Application value and difficulty analysis of fluorescence laparoscopy in lymphadenectomy of gastric cancer / 中华胃肠外科杂志

Gastric cancer is one of the most common gastrointestinal malignancies, and the incidence and mortality of gastric cancer remain high in China. In recent years, with the rapid popularization of laparoscopic technology, fluorescent laparoscopic technology is increasingly getting mature, providing a new method for accurate clinical tracing of lymph nodes and prediction of tumor metastasis lymph nodes. A large number of scientific research experiments and clinical trials have shown that, laparoscopic lymph node diagnosis technology based on the fluorescent indocyanine green (ICG) can significantly improve the efficiency of lymphadenectomy and prediction accuracy of lymph node metastasis, and can reveal a more accurate scope of lymphadenectomy in gastric cancer for surgeons, so as to avoid excessive adenectomy as well as iatrogenic injuries on patients. Although the status of the technology in gastric cancer surgery mentioned above continues improving, the overall operation process details of ICG fluorescence imaging, standardized fluorescence detecting equipment, and postoperative pathological examination process still need to be further optimized.

Laparoscopic proximal gastrectomy and lymph node resection in adenocarcinoma of the esophagogastric junction / 中华胃肠外科杂志

The proportion of adenocarcinoma of the esophagogastric junction (AEG) in gastric cancer is gradually increasing. Due to the unique anatomical structure and biological characteristics of the tumor at this site, AEG has a certain degree of complexity in many aspects of diagnosis and treatment, which brings difficulties to the operation method, the selection of the resection range, the lymph node dissection and the treatment decision-making. Therefore, AEG has always been the focus of academic debate. With the development of minimally invasive surgery in recent years, laparoscopic technology has been increasingly mature and widely used in the treatment of gastrointestinal tumors. Compared with distal gastric cancer, the minimally invasive treatment of AEG is in a lagging state, and there are also a series of problems that have not yet reached a consensus. This article reviews and summarizes the recent research progress in two aspects: proximal gastrectomy for AEG and lymph node dissection. Laparoscopic-assisted proximal gastrectomy is safe for early proximal gastric cancer and has a long-term survival outcome not inferior to total gastrectomy, but the surgical indications must be strictly selected. Abdominal lymph node metastasis of AEG is mainly in group 1, 2, 3, and 7, and mediastinal lymph node metastasis is closely related to the length of the infiltrated esophagus. The abdominal transhiatal (TH) approach can obtain a sufficient number of harvested lymph node, and has good safety and efficacy, which is the first-choice of surgical approach for early AEG. The results of the CLASS-10 clinical trial can provide a higher level of evidence for laparoscopic mediastinal lymph node dissection. Laparoscopic surgery for AEG should be carried out in experienced medical center based on clinical research.

Clinicopathological features and survival analysis of gastric cancer patients with neuroendocrine differentiation after radical resection / 中华胃肠外科杂志

