7?cm to a dose of 48-60?Gy in 8-10 fx over 21-24 days. Patients with positive supraclavicular lymph nodes received conventional fractionated radiotherapy with 12 MeV-E to a total dose of 66-70 ?Gy in 7 weeks. Therapeutic effect and survival rate were studied. Results Twelve patients achieved CR, 22 PR, 4 NR and 5 PD, with a total response rate of 79.1%(34/43). The 1-, 2- and 3-year survival rates were 75.2%, 53.2% and 35.4%. Conclusions Three-dimensional conformal hypofractionated high-dose radiotherapy combined with chemotherapy should be considered as an effective and feasible approach in the treatment of NSCLC patients. Long-term survival and possible specific injury await further study.

ObjectiveTo evaluate the effects of transcatheter arterial chemoembolization (TACE) combined with 3-dimensional conformal radiation therapy(3DCRT )for unresectable primary hepatic carcinoma (PHC). MethodsNinety-four patients with unresectable PHC were initially treated with TACE and then sequentially with 3DCRT. The therapeutic effect and survival rate of the patients were assessed as endpoints with Cox proportional hazard model used to define prognostic factors. Of these 94 patients,82 presented with a solitary lesion and 12 with multiple ones. Fifty-nine patients received only one course of TACE while 35 several courses. The total radiation dose of 42-52 Gy was delivered to 42 patients, and 53-60 Gy to 52. ResultsThe local response rates were 90.4% (85/94) in 3 months and 83.0% (78/94) in 1 year after treatment with 12 CR,73 PR,6 NR and 3 PD. The 1-,2-,and 3-year survival rates were 93.6%,53.8% and 26.0% respectively,with a median survival duration of 25.0 months. In the multivariate analysis,the number of tumor lesion,Child's classification and clinical stage presented prognostic significance for overall survival (P

Objective To investigate and analysis the clinical effect of pramipexole in Parkinson's disease with depression.Methods The patients with Parkinson disease patients with depression were selected in a total of 100 as the research object,and were randomly divided into two groups,the observation group and the control group with 50 cases in each group.The control group was taken conventional treatment,the observation group was given pramipexole based on the conventional treatment methods,the the effects of treatment were observed and compared. Results The MIHD score of the observation group after treated for 12 month (8.26 ±1.96)was lower than the score before treatment (24.91 ±4.6),and the score of the control group after treated for 12 month (11.15 ±2.10)was also lower than the score before treatment (24.48 ±5.34),the difference were all statistically significant(P<0.05). After treated for 12 month,the score in the observation group was lower than that in the control group,and the total effective rate in the two group were 94% and 80% respectively(P<0.05 ).The UPDRS score of the observation group was lower than in the control group,but the difference was not significant(χ2 =14.756,P<0.05).Conclusion Give pramipexole has notable curative effect on the depression disease in patients with Parkinson disease on the basis of conventional therapy method,and has the value of popularization.

Objective To explore the job burnout and its related factors among nurses.Methods 486 clinical nurses from a three grade second level general hospital were investigated by Moreno-Jimenez nursing burnout scale (NBS) and using SPSS17.0 software and ANOVA method to analyse the data.Results NBS results showed the score of job burnout in 486 objects was (164.92 ± 25.60).Significant differences of job burnout levels were showed among ages,marital status,professional titles,working periods,working relationship,work load,income,and housework periods (P ＜ 0.05).Conclusion Job burnout is a general phenomenon in these investigated nurses and its level is above average.Administrators should pay more attention to these related factors which can easily cause job burnout and take positive feasibility assistant strategies.

Objective To explore the feasibility and safety of combination of thoracoscopy and laparoscopy for the treatment of esophageal carcinoma.Methods Combining thoracoscopic and laparoscopic esophagectomy was attempted in 23 patients with esophageal cancer between August 2007 and July 2008.Being placed at a left lateral decubitus position,the patients received right thoracoscopic mobilization of the intrathoracic esophagus as well as lymph node dissection;then with lithotomy position,laparoscopic mobilization of the stomach and lymph node dissection were carried out,followed by creation of a gastric tube through a small incision under the xiphoid;finally we pulled out the gastric tube from the esophageal bed to the neck and made an intermittent gastroesophageal anastomosis.Results One of the patients was converted to open abdominal surgery,whereas no one was converted to open thoracic operation.The total operation time ranged from 240 to 330 minutes with a mean of 270 minutes,the operation time for laparoscopy was 38-90 minutes(mean,65 minutes),and for thoracoscopy was 55-100 minutes(mean,70 minutes).No massive hemorrhage occurred during the operation,the total blood loss ranged from 100 to 300 ml(mean,225 ml),of which 10 to 50 ml were intra-abdominal blood loss(mean,20.4 ml).Totally 225 lymph nods were removed(9.8 per patient in average).Of the resected lymph nodes,65 were para-left gastric arterial or pericardial lymph nodes(2.8 per case).The mean hospital stay in this series was 9.2 days(range:8-12 days).During the hospitalization,no patient died;postoperative complications included pulmonary infection(3 cases),cervical anastomotic leak(one case,occurred in 8 days after the surgery),chylothorax(1 patient,cured by ligation via open thoracic surgery),and hoarseness(3 cases).Of the patient,23 received an follow-up for 1 to 11 months(mean,7.7 months),during which,1 patient died and 1 patient showed extensive metastasis to the mediastinal lymph node.Conclusion Combination of thoracoscopy and laparoscopy with cervical anastomosis is feasible and safe for the treatment of esophageal carcinoma.

