Objective To evaluate the impact of comorbidity and age on the tolerance of firstline single-agent chemotherapy in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods Clinical data of 61 elderly patients with advanced NSCLC(aged over 70 years,median age 72 years) receiving first-line single agent chemotherapy were retrospectively analyzed in this study.Performance status(PS) between 0-1 score was in 52 patients,PS 2 score in the other 9 patents.Patients were treated with gemcitabine or docitaxel as the first line chemotherapy,and the median number of chemotherapy cycles was 3.4.Comorbidity was assessed by Charlson comorbidity index (CC1).Patients with CCI equal to 0 were classified as non comorbidity group(n=26),and patients with CCI≥1 were classified as comorbidity group(n=35).Adverse reactions were graded by using the criteria of NCI-CTC v3.0.Results Age and PS could not predict adverse effects of grade 3 or 4.The incidence of hematologic toxicity of grade 3 or 4 was higher in comorbidity group than in noncomorbidity group(40.0％ vs.15.4％,x2 =4.36,P=0.037).The incidences of febrile neutropenia,non hematologic toxicity of grade 3 or 4 and treatment suspension were higher in comorbidity group than in non-comorbidity group.The most common types of comorbidity were diabetes and chronic pulmonary disease.The incidence of non-hematologic toxicity of grade 3 or 4 was increased in patients with chronic pulmonary disease as compared with patients without chronic pulmonary disease(41.4 ％vs.11.5％,x2=6.061,P=0.032).Conclusions The incidences of adverse reactions,especially hematologic toxicity of grade 3 or 4 are significantly increased in patients with comorbidity after singleagent chemotherapy.Evaluation of comorbidity before treatment is helpful to predict the tolerance of single-agent chemotherapy in elderly NSCLC patients.

This paper presents a high voltage generator for the defibrillator.Its principle and design method are introduced.The high voltage generator is the core part of the defibrillator which is necessary toany hospital.There is nodomestic-patented defibrillator by now and published paper specialized in the principle and design method of the high voltage generator for the defibrillator.

AIM: To investigate curative effects of excimer laser corneal refractive surgery for adults or older adolescent with hyperopic anisometropic amblyopia.METHODS: From March 2014 to March 2016, we selected 26 cases 26 eyes of adults or older adolescent with hyperopic anisometropic amblyopia in our hospital.All eyes underwent laser in situ keratomileusis, observed for the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), diopter and stereopsis.RESULTS: At the end of the follow-up, the patient`s spherical equivalent and anisometropia were 1.47±0.51D and 1.15±0.22D, were significantly lower than that before operation (P<0.05).At the end of the follow-up, the distance and near UCVA and BCVA were 0.26±0.13 and 0.23±0.09, 0.42±0.09 and 0.31±0.16, which were significantly higher than those before operation (P<0.05).At the end of follow-up, the visual function of the patients was significantly improved (P<0.05), the rate of postoperative visual function < 100 eyes was 23%.CONCLUSION: In adult or older adolescent with hyperopic anisometropic amblyopia, excimer laser corneal refractive surgery has a certain effect.

AIM:To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with other methods in the treatment of Coats disease.METHODS:Selected 13 patients 13 eyes with Coats disease in our hospital from May 2013 to May 2016.All eyes were treated with intravitreal injection of ranibizumab and combined with scleral drainage, laser photocoagulation and so on.We observed visual acuity and retinal reattachment.RESULTS:In 13 eyes, the treatment of 4 eyes with intravitreal injection of ranibizumab and combined with scleral drainage, 3 eyes combined laser photocoagulation, 6 eyes combined vitrectomy, membrane peeling, freezing, silicone oil filling or other treatments.Eyeball retention rate was 100%.Visual acuity at 6mo after treatment significantly improved compared with before treatment (P<0.05).The visual acuity was ≥0.05-0.1, 0.01-<0.05, counting finger, light perception and hand moving before treatment in 0, 0, 38%, 38% and 23%, after treatment were 23%, 23%, 38%, 15% and 0.Complete retinal reattachment was achieved in 5 eyes, accounting for 38%;basic reset in 3 eyes, accounting for 23%;5 eyes were not reset, accounting for 38%.CONCLUSION:Intravitreal injection of anti-VEGF drugs combined with other methods for the treatment of Coats disease have a certain effect, can improve or maintain the limited visual function, avoid enucleation of eyeball due to disease progression.

