Objective To investigate the associated effect of 125I implantation plus chemotherapy in local recurrent stage Ⅲ NSCLC patients.Methods From January 2006 to January 2009,34 patients documented with local recurrent stage Ⅲ NSCLC were divided into two groups by random number table.The treatment group was treated with 125I permanent implantation combined with DP regimen (docetaxel 60 mg/m2 + cisplatinum 75 mg/m2),while the control group received only DP chemotherapy.According to the TPS,the treatment group received CT-guided percutaneous implantation of 125 I seeds with a particle activity of 2.22 ×107-2.59 × 107 Bq.The prescribed dose was in the range of 90-110 Gy and the postoperatively matched peripheral dose (mPD) and D9o were verified by TPS.The control group received a DP chemotherapy regime for 4 cycles after the procedure.This study was approved by the ethics committee,and all patients signed informed consents.The follow up time was up to disease progression.Kaplan-Meier survival analysis was used to describe the local lesion control (LLC) time and progression free survival (PFS).Log-rank test was used in the comparison of the survival rates between the two groups.Fisher's exact test was used to analyze the differences of CR rate and recent efficiency between two groups.Results In the treatment group,postoperative mPD was 93.9-130.4 (M 116.7) Gy,and D90 was 103.6-148.2 (M 130.6) Gy.The LLC time was 4.7 to 24.0 months with a median of 11.6 (95％ CI:8.7-14.6) months.In two cases,there was no recurrence during the follow-up time of 24 months.PFS was 4.7 to 24.0 months with a median of 10.5 (95％ CI:7.4-13.6) months.The recent effective rate of the treatment group was 64.7％ (11/17).CR,PR,SD and PD were 41.2％ (7/17),23.5％ (4/17),23.5％ (4/17) and 11.8％ (2/17),respectively.In the control group,the LLC time was 4.5 to 11.4 months with a median of 7.5 (95 ％ CI:6.7-8.3) months,and the median of PFS was 6.5 (4.5-10.5) (95％ CI:5.7-8.3) months.The response rate,CR,PR,SD and PD were 41.2％ (7/17),5.9％ (1/17),35.3％ (6/17),35.3 ％ (6/17) and 23.5％ (4/17),respectively.There was no statistical significance of the recent effective rate between the treatment group and control group (P =0.30),but the LLC time (x2 =8.40,P ＜ 0.01),the median of PFS time (x2 =6.27,P ＜ 0.05) and CR (P =0.04) of the treatment group were all significantly higher than those of the control group.Concltusion The implantation of 125I seeds combined with chemotherapy for recurring stage Ⅲ NSCLC patients is safe and effective,and its efficacy is superior to the second line chemotherapy alone.

Objective To investigate the expression of Dickkopf-3 (Dkk-3) in esophageal cancer and normal esophageal tissue and the relationship between Dkk-3 expression and the biological behaveior of esophageal cancer. Methods Immunohistochemical method of S-P was used to examine Dkk-3 expression in 69 cases of esophageal squamous cell carcinoma and 5 cases of normal esophageal tissue with non-tumor tissue microarray and the results were analyzed and correlated with their clinical and pathological features. Results Positive Dkk-3 expression was observed in 65.7% (44/67) of the esophageal squamous cell carcinoma cases, but only one of the five cases with normal esophageal tissue showed positive microvascular expression of Dkk-3. In cases with positive expression of Dkk-3 significant differences were found in fiber membrane infiltration, depth of invasion, lymph node metastasis and TNM staging (P < 0. 05), while no significant differences were found in the age, gender and pathological grading (P > 0. 05). Conclusions The upregnlation of Dkk-3 expression in esophageal squamous cell carcinoma may contribute to tumor invasion and metastasis.

Objective To report the clinical observation and nursing points for recurrent or refractory and aggressive non-Hodgkin's lymphoma treated with MINE regimen. Methods Patients (46 cases) with recurrent or refractory and aggressive non-Hodgkin's lymphoma were given mental nursing,preparation and evaluation of the condition of patients before chemotherapy. Complications especially extravasation of infusion fluid should be prevented during chemotherapy and myelosuppression and long-term complications should be prevented after treatment. Results No patient died after treatment but several complications such as infection(14 cases), nausea and vomiting (grade Ⅰ～Ⅱ, 22 cases, grade Ⅲ,2 cases), alopecia (grade Ⅰ～Ⅱ, 27 cases), mucositis (grade Ⅰ～Ⅱ, 4 cases), liver function lesion (grade Ⅱ, 1 case) were found and improved after proper treatment. No nephrotoxicity and hemorrhagic cystitis were found. Conclusions Selective mental nursing,proper chemotherapy preparation,evaluation of patients' condidtion and positively prevention of chemotherapy-related complications could increase the chemotherapy effect of patients with recurrent or refractory and aggressive non-Hodgkin's lymphoma.

