0.05).Conclusions IL-11 unlikely to stimulate the growth of the CEM leukemia cell.And did not affect the antitumor effect of HD-MTX.It can be used as an assisting drug in program of acute lymphoblastic leukemia(ALL) therapy.

Early enteral nutrition is more compatible with physiological status,is beneficial to cell and organ function recovery and helpful to reduce the incidence of infection and to improve the prognosis.However,due to facts like intra-abdominal hypertension,hemodynamic instability,intestinal dysfunction,early enteral nutrition is usually difficult to successfully implemented in surgical critically ill patients.This paper reviews the progress of early enteral nutrition implementation in surgical ritically ill patients.

Objective To investigate the therapeutic effects and toxic effects of radiochemotherapy versus chemotherapy alone in patients with advanced gastric cancer after gastrectomy.Methods A total of 183 patients with stage Ⅱ-Ⅳ (M0) gastric cancer,who received treatment after gastrectomy from 2004 to 2010,were included in the study.Of the 183 patients,64 received radiochemotherapy after gastrectomy,and 119 received chemotherapy alone after gastrectomy.The survival rates and hematological and gastrointestinal toxic effects were compared between the two groups;survival difference was also analyzed after the patients were stratified by TNM stage,number of metastatic lymph nodes,and extent of lymph node dissection (D0,D1,and D2).The Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis and univariate prognostic analysis;the chi-square test was used for comparing toxic effects between the two groups.Results The follow-up rate was 87.8％ ;72 patients were followed up for at least 3 years,and 29 patients for at least 5 years.The 1-,3-,and 5-year survival rates for the radiochemotherapy group were 86％,62％,and 55％,respectively,as compared with 77％,53％,and 43％ for the chemotherapy group (P =0.079).There were no significant differences in grade 3-4 hematological and gastrointestinal toxic effects between the two groups (P =0.363 and 0.617).The univariate analysis showed that radiochemotherapy had a significantly better survival benefit than chemotherapy alone in patients with stage ⅢB-Ⅳ (M0) gastric cancer,patients who underwent D0 lymph node dissection,and patients with more than 6 metastatic lymph nodes (P =0.022,0.025,and 0.021).Conclusions Compared with chemotherapy alone,radiochemotherapy tends to improve survival in patients with gastric cancer after gastrectomy,and its toxic effects are tolerable.The patients with stage ⅢB-Ⅳ (M0) gastric cancer,patients who undergo D0 lymph node dissection,and patients with more than 6 metastatic lymph nodes can benefit from radiochemotherapy.

Objective To investigate the differential value of contrast-enhanced ultrasonography (CEUS) and time-intensity curves(TIC) in diagnosing testicular and epididymal mass lesions.Methods CEUS via intravenous bolus injection of SonoVue and TIC were performed for quantitative analysis of testicular and epididymal mass lesions.Forty-one patients with 42 testicular and epididymal mass lesions and 26 normal testicles were examined with CUES,the perfusion progress were recorded dynamically,which findings were compared with surgery.Results Twenty-three (54.76％) malignant masses displayed enhanced pattern as evenly enhanced,fast-in and fast-out (8.7％),evenly enhanced,fast-in and slow-out (65.2 ％ ),unevenly enhanced,fast-in and slow-out (26.1％ ).Ninteen (45.24 ％ ) benign masses revealed enhanced pattern as unevenly enhanced,fast-in and slow-out ( 10.5 ％),evenly enhanced,slow-in and slowout ( 10.5 ％ ),unevenly enhanced,slow-in and slow-out ( 36.9 ％ ),without enhancement ( 42.1％ ).There was statistical difference of peak intensity,time to peak and areas among malignant group,benign group and normal group ( P ＜ 0.05).Conclusions CEUS combined with TIC could provide differential diagnostic value for testicular and epididymal mass lesions.

