bjective: To investigate the efficacy of pemetrexed as a second-line treatment for patients with NSCLC (advanced non-small cell lung cancer). Methods: Fifty-six patients with stages III B-IV NSCLC, who failed in the first-line cisplatin-based chemotherapy, were enrolled in this study between January 2008 and January 2012. All the patiients received pemetrexed 500 mg/m2 on day 1 and repeated every 21 days as a second-line chemotherapy. After two cycles of chemotherapy, the clinical efficacy and the adverse effects were evaluated. The median survival time and the one-year survival rate were calculated. Results: All the patients received 2-6 cycles of the chemotherapy with a total of 178 cycles. All patients were evaluable. Of the 56 patients, no one achieved complete response, 9 (16.1%) achieved partial response, 10 (33.9%) achieved stable disease, 28 (50.0%) achieved progressive disease. The objective response rate was 16.1% (9/56). The median survival time was 8.9 months, and the one-year survival rate was 30.35%. The common adverse effects were bone marrow suppression and gastrointestinal toxicities with a light severity and could be tolerable. No treatment-related deaths occurred. Conclusion: Chemotherapy with pemetrexed as a second-line treatment for advanced NSCLC has a definite efficacy, and the adverse effects can be tolerable. Copyright © 2013 by TUMOR.

Adult ; Aortic Rupture ; pathology ; Death, Sudden, Cardiac ; etiology ; Heart Ventricles ; pathology ; Humans ; Male

Objectives To learn the effect of self-recognition-based healthy management on community diabetics. Methods A total of 40 community diabetics were evaluated and trained for 3 months.SPSS11.5 software was used for data analysis. Results At 3 months, some risk factors of diabetes,including body weight, body mass index (BMI), waist circumstance (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and 2 h postprandial blood sugar (PBS), were improved (P ＜0. 05). Male patients showed statistically significant reduction in body weight, BMI and WC ( P ＜ 0. 05 ).However, female subjects were found to have significant decline in body weight, BMI, WC, SBP and DBP (P＜0. 05). Those ＞60 year-old had significantly decreased body weight, BMI, WC, SBP, DBP and 2 h PBS ( P ＜ 0. 05). Lower levels of WC, SBP and triglyceride were seen in individuals ＜ 60 year-old ( P ＜0. 05 ). Conclusion Self-recognition-based healthy management could effectively reduce diabetic risk factors and prevent the development of diabetic complications.

Objective To investigate the possible association between vascular endothelial growth factor (VEGF), endostatin (ES) and type 2 diabetic nephropathy. Methods The level of serum VEGF and ES were measured by ELISA in eighty type 2 diabetic patients including thirty subjects without diabetic nephropathy , twenty with microalbuminuria and thirty with macroalbuminuria, and the correlation was analyzed. Results The level of serum VEGF and ES in patients with macroalbuminuria were both significantly higher than that of patients with and without microalbuminuria (P < 0.05). The level of serum VEGF and ES in patients with microalbuminuria were significantly higher than that of patients without diabetic nephropathy (P<0.05). Both VEGF and ES level were positively correlated with the level of microalbuminuria (mAlb) (r=0.226, P<0.01; r=0.491, P<0.01), and negatively correlated with the level of estimated glomerular filtration rate (eGFR) (r=-0.237, P<0.05;r=-0.620, P<0.01). There was a significantly positive correlation between VEGF and ES in patients with microalbuminuria and macroalbuminuria (r1=0.633, P1<0.01; r2=0.532, P2<0.05). However, there was no correlation between VEGF and ES in patients without diabetic nephropathy (r3=0.175, P3>0.05). Conclusion The levels of VEGF and ES in type 2 diabetic nephropathy had varying degree of increasing in different diabetic nephropathy stage , and closely related to mAlb and eGFR. Disequilibrium of VEGF and ES may speed up the progression of diabetic nephropathy.

OBJECTIVETo build a type 2 diabetes mellitus rat model with cardiac ischemia.

