Purpose:To compare the survival rates of hyperf ractionated radiotherapy plus concurrent chemotherapy with hyperfractionated rad iotherapy alone in the treatment of stage Ⅲ/Ⅳ nasopharyngeal carcinoma (NPC) a nd analyze the prognostic factors. Methods:Between December 1992 and December 1995, 144 NPC patien ts were randomized into hyperfractionated radiotherapy plus concurrent chemother apy (R +C) and hyperfractionated radiotherapy alone (R alone).Radiotherapy were similar in the two groups: 1.2 Gy/f, twice a day. Chemotherapy was given to R + C patients before and during the course of radiotherapy. Results:The 5-year overall survival rates of the R + C and R alone groups were 63.3% and 50.7%,repectively . The factors influencing the resu lts were N stage,chemotherapy and the peripheral blood hemoglobin concentration . Conclusions:Hyperfractionated radiotherapy plus concurrent chem otherapy can improve the survival rate, especially for the patients with N2-N3 stage.The negative prognostic factors for Ⅲ/Ⅳ NPC are N2-N3 stage, radiothera py alone and the reduction of hemoglobin during treatment.

Objective To investigate the infection situation of Pseudomonas aeruginosa (PA) in patients with the lower respira‐tory tract infection in the department of respiratory intensive care units (RICU ) in recent five years ,and to analyze the changing trend of antibacterial resistence ,in order to guide rational selection of antimicrobial agents .Methods Strains of bacteria were isola‐ted and identified from sputum specimen of patients in the department of RICU and common ward from Jul .2008 to Jul .2013 .The situations of PA infection and antibacterial resistence were analyzed ,and differences of infection rates of PA and antibacterial resis‐tence were compared between RICU and common ward .Results 517 strains of bacteria were detected from sputum specimens of patients in the department of RICU from 2008 to 2013 ,including 141 strains of PA (accounted for 27 .3% ) ,and ticarcilli/clavulanic acid(61 .0% ) was with the highest rate of resistance among 14 drugs and colistin B(9 .2% ) was with the lowest rate of resistance . 378 strains of bacterias were detected from sputum specimens of patients in common wards ,including 125 strians of PA(accounted for 33 .1% ) ,and ticarcilli/clavulanic acid(28 .0% ) was with the highest rates of resistance and colistin B (4 .0% ) was with the low‐est rate of resistance .Conclusion In recent 5 years ,PA might be one of the main pathogenic bacterias of respiratory tract infections in the depatment of RICU in this hospital ,and antibiotic resistance may increse gradually .The antibiotic resistance in the depatment of RICU may be higher than that in cionmon wards .Clinical effective measures should be taken to prevent nosocomial infection ,and rational use of antibiotics should be taken to reduce the emergence of resistant strains .

Objective To observe the Influence of Daotan decoction on nonalcoholic steatohepatitis (NASH) in Rats, and its relative mechanisms was analyzed. Methods The rat nonalcoholic steatohepatitis model was induced by high fat diet. The rats of therapeutic groups were treated with small, middle and high dose Daotan decoction respectively. Their general condition, liver index, and the fat change and inflammation of liver were observed. The serum ALT、triglyceride(TG), total cholesterol(TCH), low density lipoprotein(HCL-C), high density lipoprotein(LDL-C)were determined respectively. Results The liver index of therapeutic groups were markedly reduced respectively compared with those of model group(P0.05). The liver inflammation in therapeutic groups were improved better those in model group(P

Female ; Humans ; Obesity ; complications ; Polycystic Ovary Syndrome ; complications ; therapy

