Objective To analyze the efficacy,complications and prognostic factors of three-dimensional conformal radiotherapy(3 DCRT)for locally advanced non-small cell lung cancer(NSCLC).Methods 56 patients who were treated either by radiotherapy alone(14 patients)or radiotherapy plus chemotherapy(42 patients)from Jan.2005 to Feb.2008 were enrolled.The patient cohort consisted of 36 men and 20 women,median age 62,median total dose 60 Gy.Results The following-up rate was 96%.The number of patients completed follow-up were 14 and 10,respectively at 3-year and 5-year.The response rate of 3DCRT was 70%.with complete mmission 9%and partial remission 61%.The 1-、3-、and 5-.year survival rates were 62%、25% and 17%,respectively,and the median survival time(MST)was 20 months.By logrank test,clinical stage,KPS perfomance,tumor volume,radiation dose,treatment regimen and response to treatment showed statistically dramatic impact on overall survival.By Cox muhivariable regression,the independent adverse prognostic factors by both univariate analysis and multivariate analysis were clinical stage,treatment type,and response to treatment.Grade 2 acute radiation pneumonitis was observed in 1 patient and grade 3 in 1 patient.Late grade 2 lung injury developed in 1 patient,and grade 3 in 1 patient.Acute grade 1 radiation esophagitis were observed in 20 patients.and above Grade 2 in 5patients.Acute grade 1+2 hematologic toxicity developed in 15 patients,and above Grade 2 developed in 4 patients.Conclusions 3 DCRT was feasible in the treatment of locally advanced NSCLC with acceptable normal tissue toxicity.Relative early stage.radio-chemotherapy with total radiation dosage≥60 Gy and good immediate tumor response are favorable prognostic factors for overall survival.

Objective: To analysis the medical expenses of six diseases and put forward the efficient methods to control their unreasonable rise. Methods: 22582 patients with six diseases in two largest hospitals in Xi'an were chosen and analyzed from 1/1/ 2003 to 10/1/2004. Results: Six diseases were the main reason of hospitalization and the malignancy was most important; drug expense of the uninsured patients, which was the key factor to induce the medical expenses rising, was higher than insured patients. Conclusion: The medical insurance program could control the drug expense efficiently; different control strategies to different diseases were important to distribute the medical resource and lighten the life burdens of the inpatients.

The Kato-Katz (KK) method is a well-known method of fecal examination for helminthiases. Its diagnostic sensitivity was found very high for clonorchiasis. The present study evaluated the correlation of Clonorchis sinensis egg counts by the KK method with those by direct smear and formalin-ether (FE) technique. The egg counts obtained by the KK method (Y) were correlated with the counts by direct smear (X) with the equation of Y = 659.4 + 0.266X (r2= 0.738), but not with those by the FE method. The present study demonstrated that the KK method and direct smear were useful for both qualitative and quantitative diagnosis of clonorchiasis, especially in the field.
Animals ; Cellophane ; Clonorchiasis/*diagnosis/parasitology ; Clonorchis sinensis/*isolation & purification ; Comparative Study ; Ether, Ethyl ; Feces/parasitology ; Formaldehyde ; Humans ; Parasite Egg Count/*methods ; Sensitivity and Specificity

ObjectiveTo explore the optimal method of protecting bone marrow in postoperative concurrent chemoradiotherapy of stage Ⅱ - Ⅲ rectal cancer by comparing two techniques of intensitymodulated radiotherapy (IMRT). MethodsFifteen patients with stage Ⅱ - Ⅲ rectal cancer after surgery had CT simulation. Clinical target volume, small bowel, bladder and bone marrow were contoured. Two IMRT treatment plannings with and without bone marrow-sparing (BMS-IMRT and IMRT) were separately designed. The dose distribution was compared based on that 95％ of the planning target volume received the prescribed dose. ResultsBMS-IMRT had an advantage over IMRT in terms of conformity indices ( 1. 06∶1. 04, t =- 2. 61, P =0. 023 ), but inferior to I M RT for homogeneity indices ( 0. 81 : 0. 75, t =- 2. 34, P =0.037)).Compared with IMRT, BMS-IMRT reduced the V5, V10, V20, V30, V40 of bone marrow (97.09％∶98.72％, t=-2.34, P=0.037;92.38％∶96.46％, t=-2.41, P=0.033;83.36％∶91.70％, t=-3. 18, P=0.008;51.47％∶69.65％, t=-4.92, P=0.000;36.34％∶49.57％, t=-2.66, P =0. 021 ). The doses received by small bowel and bladder were similar between BMS-IMRT and IMRT, except that the V20 of bladder was lower in BMS-IMRT (77. 32％∶92. 39％, t =-3.52, P=0. 004). Conclusions BMS-IMRT reduces low dose volume of bone marrow without increasing dose to other risk organs.BMS-IMRT might reduce acute hematologic toxicity and increase the feasibility of postoperative concurrent chemoradiotherapy in stage Ⅱ -Ⅲ rectal cancer.

