OBJECTIVE:To explore the potential correlation between clinical efficacy of pemetrexed in the treatment of ad-vanced breast cancer and TS mRNA expression. METHODS:Patients with advanced breast cancer were recruited in our study. Three cycles of pemetrexed was given to these patients,TS mRNA expression of their tumor tissues were detected. The relationship of ther-apeutic efficacies of different chemotherapy with TS mRNA expression were observed and compared during the study period. RE-SULTS:58 patients received pemetrexed chemotherapy and therapeutic efficacies of them were evaluated. One patient (1.7%) had complete response,19 patients(32.8%)had partial response,31 patients(53.4%)had stable response and 7 patients(12.1%)has progressive disease. Objective response rate was 34.5%,and disease control rate was 87.9%. TS mRNA expression level of 55 pa-tients with completed TS mRNA expression analysis varied from 0.04 to 5.11,with a median of 0.62. Mann-Whitney rank test showed that,responders had lower TS mRNA expression than nonsponders at all visits,there was statistical significance (P<0.05). Chi-square test showed that patients with low expression level of baseline(before chemotherapy)TS mRNA had significantly higher objective response rate(63.3%)than those with high expression(36.7%),there was statistical significance(P<0.05). CON-CLUSIONS:TS mRNA expression level is related to therapeutic efficacy of pemetrexed,which may be useful for predicting thera-peutic efficacy of pemetrexed therapy in patients with advanced breast cancer.

Objective To observe the effect of electroacupuncture(EA) on hippocampal structure in splenic asthenia pedo-rats.Methods A total of 15 SD male rats were randomly assigned to normal control group(n=5),model group(n=5) and EA group(n=5).Splenic asthenic syndrome model was established by intragastric administration of rhubarb and intraperitoneal injection of Reserpine for 14d.EA(1mA,3Hz/15Hz) was applied to bilateral "Zusanli"(ST 36) and "Sanyinjiao"(SP 6) for 20min,once a day for 14 days.The cellular structure of hippocampus was observed by light microscope and transmission electron microscope.Results Optical microscopic observation showed that in normal control group,the cellular nucleus was distinct,and the granular cell layer well-arranged and tight.In model group,the intracellular space was widened,and the granular cell layer was out of order in the arrangement.In EA group,the cellular nucleus and the granular cell layer were nearly normal.Results of the electronic microscope showed that cells in model group had a karyopyknosis with irregular appearance and clear incisure,and some of them presented dissolving and necrotic phenomena;and those in EA group were milder in injury,had nearly-normal nucleus with visible nucleoli and relatively-intact nuclear membrane.Regarding the cellular plasma,in comparison with rich normal organelles of control group,the mitochondria in model group were swelling,with vague,dissolved and broken cristae,while in EA group,majority of the organelles were well-kept,and slightly dissolved mitochondrial cristae found.In regard to the synaptic structure,in comparison with control group,synaptic apomorphosis and swelling mitochondria were found in model group.While in EA group,milder swelling and hydropic degeneration were seen.Different from the distinct pre-and post-synaptic membrane and synaptic vesicles of control group,the synaptic clefts and vesicles of model group were vague in the profile;while those in EA group were nearly-normal.Conclusion Electroacupuncture can effectively relieve splenasthenic syndrome induced pathohistological changes of neurons of the hippocampus in the rat.

