Objective: To compare the efficacy and safety of different administration of pamidronate for relieving bone pain and to improve the living quality in Chinese patients with painful bone metastases due to lung cancer. Methods:96 patients with painful bone metastases due to lung cancer were randomly enrolled to group A (150 mg) or group B (90 mg). There were 53 patients receiving 150 mg of pamidronate(34 pts for 2 days and 19 patients for 5 days administration). 43 (patients) receiving 90 mg of pamidronate. Results:There were 84.9% of patients relieving bone pain in group A and (67.4%) in group B (P=0.043). The score measuring bone pain decreased from 6.47?1.45 to (3.28?)1.71 in group A and from 6.21?1.49 to 3.49?2.88 in group B after injection of pamidronate , and the mean duration for pain relief were 28.00 days and 21.00 days respectively(P

Raltitrexed is a specific inhibitor of thymidylate synthase,and has been confirmed that ralti-trexed has no cross tolerance with 5-fluorouracil.Studies have shown that raltitrexed-based combination chemo-therapy has a beneficial effect on the treatment of advanced gastric cancer,and well tolerance,which is worthy of clinical use.

Objective To know the advantages and disadvantages of problem-based learning from students'angle. Methods Interviewed 15 students by PBL scale and face to face interview,to know their ideas about problem-based learning,and then analyzed the results. Results PBL contributed to developing problem-solving skills,self-directed learning,team collaboration and extending professional knowl-edge. But it failed to show positive effect on students'learning motivation. Conclusions PBL has two sides on the outcomes of learning. Implementing PBL appropriately could gain the optimal effects.

Objective To detect and analyze nuclear factor kappa B (NF-κB),Helicobacter pylori (HP),Helicobacter pylori cytotoxin associated protein A (CagA),platelet (PLT) and platelet associated IgG (PA IgG) in 224 patients with idiopathic thrombocytopenic purpur(ITP) from three urban hospitals of Shaoxing,in order to explore the role of NF-κB and CagA in the pathogenesis of ITP,then to improve the prognosis of ITP.Methods SABC method was used to detect the NF-κB,13C breath test for the determination of the Hp infection.CagA and PA-IgG were tested by enzyme linked immunosorbent assay.Automatic blood cell analyzer was used to measure PLT.According to the test results,the patients were divided into Hp+cagA+NF-κB+,Hp+cagA+NF-κB-,Hp+cagA-NF-κB+,Hp+cagA-NF-κB-,Hp-NF-κB+,Hp-NF-κB-PLT groups,and PA-IgG,PLT of the six groups were statistically analyzed.Results Of 224 cases with ITP,175 cases of HP positive,the positive rate was 78.13%.CagA+ 91 cases in 175 cases of Hp+,accounting for 52%,overall 43.63%.NF-kappa B+ 108 cases,the positive rate was 46.21%,78 cases were found in Hp+cagA+,accounting for 85.71% in cagA+.In 84 cases of Hp+cagA-,there were 21 cases NF-κB+,the positive rate was 25%.In 49 of HP-,9 cases with NF-kappa B+,accounting for 18.37%.PLT and PA-IgG were compared among the groups.The count of PLT of group Hp+,group Hp+cagA+ and group NF-κB+ was lower than group Hp-,group Hp+cagA- and group NF-κB-.However,the level of PA-IgG of group Hp+,group Hp+cagA+ and group NF-κB+ was higher than group Hp-,group Hp+cagA- and group NF-κB-,the difference was statistically significant(P<0.05).Conclusion CagA maybe directly or through the activation of NF-kappa B take part in the immune response of ITP,cause PA-IgG increased and thrombocytopenia.

Objective To study the technology and the result of dual plane breast augmentation using nipple margin vertical incision of areola.Methods Totally 60 cases of augmentation mammaplasty were involved in this study.The nipple margin vertical incision of areola was applied obliquely into the breast through the pectoralis major fascia.The rib starting point of pectoralis major were cut off,medial to the side of the sternum.Under the pectoralis major the cavity was peeled according to the preoperative design range.Based on the different situation of the breast types Ⅰ,Ⅱ,Ⅲ,dual plane breast augmentations were stripped respectively.After implanting the breast prosthesis,the upper part of the prosthesis was under the pectoralis major and the lower part was under the mammary gland.Results The 60 patients were all after childbearing,20 of whom underwent type 2 dual plane breast augmentation,4 underwent type 3 double plane and the rest underwent type 1 double plane.After 3 months to 2 years follow-up,all cases got satisfactory results,except 1 case of postoperative hematoma and 1 case appeared capsular contracture.Conclusions The nipple margin vertical incision of areola can complete types Ⅰ,Ⅱ,Ⅲ dual plane breast augmentation operation,at the same time it can correct mild-to-moderate mastoptosis.

