医院药库库存管理

随着医疗卫生体制改革和药品生产流通体制改革的深入,药品库存和供应管理成为药品经营的首要任务,医院药库中药品库存的相关费用在医院的全部资金投入中占有相当大的比例,但实际工作中始终面临着药房必须不间断地为患者提供充足的药品和相关服务,同时又必须避免库存费用的过分增加的矛盾。科学、合理地贮存药品,节约库存费用,加强医院资金的周转,发挥资金的最佳使用价值,

底开驳船抛投土沙水下运动特性室内试验研究

揭示抛投土沙的水下运动特性对指导疏浚土的水下抛投作业等具有重要意义。通过对底开驳船抛投土沙的室内物理模型试验研究,分析土沙的水下运动过程及其运动特性。以塑料沙、粉煤灰和长江口航道淤泥为研究对象进行静水抛投试验,分析泥沙粒径、含水率、黏性以及投放水深对抛投无黏性和黏性土沙水下运动特性的影响。采用长江口航道疏浚淤泥进行单向动水抛投试验,分析抛投黏性土沙床面落淤存留率与水流流速之间的定量关系。结果表明:黏性与无黏性抛投土沙在水下的运动过程均可分为拥挤下落、对流沉降、悬移输送、触底崩散和水平扩散5个阶段;泥沙的粒径越大、含水率越低或投放水深越大,泥沙的水下沉降速度越快;单向动水环境下,水流流速越大,现场疏浚淤泥的床面落淤存留率越低,通过对试验数据的回归分析给出了床面存留率与水流流速间的经验关系公式。

Late course three-dimensional conformal radiotherapy for esophageal carcinoma

Objective： The aim of our study was to evaluate the clinical results and acute side effects of late course three-dimensional conformal radiotherapy （3DCRT） for esophageal carcinoma. Methods： From January 2004 to October 2006, 70 patients with esophageal carcinoma received late course 3DCRT. Their clinical data were analyzed retrospectively. The short-term clinical results, acute side effects, local control rates and survival rates were evaluated. Results： The complete response rate was 62.9%, partial response rate was 35.7%, and the overall response rate was 98.6%. The 1-, 2-and 3-year local control rates were 77.1%, 51.4% and 45.7%, respectively. The 1-, 2-and 3-year overall survival rates were 75.7%, 54.3% and 38.6%, respectively. The median survival time was 26 months. Conclusion： The technique of late course 3DCRT is an effective treatment for esophageal carcinoma and tend to improve the overall survival rate.

Clinical and pathological characteristics of intraductal proliferative lesions and coexist with invasive ductal carcinomas

Objective： The purpose of this study was to study the clinical and pathological characteristics of breast intraductal proliferative lesions （IDPLs） and associated with invasive breast cancer. Methods： We reviewed 327 cases of breast intra- ductal proliferative lesions including 53 cases of usual ductal hyperplasia, 57 cases of atypical ductal hyperplasia, 89 cases of ductal carcinoma in situ, and 128 cases coexist with invasive ductal carcinomas. Cases of pure invasive cancer without intraductal proliferative lesions were excluded. The mult IDPLs biological parameters including the express of ER, PR, HER2, HIF-lo and Ki-67 detected by immunohistochemistry S-P method （n = 327） and the levels of CA153, TSGF, CA125 and CEA both in nipple discharge and serum （n = 179） measured with Electrochemiluminescence method and their relationship were studied, and 30 cases of normal pregnant women were compared with. Results： A single histologic subtype was present in 49.85% （163/327） of the cases, two subtypes in 33.03% （108/327）, and three in 17.13% （56/327）. The most common subtypes present were cribriform （43.12%, 141/327） and solid （38.53%, 126/327）, while the comedo （16.35%, 54/327）, and micropapillary （12.84%, 42/327） subtypes were less common. Comedo and solid were frequently found together for coexpres- sion as were micropapillary and papillary subtypes. However, Comedo subtype was much less likely to be found with papillary, cribriform or micropapillary subtypes. Additionally, comedo subtypes tend to be hormone receptor negative, Her2 positive and high-grade while the cribriform and solid subtype tends to be hormone receptor positive, Her2 negative and low grade. Papil- lary subtype was least likely to be associated with an invasive cancer. Furthermore, the nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in coexist with invasive ductal carcinomas patients were significantly higher than those in the benign breast disease （pure intraductal proliferative lesions） and normal pregnant women （P 〈 0.01）. Additionally, the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than in the serum （P 〈 0.01）, and had a positive correlation with the Ki-67, grade, clinical stage, lymph node metastasis and tumor recurrence （P 〈 0.05）, and negative correla- tion with the level of ER and PR （P 〈 0.05）. The sensitivity of the four serum tumor markers in combination was only 69.77%, in contrast, the combined detection both in discharge and serum was 97.67%, and the negative predictive value was 99.03%. The sensitivity of combined detection both in nipple discharge and serum were significantly higher than other detection （P 〈 0.05）. Conclusion： IDPLs often present more than one histologic subtype and the most common subtypes are cribriform and solid, while comedo and micropapillary subtypes are less common. Our results suggest that the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than those in the serum, and is associated with HIF-le. The aberration of HIF-la may play a key role during oncogenesis and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. Nipple discharge can be the earliest presenting symptom of breast cancer. The dynamic combined detection of the four tumor markers both in nipple discharge and serum are helpful to the stratification of preoperative patients and benefit to better prewarning markers for monitoring their recurrence and metastasis and clinical staging of tumors in clinic, but cannot increase the sensitivity of judging the patients with early breast cancer.

