Purpose:To observe the efficacy of capecitabi ne in the treatment of relapsed breast cancer. Methods:21 patients with relapsed breast cancer were treated. C apecitabine was administered twice a day at the dose of 2 500 mg/(m 2?d) f or two weeks. 21 days was one cycle. Patients could be evaluated after at least 2 cycles treatment. Results:20 patients could be evaluated. There were no complete response but 6 partial response, 8 stable disease and 6 progressive disease in t he group. The response rate was 30.0%. The common toxic effects were hand-foot syndrome (61.1%), nausea and vomiting(66.7%), leucopenia (42.9%) and skin pigm entation (23.8%). Conclusions:Capecitabine is effective for the relapsed breast c ancer patients who have been treated with anthracycline and taxanes. The toxic e ffects are mild and the tolerance is well. Capecitabine can be used as the secon d line regimen for relapsed breast cancer.

Objective To investigate the effects of preoperative jaundice relieving on hemihepatectomy of hilar cholangiocarcinoma.Methods The clinical data of 18 patients who received preoperative percutaneous transhepatic cholangiography and drainage (PTCD) or endoscopic nasobiliary drainage (ENBD) before hemihepatectomy at the Tongji Hospital of Huazhong University of Science and Technology from January 2007 to January 2012 were retrospectively analyzed.The condition of the 18 patients (jaundice relieving group) was compared with that of 24 patients (non-jaundice relieving group) who did not receive PTCD or ENBD before hemihepatectomy.The differences in the pre-and postoperative blood loss,blood transfusion,operation time and postoperative incidence of complications between the 2 groups were analyzed.All data were analyzed using the t test or chi-square test.Results After PTCD or ENBD,the levels of total bilirubin (TBil),direct bilirubin (DBil),alanine aminotransferase (ALT) were (27 ± 5) μmol/L,(22 ± 6) μmol/L and (52 ± 42) U/L,which were significantly lower than (287 ± 120)μmol/L,(212 ± 86)μmol/L,and (267 ± 180)U/L before PTCD or ENBD in the jaundice relieving group (t =4.33,6.61,4.19,P ＜0.05).In the jaundice relieving group,left hemihepatectomy was performed on 14 patients,and right hemihepatectomy on 4 patients,and the radical resection rate was 16/18.In the nonjaundice relieving group,left hemihepatectomy was performed on 11 patients,and right hemihepatectomy on 13 patients,and the radical resection rate was 83.3％ (20/24).There was no significant difference in the radical resection rate between the 2 groups (x2 =1.09,P ＞ 0.05).The operation time,volume of intraoperative blood loss,volume of blood transfusion were (5.0 ± 0.8) hours,(562 ± 207) ml and (430 ± 317) ml in the jaundice relieving group,and (6.3 ± 1.5)hours,(815 ± 463)ml and (750 ± 146)ml in the non-jaundice relieving group,with significant differences between the 2 groups (t =4.77,7.80,4.65,P ＜ 0.05).The incidences of postoperative complications,bleeding and postoperative hepatic failure were 3/18,1/18 and 1/18 in the jaundice relieving group,and 75.0％ (18/24),33.3％ (8/24) and 33.3％ (8/24) in the non-jaundice relieving group,with significant differences between the 2 groups (x2=5.14,7.58,7.58,P ＜ 0.05).Conclusion Preoperative jaundice relieving could shorten the operation time and reduce the volume of intraoperative blood loss and the incidence of postoperative complications.

Objective To detect the expression of osteopontin (OPN) in cervical local tissues of patients with chronic cervicitis, cervical intraepithelial neoplasia (CIN), cervical cancer. To investigate the possibility that OPN is used as tumor marker of cervical cancer. Methods The expression of OPN in 25 cases of chronic cervicitis, 18 cases of CIN and 21 cases of cervical cancer was detected by immuohistochemistry SP method. Results The positive expression rates of OPN in the chronic cervicitis, CIN and the cervical cancer had a rising trend (48 %, 77.78 % and 80.95 %, respectively) and their differences had statistical significant (P <0.05). The OPN expression level in cervical cancer had no statistical correlation with age, tumor size, clinical stage and other clinical pathological features (P >0.05). Although OPN expression level in cervical cancer wasn' t related with tumor clinical stage, positive expression rates of OPN had a gradually increased trend along with the clinical stage. Conclusion High expression of OPN is found in cervical cancer and may be related to the occurrence and development of cervical cancer.

