Inductive chemotherapy and concurrent chemoradiotherapy have been a focus on the clinical research in the treatment of nasopharyngeal carcinoma.Cisplatin,as a kind of representative platinum drug,can improve the curative effect,but it also brings a lot of side effects to nasopharyngeal carcinoma patients.The new kind of platinum drug-nedaplatin,can not only guarantee the curative effect but also reduce the side effects of chemotherapy.

Objective To investigate the efficacy of anesthesia with propofol-remifentanil given by targetcontrolled infusion (TCI) for thymectomy in patients with myasthenia gravis ( MG). Methods Forty-five ASA Ⅰ or Ⅱ MG patients aged 16-64 yr weighing 45-95 kg undergoing thymectomy were studied. Anesthesia was induced with TCI of propofol (target plasma concentration 4 μg/ml) and remifentanil (target effect-site concentration 4 ng/ml). Thracheal intubation was performed after topical anesthesia with 2% lidocaine 2-3 ml and then the patients were mechanically ventilated. Anesthesia was maintained with TCI of propofol ( target plasma concentration 3-5 μg/ml) and remifentail (target effect-site concentration 3-6 ng/ml). Sufentanil 0.15 μg/kg was injected intravenously for analgesia 30 min before operation. The success rate of intubationat at first attempt, body movement in response to skin incision, recovery time, extubation time, extubation condition at the end of operation and cardiovascular events were recorded. Results Thracheal intubation was performed successfully in all patients. The success rate of intubation at first attempt was 100%. No body movement occurred during skin incision in the patients.Recovery time was 1.0-3.2 min and extubation time 2.6-7.0 min. All patients were successfully extubated at the end of operation. Bradycardia developed in 3 patients and hypotension in 4 patients during induction, but they all returned to normal after symptomatic treatment. Bradycardia developed in 3 patients during operation, but returned to normal after symptomatic treatment. Conclusion Anesthesia with TCI of propofol and remifentanil can be used safely and effectively in MG patients undergoing thymectomy.

Interspinous process device is a kind of non-fusion implant for posterior spinal surgery.It is classified by static system and dynamic system according to its characteristics.With rapid development of internal fixator manufacture,materials for interspinous process device become increasing,such as bone allograft,titanium,poly(ether-ether-ketone) and lactoprene composite.A large number of experimental and clinical researches reveal the advantages of this technology in degenerative spinal stenosis,intervertebral original lower back pain,facet syndrome,protrusion of intervertebral disk,and lumbar instability.However,there are still many problems such as the influence on the lumbar posterior column,the mechanism to lumbar disc and the effect on the stability of spine etc.In addition,the clinical indications need to validate by long-term follow up.

Objective To probe MRI diagnostic characteristics of moyamoya disease(MMD). Methods Both MRI and MRA findings in 17 cases, aged 10~49 years, with MMD were analyzed retrospectively. Axial T_1WI and T_2WI were performed for MRI, while 3D TOF was used for MRA.Gd-DTPA enhanced MRA and T_1WI were carried out in 2 and 4 patients respectively.FLAIR was performed in 5 cases.Results ( 1 ) Multiple focal infarction was noted in 5 cases , old hemorrhage in 4 cases, dilatation of unilateral ventricle with history of ventricle hemorrhage was displayed in 2 cases;(2)MRI showed signal void of the following vessels as well as other lesions:① internal carotid artery (ICA) bifurcation, anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) (17/17);②collateral circulation from the skull base, PCA and ECA were demonstrated well in combination with MRA,T_1WI and T_2WI (17/17);③“Ivy sign” or leptomeningeal high signal intensity could be demonstrated on contrast-enhanced T_1WI or FLAIR images(2/17). Conclusion MRI findings can suggest the diagnosis of the MMD, and definite diagnosis can be usually made if combined with MRA.

The reversed-phase high-performance chromatography was developed for determing the content of berberine, palmatine, emodin and chlorogenic acid in Xiaoerniuhuang Powder on ODS column. The powder samples extracted with methanol were determined separatly at their particular absorption points using external standard method.This method had advantages of perfect separatin, high sensitivity, good reproducibility and simple operation.

A case of lung adenocarcinoma was reviewed.Its major symptoms were cough , sputum and progressive dyspnea.High resolution computed tomography presented ground-glass, bilateral fibrosis and some solid opacities.In conjunctions with the related literatures , its clinical manifestations and imaging features were analyzed for a better understanding of lung cancer.

