Lung metastasis is one of the most common metastases.Metastasectomy is only indicated for selected patients,and most patients are unsuited to surgery.The main treatment is systemic chemotherapy,however,the long-term survival is limited.With the development of precision radiotherapies such as threedimensional conformal radiation therapy (3D-CRT) and stereotactic body radiotherapy (SBRT),it is proved that radiotherapy is favorable for the patients with lung metastasis,especially for limited lung metastasis.SBRT can be obtained better survival,but still need large prospective studies.

Objective To investigate Enterococci resistance to glycopeptides and their genotypes. Methods MICs of antimicrobial agents to Enterococci were determined with agar dilution test and van genes were amplified with PCR. Results 298 E. faecalis and 42 E. faecium clinical isolates were collected from 13 University teaching hospitals around China. The resistant rates of E. faecalis to penicillins were 14.1%～17.8%, which was much lower than those of E.feacium. No glycopeptides resistant Enterococci strain was detected. 8 E. faecalis and 1 E. faecium were intermediate sensitive to vancomycin but sensitive to teicoplanin with MICs of 8～16 and 0.25～2 mg/L, respectively. PCR amplification of van genes gave rise to only vanC2/3 gene positive in E. faecalis B144. Conclusions Glycopeptide resistant Enterococci is not common in China and no vanA or vanB type Enterococci was detected in this study. Penicillins, vancomycin and teicoplanin could be employed in the treatment of Enterococcus faecalis infections. High attention should be paid to future development of vancomycin resistant Enterococcus (VRE) in China.

Objective To construct a lentiviral vector of RNA interference (RNAi) of murine triggering receptor expressed on myeloid cells-1 (TREM-1) gene and to explore the effect of TREM-1 on the inflammatory response caused by Bacteroides fragilis. Methods Four target sequences were selected according to murine TREM-1 mRNA sequence, and then 4 pairs of double-strand DNA oligo according to these target sequences and one pair of negative control double-strand DNA oligo were designed and synthesized. These fragments were subcloned into pGCSIL-GFP/Lenti plasmid. After being identified by PCR and sequencing, these plasmids were cotransfected into 293T cells to package lentiviral particles. The lentiviral vector particles were transfected into Raw 264. 7 cells and TREM-1 expression in the transfected cells was assayed by real-time PCR and ELISA. Different concentrations of Bacteroides fragilis lipopolysaccaride (LPS) were administered in the Raw264. 7 cells, and the cells were stimulated with LPS for 12 h. TREM-1 expression was determined by real-time PCR and ELISA at the time points. Results PCR and sequencing confirmed that lentiviral vectors had the correct structure and could express high titer of virus. After being transfected into Raw264. 7 cells, TREM-1 expression was knocked down significantly by all of these lentiviral vectors at both protein and mRNA levels, and the pGCSIL-GFP/Lenti-1 had the most efficient interference. TREM-1 was upregulated in the presence of Bacteroides fragilis LPS, and this increase was partly abrogated in the TREM-1 siRNA-treated cell models of endotoxemia, depending on the sequence. Conclusion The lentivirus RNAi vector of TREM-1 was constructed successfully. The lentivirus RNAi vector of TREM-1 can inhibit the expression of TREM-1 in the murine endotoxemia model caused by Bacteroides fragilis LPS.