Hepatocellular carcinoma in extremely elderly patients:An analysis of clinical characteristics,prognosis and patient survival

AIM： To identify the clinical and prognostic features of patients with hepatocellular carcinoma （HCC） aged 80 years or more. METHODS： A total of 1310 patients with HCC were included in this study. Ninety-one patients aged 80 years or more at the time of diagnosis of HCC were defined as the extremely elderly group. Two hundred and thirty-four patients aged 〉/ 50 years but less than 60 years were regarded as the non-elderly group. RESULTS： The sex ratio （male to female） was significantly lower in the extremely elderly group （0.90：1） than in the non-elderly group （3.9：1, P〈 0.001）. The positive rate for HBsAg was significantly lower in the extremely elderly group and the proportion of patients negative for HBsAg and HCVAb obviously increased in the extremely elderly group （P〈 0.001）. There were no significant differences in the following parameters： diameter and number of tumors, Child-Pugh grading, tumor staging, presence of portal thrombosis or ascites, and positive rate for HCVAb. Extremely elderly patients did not often receive surgical treatment （P 〈 0.001） and they were more likely to receive conservative treatment （P〈 0.01）. There were no significant differences in survival curves based on the Kaplan-Meier methods in comparison with the overall patients between the two groups. However, the survival curves were significantly worse in the extremely elderly patients with stage Ⅰ/Ⅱ, stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparison with the non-elderly group. The causes of death did not differ among the patients, and most cases died of liverrelated diseases even in the extremely elderly patients. CONCLUSION： In the patients with good liver functions and good performance status, aggressive treatment for HCC might improve the survival rate, even in extremely elderly patients.

Advances in diagnosis, treatment and palliation of pancreatic carcinoma: 1990-2010

Several advances in genetics, diagnosis and palliation of pancreatic cancer (PC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. PC is relatively common as it is the fourth leading cause of cancer related mortality. Most patients present with obstructive jaundice, epigastric or back pain, weight loss and anorexia. Despite improvements in diagnostic modalities, the majority of cases are still detected in advanced stages. The only curative treatment for PC remains surgical resection. No more than 20% of patients are candidates for surgery at the time of diagnosis and survival remains quite poor as adjuvant therapies are not very effective. A small percentage of patients with borderline non-resectable PC might benefit from neo-adjuvant chemoradiation therapy enabling them to undergo resection; however, randomized controlled studies are needed to prove the benefits of this strategy. Patients with unresectable PC benefit from palliative interventions such as biliary decompression and celiac plexus block. Further clinical trials to evaluate new chemo and radiation protocols as well as identification of genetic markers for PC are needed to improve the overall survival of patients affected by PC, as the current overall 5-year survival rate of patients affected by PC is still less than 5%. The aim of this article is to review the most recent high quality literature on this topic.