Objective To investigate the correlation between urinary calculi and upper urinary tract infections.Methods Twenty-six patients underwent lithiasis in upper urinary tract accompanied with infectious symptoms were enrolled in this study (test group).Blood culture was obtained in peak temperature before lithotrity,urine sample was obtained for bacterial culture.Thirty patients with calculi in upper urinary react accompanied no infectious symptoms in the same period were enrolled in control group.Calculi were pestled for bacterial culture and analyzed the components after the calculi were removed.Results In test group,the positive of blood,urine,calculi culture were 4,23,18 patients.The prominent component of calculi was hexahydrate magnesium ammonium phosphate.Bacteria in 13 positive urine sample had the same property with the calculi samples which came from the same cases.In control group,the positive of urine,calculi culture were 4,4 patients.The prominent component of calculi were calcium oxalate calculi and uricite calculi.The morbidity of upper urinary tract infections in test group was significantly higher than that in control group [69.2％(18/26) vs.13.3％(4/30)] (P ＜ 0.05).The coincidence of urine culture and calculi culture in test group was significantly higher than that in control group [72.2％(13/18) vs.25.0％(1/4)](P＜0.05).Conclusions Infectious calculi can easily result in upper urinary tract infections.Hexahydrate magnesium ammonium phosphate can make the prominent component in infectious calculi.

Objective To determine whether the extent of airflow obstruction is associated with left ventricular function in mild-to-moderate chronic obstructive pulmonary disease (COPD) patients.Methods Left ventricle end diastolic volume ( LVEDV ),left ventricle end systolic volume ( LVESV ),left ventricle stroke volume( LVSV),left ventricle ejection fraction( LVEF),heart rate ( HR),cardiac output ( CO) and cardiac index (CI) were measured by ultrasonic cardiogram.Thirty-one patients with chronic bronchitis,42 mild-to-moderate COPD patients and 16 controls with normal lung function were recruited.The relations between the extent of airflow obstruction and the impairment of left ventricular function were analyzed.Results There were no significant differences of LVEDV,LVESV,LVSV,HR,CO or CI between the control and chronic bronchitis groups.LVEDV,LVESV,LVSV,CO and CI of chronic bronchitis group were significantly higher than those of mild-to-moderate COPD group while HR was lower.LVEDV,LVESV,LVSV,CO and CI had a positive correlation with forced expiratory volume in 1 second ( FEV1 ),forced vital capacity (FVC) and FEV1/FVC ratio.And HR had a negative correlation with FEV1 and FEV1/FVC.LVEF was positively correlated with FVC,but not with FEV1 and FEV1/FVC.LVEDV,LVESV,LVSV,HR,CO and CI were linearly related with FEV1.Conclusions Left ventricular function is maintained in chronic bronchitis patients. Left ventricular function,especially left ventricular end diastolic filling,deteriorates among the mild-to-moderate COPD patients.The extent of airflow obstruction may reflect the impairment of left ventricular function in COPD patients.

Objective To investigate the effects of tetrandrine on myocardial hypertrophy in renohypertensive rats and its possible mechanism.Methods The myocardial hypertrophy models were established in two-kidney-one-clip (2K1C)renovascular hypertensive rats.Before renal artery constriction,all the rats were randomly divided into four groups(n=15 per group):(1) the sham-operated control group; (2) the 2K1C renohypertensive group; (3) the tetrandrine group,the two-kidney-one-clip renohypertensive rats were treated with tetrandrine at a dose of 50 ml/kg · d-1 from the post-operated 5th week; (4) the enapril group,the two-kidney-one-clip renohypertensive rats were treated with enapril at a dose of 6 ml/kg· d-1 from the post-operated 5th week.The standard tail-cuff method was used to measure blood pressure in conscious rats.After drug treatment for 8 weeks,the rats were killed and left ventricle was obtained to measure the ratio of left ventricle weight to body weight (LVW/BW),myocardial angiotensin Ⅱ content,and mRNA expressions of inflammatory cytokines tumor necrosis factor-α(TNF-α)and interleukin-1 β (IL-1β).Results Compared with shamgroup[(14.90±3.31)kPa; (1.89±0.27)mg/g; (27.38±7.10)pg/mg; (0.72±0.10)and(0.65±0.10)fold of GAPDH expression],the untreated 2K1C renohypertensive rats exhibited a significant increase in blood pressure [(23.53 ± 3.40) kPa],LVW/BW [(2.83 ± 0.40) mg/g],angiotensin Ⅱ content [(43.51 ± 7.37) pg/mg],and mRNA expressions of TNF-α and IL-1β [(1.47 ± 0.14) and (1.07 ± 0.11) fold of GAPDH expression].Treatment with tetradrine significantly attenuated the increase in blood pressure [(15.81 ± 3.12) kPa] and LVW/BW [(1.94 ±0.31) mg/g],angiotensin Ⅱ content [(31.31 ± 6.69) pg/mg],and mRNA expressions of TNF-α and IL-1β [(0.76 ±0.11) and (0.63 ± 0.09) fold of GAPDH expression].Conclusion Long-term related to its inhibition of local production or release of angiotensin Ⅱ and inflammatory cytokines TNF-α and IL-1β in the myocardium of renohypertensive rats.