Pemetrexed is a novel antifolate which is approved in the USA and Europe for the treatment of non-small-cell lung cancer (NSCLC).Researches reveal that pemetrexed enhances radiation-induced cell inactivation.A series of clinical trials of pemetrexed combined with radiotherapy for NSCLC also demonstrated that pemetrexed provides similar efficacy with lower toxicity and better tolerability than other third-generation chemotherapy drugs.

Chinese herbs with bitter flavor have the function of purgation and dryness as well as strengthening yin.Strengthening Yin means keeping and maintaining yin fluid.Actually,it is to draw assistance from some Chinese herbs with bitter flavor to purge excessive fire in order to maintain yin qi by heat-clearing and fire-purging,that is to say purging fire to keep or save yin.Strengthening yin of bitter herbs is different from the moistening and nourishing function of sweet-cold herbs.It can be generally divided into three aspects: purging ministerial fire and restoring renal yin,clearing heat and purging fire to maintain yin fluid;purging to preserve yin.Strengthening yin doesn't mean the property and flavor of bitter-cold can nourish yin directly.We should not only emphasize clearing fire by using herbs with bitter in flavor and cold in nature,but also pay attention to nourish yin.It is causal relation that exists between purging fire and maintaining yin.The former is only a means and method,and the latter is objection and effect.Because the bitter-flavor can only damage yin by bitterness and dryness but is not good at benefiting yin,we cannot strengthen yin by using bitter herbs in treating yin-deficiency syndrome without excessive fire.

During radiotherapy, ionizing radiation can damage some structures of the heart, including pericardium, myocardium, cardiac valve, conducting system, and coronary artery. Radiation-induced cardiac injury can manifest as abnormalities in many aspects including myocardium enzymes, perfusion imaging, electrocardiogram, strain rate imaging.

Primary tracheal tumor is an uncommon disease in clinical oncology .It tends to be misdiag-nosed in very early stage ,as well as lack of standards for staging and treatment nowdays .The main strategy for the treatment of primary tracheal tumors is surgical comprehensive treatments .But as the huge development of modern radiotherapy technology the past a few years ,radiotherapy could play more and more important roles in the treat-ment of tracheal tumors.Meanwhile,the application of tracheal scaffold have provided the patients with tracheal tumors some new choices on the treatments .Yet,there are no guildline for the standard of the surgery ,the dose of the radiotherapy and the definition for the tumor target volumes .Here,we give a review on the latest process and research on the treatment of primary tracheal tumors .

Objective To compare the efficacy and toxicity of inductive chemotherapy with pemetrexed followed by radiotherapy for patients with lung adenocarcinoma .Methods Patients with stage Ⅲa/b or Ⅳ and histologically confirmed lung adenocarcinoma were evaluated from July 2008 to April 2012 ( n=95 ) .Patients re-ceived inductive chemotherapy with pemetrexed or paclitaxel followed by thoracic radiotherapy or chemotherapy with pemetrexed alone,respectively.Primary end point was the tumor response rate (RR),progression-free sur-vival(PFS),1-year survival rate and toxicity.Results Tumor RR were 83.3%,81.8%and 62.5% in three groups of inductive chemotherapy with pemetrexed or paclitaxel followed by thoracic radiotherapy or chemotherapy with pemetrexed alone ,respectively.PFS was 12.0 months,10.9 months and 5.7 months.The 1-year survival rate was 80.0%,78.7%and 46.8%.Tumor RR and PFS were statistically superior in pemetrexed/radiotherapy versus pemetrexed alone ,and toxicity was significantly lower than in paclitaxel /radiotherapy.Conclusion The treatment of pemetrexed/radiotherapy for lung adenocarcinoma could prolong the survival of patients .Compared with the treatment of paclitaxel/radiotherapy ,pemetrexed/radiotherapy provides similar efficacy with better tolera-bility and more convenient administration .

Objective To probe the application of CT cerebral perfusion imaging on transient ischemic attacks(TIA) Methods Conventional CT and CT cerebral perfusion imaging were performed on 5 normal adults and 20 patients with clinically diagnosed TIA After regular CT examination, dynamic scans of 40 seconds were performed on selected slice (usually on the basal ganglia slice), while 40 ml non ionic contrast material were bolus injected through antecubital vein with These dynamic images were processed with the "Perfusion CT" software package on a PC based workstation Cerebral blood flow (CBF) and time to peak (TP) enhancement were measured within specific regions of the brain on CT perfusion images Quantitative analysis was performed for these images Results A gradient of perfusion between gray matter and white matter was showed on CT perfusion images in normal adults and TIA patients CBF and TP for normal cortical and white matter were 378 2 ml?min -1 ?L -1 , 7 8 s and 112 5 ml?min -1 ?L -1 , 9 9 s, respectively In 20 cases with TIA, persisting abnormal perfusion changes corresponding to clinical symptoms were found in 15 cases with prolonged TP Other 5 cases showed normal results TP of affected side (11 8?4 4) s compared with that of the contralateral side (9 1?3 1) s was significantly prolonged ( t =5 277, P

The recurrence rate of non -small cell lung cancer ( NSCLC) patients after radiotherapy and chemotherapy have been increasing .The therapy scheme consists of reirradiation、chemotherapy、and chemoradio-therapy,with the purpose of improving the local control and prolonging the survival time .Reirradiation is feasible for locally recurrence of non -small-cell lung cancer patients , treatment is security and could better improve quality of life in patients .The majority of patients are tolerable and have better short -term efficacy , No severe short term radiation induced injury is observed .But the long term radiation induced injury and long term efficacy need further investigation .In the present paper ,we review the roles of reirradiation for locally recurrence of non -small-cell lung cancer patients after radiotherapy and chemotherapy and the progress in clinical research .

