3 months. Female gender, adenocarcinoma history, non-smoking history, good PS and the presence of multiple lung metastases are associated with improved responsiveness to Gefitinib. Reflecting the results of previous clinical trials, the reports indicate that Gefitinib is generally well tolerated by Asian patients. The incidence of interstitial lung disease appears to be higher in Japanese than non-Japanese patients, although the reason for this is not clear. Recent findings regarding Erlotinib and other targeted therapy among Asian patients are discussed.

Recent progress in molecular biology has enabled us to better understand the molecular mechanism underlying pathogenesis of human malignancy including lung cancer, the advent of therapies based on mechanisms that target critical molecular pathways of tumors has evoked considerable interest. The therapeutic index is high, and optimally effective treatment can be achieved at a dose below the maximal tolerated dose,giving us a better understanding of the human lung cancer. This review focuses on the advance of targeted therapy for the first-line, second-line treatment or the maintenance treatment of non-small cell lung cancer.

Objective To study the effects of nitric oxide (NO) synthesis on serum interleukin 1? (IL-1?) and tumor necrosis factor ? (TNF-?) levels in liver ischemic preconditioning (IP) in rats. Methods 169 rats were randomly divided into ischemia/reperfusion (I/R) group, IP group,L-arginine plus IP (L-Arg+IP) group and sham operation group (S group). The concentrations of plasma NO, serum IL-1? and TNF-? were measured at 2h, 24h and 1 week after models were set up. Results ⑴ Plasma NO concentrations: In group IP and group L-Arg+IP,the NO concentration at all the 3 time points were significantly higher than those in group S (P0 05). Conclusions Liver ischemic preconditioning could down-regulate the levels of blood IL-1? and TNF-?, which may relate to the increase of NO synthesis. The increase of NO synthesis could enlarge this down-regulation effect, and further enhance the protective effect of IP on the liver I/R injury.

As a hot topic, biomarkers can provide reliable evidence for the individualized treatment of non-small cell lung cancer. With the further study of molecular biology and development of new drugs,biomarkers have shown a broad prospect in clinical application. Combining with the research in recent years,this review describes the progress in biomarkers for non-small-cell lung cancer.

A platinum-based doublet with a third-generation agent represents the standard first-line treatment for advanced non-small cell lung cancer patients with good performance status (PS). Traditional chemotherapy provides response rates of 20 %-40 % and a median survival of 8-10 months. In an attempt to improve its outcome, alternative schedules have been proposed, namely sequential, alternating, and maintenance therapy. Sequential chemotherapy with a platinum-based doublet followed by a single agent is feasible in patients with good PS; The use of sequential single agents is an option for elderly and frail patients unsuitable for a platinum-based combination. Based on trials published so far, it is unlikely that an alternating chemotherapy strategy will be proved superior to standard chemotherapy in patients with good PS.Consolidation chemotherapy may provide additional benefit for patients achieving disease control after standard first-line chemotherapy.

Objective To evaluate the indication,operation pattern and therapeutic effect of ano-saving surgery for lower rectal carcinoma. Methods Retrospective analysis on the clinical feature of 320 patients with lower rectal carcinoma (postoperative time ≥5 years)treated by ano-saving surgery, the 5-year survival rate, local recurrence rate, and mortality were compared in the various operations. Results The success performed rate of ano-saving operation for lower rectal cancer was 58.5%(320/547).Among them, anastomotic leakage after surgery occurred in 4 cases (1.25%), and 26 cases had anastomostic narrowness (8.13%) within 1 year after surgery.The defecation function after surgery, in patients received colonic J pouch or transverse coloplasty pouch was much better than that in patients received coloanal or colorectal anastomosis. 5-year survival rates, and anastomostic recurrence rates were as follows:In ultra-low anastomosis were 63.24% and 10.27%. Park′s operation 66.67% and 5.13%, local resection 89.46% and 10.71%, respectively. 5-year recurrence rate in the pelvic soft tissue was 3.44%(11/320).Two cases died after operation. Conclusions Lower or ultra-low colon-rectum anastomosis becomes the main operative pattern in preserving anal sphincter in lower rectal cancer.Local resection of lower rectal tumor might be considered if the indecation is selected strictly. Colonic-J-pouch or transverse coloplasty pouch is good for improving the defecation function after ano-saving surgery for lower rectal cancer.

