Objective To evaluate the efficacy and toxicities of intensity modulated radiation therapy (IMRT) with or without concurrent chemotherapy in the treatment of cervical cancer patients with para-aortic lymph node (PALN) metastases after initial treatment.Methods From Oct 2008 to Aug 2013,56 cervical cancer patients with PALN metastases after initial treatment,including radical resection or pelvic radiotherapy/chemoradiotherapy,were selected for analysis.The delivered radiation dose to PALN was 55-60 Gy for GTV and 45-50 Gy for CTV respectively with 25-30 fractions during 5-6 weeks.36 patients received concurrent paclitaxel (135 mg/m2) and cisplatin (60 mg/m2) chemoradiotherapy (CRT group) and 20 patients received RT alone (RT group).Results The median follow-up time after treatment was 22.7 months (2.7 to 74.4 months).98.2％ (55/56) of patients completed RT.In CRT group,38.9％ underwent concurrent TP regimen 2-3 cycles and the rest completed one cycle.The rates of CR plus PR in CRT and RT groups were 91.7％ (33/36) and 85％ (17/20),respectively (x2 =0.516,P ＞0.05).The 3-year overall survival rate in CRT group and RT group were 57.5％ and 32.7％ (x2 =4.059,P ＜ 0.05),and 3-year progression-free survival rates were 50.4％ and 29.2％ (x2 =4.184,P ＜ 0.05),respectively.TP regimen concurrent chemoradiotherapy was more effective than radiotherapy alone.The 3-year overall survival rate was 53％ and 39.5％ in patients with isolated PALN and nonisolated PALN,respectively (x2 =4.265,P ＜ 0.05).Grade 3 or 4 acute leukopenia was found in 10 (27.8％,CRT group) and 6 (30％,RT group) patients (x2 =0.693,P ＞ 0.05).Grade 3 gastrointestinal toxicity occurred in 1 patient each group (x2 =0.847,P ＞ 0.05).Conclusions TP regimen concurrent CRT is associated with better survival than RT alone,and the treatment toxicities could be tolerant.

Hypoxic preconditioning improves organism in stress response such as operation.This dissertation expound the effects of hypoxic preconditioning on hepatic carcinoma after hepatic resection.Hypoxic preconditioning protect remainder hepatocyte from ischemia reperfusion injury in the remaining liver by regulating HIF-1,nuclear factor-kappa B and being kind to our mitochondria; remote-ectopic hypoxic preconditioning and cross-pluripotential hypoxic preconditioning preserve residual liver.Hypoxic preconditioning can relieve liver from ischemia reperfusion injury after hepatocellular carcinoma hepatectomy,but no clear evidence demonstrate it improve residual liver regeneration.This need further experimental study.

Circulation of traditional Chinese medicinal materials, as the vital part of the TCM industrial chain, plays an important role in the connection of agriculture link and industry link of traditional Chinese medicinal materials, which has influence on the healthy development of the whole TCM industrial chain. Because circulation activities mainly include exchange and storage activities instead of manufacturing real products, they are much more difficult to be managed compared with producing activity. This would lead to problems in circulation of traditional Chinese medicinal materials, and impose negative effects on TCM industry. Based on scale economy theory, information asymmetry theory and cobweb model theory, this article analyzed the problems in circulation of traditional Chinese medicinal materials, discussed the deep reasons behind these problems, and proposed relevant suggestions for optimization.

Objective To summarize the experience in diagnosis and treatment for chronic lymphocytic thyroiditis or complicated with other thyroid diseases. Methods Seventy-seven patients were diagnosed as chronic lymphocytic thyroiditis or complicated with other thyroid diseases by operation and histological examination at this department from November 2002 to March 2005. All their clinical records including general information, the results of careful physical examination, thyroid correlated hormone tests, color Doppler, fine needle aspiration cytological examination and some intraoperative examinations have been retrospectively analyzed in this report. Results There were 53 cases of simple chronic lymphocytic thyroiditis, 10 cases complicated by papillary carcinoma, 1 case complicated by follicular carcinoma, 2 cases complicated by non-Hodgkin’s lymphoma, 6 cases complicated by nodular goiter, 4 cases complicated by follicular adenoma, and 1 complicated by parathyroid adenoma. Almost all the operations were successfull and the symptoms of the diseases were alleviated. Seventy-two patients had been followed up ranging from two months to two years differently and none of them relapsed. Sixty-three of these patients have received thyrine inhibition and vicariousness treatment, 2 patients who complicated by non-Hodgkin’s lymphoma had been hospitalized and 7 patients complicated by carcinoma were treated with iodine-131. Conclusion The clinical manifestations of chronic lymphocytic thyroiditis are complex, and it often complicated with other thyroid disease, which make it difficult to diagnose the diseases before operation. However, some ancillary methods such as careful physical examination, thyroid correlated hormone tests, !color Doppler and fine needle aspiration cytological examination may improve the accuracy of preoperative diagnosis. Intraoperative thyroid lamellar section and frozen histological examination are also very important for intraoperative diagnosis and operative modality selection.