OBJECTIVE: To investigate the psychological statuses of Chinese adults with moderate-to-severe persistent allergic rhinitis, and evaluate the effects of nasal symptoms on their psychological statuseses. METHOD: The Symptom Checklist-90 (SCL-90) or self-reporting Inventory was employed to analyze the psychological statuses of 539 adults with moderate-to-severe persistent allergic rhinitis. RESULT: The SCL-90 scores of the adults with moderate-to-severe persistent allergic rhinitis were statistically higher than those of non-allergic adults in terms of somatization, depression, anxiety and hostility. No statistical discrepancies existed in gender or age. The course of disease contributed to somatization and compulsion. The effects of nasal symptoms included two aspects: nasal obstruction had a conspicuous impact on somatization, compulsion, interpersonal sensitivity, depression, anxiety and psychosis, while nasal itching contributed to somatization, depression and anxiety. CONCLUSION The psychological statuses of adults with moderate-to-severe persistent allergic rhinitis is evidently worse than that of non-allergic adults. Symptoms such as nasal obstruction and itching had an obvious impact on outpatients' psychological statuses.
Adult ; Humans ; Nasal Obstruction ; Rhinitis, Allergic, Perennial ; diagnosis ; psychology

We retrospectively analyzed the clinical data of 615 recipients (347 male and 268 female, age range: 9-75 years weighing 38-100 kg) who received renal transplantation in the Third Hospital of Peking University from January 2001 to July 200 to summarize the causes and experience of surgical complications after renal transplantation. Kidney of donors with brain death wa obtained using modified in situ hypothermy perfusion method, and kidney from living bodies was obtained using posterio abdominal cavity open or abdominal speculum method. After renal transplantation, the immunosuppressive therapy including FK50 or Cyclosporine A + mycophenolate mofetial or mizoribine + Prednisone was applied and regulated according to the variation o concentration in whole blood. Recipients were followed up for at 1 year. Of 615 patients, 29 cases developed surgical complication with the incidence rate of 4.72%; Graft lost in 5 cases due to surgical complications after renal transplantation. The achievement rati of operation was 99.19%.

Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.

Objective To investigate the changes of hippocampal neurogenesis and cognitive dysfunction induced by cranial radiation therapy.Methods C57BL/6J mice aged 10 d were subjected to 10 Gy whole brain irradiation with 6 MV X-rays to develop irradiation-induced brain injury model.Morris water maze was designed to estimate spatial learning and memory.At different time post irradiation,brain tissue was removed to stain with hematoxylin-eosin for the pathological results.DCX and PCNA immunohistochemical staining was used to mark the level of neurogenesis in the hippocampus,and ED1immunohistochemical staining to mark the activation of microglia.The TUNEL assay was used to assess the apoptotic neuron death in situ in the hippocampus.Real-time PCR was supplied to inspect the expression of TNF-α and IL-1 β mRNA.Enzyme Linked Immunosorbent Assay (ELISA) was tested for the concentration of TNF-αt in the plasma.Results Pathological studies demonstrated that radiation could induce interstitial edema,inflammatory cell infiltration,cell degeneration,necrosis,apoptosis in the acute phase,edema subsiding,reduction of inflammatory cells,and cytothesis in the dentate gyrus of the hippocampus.IHC studies revealed that,at different time post irradiation,the number of DCX-positive cells and PCNA-positive cells decreased (F =4.9-12.5,5.2-15.7,P ＜ 0.05) but ED1-positive cells increased significantly (F =20.8,P ＜ 0.05).TUNEL-positive cells began to appear in the dentate gyrus of hippocampus 6 h post-irradiation,and its number reached to the highest level at 48 h post-irradiation (F =15.1,P ＜ 0.05).The formation of γ-H2AX foci got at the top 0.5 h post-irradiation (F =18.4,P ＜0.05) and then decreased.After irradiation,the expressions of TNF-α and IL-1β mRNA in the the irradiated group was higher than those of the control group (t =16.3,12.7,P ＜ 0.05).The concentration of TNF-α in the plasma of the irradiated group was higer than that in the control group 3 h post-irradiation,and maximized at 1 week post-irradiation (F =10.5,P ＜ 0.05).Morris water maze tests showed that the latency had no significant differences between the irradiated group and the control group at 1,2,3 d postirradiation,but the latency in the irradiated group was longer than that in the control group with a significant differences at 4,5,6 d post-irradiation (F =7.01,8.17,4.22,P ＜ 0.05).Conclusions Irradiation-induced cognitive dysfunction may be caused by microglial activation and suppression in hippocampal neurogenesis following cranial radiation therapy.

