Objective To investigate the effect of erythropoietin (EPO) on the expression of MMP-2 in hippocampus of neonatal rats after hypoxic-ischemic brain damage (HIBD), and the mechanism of its neuroprotective effect. Methods Neonatal Sprague-Dawley rats of 7 days old were randomly divided into three groups (n?=?48 in each group): sham-operated group, HIBD group and EPO treated group, then each group was further divided into four subgroups (n?=?12) based on different time points following the injection of medication ( 6 h, 24 h, 3 d, 7 d). The expression of MMP-2 in hippocampus was determined by immunohistochemistry and real-time lfuorescent quantitative PCR method. Results Immunohistochemistry: MMP-2 has a small amount of expression in the hippocampus of the sham-operated group, and at each time point, there is no statistically signiifcant difference (P?>?0.05);The expression of MMP-2 in HIBD group and EPO group all show a trend of increase, and peaked at 7 d, the differences between each time point in two groups are statistically signiifcant (P??0.05). Gene expression in HIBD group at 24 h and 7 d points showed twin peaks, and the peak is higher at the 7 d point, but without difference (P?>?0.05). MMP-2 expression of EPO group presents a trend of increase, and differences are signiifcant between each time point (P?

Therapeutic approaches to brain metastases from non-small cell lung cancer ( NSCLC ) include corticosteroids, anticonvulsants, surgery, radiotherapy and chemotherapy. In recent years, molecular targeted therapy such as the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) has become a new option. This article discussed the roles of surgery, brain radiation, chemotherapy, targeted therapy , and other new directions in the treatment of patients with brain metastases from NSCLC.

Objective To discuss the safety and effectiveness of heat-sensitive moxibustion for bladder dysfunction after poisonous snakebite. Method Twenty-six patients with bladder dysfunction due to poisonous snakebite were intervened by heat-sensitive moxibustion, and the changes of residual urine volume and uroflowmetry parameters were analyzed by using type-B ultrasonic scanning and uroflowmetry. Result According to the ultrasonic scanning and uroflowmetry, the residual urine volume was significantly changed after treatment in the 26 subjects (P<0.05), and the maximum urine flow rate (Qmax) was also significantly different from that before treatment (P<0.05). Conclusion Heat-sensitive moxibustion can improve the residual urine volume and Qmax in bladder dysfunction after poisonous snakebite, and it’s a safe and reliable method.

Purpose To study the prevalence and feature of EGR gene rearrangement in prostatic carcinoma. Methods 242 consecu-tive core biopsies of prostatic carcinoma were evaluated. All biopsy specimens contained 6-14 cores from left and right sides separately delivered. The patient age ranged 58 to 91 years, and PSA value 5 ng/ml to more than 5 000 ng/ml. Immunohistochemistry ( IHC) for ERG protein overexpression and fluorescent in situ hybridization ( FISH) for ERG gene rearrangement were performed. Results 42 cases were detected positive for ERG by IHC ( positive rate 17. 4%) , and positive for ERG rearrangement by FISH either, with 19 ca-ses showing fusion through deletion and 23 through insertion, while no negative cases by IHC demonstrated positive by FISH. 5 cases revealed positive and negative staining in different carcinoma foci of ERG. No ERG positive staining and rearrangement were found in adjacent benign glands. Of positive cases, 12 cases were graded as Gleason score 6, 23 Gleason score 7, and 7 Gleason score 8 or more. Positive rate was 19. 6% in the group of PSA value less than 100 ng/ml, and 10% of more than 100 ng/ml, whereas 17. 2% in the group of clinical T3 stage or less, and 19% of clinical T4 and lymph node or remote metastasis. ERG rearrangement was associated with lower Gleason score, but not with PSA value, clinical stage and progression using theχ2 test analysis. Conclusions IHC is relia-ble for detection ERG rearrangement and helpful for interpretation of prostatic carcinoma. Multiple foci are common in prostatic carcino-ma. There is no significance between ERG rearrangement and disease prognosis.

