Objective To investigate the clinical efficacy and toxicity of bevacizumab combined with chemotherapy in elderly patients with gastrointestinal neoplasms.Methods A total of 64 elderly patients with gastrointestinal neoplasms were selected.The clinical data of patients treated with chemotherapy or chemotherapy plus bevacizumab were analyzed.Patients were randomly divided into the observation group and the control group (n=32,each).The observation group was treated with bevacizumab (7.5 mg/kg) in combination with XELOX (OXA+Xeloda),and the control group was treated with XELOX only (21 weeks as a cycle).The clinical efficacy and toxicity of bevacizumab were evaluated according to WHO short-term efficacy standards and standards of anticancer drugs in acute or subacute adverse reactions.Results In observation group,complete remission was found in 4 cases,partial response in 18 cases,stable disease in 6 cases,progressive disease in 4 cases,and the total efficiency was 68.8％.In control group,partial response was found in 14 cases,stable disease in 11 cases,progressive disease in 7 cases,and the total efficiency was 43.8％.The incidences of leucopenia,hemoglobin desaturation and gastrointestinal reactions were lower and the incidence of thrombocytopenia was higher in observation group than in control group,which had no significant differences between the 2 groups.Phase Ⅳ toxicity was not found in observation group.Conclusions Bevacizumab combined with chemotherapy is safe and effective for elderly patients with gastrointestinal neoplasms.Most patients can tolerate the side effects.It is worth promoting in clinical medicine.

OBJECTIVE:To investigate the effects of calcitriol on related indicators in patients with chronic renal failure (CRF). METHODS:114 patients with CRF were randomly divided into observation group(57 cases)and control group(57 cas-es). Control group was given high-quality low-protein and low phosphorus diet,if necessary,phosphate binders,Calcium D3 tablet and other conventional treatment;observation group was additionally given 0.25 μg Calcitriol soft capsule,once a day. The treat-ment course for both groups was 8 weeks. Serum levels of inflammatory factors,alkaline phosphatase,hemoglobin,erythrocyte, serum creatinine and urea nitrogen levels and adverse reactions in 2 groups before and after treatment were observed. RESULTS:Before treatment,there were no significant differences in the serum levels of inflammatory factors,alkaline phosphatase,hemoglobin, erythrocyte,senum creatininine and ureanitrogen between 2 groups(P>0.05). After treatment,serum inflammatory factors,alkaline phosphatase,serum creatinine and urea nitrogen levels in 2 groups were significantly shorter than before,and observation group was lower than control group,the differences were statistically significant (P<0.05);there were no significant differences in the hemoglobin and erythrocyte levels before and after treatment between 2 groups(P>0.05). And there was no obvious adverse reac-tions between 2 groups during treatment. CONCLUSIONS:Based on the conventional treatment,calcitriol can reduce the levels of serum inflammatory factors and improve micro-inflammatory state and renal function in patients with CRF.

Objective To use helical tomotherapy ( HT ) for determining the difference between actual doses and planning doses to the target volume and organs at risk ( OARs ) in patients with nasopharyngeal carcinoma receiving radiotherapy, and to provide guidance for the clinical treatment. Methods Localization and delineation of the target volume and OARs were performed by computed tomography ( CT) in 21 patients with nasopharyngeal carcinoma receiving radical radiotherapy using HT. All patients underwent megavoltage CT ( MVCT) scan prior to treatment. The obtained MVCT images were used for dose reconstruction in the adaptive module of HT, in which the actual dose was obtained and the non?image?guided dose was simulated. Each single dose distribution and the corresponding CT image were sent to software MIM6. 0 for superimposition, and the overall dose was obtained. The initial plan, image?guided plan, and non?image?guided plan were named Plan?1, 2, and 3, respectively. The dose distribution in the target volume and OARs was compared between the three plans with t ? test or wilcoxon test . Results Compared with those in Plan?1, the D98 values for the planning gross tumor volume ( PGTV) and planning target volume ( PTV) in Plan?2 were significantly reduced by 1. 16% and 2. 3%, respectively ( P=0. 025;P=0. 043);the volumes of the left and right parotids in Plan?2 were significantly reduced by 46. 0% and 46. 5% on average, respectively ( P=0. 000);the distances between the midline and the center?of?mass for left and right parotids were significantly reduced by 6. 9% and 6. 5%, respectively ( P=0. 000);the V26 and Dmean for both parotid glands were significantly elevated by 32. 8% and 25. 2%, respectively ( P=0. 000) . Compared with those in Plan?1, the D98 values for PGTV, PTV?1, and PTV?2 in Plan?3 were significantly reduced by 2. 0%, 1. 9%, and 2. 4%, respectively ( P=0. 001;P=0. 007;P=0. 036);the V26 and Dmean for both parotid glands in Plan?3 were significantly elevated by 33. 6% and 25. 3%, respectively ( P=0. 000);Dmax to the spinal cord was significantly increased by 6. 9%( P=0. 005) . There was no significant difference in D2 to the spinal cord between Plan?2 and Plan?1( P=0. 392) . Conclusions The doses to both parotid glands increase during HT for nasopharyngeal carcinoma, which is closely associated with the shift of the parotid glands toward the midline. Image?guided radiotherapy does not enhance the dose to the target volume, but reduces the dose to the spinal cord.