Objective: To compare the clinicopathological characteristics and the prognosis of gastric adenocarcinoma patients with and without neuroendocrine differentiation (NED) after radical gastrectomy plus D2 lymph node dissection. Methods: A retrospective cohort study was performed. The inclusion criteria were as follows: (1) patients who underwent radical resection of gastric cancer plus D2 lymph node dissection and were confirmed as gastric adenocarcinoma by postoperative pathology and received immunohistochemical examination of neuroendocrine markers Syn and/or CgA; (2) patients aged 20 to 75 years with normal organ function; (3) patients who did not receive neoadjuvant chemotherapy or radiotherapy before operation; (4) patients with postoperative pathological stage I to III according to the 8th edition of tumor staging system of American Joint Committee on Cancer (AJCC); and (5) patients who completed adjuvant chemotherapy according to the postoperative pathological stage. Those who had other malignant tumors in the past 5 years and who could not be followed up according to the required rules were excluded. According to the above criteria, the clinicopathological characteristics of gastric cancer patients who underwent radical resection plus D2 lymph node dissection in Zhongshan Hospital of Fudan University from January 2010 to June 2017 were collected and compared. All patients were followed up till June 2020. The disease-free survival (DFS) and overall survival (OS) between the patients with and without NED were compared, and the effect of NED on the prognosis was corrected by Cox proportional hazards model. The propensity score matching method was used for sensitivity analysis. Results: A total of 539 patients were enrolled in this study, including 35 with NED and 504 without NED. Compared with the patients without NED, the patients with NED were older [(65.0±7.5) years vs. (54.5±11.3) years, t=-7.681, P<0.001], had higher proportion of undergoing proximal gastrectomy [22.9% (8/35) vs. 7.6% (36/504), χ(2)=10.335, P=0.006], higher proportion of intestinal-type based on Lauren classification [77.1% (27/35) vs. 42.5% (214/504), χ(2)=14.553, P<0.001], and higher proportion of pathologic stage III [65.7% (23/35) vs. 27.6% (139/504), χ(2)=25.653, P<0.001]. The 3-year DFS of patients with NED and those without NED was 48.9% (95% CI: 33.8%-70.8%) and 37.4% (95% CI: 32.9%-42.5%) respectively, and no significant difference was found (P=0.44). The 3-year OS was 56.1% (95% CI: 39.9%-79.1%) and 64.3% (95% CI: 59.3%-69.7%) respectively, and no significant difference was found as well (P=0.32). Univariate and multivariate analyses showed that NED was not an independent risk factor for DFS and OS (all P>0.05). Sensitivity analysis showed that there was no significant difference in DFS and OS between the two groups after propensity score matching. Conclusion: Compared with patients without NED, patients with NED were older at onset, had a higher proportion of proximal gastrectomy, intestinal-type, and later diagnostic stage, but the survival prognosis had no significant difference with that of patients without NED.

Interpretation of key points of Chinese expert consensus on function-preserving gastrectomy for gastric cancer (2021) / 中华胃肠外科杂志

Gastric cancer is one of the most common malignant tumors in China, and with the popularity of gastroscopy in recent years, the proportion of early gastric cancer is increasing gradually. Through standardized endoscopic and/or surgical treatment, patients with early gastric cancer usually have a favorable prognosis, which will inevitably lead to higher demands for postoperative quality of life. Based on this situation, function-preserving gastrectomy (FPG) has become a focus in the treatment of early gastric cancer for the purpose of improving the quality of life. The "Chinese expert consensus on function-preserving gastrectomy for early gastric cancer (2021)" will guide surgeons to perform standardized FPG, and ensure the maximum quality of life for the patients.

The influence of benazepril and amlodipine on the expression of secretin and somatostatin in spontaneously hypertensive rats / 中国应用生理学杂志

OBJECTIVES@#Investigate the influence of benazepril and amlodipine on the expression of secretin (PZ) and somatostatin (SS) in spontaneously hypertensive rats (SHR).@*METHODS@#Forty-five SHRs (14 weeks old, male) were randomly assigned into 3 groups (=15):SHR group, Benazepril group (which was given benazepril 0.90 mg·kg·d) and Amlodipine group (SHRs were given amlodipine 0.45 mg· kg·d), taking WistarKyoto(WKY) as normal control (=15), meanwhile, rats in SHR group and WKY group were given the same volume of distilled water. After 8 weeks of intervention, the expression of protein and mRNA of PZ in duodenum and SS in sinuses ventriculi was detected by enzyme-linked immunoassay and RT-PCR.@*RESULTS@#After 8 weeks of intervention, compared with the WKY group, the expression of protein and mRNA of PZ in duodenum and SS in sinuses ventriculi was increased significantly in SHR group (<0. 05). Compared with SHR group, the expression of PZ in duodenum and SS in sinuses ventriculi was decreased significantly in Benazepril group and Amlodipine group (<0.05). Compared with Benazepril group, in Amlodipine group the expression of PZ mRNA in duodenum and SS mRNA in sinuses ventriculi was decreased more significantly (<0.05).@*CONCLUSIONS@#The regulation disorder of PZ in duodenum and SS in sinuses ventriculi exists in SHR. The antihypertensive effect of benazepril and amlodipine may be realized by regulating the expression of PZ and SS, while the regulation of amlodipine is more obvious than benazepril.