Objective To evaluate the efficacy of transcatheter arterial chemoembolization (TACE) combined with hypofractionated 3 dimensional conformal radiotherapy for hepatocellular carcinoma (HCC). Methods During May 1998 and Dec. 1999, 81 unresectable HCC patients were divided into two groups. Forty one patients in group A were treated with TACE and hypofractionated 3 dimensional conformal radiotherapy and 40 patients in group B were treated with TACE alone. Acute effects were analyzed and survival rates were assessed from the date of the beginning of treatment using the Kaplan Meier method. The survival rates of two groups were compared using Log rank. The Cox proportional hazards model was used to analyze the prognostic factors in group A. Results The objective response rate in group A was higher than that in group B (85.4% vs. 65.0% , P

Objective To evaluate the effect of 3-dimensional conformal radiotherapy (3D CRT) and prognostic factors for cervical and upper-thoracic esophageal cancer. Methods Between July 1998 and July 2001, 33 patients with cervical and upper-thoracic esophageal cancer were treated with 3D CRT(2?Gy per day, 5 sessions a week to a total dose of 66-68?Gy over 6-7 weeks). Acute toxicities and survival rates were evaluated by Kaplan-Meier method and prognostic factors were analyzed by Cox proportional hazard model. Results The 1-, 2-, 3-year local control rates were 87.9%, 75.8%, 45.5% respectively. The 1-, 2-, 3-year disease-free and overall survival rates were 72.7%, 60.6%, 30.3% and 78.8%, 66.8%, 44.2% respectively. GradeⅠ-Ⅱ acute esophagitis and bronchitis were the most common radiation side effects. Multivariate analysis revealed that the depth of primary tumor invasion, regional lymph node metastasis and tumor length were independent prognostic factors (P

The effects of nicorandil ( NICO ) on the contractility, automati -city, excitability, functional refractory period ( FRP ) & dose-response curves for isoprenaline as well as calcium were studied in guinea pig papillary muscles. NICO could decrease the amplitude of contraction of papillary muscles dose-dependently. Propranolol and NICO might antagonize the inotropic effect of isoprenallne. Verapamil & NICO induced Ca2+ antagonistic effects in a non-competitive manner, & the maximal Ca2+ response of papillary muscles decreased signifi- cantly. The automaticity of papillary muscles was decreased Significantly when the concentration of NICO reached 1.4 mmol/L, but exerted no effect on their excitability & the functional refractory period.

BACKGROUND:Basic fibroblast growth factor(bFGF)can promote production of collagen,fibronectin and matrix enzyme in healing wounds.However,dysregulation of this process,such as the abnormal coordination of cell proliferation,extracellular.matrix and neovasculadzation formation,or remodeling of the wound matrix will lead to excess accumulation of scar tissues.OBJECTIVE:To investigate effects of bFGF on normal skin wound healing and hypertrophic scar formation.METHODS:Normal and hypertrophic scar fibroblasts from tissue biopsies from 5 patients who underwent plastic surgery for repairing hypertrophic scars were isolated and cultured.The expressions of collagen,fibronectin and protein synthesis were detected by RT-PCR and ELISA.The mitochonddal membrane potential changes were measured using JC-1 staining and flow cytometry.Simultaneously,adenosine tdphosphate(ATP)levels were determined by chemiluminescence method.The effects of bFGF on these indexes of normal and hypertrophic scar fibroblasts were observed.RESULTS AND CONCLUSION:Hypertrophic scar fibroblasts become slower after being exposed to bFGF,which selectively inhibited type Ⅰ collagen production in hypertrophic scar fibroblasts(P<0.05).Although bFGF inhibited type]collagen production,it had no effect on type Ⅲ collagen expression in both normal and hypertrophic scar fibroblasts.However,fibronectin expression in the normal fibroblasts was up-reguleted after bFGF treatment(P<0.05).In addition,the mitochonddal membrane potential tended to depolarization,although no statistical difference,in hypertrophic scar fibroblasts treated with bFGF(10 or 100 μg/L).bFGF treatment increased the cellular ATP levels in the normal fibroblasts,while there were no significant alterations in the hypertrophic scar fibroblasts over a treatment of bFGF(10 or 100 μg/L,P<0.05).The results suggest that there are differential effects and mechanisms on the skin fibroblasts with bFGF treatment in normal wound healing and hypertrophic scar formation.

Objective To investigate the clinicopathologic characteristics of and HPV subtypes in vulvar condyloma acuminatum(CA)and subclinical HPV infection.Methods Eighty patients with a positive acetowhite test and suspected subclinical HPV infection were selected from 272 patients with typical CA lesions in perianal and external genital region.Tissue specimens were obtained from typical CA and suspected subclinical HPV-infected lesions followed by pathological examination and HPV-DNA detection.Finally,71 patients were confirmed to suffer from both CA and subclinical HPV infection.A comparative analysis was performed to assess the differences in histopathological manifestation and HPV genotypes between CA and subclinical infection lesions.Results Pathological examination revealed typical histological changes of CA in 71(88.75％)typical CA specimens and 4(5％)suspected subclinical infection specimens,as well as squamous dysplasia in 9(11.25％)CA specimens and 71(88.75％)suspected subclinical infection specimens.HPV-DNA was positive in all(80)of the CA specimens and 93.75％(75)of the suspected subclinical infection specimens,negative in 5(6.25％)suspected subclinical infection specimens.Obvious differences were observed in pathological manifestation,koilocyte number(P ＜ 0.05),but not in the distribution of HPV subtypes(P ＞ 0.05),between typical CA and concurrent subclinical HPV infection lesions in patients.Conclusion The diagnosis of subclinical HPV infection should be based on the result of acetowhite test,with the results of pathological examination and HPV DNA detection as an adjuvant.