Objective To evaluate the effct of full increase of three-dimensional conformal radiotherapy on esophageal carcinoma.Methods 86 Esophageal cancer patients which has been pathologically confirmed were randomly divided into study group and control group.The control group showed in tumor invasion scope simulator under barium meal positioning,with three fields outside irradiation;Total dose of DT with 63～70 Gy,35 times,seven weeks to complete.Study group showed that full use of additional 3D treatment planning system design individualized treatment programs,90% of the dose contains all planned target volume,future confonnal irradiation DY 44～50 Gy,after the wild-shrinkage increases to a total dose DT66～75 Gy,30 times,completed six weeks.Results The study group and the control group after radiotherapy in a local control rates were 86.4%and 64.3%(x2=4.5420,P＜0.05).Overall response rate(CR+PR)in two group were 93.2%and 76.2%(x2=3.6014,P=0.0577).Two toxicity of the difference was not significant.Conclusion The increase in full three-dimensional conformal radiotherapy of esophageal emleer in the near future is better than conventional methods.

Objective To discuss the feasibility of double-low technique applied in aortic MSCTA.Methods Totally 70 patients with BMI not more than 25 kg/m2 were divided into a routine group and an experimental group randomly and equally,and then went through aortic MSCTA.Iohexol (350 mgI/ml) was injected with the velocity of 4 ml/s.The routine group had the parameters as 120 kV,120 mAs and 1.5 ml/kg contrast agent,and the experimental group had the parameters as 90 kV,120 mAs and 1.0 ml/kg contrast agent,while the other scanning parameters were kept the same in the two groups.The radiation doses,contrast agent doses and iodine contents were recorded in the two groups,and the image quality was assessed with double-blind method objectively and subjectively.Results The experimental group had the CT dose index volumes (CTDIvol),dose length product (DLP) and effect dose (ED) significantly lower than those in the routine group (P＜0.05).The two groups had the consistency of subjective scores (Kappa＞0.6) and image quality scores (not lower than 2) meet the desired requirements,and there were no significant differences between the scores (P＞0.05).Objective evaluation showed that the signal values of aortic trunk and major branch vessels as well as image noise SD of the experimental group were obviously higher than those in the routine group (P＜0.05).There were no statistical differences between the signal noise ratios (SNR) and contrast to noises (CNR) in the two groups (P＞0.05),The iodine content in the contrast agent of the experimental group was significantly lower than that in the routine group (P＜0.05).Conclusion Double-low technique applied in aortic MSCTA of the patient with BMI not more than 25 kg/m2 reduces the radiation dose and iodine content in the contrast agent,has the image quality meet the desired requirements,and thus is of great value for clinical application.

Objective To investigate the clinical effects of surgical treatment of acute deep vein thrombosis (DVT) in the lower limbs. Methods Twenty four cases with DVT were treated with a 2～3cm incision at the cross of superficial and deep femoral veins to take the thrombasis out. Moulding thrombasis were pulled up with ova circular tongs, and fragmented thrombi were spilled out of the incision with the prelum arteriol winding from foot to thigh. The artery was rinsed with heparinized saline for three minuets till the femoral vein was completely unobstructed. The vein was sutured, and the wound was drained under negative pressure. Results The near future effects: Limb swelling and pain disappeared in seventeen cases, conditions turned for the better in six cases, and there was no improvement in one case. The long term effects: Twenty one were followed up for an average of one year and three months. All patients had excellent walking and standing except two cases who suffered lower limb swelling and pain occasionally. Conclusions The operation of vein thrombectomy is a simple, easy and excellent approach to treat DVT, especially within six days after the the condition.

