Objective To analyze the Cost-effect of small cell lung cancer by drug economics.Methods 55 patients of small cell lung cancer were devided into 3 groups,CAV,PE and GP scheme,we evaluated the cost and effect based on drug economics.Results The effectiveness rate of CAV was 50 %,the cost of CAV was 340.76 yuan(RMB),the cost of 1 % increasing of effectiveness rate was 6.82 yuan(RMB);The effectiveness rate of PE was 71.9%,the cost of PE was 755.26 yuan(RMB),the cost of 1% increasing of effectiveness rate was 10.5 yuan(RMB);The effectiveness rate of GP was 85.7%,the cost of GP was 12 372.04 yuan(RMB),the cost of 1% increasing of effectiveness rate was 144.36 yuan(RMB).Conclusion PE is the most reasonable chemotherapy scheme for small cell lung cancer.

AIM: To determine the contents of protocatechuic acid,peoniflorin,coumarin,cinnamic acid,cinnamaldehyde and glycyrrhizic acid in categorized formulas about Guizhi Decoction (Ramulus cinnamoni,Radix paeoniae alba,Rhizoma zingiberis recens,Radix et Rhizoma glycyrrhizae and Fructus jujubae) by HPLC.METHODS: The gradient elution mode was applied in chromatographic separation.The C18 column was used with the mobile phase of 0.05% phosphoric acid-acetonitrile,flow rate was at 1.0 mL/min,detection wavelength at 230 nm and 254 nm,and the column temperature was at 30 ℃.The contents of the above-mentioned six constituents were determined in Guizhi Decoction,Guizhi Decoction plus Ramulus cinnamoni and Guizhi Decoction plus Radix paeoniae alba,respectively.The differences among all combinations were tested by one-way analysis of variance using SPSS software.RESULTS: The concentrations of the above-mentioned six constituents in different decoctions were simultaneously determined by HPLC and the linear equations of six constituents were established.Compared with Ramulus Cinnamomi alone,cinnamic acid content decreased and protocatechuic acid content increased in categorized formulas about Guizhi Decoctions significantly,but then coumarin content increased in Guizhi Decoction and Guizhi Decoction plus Radix paeoniae alba.Compared with Radix Paeoniae Alba alone,peoniflorin content decreased in categorized formulas about Guizhi Decoctions significantly.Compared with Radix et Rhizoma Glycyrrhiza alone,glycyrrhizic acid content increased in categorized formulas about Guizhi Decoctions significantly.CONCLUSION:The methods are accurate,reproducible and suitable for determineation of the contents of six constituents in categorized formulas about Guizhi Decoctions,Results show that the contents change with different decoctions.

Objective To study the characteristics of liver injury induced by simvastatin combined with HRZ (Isoniazid,Rifampicin and Pyrazinamide) in SD rats.Methods Fifty-four 8-week-old SD rats were randomly divided into 3 groups:group A (control),group B (HRZ) and group C (simvastatin combined to HRZ),half of each group were male.We calculated the accurate dose respectively before those rats were given intragastrical administration of corresponding drugs.Six rats were killed in each group on 10th,20th and 40th day,respectively.Before this,blood was fastened from femoral of every rat that would be killed to test liver function,liver tissue slices were made in order to observe the pathological characteristic.Results Alanine amiotransferase of group C elevated in line with time and reached statistic difference on 40th day,furthermore,it was significantly higher than group A (P＜0.05).Total bilirubin and direct Bilirubin of group C were significantly higher than those of group A from the beginning to the end (P＜0.05),however,they declined rapidly on 10th day,this trend also had statistic difference (P＜0.05) At the end of this experiment,hepatic cords was disordered slightly,but swelling liver cells and vacuolar degeneration were observed,the nuleus of cell condensed.Soakage of monocytes,neutrophils,and lymphocytes occurred in the portal and lobule regions,or even spotty necrosis occasionally.Conclusion Cholestasis occurs at the early stage when simvastatin is combined with HRZ in SD rats,however,it has a rapidly degressive trend.In contrast,Alanine amiotransferase elevates,furthermore,pathological injury or even spotty necrosis can emerge in liver tissue slices.

