Objective To evaluate the anti-tumor activity and toxicity of FOLFIRI regimen in the treatment of patients with advanced colorectal cancer. Methods 22 patients with advanced colorectal cancer used Irinotecan combined with 5-Fu/CF regimen to chemotherapy. Regimen: CPT-11 150 mg/m2 iv drip d1, CF 200 mg/m2 iv drip 2 h d1, 2; 5-Fu 400 mg/m2 iv drip d1, 2; 5-Fu 600 mg/m2 iv drip 22 h d1, 2. It is repeated every 2 weeks, two times a course. Efficiency and toxicity was evaluated after 4-6 cycles. Results Forty four patients were evaluated the efficiency. Two patients achieved CR, 16 PR, response rate was 40.9 %; MST was 11.3 months. TTP was 6.5 months. The main toxicity was cholinergic syndrome and delayed diarrhea,myelosuppression. There were no deaths during treatment. Conclusion The effectiveness of FOLFIRI regimen was higher and side effects was minor in advanced colorectal cancer. It should be further used and studied.

Objective To investigate the clinical value of neutrophil-to-lymphocytc ratio(NLR) in identifying blood stream infection caused by different pathogens and for differentiating coagulase negative staphylococcus(CNS)bloodstream infection and contamination.Methods Medical records of 500 patients who underwent blood culture test and routine blood test at the same time were retrospectively analyzed,blood culture negative group 356 patients,blood culture positive group 144 patients,which included Gram-negative group,Gram positive group,fungi group,CNS bloodstream contamination and mingled group.Collected the results and calculated the NLR at the same time.NLR were applied by t test of each group.ROC curve was used to determine the cut off value of NLR.Results ①Mean values of NLR in negative blood culture,blood stream infection group,CNS bloodstream infection and contamination were 6.12,13.15,10.11 and 6.24.NLR had statistical difference between negative blood culture and blood stream infection group,CNS bloodstream infection group and contamination group (P＜0.05).②Mean values of NLR in and fungi group were 15.33,11.63 and 10.58,respectively.NLR had statistical difference between Gram-positive bacteria group and Gram-negative bacteria group (P＜0.05).NLR had no differences among Gram-positive bacteria (15.33) and Gram negative bacteria (11.63) compared with (10.58) fungi respectively (P＞0.05).③The area under the curve of NLR predicting a positive blood culture,distinguishing Gram-positive bacteria and Gram-negative bacteria,differentiating CNS bloodstream infection and contamination were 0.86,0.60 and 0.75,respectively.The optimal cut off values of NLR for predicting a positive blood culture,distinguishing Gram-positive bacteria and Gramnegative bacteria,differentiating CNS bloodstream infection and contamination were 10.45,7.50 and 8.10 respectively.Conclusion NLR is highly effective in distinguishing blood stream infection and differentiating CNS bloodstream infection and contamination.

I uptake of thyroid and color Doppler flow imaging (CDFI) of superior thyroid artery (STA) were performed in 20 patients with Graves′ disease (GD) and 19 patients with other causes of hyperthyroidism. Maximum velocity and diameter of STA in patients with GD were much higher than those in non-GD group. CDFI of STA seems to be a useful tool in differential diagnosis of hyperthyoidism.

~(131)I uptake by thyroid were assayed in 64 patients with Graves′ disease (GD) and 69 patients with non-GD hyperthyroidism. GD group had higher rate of ~(131)I uptake than non-GD group at 2, 6 and 24 h, and there was no overlap between the two groups at these 3 time points.~(131)I uptake at 2 and 6 h could differentiate GD fromlow ~(131)I uptakehyperthyroidism.

ObjectiveTo detect the mutations of GJB3 and GJB4 genes in two sporadic cases of erythrokeratodermia variabilis(EKV).MethodsGenomic DNA was extracted from two sporadic patients with EKV,their family members,and 100 normal human controls.All the exons and adjacent splice sites of GJB3 and GJB4 genes were amplified by PCR.Mutation scanning was carried out via direct bidirectional DNA sequencing.ResultsA G134C mutation was found at the GJB3 gene in patient 1,which caused a substitution of glycine by alanine at codon 45 (G45A).No mutation was found in the GJB4 gene in case 1 or GJB3 and GJB4 genes in case 2.ConclusionA missence mutation G45A in GJB3 gene is found in a patient with EKV.

