Objective To investigated the efficacy and toxic effects of combined chemotherapy of vinorelbine plus cisplatin or carboplatin in patients aged ≥ 70 years and with non-small cell lung cancer (NSCLC).Methods One hundred patients with lung cancer aged ≥70 years were enrolled in the study.Fifty patients in chemotherapy group were assigned to receive vinorelbine 25 mg/m2 at the first day and the fifth day plus cisplatin 60-70 mg/m2 or carboplatin 250 mg/m2 at the second day.All treatments were repeated every 3 or 4 weeks.Another fifty patients aged ≥ 70 years were taken as control group, not receiving treatment.The primary endpoint was survival.Results Forty-five patients were evaluable for response and the partial remission rate was 35.6% (16/45).One year survival rate was 37.8% and median survival time was 9.75 months in chemotherapy group.The median survival time was 4.0 months for patients in control group.All 50 patients in chemotherapy group were evaluable for toxic side effects.WHO grade Ⅲ incidences of leucopoenia, neutropenia and anemia were 38.0%, 52.0% and 2.2%, respectively.Grade IV incidence of neutropenia was 35.5%.WHO grade Ⅲ incidences of fatigue, constipation and vomit were 22.0%, 8.0% and 14.8%,respectively.Five patients failed to complete the treatment due to side effects.Conclusions Combined chemotherapy of vinorelbine plus platinum drugs is effective and tolerated in patients aged over 70 years with advanced NSCLC.Even patients with stable clinical effects shows benefit of survival time.

Objective To evaluate one-stage procedure for the treatment of neonatal intermediate and high imperforated anus. Methods Clinical data of 21 neonates with intermediate or high imperforated anus undergoing one-stage surgical procedure were summarized. Results Postoperative complication included mucous overlap and soiling in 1 case, and occasional soiling in 2 cases. No postoperative constipation developed in any case. Conclusions Neonatal one-stage procedure avoids short comings often seen in staged procedures and needs no colostomy, promoting hyperplasia and prolongs sphincter during early stage, preventing secondary megacolon.

Objectives To investigate the changes and features of drug resistance in Haemophilus inlfuenzae (Hi) isolated from children with infection diseases in Suzhou. Methods One thousand two hundred and twenty-two Hi strains isolated from clinical specimens were collected from January 2011 to June 2012. Antimicrobial susceptibility was tested by Kirby-Bauer me-thod, andβ-lactamase was analyzed by chromogenic nitroceifn method. Then strains were divided into four groups according to their speciifc resistance patterns:①β-lactamase positive strains (except for cefuroxime-resistant strains),②β-lactamase negative ampicillin-resistant (BLNAR) strains,③cefuroxime-resistant strains, and④other resistant strains. Results The resistance of iso-lated Hi from children in Suzhou area to ampicillin, co-trimoxazole, cefaclor, tetracycline, chloramphenicol, azithromycin, cefu-roxime, ampicillin/sulbactam was 32.7%, 76.7%, 27.4%, 14.3%, 10.2%, 8.4%, 6.9%and 4.3%, respectively, and the detection rate in four groups was 29.0%, 2.6%, 6.9%, 41.2%, respectively. Multi-resistant strains were mainly distributed in Group①and Group②, accounting for 67.5%and 81.3%of each group. Azithromycin, tetracycline and chloramphenicol showed high antimicrobial activity against BLNAR and cefuroxime-resistant Hi strains. The positive rate of resistance toβ-lactamase was 30.8%. The rates of resistance to cefuroxime, cefaclor, ampicillin/sulbactam and cotrimoxazole inβ-lactamase-positive ampicillin-resistant strains are signiifcantly different from those inβ-lactamase-negative ampicillin-resistant strains. Conclusions The resistance feature of Hi isolated from children in Suzhou shows signiifcant changes, including new appearance of cefuroxime-resistant strain, a rapid increase in resistance to azithromycin, and a large proportion of multidrug-resistant strains. The rapid increase in BLNAR and the emergence of cefuroxime-resistant strains have become the new resistance pattern of Hi in this area.