Objective To discuss the radiological characteristics and improve the diagnostic ability of SARS in children. Methods The clinical data and X-ray findings of 35 SARS cases who hospitalized during Jan, 2003～Apr, 2003 were retrospectively analyzed. Results Chest X-ray features were as follows: massive consolidation (27 cases, 77.1%), pulmonary interstitial infiltration (6 cases, 17.1%), and mixed pattern (2 cases, 5.7%). There were two patients with emphysema, but no patient with lung abscess or pleural lesion. The radiological dynamic changes showed that the lesions of lung appeared early, the severest period was between the fifth day and the seventh day, the X-ray findings were not consistent with physical sign, and the absorption of lesion was slower than the clinical process. Conclusion There are some certain radiographic characteristic in children with SARS. A correct diagnosis can be made by closely combining the X-ray findings with clinical and laboratory results.

Objective To strengthen the understanding of the imaging features in congenital aberrant left pulmonary artery (CALPA). Methods All 4 patients underwent chest film and Doppler echocardiography. Thres cases were examined by enhanced spiral CT examination. In addition, MRI and DSA were performed in 2 cases respectively. Thres cases were proven by surgery or autopsy. Results (1) appearances on chest films included cardiomegaly, pulmonary overvascularity, left hilum a little lower than the right one, emphysema, atelectasis, and pneumonia. (2) bronchography showed stenosis of trachea and/or bronchia. (3) Barium esophagram showed an imprint on the left anterior wall of esophagus. (4) Contrast-enhanced spiral CT and MRI showed marked dilatation of main pulmonary artery (MPA) and the root of MPA extended backward to become right pulmonary artery (RPA), the left pulmonary artery (LPA) arose from the RPA directly. (5) echocardiography indicated LPA arose from RPA. (6) DSA showed MPA was marked dilated, and LPA arose from RPA. (7) other abnormalities included 3 PDA, 2 PLSVC, and ~1 ASD. Conclusion CT and MRI are the best methods to diagnose CALPA.

Objective To explore the clinical value of combined detection of serum beta human chorionic gonadotropin (β-hCG),estradiol (E2),progesterone (P) and antiphospholipid antibodies (ACA) in predicting the outcomes of early threatened abortion.Methods 80 pregnant women were chosen from six to eight weeks singleton pregnancies,50 cases of threatened abortion and 30 cases of normal pregnancy.The serum levels of β-HCG,estradiol,progesterone and ACA-IgG,ACA-IgM and ACA-IgA were detected.The threatened abortion patients were given intramuscular progesterone 20 mg/day/time for 1 week,then,the pregnancy outcomes were analyzed and the serum levels of β-HCG,estradiol and progesterone were explored.Results The serum β-HCG,estradiol and progesterone of the threatened abortion group [(5 140.77 ± 2 365.47) IU/L,(680.28 ± 306.06) pg/mL,(15.59 ± 3.65) pg/L]were lower than those of the normal pregnant women [(14 520.4 ± 11 016.24) IU/L,(1 142.81 ± 670.57) pg/mL,(27.6 ± 4.78) pg/L] (t =3.224,P =0.003 ; t =2.43,P =0.022 ; t =7.72,P =0.001).According to pregnancy outcome,patients with threatened miscarriages were divided into the two groups,including 45 patients with continuing pregnancies and 5 patients with inevitable miscarriages.The serum levels of β-HCG,estradiol and progesterone in ongoing pregnancies group [(10 829.42 ± 6 926.28) IU/L,(832.9 ± 397.91) pg/mL,(25.62 ± 4.51) pg/L] were higher than those in inevitable miscarriages [(6 310.14 ± 2 593.19) IU/L,(487.14 ± 275.47) pg/mL,(13.6 ±4.84) pg/L] (P ＜ 0.05) ;The serum levels of ACA-IgG,ACA-IgM and ACA-IgA in 80 cases tested,only 2 cases who appeared in the threatened abortion group were detected with the positive of serum ACA-IgG,accounted for 4％ (2/50) (x2 =68.05,P =0.000),occurred spontaneous abortion in the end.Conclusion Combined detection of serum ACA,β-HCG,estradiol and progesterone may be helpful for prognosis of threatened abortion.However,the clinical predictive value of ACA needs further study in the early threatened abortion.

