Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.

Objective To discuss the clinical value of application of three-dimensional reconstruction technique of MSCT in examination of colonic tumours.Methods Thirty patients underwent scanning using helical CT and post-processing on the workstation.All CTC images were reconstructed using shaded surface display (SSD) on workstation.Perspestive images such as the ones from DCBE were generated via raysum.The images could clearly demonstrate the extent and detail of the disorder by adjusting the CT value threshold.These results and that of barium enema and colon endoscopy were compared.Results Thirty cases had completely clinical and pathological data.3D images could correctly reveal the macroscopic morphology of colon tract and location of lesions.The correctly diagnostic rate was 100％ by MSCT,while the diagnostic rate by CTVE and colon endoscopy was basicly identical.Conclusion With the utilization of multiple methods,3D reconstruction can effectively demonstrate colonic tumours,and can be applied routinely in examination of colonic tumours.

Objective To observe the effect of anti-pyretic and anti-inflammatory of Shufeng Jiebiao decoction.Methods Intraperitoneal injection of Lipopolysaccharides (LPS) was made to cause fever in rats and then to observe the anti-pyretic effect of Shufeng Jiebiao decoction.Intraperitoneal injection of glacial acetic acid was made to led inflammatory exudate in rats and then to observe the anti-inflammatory effect of Shufeng Jiebiao decoction.Smearing cylene in auricles was done to cause inflammatory swelling in rats and then to observe the effect of the alleviation of the inflammatory swelling of Shufeng Jiebiao decoction.Results ①The temperature of rats in the group of the aspirin and the Shufeng Jiebiao decoction were become lower at each time.The basic temperature of the model control group was (37.14±0.39) ℃,the temperature in the first hour was (40.31±0.34) ℃,the second hour was (40.44±0.44) ℃,the fourth hour was (40.24±0.34) ℃,the sixth hour was (40.05 ±0.44)℃,and the eighth hour was (39.85 ±0.37)℃.The basic temperature of the aspirin group was (37.13±0.33)℃,the temperature in the first hour was (38.74±0.42)℃,the second hour was (38.86±0.33) ℃,the fourth hour was (39.05±0.36)℃,the sixth hour was (38.74±0.37)℃,and the eighth hour was 38.64±0.24) ℃.The basic temperature of the Shufeng Jiebiao decoction group was (37.03±0.46) ℃,the temperature in the first hour was (39.02±0.49) ℃,the second hour was (38.82±0.49) ℃,the fourth hour was (38.63±0.46)℃,the sixth hour was (38.62±0.52)℃,and the eighth hour was (38.42±0.44)℃.The differences were statistical significance compared with the model control group (P＜0.01),the onset of anti-pyretic of the Shufeng Jiebiao decoction group was slower than the aspirin group,but it had a longer lasting effect.Moreover,the rats' temperature decrease of the Shufeng Jiebiao decoction group in the fourth hour had a statistical significance compared with the aspirin group.(P＜0.05).② After the intevention of aspirin and the Shufeng Jiebiao decoction,the optical density of evans blue:the model control group was (0.221 ±0.045),the aspirin group was (0.162±0.053),the Shufeng Jiebiao decoction group was (0.176±0.049),the permeability of the abdominal capillary of the rats reduced significantly (P＜0.01).The intervention of the aspirin and the Shufeng Jiebiao decoction had almost no difference.③ After the intervention of the dexamethasone and the Shufeng Jiebiao decoction,the weight of the auricals:the model control group was (1.94±0.55)mg,dexamethasone group was (1.18±0.40)mg,Shufeng Jiebiao decoction group was (1.04±0.41)mg,showing the degree of the swelling of auricals decreased obviously (P＜0.01).The intervention of the dexamethasone and the Shufeng Jiebiao decoction had almost no difference.Conclusion Shufeng Jiebiao Decoction had anti-pyretic and anti-inflammatory effects.

Objective: To observe the effects of Yanggan Lidan Granule (YGLDG), a compound traditional Chinese herbal medicine, on insulin resistance in guinea pigs with induced cholesterol gallstones. Methods: Eighty guinea pigs were randomly divided into normal control group, untreated group, YGLDG group and ursodeoxycholic acid (UDCA) group, with 20 guinea pigs in each group. Except the normal control group, gallstones were induced by high-cholesterol diet in the guinea pigs. The guinea pigs in the normal control group and the untreated group were administered with normal saline. UDCA and YGLDG were given to the guinea pigs in the corresponding groups for seven weeks. Eight guinea pigs of each group were used to measure the glucose infusion rate (GIR) by using hyperinsulinemic-euglycemic clamp technique. At the end the guinea pigs were killed and their gallstone formation was observed. Results: The gallstones in guinea pigs were identified as cholesterol stones by qualitative analysis through infrared spectrum. The incidence rate of cholelithiasis of the untreated group was 82.35% . The GIR of guinea pigs in the untreated group was obviously lowered down as compared with the normal control group. Compared with the untreated group, the GIRs of the YGLDG group and the UDCA group were obviously increased, especially in the YGLDG group. Conclusion: YGLDG may improve insulin resistance in guinea pigs with cholesterol gallstones by elevating GIR obviously.

