Purpose:To evaluate the therapeutic effects of 3-D conformal radiotherapy(3D-CRT) and concurrent chemotherapy in advanced non -small-cell lung cancer(NSCLC). Methods:38 stage Ⅲ NSCLC patients were given radio therapy to a total dose of 75~80 Gy(5-10 Gy/fraction;8-10 fractions)by using SCRT.And ea ch patient was given four cycles of concurrent chemotherapy(vinorelbine 25 mg/m ~2 on Days1,8;cisplatin 80 mg/m~2 on Days1;21 days for one cycle). Results:The response rate was 92.1%,of which 16 complete respo nders and 19 partial responders .The survival rate was 74.53%at 1 year, 37.45% at 2 years,the median survival time was 16 months. Conclusions:Stereotactic conformal radiotherapy and concurrent chemotherapy,as described here,is a well tolerated regimen with acceptable toxic ity.More effective treatment schemes are required to improve local disease contr ol and overall survival.

Objective To investigate the relationship between keratinocyte growth factor (KGF), nerve growth factor(NGF)and psoriasis;and to study the interaction between keratinocytes and interstitial cells in psoriasis. Methods The expression of KGF, KGF receptor (KGFR), NGF, NGF receptor (NGFR), epidermal growth factor receptor (EGFR) and proliferating cell neuclear antigen (PCNA) was studied with immunohistochemical technique (SP) in lesional skin, non lesional skin and normal controls. Results Significant overexpression of KGF and KGFR was present in psoriatic basal cell layers and suprabasal cell layers compared to that in non lesional and normal controls (P0.05). Expression of KGF and KGFR was absent in dermis. Expression of NGF and NGFR was observed mainly in granular cell layers and upper spinous layers, and was significantly different between normal controls and non lesional, between non lesional and lesional skin (P

Objective To establish the model of amyotrophic lateral sclerosis (ALS) with selective motor neuron disorder by organotypic spinal cord cultures, and analyze the role of astrocyte in the pathagenisis of ALS.Methods Organotypic spinal cord cultures were prepared using lumbar spinal cord slices from 8-day-old SD rat pups. The threohydroxyaspartate (THA) was applied into culture medium to establish ALS organotypic spinal cord cultures model. Motor neurons survival was evaluated by monoclonal SMI-32 immunohistochemical staining and glial fibrillary acidic protein staining to show astrocyte survival.Results Compared with the control group, there was significantly astrogliosis in the anterior horn and surrounding white matter in THA 100 μmol/L group, and the level of gliosis was increased followed the elongation of THA interference time. With the increasing of the number of astrocyte, the morphology of astrocyte was changed.Conclusion There is significantly astrogliosis in the anterior horn and the time of astrogliosis is markedly earlier than the time of motor neuron loss in the ALS model intervented with THA.

University of Manchester who first introduced Problem based learning(PBL)to the UK medical education,and adopted this new curriculum in 1994.Notably,Cambridge and Oxford have always had a high proportion of student-centred and self-directed learning,and have therefore not introduced PBL.Other medical schools have followed the example of Manchester,now PBL has become the mainstream curriculum in British medical edacation.First,this article is going to introduce how PBL curriculum is structured at Manchester medical school,and then reflect and give some thoughts on its current practice.