Objectives To analyze pathogen distribution and antimicrobial resistance of bacilli among children with otitis media. Methods Pathogenic bacteria was isolated from children with suppurative otitis media. The VITEK32 was used for iden-tification. The bacterial susceptibility testing was done by Kirby-Bauer method. According to CLSI standard the antimicrobial susceptibility was determined. Results From Jan 2010 to Dec 2012, 425 children with suppurative otitis media were examined. 347 strains were isolated, of which the detectable rate was 81.65%. The detectable rate of bacteria and fungus was 93.37%(324/347) and 6.63%(23/347), respectively. Among bacteria, the detectable rate of streptococcus pneumoniae was 40.92%(142/347) and staphylococcus aureus was 33.43%(116/347). The detectable rate of haemophilus influenza was 7.78%(27/347). The preva-lence of streptococcus pneumoniae is high in children aged 1-3years, with detectable rate at 47.09%. There was no statistical dif-ference among different age groups. The prevalence of methicillin-resistant staphylococcus aureus (MRSA) in middle ear secre-tion was 1.11%(5/45), 18.75%(9/48)and 30.43%(7/23)in 2010, 2011 and 2012 respectively, with no statistical difference (χ2=3.86, P=0.145). The prevalence of penicillin-resistant streptococcus pneumoniae (PRSP) in middle ear secretion was 9.26%, 3.92%and 27.03%in 2010, 2011 and 2012 respectively, with statistical difference (χ2=11.47, P=0.003). Conclusions Choosing correct therapy according to the result of middle ear secretion culture and antibiotics sensitive test can increase the recovery rate of otitismedia.

Eight adult dogs distributed equally into control and therapy groups were fed on stock diet for 20 days and then irradiated whole-bodily with 60Co 4.65 Gy. After irradiation the control group was not given any therapeutic measure but fed on the diet as usual, while the therapy group was given with a larger amount of vitamins and high-caloric and high-protein diet, and sometimes force feeding was taken if the latter showed sign of anorexia. Whether higher values of nonprotein nitrogen in serum of two dogs in restored period and diarrhea happened in the therapy group were attribute to The treatments such as high-protein diet and force feeding were still unknown, the curing effects of nutrition and antibiotics were distinct as shown in that the body weight was easily maintained, and that the anemia and leucopenia wereless severe and recovered early. Moreover, within 30 days both the ther apy andcontrol groups one dog died respectively but survival time of the former was longer than the latter.

Objective　To evaluate the inhibition effect of immunoconjugate of doxorubicin(DXR) with a monoclonal antibody, 5F11 on human lung cancer cells and its reversal effect on resistant lung cancer cells to chemotherapeutic drug. Methods　DXR was attached to 5F11 using dilute glutaraldehyde crossing.The antitumor activity of immunoconjugate, 5F11-DXR, against the sensitive antigen-positive cell line, A2, drug-resistant antigen-positive cell lines, 801-D and 801-DDXR, and antigen-negative cell line, ascite cancer cell was evaluated by human tumor cell cloning assay and dye exclusion assay. Results　According to the results of various assays, comparing with single DXR, 5F11-DXR could significantly increase the cytotoxicity to A2, 801-D and 801-DDXR cell lines with a DXR concentration of 0.4*!μg／ml(P＜0.05), and this difference was even more distinct to A2 cell line with lower concentration of DXR (0.04*!μg/ml). However, there was no remarkable difference between 5F11-DXR and single DXR in cytotoxicity to antigen-negative ascite cancer cell(P＞0.05). Conclusion　5F11-DXR can remarkably increase the cytotoxicity of DXR to the sensitive target cells and even effectively reverse the drug-resistant cell lines to DXR. There is no significant difference between 5F11-DXR and DXR in killing antigen-negative cancer cells.

BACKGROUNDTo evaluate the activity and toxicity of paclitaxel as second-line treatment for advanced non-small cell lung cancer (NSCLC).

METHODSForty patients with recurrent advanced NSCLC were enrolled. Thirty-six patients were managed with regular regimen. Paclitaxel 135 mg/m², 3 h, on day 1; DDP 75 mg/m² or carboplatin 300-350 mg/m² on day 2. Four patients were managed with weekly regimen. Paclitaxel 60 mg/m²,3 h, on days 1,8,15; DDP 75 mg/m² on day 2. It was repeated every three or four weeks, up to two to four cycles.

RESULTSThirty-six cases were evaluated for response and 27 for survival. The objective response rate was 13.9% (5/36). At least one tumor-related symptom relief was observed in 21 patients (58.3%). The median survival duration was 26.4 weeks and 1-year survival rate was 8% (4/36). The main toxicities included myelosuppression, fatigue and myalgia-arthralgia neuropathy.

CONCLUSIONSPaclitaxel has advantage to be well-tolerated and improve tumor-related symptom. Further studies with standardization of dose and regimen will be needed to clarify its role in the second-line treatment.