BACKGROUND:Previous research have confirmed that CD34 is closely related to oncogenesis, progress, recurrence, metastasis and drug-resistance of various cancers, but its role in nasopharyngeal carcinoma remains unclear.
OBJECTIVE:Tosortcels positive and negative for CD34 in nasopharyngealcarcinoma cel lines and to detect cel proliferation and migration.
METHODS:Expressionsof CD34 in nasopharyngeal carcinoma cel lines 5-8F, 6-10B, CNE1 and CNE2 were detected by flow cytometry. And CD34+and CD34-cels were sorted based on cel surfacemarkers for purity identification. Afterwards, proliferation and migrationof CD34+and CD34-celswere detected by MTT assay, colony-formation assay and scratch assay.
RESULTS AND CONCLUSION:Al four nasopharyngeal carcinoma cel lines expressed CD34 in
0.1%-0.2%, and the level of CD34 was closely related to the cel growth density. The purity of CD34+cel was more than 98% in the sorted CD34+celpopulations, but no CD34+cels were found inthe sorted
CD34-celpopulations.At 1, 3, 5 and 7 daystheproliferation rate of CD34+cel, populationswas
significantly higher than that of CD34-cels (P< 0.05). Consistently, thecolony-formation efficiencyof CD34+cel was significantlyhigher than that ofCD34-cels (P< 0.05). Moreover, CD34+cels migrated significantly faster than CD34-cels by scratch assay (P< 0.05). In conclusion, CD34+cels culturedin vitro display higher proliferation and migration capacities, indicating that CD34+celshavethe potential of nasopharyngeal carcinoma stem cels.

Objective To study the effect and mechanism of forkhead transcriptionfactor O1( FoxO1) on proliferation of rat mesangial cells(MCs) cultured under high glucose conditions. Methods Constructing lentiviral vectors of LV-CA-FoxO1 and LV-siRNA-FoxO1 were used to upregulate or downregulate FoxO1. Moreover, negative control LV-NC-FoxO1 was also constructed. Rat MCs were separately cultured in normal glucose(5. 6 mmol/ L, NG group), only high glucose(30 mmol/ L, HG0 group), LV-NC-FoxO1 with HG(HG1 group),LV-CA-FoxO1 with HG (HG2 group), and LV-siRNA-FoxO1 with HG(HG3 group) for 72 h. MTT assay and flow cytometrywas were used to analyze cell proliferation and cell cycle distribution. The expression of FoxO1, cyclin-dependent kinase inhibitor (p27), cyclinD1, and cyclin-dependent kinase 4( CDK4) were detected by QRT-PCR and Western blot. Results The MCs proliferation rate in HG0 group was faster than that in NG group. Besides, there were no statistical differences in FoxO1 expression and proliferation rate of MCs between HG0 group and HG1 group. Nevertheless, LV-CA-FoxO1 promoted cell cycle arrest at the G1 phase and attenuated proliferation rate, along with upregulation of FoxO1 and p27 and downregulation of cyclin D1 and CDK4 in HG2 group ( all P < 0. 05). Moreover, degradation of FoxO1 by LV-siRNA-FoxO1 stimulated hyperproliferation of MCs, associating with decline of p27 and increase of cyclin D1 and CDK4 in HG3 group(all P<0. 05). Conclusion The proliferation of MCs induced by high glucose is regulated by utilizing transgenic technology targeted and regulated FoxO1 expression and consequently through FoxO1 / p27 signaling pathway. These findings indicate that FoxO1 seems to be a new therapeutic target for early diabetic nephropathy.

Objective To explore the current status of healthcare-associated infection (HAI)and antimicrobial use in a children’s hospital.Methods Prevalence rates of HAI and antimicrobial use among hospitalized patients at 0∶00—24∶00 of May 1 ,2014 were investigated by combination of bedside visiting and medical record reviewing. Results A total of 1 027 patients were investigated,8 patients developed 10 times of infection,prevalence rate of HAI was 0.78%,prevalence case rate was 0.97%.HAI mainly occurred in patients in blood center (n =4),the main infection site was respiratory tract(upper respiratory tract,n=2;lower respiratory tract,n=2),antimicrobial usage rate was 62.12%.Antimicrobial usage rate,purpose of antimicrobial use,and combination use of antimicro-bial agents among different departments were all significantly different(all P <0.05).The departments with top 3 antimicrobial usage rates were neonatal center(89.69%),emergency center(76.00%),and comprehensive depart-ment(73.91 %);except department of ophthalmology-otorhinolaryngology-stomatology (preventive antimicrobial use accounted for 57.89%)and department of surgery(therapeutic antimicrobial use accounted for 26.32%),the other departments mainly used therapeutic antimicrobial agents;department of ophthalmology-otorhinolaryngology-stoma-tology,heart center,and neurological rehabilitation center mainly adopted single medication treatment (all >95%), two-drug combination rate in neonatal center accounted for 48.28%,three-drug combination rate in blood center ac-counted for 30.30%.Conclusion Routine surveillance on departments and sites of high HAI incidence should be in-tensified in children’s hospitals,training on knowledge of HAI among health care workers should be strengthened, and antimicrobial should be used rationally.