Objective To explore the effect of clinical pharmacist on clinical rational use of antineoplastic drugs after participating in treatment group.Methods Retrospective research was used.According to whether there was a clinical pharmacist directly or indirectly involved in,all medical teams of the oncology department were divided into intervention group,advisory group and control group in our hospital.Intervention group was the medical team that had a specialist clinical pharmacist who could intervene irrational use of antineoplastic drug in the treatment on the spot.Advisory group was in the same area with the intervention group,and didn't have a specialist clinical pharmacist, but used to communicate with clinical pharmacist and take his medication advice,where clinical pharmacist indirectly involved in treatment.The control group was the medical group in the other area without clinical pharmacists of oncology department.The control group one and two were with the most beds among the control group.Randomly selected lung cancer,breast cancer,esophageal cancer,gastric cancer,colorectal cancer,gynecological cancer,liver/gallbladder/pancreatic cancer and other tumors patients from intervention group,advisory group,control group one and control group two,from January 2015 to December 2015,10 copies of each case,80 copies of each group.And antineoplastic drugs were commented specially.The information such as sex,age,clinical diagnosis,irrational antineoplastic drug use,adverse reaction and unexpected events and hospitalization time were recorded.Results The rate of irrational antineoplastic drug use of the intervention group (41.25%)was lower than the advisory group(80%),and was significantly lower than two control groups(147.50%,161.25%),advisory group was also lower than two control groups,but no significant differences between the two control groups(χ2 =0.193,P>0.05).Irrational chemotherapy, inappropriate usage and dosage and inappropriate indications were prominent problems in intervention group and advisory group.In addition,there were more improper solvent and contraindicated or adverse interaction problems in two control groups.Adverse events and incidence of unexpected events in intervention group (46.25%,12.50%) were significantly lower than those in two control groups[(73.75%,22.50%),(23.75%,18.75%)].Furthermore, the length of stay of intervention group patients was shortest in four groups (F=8.766,P<0.05).Conclusion By participating in the treatment group,clinical pharmacists can discover the irrational drug use and security risks in treatment,can provide medication guidance,consultation,publicity and other pharmaceutical service for specialist medical staff and patients.They will be more and more prominent in the treatment of cancer.

Purpose To study clinicopathologic feature of prostate cancer by complete embedding of radical prostatectomy specimen. Methods 108 cases of radical prostatectomy by systematic whole organ embedding were reviewed. Results The patient age ranged from 55 to 80 years ( mean 68. 1 years) . The preoperative average PSA value was 18. 3μg/ml. 59 cases ( accounting for 54. 6% of all prostatectomy cases) were in pT2 stage, while 23. 7% (14/59) in pT2a stage, 8. 5% (5/59) in pT2b, and 67. 8% (40/59) in pT2c. 49 cases (45. 4%)in pT3 stage, while 59. 2% (29/49) in pT3a, 40. 8% (20/49) in pT3b. 3. 6%(3/84)cases presented pelvic lymph node metastasis. 8. 3% (9/108) cases were graded as Gleason Score 6 or less, 61. 1% Gleason Score 7, 30. 6%(33/108)Gleason Score 8 or more. Gleason Pattern 5 component was found in 26. 9% (29/108) cases. Positive margin was observed in 25. 9% (28/108) cases, with 75% (21/28) in pT3 stage and 53. 6% (15/28) having Gleason Pattern 5. Patient in pT2 stage pres-ented mean PSA value of 14. 00 μg/ml, involved in no more than 2 biopsy cores in 68. 5% cases, and more than 5 cores in 4. 3%, while in pT3 stage, presented mean PSA value of 23. 82μg/ml, involved in no more than 2 cores in 19. 6%, and more than 5 cores in 28. 3%. The difference of involved core number was significant in pT2 and pT3 tumors ( P<0. 01 ) . 81. 3% cases graded Gleason Score 6 in biopsy was assigned to Gleason Score 7 or more in prostatectomy. Conclusions Completely sampling radical prostatectomy specimen should be recommended for accurate staging and margin status. Preoperative PSA value, Gleason Score of biopsy, involved core number by cancer is a still helpful parameter for clinical staging and risk estimate.

OBJECTIVE To investigate the efficacy and feasibility of endoscopic surgery to manage the tumors involving naso-ethmoidal complex and anterior skull base.METHODS 19 cases of tumors involving nasal cavity,ethmoid sinus and anterior skull base were summarized retrospectively, including 3 cases of ethmoidal squamous carcinoma, 3 cases of esthesioneuroblastoma,3 cases of melanoma,1 case of plasmocytoma,2 cases of ethmoidal adenocarcinoma,4 cases of adenoid cystic carcinoma,2 cases of meningioma.RESULTS Tumors were totally removed in 18 cases and subtotally removed in 1 case,all the cases were followed up for 1 to 3 years.Of the 3 cases of melanoma,1 case died of brain metastases 1 year after surgery,1 case recurred 8 months after surgery,1 case of adenoid cystic carcinoma recurred 17 months after surgery.No recurrence were found in the rest 16 cases during 1-3 years of following-up.CONCLUSION Endoscopic surgery is a effective method for malignant tumors localized in nasal cavity and ethmoid sinus and benign anterior skull base tumors involving nasal cavity and sinuses.Indication must be carefully selected for malignant tumors and postoperative radiotherapy should be advised.

