BACKGROUND & AIMS: OBJECTIVE:To assess the effect of preoperative local anaesthesia with ropivacaine and find out if there was a dose-response relationship with postoperative pain after inguinal hernia repair.

DESIGN:Randomised, double-blind, placebo-controlled trial.

SETTING:Two Swedish and two Norwegian hospitals.

SUBJECTS:131 Male patients undergoing elective inguinal hernia repair.

INTERVENTION:Infiltration of the inguinal field before operation with 0.5% ropivacaine 40 ml (200 mg), 0.25% ropivacaine 40 ml (100 mg) or saline 40 ml.

MAIN OUTCOME MEASURES:Wound pain at rest and during mobilisation, pressure exerted to reach pain threshold and maximum pain tolerance after 3, 6, 10, and 24 hours, and after 7 days; consumption of analgesics; and Quality of Life assessed by two independent questionnaires before and after operation.

RESULTS:Pain scores after 3 hours were significantly lower in the ropivacaine groups compared with the saline group for all variables (p < 0.05). At 6 hours pain scores were significantly lower for ropivacaine 0.5% compared with saline for wound pain during mobilisation and pressure exerted to reach maximum pain tolerance. Patients given saline made their first request for analgesics significantly sooner than in the other two groups (p < 0.05), and a significantly larger percentage of them requested analgesics during the first 24 hours (p < 0.05). Evaluation of the Quality of Life questionnaires showed no significant differences between the groups.

CONCLUSION:Ropivacaine has a significant, dose-related pain-reducing effect in the immediate postoperative period but we could find no support for the theory that preoperative infiltration analgesia reduces long term pain.

背景与目标： 目的 : 评估罗哌卡因术前局部麻醉的效果，并找出腹股沟疝修补术后疼痛是否存在剂量反应关系。
设计 : 随机，双盲，安慰剂对照试验。
设置 : 两家瑞典医院和两家挪威医院。
受试者 :131例接受选择性腹股沟疝修补术的男性患者。
干预 : 术前用0.5% 罗哌卡因40毫升 (200 mg) 浸润腹股沟，0.25% 罗哌卡因40毫升 (100 mg) 或生理盐水40毫升。
主要结果指标 : 休息和动员过程中的伤口疼痛，在3、6、10和24小时后施加压力达到疼痛阈值和最大疼痛耐受性，7天后; 服用镇痛药; 手术前后通过两个独立的问卷评估生活质量。
结果 : 在所有变量中，罗哌卡因组3小时后的疼痛评分均明显低于生理盐水组 (p <0.05)。6小时时，罗哌卡因0.5% 的疼痛评分明显低于动员期间伤口疼痛的生理盐水，并施加压力以达到最大疼痛耐受性。给予生理盐水的患者首次要求镇痛药的时间明显快于其他两组 (p <0.05)，并且在最初的24小时内要求镇痛药的比例明显更高 (p <0.05)。生活质量问卷的评估显示，两组之间没有显着差异。
结论 : 罗哌卡因具有显着性，在术后即刻的剂量相关的减轻疼痛效果，但我们无法支持术前浸润镇痛可减轻长期疼痛的理论。

BACKGROUND & AIMS: :It has been proposed that follistatin can modulate the actions of activins and/or other members of the transforming growth factor-beta superfamily of proteins on testicular function, since mice overexpressing follistatin showed spermatogenic disruption. However, since mice with targeted disruption of the follistatin gene die soon after birth, it is not feasible to determine the effect of the absence of follistatin on testicular function using this model. To further understand the role of follistatin on the development and maintenance of spermatogenesis, fetal testes, collected by Caesarean section at day 18 of gestation from follistatin null mice, were transplanted to the external ear of castrated recombination activating gene 1 immunocompromised male mice. The testicular grafts were then analysed 7-8 weeks after transplantation and showed that full spermatogenesis developed in both the testes of wild-type and follistatin null mice. This study indicates that, if follistatin is required to modulate spermatogenic development, it is not supplied by local testicular production but by circulating follistatin from the host mouse.

