Purpose:To evaluate the efficacy and toxicity of the combination of paclitacxel and carboplatin on advanced non-small-cell lung cancer (NSCLC). Methods:Forty-eight patients with locally advanced (stageⅢb) or metastatic (stage Ⅳ) NSCLC were enrolled into the study. The patients received paclitacxel 55-60 mg/m 2 on day 1,8,15, carboplatin at an AUC of 5 on day 1. administreted in a 28-day cycle. Results:An objective response was obtained in 37.5% of patients (2 complete and 16 partial responses),Significant difference existed between the naive patients and pretreated patients (46.4% Vs 25.0%,P

Objective To evaluate the methods of measuring platelet-associated antibody PAIgG/ PAIgA/ PAIgM by flow cytometry(FCM) and enzyme linked immunosorbent assay(ELISA), and to investigate their diagnostic value for patients with idiopathic thrombocytopenic purpura(ITP).Methods With FCM and ELISA respectively, PAIg on the platelet membrane and in plasma were measured in 19 patients with ITP and 17 healthy volunteers, and were compared with each other in order to find out whether there were differences in these groups.Results FCM and ELISA measurement in patients with ITP were significantly higher than those in control group (P0.05). Compared with the results of ELISA, the positive percentage of PAIgG measured by FCM(84%) in ITP patients was slightly higher than that by ELISA(79%).Conclusion The platelet-associated antibodies of PAIgG/ PAIgA/ PAIgM, especially PAIgG,are important for diagnosing ITP. FCM, in combination with ELISA, may improve the reliability and the positive percentage of detection in ITP patients.

Objective To explore the application value of spiral CT angiography in etiological diagnosis of spontaneous intracranial hematoma before surgery. Methods 48 patients with spontaneous intracranial hematoma following surgical indication assessed by CT scan were ascertained etiological diagnosis performed by CT angiography before surgery.Results The causes of intracranial hematoma were cerebral aneurysm(2 patients), arteriocenous malformation (5 patients), hypertension(40 patients), and no image in one patient performed by CT angiography.Conclusion CT angiography has important value in etiological diagnosis of spontaneous intracranial hematoma before surgery.

Objective To evaluate the necessity and clinical significance of multi-slice spiral CTA (MSCTA) in preoperative examination of complex craniocervical junction (CCJ) malformation.Methods Totally 30 patients of complex CCJ malformation were enrolled,among them 16 underwent routine CT and MRI before surgery (routine group),and the other 14 underwent MSCTA of head and neck after routine CT and MRI (CTA group).The anatomical relationship between the V3 segment of VA and the bone in CCJ was observed,and then individualized operation scheme was formulated,MSCTA data in preoperative CTA group was reconstructed.The operation time,intraoperative blood loss and complications were compared between the two groups.Results CCJ malformation and VA V3 segment variation showed obvious individual characteristics in CTA group.The average operation time was (182.86 ± 27.37)min,and the loss of intraoperative blood was (165.71 ± 42.19)ml.No obvious complications occurred,and the therapeutic effect was satisfactory during follow-up period.In routine group,the average operation time was (205.31± 29.86)min,the loss of intraoperative blood was (246.25 ± 155.22)ml.Vertebral artery injury occurred in 1 case during operation,then bleeding was controlled,and improvement was achieved during follow-up period.There was no significant difference of operation time between the two groups (t=1.878,P=0.057),while the loss of intraoperative blood in CTA group was less than that of routine group (t =2.136,P=0.042).Conclusion MSCTA is a reliable method to investigate the anatomy and variation of bone and blood vessels in CCJ.It is necessary to carry out MSCTA examination before operation in patients with complex CCJ malformation,so as to reduce the complications and avoid the risk of surgery.

Objective To estimate the effect of daily diurnal temperature range (DTR) on mortality in different areas in China.Methods A time series study using the data collected from 66 areas in China was conducted,and Meta-analysis was used to analyze the estimates of associations between DTR and daily mortality.Modifying effects of extremely low and high DTR-mortality relationship by season and socioeconomic status (SES) were also evaluated respectively.Cumulative excess risk (CER) was used as an index to evaluate the effects.Results The information about 1 260 913 registered deaths were collected between 1 January 2006 and 31 December 2011,we found the relationship between extreme DTR and mortality was non-linear in all regions and the exposure-response curve was J-shaped.In central and south areas of China,the result indicated the obvious acute effect of extremely high DTR,and the mortality effect in central area (CER=5.1％,95％CI:2.4％-7.9％) was significant higher than that in south area (CER=4.5％,95％CI:1.7％-7.3％).Regarding to the modification of seasons,the cumulative mortality effect of DTR in cold season (CER=5.8％,95％CI:2.5％-9.2％) was higher than that in hot season (CER=3.1％,95％CI:1.1％-5.1％).Generally,deaths among the elderly (≥75 years) were associated more strongly with extremely high DTR.Conclusions The mortality effects of extremely DTR in different areas and seasons showed different characteristics,that in central area and in cold season it was significantly stronger.After modified by season and SES,DTRs were the greatest threat to vulnerable population,especially to the elderly (≥75 years).Therefore,more attention should be paid to vulnerable groups and protection measures should be taken according to the local and seasonal conditions.

