Objective To preliminary study clinical efficacy and toxicity of endostatin (ES) combined radiotherapy and chemotherapy in advanced non-small cell lung cancer (NSCLC),and evaluate its effectiveness and safety.Methods We retrospectively reviewed 64 patients with Ⅲ B-Ⅳ stage NSCLC of Harbin Medical University Cancer Hospital from February 2009 to February 2012.The patients were divided into two groups:chemoradiotherapy group,39 patients and ES add chemoradiotherapy group,25 patients.The short-term effect,the total efficiency,median survival time,progression-free survival time and disease-free survival time were compared.Results The total effective rate of chemoradiotherapy group was 76.9％,while the total effective rate of ES add chemotherapy group was 84.0％ (x2 =0.47,P =0.492).Chemoradiotherapy group,compared to ES add chemotherapy group,the median survival time,median progression-free survival time,median disease-free survival time were 11.52 months vs 16.51 months (x2 =3.74,P =0.042),7.32 months vs 10.37 months (x2 =5.32,P =0.025) and 5.21 months vs 7.57 months (x2 =4.56,P =0.035) respectively.The mainly adverse drug reactions were hematologic toxicity and gastrointestinal reactions,but there were no significant differences between the two groups; radiotherapy side effects mainly showed the grade 1 to 2 radiationinduced lung injury and radiation esophagitis (chemotherapy group had one case of grade 3 radiation-induced lung injury),but also had no significant differences between the two groups.Conclusion ES combined chemoradiotherapy can achieve a better short-term clinical efficacy without increasing adverse effects of radiotherapy or chemotherapy in advanced non-small cell lung cancer.

Objective To sum up experience and lessons in the reform of the property rights of state-owned enterprises and explore policies and measures appropriate for reform in the property rights of the medical and health system. Methods Such methods as retrospective analysis, literature search and two-level data collection were used to gather relevant information and then comparisons were made of the major differences in the reform of the property rights of public hospitals and state-owned enterprises with regard to external environment, internal structure, reform progress, and changes in property rights. Results Due to the unique features of the medical and health industry, reform in the property rights of public hospitals proved to be different from that of state-owned enterprises, with the former displaying specific characteristics in the mainstay of competition, development of the elements market, and rules and manners of competition, all of which must be handled carefully. Conclusion Improvement of the external environment of competition ought to be the focus of reform in the property rights of public hospitals.

BACKGROUND:At present, it is controversial to choose methotrexate therapy alone or triple therapy in the treatment of rheumatoid arthritis.
OBJECTIVE:To systemical y evaluate the efficacy and safety of methotrexate therapy and methopterin+hydroxychloroquine+sulfasalazine triple therapy in the treatment of rheumatoid arthritis.
METHODS:Computer retrieval was performed on the Cochrane library, PubMed, EMBASE NRR (http://www.updatesoftware.com/National), CCT (http://www.control ed-trails.com) and the Chinese biomedical literature database. Manual retrieval was performed on Chinese major orthopedic journals. Randomized control ed trials of methotrexate therapy alone and methopterin+hydroxychloroquine+sulfasalazine triple therapy treatment for rheumatoid arthritis were col ected. Methodological quality of the included studies was evaluated. The statistical software Revman 5.0 provided by the Cochrane col aboration was used.
RESULTS AND CONCLUSION: A total of four literatures in a randomized control ed trial, a total of 297 cases were included;the methodological quality was al class B. Meta-analysis results showed that blood sedimentation improvements were larger in methotrexate therapy alone than in the triple therapy [mean difference=7.01, 95%confidence interval (CI) (2.82, 11.19), P=0.001). Improvements of joints were better in triple therapy than that in single therapy [OR=0.62, 95%CI (0.41, 0.95), P=0.03). There was no significant difference in adverse events. Meta analysis could not be done in ACR, because literature did not provide detailed data. Compared with the triple therapy treatment, methotrexate therapy alone obviously reduced the sedimentation of rheumatoid arthritis in adults, but in terms of joint function improvement, triple therapy was superior to methotrexate therapy alone. Moreover, on the adverse event, there was no significant difference between the two groups. Because this system evaluation included a less number of cases, it stil needs strict large-sample randomized control ed studies to increase the strength of the evidence.