背景与目标： : 已经提出，卵泡抑素可以调节激活素和/或蛋白质的转化生长因子-β 超家族的其他成员对睾丸功能的作用，因为过度表达卵泡抑素的小鼠表现出生精破坏。但是，由于具有靶向破坏卵泡抑素基因的小鼠在出生后不久就死亡，因此使用该模型确定不存在卵泡抑素对睾丸功能的影响是不可行的。为了进一步了解卵泡抑素在精子发生的发展和维持中的作用，将卵泡抑素无效小鼠在妊娠第18天通过剖腹产收集的胎儿睾丸移植到去势重组激活基因1免疫功能低下的雄性小鼠的外耳。然后在移植后7-8周对睾丸移植物进行分析，结果表明，野生型和卵泡抑制素无效小鼠的睾丸均发育了完全的精子发生。这项研究表明，如果需要卵泡抑素来调节生精发育，则不是由本地睾丸产生而是由宿主小鼠循环卵泡抑素提供的。

BACKGROUND & AIMS: Ligation of surface IgM on B cells responding to lipopolysaccharide (LPS) suppresses terminal differentiation and high-rate Ig secretion with no effect on proliferation. As shown here, different B cell populations show characteristic mean values of ligand concentration required for 50% inhibition, with Gaussian distributions of sensitivity to IgM receptor ligation that reflect cellular heterogeneity of 'al-or-none' inhibitions in single cells. Differential sensitivity of B cell populations to IgM ligation seems to be locally determined by the cellular environment and unrelated to the 'maturity' of the responding cells. Thus, while long-lived peritoneal B cells are 3- to 5-fold more resistant than splenic B cells, there is no difference in sensitivity between short- and long-lived B cells in the spleen. Furthermore, while B cells in bone marrow and spleen differ in sensitivity by two orders of magnitude, B cells differentiated in vitro from bone marrow pre-B cells are as resistant as splenic B cells. Moreover, bone marrow cell culture supernatants restore a high level of sensitivity in such cell populations. Differential sensitivity to IgM receptor ligation is reproduced by multivalent nominal antigen, in cell populations that show identical dose-response inhibition curves to direct activation of protein kinase C by phorbol esters. We conclude that the level of sensitivity to IgM ligation is independent of the life span or maturity of the B cell, but differentially regulated in vivo by putative tissue factors.

背景与目标： 对脂多糖 (LPS) 响应的b细胞上的表面IgM连接抑制了终末分化和高速度Ig分泌，而对增殖没有影响。如这里所示，不同的b细胞群体显示出50% 抑制所需的配体浓度的特征平均值，其对IgM受体连接的敏感性的高斯分布反映了单细胞中 “al-or-none” 抑制的细胞异质性。B细胞群体对IgM连接的不同敏感性似乎是由细胞环境局部决定的，与响应细胞的 “成熟度” 无关。因此，尽管长寿命的腹膜b细胞的抵抗力比脾b细胞高3至5倍，但脾脏中短寿命b细胞和长寿命b细胞之间的敏感性没有差异。此外，尽管骨髓和脾脏中的b细胞的敏感性相差两个数量级，但从骨髓前b细胞体外分化的b细胞与脾b细胞一样具有抵抗力。此外，骨髓细胞培养上清液在此类细胞群体中恢复了高水平的敏感性。在显示出与佛波酯直接激活蛋白激酶C相同的剂量反应抑制曲线的细胞群体中，多价名义抗原再现了对IgM受体连接的不同敏感性。我们得出的结论是，对IgM连接的敏感性水平与b细胞的寿命或成熟度无关，但在体内受假定的组织因素的差异调节。

BACKGROUND & AIMS: :There is strong evidence for an association between overgrowth disorders such as Beckwith-Wiedemann syndrome and the development of neoplasia. An increased cancer risk has also been observed in individuals with isolated hemihyperplasia. We critically review the evidence for tumour surveillance in Beckwith-Wiedemann syndrome and isolated hemihyperplasia and suggest local practice guidelines.