Objective To study the prognostic value of procalcitonin (PCT) level in the outcome of patients with paraquat poisoning (PQ).Methods The clinical data of 128 patients with acute PQ admitted to emergency department were collected from March 2013 through March 2014.The patients were divided into two groups:the death group and the survival group (survival of 28 days).Poisoning doses,urine concentration of PQ,time elapsed from poisoning to admission,and time elapsed from poisoning to gastrolavage were documented.And on the 1 st day,the 3rd day and the 7th day after poisoning,serum PCT were detected.The level of PCT was used to investigate the prognostic values in patients with acute PQ in the death group and survival group.Results Of 128 cases,72 (56.3％) survived and 56 died in 28 days.Among them,the level of PCT increased to some extent in the first day in 90 cases,and 48 patients died.According to trend analysis,the levels of PCT in death group on the 1st day,the 3rd day and the 7th day after PQ were significantly higher than those in survival group [ld:(0.96 ±0.13) vs.(0.08 ±0.01),3d:(1.12 ±0.14) vs.(0.28 ±0.05),7d:(1.22 ±0.14) vs.(0.20 ±0.03),P ＜0.01].There was a trend of escalating PCT levels in death group,whereas the PCT level reached the peak on the 3st day and decreased gradually in the following days in survival group.The early PCT level was obviously related to poisoning doses,urine concentration,CRP,WBC,ALT,CR (the coefficient of association were 0.794,0.723,0.724,0.332,0.700,0.414,respectively,P＜0.01).Conclusions The serum level of PCT increased in patients with acute PQ was significantly positively correlated with the oral dose and urine concentration of paraquat,and it can be used as an indicator for PQ severity.There is important clinical significance in detecting the change of serum level of PCT for estimating the condition of patients and evaluating the prognosis.

AIM:To explore whether cyclosporine A (CsA) can regulate the expression of nometastatic gene23 H1 type (nm23-H1) in human choriocarcinoma Bewo cells,in order to seek new proof of treating trophoblast diseases.METHODS:The Bewo cells were divided into two groups. The vehicle control group,and the CsA group with different concentrations from 10-2 ?mol/L to 10 ?mol/L. The effect of CsA on the transcription of nm23-H1 was determined by reverse transcription-polymerase chain reaction (RT-PCR) after cultured for 48 h and protein level of nm23-H1 was determined by In-cell Western after cultured for 72 h.RESULTS:Compared to the vehicle group,CsA significantly downregulated the transcription and translation of nm23-H1 in a dose-dependent manner from 10-2 ?mol/L to 10 ?mol/L,and the inhibition reached its top when concentration of CsA was 1.0 ?mol/L (P

Objective To discuss the maximum tolerated dose of oxaliplatin based on 5-fluorouracil derivative in patients with locally advanced rectal cancer who underwent neoadjuvant chemoradiotherapy.Methods From Mar 2015 to Oct 2015,15 locally advanced rectal cancer patients (T3,T4/N +) who received intensity modulated radiotherapy and concurrent chemotherapy with capecitabine and oxaliplatin were enrolled in this study.The prescription dose was 50.6 Gy for gross tumor volume(GTV) and 41.8 Gy for clinical tumor volume(CTV) in 22 fractions within 30 d with concomitant boost.There were four dose-level groups of oxaliplatin as 100,110,120 and 130 mg/m2 tri-weekly and fixed capecitabine dose (825 mg/m2 bid d1-5 per week).The first 12 patients were randomly assigned into 4 groups.For the 130 mg/m3 group,another 3 patients were enrolled because of dose-limiting toxicity (DLT).Treatment related toxicities and response rates were evaluated.Results The most common adverse events(AE) were radiation enteritis,skin reactions,nausea,fatigue,urinary system AE and bone marrow suppression.There was a trend of increase by the dose level of oxaliplatin for toxicities.Groups 100,110 and 120 mg/m2 had none DLT,while group 130 mg/m2 had 1 patient for grade 3 thrombopenia and 1 patient for grade 3 nausea.Postoperative pathology showed that all patients achieved tumor downstaging,among which 0,1,2,3 cases achieved complete remission of the four groups,respectively.Conclusions The combination regimen of capecitabine and oxaliplatin is safe and effective according to the preliminary results.The maximum tolerated dose of oxaliplatin was 130 mg/m2 tri-weekly.

