Objective To evaluate the efficacy and adverse effects of low doses gemcitabine chemotherapy combined with synchronous high-low oxygen radiotherapy in patients with locally advanced pancreatic cancer.Methods Fifty-six patients with locally advanced pancreatic cancer were randomly divided into two groups by envelop method:radio-chemotherapy group or chemotherapy group.Patients in radio-chmotherapy group were treated with low doses of gemcitabine chemotherapy ( 600 mg/m2 ) combined with high-low oxygen radiotherapy synchronously,paients in chmotherapy group were treated with full doses of gemcitabine chemotherapy ( 1000 mg/m2).The short-term effect,distant metastasis rate,clinical benefit rate,survival rate and adverse events of two groups were observed.Results There was one patient achievedcomplete relief and 15 patients achieved partial relief in radio-chemotherapy group with an overall effective rate of 66.7％ (16/24) ; there were 9 patients achieved partial relief in chemotherapy group with an overall effective rate of 36.0％ (9/25),the difference between the two groups was statistically significant (X2 =4.6082,P =0.0318 ).The clinical benefit rates were 83.3 ％ ( 20/24 ) and 60％ ( 15/25 ),respectively,the difference between the two groups was not statistically significant ( P =0.070).The distant metastasis rates were 66.7％(16/24) and 72％ (18/25),respectively,the difference between the two groups was not statistically significant (P =0.6855).The 12,24 months survival rates were 62.5％ vs 32％,37.5％ vs 12％,the difference between the two groups was statistically significant ( P =0.0325,0.0380).The incidence of serious adverse events was 45.8％ and 4 0 ％ without statistical difference.Conclusions Low doses of gemcitabine chemotherapy combined with high-low oxygen radiotherapy synchronously is better than full doses of gemcitabine chemotherapy with regard to total effective rates and 12,24 months survival rates,with no obvious increase in the incidence of serious adverse events.

Objective To evaluate the clinical value bronchofiberscope and perfusion in the treatment of multi- drug resistant pulmonary tuberculosis (MDR-TB).Methods Forty-two cases were treated by injecting amikacin (0.4 g), ofloxacin (0.4 g), after cleaning up exudation through bronchofiberscope and catheter intervention combined with chemotherapy therapy, while 37 controls were treated by chemotherapy only.Results By the end of 9 months, the sputum tubercle bacillus conversion rate, radiographical improvement rate were 92.9% and 90.5% respectively in the treated groups,while all these indications were higher than those of control group 62.2% and 59.5% (P

Objective To investigate the protective effects of (Val8)GLP-1-Glu-PAL to dopaminergic neurons on PD mice induced by MPTP.Methods 56 male C57BL/6 mice which are 10-12 weeks old were randomly divided into Control,model (MPTP),muti-injection (Val8) and therapy (MPTP + Val8) groups by random number table method.Mice in MPTP group were received MPTP IP.treatment (30mg/kg · d),the control group were treated with 0.9％ saline with the same volume,Val8 group were injected with (Val8) GLP-1-Glu-PAL (25 nmol/kg),and MPTP+Val8 group were going to received (Val8)GLP-1-Glu-PAL 1 h after treatment of MPTP,all the groups were treated for 8 consecutive days.Behavior test were processed 2h after drug IP injection,including swimming test and rotarod test.Mice were sacrificed immediately 1h after the final trail of behavior test in 8th day,brains were withdraw for IHC assay which tested the number TH positive neurons in SNpc area.Results The classical PD behavior symptom were induced by MPTP,from 1 st to 8th,the swimming score(1.715±0.143 and dropping latency(68.048±7.823) were both decreasing compared with control.The differences were statistically significant (P＜0.05).The positive dopaminergic neurons were significantly lower in SNpc area (P＜0.01).Compared with MPTP group,(Val8) GLP-1-Glu-PAL could statistically improved the behavior deficit,the swimming score (1.120±0.143) and dropping latency(20.546±7.823) in the MPTP+Val8 group,and differences were statistically significant (P＜0.05).Meanwhile,the TH positive neurons were significantly elevated (P＜0.01).Conclusion The results suggest that (Val8)GLP-1-Glu-PAL has protective effects for MPTP induced mice PD dopaminergic neurons.

