OBJECTIVE: To study the changes of serum vascular endothelial growth factor (VEGF) and beta 2-microglobulin levels before and after radiotherapy in 58 patients with nasopharyngeal carcinoma (NPC), and to elucidate the clinical significance of VEGF and beta 2-microglobulin test before radiotherapy. METHODS: Serum VEGF level was measured by sandwich ELISA in 58 patients with NPC and 24 healthy individuals, and the serum beta 2-microglobulin was assayed with time-resolved fluoroimmunoassay. RESULTS: The serum VEGF level in patients with NPC was (174.0+/-130.0) ng/L, higher than (134.1+/-66.6) ng/L of the healthy subjects, but the difference was not significant (P>0.05). The serum VEGF level was higher in T4 and IV a patients with NPC. No significant differences in the levels of serum VEGF were found among various N classifications in the patients with NPC. Patients with the serum VEGF level higher than 267.3 ng/L (mean+2 s of the serum VEGF level in the healthy individuals) had a shorter metastasis-free survival time (P<0.05). Although the patients with high beta 2-microglobulin level had a shorter survival time, the difference was not significant. CONCLUSION: The NPC patients with high serum VEGF level have a poor prognosis.

Objective To study the influence of sufentanil on analgesic effect and hemodynamics during recovery period of general anesthesia in elderly patients.Methods Eighty patients with general anesthesia were randomly divided into 4 groups (20 cases in each group).Ten min before surgery ended patients in each group were intravenous injected different dose of sufentanil:group S1 with sufentanil 0.2 μg/kg,group S2 0.4 μg/kg,group S3 0.6 μg/kg,and group C (control group) with saline 5 ml.The time of spontaneous breath restores,the time of summon opening eyes and extubation,the cases occurred cough,nausea,vomiting during recovery period were recorded and the VRS pain scores and Ramsay score 10 min after extubation were also recorded.Mean arterial pressure (MAP) and the heart rate (HR) were recorded before the anesthesia induction(T0),stopped anesthetic (T1),pre-extubation (T2),5 min and 10 min after extubation (T3 or T4)Results As group S1 and S2 compared with group C,there was no significant difference on the time of spontaneous breath restores,the time of summon opening eyes,and the time of extubation and leaving the operating room (P ＞ 0.05).However,there was significant difference on the time of spontaneous breath restores ((7.3 ± 4.1) min vs (10.2 ± 4.7) min),the time of summon opening eyes ((8.1 ± 3.1) min vs (11.2 ± 3.7)min),the time of extubation ((12.3 ± 3.1) min vs (16.3 ± 5.9) min),and the time of leaving the operating room((21.4 ±3.0)min vs (24.2 ±3.5)min) between the group S3 and group C(P＜0.01 or P ＜0.05)Patients occurred cough in group S1,S2 and S3 were less than those in group C (P ＜0.05),but there was no significant difference on the occurrence of nausea and vomiting between group S1-3 and group C (P ＞ 0.05)There was significant difference on VRS pain score and Ramsav score between group S1-3 and group C(P ＜0.01).MAP and HR were increased in all points of time as compared with T0 (P ＜ 0.05 or P ＜ 0.01).And there was significant difference on MAP and HR between group S1-3 and group C (P ＜ 0.05 or P ＜ 0.01).Conclusion Before the end of anesthesia sufentanil 0.2 ～ 0.4 μg/kg intravenous injection could be able to enhance analgesic effect,stabilize hemodynamics and do not affect regain consciousness in elderly patients.

Objective To observe the clinical effect of gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy in treatment of advanced nasopharyngeal carcinoma.Methods Seventy-six advanced nasopharyngeal carcinoma patients were divided into observation group(38 cases)and control group(38 cases)by radom digits table.The patients in observation group were treated with gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy.The patients in control group were treated with fluorouracil combined with cisplatin concurrent chemotherapy and radiotherapy.The clinical effect and adverse reaction were compared between two groups.Results The total effective rate in observation group was 84.2％(32/38),which significantly higher than that in control group[60.5％(23/38)](P＜0.05).There was no significant difference in 1 year overall survival rate between two groups[89.5％ (34/38)vs.76.3％(29/38)](P ＞ 0.05).The rate of gastrointestinal reactions and oral ulcers in observation group were 42.1％(16/38)and 7.9％(3/38),which significantly lower than those in control group[73.7％ (28/38),31.6％(12/38)](P ＜ 0.05).The rate of bone marrow suppression between two groups had no significant difference[31.6％(12/38)vs.23.7％(9/38)](P ＞ 0.05).Conclusion Gemcitabine combined with nedaplatin concurrent chemotherapy and radiotherapy in treatment of advanced nasopharyngeal carcinoma can enhance the clinical effect,and decrease the adverse reaction,which can be applied in clinic.