METHODSMale Wistar rats were fed high sucrose and high fat diet for four weeks and then injected with streptozoticin (STZ) (40 mg/kg .i.p.). The levels of fasting blood glucose and serum insulin were monitored every week. The body weights of rats were also measured every week. The blood levels of creatine kinase and lactate dehydrogenase (LDH) were measured following the electrocardiograph used BL-410 biological experiment system.

RESULTSThe serum insulin levels of diabetic rats were 4.05 ng/ml after four weeks high sucrose and high fat diet. The fasting blood glucose levels of diabetic rats were 17.9 mmol/L after injection. Compared with normal group, there was obvious change of S-T segment in the electrocardiograph of diabetic group at the fourteenth week. The levels of creatine kinase and lactate dehydrogenase in diabetic group significantly increased in comparison with those in normal group.

CONCLUSIONThe cardiac ischemia of diabetic rats model is suitable for investigating cardiac disease of diabetes mellitus.

Animals ; Creatine Kinase ; blood ; Diabetes Mellitus, Experimental ; physiopathology ; Diabetes Mellitus, Type 2 ; chemically induced ; physiopathology ; Diet, High-Fat ; adverse effects ; Dietary Sucrose ; adverse effects ; Disease Models, Animal ; L-Lactate Dehydrogenase ; blood ; Male ; Myocardial Ischemia ; physiopathology ; Rats ; Rats, Wistar ; Streptozocin

A profile of the standardized residency training at PUMCH in nine decades depicted the rigorous attitude, strict requirements, tight methodology, enhanced basic theories, basic knowledge and basic skills training, which constitute the characteristic standardized residency training system of the hospital.

Eleven old male patients with hyperuricemia were collected ( hyperuricemia group,65-90 years old ).10 healthy middle-aged males ( middle-aged group,30-40 years old) and 10 healthy old males ( older group 60-70 years old ) with normal blood uric acid level were used as controls.All of the subjects were given low purine content diet ( 250 mg/d ) for 3 days followed by high purine content diet ( 800 mg/d ) consecutively for another three days.The samples of fasting blood and 24 h urine were collected for assay.The results showed that there were no significant changes of serum uric acid ( UA ) concentration in three groups after low purine content diet.But the levels of serum UA in three groups all increased significantly after high purine content diet,and the change was higher in hyperuricemia group than middle-aged group [ ( 507.7 ± 108.1 vs 378.9 ± 80.1 ) μmol/L,P＜0.05 ].24 h urine uric acid excretion in three groups was all significantly decreased after low purine content diet and increased after high purine content diet.After high purine content diet,24 h urine uric acid was lower in hyperuricemia group than middle-aged group [ ( 2.99 ± 1.21 vs 3.62 ± 1.02 ) mmol/24 h,P＜0.05 ].Blood urea nitrogen levels in all subjects decreased after low purine content diet and increased after high purine content diet ( P＜0.05 or P＜0.01 ).Creatinine clearance rate in hyperuricemia group was decreased after high purine content diet compared with baseline [ (75.3 ± 20.3 vs 80.7 ±20.0) ml/min ],and there were no significant changes in other groups after low and high purine content diet.24 h urine protein in hyperuricemia group was higher than middle-aged group ( P＜0.05 ),and increased after high purine content diet with significant difference ( P＜0.05 ).These results suggest that high purine content diet and decreased by renal uric acid clearance mainly contribute to hyperuricemia in old people.

