ObjectiveTo prospectively investigate whether any of the perfusion parameters would predict early tumor response to chemotherapy and/or radiotherapy and prognosis in non-small cell lung cancer (NSCLC). MethodsIn a prospective series, Perfusion CT were performed in 152 patients suspected lung cancer with 16-slice or 8-slice multislice CT. Contrast medium (50 ml) was injected at a rate of 4 ml/s with a power injector.The scanning delay was 10 seconds and the scanning time was 50 seconds.Among 152 patients,123 patients were proved lung cancer by pathology.With the perfusion 3.0 software, the parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and capillary permeability surface area product (PS) were calculated. The perfusion image quality was evaluated on a 4-1eveal scale. The treatment response after chemotherapy and(or) radiotherapy was assessed with Response Evaluation Criteria in Solid Tumors (RECIST) ,and then the relationship between perfusion parameters with early tumor response to chemotherapy and(or) radiotherapy was evaluated. Student t test and Kaplan-Meier estimates were used for data analysis. ResultsIn 84 patients (68.3%), the perfusion image quality was staged level 2 (moderate) and level 3 (good). Among them, 35 patients with NSCLC were assessed with RECIST after chemotherapy and (or) radiotherapy.In these 35 patients, The BF of responders and nonresponders was (81.0±33.6)and (56.3±23.1) ml·min~(-1)·100 g~(-1),respectively, which was significantly different(t=2.393, P=0.023). The median PFS of low-BF group (BF≤80 ml·min~(-1)· 100 g~(-1)) and high-BF group (BF>80 ml·min~(-1)·100 g~(-1)) was 11.8 and 8.0 months respectively (P>0.05), and the median PFS of low-BV group (BF≤6 ml/100 g~(-1)) and high-BV group (BF>6 ml/100 g~(-1)) was 9.2 and 8.0 months respectively(P>0.05), both of them were not significantly different.ConclusionNSCLC in high perfusion are relatively sensitive to chemotherapy and/or radiotherapy, and the response rate is relatively higher, but the progress time is relatively shorter.

Objective To study the chemical components of Anemarrhenae Rhizoma;To establish a method to determine the content of vitexin;To compare the content difference of vitexin from Anemarrhenae Rhizoma before and after salt processing. Methods 70% ethanol extract of Anemarrhenae Rhizoma was separated and purified by silica gel column chromatography technique, and compound was identified by physicochemical properties and spectral data. HPLC was used with Ecosil column (4.6 mm×150 mm, 5μm), mobile phase of acetonitrile-0.2%acetic acid solution (14.5∶85.5), velocity of 1.0 mL/min, and determine wavelength of 340 nm. Results The compound was vitexin, a good linearity (r=0.999 8) in the range of 0.039 8-1.99μg. The average recovery rate was 98.02%, RSD=0.21%. Vitexin content was 0.008 5% in crude Anemarrhenae Rhizoma, 0.008 1% in processed products. Conclusion This is the first time separation of vitexin from Anemarrhenae Rhizoma. The method for content determination of vitexin is accurate, specific, and highly sensitive in the present experiment. Content of vitexin decreases slightly in processed products of Anemarrhenae Rhizoma compared with crude Anemarrhenae Rhizoma.

Objective To investigate the gene polymorphism of tumor necrosis factor (TNF) in patients with inflammatory bowel disease (IBD) among the Han nation and its role in the pathogenesis of IBD. Methods Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) were used to analyze the gene polymorphism of TNF? and TNF? in 131 cases of IBD. Results The genotype frequency and allelic frequency of TNF?-308 in ulcerative colitis (UC) patients (15.5% and 8.7% ) were significantly higher than those in control subjects (4.1% and 2.0% respectively, P

Objective To improve the effects of health education(HE)and satisfaction degree on HE of inpatients by executing hierarchical full-responsibility nursing. Methods Fourteen wards were randomly chosen form the hospital and divided into the control group and the experimental group, each group having 7 wards. The control group carried out routine holistic nursing model, and the experimental group carried out a new hierarchical full-responsibility nursing system. Reforming nursing scheduling and diminishing the nursing unit to assure that the patients acquired the continous and stable nursing service when they were in hospital. The effect and the degree of satisfaction of HE were compared between two groups after 6 months. Results The effects of HE in the experimental group were significantly better than those in the control group, and the degree of satisfaction on HE in the experimental group was much higher than in the control group. Conclusions The hierarchical full-responsibility nursing system can give patients systematic and normalized HE. It can significantly improve the effects and the degree of satisfaction on HE.

Objective To evaluate the effect of off-pump coronary endarterectomy (CE) plus off-pump coronary artery bypass grafting (off-pump CABG) on patients with chronic total occlusion (CTO) combined with diffuse distal atherosclerosis. Methods From October 2006 to August 2009,65 CTO patients with 176 angiographically confirmed vascular stenosis or occlusive lesions, 70 of which were complete occlusion, underwent off-pump CABG. During the operation, diffuse intimal thickening distal to occlusive lesion was found, and blood flow of the bridges was unfavorable.Results Therefore endarterectomy was performed, followed by CABG. The blood flow in the bridges were 2-10 ml/min versus 14-37 ml/min before versus after endarterectomy. Pulsatility index (PI) was 5.1-15.6 versus less than 5 before versus after endarterectomy. Left ventricular ejection fraction was also improved significantly [before operation: (0.47±0.12)%, after operation: (0. 52±0.15)%, t=2.17, P＜0.05]. Peri-operative myocardial infarction occurred in 2 cases, but without significant cardiac homodynamic changes. And 23 patients underwent coronary angiography to evaluate graft patency 3-18 months after operation, all of them had favorable blood flow. Conclusions It is feasible to perform off-pump CABG plus coronary endarterectomy for patients of chronic coronary total occlusion combined with diffuse distal atherosclerosis. This treatment is safe and effective.