Objective To conduct a computer simulation to evaluate the discrepancy between the cumulative doses calculated by four-dimensional computed tomography (4DCT) images and 4DCT scans (for real-time respiratory motions) due to the patient's irregular breathing.Methods A series of digital phantoms were generated from a patient's 4DCT images to simulate 4DCT images and 4DCT scans (for real-time respiratory motions) resulting from various irregular breathing curves.A six-field intensity-modulated radiotherapy plan was generated.Two cumulative doses in the target were calculated.The first one, named Dall, was calculated by tracking the point displacements in the target manifested on the 4DCT images;the second one, named D4D, was calculated based on the point displacements along the whole breathing motion during 4DCT scanning.Dose discrepancy between D4D and Dall was calculated to evaluate the correlation between breathing pattern and dose discrepancy in the target.Results The dose discrepancy in the target was correlated with mean motion excursion and the standard deviation of motion excursion.ΔDmin(ΔD99) in the target increased from 2.39%(2.04%) to 11.91%(5.24%) as the mean motion excursion increased from 5 mm to 15 mm, and increased from 5.93%(2.15%) to 14.65%(5.01%) as the standard deviation of motion excursion increased from 15% to 45% of the mean motion excursion.When the mean period increased from 3 s to 5 s or the standard deviation of period increased from 10% to 40% of the mean period,ΔDmin(ΔD99) in the target was greater than 6.0%(2.0%), but less than 9.0%(3.0%).When the target diameter was 2 cm, 3 cm, and 4 cm,ΔDminΔD99) in the target was 11.88%(5.50%), 6.91%(2.42%), and 7.53%(3.62%), respectively.Conclusions There is a large discrepancy between the cumulative doses calculated using 4DCT images and 4DCT scans (for real-time respiratory motions) when the patient has irregular breathing.This dose discrepancy depends on mean motion excursion and the standard deviation of motion excursion, but has little relationship with mean period, the standard deviation of period, and tumor volume.

Hydroxycamptothecin (HCPT) loaded PEG modified nanostructured lipid carriers (HCPT-PEG-NLC) and nanostructured lipid carriers (HCPT-NLC) were prepared by melt emulsification and homogenization method. The morphology, particle size and encapsulation efficiency of them were investigated. HCPT concentrations in plasma, heart, liver, spleen, lung, kidney and ovary were determined after iv of HCPT injection, HCPT-PEG-NLC and HCPT-NLC in mice. The targeting indexes of HCPT-PEG-NLC and HCPT-NLC were calculated. The transmission electron microscope imaging showed that HCPT-PEG-NLC and HCPT-NLC exhibited a spherical shape. The particle sizes of them were (88.6 +/- 22.5) and (127.2 +/- 43.4) nm. The encapsulation efficiency were (90.51 +/- 3.29)% and (84.37 +/- 2.81)%, respectively. After iv injection into the tail vein of mice, HCPT plasma concentrations of HCPT-PEG-NLC and HCPT-NLC were higher than that of HCPT injection at each sampling time. They also showed longer elimination time in every tissue. HCPT-NLC accumulated in endothelial system (RES), Re and Ce of it in liver and spleen were significantly higher than HCPT-PEG-NLC. HPCT-PEG-NLC prolonged circulation time and increased bioavailability of HCPT. MRT and AUC0-24 h of it were 19.80 and 17.02 times higher than those of HCPT injection. It also significantly reduced phagocytosis of RES, and showed lung targeting effect (Re and Ce were 14.51 and 41.35). To summarize, HCPT-PEG-NLC could prolong the circulation time of HCPT in vivo, and had the lung targeting effect. It was a promising carrier to increase therapeutic effect of HCPT in treating lung cancer.
Animals ; Antineoplastic Agents, Phytogenic ; administration & dosage ; blood ; chemistry ; pharmacokinetics ; Biological Availability ; Camptothecin ; administration & dosage ; analogs & derivatives ; blood ; chemistry ; pharmacokinetics ; Delayed-Action Preparations ; Drug Delivery Systems ; Drug Stability ; Female ; Lipids ; chemistry ; Lung ; metabolism ; Mice ; Mononuclear Phagocyte System ; physiology ; Nanoparticles ; Particle Size ; Phagocytosis ; drug effects ; Polyethylene Glycols ; chemistry ; Tissue Distribution