How to carry out the translational medicine research effectively in gastrointestinal tumors / 中华胃肠外科杂志

As a new concept, the definition of translational medicine remains obscure. The translational medicine connects the bench to bedside, and its importance would be more remarkable. The development of gastrointestinal surgery reflects the idea of translational medicine. To carry out the translational study, the gastrointestinal surgeon must learn how to find subjects from clinical problems, how to collect complete information and tissues, how to collect complete information and tissues, how to collaborate with others from different fields and how to utilize all kinds of resources. By translational studies, gastrointestinal surgeons may further improve the survival of patients with gastrointestinal tumor.

Clinicopathological features and prognosis of chronic gastric ulcer with early canceration / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinicopathological features and prognosis of chronic gastric ulcer with early canceration in order to provide useful information for diagnosis and treatment strategies.</p><p><b>METHODS</b>A retrospective review of clinical data and prognosis from 43 patients of chronic gastric ulcer with early canceration from 2003 to 2010 was conducted. These data were compared with those with primary intra-mucosa gastric cancer (type I and II 275 cases, type III 68 cases).</p><p><b>RESULTS</b>In 43 cases of chronic gastric ulcer with early canceration, 30 cases (69.8%) were male, 22 cases (51.2%) were younger than 60 years old. Lesions located in the body or antrum of the stomach in 39 cases (90.7%), were less than 2 cm in 26 cases (60.5%), were undifferentiated type in 23 cases (53.5%), and developed lymph node metastasis in 4 cases (9.3%). Lesions of 4 cases of chronic gastric ulcer with early canceration located in the upper third of the stomach, while those of type III primary intra-mucosal gastric cancer all located in the lower two thirds, and the difference was statistically significant (P<0.01). Compared to type III and type I and II primary intra-mucosal gastric cancer, chronic gastric ulcer with early canceration did not differ in clinicopathological characteristics such as histological type, vascular or lymphatic invasion, and lymph nodes metastasis (all P>0.05). The median follow-up time was 57 months (range 16 to 98 months). The 5-year overall survival was 95.3% in chronic gastric ulcer with early canceration group, similar to that of type I, II (97.4%) or type III (94.5%) primary intra-mucosal gastric cancer group (P>0.05).</p><p><b>CONCLUSIONS</b>The clinicopathological features of chronic gastric ulcer with early canceration are similar to those of primary intra-mucosal gastric cancer. The prognosis is promising for those patients undergoing surgical treatment.</p>

Association of T helper cell 1 cytokines expressions with prognosis of gastric cancer patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the association of the expressions of Th1 cytokines in gastric cancer tissue and the prognosis of patients with gastric cancer after radical resection.</p><p><b>METHODS</b>Fifty-eight patients with gastric cancer treated at the Zhongshan Hospital of Fudan University were retrospectively analyzed. The expressions of Th1 cytokines mRNA were detected in tumor tissues by real-time polymerase chain reaction(RT-PCR) method in Th1 cells including TRAV10, IRF1, TBX21, CD3Z, GZMB, GATA3, and IFNG. Association of Th1 cytokines mRNA expressions and prognosis was evaluated.</p><p><b>RESULTS</b>The median follow up was 42.5(1-64) months. The 1-year survival rate was 84.5% and the 3-year survival rate was 72.4%. Univariate Cox regression analysis showed that lymph node metastasis, distant metastasis, TNM staging, lymphovascular invasion, GNLY mRNA expression, and the overall expression level of the 8 types of Th1 cells were associated with the prognosis of patients with gastric cancer(all P<0.05). The 3-year survival was 86.2% in patients with increased expression of mRNA and 58.6% in those with decreased expression. The 3-year survival was 79.6% in patients with any increase in the 8 Th1 cytokines and 33.3% in those with consistent downregulation of the 8 cytokines. Multivariate Cox analysis showed that lymph node metastasis and the overall expression level of 8 Th1 cytokines were independent risk factors associated with the prognosis of patients with gastric cancer in this cohort(both P<0.05).</p><p><b>CONCLUSIONS</b>The mRNA expression of GNLY is associated with the prognosis of patients with gastric cancer but is not an independent risk factor. The combination of mRNA expressions of the eight cytokines is an independent prognostic factor.</p>

Application of robotic system in gastrointestinal surgery / 中华胃肠外科杂志

Robotic system helps surgeons in performing surgery. Currently Da Vinci system is the most popular. Da Vinci system has been used for the stomach and bowel diseases in 27 cases(18 cases of stomach and 9 cases of colon and rectum) in the Zhongshan Hospital, Fudan University. Accurate preoperative staging is crucial, and Da Vinci system is advantageous in lymph node dissection, preservation of nerve plexus, and complete resection of mesorectum. Adoption of gastrointestinal tract reconstruction technique should depend on the operation and experience in surgery. Though Da Vinci system has limitations and the cost is high, it is believed to be the future trend.