A clinical comparative study of GP and TP 1st-line chemotherapies for advanced non-small cell lung cancer

Objective： The aim of the study was to evaluate the efficacies of initial gemcitabine plus cisplatin （GP） and paclitaxel plus cisplatin （TP） 1st-line chemotherapies for advanced non-small cell lung cancer （NSCLC） and observe their side effects. Methods： Eighty-one cases were randomly divided into two groups： GP group and TP group. In GP group, adminis- tered gemcitabine （GEM） 1000 mg/m2 on days 1 and 8; i.v. cisplatin （DDP） 30 mg/m2 from days 2 to 4 on a 28-day cycle. In TP group, administered paclitaxel （PTX） 175 mg/m2 on day 1, i.v. DDP 30 mg/m2 from days 2 to 4 on a 28-day cycle. Results： GP group had an overall response rate （ORR; CR＋PR） of 45.0% （18/40）. TP had an overall response rate of 43.2% （16/37）. Short-term ORR had no significant difference between two groups （x2 = 0.527, P = 0.957）. GP had median survival time of 11 months and 37.7% of one-year survival rate, while TP showed 11 months of median survival time and 31.7% of one-year survival rate. Survival had no significant difference between two groups （x2 = 0.140, P = 0.708）. However, main side effects varied. Thrombocytopenia of GP group was significantly more than that of TP group, while peripheral neuritis, nausea/vomiting and myalgia of TP group were significantly more than those of GP group. Conclusion： Both GP and TP regimens had no significant difference in short-term treatment effect and survival rate for initial treatment of advanced NSCLC. However, side effects related to GP regimen treatment were slighter. Therefore, it was considered as the preferred initial first-line treatment for NSCLC.

Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

Sorafenib,a multitargeted tyrosine kinase inhibitor,has been shown to improve survival in patients with advanced hepatocellular carcinoma(HCC).As the clinical use of sorafenib increases,many adverse effects have been reported,such as hand-foot skin reaction,diarrhea,anorexia,asthenia,alopecia,weight loss,hypertension and arterial thromboembolism.However,there are no prior reports of splenic infarction as an adverse effect of sorafenib.Here,a case of splenic infarction in a patient with HCC who was treated with sorafenib is reported. The patient had no other predisposing factors to explain the splenic infarction except for the administration of sorafenib.The splenic infarction improved after sorafenib was discontinued;however,the HCC progressed.

Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma

AIM： To determine the efficacy of external beam radiotherapy （EBRT）, with or without intraluminal brachytherapy （ILBT）, in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS： We analyzed 64 patients with locally advanced hilar cholangiocarcinoma, including 25 who underwent resection （17 curative and 8 non-curative）, 28 treated with radiotherapy, and 11 who received best supportive care （BSC）. The radiotherapy group received EBRT （50 Gy, 30 fractions）, with 11 receiving an ad- ditional 24 Gy （4 fractions） ILBT by iridium-192 with remote after loading. ILBT was performed using percu-taneous transhepatic biliary drainage （PTBD） route. Uncovered metallic stents （UMS） were inserted into nonresected patients with obstructive jaundice, with the exception of four patients who received percutaneous transhepatic biliary drainage only. UMS were placed endoscopically or percutaneously, depending on the initial drainage procedure. The primary endpoints were patient death or stent occlusion. Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups. Stent patency was compared in the radiotherapy and BSC groups.RESULTS： No statistically significant differences in patient characteristics were found among the resection, radiotherapy, and BSC groups. Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone; cholangitis occurred after endoscopic stenting, and patients were treated with PTBD. A total of 16 patients were administered additional systemic chemotherapy （5-fluorouracil-based regimen in 9, S-1 in 6, and gemcitabine in 1）. Overall survival varied significantly among groups, with median survival times of 48.7 mo in the surgery group, 22.1 mo in the radiotherapy group, and 5.7 mo in the BSC group. Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery （P = 0.0076）. Cumulative survival in the radiotherapy group was significantly longer than in the BSC group （P = 0.0031）, but did not differ significantly from those in the non-resection group. Furthermore, the median survival time of patients in the radiotherapy group who were considered for possible resection （excluding the seven patients who were not candidates for surgery due to comorbid disease or age） was 25.9 mo. Stent patency was evaluated only in the 24 patients who received a metallic stent. Stent patency was significantly longer in the radiotherapy than in the BSC group （P = 0.0165）. Biliary drainage was not eliminated in any patient. To determine the efficacy of ILBT, we compared

Prognosis in epithelial ovarian cancer: Clinical analysis of 287 pelvic and para-aortic lymphadenectomy

