Clinical Observation of Sanjiao Fuzheng Mixture Combined with Concurrent Chemoradiotherapy of Paclitaxel and Nedaplatin in the Treatment of Local Advanced Non-small Cell Lung Cancer / 中国药房

OBJECTIVE:To observe the efficacy and safety of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS:A total of 68 patients with local advanced NSCLC selected from our hospital during Jan. 2015 to Jan. 2017 were divided into control group and observation group according to random number table,with 34 cases in each group. Control group was given Paclitaxel injection 135 mg/m2 intravenously,d1+Nedaplatin for injection 75 mg/m2 intravenously,d3,21 d as a treatment course,for 2 courses;routine fractionated intensity modulated radiation therapy,2 Gy each time,5 times a week,60-70 Gy in total;given 2 cycles of primary chemotherapy continuously after radiotherapy. Observation group was additionally given Sanjiao fuzheng mixture 250 mL/d,divided into 3 times,till the end of treatment,on the basis of control group. Clinical efficacies were observed in 2 groups. The levels of nutritional indexes (BMI,PAB,ALB,Hb) and tumor markers (SCC-Ag,CEA,TK1, CYFRA21-10) before and after treatment were observed. The occurrence of ADR were recorded. RESULTS:There was no statistical significance in the total effective rate between 2 groups (observation group 82.35％ vs. control group 73.53％)(P>0.05). After treatment,the levels of BMI,PAB,ALB and Hb in 2 groups were significantly lower than before treatment,but the observation group was significantly higher than the control group. The levels of SCC-Ag,CEA,TK1 and CYFRA21-1 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of Ⅲ-Ⅳ degree aleucocytosis,Ⅰ-Ⅱ degree hemoglobin reduction and thrombocytopenia in observation group were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS:The efficacy of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin is similar to that of concurrent chemoradiotherapy of paclitaxel and nedaplatin for localadvanced NSCLC,which can improve nutritional status significantly,and reduce the incidence of ADR.

The effect of Snail gene silencing on cell invasion and proliferation in human pancreatic cancer cell line PANC1 / 中华胰腺病杂志

Objective To observe the effect of silencing Snail gene on the invasion and proliferation ability of human pancreatic cancer cell line PANC1.Methods Lentiviral vectors that can express small hairpin RNA(shRNA) targeting human Snail gene(shRNA-Snail) or shRNA sequence that did not match any known mRNA(shRNA-NC) were constructed,and transfected into PANC1 cells.Untransfected cells served as control.mRNA and protein expression of Snail,α-smooth muscle actin (α-SMA) and E-cadherin was determined by real time quantitative PCR and Western blotting,respectively.In vitro invasion ability was tested by Transwell model.Proliferation ability was measured by CCK-8 assay.Results Compared with those in shRNA-NC group,Snail mRNA (0.27 ± 0.02 vs 0.92 ± 0.03) and protein level (0.26 ± 0.02 vs 0.80 ± 0.02),and α-SMA mRNA (0.33 ±0.04 vs 0.97 ±0.07) and protein level (0.31 ±0.04 vs 0.74 ±0.06) in shRNA-Snail group were obviously decreased,but E-cadherin mRNA (1.57 ± 0.45 vs 0.95 ± 0.08) and protein level (0.86 ± 0.03 vs 0.20 ± 0.03) were greatly increased.The number of cells permeating the septum of transwell [(6.80 ± 0.73)/400 magnification vs (26.80 ± 2.52)/400 magnification,P ＜0.01] was significantly decreased,and cell proliferation was inhibited (0.74 ± 0.05 vs 1.47 ± 0.04,P ＜ 0.01).All the differences above were statistically significant (all P ＜ 0.01).No significant differences were observed between shRNA-NC and normal control group.Conclusions Silencing Snail gene may restrain the invasion and proliferation ability of PANC1 cells to a certain degree.