Objective To investigate the effect of midazolam on inflammatory response in patients with moderate and severe craniocerebral injury and its protective effect on the brain and mechanism.Methods A prospective study was conducted.One hundred and twenty patients with moderate and severe craniocerebral injury admitted to the Intensive Care Unit (ICU) of Jiangsu Subei Peoples' Hospital from April 2013 to July 2016 were enrolled,and they were divided into a conventional treatment group (58 cases) and a midazolam group (62 cases) according to the random number table method.Both groups were given conventional western medicine treatment,and in cases with surgical indications,operations were performed;in midazolam group,additionally intravenous injection of midazolam 2-3 mg was given firstly,and then continuous intravenous infusion of the drug 0.05-0.10 mg· kg-1· h-1 was applied by a pump,and in operative patients,the above management was given 3 hours after operation.The mean arterial pressure (MAP),heart rate (HR),Riker sedation agitation score (SAS) and electroencephalogram bispectral index (BIS) were measured before and after treatment for 24,48 and 72 hours,respectively.The levels of interleukin-6 (IL-6) and soluble nerve chemotactic protein (sFkn) in plasm and cerebrospinal fluid (CSF) were measured by double antibody sandwich enzyme linked immunosorbent assay (ELISA) at each time point;the incidence of epilepsy and 28-day mortality were recorded.Results Before and after treatment,the MAP and HR in the two groups of patients were stable,the difference being not statistically significant (both P ＞ 0.05).Compared with those before treatment,after treatment the SAS score and BIS in two groups of patients were gradually decreased,and at 72 hours reached the lowest levels (SAS score:conventional treatment group was 3.8 ± 1.0 vs.5.7 ± 2.0,midazolam group was 3.6 ± 0.9 vs.5.8 ± 1.7;BIS:conventional treatment group was 69± 12 vs.82± 12,midazolam group was 72± 15 vs.82± 12,all P ＜ 0.05),but there were no significant differences between the two groups (all P ＞ 0.05),suggesting that the two groups had achieved the desired goal of sedation.ELISA results showed:compared with those before treatment,after treatment for 24 hours,the CSF IL-6,sFkn and plasm sFkn levels were temporarily increased in short term,and then showed a tendency of gradually decreasing,and the plasm IL-6 presented persistently descending in the conventional treatment group,while in the midazolam group,since 24 hours after treatment,each index showed a trend of decrease and continued to 72 hours.After treatment at each time point,the CSF and plasm levels of IL-6 and sFkn were significantly lower in midazolam group than those of the conventional treatment group,and reached to the minimal levels at 72 hours [CSF:IL-6 (ng/L) was 251.6 ± 145.7 vs.347.3 ± 146.4,sFkn (ng/L):289.7 ± 79.3 vs.423.6 ± 132.8;plasm:IL-6 (ng/L) was 54.4± 27.3 vs.85.6 ± 41.8,SFkn (ng/L):919.9±426.3 vs.1 199.4 ± 414.8,all P ＜ 0.05].The incidence of epilepsy in the midazolam group was obviously lower than that in the conventional treatment group [1.61％ (1/62) vs.10.34％ (6/58),P ＜ 0.05],but there was no significant difference between midazolam group and the conventional treatment group in the 28-day mortality [11.29％ (7/62) vs.10.34％ (6/58),P ＞ 0.05].Conclusion Midazolam can reduce the incidence of epilepsy in patients with moderate and severe traumatic brain injury,and its brain protective effect may be related to the decrease of CSF and plasm IL-6 and sFkn levels.

Objective:To study the expression and significance of ADMA/NOS/NO/cGMP pathway in the maternal-fetal interface of patients with preeclampsia. Methods: 60 patients were selected and divided into severe preeclampsia group, mild preeclampsia group and gestational hypertensive group according to the disease condition, meanwhile 20 healthy pregnant women of singleton receiving cesarean section were chosen as control group. Levels of NO and cGMP in placenta of the four groups were detected and compared,and activities of total NOS in placenta were measured and compared. The expression of eNOS and iNOS in placental tissue was detected by immunohistochemistry SP method. High-performance liquid chromatography was used to detect the level of ADMA in HUVECs. Results:The levels of NO in placenta of severe and mild preclampsia groups were (7. 6±3. 6) and (11. 4±4. 3) μmol/g, which were statistically significantly lower than that in control group(P<0. 05). The levels of cGMP in placenta of severe and mild pre-clampsia groups were ( 3. 26 ± 0. 31 ) and ( 4. 53 ± 0. 42 ) pmol/g, which were aslo significantly lower than that in control group ( P<0. 05). In the four groups,the level of cGMP in placenta was positively correlated with the level of NO in placenta(r=0. 672). The activities of total NOS in placenta of severe and mild preeclampsia groups were (10. 4±3. 0)and (14. 8±1. 6)U/mg protein,which were statistically significantly lower than that in control group ( P<0. 05 ) . In placenta of the four groups, the activity of total NOS was positively correlated with the level of NO(r=0. 785). The expression of eNOS in placenta of severe and mild preeclampsia groups was statistically significantly lower than that in control group ( P<0. 05 ) , the expression of iNOS in severe preeclampsia group was significantly higher than that in the control group(P<0. 05). The levels of ADMA in HUVECs of severe preeclampsia group,mild pre-eclampsia group and gestational hypertensive group were statistically significantly higher than that in the control group(P<0. 05). The level of ADMA in HUVECs was negatively correlated with the level of NO in placenta of the four groups ( r=-0. 582 ) . Conclusion:ADMA/NOS/NO/cGMP pathway may play an important role in the pathogenesis of preeclampsia.