Objective: To evaluate the relationship between the pelvic and para-aortic lymphadenectomy and the prognosis of epithelial ovarian cancer. Methods: 287 patients suffering from primary epithelial ovarian cancer from 1995 to 2005 were analyzed retrospectively. Results: The 3-, 5-, 10-year survival with systematic lymphadenectomy (SL) were slightly higher than those without SL, but there were no statistically significance (P > 0.05). The 3-, 5-, 10-year survival of clinical stages without SL were lower than those with SL, but there were no significant difference either (P > 0.05). The 3-,5-, and 10-year survival rates with SL were higher than those without SL with no statistically differences (P > 0.05) among the subgroups such as absent, ≤ 2 cm and > 2 cm residual tumor. The survival rates of the groups without residual tumor and the group with ≤ 2 cm residual tumor were significantly higher than that of > 2 cm (P < 0.005). On multivariate analysis, patient staging (P = 0.01) and size of residual disease after primary cytoreductive surgery (P < 0.001 and = 0.002, respectively) retained prognostic significance. SL was not proved to be an independent prognostic factor (P = 0.69). Conclusion: Systematic pelvic and para-aortic lymphadenectomy can not improve and prolong the survival time significantly.

Unsuspected Gallbladder Cancer During or After Laparoscopic Cholecystectomy

Objective To summarize the clinical features and outcomes of unsuspected gallbladder carcinoma （HGC） detected during or after laparoscopic cholecystectomy. Methods Medical records of 8005 patients, who underwent laparoscopic cholecystectomy in Peking Hnion Medical College Hospital between June 1993 and June 2011, were reviewed. Patients that pathologically diagnosed as HGC were retrospectively studied in terms of clinical features, preoperative and postoperative diagnosis, surviving period, and complications. Results In the 8005 patients who received laparoscopic cholecystectomy, 36 （0.45%） were diagnosed as LIGC during （25 patients） or after （11 patients） laparoscopic cholecystectomy. The gallbladder cancer was staged as T1 in 16 patients, T2 in 11 patients, and T3 in 9 patients. The 1-, 3-, and 5-year survival rates of all the patients were 88.9% （32/36）, 63.9% （23/36）, and 58.3% （21/36）. The 5-year survival rates in T1 stage, T2 stage, and T3 stage patients were 100%, 75.0%, and 0.0%, respectively. Conclusions The survival rate of HGC is associated with tumor stage, not with operation approaches. Laparoscopic cholecystectomy is appropriate for T 1 patients.

Analysis of Clinical Manifestations and Prognosis of 92 Cases with Non-Hodgkin's Lymphoma

OBJECTIVE To analyze the risk factors and influence of various treatments on the prognosis of non-Hodgkin's lymphoma (NHL). METHODS Clinical data of 92 patients with NHL from our hospital were retrospectively reviewed.Kaplan-Meier statistics were used to analyze the differences in survival times of the patients receiving various treatments.Cox regression model was employed for analyzing the prognostic factors. RESULTS Among our patients,the 2 and 5-year disease-free survivals (DFS) were respectively 68%and 51%.The 5-year cancer-specific survival (CSS) was 55%.Mono-factorial analysis showed that the main independent prognostic factors included Ann Arbor Staging,B symptoms,lactate dehydrogenase (LDH),the international prognostic index (IPI) and age.Concerning the IPI,the 5-year CSS for the low-risk factors(0～1),lower-moderate risk (2),higher-moderate(3) and high-risk (4～5) were respectively 60%,62%,42% and 33%.Analysis of the prognoses,based on treatment of the patients with different stages,was as follows:the 5-year survival rates of the Stage-Ⅰ and Ⅱ patients,receiving surgery or chemotherapy alone,or a combined therapy,were respectively 19%,72% and 68%,showing that the survival rates of the group with a combined therapy and the chemotherapy alone were superior to the group with surgery alone;the 5-year survival rates of the Stage-Ⅲ and Ⅳ patients,receiving surgery or chemotherapy alone or a combined therapy,were respectively 50%,35% and 60%,indicating that the survival rate of the group with a combined therapy was superior compared to the group with chemotherapy alone. CONCLUSION Long-term survival of non-Hodgkin's lymphoma patients is closely related with multiple factors. Rational detection and assessment of the risk factors may prolong the living time of the patients.Different methods of treatment can influence the patient's prognosis.Correct evaluation of the prognostic factors,and rational and effective therapy can prolong the patient's survival.

