Objective To discuss the effect of three-dimensional conformal hypofractionated high-dose radiotherapy on non-small cell lung cancer in the elderly. Methods All patients were treated by the same way of fraction radiotherapy,with a prescription dose of 4-5?Gy,every other day,to a total dose of 48-55?Gy. Results Complete response was observed in 23(51.1%) patients,partial response in 15(33.3%) patients, with the overall response rate of 84.4%. The overall 1-,2-,3-year survival rates were 66.7%,48.9% and 39.1%.Conclusions Three-dimensional conformal hypofractionated high-dose radiotherapy is safe and effective, giving mild untoward side-effects.

Objective To analyze the clinical characteristics of children tsutsugamushi infection in order to strengthen understanding,reduce the misdiagnosis rate,reduce the complications and improve the level of diagnosis and treatment.Methods To analyze retrospectively the clinical data and treatment outcome of 22 cases of children tsutsugamushi disease,including symptoms,physical signs and laboratory examination.Results All the cases with fever onset,high fever (＞ 39 ℃) was 72.7％ (16/22),all cases were typical eschars and ulcers,while 8 cases (36.4％,8/22)had lymphadenectasis.Merger multiple organ damage in 14 cases (63.6％,14/22),anemia in 11 cases (50.0％,11/22)and liver function abnormal in 4 cases (18.2％,4/22).All of 22 cases were treated with azithromycin.All cases after treatment with azithromycin heal,no recurrence.Conclusions The manifestation of tsutsugamushi disease is diversity,much complications,among which hematology and liver are the most common cases.Physical examination roundly might reduce missed diagnosis and misdiagnosis as greatly as possible.Azithromycin has good therapeutic effects on children tsutsgamushi disease.

Objective To analyze the learning curve of microendoscopic lumbar discectomy (MED) and summarize the operative experience. Methods From July 2010 to March 2012, the first 100 patients with single level lumbar disc herniation managed with MED were divided into chronological groups (A, B, C and D), 30 patients in group A, B, C and 10 patients in group D. The comparsons were conducted in terms of operative time , estimated blood loss , number of cases with transition from MED to open surgey or for reoperation , rate of complications and postoperative efficacy. Results The mean operative time and the mean estimated blood loss in each group was valuated respectively. In group A , the operative time and estimated blood loss were significantly decreased as compared with those in group B, C and D respectively (P < 0.05), but those in group B were not significantly different from those in group C and D (P > 0.05). There were 6 complications in group A, 1 complication in group B and C respectively and no complication in group D. The leg pain visual analogue scale and Oswestry disability index at the first month and the twelfth month postoperatively were all improved respectively as compared with those preoperatively (P < 0.01). Conclusion The learning curve of microendoscopic lumbar discectomy generally may reach the plateau when about 30 cases are operated on. The key procedure to pass over the learning curve includes puncture and location , flavectomy , anatomy mark identification, and precaution of damage in dural sac.

Objective To study the effect of transcatheter arterial chemoembolization(TACE) combined with three-dimensional conformal radiotherapy(3DCRT) for inoperable primary liver cancer.Methods Ninety-six such patients were prospectively randomized to TACE therapy alone group(TACE group-,47 patients) and TACE+3DCRT group(combined group-,49 patients).Results The overall 1-,2-,3-year survival rate was 82%,63%,43% in the combined group.It was 55%,28%,15% in the TACE group.The difference between the two groups was significant(P0.05).Conclusion Transcatheter arterial chemoembolization combined with three-dimensional conformal radiotherapy is more effective than transcatheter arterial chemoembolization therapy alone for inoperable primary liver cancer,without inflicting more treatment-related toxicities.

Objective To evaluate the value of 3-dimensional conformal radiotherapy combined with Hydroxycamptothecin(HCPT) in the treatment of local advanced non-small cell lung cancer.Methods A total of 95 cases were enrolled and randomly assigned to treatment group and control group.The treatment group was treated with 3-dimensional conformal radiotherapy(3DCRT) combined with HCPT.The control group was treated with 3DCRT only.Results Response rate(CR+PR) is respectively 73.4 % and 62 %.The response rate of treatment group is higher than that of control group(P

From the aspects of strengths,weaknesses,opportunities and threats,this paper analyzed external factors of the reorganizations and group building reform of public hospitals in Shanghai.Points made are as follows:Characteristics of individual hospitals should he respected instead of a generalized pattern for all;the role of the government to play in this regard should he guidance of an orderly competition,Strengthen Supervision,and promotion of the reform in property rights,These efforts will create a desirable environment for hospital groups;mid- and long-term goals for the reform should consolidate the independent legal entity status of such groups.