背景与目标： : 有强有力的证据表明，Beckwith-Wiedemann综合征等过度生长性疾病与肿瘤的发展之间存在关联。在孤立的半增生个体中也观察到癌症风险增加。我们严格审查了Beckwith-Wiedemann综合征和孤立性半增生中肿瘤监测的证据，并提出了当地实践指南。

BACKGROUND & AIMS: :In a context of automation of cryo-electron microscopy, we developed a novel method for improving visibility of diffraction rings in the power spectra of cryo-electron micrographs of vitreous ice (without carbon film or high concentration of diffracting material). We used these enhanced spectra to semi-automatically detect and remove micrographs and/or local areas introducing errors in the global 3D map (drifted and charged areas) or those unable to increase global signal-to-noise ratio (non-diffracting areas). Our strategy also allows a detection of micrographs/areas with a strong astigmatism. These images should be removed when using algorithms that do not correct astigmatism. Our sorting method is simple and fast since it uses the normalized cross-correlation between enhanced spectra and their copies rotated by 90 degrees. It owes its success mainly to the novel pre-processing of power spectra. The improved visibility also allows an easier visual check of accuracy of sorting. We show that our algorithm can even improve the visibility of diffraction rings of cryo-electron micrographs of pure water. Moreover, we show that this visibility depends strongly on ice thickness. This algorithm is implemented in the Xmipp (open-source image processing package) and is freely available for implementation in any other software package.

背景与目标： : 在冷冻电子显微镜自动化的背景下，我们开发了一种新颖的方法，用于提高玻璃冰冷冻电子显微照片 (没有碳膜或高浓度衍射材料) 的功率谱中衍射环的可见性。我们使用这些增强的光谱来半自动检测和删除显微照片和/或在全局3D地图中引入错误的局部区域 (漂移和带电区域) 或无法增加全局信噪比的区域 (非衍射区域)。我们的策略还允许检测具有强散光的显微照片/区域。当使用不校正散光的算法时，应删除这些图像。我们的排序方法简单，快速，因为它使用了旋转90度的增强光谱及其副本之间的归一化互相关。它的成功主要归功于功率谱的新颖预处理。改进的可见性还可以更轻松地视觉检查排序的准确性。我们证明，我们的算法甚至可以提高纯水的低温电子显微照片的衍射环的可见性。此外，我们表明这种能见度在很大程度上取决于冰的厚度。此算法在Xmipp (开源图像处理包) 中实现，并且可以免费在任何其他软件包中实现。

BACKGROUND & AIMS: BACKGROUND:This study aimed at analyzing different treatments of breast cancer (BC) prevalent in the region, their effect on patients' survival, and discusses the most suitable method within available resources. METHODS:The study was set up at a tertiary care hospital in north India. We retrospectively reviewed data of 473 female BC patients who attended the departments of Surgical Oncology and Radiotherapy from January 1997 to December 1999. Patients with cTNM stage IV and inoperable stage III were included; those who defaulted or were lost to follow-up were excluded. Out of 473 patients, 372 were selected. The selected patients were divided into groups on the basis of place and type of local treatment they received: (1) local excision only, (2) standard breast conservation therapy (BCT), (3) total mastectomy (TM) + axillary lymph node dissection + radiotherapy (RT), and (4) modified radical mastectomy (MRM) + RT. Data regarding recurrence and survival were analyzed in December 2005. Minimum follow-up was 6 years. RESULTS:Overall recurrence rates were significantly higher in patients operated elsewhere (P <0.0001). Of 194 operated at our Breast Unit, 25 (14.6%) of 171 MRM patients and none of 23 BCT had recurrence. Of 178 patients operated elsewhere, 44 (100%), 6 (42.9%), 41 (41%), and 8 (40%) developed recurrence in groups 1, 2, 3, and 4 respectively. Overall survival was significantly better in patients with MRM at our unit versus TM outside (93.6% vs. 80%). CONCLUSIONS:Several types of treatment from improper local excision alone, BCT, TM, to a carefully done MRM are prevalent here. Properly done, MRM yields significant local control with survival benefit and appears to remain the gold standard in management of our BC patients.