Clinical analysis of concurrent chemoradiotherapy in 83 patients with locally advanced non-small cell lung cancer

Objective:The purpose of this study was to evaluate the efficacy and safety of concurrent chemoradiotherapy (CCRT) in patients with locally advanced non-small cell lung cancer (LANSCLC). Methods:83 cases of patients who have been diagnosed for locally advanced NSCLC by determined cytology or pathology were divided into two groups randomly, 42 patients in NP group and 41 patients in EP group. All patients accepted thoracic three-dimensional conformal radiotherapy (3D-CRT) and concurrent either NP chemotherapy in NP group or EP chemotherapy in EP group. 3D-CRT were started on day 1 in the first cycle of chemotherapy. Chemotherapy were carried out for 4 cycles, every cycle was 21 days. Thoracic radiotherapy adopted conventional fractionated irradiation with 15 MeV-X ray, a total dose of 60 Gy. Results: In 83 patients were evaluable, there were 5 cases complete regression to be observed, 29 cases had partial regression (PR), 7 cases with stable disease (SD) and 1 case with progression disease (PD) in NP group. CR 3 cases, PR 27 cases, SD 9 cases and PD 2 cases in EP group. The overall response rate (RR) both NP group and EP group were 80.9%, 73.2%, respectively (P = 0.785).1-, 2-, 3-year survival rate were 90.5%, 69.0%, 28.6% and 82.9%, 51.2%, 21.9%, respectively (P = 0.393). The incidence of leukopenia and thrombocytopenia in NP group was higher than that in the EP group (P < 0.05). Conclusion:CCRT in patients with locally advanced non-small cell lung cancer, 3D-CRT with concurrent NP or EP chemotherapy. 1-, 2-, 3-year overall survival (OS) and average survival time (AST) were not statistically differences, a higher incidence of toxicities were observed in NP group but can be tolerable.

Clinicopathological and prognostic analysis of 429 patients with intrahepatic cholangiocarcinoma

AIM:To understand the clinicopathological characteristics and treatment selections and improve survival and provide valuable information for patients with intrahepatic cholangiocarcinoma(ICC). METHODS:We retrospectively evaluated 5311 liver cancer patients who received resection between October 1999 and December 2003.Of these,429(8.1%)patients were diagnosed with ICC,and their clinicopathological, surgical,and survival characteristics were analyzed. RESULTS:Upper abdominal discomfort or pain(65.0%), no symptoms(12.1%),and hypodynamia(8.2%)were the major causes for medical attention.Laboratory tests showed 198(46.4%)patients were HBsAg positive, 90(21.3%)hadα-fetoprotein>20μg/L,50(11.9%) carcinoembryonic antigen>10μg/L,and 242(57.5%) carbohydrate antigen 19-9(CA19-9)>37 U/mL.Survival data was available for 329(76.7%)patients and their mean survival time was 12.4 mo.The overall survival of the patients with R0,R1 resection and punching exploration were 18.3,6.6 and 5.6 mo,respectively. Additionally,CA19-9>37 U/mL was associated with lymph node metastases,but inversely associated withcirrhosis.Multivariate analysis indicated that radical resection,lymph node metastases,macroscopic tumor thrombi and size,and CA19-9 were associated with prognosis. CONCLUSION:Surgical radical resection is still the most effective means to cure ICC.Certain laboratory tests(such as CA19-9)can effectively predict the survival of the patients with ICC.

Diagnosis and Treatment of Primary Adult Renal Sarcoma

Objective To investigate the clinical characteristics of primary adult renal sarcoma.Methods A total of 1654 cases with adult renal tumors were treated during 1985 to 2009 in Peking Union Medical College Hospital.Of all,17 cases were diagnosed as primary renal sarcoma and underwent radical nephrectomy.The clinical features of 17 such patients were retrospectively analyzed.Results The first symptom of 10(59%) cases in all renal sarcomas was abdominal mass.The pathological diagnosis was leiomyosarcoma(7 cases),rhabdomyosarcoma(2 cases),malignant fibrous histiocytoma(2 cases),low-differentiated sarcoma(2 cases),chromophobe renal cell carcinoma coexisting with liposarcoma(1 case),fibrosarcoma(1 case),embryonic sarcoma(1 case) and leiomyosarcoma(1 case).One patient died of tumor thrombus of the inferior vena cava during surgery.Finally,15 cases were regularly followed up for 4 to 60 months.Till now,1 had tumor-free survival for 9 months,and the other 14 cases died 2-38 months after the operation with a median survival time of 18(range,5-60) months.The median survival time of leiomyosarcoma group was 28(range,11-60) months,and 2 cases of malignant fibrous histiocytoma died 4 and 8 months after the operation respectively.Conclusions The primary renal sarcoma has the clinical symptom similar with advanced renal cell carcinoma and has poor prognosis.Leiomyosarcoma might have relative good prognosis.

