Abstract To analyse the mechanism of TECA bio-artificial liver support system(BALSS)to treat acute liver failure (ALF) canines. The blood of partial liver resection-induced ALF canines or RPMI1640 solution were circulated in the inner space of the hollow fibers (blood loop), and porcine hepatocytes were cultured in outer space of the hollow fibers (cell loop). The concentrations of lidocaine, albumine and urine in the RPMI1640 solution were measured. The compositions of proteins in cell loop and blood loop were analysed by polyacrylamide gel electrophoresis (PAGE). The ultrastructure of porcine hepatocytes in BALSS was observed with transmission electronic microscopy. There were not any proteins in RPMI1640 solution before BALSS circulation. After 6 hours of the BALSS circulation, the concentration of lidocaine in RPMI1640 solution decreased significantly,and concentration of albumine and urine nitrogen increased gradually. The ultrastructure of the porcine hepatocyte shown damaged after BALSS 6h. The results suggested that TECA BALSS could replace temporarily the functions of failure liver by the effects of biologic transform and synthesis of porcine hepatocytes.

Objective　To investigate the prognostic significance of N1 stage in non-small cell lung cancer (NSCLC) by comparing is survival with N0 and N2 stages. Methods　From Jan. 1982 to Dec. 1994, 138 NSCLC patients with surgical-pathological N1 stage had received complete mediastinal lymph node dissection. Two subgroups of N1 node were identified by using New Regional Lymph Node Classification for Lung Cancer Staging. Their prognostic significances were tested and 5-year survival rates were compared with those of surgical-pathological N0 (307 cases) and N2 (176 cases) patients received radical operation during the same period. Results　The overall 5-year suvival rate of N1 patients was 30.4 %. five-year survival was significantly better when N1 involvement was intralobar as compared with extralobar involvement, 50.3 % versus 26.5 % (P=0.001). Intralobar N1 5-year survival was similar to that of N0 (51.4 % vs 50.3 %), and extralobar N1 5-year survival was similar to that of N2 with singl focus (26.5 % vs 23.5 %). Conclusion　N1 stage in NSCLC is a compound with two subgroups; the prognostic significance of intralobar subgroup is related to N0 stage and extralobar subgroup is related to that of single focus N2.

Objective To analyze the relationship among the general self-efficacy,self-esteem and professional identification of nursing baccalaureate students and to provide some suggestions for educational practice. Methods A total of 403 nursing baccalaureate students in traditional Chinese medicine colleges were recruited. They were investigated with general self-efficacy scale (GSES), Rosenberg self-esteem scale(SES)and questionnaire for baccalaureate nursing students (QBNS). The relationship among general self-efficacy,self-esteem and professional identification was analyzed by multiple stepwise regression analysis. Results The mean score of general self-efficacy was 23.81± 5.27. There were significant differences in the score of general self-efficacy among different grades and enrollment methods (P<0.01). The nursing students,general self-efficacy was positively correlated with self-esteem,professional identification,professional emotion and professional skills(r=0.11-0.50, P<0.05). Conclusions Nursing educator should pay attention to the cultivation of self-esteem and professional identity in the training of nursing student in order to improve the self-efficacy of nursing students.

Objective To establish a HRM assay to screen for KRAS mutations in clinical colorectal cancer patients.Methods The sensitivity of HRM was analyzed by detecting somatic mutations in exon 2,notably codons 12 and 13 of the KRAS gene in the serial plasmid mixture samples which were mixed using the different proportions mutation plasmid and wide type plasmid of KRAS.HRM analysis was performed for KRAS on DNA insolated from a panel of 60 colorectal cancer samples derived from fresh tissues.The results were compared with the direct sequencing data.Results After the PCR amplification,the mutation results could be available by performing HRM analysis in the same tube on a real time PCR machine with HRM capability.HRM detection could identify KRAS mutation in a proportion of 10% of mutation plasmid DNA.All 60 samples identified the KRAS mutation by HRM and sequencing.17 samples were positive(28.3%) by HRM for KRAS exon 2 mutations,and 15 samples were confirmed the presence of codon 12 or 13 mutations(25.0%) and the other 2 samples were wild type by sequencing.The 60 samples detected by HRM were given 100% sensitivity with 96% specificity.Conclusions HRM is a sensitive intube methodology to screen for mutations in clinical samples.HRM will enable high-throughput screening to gene mutations to allow appropriate therapeutic choices for patients and accelerate research aimed at identifying novel mutations in human cancer.

BACKGROUNDTo investigate the role of interferon-alpha (IFN-α) in completely resected stage I and II non-small cell lung cancer (NSCLC) patients.

METHODSForty-four stageIand II NSCLC patients were randomized to two groups. Study group (surgery+IFN-α) received IFN-α injection, 3 million unit, every two days, with a period of treatment of 90 days. Control group (surgery only) received no adjuvant therapy until relapse or metastasis were detected. pTNM stage, histological types, relapse or metastasis, survival time were observed and evaluated.

RESULTSMedian follow-up was 49.9 months. The 1-, 2-, 3-, 4-year survival rates were 90.5%, 80.9%, 52.4%, 52.4% in the study group and 95.2%, 80.9%, 66.0%, 50.8% in the control group respectively. No significant statistic difference was found between the two groups ( P = 0.663 9 ). Kaplan-Meier and Cox Model analysis showed pTNM stage ( P =0.010 2), N status ( P =0.015) and weight loss ( P =0.030) were prognostic factors in completely resected stage I and II NSCLC.