The poly ester-amide (PEA) nanofiber membrane was prepared by electrospinning and the surface topography of nanofiber membrane was observed by scanning electron microscope (SEM). It was found that with the increasing of spinning fluid concentration from 10% to 20%, the diameter of prepared fibers was increased from 180 nm to 305 nm. The chemical structure of PEA was detected by infrared spectrum, which showed that electrospinning had no significant effect on PEA. X-ray diffraction spectrogram and differential scanning calorimetry revealed that the crystallinity of PEA was decreased after electrospinning. Mechanical property test demonstrated that the mean breaking strength and elongation at break of PEA nanofiber membrane with (0.50±0.05) mm thickness were (1.00±0.18) MPa, and (18.20±2.86)%, respectively. MTT results showed that the endothelial cells proliferated actively on the PEA nanofiber membrane, and presented good adhesive and growth status.

Objective To retrospectively analyze the diagnostic value of a noninvasive score system based on transient elastography (TE),serological test and imaging examination on esophageal variceal bleeding (EVB) in patients with hepatitis B virus (HBV)-related cirrhosis.Methods Between April 2011 and December 2012,172 patients with HBV-related cirrhosis including 120 males and 52 females who visited clinic or hospitalized at the Department of Hepatology,Tianjin Third Central Hospital,were retrospectively enrolled.The mean age was (52.9 ± 10.6) years.Patients underwent upper gastrointestinal endoscopy to evaluate esophageal varices (EV) and were further categorized into three stages of mild,moderate and severe according to the morphology of EV and the risk of bleeding.Liver stiffness and spleen stiffness measurement were performed using Fibroscan.Portal vein width,splenic width and spleen thickness were measured using color Doppler ultrasound.All the patients were tested for white blood cell counts and platelet counts.With endoscopy as the gold standard,receiver operating characteristic (ROC) curves and the areas under curves (AUC) were used to assess the performance of the noninvasive score system in predicting EV by liver stiffness,spleen stiffness,portal vein width,spleen thickness and platelet counts.Student's t-test was performed to determine differences between continuous variables.Pearson's correlation was used to evaluate the association between EVB and these parameters.Results All these 172 patients underwent endoscopy.Among them,41 were EVB patients and 131 with no bleeding of EV.Among 172 EV patients,39 without EV,30 were mild EV,47 were moderate EV and 56 were severe EV.EVB was all positively correlated with liver and spleen stiffness,portal vein width,spleen thickness,splenic vein width (r=0.224,0.771,0.214,0.425 and 0.364,respectively; all P＜0.05).EVB was negatively correlated with platelet counts (r=-0.408,P=0.000).Liver stiffness,spleen stiffness,portal vein width,spleen thickness and splenic vein width in EVB patients were significantly higher than those in EV patients (P＜0.05).In contrast,platelet counts level was lower in EVB patients with difference of statistical significance (P＜0.05).AUC of non-invasive score system for EV and EVB were 0.953 and 0.882,respectively (P＜0.05).The optimal cut-off level of noninvasive score system for prediction of EV and EBV were 7 (sensitivity:96 ％,specificity:85 ％) in EV patients and 10 (sensitivity:78％,specificity:89 ％) in EVB patients.Conclusion Non-invasive score system based on liver stiffness,spleen stiffness,spleen thickness,width of splenic and portal vein and platelet counts is of clinical importance in assessing the presence of EV in patients with HBV-related cirrhosis,which is higher clinically valuable in the diagnosis for EV.

In China, the morbidity and mortality of lung cancer both rank the first. EGFR-TKI occurring has pushedthe treatment of lung cancer to an unprecedented new stage. At the same time of targeted drugs working, the side effects on associated rash also gradually attracted people's attention.Traditional Chinese medicine has its own specific advantage of treating sample acne skin rash.Thisarticle from the understanding of acne, andvarious of acne syndrome differentiation of traditional Chinese medicine experience of ancient doctorsto sample acne skin rash was summarized. At the same time, the paper wassummarized forEGFR-TKI induced sample acne skin rash in the treatment with traditional Chinese medicine from the etiology and pathogenesis, differentiation of symptoms and signs,principle and prescription of treatment,in order to cure the current disease by learning the ancient method.