Value of probe-based confocal laser endomicroscopy for differential diagnosis of biliary stricture / 中华消化内镜杂志

Objective To discuss the feasibility and application value of probe-based confocal laser endomicroscopy(pCLE)for differential diagnosis of maligant biliary stricture. Methods The pCLE images of 10 patients with definite biliary structure were retrospectively analyzed to establish pCLE classification of biliary lesions, and then the patients, who accepted pCLE examination and traditional brush cytology successively,were selected for further prospective research. Each patient was scored in terms of sign of malignant lesion to analyze diagnostic efficacy of combinations of different signs using classification standard of pCLE image. The results were compared with cell brushing test. The diagnostic consistency of observers using pCLE was also evaluated. Results A total of 25 patients completed the prospective research. When patients presented with any two or more malignant signs,diagnostic efficacy of pCLE was best with accuracy rate of 84.0%(95%CI:64.7%-94.2%),and sensitivity,specificity,positive predictive value and negative predictive value was 87.5%(95% CI: 62.7%-97.8%), 77.8%(95% CI: 44.3%-94.7%), 87.5% (95%CI: 62.7%-97.8%), and 77.8%(95% CI: 44.3%-94.7%), respectively. The corresponding indicators of brush cytology was 56.0%(95% CI: 37.1%-73.4%), 31.3%(95% CI: 13.9%-55.9%), 100.0%(95%CI:65.5%-100.0%),100.0%(95%CI:51.1%-100.0%),and 45.0%(95%CI:25.8%-65.8%),respectively,and the sensitivity(P=0.001)and accuracy(P=0.03)were significantly lower than that of pCLE. The κ value of interobserver agreement level was 0.73, which revealed a significant consistency. Conclusion pCLE provides a new approach for the differential diagnosis of biliary stricture, and shows a potential clinical application value.

Clinical Effect of Mild Hypothermia Combined with Puncture Aspiration Operation on the Hypertensive Intracerebral Hemorrhage and Its Effect on the Serum TNF-α, IL-6 and CRP Levels / 现代生物医学进展

Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86％,which was significantly higher than of the control group(76.79％.P＜0.05).The incidence of MODS and complications were 0％ and 26.79％ respectively,which were significantly lower than those of the control group(P＜0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P＜0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P＞0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P＜0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P＜0.01).The favorable prognosis of observation group was 80.36％,which was significantly higher than that of the control group (62.50％,P＜0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.

Perioperative management of bilateral bronchial foreign bodies in infants / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the perioperative management of bilateral bronchial foreign bodies in infants to improve the cure rate in the children.</p><p><b>METHODS</b>The medical charts of 45 infants with bilateral bronchial foreign bodies were reviewed. Clinical features and key points to surgery as well as post-operative care were analyzed.</p><p><b>RESULTS</b>All foreign bodies were removed with rigid bronchoscopy under general anesthesia, and 44 of 45 infants were cured with assistance of anti-infective treatments within 3-5 days and one with acute laryngitis and bronchitis was cured through 10-day anti-infective treatment with vancomycin.</p><p><b>CONCLUSION</b>Removal of foreign body by rigid bronchoscopy under general anesthesia is a preferred method to treat bilateral bronchial foreign bodies in infants, to whom early diagnosis, early treatment and postoperative careful care are keys to get a good outcome.</p>

Influence of preferred contract-altering system on contracted nurses / 现代临床护理

Objective To explore the influence of preferred contract-altering system on contracted nurses to provide reference for stabilizing a team of high quality nursing.Method A scale on effort-reward unfairness(ERI)was used to investigate the ERI conditions among 348 contracted nurses before and after the enforcement of preferred contract-altering system.Results The scores on satisfaction with nursing work and the security in nursing work after the enforcement of the system were higher than before the enforcement(P<0.01).The ratio between effort and reward after the enforcement was lower than before the enforcement(P<0.01). Conclusions The preferred contract-altering system may enhance the job security and sense of belonging.It may decrease the ERI condition among contracted nurses,which are beneficial for stabilizing the nurses team,retaining talents and increasing the group’s competitiveness and vigour.

Anterior Cervical Decompression under Microscope for Cervical Spondylotic Myelopathy: 64 Case Report / 中国康复理论与实践

@#Objective To investigate the effects of anterior cervical decompression and implanting bone fusion with plate internal fixation under microscope on cervical spondylotic myelopathy. Methods 64 patients were performed anterior cervical decompression and implanting bone fusion with plate internal fixation under microscope. They were assessed with the assessment of Japanese Orthopedic Association (JOA), imageologic and clinical finding 6 months after operation. Results The score of JOA improved from (9.1±2.4) pre-operation to (13.5±3.1) post-operation. Imageologic and clinical features showed satisfactory outcome. Conclusion Most patients with cervical spondylotic myelopathy can achieve satisfied prognosis by decompression through anterior approach; microsurgery.