Objective To evaluate the primary result of proximal femoral nail anti-rotation(PF-NA)in treating osteoporotic intertrochanterie fractures. Methods Between March 2006 and August 2007.PFNA or Gamma nail intemal fixation were performed in 31 patients with osteoporotic intertrochan-tefie fractures.of whom were 19 males and 12 females at a mean age of 75.6 years(45-89 years).Ac-cording to AO classification,there were 8 type A1 fractures,16 type A2 fractures and 7 type A3 fractures.Aeearding to Evans-Jensen classification.18 cases were rated as Evans Ⅱ and 13 as Evans II.AIl frac-tares were closed ones and 6 patients were combined with internal diseases.PFNA was implanted throush a mini-incision without exposure of the fracture section during operation in 12 patients. Results Of all.6 patients received emergency operation,19 did operation within 3 days and 6 waited for selective op-eration(5-7 days)after controlling internal diseases.PFNA had shorter operation time,less hlool loss and shorter union time compared with Gamma nail(P＜0.05).No complications such as infection,non-union or loosening of nails were found.According to HarriS hip rate scale system,the excellence rate of PFNA was 83.4%and that of Gamma nail 73.7%. Conclusion PFNA is a good choice to treat osteo-perotie intertrochanteric fractures.owing to its advantages of stable fixation,minor trauma,eaSy opera-tion.short operation time,little bleeding,minor lOSS of selerotin and early exercise.

Objective To study the change of the hyaluronic acid (HA),laminin (LN) and col- lagen type IV (C_(?)) within the renal grafts and in serum during acute rejection and to investigate their relationship.Methods Male Wistar and Sprague-Dawley rats were used as donors and recipients,re- spectively.Rat orthotopic kidney transplantation was performed according to a modification of the method decribed by Biota.Experimental rats were randomly divided into 4 groups,homotransplanta- tion rats treated with cyclosporine,isotransplantation,pseudooperation and controls.Animals were subsequently killed at defined time points for determination of the extracellular matrix (ECM) parame- ters (HA,LN and C_(?)) within the graft and in serum by radioimmunoassay.Results Significant increases in HA,LN and C_(?) levels within the renal grafts were found in the rejection group as compared with the non-rejection groups.Serum levels of HA,LN and C_(?) were also significantly elevated in the rejection group at diagnosis of rejection.Serum HA,LN and C_(?) levels were correla- ted with those within the renal grafts.Histologic examination revealed that 4 cases developed acute re- jection in homotransplantation rats treaded with cyclosporine,17 cases in controls.HA,LN and C_(?) levels within the renal grafts were correlated with acute rejection Banff scores.There was correlation between serum levels of HA,LN and C_(?) and acute rejection Banff scores (P＜0.01).Conclusion HA,LN and C_(?) play an important role in the pathogenesis of acut allograft rejection.In addition, serum levels of HA,LN and C_(?) may be a sensitive marker of acute rejection in the postoperative period of renal transplantation.

Objective To explore the image quality and radiation dose for coronary angiography using DSCT (dual-source computed tomography) under lower tube voltage and lower contrast agent concentration ('double low').Methods A total of 160 patients with suspected coronary artery disease underwent dual-source CCTA.80 patients (BMI ＜ 25 kg/m2) were randomly assigned to group A (270 mg I/ml-80 kV) and B (350 mg I/ml-120 kV).The other 80 patients (25 ≤ BMI ＜30 kg/m2) were randomly assigned to group C (270 mg I/ml-100 kV) and D (350 mg I/ml-120 kV),sonogram affirmed iterative reconstruction technology and 270 mg I/ml contrast agent were applied to group A and C ; FBP technology and 350 mg I/ml contrast agent were applied to group B and D.Adaptive cardio-sequence prospective ECG-gated technology was applied in all patients,while the acquisition phase was 65％-75％ RR interval (when heart rate ＜ 75 beats / min) or 40％-50％ RR interval at when heart rate ≥ 75 beats/min.Volume CT dose index (CTDIvol),dose length product (DLP),effective dose (E),size specific dose estimates (SSDE),image noise,CT value,signal-to-noise ratio (SNR),and contrast-to-noise ratio(CNR) were all evaluated for each patient.Results There was not statistical difference in scan length among groups A and B,C and D.There was statistical difference in tube current between group A and B (t =8.932,P ＜0.05).There was not statistical difference in tube current between group C and D (tCD =-1.212,P ＞ 0.05).There was statistical difference in CTDIvol,DLP,E and SSDE between group A and B,C and D (tCTDIvol =-16.141,-11.440 ; tDLP =-17.454,-10.521 ; t =-17.444,-10.523 ;tSSDE =-13.032,-9.119,P ＜0.05).Compared to group B,the SSDE in group A decreased by 64.4％.Compared to group D,the SSDE in group C decreased by 39.3％.There was no statistical difference in image noise between group A and B,C and D (P ＞ 0.05).There was statistical difference in CT value,SNR and CNR between group A and B (t =0.436,4.623,3.272,P ＜ 0.05).There was no statistical difference in CT value and CNR between group C and D,while there was statistical difference in SNR between group C and D (t =2.981,P ＜0.05).There was no statistical difference in image quality scores between group A and B,C and D (P ＞ 0.05).Conclusion Compared with conventional DSCT coronary angiography,'double low' DSCT coronary scanning solution can significantly reduce the radiation dose and contrast agent,and could provide the effective coronary images which meet the clinical diagnostic needs.