A rapid and simple flow-injection-catalytic spectrophotometric method using stopped-flow technique for determination of trace phenols is described. This methods is based on the catalytic effect of phenols on the reaction of rhodamine B and potassium bromate in sulfuric acid medium. The optimal experimental conditions are obtained by using the controlled and weighed centroid simplex method. The linear range of the determination is 0.60～4．00 mg/L for phenols, and the detection limit is 0.1 mg/L with the sample throughput of 34/h. The relative standard deviation of eleven replicate measurements is less than 2.0%. It has been applied for the determiantion of phenols in waste water with satisfactory results

A rapid and sensitive flow-injection spectrophotometric method was proposed for the determination of metoclopramide. This method was based on the diazotisation of metoclopramide with sodium nitrite in acidic medium and coupling with α-naphthylamine. The optimal experimental condition was obtained by using the simplex optimization method. The linear range was 0.0 ～ 30 mg/L, and the sample throughput was 160 samples h-1. The relative standard deviation of eleven replicate measurements was less than 0.6%. The method was used to determine metoclopramide in tablets and injections. The results were statistically compared with those obtained by pharmacopoeia method.

ObjectiveTo compare the levels of sFas in the sera among Kawasaki disease (KD),incomplete Kawasaki disease (IKD),and normal control groups,and to analyze the relationship of sFas with IKD children.MethodsA total of 32 cases of acute KD and acute IKD children,and 20 cases of the control children were selected,respectively.The levels of serum sFas among three groups were measured using ELISA kits.Each child among the three groups was examined by echocardiography.Results(1)The levels of serum sFas among the three groups were[ (0.54±0.20)ng/L in KD,(0.55±0.16)ng/L in IKD,and (0.24 ± 0.04) ng/L] in control group,respectively.The overall means of sFas in the KD and IKD groups were higher than the control group,and the differences were statistically significant( F=29.276,P＜0.05 ).(2)The levels of serum sFas among echocardiography abnormal and normal groups were[ (0.65±0.19) ng/L and (0.49±0.10)ng/L],respectively; and the difference between two groups were statistically significant ( t=3.139,P ＜ 0.05 ).ConclusionsThe expression levels of sFas in the peripheral serum of IKD children were increased,and there was a close association of overexpression of sFas with the cardiovascular damage in IKD children.

ObjectiveTo study the value of strain ratio from longitudinal section and cross section in differential diagnosis of benign and malignant thyroid nodules using ultrasonic elastography.MethodsA total of 118 patients with 153 thyroid nodules underwent examinations with real-time ultrasonic elastography to obtain the strain ratio from longitudinal section and cross section. Receiver operating characteristic (ROC) curves were used to evaluate the value of elastography. The nodules are divided into two groups, group one included nodules which were near the isthmus and group two included other nodules. Diagnostic results were compared with pathological results.ResultsThe area under the ROC curve (AUC) of the strain ratios for differentiating benign and malignant thyroid nodules were 0.906 and 0.844. There was no statistical difference (Z=1.542,P>0.05). The best diagnostic cut-off points of the strain ratios were 3.65 and 3.58. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 81.2%, 80.8%, 81.0%, 87.2% and 71.2% and those of strain ratio from cross section were 77.2%, 76.9%, 77.1%, 84.4% and 63.4%. In group one, the AUC were 0.903 and 0.830. There was no statistical difference (Z=1.125,P>0.05). The best diagnostic cut-off points were 3.30 and 3.28. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 86.2%, 68.8%, 80.0%, 83.3% and 73.3% and those of strain ratio from cross section were 78.6%, 58.8%, 71.1%, 75.9% and 62.5%. In group two, the AUC were 0.906 and 0.852. There was no statistical difference (Z=0.936,P>0.05). The best diagnostic cut-off points were 3.33 and 3.71. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the strain ratio from longitudinal section for differentiating benign and malignant thyroid nodules were 90.1%, 75.7%, 85.2%, 87.7% and 80.0% and those of strain ratio from cross section were 84.7%, 70.3%, 80.6%, 83.6% and 72.2%. ConclusionReal-time ultrasonic elastography is helpful to the differential diagnosis of thyroid nodules, but there is no statistical difference between the strain ratio from longitudinal section and cross section.

BACKGROUNDThere is no effective regimen for recurrent small cell lung cancer patients now. The aim of this study is to assess the activity and toxicity of topotecan combined with cisplatin in the treatment of recurrent small cell lung cancer patients.

