Objective To investigate the short-term improvement of life quality in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)after temperature-controlled radiofrequency ablation(TCFR).Methods Totally 70 patients with OSAHS were diagnosed by polysomnography(PSG)and received TCRF in our department.The Epworth Sleepiness Scale(ESS)and Calgary Sleep Apnea Quality of Life Index(SAQLI)were surveyed before and after the therapy.The results were followed up for six months after the operation.Results The pre-operative scores of ESS was correlated with body mass index(BMI),apnea hypopnea index(AHI),lowest saturation(LSaO2)and the scores of SAQLI(correlation coefficient:0.410,0.371,-0.441,and-0.411 respectively;all P

OBJECTIVE:To compare the efficacy and safety of gio combined with oxaliplatin (SOX) versus 5-fluorouracil (5-FU)combined with calcium folinate and oxaliplatin(mFOLFOX6)in the treatment of diffuse advanced gastric cancer. METH-ODS:The data of 128 patients with diffuse advanced gastric cancer was retrospectively analyzed and patients were divided into SOX group(66 cases)and mFOLFOX6 group(62 cases)by different medication. SOX group received Gio capsule after breakfast and dinner,which was <1.25 m2,40 mg,1.25-1.5 m2,50 mg,>1.5 m2,60 mg,d1-14+130 mg/m2 Oxaliplatin for injection,intrave-nously,d1;3-week was regarded as a treatment course,the efficacy was evaluated every 2 courses,and it lasted a maximum of 8 courses but a minimum of 2 courses. mFOLFOX6 group received 85 mg/m2 Oxaliplatin for injection,intravenously,d1+200 mg/m2 calcium folinate,intravenously,d1+400 mg/m2 5-FU for injection by rapid intravenous injection,d1,then 2 400 mg/m2 5-FU,main-taining 46 h by continuous infusion. 2-week was regarded as a treatment course,the efficacy was evaluated every 3 courses,and chemotherapy was conducted in a maximum of 12 courses but a minimum of 3 courses. Clinical efficacy,time to progression,sur-vival time and incidence of toxicities in 2 groups were observed. RESULTS:The objective response rate,time to progression and median survival time in SOX group was significantly higher than mFOLFOX6 group,the difference was statistically significant (P<0.05 or P<0.01). There was no significant difference in the disease control rate and incidence of toxicities in 2 groups(P>0.05). CONCLUSIONS:The efficacy of SOX is superior to mFOLFOX6 in the treatment of diffuse advanced gastric cancer,it can prolong the survival time,with similar safety.

Objective:To investigate mechanism of TRAIL-resistance in A549 cells ( a cell line of non-small cell lung carcino-ma cells) due to Akt phosphorylation .Methods:A549 cells were treated with Akt inhibitor Perifosine and rsTRAIL protein individual-ly and in combination.The expressions of Akt phosphorylation(p-Akt),c-FLIPLL and caspase-8 were detected by Western blot.The apoptotic rate of the A549 cells treated was detected by flow cytometry and the cell proliferation was evaluated by MTT assay .Results:A549 cells showed the increased level of Akt phosphorylation mediated by rsTRAIL protein .Treatment with the Akt inhibitor Perifosine induced a suppression of Akt activation in A 549 cells and a concomitant decrease in the expression of c-FLIPLL .As a result, Perifosine significantly enhanced TRAIL-induced apoptosis rate of (76.5 ±3.02)%and cytotoxic rate of (83.2 ±2.54)%by promoting the activ-ity of caspase-8.Conclusion:Akt activity promotes A549cells survival against TRAIL-induced apoptosis and that the cytotoxic effect of rsTRAIL protein can be enhanced by modulating the Akt phosphorylation in human non -small cell lung carcinoma cells .

Photodynamic therapy(PDT)is a new type of minimally invasive treatment in recent years.After the photosensiti-zer is injected into the body for a period of time,it specifically accumulates in the tumor tissue.At this time,the tumor tissue site is ir-radiated with light of a specific wavelength and the photosensitizer occurs photodynamic reaction to kill tumor cells.With the continu-ous progress of endoscopic guidance technology and the emergence of new photosensitizers,PDT has made significant progress in the treatment of gastrointestinal malignancies and the curative effect is remarkable.This article describes the principle of PDT,and focuses on the application of PDT in gastrointestinal cancer for clinical treatment and research as a reference.