Clinical significance of the negative lymph node count after the axillary dissection of breast cancer patients

Objective： The purpose of this study was to evaluate the impact of the negative lymph node （LN） count on the survival of the breast cancer patients in early stage after the axillary dissection. Methods： The breast cancer patients with T1-2N0-1M0 stage between January 2001 and December 2005 in Jiangsu Cancer Hospital, who underwent the axillary LNs dissection, were enrolled in this study. We analyzed the data of these patients including information of follow-up and postop- erative pathological results. All patients were divided into two groups according to the axillary LN status and each group was divided into four subgroups according to the negative LN count. Cox regression analysis was performed to screen the patho- logical factor including the negative LN count on the survival and to compare the different negative LN count on the survival. Results： COX proportional hazard regression model showed that the survival of the breast cancer was significantly associ- ated with the negative LN count. In T1 2N0 group, when the negative LN count was 3 or less, 4 to 5, 6 to 9 and 10 or more, the median survival time was （82.6 ±4.1） months, （101.5 ± 1.3） months, （104.7 ±1.0） months, and （110.5 ±0.9） months respectively （P 〈 0.05）. In T1-2N0 group, when the negative LN count was 6 or less, 7 to 8, 9 to 10 and 11 or more, the median survival time was （95.4 ± 1.9） months, （101.8 ± 1.1） months, （104.9 ± 1.0） months, and （106.5 ± 0.9） months respectively （P 〈 0.05）. Conclusion： The negative LN count can reflect the adequacy of the axillary dissection. Increasing negative LN count is independently associated with improved survival in pT1-2N0M0 or pT1-2N0M0 staging breast cancer patients. The negative LN count should be considered for incorporation into staging for breast cancer with the axillary LN dissection.

Clinical analysis of PF plus concurrent radiotherapy in locally advanced nasopharyngeal carcinoma

Objective： The prognosis of patients with nasopharyngeal carcinoma （NPC） depends on the stage of the disease at diagnosis. Unfortunately, at diagnosis, most of patients have locally advanced, non-metastatic stage III or IVa disease. The study was to evaluate the efficacy and toxicities of cisplatin plus 5-fluorouracil combined with concurrent radiotherapy for locally advanced nasopharyngeal carcinoma. Methods： Sixty-six patients with locally advanced nasopharyngeal carcinoma received chemotherapy of cisplatin plus 5-fluorouracil jointing concurrent radiotherapy; concurrent radiotherapy started on day 1 in the first cycle of chemotherapy of PF, 5-fluorouraci1500 mg/m^2 intravenous infusion on days 1-5, cisplatin 80 mg/m2 intravenous infusion on days 1-3, 21 days for a cycle, a total of three cycles; nasopharyngeal lesions and positive lymph node were given a total amount of 70 Gy, prophylactic neck radiation were given the amount of 50 Gy, radiotherapy five times a week, Gy/f. Results： All patients who can be evaluated, the response rate （RR） was 100%; 1-, 3- and 5-year overall survival （OS） were 100%, 86.4%, 21.2%, respectively; 3-year, 5-year disease-free survival （DFS） were 72.7% and 18.2%, respective- ly; the average survival time and median survival time were 49.0 months and 48.5 months, respectively; the average survival time and median survival time of DFS were 46.1 months and 46.5 months, respectively. Conclusion： For patients with locally advanced nasopharyngeal carcinoma, who accepted RT combining concurrent chemotherapy of cisplatin plus 5-fluorouracil, clinical efficacy is satisfaction and toxicities could be tolerated.