Objective To explore the characteristics of constitution according to traditional Chinese medicine and the anxiety susceptibility of the population, providing the theoretical basis for carrying out population intervention in anxiety and taking full advantage of the preventive treatment by investigating anxiety emotion of patients. Methods A cross-sectional study method was adopted. 317 anxiety patients were recruited into an observation group and another 251 anxiety patients were recruited into a control group. Based on the traditional Chinese medicine constitution scale we defined every participant’s constitution type and got the distribution of different constitution types among all the participants. Then we usedχ2 test and binary regression to analyze the impact of constitution on anxiety. Result The observation group constitution type distribution:Qi stagnation(19.24%), Qi deficiency(16.40%), blood stasis(15.46%), damp heat (11.04%), Yang deficiency(10.41%), Yin deficiency(8.83%), phlegm dampness(6.62%), mild quality(5.99%), special intrinsic quality(5.99%). The control group constitution type distribution:damp heat(17.53%), Yin deficiency (14.34%), phlegm dampness (13.94%), Yang deficiency(11.55%),mild quality (11.55%), Qi stagnation (8.76%), Qi deficiency (8.37%), blood stasis (7.97%), special intrinsic quality (5.98%). The result ofχ2 test showed that the distribution of constitution types among participants in the observation group were different from that in the control group and the difference was statistically significant(P<0.001). Three kinds of constitution types(Qi stagnation, Qi deficiency, Blood stasis)showed a different distribution percentage in the observation group(51.10%)and the control group(25.10%, P<0.01). In the observation group, the distribution ratio among Qi stagnation, Qi deficiency, blood stasis had no significant differences (P>0.05). The binary regression result showed that the three constitutions of Qi stagnation, Qi deficiency and blood stasis had significantly positive correlation with anxiety(P<0.05). Odds ratios showed Exp of Qi stagnation, Qi deficiency and blood stasis was 4.447, 3.942 and 3.929. while the other six constitutions are independent factors to anxiety. Conclusion Qi stagnation, Qi deficiency and blood stasis constitutions were possible risk factors for anxiety.

OBJECTIVE: To observe the effect of triamcinolone combined with vitamin E on preventing fibrous capsule contracture following the second breast augmentation. METHODS: Totally 65 patients who had 130 breasts receiving the second breast augmentation at the Department of Plastic and Aesthetic Surgery, No.1 People's Hospital of Nanning were collected and served as the treatment group, including 47 cases with capsules contracture and 18 cases with hydrogel clearing. Tri-Kort was injected after the second breasts augmentation, and vitamin E was taken orally for 3 months. Additional 65 cases with 130 breasts received the second breast augmentation were served as control group. The follow-up was performed after half month, and the curative effect was evaluated by Baker grading at 1 year after operation. RESULTS: All cases in the two groups were received 6-24 months follow-up. Only 3 cases (5 breasts) in 65 patients (130 breasts) in the treatment group had capsule contracture (Baker II-III), with 3.8% of capsule contracture, which was obviously less than 18% of capsule contracture in the control group (P < 0.01,13 cases with 23 breasts in the control group). Simultaneously, no drug adverse reaction occurred in the treatment group. CONCLUSION: Triamcinolone combined with vitamin E can obviously depress the rate of capsule contracture after the second breast implantation.

Objective To discuss the nursing countermeasures of common problems in patients with spinal fracture. Methods All patients received evidence- based nursing in on:ler to tackle problems such as pain, paralysis, pulmonary infection, pressure ulcer, urinary tract infection and deep vein thrombosis. Results No one complicated with pulmonary infection, pressure ulcer and deep vein thrombosis, 2 with lower limb swelling and 3 with urinary tract infection. Conclusions Evidence- based nursing is the base of clinic nursing. It can not only improve the quality of nursing and benefit patients,but also can expand the nurses' knowledge.

Objective To investigate the relationships between the parameters of intravoxel incoherent motion (IVIM)DWI at 3.0 Tesla and T staging of moderately differentiated adenocarcinoma of rectum.Methods Clinical data and MRI findings including con-ventional imaging and IVIM-DWI were collected in a total of 37 patients with moderately differentiated adenocarcinoma of rectum proven by pathology.The patients were divided into two groups without (staging T1 and T2)or with myometrial invasion (T3 and T4).The D,D? ,f and ADC values of rectal cancer and normal rectal wall were measured and were compared between the lesion and normal rectal wall,between both groups and among different T stages.The relationships of the parameters of IVIM-DWI and ADC values with the T staging of moderately differentiated adenocarcinoma of rectum were analyzed.Results The D,D? ,f and ADC val-ues of rectal cancer were lower than those of normal rectal wall with statistical differences in D,f and ADC values (P <0.05).The differences in D and D? values among different T stages were statistically significant,and LSD Duncan test showed that the differ-ence in D? value between T1 and T4 (P =0.01 7)and between T3 and T4 (P =0.003)and in D value between T2 and T3 (P =0.005) were statistically significant.The D,f,D? and ADC values of noninvasion group and invasion one were (0.93±0.1 6)×10 -3 mm2/s versus (0.77±0.1 9)×10 -3 mm2/s,(27.1±2.94)% versus (24.6 ±4.13)%,(12.6±2.44)×10 -3 mm2/s versus (12.3±3.49)× 10 -3 mm2/s,and (0.95±0.09)×10 -3 mm2/s versus (0.87 ±0.12)×10 -3 mm2/s respectively,and the difference in D value was statistically significant (t=2.5 12,P =0.01 7).Conclusion The parameters of IVIM-DWI and the ADC values are different in rectal cancer and normal rectal wall,and the D value may help to identify the tumor invasion into the muscularis propria.