Effect of Rehabilitation Exercises on Limb Function of Patients with Cervical Spondylotic Myelopathy after Artificial Intervertebral Disc Replacement: 42 Cases Report / 中国康复理论与实践

@#Objective To observe the effects of rehabilitation exercises on limb function of patients with cervical spondylotic myelopathy (CSM) after artificial intervertebral disc replacement.Methods 42 CSM patients undergone anterior cervical decompression and Bryan disc prosthesis under microscope were randomly divided into the normal care group (n=20) and rehabilitation exercises group (n=22). All patients of two groups were assessed by JOA scale at 2nd week and 6th month after operation.Results The JOA scores of two groups at 6th month were all higher than that at 2nd week and scores of the rehabilitation exercises group were also higher than that of the normal care group ( P<0.01).Conclusion Rehabilitation exercises after artificial intervertebral disc replacement can improve spine cord function of CSM patient.

Analysis of curative effect for concurrent chemoradiotherapy versus neoadjuvant chemotherapy for stage ⅡB-ⅢB cervical cancer / 肿瘤研究与临床

Objective To observe the effect and side effects of concurrent chemoradiotherapy for stage ⅡB～ⅢB cervical cancer. Methods 126 patients with stage ⅡB～ⅢB cervical cancer were randomly allocated into 2 groups. Concurrent chemoradiotherapy group: radiotherapy carried out same as the neoadjuvant chemotherapy group, i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 4 cycle; the neoadjuvant chemotherapy group i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 2 cycle, after chemotherapy received routine radiotherapy 2 Gy per day, 5 times a week to a total dose of 30 Gy with 192Ir brachytherapy, 7 Gy per week. When total dose reached 46 Gy, the middle field was shielded by plumbum, then continuous radiotherapy, total dose reach A point 65-70 Gy, B point 50-56 Gy. Results All patients were followed-up for more than five years. The follow-up rate was 94.4 %. In concurrent chemoradiotherapy group the 3 year survival rate and the 5 year survival rate were 82.8 %, 65.6 %, In neoadjuvant chemotherapy group the 3 year survival rate and the 5 year survival rate were 67.7 %, 46.8 %. There was a significant difference in two groups (X2=3.86, P＜0.05; X2=5.01, P＜0.05), no significant difference in toxicity-side effect. Conclusion Concurrent chemoradiotherapy for advanced cervical cancer can significantly improve the 3-year and 5-year survival rate and has little increase in toxicity-side effect.

Relationship between the expression of high mobility group protein B1 and blood-borne metastasis in pancreatic carcinoma / 中华胰腺病杂志

Objective To investigate the correlation of the expression of high mobility group protein B1 (HMGB1) and blood-borne metastasis in patients with pancreatic carcinoma. Methods The serum HMGB1 levels were determined by Western blot analysis in 68 patients with pancreatic cancer, 18 patients with chronic pancreatitis and 21 healthy controls. Among the 68 patients with pancreatic cancer, the serum HMGB1 levels of 37 patients before and after operation were compared. The expression of HMGB1 and CD31 were detected by immunohistochemistry in 67 patients with pancreatic carcinoma. Results The serum HMGB1 levels in patients with pancreatic cancer was (119.7±54.5) ng/ml, which was significantly higher than (40.2±25.5) ng/ml in chronic pancreatitis (P<0.001) and (13.1±4.3) ng/ml in healthy control (P< 0.001). The serum HMGB1 levels in patients with pancreatic cancer before operation was (120.2±8.2) ng/ml, which was significantly higher than (69.3±5.1) ng/ml after operation (P <0.001). The expression rate of HMGB1 in pancreatic cancer tissues was 43.6%. The expression of HMGB1 were significantly related with tumor differentiation, TNM stage, blood-borne metastasis, and vascular density(P <0.01). The HMGB1 positive tumor cells were adjacent to the blood vessels with lumen, and the rate of HMGB1 expression in intravascular tumor cells was 71%. Conclusions The HMGB1 was highly expressed in pancreatic cancer tissues. HMGB1 expression positive pancreatic carcinoma cells were prone to invade blood vessels with lumen which may be related to blood-borne metastasis in pancreatic cancer.

The dynamical changes of mitogen-activated protein kinase signal transduction in rats with severe acute pancreatitis / 中华消化杂志

Objective To investigate the dynamical changes of mitogen activated protein kinase (MAPK) signal transduction in rats with severe acute pancreatitis(SAP). Methods The SAP model was induced by bili pancreatic duct infusion with 5% sterile sodium taurocholate solution. Fifty six SD rats were randomly divided into seven groups: control group, 0.5 h postoperation group, 1 h group, 3 h group, 6 h group, 12 h group,24 h group. Western blot analysis was used to determine the activities of p38MAPK and c Jun N terminal kinase (JNK) in the pancreas and lung. Results In the rats of control group, the basal p38MAPK activity can be detected whereas JNK cannot. After the SAP was performed, the p38MAPK activity in pancreas increased obviously, which peaked at 3 h, but the p38MAPK activity in lung peaked at 6 h. The p38MAPK activity of pancreas and lung was significantly higher than basal activity at 24 h point. The activity of JNK was only increased at 12 h point and was not detected at 24 h point. Conclusions MAPK signal transduction pathway, in particular p38MAPK, plays an important role in the pathogenesis of SAP.

