Objective To evaluate the safety and efficacy of epirubicin (EPI) and gemcitabine (GEM) alternating sequential intravesical chemotherapy after transurethral resection in the treatment of non-muscle invasive bladder cancer.Methods 240 patients with primary non-muscle invasive bladder urothelial carcinoma were randomly divided into 2 groups.There were 120 cases for each group,EPI group was given EPI 50 mg (once a week),bladder perfusion,while the EPI+GEM group was given EPI 50 mg (once every other week),GEM 1000 mg (once every other week),alternating sequential perfusion.The follow-up time ranged from 6 to 24 months when the time of tumor recurrence and adverse reactions of chemotherapy were observed and recorded.Results The 2-year tumor free survival rate for EPI group recurrence was 60.0 ％ (72/120),and 75.0 ％ (90/120) for EPI+GEM group.There were statistical significance between the differences of the 2 groups (x2 =5.489,P ＜ 0.05).3 cases in EPI group and 2 cases in EPI+GEM group progressed to muscle invasive bladder cancer,and there was no statistical significance between the differences of bladder cancer progression rates for the 2 groups (2.5 ％ and 1.7 ％) (x2 =0.000,P ＜ 0.05).The main adverse reaction during the treatment was gastrointestinal discomfort (15 cases and 6 cases respectively),no serious haematological toxicity and other adverse reactions were frequent urination,urgency,dysuria and hematuria.The differences between the occurrence rates of adverse reactions for the 2 groups were 25.0 ％ and 11.7 ％,which were statistically significant (x2 =6.252,P ＜ 0.05).Conclusion For non-muscle invasive urothelial bladder carcinoma,the curative effect is better to use EPI and GEM sequential intravesical chemotherapy than to use EPI alone,which can not only reduce the 2 years recurrence rate after the operation,but also reduce the incidence rate of adverse reactions.Yet,this method cannot change the progress of bladder cancer.

Objective To understand the situation of iodine nutrition in school children aged 8-10 and pregnant women in Jinping County of Guizhou Province,and to provide a scientific reference for control of iodine deficiency disorders (IDD).Methods Based on Surveillance Scheme of IDD of Guizhou Province (2012),no less than 40 children aged 8-10 and 20 pregnant women were chosen as the research subjects according to the east,west,south,north,and centre 5 directions in Jinping County of Guizhou Province in 2015;a total of 222 children aged 8-10 (half males and half females) and 111 pregnant women were chosen.Arsenic and cerium catalysis spectrophotometry method (WS/T 107-2006) was used to detect urinary iodine content of children and pregnant women;direct titration was used to detect edible salt iodine content from pregnant women.Results The median of urinary iodine of children was 252.0 μg/L in Jinping County in 2015,＜ 100 μg/L accounted for 12.16％ (27/222),100-199 μg/L accounted for 23.42％ (52/222),200-299 μg/L accounted for 27.03％ (60/222),and ≥ 300 μg/L accounted for 37.39％ (83/222);the medians of urinary iodine of children aged 8,9 and 10 were 225.5,252.0 and 286.0 μg/L,respectively;the medians of urinary iodine of male and female children were 237.0 and 255.0 μg/L,respectively;the median of urinary iodine of pregnant women was 198.0 μg/L,＜ 150 μg/L accounted for 35.14％ (39/111),150-249 μg/L accounted for 33.33％ (37/111),and ≥250 μg/L accounted for 31.53％ (35/111);the median of salt iodine from pregnant women was 27.8 mg/kg,21-39 mg/kg accounted for 94.59％ (105/111),the coverage rate of iodized salt was 100.00％ (111/111),the consumption rate of qualified iodized salt was 94.59％ (105/111).Conclusions The median of urinary iodine of children in Jinping County is high,the iodized salt coverage and qualified iodized salt consumption rates are up to the requirements,and the salt iodization standards are still have some space for downward adjustment.