Objective:To explore the development, application and practical experience of investigator-initiated integrated clinical research information platform.Methods:The process of developing and constructing an integrated clinical research platform in a tertiary hospital in Beijing was introduced, the functions and advantages of the platform were described and displayed, and the main problems and risk points in the development and construction process were analyzed.Results:The integrated clinical research platform meets the management requirements of clinical research initiated by investigators, and the standardized management of the whole life cycle of the project can be realized through the platform, and the key issues of data security, information capture, sharing and interoperability need to be further explored in terms of platform docking.Conclusions:The integrated clinical research platform effectively improves the standardization, management quality and efficiency of investigator-initiated clinical research.

Since March 2013,China had experienced five seasonal epidemics related to Avian influenza A (H7N9).An unprecedented outbreak of H7N9 epidemic started from September 2016,with 730 cases reported till June 30th 2017,in mainland China that caused profound influences on both social development and health of the people.As an emerging infectious disease,information on pathogenic characteristics,transmission patterns and other epidemiological features of H7N9 virus somehow remained unclear.Data from previous studies suggested that the live poultry market (LPM) seemed to have served as main places where H7N9 virus got originated,mutated,spread and thus infected the human beings.Hence,closure of LPMs was suggested a major measure to control and prevent H7N9 epidemics in China.However,the effectiveness of different ways of LPM closures on H7N9 epidemics had been controversial.This study systemically summarized the effects of different ways of LPM closures on H7N epidemics from previous studies,aiming to provide references for developing a better program on H7N9 control and prevention in the country.

Objective: To investigate the effects of artesunate combined with bortezomib on the proliferation, apoptosis and autophagy of human acute myeloid leukemia cell lines MV4-11, and its mechanisms. Methods: MTT method was used to determine the anti-proliferation effect of different concentrations of artesunate, bortezomib and their combination on MV4-11 cells. The cell apoptosis were analyzed by flow cytometry. The expression of cleaved-Caspase-3, Bcl-2 family protein (Bcl-2, Mcl-1, Bim, Bax) and autophagy-related protein LC3B were assayed by Western blot. Results: Artesunate displayed a proliferation inhibition effect on MV4-11 with dose- and time-dependent manner, the IC₅₀ of artesunate on MV4-11 after 48 hours was 1.44 μg/ml. Bortezomib displayed a proliferation inhibition effect on MV4-11 with dose-dependent manner, the IC₅₀ of bortezomib on MV4-11 after 48 hours was 8.97 nmol/L. The combination of artesunate (0.75, 1.0 μg/ml) and Bortezomib (6, 8 nmol/L) showed higher inhibition on MV4-11 than artesunate or bortezomib alone in the same concentration gradient after 48 hours (P<0.05) . The cooperation index of the two drugs were all less than 1. The 48 h apoptotic rate of artesunate (1.5 μg/ml) on MV4-11 was (15.27±2.18) %, (19.85±3.23) % of bortezomib (8 nmol/L) , (81.67±5.96) % of combination of the two drugs, significantly higher than the single group (P<0.05) . When combination of the two drugs on MV4-11 after 24 hours, the levels of pro-apoptotic protein Bim and the cleaved activation of Caspase-3 and autophagy-related protein LC3B were up-regulated and the anti-apoptotic protein Bcl-2 expressions was down-regulated. Conclusion Combination of artesunate with bortezomib shows a significant synergistic effects on proliferation, apoptosis and autophagy of MV4-11 cell lines, which may be associated with Bcl-2 family proteins expression.

BACKGROUNDStudies have shown that the drug resistance of gastric cancer cells can be modulated by abnormal expression of microRNAs (miRNAs). We investigated the role of miR-503 in the development of cisplatin resistance in human gastric cancer cell lines.

METHODSMiR-503 expression was measured by quantitative real-time PCR. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide) and clonogenic assays were used to examine changes in cell viability and the drug resistance phenotype of cancer cells associated with upregulation or downregulation of the miRNA. A dual-luciferase activity assay was used to verify target genes of miR-503. Immunohistochemistry, Western blotting analysis, and a flow cytometric apoptosis assay were used to elucidate the mechanism by which miR-503 modulates drug resistance in cancer cells.

RESULTSMiR-503 was significantly downregulated in gastric cancer tissues and several gastric cancer cell lines. Additionally, downregulation of miR-503 in the cisplatin (DDP)-resistant gastric cancer cell line SGC7901/DDP was concurrent with the upregulation of insulin-like growth factor-1 receptor (IGF1R) and B-cell lymphoma 2 (BCL2) expression compared with the parental SGC7901 cell line. An in vitro drug sensitivity assay showed that overexpression of miR-503 sensitized SGC7901/DDP cells to cisplatin. The luciferase activity of reporters driven by IGF1R and BCL2 3'-untranslated regions in SGC7901/DDP cells suggested that IGF1R and BCL2 were both direct target genes of miR-503. Enforced miR-503 expression in SGC7901/DDP cells reduced expression of the target proteins, inhibited proliferation, and sensitized the cells to DDP-induced apoptosis.

CONCLUSIONOur findings suggest that hsa-miR-503 modulates cisplatin resistance of human gastric cancer cells at least in part by targeting IGF1R and BCL2.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Humans ; Immunohistochemistry ; MicroRNAs ; genetics ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; Real-Time Polymerase Chain Reaction ; Stomach Neoplasms ; genetics