Clinical features of coronary artery ectasia in the elderly

Objective To investigate the incidence, imaging and clinical characteristics in elderly patients with coronary artery ectasia （CAE）. Methods A retrospective analysis was conducted on patients with CAE who underwent coronary angiography between January 2006 and December 2012. According to age, the enrolled patients were divided into two groups （elderly group, age≥ 65 years; non-elderly group, age 〈 65 years）. The clinical feature, imaging characteristics and the 5-year survival rate of the two groups were compared.Results The preva-lence of CAE in elderly patients was 0.33%. Patients in elderly group were found to have significantly higher proportion of female （30.1%vs. 10.1%,P〈 0.001）, three-vessel disease （60.5%vs. 45.2%,P = 0.003） and localized ectasia （55.0%vs. 40.2%,P = 0.003）. In addition, body mass index （20.90 ± 2.71 kg/m2vs. 22.31 ± 2.98 kg/m2,P 〈 0.001） and percentage of current smokers （45.0%vs. 64.6%,P 〈 0.001） were significantly lower in elderly group. Cumulative survival curves demonstrated reduced 5-year cumulative survival at the follow-up in the elderly group compared with the non-elderly group （88.0%vs. 96.0%,P = 0.002）. But the 5-year event free survival rate failed to show a significant difference between the two groups （31.0%vs. 35.0%,P= 0.311）.ConclusionThe prevalence of CAE in elderly patients was 0.33%, which was about 1/3 of the entire numbers of CAE patients. There were significant differences between the elderly and the non-elderly patients with CAE in terms of coronary artery disease risk factors and coronary artery ectatic characteristics. CAE might be asso-ciated with increased mortality risk in the elderly.

Using Parallel Packed Bed within a High Temperature Thermal Energy Storage System for CSP-Plants

In order to optimize the electricity yield of CSP （concentrated solar power） plants, TES （thermal energy storage） systems are regarded as an essential component. Furthermore, for many electricity grid operators, it is important to have spinning reserves in the grid and dispatchable power available, both offered by CSP-plants with integrated thermal energy storage. Enolcon is developing a new TES-system since several years. The system itself was designed to offer a principle simple and robust setup （with regard to execution and operation） and which is reducing the electricity costs of CSP-power plants by the consequent use of state of the art technology. Furthermore, such system shall be open to future developments of CSP-systems with regard to increasing steam temperatures and steam pressure. Such TES-system shall be commercially available for large scale application already in year 2014/2015. The key elements of the enolcon-TES are the open cycle using always ambient air with an air-air-heat exchanger and the arrangement of the storage material in such way to minimize the pressure losses and the own electricity consumption. The development is progressing in a structured way by studies, engineering works, TES-pilot plants, isothermal air flow test plant for the verification of the CFD-calculations, and since end of 2012 by the operation of a high temperature TES-module with all features of the large scale modules.

Comparison of two different kinds of regimens in treatment of advanced non-small cell lung cancer

Objective： The aim of this study was to analyze and compare the recent efficacy and toxicity of a three-drug platinum-based regimen （A regimen）： [cisplatin （DDP） ＋ gemcitabine （GEM） ＋ vinorelbine （NVB）] and a two-drug combination without a platinum drug （B regimen）： GEM ＋ NVB, which were used to treat 55 advanced non-small cell lung cancer （NSCLC） patients, in a bid to provide a guidance for clinical treatment. Methods： Twenty-four cases of advanced NSCLC （stage Ill-IV） patients were treated with A regimen （DDP 35 mg/m^2 d1-3; GEM 1250 mg/m^2 d1, 8 ）. The other 31 cases were treated with B （GEM 1250 mg/m^2 d1,8; NVB 25 mg/m^2 d1, 8 ）. Repeat every 3 weeks for 6 courses. Results： In A regimen group, the overall response rate was 45.8% （CR ＋ PR = 11）, median response time was 5.5 months, median survival time was 11 months and 1-year survival rate was 41.7%. In B regimen group, the overall response rate was 48.4% （CR ＋ PR = 15） and median response time, survival time and 1-year survival rate were respectively 6.5 and 10 months and 41.9%. The major toxicities were nausea/vomiting, myelosuppression in A regimen group, myelosuppression and phlebitis in B regimen group, respectively. Conclusion： A regimen and B regimen for advanced NSCLC have similar response rate （P 〉 0.05）. B regimen, a two-drug combination without a platinum drug is of less toxicity and more safety than A regimen, a three-drug platinum-based regimen and is recommended to be a regimen in the first-line treatment for advanced NSCLC.