Objective To evaluate clinical features, diagnosis and treatment of anorectal malignant melanoma (ARMM).Methods The clinical data of 15 patients of ARMM in our hospital and 18 patients in the First Affiliated Hospital of China Medical University from 1990 to 2010 were reviewed.Twenty-five patients underwent curative surgical resection, 14 patients underwent abdominoperineal excision of the rectum (APR), and 11 patients underwent local excision (LE).Survival analysis was carried out.Fisher's exact test and Log-rank test was used to compare the effects of these two different surgical procedures.Results ARMM had a female predominance, the mean age was 22 -77(54.5 ± 7.6) years.The major clinical signs included hematochezia, anus pain.The misdiagnosis rate was 67% (22/33).The average tumor size was (3.5 ±1.7) cm.Thirty-one petients(94% ,31/33) had ARMM within 5 cm from anus margin.Mean survival time was (14.0 ± 6.5)months.The overall 1-,3-,and 5-year survival rates were 48% ,22% , and 10% , respectively.Local recurrence after curative LE was higher than APR (LE,64% vs APR, 21% , P = 0.049) , The overall 3-year disease-specific survival rates after curative LE was not significantly different from that of APR (LE, 28% vs APR ,31%, x2 = 0.268, P = 0.582).Conclusions Anorectal malignant melanoma has a high rate of misdiagnosis.Radical resection could not prolong the survival time significantly in anorectal malignent melanoma patients.

Objective To observe the effects of one kind of angiotensin converting enzyme inhibitor (ACE1) drugs fosinopril (FOS) on transforming growth factor β1 (TGF-β1)and β1- integrin( Itg-31 ) expression in rat glomerular mesangial cells (GMC)induced by lipopolysacchatide (LPS).Methods We established the cultured glomerular mesangial cells of rat in vitro and passages 3 ～ 10 of cells were used in the experiment after identification.The experiment included the following groups:Control group,LPS induced group (LPS group) and FOS intervened group.According to the different concentrations of FOS,FOS intervened group was divided into high,middle and low dose FOS groups,which were FOS1 group,FOS2 group and FOS3 group respectively.The changes of TGF-β1 protein secretion was detected by the enzyme-linked immunosorbent-assay; The changes of TGF-β1 and Itg-β1 mRNA expression was detected by quantitative real-time RT-PCR.Results (1) TGF-β1protein secretion in rat GMC at 6h,12h,24h three time points:They were 958.55 ± 34.67 ( ng/L),1052.05 ±48.59( ng/L),1166.06 + 35.39 (ng/L) respectively in Control group.They were 1342.12 + 39.87 ( ng/L),1432.31 + 39.33 (ng/L) and 1 537.77 + 43.79 (ng/L) respectively in LPS group,which were higher significantly than those in Control group ( all P ＜ 0.01 ).They were 779.58 ± 48.64 ( ng/L),878.33 ± 29.50 (ng/L) and 962.57 ±31.94( ng/L) in FOS1 group,989.311±73.56(ng/L),1073.29±66.89(ng/L) and 1210.75 ±61.68(ng/L) in FOS2 group,1 253.78 ±45.32( ng/L),1 348.18 ±45.81 (ng/L) and 1450.06 ±46.24( ng/L) in FOS3 group respectively,which were lower significantly in all FOS intervened groups than that in LPS group (all P＜O.01).(2)TGF-β1 mRNA expressions in rat GMC at6h,12h,24h three time points were higher significantly than that in Control group.TGF-β1 mRNA expressions were lower significantly in all FOS intervened groups than that in LPS group.( 3 ) Itg-β1 mRNA expressiones in rat GMC at 6h,12h,24h three time points were higher significantly than that in Control group.Itg-β1 expressions were lower significantly in all FOS intervened groups than that in LPS group.Conclusions LPS can induce the increase of TGF-β1 secretion and mRNA expression.FOS can inhibit the TGF-β1 secrection and mRNA expession in GMC as dose-dependent manner,at the same time down regulated the Itg-β1 mRNA expression iuduced by LPS.All above supply the theoretical evidence for the renal protection of FOS by non-hemodynamics mechanism.

Objective To investigate the surgical selection of retinal detachment with myopic macular holes. Methods Management strategies were adopted according to the ocular symptoms of patients with high myopia involved in posterior chorioretinal atrophy, the colour showed by the bottom of macular holes and the shape of posterior staphyloma. Seventy-five eyes of 72 patients fulfilled the study criteria. The patients were followed up in an average of eight-month-observation and were divided into three groups: single 16% C2F6 gas tamponade (26 eyes of 26 patients) as group A,vitrectomy combined with 16% C2F6 gas tamponade (26 eyes of 23 patients) as group B and vitrectomy with silicon oil tamponade (23 eyes of 23 patients) as group C. Results 69.2%(18/26) of the macular holes were closed in group A, 73.1%(19/26)in group B and 87.0% (20/23) in group C after the primary surgery. Comparison of postoperative outcomes,macular hole closure rate was not significantly different among three groups (P= 0.3184). Conclusions It suggests that good anatomic retinal reattachment be achieved using any approach. However, the optimal surgical choice regarding of the personality case offered less surgical burden and more rapid visual rehabilitation to patients.