Peptide self-assembled multilayers ( SAMs ) was coated onto the quartz surface. The assembly conditions, such as the assembly agent concentration and assembly time, were examined. The SAMs was characterized via UV-vis absorption spectrometry and scanning electron microscope. Our results showed that the optimal concentration and assembly time for the 3-aminopropyl-triethoxysilane aqueous were 1% ( V/V ) and 3 h respectively, and those of gold nanoparticles were 2. 4 × 10-4 mol/L and 12 h, respectively, while those of peptide solution were 1 × 10-4 mol/L and 12 h, respectively. A new sensitive method, based on the theory that peptide could be cleaved at the site of Arg-Gly by thrombin, was established to detect thrombin. In addition, a good linear relationship was obtained in the range from 2. 8×10-12 mol/L to 9. 9×10-10 mol/L, and the detection limit was 1. 4×10-12 mol/L. The peptide self-assembled multilayers were also used in the analysis of blood serum samples, and the recovery rate was within the range from 91. 6% to 107. 6%.

It is complicated to decide the treatment plan of hopeless anterior teeth in esthetic zone due to severe periodontitis, periodontal-endodontic combined lesion or teeth trauma.The optional treatment plan for this kind of teeth includes retention after periodontal treatment, extraction and implant treatment, extraction and prosthodontic treatment and so on.To make an appropriate treatment plan, patients'' periodontal conditions, periodontal biotype, local anatomy, esthetic demand, economic condition and social psychological status should be comprehensively considered.A combine of periodontal, endodontic and orthodontic therapy may achieve a good treatment effect in hopeless anterior teeth with severe periodontal destruction, tooth extrusion and occlusal trauma.In this case, a 20-year-old female who presented with symptoms of bleeding on brushing and upper incisors loosening for 1 month came to the Department of Periodontology, Peking University School and Hospital of Stomatology.The clinical examinations revealed that the patient''s right upper incisor had signs of mobility (Ⅲ°), intrusion of 1-2 mm, and probing depth (PD) of 9-10 mm.The periapical radiograph showed that the alveolar bone of right upper incisor absorbed horizontally to the apex.And the patients showed Angle Ⅱ° malocclusion with Ⅱ° overbite in anterior teeth and maxillary protrusion.A diagnosis of aggressive periodontitis and Angle Ⅱ° malocclusion was made.The treatment of this patient lasts for 5 years which include periodontal initial therapy, orthodontic therapy, guided tissue regeneration (GTR) of right upper incisor and supportive periodontal therapy and the clinical result is fine.A hopeless upper incisor was successfully retained and the longtime clinical condition was stable.The strategy of retention of hopeless upper anterior teeth, the relationship of periodontal treatment and orthodontic treatment, and the indications of periodontal and orthodontic combined therapy were also discussed on the basis of this case.Generally, the positive factors in retention of hopeless teeth includes young age, absence of systemic conditions, strong motivation for maintaining the tooth, single root anatomy, integrated dentition, good response to cause-related therapy, intrabony alveolar bone defect, thick periodontal biotype, and regular supportive periodontal therapy.And in the progress of orthodontic therapy, regular supportive periodontal therapy and good plaque control is extremely important.

BACKGROUND: Denddtic cells (DCs) constitute the dominant population of antigen presenting cells (APCs) by possessing potent ability to initiate T cell immunity. The ultrastructure study of DCs is less reported. OBJECTIVE: To investigate the ultrastructure of DCs from mice bone marrow at different maturation stages, and the morphology of DCs between CD40 ligation and tumor necrosis factor-alpha (TNF-α) stimulation in vitro. METHODS: Mice myeloid DCs were generated from bone marrow in vitro using granulocyte-macrophage colony-stimulating factor (GM-CSF)and interleukin-4 (IL-4). Immature DCs were loaded with apoptotic tumor cells (AP-DC), and AP-DC was then stimulated with CD40L-CHO cells and TNF-α for 48 hours, respectively. DCs were routinely sectioned, and ultrastructure was observed under transmission electron microscope. RESULTS AND CONCLUSION: Immature DCs showed a few short and blunt cytoplasmic processes, there were specific morphology lysosomes that liked earphone in some cells; DCs engulfing the apoptotic bodies were observed; sub-cellular structures between CD40 ligation and TNF-α stimulated DCs were different, the former had typical morphology of mature DCs which exhibited many dendritic protrusions, however, some DCs displayed apoptosis and autophagy after TNF-α stimulation. In a conclusion, CD40 ligation plays an essential role in myeloid DCs differentiation and maturation, TNF-α can mediate apoptosis and autophaqy of DCs.