Relationship of gallstone formation after radical gastrectomy with the polymorphisms of apolipoprotein B Xba I and lipoprotein lipase Hind III gene / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship of gallstone formation after radical gastrectomy with the polymorphisms of apolipoprotein B (ApoB) Xba I gene and lipoprotein lipase (LPL) Hind III gene.</p><p><b>METHODS</b>A total of 80 gastric cancer patients who underwent radical gastrectomy at our hospital between January 2006 and December 2006 were divided into different groups according to the polymorphisms of ApoB Xba I gene and LPL Hind III gene. The gene polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism. Gallstone formation 2 years after radical gastrectomy was compared among different genotype groups.</p><p><b>RESULTS</b>Eight patients were lost to follow-up. According to the genotype detection, 72 patients were divided into X(+)X(-) group (10 cases), X(-)X(-) group (62 cases), H(-) group (27 cases) and H(-) deletion group (45 cases). The incidence of gallstone was significantly higher in X(+)X(-) group than that in X(-)X(-) group (60.0% vs 6.5%, P<0.01). The serum levels of total cholesterol TC and low density lipoprotein were significantly higher in X(+)X(-) group than those in X(-)X(-) group (P<0.05), but the level of ApoB was not significantly different between the two groups. The incidence of gallstone was not significantly different between H(-) group and H(-) deletion group (14.8% vs 13.3%). The level of triglyceride in H(-) group was significantly lower than that in H(-) deletion group before operation, however the difference disappeared after operation.</p><p><b>CONCLUSION</b>X(+) allele may be associated with gallstone formation after radical gastrectomy, while H(-) may not.</p>

Da Vinci robot-assisted gastrectomy with lymph node dissection for gastric cancer: a case series of 9 patients / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the technical feasibility, effectiveness, and safety of robot-assisted gastrectomy(RAG) with lymphadenectomy using the Da Vinci system.</p><p><b>METHODS</b>A total of 9 patients in our institute from March 17 to April 24 2010 underwent RAG. Clinicopathologic characteristics and surgical outcomes were summarized.</p><p><b>RESULTS</b>All operations were performed successfully without conversion to either open or laparoscopic approach. There were 5 total gastrectomies,2 distal gastrectomies, 1 proximal gastrectomy and 1 wedge gastrectomy with D(1) or D(2) lymphadenectomy. The total operative time was 150 to 440 minutes. Total blood loss ranged from 10 to 100 ml. The ranges of harvested lymph nodes were 19-24 for D(1) patients and 28-38 for D(2) patients. There was 1 case of postoperative gastric leakage, which were managed conservatively.</p><p><b>CONCLUSIONS</b>RAG with lymphadenectomy can be applied safely and effectively for patients with gastric cancer.</p>

Risk factors for postoperative pancreatic leakage after D(2) resection of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of pancreatic fistula following D(2) gastrectomy and associated risk factors.</p><p><b>METHODS</b>A total of 132 consecutive cases of gastric cancer underwent D(2) gastrectomy between Jul 1, 2009 and Dec 2009. Amylase concentration of the drainage fluid and serum amylase concentration were tested on day 1, 4, 7 after operation. Univariate analyses were performed to evaluate the significance of various covariates as risk factors for the pancreatic fistula-related complications.</p><p><b>RESULTS</b>The incidence of pancreatic fistula was 17.4%. None of the following factors including age, gender, tumor location, tumor stage, N stage, range of resection, fistula output, and serum amylase were associated with pancreatic fistula.</p><p><b>CONCLUSION</b>The incidence of pancreatic fistula following D(2) gastrectomy is high. Drainage tube is necessary to prevent serious complications.</p>