背景与目标：

BACKGROUND & AIMS: PURPOSE:The distribution, content, timeliness, use, and influence of pharmacoeconomic assessments (PEAs) of drugs in New Zealand public hospitals were examined. METHODS:In April 2005, a questionnaire-based, cross-sectional survey was sent to chief pharmacists at all 29 New Zealand hospitals employing a pharmacist. The questionnaire asked pharmacists about the use and influence of PEAs in their hospitals' formulary decision-making process. Answers were given using a scale of 1 to 6, with 1 being the most positive response. RESULTS:Of the 29 surveys mailed, 24 (83%) were completed. Data on 12 PEAs were analyzed. Assessments were seen and summaries read in most hospitals (median, 77% and 65%, respectively). Full documents were read in fewer hospitals (35%). In general, the PEAs were considered moderately easy to understand, provided a concise summary, and contained adequate detail of the methodology. Of the 24 respondent hospitals, 21 had assessment processes for new medicines; hence, a total of 252 hospital evaluations of Pharmaceutical Management Agency (PHARMAC)-assessed drugs were possible. A total of 132 possible evaluations (52%) were undertaken. More evaluations (106 [42%]) took place before PHARMAC's PEAs were distributed and fewer (26 [10%]) after distribution. Where used, the PEAs appeared to have a modest effect on hospital decisions. CONCLUSION:The provision of 12 PEAS by PHARMAC to hospitals in New Zealand had only a modest influence on their formulary decision-making process, mostly due to the lack of timeliness of the PEAs. The timely delivery of centrally developed PEAs may be essential to generating a greater effect on the formulary decisions at a wider level.

背景与目标：

BACKGROUND & AIMS: :DuPage County Health Department collected de-identified data from health forms submitted by participating schools for academic years 2011-2015 for kindergarten, sixth-, and ninth-grade students to determine the prevalence of obesity and elevated blood pressure among public school students. The prevalence of obesity in students for the 2014-2015 school year was 15.1%, and the prevalence of elevated blood pressure was 22.8%. Students in the "obese" body mass index percentile category had an elevated blood pressure prevalence of 44.2%, which was higher than students in the "nonobese" category (P < .001). Significant differences were also observed both by sex and by grade. The results identify the need to support implementation and evaluation of policies to reduce childhood obesity and improve health outcomes. By partnering with schools to obtain preexisting health data, state or local health departments with limited resources may replicate these methods to develop a childhood obesity surveillance system.

背景与目标： : 杜佩奇县卫生部门从参与学校提交的2011-2015学年幼儿园，六年级和九年级学生的健康表格中收集了不识别的数据，以确定公立学校学生中肥胖和血压升高的患病率。2014-2015学年学生的肥胖患病率为15.1%，血压升高的患病率为22.8%。“肥胖” 体重指数百分位类别的学生的血压患病率升高为44.2%，高于 “非肥胖” 类别的学生 (P <.001)。按性别和等级也观察到显着差异。结果表明需要支持实施和评估减少儿童肥胖和改善健康结果的政策。通过与学校合作以获取先前存在的健康数据，资源有限的州或地方卫生部门可以复制这些方法来开发儿童肥胖监测系统。