ObjectiveTo review the clinical features,management and prognosis of renal Ewing's sarcoma (ES) of a single case report.MethodsA single case of renal ES was reported.A 33-year-old male presented with a mass in the left kidney found during a three day medical examination.B-ultrasound examination showed a lesion with rich blood flow signals and well defined margins in the inferior portion of the left kidney.The CT scan revealed a solid mass of 5.1 cm × 4.7 cm in the inferior portion of the kidney with un-even enhancement by contrast.A possible diagnosis of renal carcinoma was given prior to surgery.No metastasis was proven.A literature review of ES was then conducted.ResultsA left retroperitoneoscopic radical nephrectomy was successfully performed.Gross pathologic examination showed a solid tumor with necrosis,localized at the inferior pole of the left kidney.The histopathological examination revealed the tumor consisted of small round tumor cells,which were positive for CD99,vimentin and PAS,but negative for WT-1.A diagnosis of ES of the kidney was then determined.The patient received alternating short cycle ( CTX + VCR + THP) and long cycle ( IFO + VP-16) adjuvant chemotherapy for 6 cycles after the operation.There has been no evidence of recurrence at the 14-month follow up.ConclusionsES of the kidney is a rare disease with no specific clinical feature in most cases.Diagnosis of renal ES must be confirmed with histological features.Surgery combined with radiotherapy and chemotherapy is the main method of therapy for renal ES.The prognosis of renal ES is poor.

Objective To summarize the types and imaging features of periosteal anomaly in osteosarcoma.Further to seek the feature of genesis and advancement of periosteal anomaly and its clinical significance.Methods One hundred and twenty-eight patients with osteosarcoma were enrolled in this study,which consisted of 76 males and 52 females aging from 5 to 66 years old with an average of 19 years.Both x-ray plain film and MR images were obtained in all patients.and DWI were done in 23 patients.CT scanning was conducted in 48 patients.which included post-contrast scanning done in 36.The pathological gross specimen,macrosection and point-to-point microsection were obtained in each of 14 cases to correlate the imaging findings of periosteal anomaly to the pathological outcome.Results The imaging and pathological finding:(1)Periosteodema,occurring in 96 patients.The sign was merely demonstratable on MR image and presented as loosened periosteal structure with no tumoral infiltration pathologically.(2)Periosteal lift and thickening,demonstratable on both CT and MR image,including 13 noted on CT and 42 on MR image.Pathologically,non-tumoral infiltration was noted in the thickened periosteum.(3)Periosteal destruction,occurring in 48 patients.Periosteal destruction was merely demonstratable on MR image and presented as localized or generalized tumoral infiltration of the periosteum.(4)Linear periosteal neo-bone formation,demonstrated in 42 cases on plain films,13 cases on CT and 22 on MR images,respectively.The linear periosteal neo-bone formation was pathologically regularly arranged periosteal neo-bone.(5)Laminar periosteal neo-bone fomarion,demonstrated in 21 cases on plain films,6 cases on CT and 21 on MR images,respectively.Pathologically,it appeared as multi-layer arrangement.(6)Radiated and spiculate periosteal neo-bone formation,demonstrated in 13 cases on plain films,7 cases on CT and 14 on MR images,respectively.On both plain film and CT,the closer to the center of the tumor,the longer and denser the spicule was.The interspiculate structure was tumoral tissue pathologically.(7)Periosteal neo-bone formation of mixed type,demonstrated in 7 cases on plain films,4 cases on CT and 8 on MR images,respectively.It was composed of 2 types or more of periosteal neo-bone.Conclusions (1)Multiform periosteal anomaly can be induced by osteosarcoma,and difierent periosteal anomaly possesses different imaging findings and different pathological basis.(2)The pathologically-based classification of periosteal anomaly generalizes the 3-modality imaging findings of various periosteal pathological alterations.(3)MR imaging enables to demonstrate periosteal anomaly more early,and periosteodema and periosteal destruction without neo-bone formation can only be demonstrated by MR imaging.MR imaging is more sensitive than CT in displaying periosteal thickening.