[Objective]To translate the SRS-22 Questionnaire from English edition into Chinese version for the use of Chinese adolescents with idiopathic scoliosis and to evaluate the metric qualities of this questionnair. [Method] Transcultural adaptation of the SRS-22 Questionnaire was carried out according to the International Quality of Life Assessment Project guide-lines,The final version was decided on by a committee of experts.The Questionnaire was completed by 86 adolescents(M=11,F=75) with idiopathic scoliosis.The patients were 10~18 years old(mean,13.9 years).Curve magnitude ranged from 25? to 45?(mean,35.6?).Out of them,30 patients repeated the questionnaire 3~4 weeks later.[Result]The overall alpha coefficient of the questionnaire was 0.88.Coefficients for individual domains were as follows:function/activity,0.70;pain,0.80;self-image,0.80;mental health,0.88;and satisfaction,0.81.The questionnaire as a whole had a test-retest correlation coefficient of 0.97.Test-retest correlation coefficients for individual domains were as follows:function,0.85;pain,0.96;self-image,0.96;mental health,0.95;and satisfaction,0.91.Six common factors were acquired from factor analysis,and the cumulative contribution rate was 72.29%. [Conclusion] The Chinese version of the SRS-22 Questionnaire has eligible reliability and validity.It can be used to measure health-related quality of life of adolescents with idiopathic scoliosis in China.

Objective To investigate the effect of dexmedetomidine on the stress responses during wakeup test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.Methods Thirty-six ASA physical status Ⅰ or Ⅱ patients,undergoing cerebral functional area operation requiring wake-up test,aged 18-60 yr,weighing 50-70kg,were randomly divided into control group (group C) or dexmedetomidine group (group D) with 18 cases in each group.Dexmedetomidine 0.8 μg/kg was infused over 10 min before induction of anesthesia followed by infusion at 0.4 μg·kg-1 · h-1 in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with target-controlled infusion of propofol and remifentanil and iv injection of cisatracurium.At 30 min prior to wake-up test,target-controlled infusion of propofol and application of mulscle relaxants were stopped,the target plasma concentration of remifentanil was decreased to 1 ng/ml,and in group D the infusion rate of dexmedetomidine was decreased to 0.1 μg·kg 1· h-1.Anesthesia time and consumption of anesthetics before wake-up test,wake-up time,and development of complications and intraoperative awareness during wake-up test were recorded.At 30 min prior to wake-up test (T1),immediately after wake-up (T2),at 5 min after wake-up (T3),and at 10 min after the anesthetic depth was deepened (T4),HR,mean arterial pressure and BIS value were recorded and blood samples were taken for determination of plasma concentrations of epinephrine (E) and norepinephrine (NE).Results Compared with group C,the consumption of propofol and remifentanil was significantly reduced before wake-up,the incidence of hypertension was decreased during wake-up test,and HR and plasma E and NE concentrations were decreased at each time point (P ＜ 0.05),and no significant difference in mean arterial pressure and BIS value was found in group D (P ＞ 0.05).Tachycardia,restlessness,bucking and awareness were not observed during wake-up test in group D.Conclusion Dexmedetomidine can inhibit the stress responses during wake-up test and raise the quality of wake-up test in patients undergoing cerebral functional area operation performed under propofol combined with remifentanil anesthesia.

Objective To investigate the relationship between the expression of BRCA1 in breast cancer tissues and the sensitivity to docetaxel chemotherapy.Methods The expression of BRCA1 was detected by immunohistochemical method and the new adjuvant chemotherapy containing docetaxel chemotherapy regimen (TEC)was given.The relationship between BRCA1 expression and efficacy of neoadjuvant chemotherapy with docetaxel was studied.Results The rate of complete response,partial response,stable disease and progress disease was 22.6％,71.7％,5.7％,and 0％ respectively in breast cancer patients with positive BRCA1 expression and 11.8％,58.9％,27.4％,and 2.0％ in breast cancer patients with negative BRCA1 expression.The difference between the 2 groups had statistical significance.Conclusion BRCA1 expression has a positive relationship with sensitivity to chemotherapy regimen containing docetaxel chemotherapy regimens (TEC),and can be used as a good marker for predicting efficacy of chemotherapy and screening agents.

Acupuncture Points ; Administration, Cutaneous ; Adolescent ; Adult ; Bloodletting ; Drugs, Chinese Herbal ; administration & dosage ; Ear ; blood supply ; Female ; Hordeolum ; drug therapy ; therapy ; Humans ; Male ; Young Adult