Objective To investigate the resistance of clinical isolates from Yuebei People’s Hospital so as to provide the ref-erence for clinical use of antibiotics.Methods To comprehensively analyze the drug resistance,AST was performed with K-B or MIC method to 2 527 strains of clinical isolates and the data were analyzed by WHONET 5.4 and SPSS19.0 softwares according to the breakpoints of CLSI 2012 standard.Results MRSA accounted for 30.9% in Staphylococcus aureus iso-lates,MRCNS accounted for 76.2% incoagulase negative Staphylococcus isolates ,no detection of vancomycin or linezolid re-sistant strains.The antimicrobial drug resistance of Enterococcus faecium was significantly higher than that of Enterococcus faecalis ,no detection of glycopeptide and linezolid resistant strains in Enterococcus faecalis ,but one linezolid resistant strains and two teicoplanin resistant strains in Enterococcus faecalis .Enterobacteriaceae remain highly sensitive to carbapen-em antibiotics,ESBLs produced strains in Escherichia coli ,Klebsiella pneumoniae were 43.9% and 37.5% respectively,five polymyxin B resistant strains were detected in Pseudomonas aeruginosa ,and 63.7% of MDRO rate in Acinetobacter bau-mannii .Conclusion Drug resistance of clinical pathogenic bacteria remain seriously in hospital,clinical application of antibi-otics should be reasonable based on the result of drug sensitivity.

AIM: To study the effect of ligustrazine on the cardiacmyocyte lesion in rats with type 2 diabetes mellitus.METHODS: Male Wistar rats were injected with STZ via tail vein under high-glucose and high-fat feeding for 4 weeks to establish the animal model of type 2 diabetes mellitus.Ligustrazine at different doses was used to treat the diabetic rats.The body weight, blood glucose and the morphology of heart tissues were observed.The myocardial levels of IL-1β, IL-6 and TNF-α were detected by ELISA, and the protein expression of IKKβ and NF-κB in the myocardium was determined by Westeren blotting.RESULTS: Ligustrazine at high dose alleviated the body weight reduction and blood glucose elevation cause by diabetes, and reduced pro-inflammatory factors IL-1β, TNF-α and IL-6.Moreover, the protein expression of IKKβ and NF-κB was significant decreased by ligustrazine.CONCLUSION: Ligustrazine inhibits the myocardial inflammation caused by diabetes through anti-inflammatory pathway.

Objective To use thrombelastography (TEG) and conventional coagulation tests (CCTs) to diagnose disseminated intravascular coagulation (DIC) and find a better diagnostic method.Methods Patients with potential DIC factors,DIC clinical manifestation or DIC patients suspected by laboratory tests were included after their admission into our hospital.TEGs and CCTs were detected,respectively.DIC score was evaluated.The single factor logistic regression was used to evaluate the correlation between TEG and CCTs as well as the diagnostic accuracy.Results The international normalized ratio (INR) in CCTs of the DIC patients were significantly higher,the reaction rime (R),clot formation time (K),angle rate of clot formation (α),maximum amplitude (MA),and composite index (CI) figures in TEG were significantly increased (P ＜ 0.05).The sensitivity and specificity of TEG were 82.4％,and 62.2％,which were significantly higher than 21.6％ and 47.2％ in CCTs (P ＜ 0.05).Single factor logistic regression results show that odd ratio (OR) in prothrombin time (PT) and INR of CCTs was 1.23 and 1.27,respectively.The OR in R,K,α,MA,and CI of TEG was 5.13,6.14,1.37,1.25,and 3.02,respectively.Conclusions Compared to CCTs,TEG is more indicative of the conditions of DIC patients and it might be a better way to predict the DIC risks,which is of greater value in clinical diagnosis.

OBJECTIVE:To establish the fingerprint of Artemisia apiacea to identify common model and evaluate the quality coherence of the commercially available A. apiacea decoration pieces in Chongqing. METHODS:HPLC method was performed on the column of Waters XTerra C18 with the mobile phase consisted of methanol-0.1% phosphoric acid(gradient elution)at the flow rate of 1.0 ml/min. The detection wavelength was 220 nm,column temperature was 30 ℃ and the sample size was 10 μl. The simi-larity of 12 batches of samples was evaluated by TCM Chromatogram Fingerprint Similarity Evaluation System(2004A edition);a common model of fingerprints was identified by principal component analysis(PCA)and cluster analysis(CA). RESULTS:Total-ly 11 batches of samples were screened to establish common model of fingerprints and 16 common peaks were obtained,among which,3 common components were identified;RSDs of precision,stability and reproducibility tests were lower than 2.53%. The similarity of 11 batches of A. apiacea and reference chromatogram was more than 0.990. CONCLUSIONS:The method is stable and easy,and can provide reference for the scientific quality evaluation and control of A. apiacea;the quality of commercially available A. apiacea decoration pieces is generally good,however,there is still a little number of batches with poor quality. The production procedures and supervision of A. apiacea decoration pieces should be strengthened.