Objective To search for chemical constituents with anti-oxidative activity from seeds of Jatropha curcas.Methods DPPH radical scavenging assay was used to screen fractions or constituents with anti-oxidative activities.Active fractions were separated by varied chromatography and then identified on the basis of physiochemical properties and spectroscopic methods.Results The n-butanol layer of ethanol extract from the seeds of J.curcas showed stronger activity than other fractions and was studied further.A new compound was isolated from this active layer, and its structure was identified as jatrophasin A (3,4,4',5'-tetrahydroxyl-3'-methoxyl-bisepoxylignan, 1).It showed stronger anti-oxidative activity compared with resveratrol.Conclusion Compound 1 is a new compound which has never been reported with strong anti-oxidative activity.

Objective To study the inhibiting effect of genistein and cisplatin on tumor recurrence and metastasis after hepatectomy in mice. Methods A posthepatectomy high-metastatic-and-recurrent athymic mouse model simulating human HCC was established.Genistein,cisplatin,and combination genistein and cisplafin respectively were given intraperitoneally.Mice were sacrificed after 4 weeks,the volume and pulmonary metastasis of the recurrent tumor was observed.Caculate q value using Jin Zhengjun formula was used to evaluate the synergistic effect of combination genistein and cisplatin.Immunohistochemistry and real time fluorescent quantitation PCR were used to detect the expression of MMP2 and MMP-2 mRNA in liver recurrent tumor. Results Compared with single drug group,mice in genistein combined with cisplatin group had smaller liver recurrent focus volume,less pulmonary metastasis.Genistein and cisplatin displayed additional inhibiting effect on tumor recurrence and metastasis after hepatectomy in vivo,and displayed synergistic inhibiting effect on pulmonary metastasis.The MMP-2 expression of the recurrent tumor in single cisplatin group increased compared with control group(t=26.17、P＜0.05),while in single genistein group and genistein and cisplatin combined group it decreased(t=5.58,13.90,P＜0.05).The expression of MMP-2 mRNA in genistein group was 90%the level of the control group,in cisplatin group it was 2.06 times that of the control group,in combination genistein and cisplatin group it was 44%the level of the control group. Conclusions In vivo,genistein reinforces the effect of cisplatin in inhibiting tumor recurrence and metastasis after hepatectomy,possibly by a mechanism in which genistein inhibits the up-regulation of MMP-2 induced by cisplatin.

Objective To explore the association between acute ischemic stroke and albumin to creatinine ratio (ACR).Methods A case-control study.During January to December in 2013, 127 acute ischemic stroke patients as case group and 150 controls who were similar with case group in age and gender were recruited in Tianjin Union Medicine Center . According to diabetes , hypertension , cardiovascular diseases and patients without these three diseases , case group was divided into A1, B1, C1 and D1 subgroups, control group was divided into A2, B2, C2 and D2 subgroups in the same way.The first morning urine from participants were collected .Urinary albumin concentration was tested by nephelometry , urinary creatinine was examined by using enzymic method , ACR were calculated(≥30 mg/g as the cutoff value). Then difference of ACR between case and control group was compared , the cutoff value of albuminuria for ischemic stroke patients was analyzed by ROC , and the risk factor of ischemic stroke were analyzed by logistic regression analysis.Results The prevalence of albuminuria in ischemic stroke patients was 38.58%(49).According to analysis of covariance, after adjustment for age, gender, cardiac-disease, diabetes, hypertension, lnACR in case group was significantly higher than control group (3.18 mg/g vs 2.78 mg/g, t=2.13 P=0.03), especially D1 was significantly higher than D2 subgroup (3.01 mg/g vs 2.51 mg/g,t=5.56,P=0.009) .If 19.82 mg/g from ROC analysis was used as the cut-off value, the sensitivity and specificity are 68.5% and 61.7%.The odds ratio ( OR ) of ACR >19.82 mg/g was about 2-fold when compared with ACR<19.82 mg/g adjusted for stroke risk factors , and the OR value is 2.43 in comparison of patients without diabetes , hypertension and cardiovascular diseases .Conclusions Urinary albumin excretion is the independent risk factor of ischemic stroke .The increased urinary albumin has important clinical significance to predict the risk of ischemic stroke for the patients without diabetes , hypertension and cardiovascular diseases.