OBJECTIVETo evaluate the efficacy and toxicity of Serratia marcescens (S311) vaccine in the treatment of malignant pleural effusion.

METHODSThirty-four patients with malignant pleural effusion were given S311 as intrapleural injection with a dose of 10(9) U (0.32 mg) on D 1, 8 and 15, and observed for four weeks.

RESULTSThe overall response rate (CR + PR) was 97.1% (CR in 12 patients and PR in 21 patients). The systemic toxicity was mild, including fever (82.4%), pleuritic pain (50.7%), nansea (26.5%), dyspnea (17.5%) and chills (5.9%).

CONCLUSIONSerratia marcescens vaccine is effective for malignant pleural effusion, with tolerable toxic effects. Further study is warranted.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacterial Vaccines ; adverse effects ; immunology ; therapeutic use ; Chest Pain ; chemically induced ; Dose-Response Relationship, Drug ; Female ; Fever ; chemically induced ; Humans ; Male ; Middle Aged ; Pleural Effusion ; drug therapy ; immunology ; Serratia marcescens ; immunology ; Time Factors ; Treatment Outcome

Objective To investigate the effect of hyperbaric oxygen preconditioning (HBO) on activation of extracellular signal-regulated kinase (ERK) and death-associated protein kinase 1 (DAPK1)in ischemia-like treated neurons.Methods (1) Cultured mouse primary neurons were allocated into control,ischemia-like condition treated and HBO preconditioning groups.Neurons in ischemia-like condition treated group were treated with 95％ NO2+5％ CO2 for 30 min,and cells in the HBO preconditioning group were pretreated with 98％ O2+2％ CO2 for 2 h,followed by ischemia-like condition treatment.At the end ofthe treatment,the growth of neurons was measured by MTT assay and expression of phosphorylated extracellular signal-regulated kinase (p-ERK) was detected by Western blotting.Neurons were transfected with ERK over-expression vector and pretreated with HBO and ischemia-like condition,and then,the expressions of activated caspase-3 (cleavage caspase-3) and DAPK1 in neurons were analyzed by Western blotting.The interactions of ERK with DAPK1 were also detected by irnmunoprecipitation.(2) Forty-five BALB/c mice were randomized into control,ischemia treated and HBO preconditioning groups.After finishing the treatments,the interactions of ERK with DAPK1 in hippocampal neurons were detected by immunoprecipitation.Results As compared with control group,cells in ischemia-like condition group showed a reduction of cell survivals,while cells in HBO preconditioning group exhibited an inhibition effect on ischemia-like condition-induced cell survival reduction.The expressions of p-ERK were increased by ischemia-like condition,while decreased by HBO preconditioning,with significant difference (P＜0.05).Moreover,over-expression of ERK promoted level of cleavage caspase-3 in neurons; however,DAPK1 expressions were not affected by ischemia-like condition or HBO preconditioning.The interactions of ERK with DAPK1 were attenuated by HBO preconditioning as compared with those by ischemia-like condition treatment.Conclusion HBO preconditioning inhibits ERK activation and disturbs the interaction between ERK and DAPK1,which blocks cell apoptosis and thus induces ischemic tolerance.

Objective:To investigate the molecular mechanism of transcytosis of Leptospira interrogans ( L. interrogans) across vascular endothelial cells. Methods:Transwell assay was performed to observe the ability of L. interrogans strain Lai across the monolayer of human vascular endothelial cells (HUVEC). Transmission electron microscopy and laser confocal microscopy were used to detect the endocytic vesicles containing L. interrogans strain Lai in HUVEC. The leptospiral endocytic pathway was determined by endocytic inhibition test. Laser confocal microscopy was also used detect the co-localization of L. interrogans with lysosomal marker LAMP1 in HUVEC. The exocytosis of L. interrogans from HUVEC was detected using Petroff-Hausser counting chamber and darkfield microscopy. Results:L. interrogans strain Lai could rapidly transmigrate through HUVEC monolayers and be internalized into HUVEC by PI3K-microfilament-dependent endocytosis to form leptospiral endocytic vesicles. The internalized L. interrogans did not co-localize with LAMP1, indicating the leptospiral endocytic vesicles did not fuse with lysosomes. The exocytosis of internalized L. interrogans was through FAK-microfilament/microtubule pathway. Conclusions:L. interrogans strain Lai could transmigrate through HUVEC by transcytosis to diffuse in vivo and cause disease aggravation.