METHODSTwenty-eight patients with progressive disease after one first-line regimen enrolled in the study from May 2002 to October 2004. Topotecan was given at the dose of 1.2mg/m² from 1st to 4th days and cisplatin was administered at the dose of 25mg/m² from 5th to 7th days in a cycle of 3 weeks. The patients could be evaluated at least after 2 cycles.

RESULTSOne patient got complete response and ten patients got partial response in this group. The overall response rate was 39.3% , and the response rate of refractory group and sensitive group was 37.5% (3/8) and 40.0% (8/20) respectively. The median time to progression was 4.2 months. The main toxicity was hematological toxicity. Grade III+IV neutropenia occurred in 42.9% (12/28) of the patients.

CONCLUSIONSThe regimen of topotecan and cisplatin shows better activity in retreated small cell lung cancer patients. The main toxicity is hematological toxicity and can be tolerated.

Objective To investigate the relationship among Helicobacter pylori(H.pylori),CD4 positive cells and CD8 positive cells in gastric mucosa of the AIDS patients with gastritis.Methods Fiftyeight AIDS patients with upper abdominal pain were diagnosed with chronic gastritis through gastroscopy.The gastric biopsies from them were used for H.pylori detection with rapid urease test and Giemsa staining,pathology examination with HE staining,and immunohistochemistry analysis for CD4,CD8 positive cells in Gastric mucosa.And the application of flow cytometry was for the detection of peripheral blood CD4 and CD8 lymphocytes from the patients.Results H.pylori was positive in 26 cases,and negative was in 32 cases.CD8 cell expression in gastric mucosa of the AIDS patients with H.pylori positive was significantly higher than H.pylori negative patients(P＜0.05).There is no difference CD4 cell expression in gastric mucosa between the AIDS patients with H.pylori positive and H.pylori negative patients.Moreover,CD8 positive lymphocytes in gastric mucosa of those patients with H.pyloriinfection were significantly stronger than the CD4 positive lymphocytes.However,the peripheral blood CD4 lymphocytes from the patients with H.pylori infection were more than those from H.pylorinegative patients significantly(P＜0.05).Conclusion The expression level of CD8 cells in gastric mucosal tissues of AIDS patients with H.pylori infection were higher than those without H.pylori infection.The CD4 lymphocytes from the peripheral blood of the patients with H.pylori infection were more than those without H.pylori negative patients.

Objective To summarize surgical experience of eight patients with pentalogy of Cantrell. Methods Six male and two female patients with pentalogy of Cantrell,aged from 4 months to 26 years old, average 7.35 years old, underwent surgical therapy for intracardiac anomalies and extracardiac anomalies from July 2007 to June 2009. Eight case with intracardiac anomalies include one case with only VSD, one case with only ASD, two cases with DORV, four cases with VSD and ASD or PTO. Experts majoring in cardiovascular surgery cooperated with doctors majoring in thoracic surgery and general surgery for satisfactory correction of intracardiac anomalies and extracardiac anomalies and repositioning heart to thoracic cavity. Results Ectopic heart of the first patient was simply repositioned into thoracic cavity following surgery of double outlet of right ventricle in another hospital two years before. Correction of introcardiac anomaly and reposition of ectopic heart finished at one time in 7 cases. Eight patients got full recovery except that residual shunt occurred in the second case which also got full recovery after transcatheter therapy. Ventricular diverticulum was removed in the fourth case because of difficult reposition of ectopic heart.With the help of general surgeon and thoracic surgeon, partial coronary ligament of liver and falciform ligament of liver in the left was cut in the first case and the left half lobe of liver was pushed downward. Bilateral pleural and marginal costal costochondral was cut and make thoracic wall upward so that ectopic heart can reset into thoracic cavity. And then, defect of diaphragm and abdominal wall were repaired with Proceed patch. In the other seven cases, bilateral pericardium and mediastinal pleura was cut and the 7th and 8th cartilage was transected and bilateral costal arch was closed so for complete thoracic angioplasty.Left ventricular dysfunction occurred in the fifth case with DORV and also got full recovery after symptomatic treatment. Full recovery was got in all cases after followingup from 1 to 23 months. No adverse complications occurred and every case live a wonderful life. Conclusion Pentalogy of Cantrell can be cured at one time by accurate correction of cardiac anomalies, cutting of bilateral pleural and marginal costal costochondral to make thoracic wall upward and enlarge thoracic space for repositinning of ectopic heart and using artificial patch to repair defect of diaphragm when necessary.