Objective To evaluate the curative effect and security ofYangxue-Qingnao granules on posterior circulation ischemia.Methods 52 patients with posterior circulation ischemia from September 2012 to January 2014 in Remin hospital of Wuhan Universityk, were randomly recruited into a control group and a treatment group, with 26 cases in each group. The control group was only treated with flunarizine HCL and Betahistine Mesilate Tablets, while the treatment group was givenYangxue-Qingnao granules based on the control group. The change of clinical symptoms, TCD and cervical vascular ultrasound were observed before and after the treatment.Results After the treatment, the total effective rate of treatment group was significantly different to the control group (96.2%vs. 76.9%;χ2=4.127,P=0.042). The changes of blood flow velocity of vertebral artery, basilar artery and posterior inferior cerebellar artery were all decreased after the treatment in both groups (tvalue in the treatment group were 20.624, 13.773, and 9.485 respectively,t value in the control group were 13.203, 9.550, and 5.655, respectively, allP<0.01), besides such decreases in the treatment group were better than the control group (allP<0.01). After the treatment, the condition of carotid IMT decrease was significantly better in the treatment group than the control group (the number rate of IMT decrease was (96.2%vs. 69.2%;χ2=5.318,P=0.021).ConclusionYangxue-Qingnao granules can obviously improve the blood flow velocity and the thickness of IMT in patients with posterior circulation ischemia. The short-term curative effect is obvious.

BACKGROUND:Chemokine receptor 4 (CXCR4) is the main homing regulating factor for mesenchymal stem cells in vivo. How to improve the self-expression of CXCR4 is crucial for regulating the homing ability of stem cells in vivo targeting organs. OBJECTIVE:To construct lentiviral vectors carrying CXCR4 or green fluorescent protein (GFP) gene, and to observe their effects on growth and secrete function of bone marrow mesenchymal stem cells. METHODS:Lentiviral vectors were used to over-express CXCR4 in rat bone marrow mesenchymal stem cells. GFP gene was transfected as a control. Transfection efficiency was analyzed using fluorescence microscopy, RT-PCR and western blot assay for detecting the expression of CXCR4 or GFP in cells at both the mRNA and protein levels. Effects of CXCR4 expression modified on the cellular proliferation of bone marrow mesenchymal stem cells were assayed with flow cytometry. Effect of CXCR4 regulation on secretion function of bone marrow mesenchymal stem cells was determined by protein analysis from cellsupernatant. RESULTS AND CONCLUSION:CXCR4 gene or GFP gene could be transfected into bone marrow mesenchymal stem cells safely and effectively with lentivirus transfection system. Analysis of CXCR4 expression at the mRNA and protein levels confirmed the transfection efficiency. Effects of CXCR4 over-expression on the cellular proliferation of bone marrow mesenchymal stem cells and effects of CXCR4 regulation on secretion of protective factors from bone marrow mesenchymal stem cells were improved. The proliferation ability of bone marrow mesenchymal stem cells with CXCR4 over-expression was improved, which was approved with flow cytometry (P<0.05). And it was helpful for bone marrow mesenchymal stem cells to secrete some protective factors. Many protein and soluble factors were at higher levels, and those were good at cells proliferation and immunoloregulation in bone marrow mesenchymal stem cells (P<0.05). The method of lentiviral transfection is a safe and effective way to modify bone marrow mesenchymal stem cells. We can improve the ability of bone marrow mesenchymal stem cells in the survival and emiocytosis ability through genetic engineering.