Objective To investigate the role of NF-κB in aldosterone-1％NaCl-induced renal injury in uninephrectimized SD rats and the potential mechanisms.Methods Thirty-teo male SD rats were uninephrectomized and treated for 4 weeks.Rats were divided into four groups randomly:control group (n=8),1％NaCl group (1％NaCl in chow,n=8),aldosterone group (1％NaCl in chow,0.75 μg/h aldosterone delayed relase by osmotic mini-pump,SC,n=8),PDTC group (1％NaCl in chow,0.75 μg/h aldosterone,SC,100 mg/kg PDTC,IG,n=8).Systolic blood pressure (SBP),urinary protein,renal function and renal morphologic were observed.The expression of intercellular cell adhesion molecule 1 (ICAM-1) and connective tissue growth factor (CTGF) were measured respectively by Western blotting and real-time PCR.The activity and location of NF-κB in renal cortex were detected by electrophoretic mobility shift assay (EMSA) and immunohistochemisty.Results Rats of aldosterone group exhibited higher blood pressure and more serious renal injury characterized by proteinuria,glomerular sclerosis compared with rats of the 1％ NaCl group.Protein and mRNA levels of ICAM-1 and CTGF were significantly increased inaldosterone group rats than those in 1％NaCl group (all P＜0.05).Moreover,all these changes were associated with an increase in NF-κB activity.Treatment with PDTC which is a specific inhibitor of NF-κB notably alleviated SBP,proteinuria and renal injury in aldosterone-infused rats.Furthermore,PDTC markedly reduced the expression of ICAM-1 and CTGF (all P＜0.05).Conclusion PDTC can alleviate aldosterone-1％NaCl-induced renal injury in uninephrectimized SD rats by preventing the expression of ICAM-1 and CTGF.

Objective To evaluate the short- and long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating metastatic nasopharyngeal carcinoma to the cervical lymph nodes. Methods A total of 154 cases of stage N2-N3 nasopharyngeal carcinoma (1992 stage system) were randomized into two groups: group A (76 cases, treated with microwave hyperthermia combined with chemoradiotherapy) and group B (78 ca-ses, treated with chemoradiotherapy alone). Both groups received 1 to 2 cycles of chemotherappy with cisplatin and 5-fluorouracil and then received regular radiotherapy. The total doses of radiotherapy were 70-78 Gy/35-39 f, 47-51 d for the primary loci of nasopharynx and 68-72 Gy/34-36 f,46-50 d for the metastatic loci in the neck. Group A received microwave hyperthermia on the metastatic cervical node at the beginning of radiotherapy, with the micro-wave hyperthermia administered for 45 min every time,two times a week, totaling 8 to 14 times. Results The complete extinction rates of neck metastatic carcinoma were 80.3% and 61.5% , respectively, in groups A and B (P<0.05). The overall response rates of neck metastasis in the two groups were 100% and 96.2% , respective-ly. When the cervical lymph node metastasis disappeared, the radiotherapy doses in group A and B were (45.8 ± 5.46 ) Gy and (58.8±5.03 ) Gy, respectively (P<0.01). The 5-year local control rates of cervical lymph node in group A and B were 97.4% and 76.9%(P<0.05 ), respectively. The one-, three- and five- year survival rates were 97.4% , 76.3% and 59.2% respectively, in group A, versus 93.6% (P>0.05) ; and 52.6% (P< 0.01) and 41.0% (P<0.05), respectively, in group B. Conclusions Microwave hyperthermia combined with chemoradiotherapy can elevate the complete extinction rate of cervical lymph node metastasis of nasopharyngeal carcinoma and reduce the radiotherapy dose needed of effective control. The 5-year local control rate of cervical lymph node metastasis in combined therapy group is superior to that in the chemoradiotherapy alone group,and can elevate the long-term survival rate of patients.

Objective To evaluate long-term efficacy of microwave hyperthermia combined with chemoradiotherapy for nasopharyngeal carcinoma (NPC) with cervical lymph node metastasis. Methods A total of 154 patients with stage N2 or N3 NPC ('92 staging system) were randomized into two groups:microwave hyperthermia combined with chemoradiotherapy (Group A, 76 cases) and chemoradiotherapy alone (Group B, 78 cases). Both of the two groups received 1 -2 cycles of chemotherapy of cisplatin and 5-fluorouracil, followed by conventional radiotherapy of 70 - 78 Gy in 35 - 39 fraction to the nasopharynx and 68 -72 Gy in 34 - 36 fractions to the neck. Group A received microwave hyperthermia to the metastatic cervical nodes at the beginning of radiotherapy. The hyperthermia was given as 45 min every time, twice a week for 8 - 14 times totally. Results The 5-year complete response rates of cervical lymph nodes in group A and B were 97% and 77% (x2 = 14. 24,P<0. 01). The distant metastasis rates in the two groups were 37% and 44% (x2 = 0. 73, P > 0. 05). The disease-free survival rates were 51% and 21% (x2 = 15.91, P <0. 01). The 5-year overall survival rates were 59% and 41%, respectively (x2 = 5.09, P < 0. 05).Conclusions For patients with stage N2 or N3 NPC, microwave hyperthermia combined with chemoradiotherapy can improve the complete response, disease-free survival and overall survival.