Objective To observe the k-ras mutation rate of colorectal cancer in China, and assess the effect and toxicity in advanced colorectal cancer (CRC) patients (pts) receiving chemotherapy combined with monoclonal antibody against Epidermal Growth Factor Receptor (EGFR). Methods The k-ras mutation of 139 samples collected from our hospital were tested by pyrophosphoric acid sequencing. Twenty-three advanced colorectal cancer patients were treated with chemotherapy combined with anti-EGFR monoclonal antibody, including 3 initial treated and 20 retreated. In the total 23 patients, 18 were treated with cetuximab and chemotherapy, and S were treated with nimotuzumab and chemotherapy. Cetuximab was taken with 400 mg/m2 first time, and then 250 mg/m2 every week. Nimotuzumab was taken with 400 mg first time, and then 200 mg every week. Eight patients of the total 23 received anti-EGFR monoclonal antibody combined with irinotecan, 12 with FOLFIRI, 3 with FOLFOX4. Results k-ras mutation type (mt) was detected in 39.6 % (55/139) of pts, k-ras wild type (wt) was 60.4 % (94/139). In 22 effect evaluable patients, 5 received PR and 9 SD, and RR and DCR were 22.7 % and 63.6 %, respectively. TTP was 124 days. Thirteen of the 22 patients tested k-ras mutation, of the 11 k-ras mt pts, 4 received PR, 4 SD and 3 PD. Two patients of k-ras mt received PD after 2 cycles treatment. Acneform eruptions were observed in 15 patients of 18 pts who received cetuximab and paronychia in 3 pts. Eruption or paronychia was not observed in all patients who received nimotuzumab. Grade 3 hypersensitivity were occured in 2 patients with cetuximab, and one of them alternated nimotuzumab in next cycle didn't get hypersensitivity any more. Conclusion The mutation rate of k-ras in Chinese colorectal cancer patients was similar with westerners. The effect of cetuximab combined with chemotherapy on advanced colorectal cancer was reliable. Nimotuzumab combined with chemotherapy worth to be studied further because of the promising effect and mild toxicity.

Objective Bevacizumab ( BM ) is an angiogenesis inhibitor widely used in cancer therapy, but its off-target effect of proteinuria may lead to discontinuation of treatment.This study was to explore the mechanisms of BM inducing proteinuria in mice. Methods Twenty-four healthy mice were randomly divided into four groups, saline control, low-dose BM, medium-dose BM, and high-dose BM, treated by injection of normal saline and BM at 10, 35, and 60 mg per kg of the body weight, respectively, though the tail vein.At 4 weeks after injection, 24-hour urine was collected to determine the total urine protein and blood obtained from the eyeballs for biochemical analysis.Then all the mice were sacrificed and the kidneys harvested for observation of pathologic changes in the glomeruli as well as for immunohistochemistry, Western blotting, and real-time PCR analysis. Results Compared with normal saline,BM obviously elevated the level of 24-hour urine protein, with statistically significant differences between the control and the medium-and high-dose BM groups (0.23 ±0.02 vs 1.14 ±0.13 and 1.43 ±0.10, P<0.01), but not between the control and the low-dose BM (0.23 ±0.02 vs 0.29 ±0.07, P>0.05).No significant differences were observed among the four groups in the levels of Cr, BUN, AST and ALT (P>0.05).Under the optical microscope, the kidneys showed normal structures in the control group, no signifi-cant pathologic changes in the low-dose BM, and vacuolus-like alteration with atrophic glomerular endothelial cells in the medium-and high-dose BM groups.Immunohistochemical analysis demonstrated the expressions of VEGF and podocin were moderately or strongly positive in the control and low-dose BM groups, by weakly positive or negative in the medium-and high-dose BM groups.Compared with the control group, the expression of the VEGF protein in the renal tissue was significantly decreased in the high-dose BM group (0.76 ±0.09 vs 0.39 ±0.05, P<0.01) but had no remarkable difference from that in the low-dose (0.81 ±0.10) or medium-dose BM (0.64 ±0.08) group (P>0.05), and the expression of the podocin protein was significantly reduced in the medium-dose BM (0.67 ±0.07 vs 0.43 ±0.10, P<0.05) and high-dose BM (0.67 ±0.07 vs 0.19 ±0.04, P<0.01), but not in the low-dose BM group (0.67 ±0.03) (P>0.05).The mRNA expressions of VEGF and podocin were not significantly changed in the low-dose BM group as compared with the control (1.07 ±0.61 and 1.12 ±0.09 vs 1.23 ±0.25 and 1.17 ±0.19, P>0.05) but remarkably de-creased in the medium-dose (0.82 ±0.38 and 0.71 ±0.18) and high-dose BM groups and (0.47 ±0.64 and 0.42 ±0.09) groups (P<0.01). Conclusion Bevacizumab damages glomerular filtration membrane and induce proteinuria partially by down-regulating the protein and mRNA expressions of VEGF and podocin.