Objective To investigate the value of prospectively electrocardiogram (ECG)-triggered high-pitch coronary computed tomography angiography at 70 kV and 30 mL contrast medium with Stellar detector dual-source CT.Methods 60 patients with the BMI<24.9 kg/m2 were randomized into two groups:Group A (30 cases)with the tube voltage of 70 kV and 30 mL contrast medi-um.Group B (30 cases)with the tube voltage of 100 kV and 50 mL contrast medium.All the patients were performed with a Stellar detector dual-source CT using a prospectively ECG triggered high-pitch spiral technique.The images of Group A were reconstructed with SAFIRE technique,while Group B were with FBP technique.The objective image quality includes CT attenuation,SNR, CNR.And radiation dose was also calculated.The subjective was evaluated by 4-scale point.Independent sample t test was used.Re-sults There was no difference for subjective image quality between the groups,A:(3.38±0.942),B:(3.50±0.682),(t=-0.562, P >0.05).The CT attenuation of the 70 kV group were higher than that of the 100 kV group for all the segments(P <0.01).The SNR and the CNR have no statistically significant difference between the groups (P >0.05).Compared with the 100 kV group,the radiation dose of the 70 kV group was reduced by 76.5% (A:0.19±0.023 mSv,B:0.81±0.101 mSv,P <0.01).Conclusion Using 70 kV with 30 mL contrast medium in Stellar detector dual-source CT coronary angiography for the patients with a normal BMI could obtain qualified diagnostic image with low radiation dose and contrast medium.

Objective To evaluate the difference between CT and CT/MR DWI images for gross tumor volume (GTV) delineation in precision radiotherapy for esophageal squamous cell carcinoma.Methods 20 patients with pathologically confirmed as esophageal squamous cell carcinoma were selected for target delineation.The GTV based on CT and CT/MR DWI images of the patients were delineated by six radiation oncologists.The mean,standard deviation,coefficient of variation (CV =standard deviation/mean) of GTV volume,the ratio of minimum value and maximum value (ratio =maximum value/minimum value) of the GTV volume were calculated.And the CV and ratio of the GTV by the two methods were compared.Results The biggest difference of GTV volume on CT and on CT/MR DWI images was 55.71 and 13.89 cm3 (F =12.80,P ＜ 0.05).The CV on CT and CT/MR DWI images were 0.30 ± 0.08,0.11-±0.04 (Z =-3.92,P ＜ 0.05),and the ratio of GTV volume were 2.38 ± 0.62,1.34 ± 0.13,respectively (Z =-3.92,P ＜ 0.05).Conclusions CT/MR DWI images could display GTV more directly,which may help to increase consistency of GTV for esophageal squamous cell carcinoma delineation among different radiation oncologists.

Objective To evaluate feasibility and time efficiency of dual-source flash post-processing software (Bone Reading)for reconstruction of bronchial artery.Methods The imaging data of 70 patients with suspected bronchial artery dilatation who underwent bronchial artery-CTA were evaluated by 2 independent radiologists.First,the related contents of bronchial artery such as origination,number, type,route and lumen diameter were evaluated by multiple planar reconstruction (MPR),maximum intensity projection (MIP)and volume rendering technique (VRT).The results and process time were recorded.After a month,the post-processing software(Bone Reading)was used to evaluate the same contents.Results There was very good correlation between both readers for both reading methods without significant differences.There was significant difference of process time between with regular method and with Bone Reading (P<0.05)for both readers.Process time could be decreased by approximately 35%.Conclusion The application of CT software (Bone Reading)is feasible in the CTA of bronchial artery.This method may gain a significant time saving in comparison to regular method.

Objective:To explore the efficacy of sequential and concurrent chemoradiotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) in the elderly, and to analyze the influencing factors of prognosis and outcome.Methods:The clinical data of 195 elderly patients with advanced NSCLC admitted to Beijing Shijingshan Hospitaland and Beijing Shijitan Hospital from March 2015 to March 2018 were retrospectively analyzed. They were divided into the concurrent chemoradiotherapy (100 cases) and the sequential chemoradiotherapy (95 cases) according to different chemoradiotherapy regiments. The short-term efficacy, 3-year survival, influencing factors of prognosis and toxic and adverse effects of the two groups were compared.Results:The objective response rate in the concurrent chemoradiotherapy group was significantly higher than that in the sequential chemoradiotherapy group: 61.00%(61/100) vs. 44.21%(42/95), there was statistically difference ( χ2 = 5.51, P<0.05). The 2-year and 3-year survival rate in the concurrent chemoradiotherapy group were 52.00% and 23.00%, which were significantly higher than those in the sequential chemoradiotherapy group: 32.60%, 11.60%, there were statistically differences ( P<0.05). Multivariate analysis results showed that smoking, Karnofsky score<70, TNM stage Ⅲb, short-term efficacy and treatment methods/sequential chemoradiotherapy were independent risk factors ( P<0.05). The incidence of radiation esophagitis, bone marrow suppression and lung function damage in the concurrent chemoradiotherapy group were higher than those in the sequential chemoradiotherapy group: 45.00%(45/100) vs. 27.37% (26/95), 36.00%(36/100) vs. 22.11%(21/95), 48.00%(48/100) vs. 26.32%(25/95), there were statistically differences ( χ2 = 6.54, 4.55, 9.78; P<0.05). Conclusions:Concurrent chemoradiotherapy can improve the short-term efficacy, and improve the 2-year and 3-year survival rates in advanced NSCLC in elderly patients, but the adverse effects are significantly enhanced.

Gynaecomastia is a kind of benign and hyperplastic disease of male breast tissue. Based on the literature at home and abroad, different classification or standard of gynaecomastia has been expounded respectively from the pathogenesis, age, pathology, degree and iconography, and several common classification has been compared. Summarizing the advantages and disadvantages of these classification standards, evidence can be provided for clinical diagnosis and preoperative assessment of gynaecomastia, improvement direction can be offered for domestic classification criteria.