Medical research has entered the era of mega-science.The multidisciplinary collaboration has attracted great attention.besides studies on genes and the environment interaction,multidisciplinary research between natural sciences has received widespread recognition.However muhidisciplinary researches on the interaction between the gene and social factors or behavioral factors on health science deserve more emphasis.This article described development of multidisciplinary research and its features;analyzed importants of conducting multidisciplinary research between natural and social disciplines,and finally provided suggestions on research organization reform in order to promote the multidisciplinary research.

Objective To investigate the relationship of matrix metalloproteinases(MMP?3 and MMP?9)and the tissue inhibitor TIMP?1 with left ventricular hypertrophy(LVH)in patients with primary hypertension. Methods Totally 140 patients with primary hypertension and 132 healthy controls were included. Matrix metalloproteinase?3(MMP?3),matrix metalloproteinase?9(MMP?9)and tissue inhibitor metalloproteinase?1 (TIMP?1)were measured. All subjects were taken echocardiography examination ,then left ventricular mass index(LVMI)was calculated. Re?sults MMP?3,MMP?9,TIMP?1(488.32±100.32 vs 314.59±99.78;340.56±43.21 vs 290.15±33.98;389.16±57.53 vs 243.45±62.31;P<0.001) and LVMI(113.7±9.9 vs 88.3±10.4,P<0.001)in patients with primary hypertension were significantly higher than those in controls. In a multiple stepwise regression analysis with LVMI as the variable,it was found that age,SBP,MMP?3,MMP?9 and TIMP?1 were main determinants for LVMI (r2=0.78,P<0.001). 3. Patients with primary hypertension were divided into two subgroups according to LVMI,i.e.,hypertension with LVH (group A)and hypertension without LVH(group B). SBP,MMP?3,MMP?9 and TIMP?1(178±31 vs 166±25;490.14±99.13 vs 405.56±53.12;340.56±43.21 vs 290.15±33.98;393.45±47.69 vs 301.58±39.57;P<0.05)of group A were significantly higher than those of group B. Conclusion MMP?3,MMP?9 and TIMP?1 are influencing factors for LVH in patients with primary hypertension.

Objective To study the protective effect of total glucosides of Mudan cortex(TGM) on acute myocardial ischemia in mice and its mechanism. Methods The total of 60 mice were randomly divided into 5 groups (n = 12),normal control and model control (were given equal capacity of 0.9% sodium chloride solution),and TGM at low,middle,high dose (were given with 50,100,200 mg?kg-1 TGM).The mice were administered once daily for consecutive seven days.After the last administration,the mice in the model control and drug groups were treated by intraperitoneal injection of 15 mg ? kg-1 isoproterenol to to make myocardial ischemia animal model. TGM on the T wave and J point on ECG, and serum lactate dehydrogenase (LDH),myocardial tissue superoxide dismutase (SOD),malondialdehyde (MDA) changes was detected,and the extent of myocardial ischemic injury in mice was measured by Nagar-Olsen staining. Results TGM significantly reduced the displacement of ECG T wave and J point,and improved the related biochemical indexes in mice with myocardial ischemia.The activity of LDH [(898.992± 285.108) μmol?mg-1 ] ,the content of MDA [(11.737 ±5.162) nmol?mg-1 ]in mice treated with TGM at high dose obviously decreased in comparison to the model controls,and the activity of myocardial SOD [(45. 505 ± 20.711) U?mg-1 ] significantly elevated compared with the model control.It was showed that TGM significantly diminished the areas of cardiac muscles ischemia injured via Nagar-Olsen staining. Conclusion TGM has the remarkable protective effect on acute myocardial ischemia injury in mice.