BACKGROUND & AIMS: :Repetitive transcranial magnetic stimulation (rTMS), a non-invasive form of brain stimulation, has shown experimental and clinical efficacy in a range of neuromodulatory models, even when delivered at low intensity (i.e. subthreshold for action potential generation). After central nervous system (CNS) injury, studies suggest that reactive astrocytes and microglia can have detrimental but also beneficial effects; thus modulating glial activity, for example through application of rTMS, could potentially be a useful therapeutic tool following neurotrauma. Immunohistochemistry was used to measure the effect of low intensity rTMS (LI-rTMS) on GFAP (astrocyte), IBA1 (microglial), and CS56 (proteoglycan) expression in a unilateral penetrating cortical stab injury model of glial scarring in young adult and aged male and female C57BL6/J mice. Mice received contralateral low frequency, ipsilateral low frequency, ipsilateral high frequency or sham LI-rTMS (4-5mT intensity), for two weeks following injury. There was no significant difference in the overall volume of tissue containing GFAP positive (+) astrocytes, IBA1+ microglia, or proteoglycan expression, between sham and LI-rTMS-treated mice of all ages and sex. Importantly however, the density of GFAP+ astrocytes and IBA1+ microglia immediately adjacent to the injury was significantly reduced following ipsilateral low and high frequency stimulation in adult and aged females (p≤0.05), but was significantly increased in adult and aged males (p≤0.05). LI-rTMS effects were generally of greater magnitude in aged mice compared to young adult mice. These results suggest that sex differences need to be factored into therapeutic rTMS protocols. In particular, more work analyzing frequency and intensity specific effects, especially in relation to age and sex, is required to determine how rTMS can best be used to modify glial reactivity and phenotype following neurotrauma.

背景与目标： 重复经颅磁刺激 (rTMS) 是一种非侵入性的脑刺激形式，即使在低强度 (即动作电位产生的亚阈值) 下，也已在一系列神经调节模型中显示出实验和临床功效。中枢神经系统 (CNS) 损伤后，研究表明反应性星形胶质细胞和小胶质细胞可能具有有害但有益的作用; 因此，例如通过应用rTMS调节神经胶质活性，可能是神经创伤后有用的治疗工具。免疫组织化学用于测量低强度rTMS (LI-rTMS) 对年轻成年和老年C57BL6/J小鼠单侧穿透性皮质瘢痕损伤模型中GFAP (星形胶质细胞)，IBA1 (小胶质细胞) 和CS56 (蛋白聚糖) 表达的影响。损伤后两周，小鼠接受对侧低频，同侧低频，同侧高频或假LI-rTMS (4-5mT强度)。在所有年龄和性别的sham和LI-rTMS治疗的小鼠之间，含有GFAP阳性 () 星形胶质细胞，IBA1小胶质细胞或蛋白聚糖表达的组织的总体积均无显着差异。然而，重要的是，在同侧低频和高频刺激后，与损伤紧邻的GFAP + 星形胶质细胞和IBA1 + 小胶质细胞的密度在成年和老年女性中显著降低 (p ≤ 0.05)，但在成年和老年男性中显著增加 (p ≤ 0.05)。与年轻的成年小鼠相比，老年小鼠的LI-rTMS效应通常更大。这些结果表明，需要将性别差异纳入治疗性rTMS方案。特别是，需要更多的工作来分析频率和强度的特定影响，尤其是与年龄和性别有关的影响，以确定rTMS如何最好地用于改变神经创伤后的神经胶质反应性和表型。

BACKGROUND & AIMS: BACKGROUND:The majority of patients receive HT after biochemical progression despite primary therapy of prostate cancer with curative intent. It is difficult to differentiate at a low rise in PSA level, e.g.,

BACKGROUND & AIMS: :Seventeen consecutive patients with dystrophic amyloidosis are reported here (eight Chinese, three Indian, three Iban, two Malay and one Caucasian). Ten were females and seven males, with ages ranging from 12 to 80 years (mean of 48 years). Five instances of dystrophic amyloidosis occurred in areas of tissue damage in the cardiovascular system, including fibrotic cardiac valves and an atheromatous plaque. Three occurred in osteoarthritic joint tissue. Of note were three occurrences in endometriotic cyst walls, four in the fibrotic walls of epidermal cysts, one in a hernial sac and one at the edge of a skin ulcer. All deposits were congophilic and exhibited green-birefringence and permanganate-resistance. Immunohistochemistry did not reveal reactivity for AA protein or immunoglobulin lambda or kappa light-chains. AP protein was detected in 35% of cases. Our results show that, besides the usual sites of osteoarthritic joints and damaged heart valves, dystrophic amyloidosis can complicate other areas of chronic tissue damage and fibrosis such as walls of cysts and ulcers. While the pathogenesis and biochemical nature remain unresolved, immunohistochemistry indicates that neither AA nor AL proteins are present in the deposits, and suggests that a different amyloid protein is involved.