Objective To explore the writing quality and rational use of drugs for outpatient prescription of western medicine in Yanqing District Hospital of Beijing.Methods From January 2011 to December 2015, 12 000 prescriptions of western medicine were selected randomly.The prescriptions were analyzed by Excel and the Pareto diagram analysis was used to find out the main reasons of irrational prescription.Results From 2011 to 2015, the basic indicators of prescription of western medicine were reasonable:the average number of drugs on each pre-scription was 2.31,the utilization rate of injections was 15.91%,the utilization rate of essential drugs was 38.00%, the utilization rate of antibacterial was 14.56%.The unreasonable rate of prescription was 6.32%,and the main irra-tional reason were dosage inappropriate,indications inappropriate,inappropriate selection of drugs and combination therapy was not suitable.Conclusion By prescription review,we have listed the problems,and provide the basis for rational drug use and improvement measures.

Good self-management behaviors can control symptoms of the patients with osteoarthritis, improve the patients' joint function and quality of life. Patients' self-management behaviors have been impacted by disease knowledge, self-effcacy, emotional state, and social support. All the above factors should been taken into full consideration when intervening. Self-management program is an intervention mode which can improve patient self-management behaviors and promote patient health.

Objective To observe the therapeutic effect of heat-clearing and dampness-removing therapy combined with Bifico for ulcerative colitis ( UC) induced by trinitrobenzene sulfonic acid ( TNBS), and to explore its influence on tumor necrosis factor alpha ( TNF-α) and interleukin-10 ( IL-10) in rats. Methods Forty female adult Sprague-Dawley rats were evenly randomized into five groups, namely normal control group, model group, Bifico (175 mg/kg) group, Chinese medicine group(enema with Changdiqing 3.6/kg and oral use of Changyanling Recipe l) , and Chinese medicine plus Bifico group. After treatment, the damage of colonic mucous membrane was evaluated, and expression levels of IL-10 and TNF-α in colonic mucosa were observed through immunohistochemical assay. Results The degree of colonic mucosal injury was severer and the inflammation was more obvious in the model group than those in the normal control groups ( P<0.01) , and the above changes were relieved to various degrees in the medication group ( P<0.01 compared with those in the model group) . Chinese medicine plus Bifico group had better effect on reducing colonic mucosa damage index ( CMDI) and inflammation, and on promoting the healing of colonic mucosa than Bifico group and Chinese medicine group (P<0.05 ) . The expression level of TNF-α in the colonic mucosa was markedly increased while that of IL-10 was markedly decreased in the model group ( P<0.01 compared with those in the normal control group) . The medication groups could counteract the above changes in the colonic mucosa ( P<0.01 compared with those in the model group) . The combination group and Chinese medicine group had better effect on decreasing TNF-α expression level and on increasing IL-10 expression level than Bifico group ( P<0.05) . Conclusion IL-10 and TNF-α play an important role in the pathogenesis and development of ulcerative colitis. Chinese medicine combined with Bifico has satisfactory therapeutic effect on UC rats, and its mechanism may be related with the increase of IL-10 expression level and with the decrease of TNF-α expression level.

Acute myeloid leukemia (AML) is a group of highly-heterogeneous clonal diseases. Chemotherapy and hematopoietic stem cell transplantation are considered as effective treatment for AML. For high-risk AML patients, allogeneic hematopoietic stem cell transplantation is an effective therapeutic option. However, some AML patients may still face the problem of disease recurrence after hematopoietic stem cell transplantation. A majority of recurrent patients cannot be effectively treated by chemotherapy or secondary transplantation, which is the main cause of death after allogeneic hematopoietic stem cell transplantation. Therefore, it is of significance to strengthen follow-up of AML patients after allogeneic hematopoietic stem cell transplantation and implement appropriate measures to prevent postoperative recurrence. In this article, the monitoring, drug prevention and cell therapy of recurrence after allogeneic hematopoietic stem cell transplantation in high-risk AML patients were reviewed, aiming to provide reference for improving clinical prognosis of high-risk AML patients undergoing allogeneic hematopoietic stem cell transplantation.