1)After 48 h of SAHA treatment,the OD value of SKOV3, SKOV3/DDP,and HO8910 showed a trend of gradually reduce (P<0.05).(2)The apoptotic rates were significantly higher in SAHA 1 and SAHA 2 groups than those of control group (P<0.05). Compared with control group, after 48 h of SAHA treat-ment,S phase and G2/M phase of SKOV3 and SKOV3/DDP cells increased;G0/G1 phase of HO8910 and HO8910-PM cells increased in SAHA 1 and 2 groups (P<0.05).(3)The expression levels of CyclinB1 and Cdc2 (p34) mRNA were significant-ly lower in SAHA 1 and 2 groups than those of control group,while the expression levels of Caspase-3,p21 and p53 mRNA expression were significantly higher in SAHA 1 and 2 groups than those of control group. Furthermore,the expression of Ac-Histone H3,Ac-Histone H4,p53 protein were markedly improved,and CyclinB1,Cdc2(p34) protein decreased in SAHA 1-4 groups. Conclusion SAHA may suppress cell growth, induce apoptosis and cause cycle arrest in ovarian carcinoma cells by promoting histone acetylation or modulating their phenotype-related proteins of Caspase-3, p53, CyclinB1 and Cdc2(p34).