Objective To investigate the risk factors of portal vein thrombosis (PVT) in patients with liver cirrhosis.Methods From January 2009 to December 2011,the data of 294 hospitalized patients diagnosed as liver cirrhosis were retrospectively analyzed.PVT was diagnosed according to multislices spiral computed tomography or color doppler ultrasonography.Fifty-five patients with liver cirrhosis and PVT were in PVT group,239 patients with liver cirrhosis however no PVT were in non-PVT group.Age,gender,etiology of cirrhosis,Child-Pugh grading and score,blood routine examination,blood chemistries,blood coagulation function,D-dimer,main portal vein (MPV) internal diameter,portal vein velocity (PVV) and thickness of spleen were recorded and analyzed.The measurement data were analyzed by t test.Unconditional Logistic regression model was performed to screen corresponding risk factors.Area under curve (AUC) was calculated according to receiver operator characteristic (ROC) curve to evaluate the diagnostic value of each index.Results The results of white blood cell,hemoglobin,total bilirubin,creatinine,serum natrium,prothrombin time,activated partial prothrombin time,fibrinogen and international normalized ratio of PVT group were similar with those of non-PVT group and there were no statistically significant differences (all P＞ 0.05).Compared with those of non-PVT group,the differences in platelet count,albumin level,the level of D-dimer,MPV internal diameter,PVV,spleen thickness,and Child Pugh score of PVT group were statistically significant ((82.55 ± 23.04) × 109/L vs (99.66±20.23)×109/L(t=-0.308,P=0.022),(30.53±2.32) g/L vs (33.36±3.62) g/L(t=-2.117,P=0.036),(1.00±0.22) mg/L vs (0.77±0.15) mg/L(t=7.557,P=0.003),(15.11± 1.32) mmvs (13.40±1.43) mm(t=8.013,P=0.014),(13.51±1.51) cm/s vs (15.16±1.60) cm/s (t=-6.979,P=0.036),(59.35±5.45) mm vs (54.64±5.92) mm(t=1.9555,P=0.043),(11.73± 2.01) scores vs (8.18 ± 3.05) scores (t =6.225,P =0.006)).The results of unconditional Logistic regression model analysis indicated that D-dimer,Child-Pugh score,MPV and PVV were independent risk factors of PVT in patients with liver cirrhosis (OR=13.420,10.237,8.534,0.151; P=0.001,0.014,0.019,0.025).ROC curve analysis indicated that the AUC of D-dimer,Child-Pugh score,MPV and PVV was 0.868,0.823,0.810 and 0.756,respectively.The predicate value was D-dimer＞ Child-Pugh score＞ MPV＞ PVV.Conclusion D-dimmer,Child-Pugh score,MPV and PVV are independent risk factors of PVT in paitients with liver cirrhosis.

Stereotactic radiotherapy is a rapidly growing treatment strategy for tumor due to the advances in target definition,radiation dose delivery,and image guidance of radiation.We reviewed the clinical application of stereotactic radiotherapy in the management of early stage non-small cell lung cancer including the technique,the workflow of the technique established,the outcome and relative radiation toxicity.

Asingleparticle-inductivelycoupledplasmamassspectrometric(SP-ICP-MS)methodwas established to detect the size distribution and number concentrations of silver nanoparticle ( AgNPs) in dilute aqueous solution. The optimal dwell time was 3 ms to reduce possibility of two or more particles entering into detector simultaneously. An iterative algorithm was applied to distinguish AgNPs as outliers from baseline and dissolved metal ion signal if the measured intensity was beyond five time standard deviation of whole data. Size distribution and number concentration of three commercial silver nanoparticle dispersions ( nominal diameters of 30, 50, 100 nm) were determined using SP-ICP-MS. The result of SP-ICP-MS is accurately similar to the transmission electron microscopy ( TEM) , indicating that SP-ICP-MS is able to size silver nanoparticles. The particle size detection limit is 25 nm and the limit of number concentration is 8 × 104 particles/L in dilute solution. Tap water added with silver nanoparticle was tested to obtain a similar size distribution and number concentration. This method is simple, fast and highly sensitive, which can be used to investigate risk assessment of silver nanoparticle in aqueous environment and monitor silver nanoparticle in drinking water.

Objective To study the effect and prognosis of multiple channels percutaneous renal ureteral calculi removal in the treatment of patients with complex renal calculi.Methods One hundred and forty-four cases patients with complex renal calculi accepted treatment in Dongda Hospital of Shanxian County from June 2012 to March 2015 for research.According to the random number table method,the patients were divided into the observation group and the control group,72 cases in each group.The single channel type was used in the control group,while multi-channel type operation was use in the observation group.Indicators related to the operation,stones clearance rate,changes in the degree of hydronephrosis,and the major complications after treatment of the two groups were compared.Results The operation time of the observation group was (104.82 ±8.54) min,significantly longer than that of the control group ((90.23 ±7.68) min),but the duration of hospital stay,fistulation tube indwelling time and the residual stone surface area were (6.84±1.25) d,(5.23±2.16) d and (223.16± 113.49) mm2 respectively,significantly less than that of the control group ((8.33±2.13) d,(6.74 ± 2.19) d and (429.54 ± 107.88) mm2 respectively),the differences were statistically significant(P =0.000).The stone removal rate of the observation group was 86.11％ (62/72),significantly higher than that of the control group(72.22％ (52/72)),the difference was statistically significant (P =0.040).There was no significant difference in terms of the total stone clearance rate and the degree of kidney water after treatment between the two groups (P＞0.05).The total complication rate of the observation group was 11.11％(8/72),of the control group was 9.72％ (7/72),and the difference was not statistically significant(P ＞0.05).Conclusion The efficacy of multi-channel operation for complex renal calculi is better,safe and feasible,but should reduce the number of channels as much as possible,so as to reduce the damage to patients effectively.