Objective To explore clinical characteristics of diagnosis and treatment of solid-cystic papillary tumor(SCPT) of the pancreas in children.Methods There were retrospectively analyzed about the 7 patients treated in our hospital for SCPT,with the ave-rage age of 11.5 years.All patients complained abdominal pain following a trauma(71.4%) or overeating(28.6%).The main presentation was abdominal mass.Of the 7 patients,4 received distal pancreatectomy,2 pancreatico-duodenectomy,and 1 only biopsy.Results The nicks of all patients were primany hed.All patients were pathologically confirmed as SCPT after operation.All patients were followed up for 4 monthes to 4.5 years,the recent result was well.Conclusions SCPT is a low-grade malignant tumor,which is often asymptomatic,but the patients with symptoms generally suffer from an abdominal mass or abdominal pain.The prognosis is excellent after operation.

Objective To analyze the CT findings of endobronchial spread in lung adenocarcinoma. Methods The CT findings of 15 lung adenocarcinomas or bronchioloalveolar carcinomas with endobronchial spread were reviewed,the distribution and the progression of the spread were evaluated.Results All of the primary tumors were consolidation form.The spread lesions distributed in one side of the lung or both sides along the bronchus.The pleural surface was spared.The CT findings of the spread included centrilobular nodules(n=5),tree-in-bud(n=7),acinar nodules(n=2),ground-glass opacities(n=10)and air- space consolidations(n=13)in the first CT examination.5 cases of the spread lesions only presented centrilobular nodules(single form)and 10 cases presented several appearances(complex form).All of the cases were diagnosed as tuberculosis or pneumonia,and antituberculotic or antibiotic therapy was taken with no effect.The follow-up CT scans showed progression in all cases,and the spread lesions with single form became multiple consolidations.The spread lesions with complex form deteriorated faster than the single one. Conclusion Although the CT findings of the endobronchial spread of the lung adenocarcinoma is specific, the clinical history and laboratory examination also are important for the differential diagnosis with tuberculosis and other infectious diseases.

Objective To analyze effects of thoracoscopy in the diagnosis and treatment of suspected diaphragmatic injury after thoracoabdominal stab wound.Methods Sixty-eight patients who received thoracoscopic diagnosis and management of diaphragmatic injuries due to thoracoabdominal stab wounds from April 2000 to October 2011 were retrospectively analyzed.Results Occult diaphragmatic injuries were found in 11 patients.Seven patients underwent thoracoscopic suture,of which five had synchronous laparotomy for inspected abdominal organ injuries.Pulmonary parenchymal lacerations occurred in 15 patients who received thoracoscopic repair or resection.Coagulated hemothorax in 13 patients were removed.Postoperative complications included pleural effusion in one patient,pneumonia in two and pulmonary atelectasis in one.Hospital stay was(7.9±13.5)days,without ICU stay.The length of drainage,operation time and intraoperative blood loss were(3.3±1.5)days,(45.6±78.1)minutes and(57.8±24.3)ml respectively.There was no conversion to thoracotomy.Thoracic CT scan was performed six months postoperatively,without hernias.The accuracy of thoracoscopy in diagnosing diaphragmatic injury was 100％.Conclusion Thoracoscopy should be performed for the thoracoabdominal stab wounds with stable hemodynamics,with definite significance especially for the diagnosis and treatment of wounds at the 7-9th intercostal spaces.

Objective To explore the appropriate pneumoperitoneum pressure in different surface area children during pediatric laparoscopic surgery,so as to attenuate the intederence with physiological function and avoid pneumoperitoneum correlative complications.Methods 120 patients underwent laparoscopic surgery were divided into three groups by different surface area:A(0.43～0.67m2),B(0.68～0.92m2),C(0.93～1.17m2).Each group was divided into two subgroups again by different pneumoperitoneum pressure:A1(4 mm Hg),A2(6mm Hg),B1(7mm Hg),B2(9mm Hg),C1(10mm Hg),C2(12 mm Hg).The cardiorespiratory function and blood gas analysis in different time point before and after pneumoperitoneum were monitored.Results The increase of PET CO2,Paw,HR,MAP and PaCO2 in A2,B2,C2 were more obvious than in A1,B1,C1(P ＜ 0.01).The eligible pneumoperitoneum pressure for A,B,C were 4,7,10mmHg respectively.The complications of gastric contents back-streaming and respiratory acidosis were 7 cases in A2,B2,C2 in all,and 3 cases in A1,B1,C1.Conclusion Using a compatible pneumoperitoneum pressure for different surface area children could attenuate the interference of physiological function and avoid pneumoperitoneum correlative complications.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; pathology ; Dinucleotide Repeats ; genetics ; Female ; Humans ; Introns ; genetics ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Receptor, Epidermal Growth Factor ; genetics ; metabolism