Objective To investigate the efficacy of oxaliplatin plus S-1 versus the XELOX(oxaliplatin + capecitabine) program in the adjuvant chemotherapy in the patients with postoperative gastric cancer .Methods A total of 81 cases with postoperative gas-tric cancer were randomly divided into the treatment group and the control group .The treatment group (41 cases) received the chemotherapy of oxaliplatin +S-1 ,while control group was given the chemotherapy of XEOLX program .Results The 1-year and 2-year recurrence-free survival (RFS) of the treatment group and the control group were 51 .3% vs .61 .5% ,25 .6% vs .20 .5% ,there were no statistically significant differences between the two groups (P=0 .361 ,P=0 .591) .The 1-year and 2-year overall survival period of the treatment group and the control group were 64 .1% vs .69 .2% ,30 .8% vs .25 .6% ,respectively ,there were also no sta-tistically significant differences between two groups(P=0 .631 ,P=0 .615) .The mainly adverse reactions of the two groups were myelosuppression ,gastrointestinal reactions ,hand-foot syndrome ,mucositis ,peripheral nerve toxicity ,hepatic and renal function damage .The occurrence rate of hand-foot syndrome in the control group was significantly higher than that in the treatment group (P=0 .001) ,the adverse reactions were improved after symptomatic treatment .Conclusion Oxaliplatin plus S-1 and oxaliplatin plus capecitabine are therapeutic equivalence and well tolerated in the patients with postoperative gastric cancer .

ObjectiveTo explore the relationship between the core self-evaluations,copying style and learning engagement of college students.Methods 250 college students were asked to complete the core self-evaluations scale,copying style scale and learning engagement scale.ResultsBivariate correlations results indicated that there was significantly positive correlation between the core self-evaluations,copying style and learning engagement in college students( r=0.179 ～ 0.586,P＜ 0.05 ) ; core self-evaluations affected motivation indirectly by the copying style; core self-evaluations had a direct influence on vigor and absorption; core self-evaluations had a indirect influence on vigor and absorption.ConclusionCopying style was a full mediator of the relationship of the core self-evaluations and motivation,but copying style partially mediated the relationship of the core self-evaluations and vigor and absorption.

BACKGROUND:To construct tissue engineering cartilage would open up a novel way for the repair of cartilage damage in avoidance of the disadvantages of traditional therapeutic method.OBJECTIVE: To probe the techniques for the isolation of mesenchymal stem cells (MSCs) from bone marrow, as well as the in vitro differentiation into chondrocytic phenotype in a specific culture fluid.DESIGN:A complete randomized experimentSETTING:The Department of Traumatic Orthopedics and Hand Surgery of the First Affiliated Hospital of Guangxi Medical University, and Teaching and Research Faculty of Histology and Embryology of Guangxi Medical University.METHODS: The experiment was carried out at Guangxi Medical University between August 2002 and April 2003. Twenty SD neonatal weaning rats were selected. Bone marrow was aspirated from the bones of rat limbs and was isolated by gradient centrifugation in Percoll, and MSCs could be obtained in combination with adherent screening method, which were then cultured in DMEM-LG with 15% fatal bovine serum (FBS) in the incubator of 37℃ with 5% CO2 for 10-14 days. The passage cells were induced in DMEM-HG with 15% FBS (containing TGF-β1 10 μg/L, 10-7 mol/L dexamethasone, 50 mg/L VitC).MAIN OUTCOME MEASURES :The morphology, growth, as well as proliferation and specific expression of chondrogenic matrix of in vitro cultured MSCs due to specific induction.RESULTS: Totally 20 SD rats were observed and analyzed with no loss SCs grew in visible symmetric colonies, displaying a long-spindle shape,and the morphological characteristics of marrow-derived MSCs had no obvious changes during passage-culture, but its proliferation time was found from a shuttle fibroblastic appearance to polygonal shape, displaying posiHC staining of type Ⅱ collagen of cartilage specific matrix.bronectin adherent screening technique is a convenient, effective and practical method to separate and collect MSCs from rat bone marrows in chondrogenic phenotype when induced by a specific medium and can secrete cartilage specific matrix, and they can be the optimal seed cells for cartilage tissue engineering.

The role of insulin pump in the treatment of diabetes is becoming more and more significant. Based on the systematic literature review, collation and analysis, this article introduces the management of insulin pump outside the hospital from the development trend of insulin pump, application and common problems. In order to enhance the therapeutic satisfaction of patients and improve their quality of life, our aims are to put forward the strategy of standardized management and provide a reference for establishing and improving the standardized management system of insulin pump therapy outside hospital.