Objective To determine the relationship between serum levels of MCAF/MCP-1 (monocyte chemotactic and activating factor/monocyte chemoattractant protein-1), RANTES(regulated on activation, normal T-cell expressed and secreted) and the disease activity of systemic lupus erythematosus(SLE). Methods Serum levels of MCAF and RANTES were measured by ELISA. Results ①Serum level of MCAF but not RANTES, was significantly increased in patients with SLE as compared with controls. ②Serum level of MCAF but not RANTES, was markedly higher in patients with active disease than those with inactive disease. ③No significant differences were found in the serum levels of MCAF and RANTES between patients with renal damage and those without. Conclusions These results suggest that MCAF may be involved in the pathogenesis of SLE, and serum MCAF levels could be an indicator for the disease activity of SLE.

Objective To explore the physiological and psychosocial risk factors of the patients with somatoform disorders and to provide references for clinical psychological intervention.Methods Totally 60 patients with somatoform disorder and 60 normal controls were tested with biochemical analyzer,electrocardiogram machine,electroencephalogram machine,computed tomographic scanner,general situation questionnaire,minnesota multiphasic personality inventory(MMPI),toronto alexithymia scale(TAS),life event scale(LES),defense style questionnaire(DSQ) and social support rating scale(SSRS) to explore the physiological and psychosocial risk factors of the patients with somatoform disorders.Results The score of immature defense styles of the study group(4.04±0.89) were higher than those in the control group(3.43 ± 0.65)with significant difference (P＜0.05).The total and factor scores of TAS of study group((86.20±11.15),(21.12±3.28),(26.08±3.86),(18.21±4.69),(23.44±5.60)) were higher than control group((65.00±10.12),(12.43±5.18),(15.64±5.57),(15.56±3.16),(18.71 ±4.30)) with significant difference (P＜0.05).The MMPI scale scores of Hs (hypochondriasis),D (depression),Hy (hysteria),Men-Nancy (Mf),Paranoid (Pa),Psychotic (Pt) were higher in patients with somatoform disorder ((72.79± 10.50),(68.46±13.63),(79.03±12.12),(51.72±7.74),(57.98±10.60),(54.98±8.83)) than those in normal controls((51.66±10.11),(47.96±9.42),(51.47±11.90),(43.66±8.77),(47.67±6.69),(47.48±8.67)) with significant difference(P＜0.05).The total life event score and the negative life event score of LES of the study group ((89.66±68.60),(82.65±65.16)) were higher than those in the control group((56.00±56.79),(39.14± 46.05)) with significant difference (P＜ 0.05).Multiple factors logistic regression analysis showed immature defense styles,higher alexithymia score,higher negative life event score,higher HS,D,Hy of MMPI may increase the risk of somatoform disorders(OR=6.84,9.12,5.83,2.69,1.81,11.20,P＜0.01).Conclusion Patients with somatoform disorder are almost in normal physiological condition.They have the personality characteristics and significant alexithymia.Their social support are almost normal,but they have more negative life events and their defense styles are almost immature.

Hematologic Diseases ; Hemolysis ; Humans ; Infant, Newborn

Objective:To investigate the expression and relationship of differentiated embryo-chondrocyte expressed gene1(DEC1) and the signal tranducers and activator of transcription3 (STAT3) in gastric cancer tissues,and the significance of the two genes in gastric carcinogenesis. Methods:Immunohistochemistry method of SP was adopted to discover the expression of DEC1 and STAT3 in 59 gastric cancer tissues,19 normal tissues distant from tumor were regarded as control. Results:The positive expression rate of DEC1 in gastric cancer tissues was 71.2%(42/59),which was significantly higher than that in normal para-cancer tissues(26.3%)(P0.05). STAT3 expression was associated with TNM staging,invasion depth,lymph node involvement and tumor grade (P0.05). Conclusions:DEC1 expression was higher in gastric cancer tissues than that in normal para-cancer tissues distant from tumor,and was correlated with STAT3 in gastric cancer. DEC1 and STAT3 are both transcription factors,therefore the co-activation of DEC1 and STAT3 may play an important role in the carcinogenesis and development of gastric cancer.