CLINICAL STUDY ABOUT ENDOSCOPIC TREATMENT OF PANCREATIC DUCTAL STONES / 解放军医学杂志

To evaluate the effect of endoscopic treatment of pancreatic ductal stones (PDS), 31 patients with PDS treated in our hospital from January 1998 to Octomber 2001 were analyzed retrospectively. PDS were successfully extracted in 10 patients by endoscopic papillotomy (EPT) or endoscopic pancreatic sphincterotomy (EPS). In 2 patients, one was treated with extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde pancreatic drainage (ERPD), another with EPS and ESWL, the PDS were all disappeared in 6 months. Fourteen patients with pancreatic ductal stricture were treated with ERPD, and 4 with EPS+ERPD. However, 4 patients were subjected to operation for pancreatic carcinoma and recurrent symptom. Only one of them failed owing to severe pancreatic ductal stricture. The success rate of the procedure was 96 8%, and the remission rate of abdominal pain was 90% shortly after operation and 70 4% in the follow up interval. The body weight and pancreatic exocrine function were also improved. But the stent occlusion was found in 3 patients and their stents were changed. So endoscopic therapy such as EPS, ESWL, and ERPD are effective and safe methods in treatment of PDS.

Role of p38MAPK in production of pro-inflammatory cytokines in Kupffer cells from severe acute pancreatitis rats / 中国病理生理杂志

AIM: To investigate the role of p38 mitogen-activated protein kinase (p38MAPK) signaling pathway in the Kupffer cells (KCs) production of pro-inflammatory cytokines, tumor necrosis factor-?(TNF-?) and interleukin-1?(IL-1?), in severe acute pancreatitis (SAP) rats. METHODS: Sprague-Dwaley rats were randomized into three groups: ①sham operation rats, ②SAP rats, ③SAP rats given the p38 MAPK inhibitor CNI-1493(10 mg/kg, iv). The SAP model was induced by the bili-pancreatic duct infusion with 5% sterile soduim taurocholate solution. Rats from each group were killed at 12 h after sham operation or SAP and Kupffer cells (KCs) were isolated. The mRNA expressions of TNF-? and IL-1? (by quantitative real-time RT-PCR) and p38 MAPK activity (by Western blot analysis) in KCs were examined. The levels of TNF-? and IL-1? in plasma were determined by ELISA. RESULTS: There was a significant acvitation of p38 MAPK in KCs harvested from SAP rats than those from sham operation rats. SAP also promoted the mRNA expressions of TNF-? and IL-1? in KCs and the plasma levels of TNF-? and IL-1?. These events were significantly inhibited by treatment with CNI-1493.CONCLUSIONS: p38 MAPK activation is one important aspect of the signaling events that may mediate the KCs production of pro-inflammatory cytokines, TNF-? and IL-1?, in SAP rats. The inhibition of the p38 MAPK may be a potential target in the prevention and treatment of SAP.

The effects of ascites in severe acute pancreatitis on the normal kidney cells / 中国现代普通外科进展

Objective:To explore the mechanism of renal injury in severe acute pancreatitis(SAP).Methods:54 SD rats were randomly divided into sham operation group(n=24) and SAP group(n=30).SAP model was induced by injection of 5% sodium taurocholate solution into bilo-pancreatic duct.Rats from each group were killed and the serum and ascite were collected at 6h,12h,24h after operation.Tumor necrosis factor-?(TNF-?)level of serum and ascite were measured by enzyme linked immuno-sorbent assay (ELISA).The expressions of TNF-? mRNA were assessed by RT-PCR analysis.The serum and ascites that had been collected at 24h after development were injected into medium of NRK cell,then the levels of TNF-? secreted by NRK cell were measured after injection 6h,12h,24h,and the cell apoptosis were also evaluated after injection 24h.NRK cell apoptosis were evaluated by flow cytometry (FCM).Results:①The serum and ascites levels of TNF-? were signficantly elevated in SAP groups compared with sham operation groups at any time point(P