Purpose To compare radiation dose and image quality of different scan modes for CT pulmonary angiography (CTPA) including high-pitch flash mode, dual energy CT (DECT) mode, 128-slice mode of dual source CT and 64-slice CT mode. Materials and Methods One hundred and sixty-seven patients with suspected pulmonary embolism were retrospectively studied. All the patients underwent CTPA. Twenty patients were selected randomly from the patients scanned by high-pitch flash mode. Patients who were scanned by the other three modes were selected with body mass index and age matched those in high-pitch flash mode, with 20 patients in each group. Two radiologists assessed signal-to-noise ratio (SNR) and image quality with 5-piont scale. Dose parameters of volume CT dose index (CTDIvol), dose length product (DLP), and effective dose (ED) were compared among the four groups. Results Mean CTDIvol, DLP and ED were (3.72±0.74) mGy, (137.5±28.7) mGy · cm, and (2.34±0.41) mSv for Flash mode;(5.31±1.21) mGy, (181.6±34.5) mGy· cm and (3.24±0.57) mSv for DECT mode;(5.66±1.47) mGy, (198.7±42.1) mGy·cm and (3.58±0.63) mSv for 128-CT mode;and (6.75±1.68) mGy, (231.5±54.2) mGy·cm and (4.21±0.89) mSv for 64-CT mode. There was no significant difference of SNR and image quality among the four modes (P>0.05). Conclusion There are no significant difference of image quality among the four groups. Flash mode allows for minimum radiation dose compared to other modes. DECT mode and 128-CT mode get higher radiation dose with no difference between them. 64-CT mode gets the highest radiation dose.

Objective To investigate the characteristics of click -auditory brainstem response (ABR) in nor-mal infants of 1 to 6 months old ,and to establish the normative values for latencies of Wave I ,III ,V and interpeak latencies of I- Ⅲ ,III-V and I-V for younger infants .Methods Click auditory brainstem responses were recorded from infants within 6 months :166 infants of 1 -months old(269 ears) ,141 2 -month old (226 ears) ,111 3 -months old(177 ears) ,58 4-months old(96 ears) ,78 5-months old(121 ears) and 45 6-months old(76 ears) .We compared the latencies of wave I ,III ,V and interpeak latencies of I - Ⅲ ,III-V ,I-V obtained from infants of differ-ent ages at different stimulus intensities .Results The average threshold of 1 to 6 months infants was 16 .18 ± 5 .35 dB nHL ,the average latency of Wave V was 9 .03 ± 0 .49 ms .The differences among the thresholds were statistical-ly insignificant(P>0 .05) .Wave I ,III and V were noticeable in all ears tested at 80 dB nHL .Wave I disappeared first as the stimulus intensity decreased ,and the latencies of Wave I ,III and V prolonged;on the contrary ,interpeak latencies of I -III ,III-V ,I-V shortened significantly .At the same stimulus intensity ,the latencies of Wave III , V and the interpeak latencies of I - Ⅲ ,III-V ,I-V shortened significantly except for Wave I .When comparing the differences among the testing parameters as a function of each month ,we found that there were statistically signifi-cant differences for the latencies of wave III ,V and the interpeak latencies of I -III ,III-V ,I-V before the 4 months old(P<0 .05) ,and there were no significant differences after 4 months old(P>0 .05) .Conclusion It is recommen-ded that 16 .18 ± 5 .35 dB nHL be used as the normative references for the evoked threshold of click auditory brain-stem responses for 1~6 month old infants .The development of central nervous system below the inferior calicles is fast before the 4 months old .

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.

OBJECTIVE:To explore the effects of extracts from Siegesbeckiae herba (HS) on doxorubicin (DOX)-induced chronic myocardial injury in mice. METHODS:48 mice were randomly divided into 3 groups. Mice in blank control(Con)group received distilled water once every day,ig,and normal saline(2 mL/100 g)once every day,ip,for 8 weeks;mice in DOX mice received distilled water(2 mL/100 g)once every day,ig,and DOX(3 mg/kg)once every week,ip,for 8 weeks;mice in DOX+HS group received HS(340 mg/kg)once every day,ig,and DOX(3 mg/kg)once every week,ip,for 8 weeks. After administra-tion,body mass,heart coefficient,cardiac function changes,serum biochemical index levels [alanine aminotransferase(ALT),as-partate aminotransferase (AST), creatine phosphokinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH)and total cholesterol(TC)] of mice were determined. RESULTS:Compared with Con group,body mass of mice in DOX group was decreased(P<0.01);heart coefficient was increased(P<0.05);heart rate slowed down,R-wave was increased(P<0.05 or P<0.01);serum biochemical indexed were increased,there was significant difference in AST(P<0.01). Compared with DOX group,heart coefficient of mice in DOX+HS group was decreased (P<0.01);heart rate was increased (P<0.01);serum biochemical indexes were decreased,there was significant differences in CK,LDH,TC(P<0.01). CONCLUSIONS:HS has cer-tain protective effects on DOX-induced chronic myocardial injury in mice.