AIM: To observe the influence of overexpression of ?-synuclein on the cultured SH-SY5Y cells. METHODS: The plasmid of ?-synuclein-pcDNA_3 was transfected into SH-SY5Y cells with LipofectAMINE. The expression of ?-synuclein was determined by anti-?-synuclein immunocytochemistry. The intracellular reactive oxygen species was determined with 2', 7'-dichlorofluorescein diacetate (DCF-DA) by using a FACSCAN flow cytometer and fluorescent microscope. The intracellular content of reduced GSH was detected with glutathione assay kit by spectrophotometer. RESULTS: The ?-synuclein was expressed in cultured SH-SY5Y cells transfected with the plasmid of ?-synuclein-pcDNA_3. The DCF loading analysis and the intracellular level of reduced GSH suggested that the transfected cells were under oxidative stress. CONCLUSION: Overexpression and accumulation of ?-synuclein in SH-SY5Y cells increase intracellular reactive oxygen species levels, it is suggested therefore that the ?-synuclein does play an important role in the pathogenesis of Parkinson's disease.

ObjectiveTo study the distribution,location and hemodynamics of perforating branches of the ulnar artery with color Doppler flow imaging (CDFI).MethodsPerforating branches of ulnar arteries were examined in 80 healthy volunteers in both forearms using CDFI.Following parameters were detected:number,diameter,jumping-off point,course,location and peak blood velocity.All the parameters data were analyzed statistically.ResultsThree hundred and forty-five perforating branches were detected in total 160ulnar arteries.These branches were classified into three types:type Ⅰ,myocutaneous perforator (10.3 ％);type Ⅱ,septocutaneous perforator(87 ％ ) ; type Ⅲ,direct cutaneous perforator (2.7 ％ ).The most dominant branches were located in the mesial of the upper third,middle third and lower third of the forearm.There was no significant difference among all age groups and no difference in peak blood velocity between left side and right side( P ＞0.05).The peak blood velocity was higher in male than that in female.( P ＜0.05).In relaxing period,the blood flow rate was almost disappeared and the frequency spectrum showed the characteristics of single direction,lower blood velocity and higher blood resistance.ConclusionsCDFI with high resolution showed better results of distribution and location of perforating branches of the ulnar artery and a better quality evaluation of the these branches.CDFI was helpful to design the skin flap containing cutaneous perforators of ulnar artery.

Objective To observe the short-term efficacy and safety of sequential administration of erlotinib and chemotherapy in unselected, chemonaive patients with advanced non-small-cell lung cancer (NSCLC). Methods Previously-untreated patients (n=23) with stage Ⅲ_B/Ⅳ NSCLC and ECOG PS of 0/1 received erlotinib (150 mg/d) on days 15-28 of a 4-week cycle that included gemcitabine (1250 mg/m~2, days 1 and 8), and either cisplatin (75 mg/m~2, day 1) or carboplatin (AUC=5, day 1). The primary end points were tumor response rate and safety. Results 23 patients received a total of 95 cycles of treatment, and all were evaluable for efficacy and toxicity. The overall response rate was 30.4%, 0 case achieved complete responses (CR), 7 cases (30.4%) achieved partial responses (PR), 14 cases (60.9 %) achieved stable disease (SD), 2 cases (8.7 %) achieved progression disease (PD). The disease control rate was 91.3 %. The sequential administration of erlotinib following gemcitabine/platinum chemotherapy was well tolerated. The major grade 3 treatment-related adverse events were eutropenia (13.4%), rash (8.7%), nausea (8.7%) and thrombocytopenia (8.7%). No treatment-related interstitial lung disease. Conclusion equential administration of erlotinib following gemcitabine/platinum chemotherapy was effective, and the toxicity was tolerable. This treatment strategy warrants further investigation.

Objective To determine the efficacy and toxicity of docetaxel in patients with paclitaxel-resistant advanced non-small cell lung cancer (NSCLC). Methods The clinical data from 15 patients with NSCLC who were admitted in the Shanghai Chest Hospital from January 2005 to May 2008 were retrospectively analyzed. The effects and toxicities of the second-line treatment were assessed. The progression-free survival time(PFS) and overall survival time(OS) were analyzed. Results The disease control rate was 66.7 %, with a progression-free survival time of 6 months, and a overall survival time of 17.3 months. The 1-year survival rate was 63.3 %. The toxic effects were as expected. Conclusion The doeetaxel-based agent is active in patients with paelitaxel-resistant advanced NSCLC.