Objective To investigate the changes and clinical significance of helper T cells (Th)22,Th17,Th1 and regulatory T cells (Treg) in the peripheral blood before and after antiretroviral treatment (ART) of human immunodeficiency virus (HIV)-1 infected patients.Methods Forty HIV-infected patients were recruited into this study,and 30 healthy subjects were recruited as controls.Peripheral blood of the patients was collected at baseline and after 3 months of ART treatment.The frequencies of Th22,Th17,Th1 and Treg were detected by flow cytometry.Tests for homogeneity of variance and paired t test for comparison was adopted.Spearman rank test was used for correlation analysis.Results The frequencies of peripheral Th22,Th17,Th1 and Treg from HIV-infected patients before treatment were significantly decreased compared to the healthy controls ([0.59± 0.47] ％ vs [1.65 ± 0.56] ％ [t =8.544,P＜0.01],[4.46±1.84]％ vs [6.98±1.86]％[t=5.619,P＜0.01],and [16.75±6.72]％ vs [22.77±6.87]％; [t=5.311,P＜0.01].The frequencies of peripheral Th22 and Th17 after 3 months of treatment were significantly higher than those at baseline ([1.60± 1.10] ％ [t=5.268,P＜0.01] and [6.33±2.64]％ [t=3.663,P＜0.01] and no difference from those of healthy controls (t=1.783 and 1.143,respectively; both P＞0.05).However,the Th1 frequency showed no difference compared to the baseline.The frequency of Treg in the HIV infected patients was significantly increased compared with the healthy controls ([10.76±3.76]％ vs [7.01±1.88]％,t=5.003,P＜0.01).However,it gradually decreased along with the ART treatment ([9.22±2.56]％ after 2 months; [8.57± 2.36]％ after 3 months),which was still higher than that of healthy controls (t=2.984,P=0.004).The ratios of Th22/Treg,Th17/Treg and Th1/Treg of the HIV-infected patients were significantly decreased in comparison with the healthy controls (0.05±0.03 vs 0.25±0.10,t=11.69,P＜0.01; 0.46 ± 0.27 vs 1.07±0.42,t=7.728,P＜0.01; 1.56±0.89 vs 3.37± 1.02,t=7.052,P＜0.01),and those were significantly increased after 3 months of treatment (0.17±0.10[t=6.852,P＜0.01],0.81±0.46[t=4.253,P＜0.01] and 2.31±1.27[t=3.030,P＜0.01]).Correlation analysis showed that the ratio of Th17/Treg of the HIV-infected patients was positively correlated with the peripheral CD4+ T cell count (r=0.312 5,P=0.049 6),and negatively correlated with HIV RNA viral load (r=-0.474 7,P=0.002 0).The ratio of Th1/Treg of the HIV-infected patients was positively correlated with the peripheral CD4+ T cell count (r=0.333 5,P=0.035 5).Conclusions Th22,Th17,Th1 and Treg cells in the peripheral blood of HIV-infected patients are closely related to CD4+ T cell count.ART can partially recover immune imbalance,and help to rebuild immune function of HIV-infected patients.

AIM:To determine the contents of euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae and Semen Euphorbiae Pulveratun from different habitats.METHODS:A kromasil C_(18) column(150 mm×4.6 mm,5 μm)was used with methanol-water(68:32)as the mobile phase and UV detection was at 280 nm.RESULTS:The linear ranges of euphorbiasteroid and lathyrol diadetate benzozte were from 0.200 μg to 1.200 μg and 0.206 μg to 1.651 μg(r = 0.999 7,r = 0.999 9).The contents of euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae from different habitats ranged from 0.450 8% to 0.625 1 % and 0.692 3% to 0.752 9%.The contents of two kinds of compositions in Semen Euphorbiae Pulveratun ranged from 0.156 8% to 0.221 1% and 0.232 2% to 0.283 0%.CONCLUSION:The method for quantitating euphorbiasteroid and lathyrol diadetate benzozte in Semen Euphorbiae is accurate and reliable,and can be used to control the quality of toxicity Semen Euphorbiae and Semen Euphorbiae Pulveratun.

Objective Antiangiogenesis therapy has been shown to prolong survival for patients with malignant tumor .However the present study has not been observed the clinical benefit of antiangiogenesis therapy combination with chemotherapy treated with gastric canc-er.Human recombinant vascular endothelial inhibition (endostar) as a multi-targeted anti-angiogenesis drug, the mechanism is different from other Antiangiogenesis drugs.It can block different pathways of signal transduction to inhibit angiogenesis .This study aimed to observe the effect of combined application of endostar and paclitaxel on biological behavior of gastric cancer cell lines . Methods MMT assay and Tr-answell invasion assay were respectively used to examine the inhibition rate of cell growth and invasion ability when cells were treated with va-rious concentrations of endostar and paclitaxel alone or in combination.The protein expressions of VEGF,MMP-2 and MMP-9 were examined by Western blot. Results Endostar or paclitaxel effectively inhibited the growth of MGC803 cells and the in vitro invasion of MGC803 cells in a concentration-dependent manner.The proliferation and invasion ability of combined treatment with endostar and paclitaxel was significantly lower than that of endostar or paclitaxel alone (P<0.05).Compared with con-trol group, the VEGF,MMP-2 and MMP-9 protein expressions were de-creased in experimental groups ( P <0.05).Compared with paclitaxel group, the VEGF, MMP-2 and MMP-9 protein expressions were relatively reduced in combination groups (P<0.05). Conclusion Endostar combined with paclitaxel can suppress the growth and invasion of MGC803 cells, and the decreasing VEGF , MMP-2 and MMP-9 expressions may be involved in the mechanism .