Objective To study the effects of Apelin on glucose toxicity and islet cells PDX-1 protein expression.Methods The islet β cell line NIT-1 cells were incubated in the medium containing different glucose concentrations(normal glucose concentration group 5.6 mmol/L,high glucose concentration group 16.7 mmol/L,extremely high glucose concentration group 33.3 mmol/L) and +/-Apelin-36 respectively for 3 d.Then the basic insulin secretion amount of islet cells and their secretion amount after glucose stimulation were detected.The intracellular insulin content and the PDX-1 protein and mRNA expression were detected.Results Compared with the normal glucose group,the basic insulin secretion,secretion after stimulation and intracellular insulin in the high glucose group and extremely high glucose group were significantly decreased and PDX-1 protein expression was declined(P＜ 0.05);compared with non-adding Apelin group,the basic insulin secretion,secretion after stimulation and intracellular insulin in the adding Apelin high glucose group and extremely high glucose group were significantly decreased and PDX-1 protein expression was decreased(P＜0.05);the insulin level in islet cells of 6 groups was positively correlated with PDX-1 protein expression and had no correlation with PDX-1 mRNA expression.Conclusion Apelin may participate in the glucose toxic effect by decreasing PDX-1 protein expression,causes the decrease of insulin secretion,thus plays a role in the pathogenesis of diabetes.

Objective To explore the effects of different probe tone and tympanometric admittance measure-ment methods on the diagnose of otitis media prediction ,and to provide a clinical reference for the selection of probe tones and measurement method to apply to newborn infants .Methods Tympanograms with 226 Hz and 1 000 Hz probe tones were obtained from normal infants (142 ears) and infants with otitis media (90 ears) .Mean values , standard deviations ,the 90% range and 95% mean confidence interval were recorded as the variable to observe po-tential impacts on tympanometric admittance with 226 Hz probe tone and tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods respectively according to Linder/Jerger classification ,the Baldwin classification and baseline classification adapted from Baldwin .The four indexes were tested with compara-tive analysis .The area under ROC curve simultaneous detects the normal group and otitis media group ,with refer-ences to the accuracy of the detection method to disease (including specificity and sensitivity ) .Results In 1-to -3 month group ,tympanometric admittance with 226 Hz probe tone and tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods were 0 .83 ± 0 .29 ,0 .60 ± 0 .55 ,0 .74 ± 0 .56 ,0 .90 ± 0 .59 in nom-al infants and 0 .82 ± 0 .35 ,0 .01 ± 0 .06 ,-0 .24 ± 0 .15 ,-0 .29 ± 0 .21 in infants with OME ,respectively .The areas under ROC curve of the four kinds of measurement methods were 0 .507 ,0 .896 ,0 .976 ,0 .988 ,respectively .In 4 to 6 month group ,tympanometric admittance with 226 Hz probe tone and tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods were 0 .60 ± 0 .35 ,0 .55 ± 0 .58 ,0 .76 ± 1 .0 ,0 .86 ± 0 .72 in nomal infants and 0 .36 ± 0 .24 ,0 ± 0 ,-0 .34 ± 0 .16 ,-0 .44 ± 0 .28 in infants with OME ,respectively .The areas under ROC curve of the four kinds of measurement methods were 0 .749 ,0 .888 ,0 .969 ,0 .988 in 4 to 6 month infants ,re-spectively .Tympanometric peak admittance with 1 000 Hz probe tone by three different measurement methods were significantly better than that with 226 Hz probe tone .The areas under ROC curve of tympanometric peak admittance with 1 000 Hz probe tone by baseline classification adapted from Baldwin were bigger than others and the differences were significant(P<0 .05) ,but no difference between the Baldwin classification and baseline classification in 4 to 6 month infants(P>0 .05) .Conclusion Tympanometric peak admittance with 1 000 Hz probe tone were better than that with 226 Hz probe tone to assess otitis media in 1~6 month infants .The baseline classification adapted from Baldwin was appropriate for the measurement of tympanometric peak admittance with 1 000 Hz probe tone .