Objecfive To investigate the role of serum Insulin-like growth factor(IGF)-1,insulinlike growth factor-binding potein(IGFBP)-3 in children with Henoch-Schonlein purpura(HSP).Methods The serum concentration of IGF-1,1GFBP-3 was measured by enzyme-linked immunosorbent assay(ELISA)method in 45 acute SHP patients,40 recoverv patients and 30 healthy controls.Results The serum levels of IGF-1 [(452±183)μg/L],IGFBP-3 [(13 897±3124)μg/L] and C-reactive protein(CRP)[(20±8)mg/L]in acute phase were significantly higher than those in healthy controls(P<0.0 1)and higher than those during recovery period.The serum level of IGF-1,IGFBP-3 for the HSP patients dropped back slowly and their levels during recovery period were the same as those in healthy controls(P>0.05).The serum levels of IGF-1[(621±253)μg/L] and IGFBP-3[(18 763±3173)μg/L] were higher in the renal damage group than in the non-renal damage group(P<0.01).and the same in patients with gastrointestinal symptoms group as in patients without gastrointestinal symptoms group(P>0.05).whereas the serum level of CRP was not significantly different(P>0.05).The serum levels of IGF-1,IGFBP-3 showed positive correlation with the level of CRP(r=0.624,0.672,P<0.01).Conclusion The IGF-1 and IGFBP-3 may play an important role in the pathological mechanism of HSP.The level of IGF-1 may be used as an indicator for HSP disease activity and progression.IGF-1 mav have a close relation with the damageof renaJ system in HSP.

Objective To assess the value of using MRI to evaluate the histopathological characteristic of limb soft-tissue aggressive fibromatosis (AF). Methods The MBI findings and histopathological data of 20 patients with AF were obtained and analyzed. The difference between the different signal regions in AF were compared of signal intensity in T1-weighted images, T2-weighted images and degree of enhancement. The data were processed with paired t test. The histopathology of different signal regions was observed in 6 cases on HE stain and Masson trichromic stain of AF specimen. Results (1) AF predominantly originated from the skeletal muscles (19/20), presenting as Iobulated mass with infiltrative growth(20/20) ;(2) A few claw-shaped neo-arteries(7/7) were delineated in the periphery of the mass in the 3D DCEMRA images as well as the mild tumor staining(7/7) ; (3) Based on the MRI findings, the porenchyma of 20 AF was divided into two distinct regions of structure: region Ⅰ and region Ⅱ. Region Ⅰ presented as hypointensity on both T1-weighted and T2-weighted images and no enhancement after i. v. administration of contrast. Region Ⅱ presented as mild hyperintensity on T2-weighted images and iso- or hypointensity on T1-weighted images and marked enhancement; (4) The signal intensity in T1-weighted images, T2-weighted images and degree of enhancement was 0. 10 ± 0. 02,0. 24 ± 0. 03, and ( 5.22 ± 0.42)% in region Ⅰ , respectively; and 0.79±0.04,3.05±0.08 and(151.5±8.61)% in region Ⅱ, respectively. The differences between region Ⅰ and region Ⅱ were statistically significant of signal intensity in T1-weighted images( t = 67. 37 ), and signal intensity in T2-weighted images( t = 196. 56) and degree of enhancement(t =76. 62) (P <0. 01 ) ; (5) Histologically, AF was composed of fibroblasts, fibrecytes and bundles of collagen fiber. On Massen triehromie stain, region Ⅰ was stained blue, being proven the mature collagen fibers. Region Ⅱ was predominantly composed of fibroblasts, fibrecytes and was not stained. Conclusion The region Ⅰ and region Ⅱ are the characteristic MRI manifestations of AF, and MBI precisely reflects the histopathological and biological feature of the tumor.