Objective Scutellarin (SCU), a Chinese traditional medicine, has a protective effect against ischemia-reperfusion (IR) induced myocardial injury, but it is not yet clear whether SCU acts against vascular endothelial IR injury via extracellular signal-regulated kinase 1/2 (ERK1/2).The aim of this study was to explore the effect of SCU on hypoxia-reoxygenation (HR)-induced injury to human cardiac microvascular endothelial cells (HCMECs) and its influence on the ERK1/2 signaling pathway.Methods HCMECs were subjected to normal culture and divided into a normal control, a DMSO, an SCU 1 μmol/L, and an SCU 10 μmol/L group.The model of HR injury was established by exposing the HCMECs to 12-h hypoxia and 12-h reoxygenation after treated with DMSO or SCU at 1 and 10 μmol/L for 2 hours.Then, the survival rate of the HCMECs was detected by MTT and trypan blue staining, the concentration of malondialdehyde (MDA) in the cells measured, and the expressions of the p-ERK1/2, ERK2 and GAPDH proteins determined by Western blot.Results SCU at 1 and 10 μmol/L significantly increased the survival rate of the normally cultured HCMECs ([110.40±2.34] and [122.00±1.25] ％) as compared with that of the normal control (100％) (P<0.05), while HR injury markedly decreased the vitality of the HCMECs ([68.00±4.06] ％) in comparison with that of the blank control (100％) (P<0.05).The survival rate of the HCMECs was remarkably higher in the HR+SCU 1 μmol/L and HR+SCU 10 μmol/L groups than in the HR model group ([90.53±3.67] and [92.04±2.32] ％) (P<0.05), and so was their vitality in the SCU 10 μmol/L group than in the normal control ([96.78±2.01] vs [90.06±1.85] ％, P<0.01), while their survival rate was significantly lower in the HR model than in the blank control ([73.72±4.91] vs [91.83±2.34] ％, P<0.01) and remarkably higher in the SCU 10 μmol/L ([87.59±2.64] ％) than in the HR model group (P<0.05).The MDA concentration in the HCMECs was markedly increased in the HR model and HR+DMSO groups as compared with the blank control (P<0.01), but decreased in the HR+SCU 1 μmol/L and HR+SCU 10 μmol/L groups in comparison with the HR model group (P<0.05).The expression of the p-ERK1/2 protein was significantly down-regulated in the HR model group as compared with the blank control (P<0.01), but up-regulated in the HR+SCU 10 μmol/L group in comparison with the HR model (P<0.01).Conclusion HR injury reduces the vitality of HCMECs, increases the MDA concentration, and down-regulates the expression of the p-ERK1/2 protein in HCMECs, while SCU acts against ischemia-reperfusion injury to HCMECs by increasing ERK phosphorylation.

Objective To summarize the experience of surgical management of postoperative intrahepatic duct stones and strictures with choledochoscope.Methods The clinical data of 1241 patients with intrahepatic duct stones and strictures who were admitted to the Shenzhen People's Hospital from January 2000 to December 2011 were retrospectively analyzed.All patients were divided into postoperative choledochoscopy group (652 patients were treated by choledochoscope through T-tube fistula) and conservative treatment group (589 patients were treated by cholangic and antibiotic drugs) according to treatment plan.The clinical data including stricture alleviation,incidence of complications and treatment efficacies of the 2 groups were compared using the chi-square test.Results In the postoperative choledochoscopy group,the intrahepatic duct stones of 630 patients were completely removed,with the removal rate of 96.63％ (630/652),which was significandy higher than 76.23％ (449/589) of the conservative treatment group (x2=113.407,P ＜ 0.05).A total of 1237 intrahepatic duct strictures were detected in the postoperative choledochoscopy group,including 698 cases of membranous stricture (the length of strictured bile duct ＜ 2 mm),529 cases of spool-shaped stricture (2 mm ≤ the length of strictured bile duct ≤5 mm),8 cases of long tube-shaped stricture (the length of strictured bile duct ＞ 5 mm),2 cases of crackshaped stricture.The alleviation rate of the stricture was 99.35％ (1229/1237).The conditions of 6 cases of long tube-shaped stricture and 2 cases of crack-shaped stricture were not alleviated.There were 986 cases of intrahepatic duct strictures in the conservative treatment group,and the stricture alleviation rate was 80.43％ (793/986).There was a significant difference in the stricture alleviation rate between the 2 groups (x2=238.994,P ＜ 0.05).Nine patients in the postoperative choledochoscopy group had severe complications.Five patients had intrahepatic duct hemorrhage with a volume of blood loss more than 1500 ml,and they were treated by balloon dilatation hemostasis.One patient with repeated intrahepatic duct bleeding received hepatectomy.Two patients with severe intrahepatic cholangitis received choledochoscopy.Two patients had incomplete formation of sinus and they received implantation of biliary stents under duodenoscope.Conclusion Standard surgical management with choledochoscope can effectively alleviate postoperative intrahepatic duct stones and strictures.

Objective To observe the C-V curve of source point of 12 channels in patients with lumbar disc herniation. Methods 40 patients with lumbar disc herniation were examined with Cowital Human Meridian Diagnosing and Analyzing System, which can achieve quantitative analysis on C-V curve from the source points of 12 channels. The curves obtained before and after treatment were comparisd. Results The abnormal rates of source point on kidney and bladder meridians were more than those on the other meridians. The improving rates of source point on kidney and bladder meridians were better than those of the other meridians after treatment. Conclusion C-V curve observation can be used to diagnose, deduct and evaluate treatment for the lumbar disc herniation.