CONCLUSIONSPostoperative low-dose IFN-α short-term therapy cannot significantly improve 3- and 4-year survival rates of patients with stage I and II completely resected NSCLC.

BACKGROUNDRRM1 may be a prognostic factor in non-small cell lung cancer (NSCLC). The aim of this study is to evaluate RRM1 expression and prognosis in NSCLC by the means of tissue microarray.

METHODSA total of 417 paraffin-embedded specimens of NSCLC from Lung Cancer Study Center in Guangdong Provincial People's Hospital were collected and tissue microarray was constructed. RRM1 expression was detected by SP method and its correlation with prognosis was evaluated.

RESULTSNo statistic difference was found in RRM1 expression in different gender, age, tumor site, histology, differentiation, T stage, N stage, M stage and pTNM stage groups (P > 0.05). Univariate analysis showed that RRM1 was not an independent prognostic factor (P > 0.05). At the multivariate analysis, differentiation and N stage were considered independent prognostic factors.

CONCLUSIONSRRM1 expression detected by immunohistology is not an independent prognostic factor in NSCLC. TNM stage is still the best prognostic factor up to now.

OBJECTIVETo study the survival and prognostic factors of stage III N2 non-small cell lung cancer (NSCLC) after surgical treatment.

METHODS266 patients with stage III N2 NSCLC underwent operation from 1982 to 1996, with the 5-year survival rate compared with those of stage N0 and N1 patients who received operation in the same period. Histological classification, number of positive nodes, location and extent of mediastinal lymph node involvement, T primary tumor status, complete or incomplete operation, the procedure of operation were univariately and multivariately analyzed to determine their impact on the 5-year survival.

RESULTSThe 5-year survival rate of patients with stage III N2 non-small lung cancer after surgical treatment was 17.3%, which was significant lower than those with N0 (51.4%) and N1 (30.4%). Four prognostic factors significantly influenced the outcome: number of positive nodes, location and extent of mediastinal lymph node involvement, T primary tumor status and complete resection of the tumor.

CONCLUSIONPatients with stage III N2 NSCLC are candidates for surgical treatment if they have evidence of limited mediastinal lymph node metastasis and prospects of complete resection.

Aged ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; mortality ; secondary ; surgery ; Female ; Humans ; Lung Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Rate

BACKGROUNDTo explore the experience of gefitinib molecular target therapy for Chinese patients with non-small cell lung cancer (NSCLC).

METHODSThe unpublished data of gefitinib for advanced NSCLC in 7 hospitals were collected. The detailed data from Guangdong Provincial People's Hospital were analyzed.

RESULTSA total of 282 patients with advanced NSCLC was treated with gefitinib from July 2001 to December 2003. Response rate was 22.2%-47.7%, disease control rate 62.6%-81.8%. No severe side effects were surveyed.

CONCLUSIONSGefitinib can be used safely and effectively in Chinese patients with advanced NSCLC.

Objective To evaluate the value of MR angiography in thrombolytic therapy of acute ischemic stroke. Methods According to inclusion criteria, 65 patients who also having large vessel occlusion were selected, and they were performed rt-PA treatment (38 patients) and routine treatment (27 patients) within 3-6 hours of onset of symptoms, respectively. Mann-Whitney U test and chi square test were performed to compare the clinical and MR imaging baseline index and the clinical outcome between the two groups respectively. Clinical outcome was assessed after 3 months using a dichotomized modified Rankin scale score.Data were also compared with the combined analysis of the ATLANTIS, ECASS, NINDS rt-PA trials. Resets The difference of clinical outcome in 3 months between the two groups was significant (P < 0. 05) and the median of the two group was 1 and 3, respectively. The ratio of favorable outcome (mRS 0-1) in the two groups was 52. 6% (20/38) and 33.3% (9/27), respectively. Conclusion MR angiography plays an important role in thrombolytic therapy of acute ischemic stroke and it should be used to consummate the conventional inclusion criteria, the patients with large vessel occlusion should be treated by rt-PA.

ObjectiveTo investigate the fusion sequence complexity of EML4-ALK in non-small cell lung cancer (NSCLC) patients,and the potential mutation in tyrosine kinase ( TK ) domain of ALK gene.MethodsIn routine practice,a novel echinoderm microtubule-associated protein-like4 and anaplastic lymphoma kinase (EML4-ALK) V3c variant was detected by rapid amplification of cDNA ends-polymerase chain reaction ( RACE-PCR )-sequencing technology in a patient with NSCLC.The further consecutive 39 cases( total of 40 cases)were screened by use of reverse transcription (RT)-PCR for EML4-ALK fusion.Positive PCR products were purified and cloned into T vectors,transformed into DH5a germ cells and colony picked up and sequenced for sequence complexity analysis.Tyrosine kinase domain of ALK was amplified by RT-PCR and sequenced.ResultsThree out of 40 cases had EML4-ALK fusion.One case had six novel variants of EML4-ALK co-existing,termed as V3c ( 64.6％ ),V3d ( 25.0％ ),V3e ( 2.1％ ),V3f (4.2％ ),V3g(2.1％ )and V3h(2.1％ ) variants,whereas without common V3a and V3b variants.In other two positive cases,one was V1 variant,another was concurrent V2,V3a and V3b variants.No mutations were detected in the TK domain of EML4-ALK in any case.ConclusionsSeveral EML-ALK variants could co-exist in a given lung cancer tissue,which suggest that the diversity and sequence complexity of EML4-ALK fusion are exist.Attentions should be paid to screen all the variants in clinic to improve the pick-up rate.