Objective To assess the clinical effect of oblique lumbar interbody fusion (OLIF) combined with percutaneous pedicle screw fixation on computer navigation for lumbar spondylolisthesis.Methods Total 20 patients (8 males and 12 females with average age of 54.1± 12.3 years) with lumbar spondylolisthesis were enrolled in our study during Oct.2014 and May.2016.All patients were treated with OLIF combined with percutaneous pedicle screw fixation on computer navigation.Operation time,blood loss and complications were all recorded.Clinical and Radiographic evaluation were investigated on 1 week,3 months,6 months,12 months postoperatively and final follow-up.Visual analogue scale (VAS) for low back pain and leg pain,Oswestry disability index (ODI) for low back pain and the MOS item short form health survey (SF-36) were used to evaluate the clinical efficacy of surgery.Disc height,disc angle,lumbar lordosis and degree of upper vertebral slip of patients were investigated with X-ray.Cross-sectional area of intervertebral foramina was measured with three-dimensional CT and MRI.The cross-sectional area and sagittal diameter of the thecal sac were measured on T2-weighted axial and sagittal magnetic resonance images.Accuracy of pedicle screw placement was investigated with three-dimensional CT.Fusion rate was investigated with three-dimensional CT and Xray.Results All patients were followed for 12-30 months (22.9±4.8 months).The mean operation time was (119.0±23.8) min,the mean blood loss was (57.8±20.6) ml.VAS for low back pain,VAS for leg pain,and ODI were significantly improved from (6.7± 2.6),(6.3±2.7) and 50.5％±18.2％ preoperatively to (1.3±1.0),(0.8±1.0) and 14.0％±9.6％ at the latest follow-up.The SF-36 PCS and MCS scores were improved from (27.1 ± 13.9) and (51.0±22.7) preoperatively to (67.3± 18.9) and (81.2±14.1) at the latest follow-up.Disc height,disc angle,lumbar lordosis were significantly increased from (6.0±3.6) mm,1.8°±6.2° and 39.2°±8.4° preoperatively to (10.8± 1.7) mm,6.2°±3.5° and 45.0°±7.8° at the latest follow-up.Degree of upper vertebral slip of patients was reduced from 23.5％±7.4％ preoperatively to 4.2％±3.1％ at the latest follow-up.Cross-sectional area of intervertebral foramina in CT and MRI were significantly increased from (140.6±36.0) mm2 and (78.1±31.2) mm2 before surgery to (179.8±35.6) mm2 and (141.7±29.5) mm2 at 6 months after surgery.Cross-sectional area and sagittal diameter of thecal sac were significantly increased from (73.4±29.3) mm2 and (5.2±3.2) mm before surgery to (124.5±26.6) mm2 and (9.5±2.0) mm at 6 months after surgery.Accuracy of pedicle screw placement was 95％,and fusion rate was 100％ at 6 months after surgery.There were no severe vascular and nerve injuries.Conclusion OLIF combined with percutaneous pedicle screw fixation on computer navigation has good indirect decompression effect on lumbar spondylolisthesis,and was associated with high fusion rate.It can also effectively decrease the surgical trauma,improve the accuracy of pedicle screw placement,and increase disc height,disc angle and lumbar lordosis.

Percutaneous imaging-guided cryoablation (PICA) is a recently developed technique,which applies extreme hypothermia to destroy tumors guided with CT,MRI or ultrasound images.Compared with other oncologic cryoablation therapies,PICA has some advantages,such as treating under local anesthesia,superior monitoring capability on multimodal imaging,less intraoperative and postoperative pain and preservation of tissue collagenous architecture.In recent years,PICA has been used in treatment of tumors in lung,liver,kidney,breast,prostate and so on.In this article,the principle of cryoablation and the application progresses of PICA in oncotherapy were reviewed.

Objective To comparatively analyze the radiological and pathological findings of neuroendocrine tumor in pancreas.Methods The clinical features of 36 patients with complete ra-diologic and pathologic diagnosis of neuroendocrine tumor of pancreas treated in our hospital from 2009 to 2012 were analyzed.Results The difference was not significantly different in tumor loca-tion,distinct outline,necrosis and calcification.The higher the tumor enhancement was,the more declining of the pathology grade .The difference was significant in A 1 and A 2 parameters (P <0.05).The difference was significant in benign and malignant tumor and the maximum diameter of unfunctional tumor.However,the difference was not significant in refection of remarker of en-docrine(P >0.05).Conclusion The dynamic enhancing scanning is helpful to grade the neuroen-docrine tumors in pancreas before operation.The more grading the tumor is,the worse the enhance-ment is.And the maximum diameter of the tumor is indicative to diagnose benign tumor or malig-nant tumor.