Objective To observe the changes of tongue and pulse parameters in the patients with chronic hepatitis B(CHB)after pegylated interferon alpha-2a(PEG-IFNα-2a)treatment,to investigate its value in evaluation clinical efficacy of PEG-IFNα-2a treatment.Methods 120 patients with CHB who confirmed to the standard received PEG-IFNα-2a antiviral therapy for 48 weeks,and followed up for 24 weeks.The tongue and pulse parameters were detected by DS01-A type digital tongue and pulse presentation analyzer.The changes of liver function,serum HBV markers,HBV DNA,tongue and pulse parameters were observed before and after treatment.Results 113 patients completed the course of treatment,46 cases received complete response(response rate 40.7%).The response rate of liver stagnation and spleen deficiency group was higher than that of blood stasis group(95%CI:0.010-0.677,P <0.05).The baseline of tongue and pulse parameters had no significant difference between response group and non response group(h3 /h1,t =1.799,P =0.074;h4 /h1,t =1.383,P =0.169;h5 /h1,t′=0.461,P >0.05;W/t,t′=0.688,P >0.05;R,t =1.317,P =0.190;G,t =0.346,P =0.729;B,t =1.720,P =0.088).After 48 weeks treat-ment,and followed up for 24 weeks,the tongue and pulse parameters of response group and non response group were compared with baseline,h3 /h1,h4 /h1 decreased,R value and G value increased,the differences were statistically sig-nificant(Response group:h3 /h1,t =3.004,P =0.003;h4 /h1,t =2.702,P =0.008;R,t′=2.258,P <0.05;G,t′=3.052,P <0.05.Non response group:h3 /h1,t =1.978,P =0.049;h4 /h1,t =2.487,P =0.014;R,t′=2.661,P <0.05;G,t′=2.318,P <0.05).But there were no significant differences between the response group and no response group after treatment(h3 /h1,t′=0.191,P >0.05;h4 /h1,t =0.390,P =0.697 2;h5 /h1,t′=0.957,P >0.05;W/t,t =0.149,P =0.881;R,t =1.343,P =0.181;G,t =0.994,P =0.322;B,t =0.565,P =0.572).Conclusion The changes of tongue and pulse parameters have improved after treatment with PEG-IFNαin patients with CHB. However,the value in predicting the efficacy of antiviral therapy may be limited.

Objective To analyze the experience of 745 cases of lumbar disc herniation(LDH) and investigate the relevance between the clinical symptoms,signs and operative observation.Methods From 1982 to 2003,745 cases of LDH were treated operatively.In order to investigate the relationship between clinical presentations and operative results,a statistic analysis was conducted using the clinical symptoms,signs and operative observations.Results As the predominant manifestions,the pain in the low back and leg was seen in 96.4% of LDH,the pain aggravated by belly pressure in 93% of LDH,local tenderness and radicular pain around the lumbat spinous process in 70.8% of LDH,rectoleg elevation test(+) in 91.6% of LDH.operation observation:77.6% of LDH was classified as lateral type,10.9% as medial type and 11.5% as rupture or sequestration type.Weakness of extensor hallucis longus could seen in 65.6% of LDH of L_4,L_5,in 32.3% of LDH of L_5S_1.Conclusions Although the extensive usage of computed tomography(CT) and magnetic resonance imaging(MRI) provides a prompt and accurate basis for diagnosis of LDH,the physical examination remains the most important routine way to make a diagnosis.It is suggested that during the diagnosis and treatment of LDH,besides the common features of the disease,some individual presentations should not be neglected in few rare atypical cases,so as to diagnose and treat correctly.

Objective To explore the CT and MR features of cystic nephroma. Methods CT and MRI findings of 8 patients with cystic nephroma comfirmed surgically and pathologically were analyzed retrospectively. Results In all 8 patients, cystic nephromas were unilateral and solitary, and diameter of lesions was 2.92-7.81 cm. The CT and MR scans showed multilocular cystic lesion with clear border. These locules did not communicate with each other. The septa were intact and smooth, and showed slight to moderate and gradual enhancement. The interlocular septa were demonstrated clearly on coronal T2WI, and showed hypointensity signals. The intracapsular liquids were heterogenous in 4 patients on MR images. The CT scanning showed a patchy calcification in 1 case. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epitheial cells, of which hemosiderin depositions were presented in 4 patients. Conclusion CT and MR are valuable in the diagnosis of cystic nephroma, and MRI can reflect the pathology of cystic nephroma more clearly, and supply the accurate reference information for diagnosis.