Evaluation the value of number of metastatic perigastric lymph nodes on prognosis in patients with gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To find out a simple and reproductive prognostic index in gastric cancer patients,which can be used as a comparable parameter among different regions of China.</p><p><b>METHODS</b>The perigastric metastatic lymph nodes(PGMLN) with long-term survival data were retrospectively evaluated in 148 gastric cancer patients, undergone potentially curative resections.</p><p><b>RESULTS</b>The 3-year cumulative survival rate was 62.8% and the survival rate decreased significantly with the increase of PGMLN, especially when the PGMLN was more than 6. The PGMLN had a clear linear relationship with total positive lymph nodes(r=0.94, P<0.01), while it had little correlation with total resected lymph nodes(r=0.18,P=0.2).</p><p><b>CONCLUSIONS</b>PGMLN is a convenient and reliable prognostic factor in gastric cancer patients, which may be a good candidate of comparable parameters among different regions of China.</p>

Correlation of the Characteristics of SCL-90 and the Professional Ennui of Teachers in University / 中国康复理论与实践

@#ObjectiveTo analyzes the influence of psychological factors on the rehabilitation of the professional ennui (PE) of teachers in Institutions of Higher Learning (TIHL).MethodsMaslach Burnout Inventory-ES and the Symptom Checklist 90 (SCL-90) were used to investigate the subjects of TIHL. ResultsThe scores of PE showed distinct positive correlation with every factor of SCL-90 (P<0.01). ConclusionPE of TIHL is correlative with SCL-90, which seems that improvement of psychology may improve the PE of TIHL.

Clinical use of endoscopic ileus tube drainage in preoperative therapy for acute low malignant colorectal obstruction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical use of endoscopic ileus tube drainage in preoperative therapy for acute low malignant colorectal obstruction.</p><p><b>METHODS</b>From Nov. 2004 to Dec. 2005, 15 cases with acute low malignant colorectal obstruction received emergency colonoscopy and endoscopic ileus tube drainage was performed. Radical resection was then performed after seven days of drainage.</p><p><b>RESULTS</b>Endoscopic ileus tube drainage was successful in 13 cases, and failed in 2 cases because the guide wire cannot be inserted through the tumor in one case, and in the other case the tumor was located in the middle of the transverse colon so that the ileus drainage tube was not long enough. Abdominal girth decreased from (91+/- 4) cm to (82+/- 2) cm after tube drainage. The everyday drainage volume minus rinsing volume ranged from - 600 ml to 3200 ml. Abdominal X ray showed that obstruction was relieved. Intra-operative exploration revealed that colon edema was not evident, which increased resection rate.</p><p><b>CONCLUSION</b>Endoscopic ileus tube drainage is effective, safe and maybe the first choice of acute low malignant colorectal obstruction.</p>

In vitro evidence for pancreatic lineage: Ngn3 positive cells are endocrine progenitors derived from cultured islets / 中华外科杂志

<p><b>OBJECTIVE</b>Further studies have been conducted to evaluate the roles of Ngn3 in adult islet maintenance and renewal.</p><p><b>METHODS</b>Islets were isolated from 6 - 8 week old male C57BL/6 mice. After common bile duct cannulation, the pancreas was resected and digested in collagenase V (2.5 mg/ml). Islets were then handpicked and 10 - 12 islets were plated in 60 mm culture dish and cultivated with RPMI-1640, which contained 12.5 mmol/L HEPES, 5.2 mmol/L glucose and 2% fetal bovine serum (FBS). Islet cells were analyzed by immunocytochemistry methods for A6, insulin, glucagon, nestin, Ngn3 and 5-bromo-2'-deoxy-uridine (BrdU).</p><p><b>RESULTS</b>The results of these studies indicated that less than 15 percent of proliferated islet cells were Ngn3 expressing cells, in which about one third of the Ngn3 positive cells co-expressed A6. The existence of Ngn3 in cultured islet cells is consistent with the results from other's findings both in embryogenesis and adult islet studies. A significant finding of our study is that the existence of A6 and Ngn3 co-expressing cells in the cultured islet. A6 is a marker for identifying bile duct epithelial cell oriented hepatic progenitor cells. Islet-derived A6 cells are possibly born in the adult pancreatic duct and migrate into islets. A6 cells co-express Ngn3 when these cells commit to endocrine lineage within the islets. More interestingly, islet-derived A6 positive cells have the potential to transdifferentiate into hepatic cells.</p><p><b>CONCLUSION</b>The presence of Ngn3(+) and A6(+) cells in the cultured islets suggests that the four established islet cell types arise from a common endocrine lineage residing within the adult islets. A6 and Ngn3 are useful markers for understanding intra-islet adult stem cell lineages in our future studies. This approach may allow for significant advances in understanding the IPC proliferation and differentiation, and open the possibility of using intra-islet adult stem cells for diabetes treatment.</p>