Objective To investigate the diagnostic value of serum soluble transferrin receptor(sTfR) in children with iron deficiency anemia(IDA).Methods Sixty-three children with microcytic hypochromic anemia were divided into IDA and non-IDA(n-IDA)groups,on which sTfR and other iron metabolism related indexes such as serum ferritin(SF) and serum iron(SI) were measured,and(t-test) between groups and analysis of ROC curve were carried out.Results The mean concentration of sTfR in the group of IDA was above normal value and t-test difference was extremely significant compared with n-IDA group(P

Objective To explore the feasibility of “double low ”(low tube voltage and low contrast agent concentration)imaging technology of dual-source computed tomography (DSCT)in coronary angiography for low-weight patients.Methods 60 patients (BMI≤25 kg/m2 )who underwent coronary CT angiography (CCTA)on DSCT scanner were divided randomly into 2 groups:group A was “double low”group (n = 30,tube voltage = 80 kVp,using sinogram affirmed iterative reconstruction technology and 270 mg I/mL concentration of contrast agent);Group B was conventional group (n=30,tube voltage=120 kVp,using filtered back projection technology and 350 mg I/mL concentration of contrast agent).Adaptive cardiosequence prospective ECG-gated technology (CorAdSeq)was applied in both the groups,The collecting phase was 65%-75% RR interval (when heart rate<70 beats per mi-nute)or 40%-50% RR interval (when heart rate≥70 beats per minute).Subjective and objective methods were applied to evaluate the image quality.The image quality and.radiation dose were compared between the “double low”group and the conventional group by using SPSS 1 9.0 software.The differences between measurement data were analyzed by using independent samples t-test.Results The effective dose with size specific dose estimates (EDssde)of group A(1.22±0.31)mGy/cm was significantly lower than that of group B (3.44±0.80)mGy/cm with P <0.001.Contrast-noise ratio,signal-noise ratio and CT value of group A were signifi-cantly higher than those of group B (all P <0.05 ).Conclusion Compared with conventional DSCT coronary angiography,“double low”DSCT coronary scanning proposal for low-weight patients can significantly reduce the radiation dose and the amount of contrast agent,and the image quality can meet the needs of clinical diagnosis.

Objective To evaluate the impact of cerebrospinal fluid drain(CSFD) on the incidence of acute spinal cord injury(SCI) following extensive TAAA repair.Methods From February 2009 to July 2016,153 patients underwent extensive TAAA repairs with a consistent strategy of normal thermia,non-circulatory bypass,sequential aortic cross clamping,aortic-lilac bypass,and intercostal artery reconstruction.The repairs were performed with preoperative CSFD (n =78) or without CSFD (n =75).In the former group,CSFD was inserted after the patient has been anaesthetized and continued for 72 hours after surgery.The target CSF pressure was 10 mmHg or less.Results The mean age of patients was (38 ± 10) years and 108 (70.6％) were male.There were 87 (53.8％) patients with previous aortic surgeries and 33 (22％) with Marfan syndrome.The two groups had similar risk factors for paraplegia.Aortic clamp time,operation time and number of reattached intercostal arteries were similar in both groups.In-hospital mortality rates were 1.3％ (one patient) and 6.7％ (five patients) for CSFD and the group without CSFD,respectively (P =0.086).Ten patients (13.3 ％) in the group without CSFD had paraplegia develop.In contrast,only two patients in the CSFD group(2.6％) had postoperative paraplegia(P =0.013).Stepwise logistic regression analysis identified CSFD had spinal cord protection,P =0.026;OR =0.171;95％ CI:0.036-0.809).No patients occurred CSF catheter related complications.Conclusion This randomized clinical trial showed that preoperative CSFD placement could be an effective strategy in preventing SCI following extensive aortic aneurysm repair.Care should be taken to prevent complications related to overdrainage.