Objective To explore the application of ABCD3 score on stratifying the antithrombotic treatment strategy in patients with capsular warning syndrome (CWS).Methods The clinical features of 15 patients with CWS were analyzed retrospectively,and the risk of stroke were evaluated by ABCD3 score and to guide the treatment of Stratifying antithrombotic therapy.The status of patients hospitalized,discharged and discharged after 90 d were evaluated.Results The frequency of patients with CWS accounted for 2.51％ (15/ 597) of all patients with transient ischemic attack(TIA),and the mean age in patients with CWS was (70.27 ±8.29) years old.The duration of the first onset was (10-30) min,the mean time was (17.33±1.53) min,and ABCD2 score was 5.0-9.0 points,mean score was 7.00±0.26 points,and the total episodes of CWS were 51 times during 24 hours,the mean duration was (18.13 ± 15.36) minutes ((3.0-60.0) min).All 15 cases presented with limb hemiparesis.Of them,9 cases had dysarthria,5 case with ipsilateral facial palsy.All 15 cases CWS patients showed no signs of cortical deficit.The mean NIHSS score at onset was 1.0-6.0 points,mean scores was 3.20±0.31 points.Fourtheen patients were treated with clopidogrel plus aspirin,and 2 cases with administration of the loading dose 300 mg of clopidogrel,1 case was treated with clopidogrel plus aspirin orally followed by intravenous rt-PA thrombolysis.The average hospital periods of all 15 patients was (7.67±0.29) days.The NIHSS score were 0 point at discharge.There was no symptomatic intracranial hemorrhage or death within 90 days follow-up periods.Conclusion CWS is prone to develop a completed stroke.Stratified antithrombotic therapy guiding by ABCD3 score may decrease the risk of ischemic stroke.

Objective HupA is one of the potential drugs which can be used to treat Alzheimer's disease(AD).The aim of this study was to explore the pharmacokinetics and biodistribution of HupA in vivo by using 11C-HupA.Methods A total of 25 SD rats were studied.They were divided into 5 groups (5 rats in each group).All had intravenous injection of 22 MBq(in0.2 ml)11C-HupA through tail vein.Dynamic im-aging Was acquired from 5 to 90 minutes after injection.Venous blood and organ activities were collected at 5,15,30,60.and 90 minutes after injection.Percentage activity of injected dose per gram of tissue(%ID/g)was calculated to characterize the biodistribution of tracer in different brain regions: frontal,apical, temporal,occipital,cerebellum,hippocampus,striatum,thalamencephalon, and brain stem, Variance analysis using SPSS 11.5 software was performed and compared among the study groups.Results 11C-HupA was character-istic for its quick clearance from blood,with half time T1/2 of (14.61±1.77) min,and clearance rate (CL)macokinetics of 11C-HupA in rats corresponded to a one-compartment model.with an activity curve(area 11C-HupA distribution in different brain regions,being greater in cerebral cortex,hippocampus,hypothala-mus and brain stem. Conclusions Pharmacokinetic study of 11C-HupA in brain was fast.convenient and showed high specificity and sensitivity.Its ability to quantitatively evaluate brain function and its character-istic distribution in mice provided some evidence for monitoring therapy in AD patients.

Objective To analyze the clinical characteristic and prognosis of Serratia infections in newborn infants and increase awareness of Serratia infections.Methods The clinical manifestations,diagnosis,complications,treatment and prognosis of Serratia infections were analyzed in 4 hospitalized newborn infants in neonatology center from Jul.2008 to Feb.2009.Results Among the 4 cases,blood culture revealed Serratia marcescens in 3 cases(1 case was preterm infant),cerebral spinal fluid culture revealed Serratia liquefacien in the fourth case.The main clinical manifestations were fever,convulsion and poor response,WBC and CRP were much higher,while obvious thrombocytopenia was only found in the preterm infant.Two cases of septicemia infection alone recovered after the treatment of the third-generation cephalosporin for at least 2 weeks,while the other 2 cases of septicemia infection combined with purulent meningitis,included 1 case of preterm infant and 1 case of Serratia liquefacien infection,developed meningoencephalitis and brain abscess confirmed by serial imaging,both of which had poor neurological sequelaes.Conclusions As a opportunistic pathogen,Serratia can cause severe infection in newborns.The patients complicated with meningitis should be followed up and pay more attention to the high incidence of neurological sequelaes.