Objective To investigate the effect of β-catenin on the osteogenic differentiation of human periodontal ligament stem cells (PDLSCs) under mechanical tension.Methods PDLSCs were seperately cultured in vitro from the periodontium attached at freshly extracted teeth.β-catenin-targeting agonist or inhibitor was applied to the PDLSCs to upregulate or downregulate the expression of activity of β-catenin protein.The expression of β-catenin protein and the osteogenetic related markers(ALP,BMP2,Runx 2) under the mechanical tension with different period(0,6,12,24 h) were assessed with Western blot in the PDLSCs irritated with agonist or inhibitor.Results Compared with the PDLSCs without mechanical tension,the expression of osteogenesis related marker proteins,ALP and Runx 2,in PDLSCs were enhanced under the circular mechanial tensile stress (P ＜ 0.05).In the PDLSCs irritated with WAY-262611,the β-catenin-targeting agonist,the expression of osteogenetic related markers ALP in the PDLSCs was improved during the first 12 h period of mechnical tensile load,which was significantly higher than that in the DMSO group.Conclusion Wnt/β-catenin signaling pathway plays an important role in the early osteogenesis differentiation of PDLSCs under cyclic tension.The β-catenin promotes osteogenic differentiation of PDLSCs under mechanical tension.

Objective To develop an assay to determine Mycobacterium tuberculosis resistance to rifampin, isoniazid, ofloxacin and amikacin by pyrosequencing and evaluate the value of this method in clinical application. Methods Eighty-nine clinical isolates of Mycobacterium tuberculosis from tuberculosis patients were collected from Shanghai Pulmonary Hospital during 2008 to 2009. All strains were isolated from decontaminated sputum, cultured on Lowenstein-Jensen media and identified by traditional biochemical tests with standard methods. Ten Mycobacterium tuberculosis were selected from the strain bank of Shanghai Pulmonary Hospital. The optimal conditions of detection of rpoB, katG, gyrA and rrs gene by pyroseuencing were determined, using the 10 Mycobacterium tuberculosis strains whose drug susceptibility of Bactec 960 and sequence of rpoB, katG, gyrA, rrs gene were known. Then the drug susceptibility of 89 Mycobacterium tuberculosis clinical isolate strains were detected by pyrosequencing using this conditions and the results were compared with that of the Bactec 960 methods. Results The pyrosequencing program of sequence analysis was suitable for the detection of the mutations of rpoB and gyrA genes, and the program of single nucleotide polymorphism was suitable for katG and rrs genes. Among the 89 Mycobacterium tuberculosis clinical isolates,when using the drug susceptibility of Bactec 960 as the standard, the sensitivity of rifampin, isoniazid,ofloxacin and amikacin is 98.0%, 64. 1%, 79.5%, 78. 3% respectively, the specificity is 97.5%,100. 0%, 90. 0%, 100. 0% respectively, the accuracy is 97.8%, 77. 5%, 85.4%, 94. 4% respectively,tested by pyrosequencing. The results of the detection of resistance to rifampin, isoniazid, ofloxacin and amikacin in Mycobacterium tuberculosis using pyrosequencing technique were almost the same with that of Bactec 960, and Kappa ≥0. 7 in each detection. Conclusion Pyrosequencing is thus a rapid, accurate and high throughput method for detecting Mycobacterium tuberculosis resistance to these four drugs.

Objective To evaluate the ultrasonic feature and clinical significance of persistent left superior vena cava(PLSVC)in fetal life.Methods Fetal echocardiography was performed in 3368 fetuses.Thirty-one fetuses of PLSVC were confirmed.Results The dilated coronary sinus was observed in 30 of 31 fetuses.Congenital heart defects were presented in 14 of these cases,and extracardiac anomalies were presented in 6 fetuses.Both congenital heart defects and extracardiac anomalies were observed in 4 fetuses.Conclusions PLSVC is always associated with congenital heart defects.The prognosis Of affected fetuses largely depends on whether or not the PLSVC is associated with a congenital heart defect.Prenatal diagnosis of PLSVC can help US plan perinatal counseling and ameliorate the postnatal course.