Adult ; Churg-Strauss Syndrome ; complications ; Humans ; Male ; Myocardial Infarction ; complications

Objective To assess the life quality of patients with chronic hepatitis B after the treatment of lamivudine,to find an ideal way of medical treatment for the chronic hepatitis B.Methods The quality of life of 150 patients with chronic hepatitis B and 50 healthy controls were assessed by the quality of life questionnaire.The laboratory data and marks of questionnaires were compared before and after the using of lamivudine in order to assess its comprehensive curative effect on chronic hepatitis B.Results The marks of SF-36 of chronic hepatitis were significantly different compared with those of control group (P

0.05).Compared with group A,the aortic occlusion time,ventilation time and the length of stay in ICU were shorter in groups B and C(P0.05)were found between group B and C in the aortic occlusion time,ventilation time and length of stay in ICU.Conclusion TTS is a safe and reliable surgical madality for the treatment of pediatric cardiac diseases.Patients weighed over 20kg are strong enough to withstand TTS and may recover sooner.

Objective: To assess the validity and reliability of Chinese edition of SADQ. Methods: 105 stroke patients within 2 weeks after onset were assessed with Hamilton Depression Rating Scale(HAMD) and Beck Depression Inventory(BDI). While patients were completing these assessments, their carers were asked to complete SADQ in respect to the patients. SADQ was also administered to 30 carers on two occasions at a 2-week interval. Results: Test-retest reliability was 0.754, and internal consistency reliability was 0.809. The structure validity was evaluated by factor analysis. Seven factors was got that explain 65.641% of total variance. The SADQ were significantly related to HAMD and BDI(r=0.548 to r=0.488, P

[Objective]To investigate the treatment effects of the anatomical plate on proximal humeral fractures and analyze the structural characteristics of the plate clinically.[Method]From June 2003 to June 2005,comminuted fractures of the proximal humerus of 32 patients(18 males and 14 females,with average age of 39 years)were treated with anatomical plates.Fractured proximal humerus was exposed by a standard deltopectoral approach after a dissection from the deltoid and pectoral muscle.Anatomical plates were placed on lateral sides of the humerus after reduction.The arm was immobilized in a sling,passive movement was begun on the first day after surgery,and active movement of the shoulder was started after three week.Active movement with resistance was allowed when there was radiological evidence of bone healing which usually occurred after six weeks.The patients were reviewed clinically and radiologically.[Result]All 32 patients were available at follow up with mean duration of 20 months (7~28 months).No complications such as nonunion of fractures,infection,the loosening and breakage of the plate were ever occurred.The clinical results were graded as excellent in 21 patients,good in 7,fair in 2,and poor in 2 according to the Neer's classification.The excellent and good rate was 87.5%.[Conclusion]Anatomical plate for the proximal humerus holds a 3-dimensional structure,which facilitates the fracture exposure,bone fragments reduction and fixation.It is concluded that rigid fixation of displaced fractures of the proximal humerus with an anatomical plate provides sufficient primary stability to allow early functional treatment.And is advocated that primary open reduction and rigid internal fixation using anatomical plates for the proximal humerus fracture.

Objective To investigate the present status of Chinese patent medicine with realgar (As2S2) and to research arsenic dissolution in different pH values. Methods Data on the amount of Chinese patent medicine with realgar, the content of realgar, the method of taking medicine and so on were collected from the Chinese traditional medicine protection and criterions issued by the Chinese Ministry of Health in 2005, and evaluated the using status of Chinese patent medicine with realgar. The realgar powder was dissolved in solutions at different pH values (1, 3, 5, 7, 9, 11) in 37℃ water for 4 h, respectively, then arsenic was determined with cold trap hydride generation atomic absorption spectrometry to calculate the amount of dissolved arsenic. Results One hundred and twenty-one (3.13%) realgar medicaments were recorded in a total of 3 860 various Chinese patent medicaments, including 74 medicaments with both realgar and cinnabar (HgS) . Of all medicaments with realgar, 97 medicaments (80.17%) were for oral application, 10 medicaments (8.26%) were for external application, and 14 medicaments (11.57%) were for both oral and external application. 45 medicaments with realgar (1.17%) could be used in children; 108 medicaments with realgar (89.26%) contained arsenic 15%; The relative amount of arsenic in medicaments with realgar was from 0.46% to 27.52%. Daily intake of arsenic was 500 mg for 11 medicaments (9.09%). Only inorganic arsenic (iAs) was detected when 1 mg realgar was dissolved in solution with pH values of 1, 3, 5, 7, 9, 11. The levels of dissolved iAs seemed increased with the pH values, which were 1.58 ?g, 1.24 ?g, 1.57 ?g, 1.62 ?g, 2.28 ?g and 4.76 ?g, respectively. Conclusion Considering the common use of realgar in Chinese patent medicine and the high level of arsenic in realgar, the potential danger can not be ignored. It is possible that arsenic in realgar may be much easier to be absorbed in intestine than in stomach.

Unexplained syncope (UPS) is a common clinical disease.It may occur at all ages.But the pothogenisis of UPS is still unclear.There are many researches at home and abroad reporting that the cardiovascular system has endogenous circadian rhythm.And the circadian variations of autonomic nervous system,ambulatory blood pressure,and heart rate variability may contribute to the observed circadian rhythm of cardiovascular.Sudden cardiac and cerebral events are most common in the morning.The time rhythm of UPS may have potential implications for management.