Objective To establish a reverse transcription nested polymerase chain reaction ( RT-nPCR ) assay for detection of tree shrews orthoreovirus (TRV).Methods Three strains of TRV were respectively isolated from fresh feces of three tree shrews that came from the same field at different times .We designed and synthesized two pairs of MRV L1 gene nested primers and established the system of RT-nPCR.The TRV RNA was extracted and reversely transcribed to cDNA as a template for nested-PCR amplification.The developed RT-nPCR was optimized.The specificity and sensitivity were tested.Finally, the RT-nPCR was used to detect TRV in 25 tree shrew samples.Results Taking the genomic RNA of TRV as template, the RT-nPCR was able to amplify a specific fragment band targeting the L 1 gene, while there were no target bands in the normal cell control , ( Wa strain rotavirus , hepatitis A virus , and herpes simplex virus ) .The RNA of TRV was diluted by 1:10 to 1:109 .Each dilution sample was analyzed by the RT-nPCR.The minimum detectable concentration of RNA was 0.01 pg/μL.The results of RT-nPCR detection showed that 4 of the 15 tree shrews were TRV-positive in the survival group , and 10 of 10 tree shrews were TRV-positive in the death group . Conclusions The RT-nRCR assay established in this study is accurate , specific and sensitive .Therefore, it can be used for routine detection of TRV in quality assurance testing .

Objective To investigate the occurrence of postoperative pain of hepatectomy and its possible related factors.Methods The clinical data of 555 cases undergoing hepatectomy was analyzed retrospectively,and the related influencing factors on postoperative pain of hepatectomy were analyzed by univariate analysis and multivariate logistic regression.Results Moderate postoperative pain was reported in 255 cases among 555 patients who underwent hepatic resection (with an incidence of 45.95％).Incision pain which was often sharp was most common,followed by postoperative complication caused pain.According to whether the postoperative pain occurred or not,all cases were divided into postoperative pain group (n =255) and non-postoperative pain group (n =300),univariate analysis showed that age (P ＜0.01),surgical history (P ＜ 0.01),surgical approach (P ＜ 0.01),incision length (P ＜ 0.01),xiphoid removal(P ＜ 0.01),the final outcome of incision (P ＜ 0.01),complications (P ＜ 0.01) were significantly different between the two groups.Logistic multiple regression analysis showed that the independent influencing factors of postoperative pain included surgical history (P =0.001),surgical approach (P =0.005),incision length (P =0.000),xiphoid process removal (P =0.001),complications (P =0.000).Conclusions The postoperative pain of hepatectomy has a high incidence.Surgical history,surgical approach,incision length,xiphoid process,removal and postoperative complications are the independent impact factors of postoperative pain.

Objective To explore high-risk factors that affect the severity of diabetic foot ulcers and the relationship between the severity of diabetic foot ulcers and the general somatic conditions by analyzing clinical data of 218 diabetic foot patients.Methods A retrospective analysis of the clinical data of 218 diabetic foot patients,admitted from 2006 to 2010 was performed.Fasting and postprandial blood glucose ( FBG and PBG ),glycosylated hemoglobin,hemoglobin,serum albumin,serum creatinine,as well as serum urea nitrogen and fibrinogen were determined in patients with different Wagner levels.The effects of peripheral arterial disease,neuropathy,infections and other factors on severity of diabetic foot ulcers,and the prognosis of those patients with different Wagner levels were analyzed.Results ( 1 ) FBG and PBG in Wagner 5 patients were significantly higher than those in Wagner 1,but there was no statistical significance in HbA1C difference.(2) Hemoglobin,total cholesterol,serum albumin in Wagner 5 patients were decreased significantly ; white blood cells,serum creatinine and fibrinogen were increased significantly ( P＜0.01 ).(3) The intima-media thickness(IMT) of femoral artery in Wagner 2-and-above patients was increased significantly compared with that in Wagner 1 ( P＜0.05 ).( 4 ) Logistic regression analysis showed that hemoglobin,fibrinogen,glycated hemoglobin,femoral artery intima-media thickness,and bacterial infection were correlated independently with the severity of diabetic foot ulcers.(5) The hospitalized days were increased with rising Wagner levels ; the prognosis of Wagner 5 patients was the worst,with the highest mortality in the group.Conclusions Changes in blood level of hemoglobin,fibrinogen,along with higher HbA1C and femoral artery IMT,as well as infections are high-risk factors of severity in diabetic foot patients.HbA1C is not a good indicator of blood glucose control in patients with Wagner 5 grade.The higher the Wagner grade,the longer the time spent in hospital,and the worse the prognosis wouldbe.