AIM: To observe the effects and location of autologous bone marrow stem cells(BMSCs) transplanted through renal artery into ischemic-reperfusion(I/R) injured kidney.METHODS: BMSCs were collected from rabbits after isolated and then labeled with 5-bromo-2-deoxyuridine(BrdU).Twenty-eight rabbits were subjected to clamping renal pedicles for 105 min and divided into the transplantation group and control group randomly.BrdU labeled BMSCs or saline were injected into the kidney by renal artery,respectively.Before and after I/R at the 1st,3rd, 5th,7th,14th,21th and 28th d,the venous blood was collected to measure serum Cr and BUN.In the same time,renal tissue was collected for pathological and immunohistochemical study.RESULTS: After I/R,serum Cr and BUN levels in the rabbits in two groups became higher,and on the 1st and 3rd d after I/R,reached the highest level.On the 7th d the serum Cr and BUN levels in transplantation group were lower than those in control group.On the 28th d the levels of serum Cr(90.1?11.1) ?mol/L and BUN(8.0?1.5) mmol/L in transplantation group were significantly lower than those in control group(135.6?32.5) ?mol/L and(10.9?2.5) mmol/L,respectively(P

[Objective] To observe the inhibitory effect of acupuncture combined with herbal medicine on hyperplasia of mammary glands in rats. [Methods] Rats were randomized into 6 groups: A (normal) , B (model) , C (acupuncture) , D ( herbal medicine), E (acupuncture combined with herbal medicine) and F (triphenyloxamine) . Rat models of hyperplasia of mammary glands in Group B, C, D, E and F were established by intramuscular injection of estradial benzoate and progesterone. Nipple height in rats were detected before and after treatment. The number of acini in each lobule, the diameter of acinar cavity and duct in the second pair of mammary glands were calculated under light microscope. The expression of estrogen receptor (ER) and progesterone receptor (PR) in the tissues of mammary gland were examined by immunohistochemical method after treatment. [Results] Nipple height in group B was more than that in group A and the scores of ER and PR expressions were also higher (P

Objective Using rutin as the model drug to prepare floating alginate-chitosan microcapsule and investigate the feasibility of this pulsatile drug delivery system applied in Chinese materia medica.Methods By means of complex coacervation to prepare alginate-chitosan microcapsule and foaming agent to turn the microcapsule into gastric floating system and to investigate the release profile of the microcapsule in vitro and the influence of gas forming agent to the lag-time of the microcapsule.Results In vitro release,the microcapsule responded to the change of pH value and the release profile showed "S" profile,the lag-time increased from 3 h to 6 h as the quantity of gas forming agent with the dosage of foamer increased.Conclusion Floating alginate-chitosan microcapsule is suitable to be applied in pulsatile drug delivery system of Chinese materia medica with the desirable entrapment efficiency.

Objective To evaluate the efficacy of liposuction-curettage under negative pressure combined with Xiaozhiling injection for the treatment of axillary bromhidrosis.Methods The operative field was marked along the border of hair-bearing area of axilla with a distal margin of 0.5-1 cm.Subcutaneous tissue was removed by stroke movement under negative pressure after tumescent anesthesia.Subsequently,Xiaozhiling injection was injected into the subcutaneous space.All the patients were followed for at least 3 months,and therapeutic efficacy was evaluated quantitatively.Results A total of 72 patients (144 sides) with axillary bromhidrosis were treated with this method from March 2009 to May 2012,including 16 males and 56 females aged 14-41 years.All the patients experienced primary healing with no necrosis or hematoma formation within one week after the operation.The follow-up lasted 3 to 18 months (average: 8 months).Among the 144 sides,133 (92.4％) were cured,11 (7.6％) were improved,with the response rate being 100％.Postoperative scar is invisible,and patients were satisfied with the treatment outcomes.Conclusion The combined therapy is a simple and effective approach to the treatment of axillary bromhidrosis with a fast recovery and less complications.