BACKGROUND:Up to date,whether prosthesis can be implanted simultaneously with the residue of polyacryamide hydrogel (PAMHG) in the breasts still not consistent. OBJECTIVE:To explore the feasibility and long-term curative effect of prosthesis implanted simultaneously with the residue of PAMHG in the breasts. DESIGN,TIME AND SETTING:The clinical cases analysis was performed at the Department of Plastic and Aesthetic Surgery,No.1 People's Hospital of Nanning were collected. PARTICIPANTS:Totally 23 cases,aged 22-42 years,who received silicone gel breast implant (SBI,100-400 mL) were collected. The time from injection to hospital visit was 0.4-4.5 years. METHOD:PAMHG was cleared as possible,followed by implanted 200-260 mL SBI was via retro-mammary space or sub-pectoral space when cases without inflammation reaction. MAIN OUTCOME MEASURES:The wound healing,regression of breast induration,as well as complication and long-term curative effect was followed up. RESULT:The 0.3-3 years follow-up showed that the whole PAMHG was cleared in 7 cases,a majority of PAMHG was cleared in 8 patients,and partially PAMHG was remained in ectopectoralis of 8 patients. All the breasts of the patients were good at exterior. No obvious nodules,infection,ulcer or gel migration occurred. All patients were satisfied with the surgical results. CONCLUSION:It is feasible and safe to implant prosthesis simultaneously with minimal residue of PAMHG if there is no inflammatory reaction.

Aim To observe the correlation between the TPL's suppression on myofibrolbasts(MFBs)activation and TGF-β1/ERK/Smad3 pathway by performing in vivo and in vitro experiments.Methods In vitro model of MFBs activation was set up by stimulating fibroblasts with TGF-β1,and in vivo model of MFBs activation in radiated lung tissue was built by thoracic radiation on C57BL/6 mice.MFBs activation was analyzed by detecting the expression of α-SMA(using RT-PCR and Western blot)and Col Ⅰ(using RT-PCR and ELISA methods).The levels of p-ERK,p-Smad3(Ser208)and p-Smad3(Ser423)were measured by Western blot.ERK siRNA and Smad3 siRNA were used to observe the status of ERK and Smad3 in MFBs activation.Results TGF-β1 activated p-ERK/p-Smad3(Ser208)and p-Smad3(Ser423),increased the expression of α-SMA and synthesis of Col Ⅰ,which indicated MFBs activation.siRNA knockdown assay showed that both ERK and Smad3 were involved in regulating the levels of α-SMA and Col Ⅰ,and ERK influenced MFBs transformation possibly through its phosphorylation of Smad3(Ser208).TPL treatment inhibited the phosphorylation activation of ERK,Smad3(Ser208),Smad3(Ser423)in vitro and in vivo,therefore significantly reduced the level of α-SMA and Col Ⅰ,and the number of activated MFBs was decreased.Conclusion TPL mitigates radiation-induced pulmonary fibrosis by inhibiting the activation of MFBs,which is partly through suppressing TGF-β1/ERK/Smad3 pathway.

Objective To compare the efficacy and side effects of S-1 combined with oxaliplatin and capecitabine combined with oxaliplatin in treatment of advanced gastric cancer. Methods From Mar 2011 to Dec 2014, the data of 93 cases with gastric cancer in Zhengzhou Peopleˊs Hospital were studied retrospectively. 48 cases treated by S-1 combined with oxaliplatin (SL group) and 45 cases treated by capecitabine combined with oxaliplatin (XL group). The patients of SL group received S-1 80 mg·m-2·d-1, bid, po, d1-14, L-OHP 130 mg/m2, ivgtt, 2 hours, d1. The patients of XL group received capecitabine 2 000 mg·m-2·d-1, bid, po, d1-14, L-OHP 130 mg/m2, ivgtt, 2 hours, d1. The course was 21 days in two groups. The efficacy and side effects were evaluated after two courses. Results The efficacy rates of SL and XL group were 52.08 % (25/48) and 53.33 % (24/45), respectively there was no significant difference (P > 0.05). The incidence rate of gastrointestinal reaction in SL group was obviously higher than that in XL group [52.08%(25/48) vs 24.44%(11/45), P<0.05]. The incidence rate of oral mucositis in SL group was significantly lower than that in XL group [25.00 % (12/48) vs 51.11 % (23/45), P< 0.05]. Conclusion Both S-1 combined with L-OHP and capecitabine combined with L-OHP for gastric cancer treatment are safe and effective.