Objective To assess the feasibility for the automated treatment planning verification system Mobius3D (M3D) to perform an independent 3D dose calculation in intensity-modulated radiotherapy (IMRT) for cervical cancer.Methods Twenty patients with cervical cancer were randomly selected.With treatment planning systems (Pinnacle,Version 9.2;Eclipse,Version 13.5),all IMRT plans were divided into 7 fields to meet the dosimetric goals.The optimized plans were exported to the M3D server.The percentage differences in the volume of region of interest (ROI) and the dose calculation of target volume and organ at risk (OAR) were evaluated for the two treatment planning systems,and theγ passing rate was used to assess the accuracy of M3D calculation.Results The difference in the volume of ROI for Pinnacle 9.2 to M3D was less than that for Eclipse 13.5 to M3D,with maximum differences of 0.22％±0.69％ and 3.5％±1.89％ for Pinnacle 9.2 and Eclipse 13.5,respectively.The differences in the dose calculation of target volume and OAR for the two treatment planning systems to M3D were within ± 1％.After recalculating by M3D,the dose difference between Pinnacle 9.2 and M3D was smaller than that between Eclipse 13.5 and M3D,but the mean differences were all within ±3％.The γ passing rates for target volume and OAR were more than 95％ on average.Conclusions The method of utilizing the automated treatment planning verification system to validate the accuracy of plans is convenient.It can be used as a secondary check tool to improve accuracy in IMRT dose calculation.

Objective To explore the effect of laparoscopic bile duct exploration,balloon dilation,and catheter drainage in the treatment of postoperative recurrent choledocholithiasis.Method The data of 61 patients with postoperative recurrent bile duct stones from August 1999 to August 2009 were retrospectively analyzed.The patients received laparoscopic bile duct exploration (LCDE),laparoscopic papillary balloon dilation (LPBD),and laparoscopic papillary balloon dilation endoprosthesis (LPBDE).ResultSatisfactory outcome was achieved in all the 61 patients.Among the 61 patients,20 patients received LPBD and primary suturing,36 patients received LPBDE and primary suturing,and 5 patients received LPBDE and T-tube drainage.There was no residual stone.There was no perioperative mortality or serious complications including biliary leak and hemobilia.On follow up for 1 to 9.5 years in 56 patients,there was no recurrent choledocholithiasis.ConclusionThe procedures were feasible and safe,and they prevent recurrence of choledocholithiasis.

Objective To investigate the knowledge of chronic heart failure (CHF) and influencing factors in general practitioners (GP) in Beijing.Methods A self-designed questionnaire contained total 28 items,including basic knowledge of CHF,non-drug management,drug management and other management ; clinical cases were used to test clinical ability in 7 items.The questionnaire survey was conducted among GPs who participated in continuing education courses from 16 counties/districts in Beijing during January to June 2013.Results Total 720 questionnaires were distributed and 657 valid questionnaires were returned with a recovery rate of 91.3％.Total scores was 60.6.Scores of basic knowledge,non-drug management,drug management and other management was 63.1,76.9,44.0 and 56.9,respectively.There were statistical differences in scores of basic knowledge,non-drug management,drug management and other management between GPs with different diploma (F value:36.8,5.8,21.6,12.2,respectively; P ＜0.01) ; there were significant differences in scores of basic knowledge and drug management among GPs with different working years (F value:15.1 and 17.4,respectively ; P ＜ 0.01) ; there was significant difference in scores of drug management among GPs with different professional title (F =7.69,P ＜ 0.01).Only for GPs with junior college diploma,the scores of basic knowledge and drug management in GPs with working ≥20 y were higher than those working ＜ 20 y(P ＜ 0.01).The accuracy of clinical ability in GPs with junior college diploma,undergraduate diploma and post-undergraduate diploma was 39.6％,41.6％,41.8％ (P ＞ 0.05).Conclusions The knowledge of CHF is less desirable in GPs of Beijing,so that measures should be taken to improve the GP's knowledge of CHF.