Objective To establish an experimental subarachnoid hemorrhage(SAH)model with endo- cerebrovascular peroration.Method The right external carotid artery of SD rats were isolated,leaving a stump of approximately 3 to 4 mm.A-3-O monofilament nylon suture was inserted up through the stump of external carotid artery to the internal carotid artery for about 18～19 mm.A small resistance was usually felt,and the suture was then advanced 2 mm further and the suture was immediately withdrawn.Two hours or two days after SAH induction,SAH extension was observed.Two days after SAH induction,the diameter of the basilar artery was measured.Results SAH extends from the ipsilateral artery to the eontralateral artery after SAH induction.The diameters of basilar arteries in SAH animals were smaller than those of control rats,indicating the present of cerebrovascular spasm in SAH animals.Conclusions The endo-cerebrovascular perforation technique for establishing a non-craniotomy SAH model is reliable.

OBJECTIVE:To compare the efficacy,safety,vascular endothelial growth factor(VEGF)and matrix metallopro-teinase-2 (MMP-2) of docetaxel combined with carboplatin and paclitaxel combined with cisplatin (DDP) in the treatment of ad-vanced ovarian cancer. METHODS:120 patients with advanced ovarian cancer were randomly divided into docetaxel combined with carboplatin group(60 cases)and paclitaxel combined with DDP group(60 cases). Docetaxel combined with carboplatin group received 70 mg/m2 Docetaxel injection,intravenous infusion of 1 h,d1;50 mg/m2 carboplatin injection,intravenous infusion of 1 h,d2. Paclitaxel combined with DDP group received 135 mg/m2 Paclitaxel injection,intravenous infusion of 24 h,d1;30 mg/m2 DDP for injection,intravenous infusion,d3;60 mg/m2 Paclitaxel injection (a maximum of 2.0 m2) by intraperitoneal infusion,d8. 3-week was regarded as 1 treatment course,and it lasted 6 courses. Clinical efficacy,VEGF,MMP-2,progression-free survival, overall survival before and after treatment,mortality rate within 2 years of treatment and the incidence of adverse reactions in 2 groups were compared. RESULTS:There were no significant differences in the objective response rate,disease control rate,mortal-ity rate,incidence of adverse reactions between 2 groups(P>0.05). The progression-free survival in docetaxel combined with car-boplatin group was significantly longer than paclitaxel combined with DDP group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in VEGF and MMP-2 level between 2 groups(P>0.05). After treat-ment,VEGF and MMP-2 level in 2 groups were significantly lower than before,and VEGF at different time points and MMP-2 level after 4 weeks,8 weeks and 12 weeks of treatment in docetaxel combined with carboplatin group were lower than paclitaxel combined with DDP group,the differences were statistically significant(P<0.05). CONCLUSIONS:Docetaxel combined with car-boplatin and paclitaxel combined with DDP shows similar efficacy and safety in the treatment of advanced ovarian cancer,but docetaxel carboplatin combined with is superior to paclitaxel combined with DDP in reducing VEGF and MMP-2 and improving pro-gression-free survival.

Objective:This study was to explore "Internet + nursing service" mode, the tumor specialist nurses nursing service experience and feelings, in the process of mining "Internet + nursing service" model of current existing problems and future development direction, discussed under the background of constructing a new mode of medical and health services, how to expand the tumor specialized subject "Internet + nursing service" the breadth and depth to improve the quality of life of cancer patients and nursing service benefit.Methods:Through the review of the literature, the focus and direction of the research were determined. A semi-structured interview was conducted with 12 oncology nurses enrolled in "Internet + nursing service" by qualitative research. Colaizzi seven-step method was used to encode, classify and extract the data.Results:The experience of "Internet + nursing service" carried out by oncology nurses can be summarized into the following five themes: Be more willing; professional identity of specialist nurses is higher (self-identity, patient identity, social identity); Multiple psychological experience (stress experience: the limitation of specialized operation and the pressure of communication; Adaptive experience: "Specialist cooperation and two-person home visit mode" is well adapted). The time and economic cost of specialist services are higher. The matching degree of service item supply and market demand is insufficient.Conclusions:In order to further expand the depth and breadth of "Internet + nursing service" in oncology, and to benefit more cancer patients in the long-term treatment and rehabilitation process, it is necessary to improve the recognition degree of nurse specialty, so as to improve the willingness to work; increase nurse training to enhance nurses' comprehensive coping ability; improving policy and economic support based on the characteristics of tumor diseases; improve the oncology "Internet + nursing services" project.