Objective:To investigate the effects and mechanisms of Xuebijing injection on early sepsis induced acute lung injury and explore a new therapy.Methods:Thirty healthy male Sprague-Dawley rats were randomly divided into 3 groups:Sham group(n=10),NS group (NS 4mL/kg n=10),Xuebijing Group(Xuebijing 4mL/kg n=10).Cecal ligation and puncture (CLP) was used to duplicate severe sepsis model.At 6h after CLP,the rats were sacrificed,the lungs were resected and histopathological characteristic was observed by transmission electron microscopy technique.The change of the lung wet/dry (W/D) weight ratio were studied.Meanwhile,the lungs were resected for detection of ET-1,iNOS,MMP-9,TIMP-1 mRNA with reverse transcription-polymerase chain raction (RT-PCR).Results:The changes of pulmonary alveoli and the interstitial edema as well as lung tissue in Xuebijing group were better than those of NS group.The change of lung wet/dry (W/D) weight ratio in septic rats showed was significantly increased at 6 h after CLP (vs Sham group:5.37± 0.12 vs 4.33± 0.06,P＜0.01).The lung W/D was significantly decreased in XBJ group (vs NS group:4.67± 0.09 vs 5.37± 0.12,P＜0.05).The expressions in XBJ group lung tissue of ET-1 (0.511 ± 0.111 vs 0.705± 0.122,P＜0.01),iNOS(0.45610.075 vs 0.548± 0.098,P＜0.05)、MMP-9 (0.617± 0.079 vs 0.732± 0.131,P＜0.05),TIMP-1 (0.438± 0.043 vs 0.515± 0.049,P ＜0.01) mRNA were significantly decreased than those in NS group.And the expressions of ET-1 (0.705± 0.122vs 0.400± 0.033,P＜0.01),iNOS (0.548± 0.098 vs 0.334± 0.027,P＜0.01),MMP-9(0.732± 0.131 vs 0.352± 0.061,P＜0.01),TIMP-1(0.515± 0.049 vs 0.365± 0.068,P＜0.01) mRNA in NS group were significantly increased compared with those in the sham group.Conclusions:Xuebijing could protect against sepsis induced acute lung injury,which might be related with the decrease ofET-1,iNOS,MMP-9 and TIMP-1 mRNA expressions.

OBJECTIVE:To systematically review the efficacy and safety of pirfenidone in the treatment of idiopathic pulmo-nary fibrosis (IPF),and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane Library, PubMed,EMBase,CJFD,CBM,VIP Database and Wanfang Database,randomized controlled trials (RCT) about the efficacy and safety of pirfenidone (test group) versus placebo (control group) in the treatment of IPF were collected,and Meta-analysis was performed by using Rev Man 5.1.7 software after data extracting and quality evaluating by modified Jadad. RESULTS:Totally 4 RCTs were enrolled,involving 1 153 patients. Results of Meta-analysis showed the decrease value of lung capacity [WMD=0.39,95%CI(0.16,0.61), P<0.001] and decrease value of the percentage of forced vital capacity to expected value [RR=0.68, 95%CI(0.53,0.87),P=0.002] in test group were lower than control group,there was significant difference between 2 groups;there was no significant difference in the lowest oxygen saturation [WMD=0.53,95%CI(-0.78,1.84),P=0.43] between 2 groups,however,the results of subgroup analysis showed the remission degree of 1 200 mg/d PFD for the decrease of lowest oxy-gen saturation was superior to placebo group,there was significant difference between 2 groups [WMD=1.72,95%CI(1.33,2.10), P<0.001],but therewas no significant difference between the remission degree of 1800 mg/d and placebo;and there was no signifi-cant difference in the incidence of adverse reactions between 2 groups [RR=1.70,95%CI(0.46,6.31),P=0.43],but the incidence of photosensitivity veactions in test group was significantly higher than that of control group,there was significant difference [RR=9.35,95%CI(4.23,20.67),P<0.001]. CONCLUSIONS:The efficacy of pirfenidone in the treatment of IPF is good,but the inci-dence of photosensitivity reactions should be noticed.