Objective To observe the effects of asthmatic children treated by inhaled salmeterol xinafoate and fluticasone propi-onate powder. Methods One hundred and fourty cases of moderate and severe asthmatic children were treated in non- acute period aged from 4 to 14 years by inhaling salmeterol xinafoate and fluticasone propionate powder, compared with control group treated by flu-ticasone propionate in 106 cases, and the pulmonary function was monitored simultaneously. Results The total effective rate of the treatment group and control group were 99. 3 % , 99. 1 % , respectively.The pulmonary function indexes such as the first one second expiration volume(FEV1), flow velocity of 50 % expiration vital capacity(FEF50%), peak expiration velocity(PEF1) after being treated 4 months was improved significantly compared with those before treatment.The difference between them was statistically significant (P

Objective To compare the long-term outcomes of partial hepatectomy versus choledocholithotomy both combined with choledochoscopy,for the treatment of hepatolithiasis.Methods Patients who underwent either type of the operations were followed up and examined using hepatobiliary magnetic resonance (enhanced MRI + MRCP).The incidences of abnormal imaging in the two groups were compared.Results Of 268 patients,138 patients underwent partial hepatectomy and the remaining 130 patients underwent choledocholithotomy.When hepatectomy was compared with choledocholithotomy,the recurrence rate of acute cholangitis combined with bile duct stone (5.8％ vs.21.5％),the reoperation rate (5.8％ vs.21.5％),the bile duct stricture rate (8.0％ vs.44.6％),the abnormal liver parenchyma perfusion rate (4.3％ vs.23.1％),the incidence of intrahepatic bile duct enhancement or thickening (1.5％ vs.26.9％),the incidence of hepatic atrophy (3.0％ vs.30.0％) and the incidence of cholangiocarcinoma (0 vs.2.3％) were better.Conclusions The long-term adverse outcomes were significantly worse in the choledocholithotomy group than in the partial hepatectomy group.Choledocholithotomy combined with choledochoscopy should only be considered as a complementary procedure to partial hepatectomy in hepatolithiasis.

OBJECTIVETo establish a method for determining the content of caffeic acid in compound Yinhuangjiedu decoction using high-performance capillary electrophoresis (HPCE).

METHODSThe optimized HPCE for determining caffeic acid content utilized a fused-silica capillary tube (75 microm x 60 cm, effective length of 53 cm) with 20 mmol/L borate as the running buffer (pH=9.18), a constant voltage of 12 kV, a sampling time of 5 s at 25 degrees celsius, and UV detection wavelength at 313 nm.

RESULTSThe linear range of caffeic acid was 20-100 microg/ml.

CONCLUSIONHPCE is simple, rapid, and sensitive for quality control of the compound Yinhuangjiedu decoction.

By retrospectively reviewing the current status of traditional Chinese medicine (TCM) and Western medicine treatments of chronic nonbacterial prostatitis (CNP), the TCM understanding of its etiologies and pathogenesis, the therapeutic principles and the mechanisms of acupuncture treatment of CNP, the clinical study strategies of acupuncture treatment for CNP were further proposed, which could provide more scientific basis and support for the definite longer-term therapeutic efficacy of acupuncture treatment of CNP. Breakthrough in the treatment of CNP will be achieved with the application of acupuncture therapy both in clinical practice and experimental research.

Objective:To evaluate the feasibility and safety of total aortic arch surgery under mild hypothermicvia single upper hemisternotomy approach.Methods:From January 2019 to July 2019, 35 patients(31 male and 4 female) with Stanford A type aortic dissection were diagnosed, who were(43.7±5.7)years old. Aortic arch surgeries were carried out under mild hypothermic via single upper hemisternotomy approach and the perioperative mortality, time of cardiopulmonary bypass(CPB), aortic cross clamp(ACC), circulation arrest(CA) and morbidity of neurological dysfunction were respectively were recorded.Results:All patients were finished aortic arch surgery under mild hypothermic single upper hemisternotomy approach, with 8.6% of mortality(3 patients died perioperation). The time of CPB, ACC and CA were respectively(202±53)min, (128±28)min and(8±3)min. There were 6 cases of transient neurological dysfunction(17.1%) and 1 case of permanent neurological dysfunction(2.9%).Conclusion:Aortic arch surgery under mild hypothermic for Standford A dissectionvia single upper hemisternotomy approach is safe and feasible.