[Summary] Type 2 diabetic rat model accompanied by insulin resistance was established by high fat/high glucose diet and streptozotocin.Following metformin treatment for 4 weeks,realtime PCR and Western blot were used to detect the expressions of SIRT3 mRNA and protein in skeletal muscle tissue,respectively.The results showed that insulin sensitivity,superoxide dismutase (SOD),and glutathione (GSH) levels were significantly reduced in diabetic group compared with the control group (P＜0.05),while methane dicarboxylic aldehyde (MDA) level was increased (P＜0.05),along with the decreased expressions of SIRT3 mRNA and protein in skeletal muscles (P＜0.01).After metformin treatment,the insulin sensitivity,SOD,GSH,and SIRT3 mRNA and protein levels were significantly increased (P＜ 0.05 or P＜ 0.01),while MDA level was decreased (P ＜ 0.05),suggesting that metformin may ameliorate insulin resistance via upregulating SIRT3 expression in skeletal muscles of diabetic rats.

Objective To analyze the clinical efficacy,adverse events and corresponding preventive measures of high dose methotrexate in the treatment of acute lymphoblastic leukemia(ALL).Methods Ninety-two patients with ALL who hospitalized in Heamotology Department of Jinshan Hospital Affiliated to Fudan University were randomly divided into observation group and control group,and each group had 46 cases.Patients in observation group were given high dose melhotrexate + vincristine + cytoxan + pirarubicin chemotherapy treatment,and in control group were given soft red enzyme + vincristine + metacortan dracin + L-asparaginase treatment.The clinical efficacy,adverse events and the required course of remission of two groups were compared.Results The total effective rate in the observation group was 84.78％,while it was 80.43％ in the control group,and there was no statistically significant difference (x2 =0.45,P ＞ 0.05).The average remission was (1.26 ± 0.28) in the observation group,while (1.31 ± 0.31) in the control group,and no significant difference was observed (t =2.13,P ＞ 0.05).The complete remission rate of initial treatment,retreatment and refractory were 75.00％ (24/32),50.00％ (4/8) and 33.33％ (2/6) respectively in observation group,while 76.67％ (23/30),50.00％ (4/8) and 25.00％ (2/8) respectively in control group,and there was no statislically significant difference between two groups (x2 =0.98,P ＞0.05).The rate of bone marrow suppression in the observation group(23.91％) was lower than that in the control group(43.48％),while the rate of liver and kidney injury(54.35％) was higher than that inthe control group(17.39％),which showed significant difference (P ＜ 0.05).The survival rate of 5 years in observation group was 67.39％,while 45.65％ in control group,and there was statistically significant difference between two groups (P ＜ 0.05).Conclusion The high dose methotrexate in the treatment of acute lymphoblastic leukemia was proved to be effective and the adverse reactions could be tolerated.

Objective: To observe the clinical efficacy of acupuncture plus patent Chinese medicine in treating post-stroke constipation. ＜br> Methods: Sixty eligible patients with post-stroke constipation were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture plusMa Zi Ren pill, while the control group was byMa Zi Ren pill alone. The symptoms of constipation were observed before and after intervention. ＜br> Results: After 2-week treatment, the constipation condition was improved in both groups, and the improvement in the treatment group was statistically more significant than that in the control group (P＜0.05); respectively two weeks and a month after the intervention, the treatment group was superior to the control group in comparing the constipation score (P＜0.05). However, acupuncture didn’t show marked effect in improving defecation speed, initial defecation time, and spontaneous discharge frequency. The treatment group had a significantly higher short-term markedly-effective rate compared with the control group (P＜0.05); the long-term therapeutic efficacy of the treatment group was significantly higher than that of the control group (P＜0.05). The adverse events happened in the treatment group were significantly less than those in the control group (P＜0.05). ＜br> Conclusion: Acupuncture at specific acupoints plus patent Chinese medicine can produce a content therapeutic efficacy.

OBJECTIVE: To study the relationship among the dosage, serum concentration and clinical effect of phenytoin(PHT) in treating epileptic patients .METHODS: 130 steady -- state serum concentrations of PHT were determined by fluores-cence polarization immunoassay(FPIA) in 70 patients with or without other drugs used in combination .RESULTS: The indi-vidual difference among the patients who received routine dosage of PHT was very significant. Intoxication occurred ex-tremely often in patients whose PHT serum concentrations were over 30?g/ml .CONCLUSION: It is necessary to perform TDM(Therapeutic Drug Monitoring) and individualize the use of PHT,so that the safe and effective use of drug can be ensured.