背景与目标： : 这里连续报道了17例营养不良性淀粉样变性患者 (八名中国人，三名印度人，三名伊班族，两名马来人和一名高加索人)。10名女性和7名男性，年龄在12至80岁之间 (平均48岁)。5例营养不良性淀粉样变性发生在心血管系统组织损伤区域，包括纤维化心脏瓣膜和动脉粥样斑块。3例发生在骨关节炎关节组织。值得注意的是，在子宫内膜异位囊肿壁中发生了3次，在表皮囊肿的纤维化壁中发生了4次，在疝囊中发生了1次，在皮肤溃疡的边缘发生了1次。所有沉积物都是亲血的，并表现出绿色双折射性和高锰酸盐抗性。免疫组织化学未显示对AA蛋白或免疫球蛋白 λ 或 κ 轻链的反应性。在35% 病例中检测到AP蛋白。我们的结果表明，除了通常的骨关节炎关节和受损的心脏瓣膜部位外，营养不良性淀粉样变性还会使慢性组织损伤和纤维化的其他区域复杂化，例如囊肿和溃疡壁。尽管发病机理和生化性质仍未解决，但免疫组织化学表明沉积物中不存在AA和AL蛋白，并表明涉及不同的淀粉样蛋白。

BACKGROUND & AIMS: :A recently released report of the Exploring Accreditation Project affirmatively answered the questions regarding the desirability and feasibility of establishing a national voluntary public health accreditation program. The report's recommendations were made after 10 months of inquiry from public health experts, elected officials, the general public health workforce, academicians, and other interested parties, more than 650 public health professionals in all. Recommendations regarding how such a program might be implemented insofar as its governance, principles for standards development, financing and incentives, and evaluation were included. The report provides a blueprint for establishing a national voluntary public health accreditation program. This article describes key aspects of the Steering Committee recommendations, with limited linkage to implementation strategies where relevant, in the four areas in which the project was designed. Details are provided in the final reports of the Steering Committee (www.exploringaccreditation.org) and in other articles in this issue.

背景与目标： : 最近发布的 “探索认证项目” 报告肯定地回答了有关建立国家自愿公共卫生认证计划的可取性和可行性的问题。该报告的建议是在公共卫生专家，民选官员，一般公共卫生工作人员，院士和其他有关方面，共有650多名公共卫生专业人员进行了10个月的调查后提出的。包括了关于如何实施此类计划的建议，包括其治理，标准制定原则，融资和激励措施以及评估。该报告提供了建立国家自愿公共卫生认证计划的蓝图。本文介绍了指导委员会建议的关键方面，在设计项目的四个领域中，与相关实施战略的联系有限。指导委员会的最终报告 (www.exploringaccreditation.org) 和本期的其他文章提供了详细信息。

BACKGROUND & AIMS: :Laparoscopy is frequently associated with postoperative shoulder pain that may last several days. We have assessed the analgesic effect of intraperitoneal local anaesthetics during day-case diagnostic laparoscopy. 80 young women were randomly assigned to one of four groups of 20 patients each: group 1, no peritoneal administration; group 2, 80 ml saline injected under direct vision in the right subdiaphragmatic area at the start of the procedure; group 3, 80 ml 0.5% lignocaine with adrenaline (320,000 dilution); group 4, 0.125% bupivacaine with adrenaline (800,000 dilution). Scapular pain was assessed with a visual analogue pain scale, and information about nausea, vomiting, abdominal pain, and analgesic requirements during the first 48 h was sought. Both local anaesthetics were more effective in reducing postoperative shoulder pain than either control or saline. Analgesic requirements were greater in the non-treatment groups than in the local anaesthetic groups. Intraperitoneal local anaesthetic administration during laparoscopy is both a non-invasive and an efficient method of reducing the intensity of scapular pain.