·AIM:To investigate the therapeutic effect of intravitreal injection of Ranibizumab combined with laser for diabetic macular edema (DME). ·METHODS: Totally 60 cases (60 eyes) of DME patients treated in ophthalmology department of our hospital from June 2014 to June 2016 were selected and divided into the observation group and the control group. The control group were treated with laser therapy, and the observation group received intravitreal injection of ranibizumab on the basis of the treatment of the control group. Comparison between two groups on the best corrected visual acuity before operation and at 1wk,1,3, 6mo after operation was taken. The non - contact tonometer was used to measure intraocular pressure before and after treatment. The optical coherence tomography(OCT) was conducted to assess preoperative and postoperative central macular thickness (CMT).The postoperative complications of two groups were recorded subsequently. ·RESULTS: The two groups' postoperative visual acuity was significantly improved,data of the observation group at 1,3mo after operation was sharply higher than that of the control group, there was statistical significance (P<0.05), and data at 1wk, 6mo after operation had no evident difference (P>0.05). After 1wk of treatment, the two groups'intraocular pressure increased,with statistical significance (P<0.05);there was no significant difference between the two groups on intraocular pressure before treatment and at 1,3,6mo after treatment(P>0.05). The postoperative CMT of two groups significantly decreased, data of the observation group at 1, 3mo after treatment was evidently lower than that of the control group, there was statistical significance (P<0. 05), and data before treatment, at 1wk, 6mo after treatment showed no significant difference(P>0.05). In the observation group, 5 cases (5 eyes) recurred within 6mo,the recurrence rate was 17%. In the control group, 10 cases (10 eyes) relapsed,the recurrence rate was 33%,the difference was statistically significant (P<0.05). At postoperatively 2d, 2 cases(2 eyes) of the observation group and 3 cases (3 eyes) of the control group had high intraocular pressure, and then returned to normal by given the carteolol eye drops. ·CONCLUSION: Compared with laser therapy alone, intravitreal injection of ranibizumab combined with laser therapy has a significant and safe short-term treatment effective for DME patients with a fast visual acuity recovery.

Some research on intelligent non-invasive temporary pacemakers is introduced in this paper. An industrial computer, some IC chips and other elements are used to construct its hardware, and its software is in C++ language. The experimental device has some intelligent functions of recognizing some arrhythmia. The system has a pacemaker module and an ECG monitor module. Its software includes a main program, a RS-232C communication program, a printer VxD, a pacing control VxD and ECG signal pretreatment and recognizing program and so on. The pacing-generating circuit is employed to make the precision control of pacing current. The communication between industrial-computer system and ECG module is completed through the DLL. The real time processing of ECG signals is based on filter method for a higher recognizing ratio. The system calculates several parameters to recognize certain arrhythmia and uses MIT/BIH database to validate the reliability of ECG recognition.
Algorithms ; Arrhythmias, Cardiac ; diagnosis ; therapy ; Artificial Intelligence ; Echocardiography ; Equipment Design ; Humans ; Pacemaker, Artificial ; classification ; Signal Processing, Computer-Assisted ; instrumentation ; Software Design

Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in SPECT showed decreased uptake at sacrum. Of the bone metastatic patients (n =21 ) ,12 (51.7%) had sole metastasis to sacrum. Tumor with type Ⅰ (6/6) or type Ⅱ (16/19) uptake was likely to be a malignancy,whereas type Ⅲ uptake tended to occur in the benign disease in those patients without polyostotic involvement( 5/7 ),and type Ⅳ was all appeared in giant cell tumors( n = 5 ). Conclusions Preoperative bone scintigraphy is useful in examination of polyostotic involvement for the patients with sacral tumor,but it is limited for diagnosing isolated sacral metastatic disease. Tumor uptake on bone scintigraphy can be helpful in differential diagnosis of sacral tumor.

This study was purposed to construct the recombinant hF9 minigene and its stable nonsense mutant cell lines, and to investigate its significance. Minigene hF9 was cloned into the mammalian expression vector pCMV-Tag3B; a nonsense mutant containing a premature termination codon (PTC) in the 121(st) amino acid residue was obtained by PCR site-directed mutagenesis; minigene hF9 and nonsense mutant were respectively transfected into HepG2 cells with G418 treatment to get stable HepG2-WT and HepG2-N cell lines. The results confirmed that the minigene hF9 and nonsense mutant were constructed successfully. The gene of interest was amplified by RT-PCR from the stable cell lines, and the minigene hF9 was expressed in the stable cell lines. It is concluded that the recombinant hF9 minigene and its stable nonsense mutant cell lines are constructed successfully. The cell lines can be used to screen the drugs treating the nonsense mutation-caused hemophilia according to PTC read-through approaches.
Cell Line, Tumor ; Codon, Nonsense ; Factor IX ; genetics ; Genetic Vectors ; Hemophilia B ; genetics ; Humans ; Recombinant Proteins ; genetics