Eight Cases of Caroli′s Disease in Children / 实用儿科临床杂志

Objective To explore the clinical characteristics and treatment of Caroli′s disease in children.Methods The clinical data,laboratory examination and radiological feature of 8 children with Caroli′s disease between Feb.1998 and Dec.2007 were analyzed retrospectively.All children underwent CT and abdominal ultrasonogram.Results Five cases of the 8 children were male and 3 cases were female.The mean age was 6.3 years old.The cases′ history were from 5 days to 4 months.The clinical symptoms showed that 3 cases had hematemesis,5 cases had hepatosplenomegaly,and 1 case had fever and turbid urine.Of the total 8 cases,5 cases were hepatic fibrosis and liver cirrhosis and hepatosplenomegaly,3 cases were portal hypertension,and 1 case had cholangitis.The other 3 cases were simple types.One case had infantile polycystic kidney disease.Laboratory analysis revealed 2 cases had dysfunction of liver and 1 dysfunction of renal.The imaging characteristics showed multiplied irregular dilatation of the intrahepatic bile ducts in enlarged liver,with central dot sign on CT scan.One case presented enlarged gastroesophageal vein.The 8 cases undertook conservative treatment,with no surgery.Conclusions The symptoms of Caroli′s disease are highly variable.Caroli′s disease should be focused especially on children with abdominal pain and hepatomegaly.CT is important for diagnosis of Caroli′s disease at earlier stage.The disease can be conservatively treated,and(or) surgically operated.

Comparision of high dose impulsion and low dose density chemotherapeutic regimens with paclitaxel plus cisplatin in advanced NSCLC / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore high effective and low toxic chemotherapeutic regimens in the treatment of non-small-cell lung cancer (NSCLC).</p><p><b>METHODS</b>A total of 126 patients with advanced NSCLC (Stage III, IV) were randomly divided into two groups: high dose impulsion chemotherapy group (HDIC group) and low dose density chemotherapy group (LDDC group) with 54 patients in HDIC group who received paclitaxel 135-175 mg/m2 on day 1, DDP 80-100 mg/m2 on day 1 and BCNU 125 mg given for brain metastasis on days 1-3 in a 4-6 weeks cycle. Seventy-two patients in LDDC group were given paclitaxel 60-80 mg/m2 on day 1, DDP 40-80 mg/m2 on day 1 repeated weekly and BCNU 125 mg given for brain metastasis with an interval of 2 weeks, in a 4-6 weeks cycle. Antiemetic agent and fluid were administered routinely in HDIC group whereas LDDC group was given antiemetic agent only.</p><p><b>RESULTS</b>Of 157 courses in HDIC group, an average of 2.9 courses per patient, CR 3, PR 23, SD 17 and PD 11 were observed. The effective remission rate was 48.1%, the median effective remission period was 4.5 months and the 1-year survival rate was 46.3%. Of 184 courses in LDDC group, an average of 2.6 courses per patient, CR 9, PR 30, SD 24 and PD 9 were observed. The effective remission rate was 54.2%, the median effective remission period was 6 months and the 1-year survival rate was 56.9%. The effective remission rate and the 1-year survival rate were higher in HDIC group than those in LDDC group, but there was no statistical difference between the two groups (P > 0.05). Severe toxicity was higher in HDIC group than in LDDC group. Two patients in HDIC group died of treatment-related complications (3.7%). Quality of life was better in LDDC group (70.8%) than in HDIC group (51.9%).</p><p><b>CONCLUSION</b>When comparing with high dose impulsion, low dose density regimen of paclitaxel plus cisplatin is more effective and better tolerated with improvement of quality of patients' life in the treatment of NSCLC due to its low dose and short interval duration.</p>