背景与目标： : 腹腔镜检查通常与可能持续数天的术后肩部疼痛有关。我们在日间诊断性腹腔镜检查中评估了腹膜内局部麻醉剂的镇痛作用。80名年轻女性被随机分配到四组中的一组，每组20名患者: 第1组，不腹膜给药; 第2组，在手术开始时在右侧膈下区域直视下注射80毫升生理盐水; 第3组，用肾上腺素 (320,000稀释) 80毫升0.5% 利多卡因; 第4组，0.125% 布比卡因与肾上腺素 (800,000稀释)。用视觉模拟疼痛量表评估肩cap骨疼痛，并寻求有关头48小时内恶心，呕吐，腹痛和镇痛需求的信息。与对照组或生理盐水相比，两种局部麻醉剂在减轻术后肩部疼痛方面都更有效。非治疗组的镇痛需求高于局部麻醉组。腹腔镜检查过程中腹膜内局部麻醉给药既是一种非侵入性的，也是减轻肩胛骨疼痛强度的有效方法。

BACKGROUND & AIMS: PURPOSE:To assess if local intra-arterial administration of paclitaxel using drug-coated balloons or an admixture of paclitaxel to contrast medium inhibits stenosis after percutanous transluminal angioplasty (PTA) of peripheral arteries in a porcine overstretch model. METHODS:Neointimal proliferation and stenosis were induced by overstretch and stenting of 40 peripheral arteries in 20 pigs. Paclitaxel was administered locally during PTA using coated balloons (n = 20) or dissolved in contrast medium (n = 10). Conventional balloons and contrast medium were used in a control group (n = 10). Reangiography with quantitative analysis was performed after 5 weeks. RESULTS:On reangiography diameter stenosis and late lumen loss were significantly reduced by both methods of local drug delivery compared with control group; minimal luminal diameter was significantly larger in the treatment groups. CONCLUSIONS:Local short-term administration of paclitaxel during PTA of peripheral arteries using balloons or contrast medium as drug carriers reduced stenosis due to intimal hyperplasia.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To evaluate clinical effects of shenqi fuzheng Injection ([Chinese characters: see text]) in the neoadjuvant chemotherapy for local advanced breast cancer and the effects on T-lymphocyte subsets. METHODS:During the period from 2000 to 2005, 126 patients with local advanced breast cancer were treated with the neoadjuvant chemotherapy. They were randomly divided into the following two groups: a control group of 61 cases treated by chemotherapy alone and a study group of 65 cases treated by chemotherapy plus shenqi fuzheng injection. All the cases of both groups were given the CEF (CTX 500 mg/m2, d1,8; EPI 40 mg/m2, d1, 8; and 5-Fu 500 mg/m2 d1,8) regimen. The clinical effects, the effects on T-lymphocyte subgroup and NK cells, and the toxic side effects were observed. RESULTS:All the patients completed two cycles of the chemotherapy, and the efficacy and the toxic side effects were evaluated. For the primary tumor in the breast, the total effective rate was 69.2% (45/65) in the study group and 49.2% (30/61) in the control group with a statistically significant difference in the intergroup comparison (chi2 = 5.251, P = 0.022, < 0.05). There was no progression of the disease in both the groups, and there were no grade IV toxic side effects in the two groups. The major toxic responses were myelosuppression and gastrointestinal reaction, which were milder in the study group than the control group, and with a shorter recovery course in the former than the latter. Besides, an obvious rise of the T-lymphocyte subgroup and NK cells was found in the study group after the neoadjuvant chemotherapy, with a very significant difference from the controls (P < 0.01). CONCLUSIONS:Shenqi fuzheng Injection can improve and regulate immune function of the patients with local advanced breast cancer given the neoadjuvant chemotherapy, and therefore it can enhance the curative effect and reduce the side effect as well.

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