Objective To explore the effect of fiberoptic bronchoscopy lavage sputum suction on sputum aspiration in thoracic neoplasm patients with difficulty in postoperative expectoration .Methods Sixty thoracic neoplasm patients with postoperative expectoration difficulty who met the inclusion criteria were divided into the control group and the observation group according to the order number in ICU , each with 30 cases.The control group received the conventional sputum suction , and the observation group received the fiberoptic bronchoscopy lavage sputum suction on the basis of routine sputum suction .The effect of sputum aspiration was compared between the two groups .Results The cases of complications including mucosa damage , atelectasis, pulmonary infection were respectively 7, 2 and 5 cases in the observation group , and were lower than those in the control group , and the differences were statistically significant (χ2 =4.59 ,4.01 ,4.02 , respectively;P<0.05).The time of staying in the ICU was (6.25 ±2.58) d in the observation group, and was (8.29 ±3.52) d in the control group , and the difference was statistically significant ( t=2.56 ,P<0.05 ) .The average times of sputum aspiration every day were (5.0 ±2.0) in the observation group, and were lower than (7.5 ±2.8) in the control group , and the difference was statistically significant ( t =3.98 , P <0.01 ) .Conclusions The methods of fiberoptic bronchoscopy lavage sputum suction combined with routine clinical sputum suction can effectively maintain the normal lung ventilation function , and reduce the duration of hypoxemia and the occurrence of postoperative complications , and shorten the time of staying in the ICU .

ObjectiveTo analyze the causes of occupational acute 1,2-dichloroethane (1,2-DCE) poisoning accident during the use of polyurethane grouting materials for waterproof plugging operation in the construction industry. Methods By combining the clinical symptoms of the patient, worksite survey of occupational health and workplace occupational hazards monitoring method, the cause of an occupational acute 1,2-DCE poisoning accident was investigated at a construction site during the use of polyurethane grouting material for waterproofing and plugging operations. Results The patient was engaged in waterproof grouting work using polyurethane grouting material. The main volatile organic components in the raw materials were 1,2-DCE, with traces of dichloromethane, methyl acetate and others. The result of post-incident on-site investigation showed that the short-term exposure concentration of 1,2-DCE in the workplace air was 578.70 mg/m³, which was more than 30 times higher than the national occupational health standard limit. The mass concentration of 1,2-DCE in the patient's blood was 230 μg/L. Combined with the patient's occupational hazard exposure history, clinical manifestations, worksite survey of occupational health, and laboratory test results, according to GBZ 39-2016 Diagnosis of Occupational Acute 1,2-Dichloroethane Poisoning, this incident was diagnosed as a severe occupational acute 1,2-DCE poisoning event caused by the use of inferior polyurethane grouting material. Conclusion The excessive concentration of 1,2-DCE in the workplace air is the main cause of this poisoning accident. Construction sites with confined space operations should improve various occupational health management systems, occupational health engineering protective facilities, and personal protective equipment must be provided for workers.

Objective To comparatively analyze the radiological and pathological findings of neuroendocrine tumor in pancreas.Methods The clinical features of 36 patients with complete ra-diologic and pathologic diagnosis of neuroendocrine tumor of pancreas treated in our hospital from 2009 to 2012 were analyzed.Results The difference was not significantly different in tumor loca-tion,distinct outline,necrosis and calcification.The higher the tumor enhancement was,the more declining of the pathology grade .The difference was significant in A 1 and A 2 parameters (P <0.05).The difference was significant in benign and malignant tumor and the maximum diameter of unfunctional tumor.However,the difference was not significant in refection of remarker of en-docrine(P >0.05).Conclusion The dynamic enhancing scanning is helpful to grade the neuroen-docrine tumors in pancreas before operation.The more grading the tumor is,the worse the enhance-ment is.And the maximum diameter of the tumor is indicative to diagnose benign tumor or malig-nant tumor.