Infiltrated immune cells and cytokines in the tumor microenvironment may play different functions that appear tightly related to clinical outcomes.Radiotherapy mainly kills tumor cells through radiobio-logical effect,meanwhile it can indirectly change tumor immunologic microenvironment,and has a local or dis-tant anti-tumor immunological effect cooperatively.Animal experiments and clinical trials of radiotherapy com-bined with immunotherapy display well applied prospects,but the mode of radiotherapy in combined treatment needs further research.

Objective To investigate the effect of sevoflurane preconditioning on lung compliance and oxygenation index during one lung ventilation( OLV) . Methods In this study, sixty patients, ASAⅠorⅡ, scheduled for pul-monary surgeries were enrolled, and randomly divided into two groups:sevoflurane preconditioning group(n=30) and total intravenous group( n=30 ) . For preconditioning, patients in sevoflurane preconditioning group were ad-ministrated with one minimal alveolar concentration(1MAC) sevoflurane for 30 min after general anesthesia induc-tion and then followed with total intravenous anesthesia. While in total intravenous group, only intravenous anes-thetic agents were administrated for maintenane of anesthesia after induction. The indexes of hemodynamics, pulse oximeter( SpO2 ) , plateau pressure( Pplat) and lung compliance( Cdyn) were recorded at the following time points:before anesthesia( T0 ) , after anesthesia induction at laternal position TLV 30 min( T1 ) ,30 min after OLV( T2 ) , 60 min after OLV( T3 ) and recovering TLV 20 min( T4 ) . Arterial blood samples were taken to measure partial pressure of carbon dioxide( PaCO2 ) , partial pressure of oxygen( PaO2 ) , pH, oxygenation index( PaO2/FiO2 ) at the follow-ing time points: T1 , T2 , T3 , T4 . Results Compared with T1 , the oxygenation index and lung compliance de-creased significantly at T2 ,T3 ( P<0. 05 ); compared with total intravenous group, the lung compliance was obvi-ously higher than that in sevoflurane preconditioning group at T2,T3(P<0. 05). There were no significantly differ-ences in the oxygenation index between total intravenous group and sevoflurane preconditioning group at all time points. Conclusion Compared with total intravenous anesthesia with propofol , sevoflurane preconditioning can im-prove lung compliance, but does not make contribute to improve oxygenation index.

0.05), while those in group B were statistically significant(P

Objective:To investigate the effects of CCR3 on Muc5ac in the airway of asthmatic mice.Methods: Fifty clean BALB/c mice were randomly divided into control group,asthmatic group,dexamethasone treatment group,SB328437 treatment group, vehicle-control group.Total cells and differential inflammatory cells were counted in BALF, the levels of IL-4 and TNF-αwere determined by ELISA,lung tissue HE staining the expressions of Mucin5ac(Muc5ac) and CCR3 in lung tissue were detected by immu-neohistochemical staining and RT-PCR.Results:The total cells,eosinophil,monocytes and lymphocyte cells in BALF,the levels of IL-4,TNF-αin BALF ,the goblet cell of airway wall,the expression of Muc5ac and CCR3 positive staining IOD in the airway and the expression of Muc5ac and CCR3 mRNA lung tissue obviously decreased in SB328437 treatment group and DEX treatment group which compared with asthmatic mice model group ( P<0.05 ) .Conclusion: SB328437 can inhibit the expression of CCR3 in pulmonary tissue,furtherly inhibit the expression and secretion of Muc5ac and control the airway inflammation.

Objective To analyze the relationship between obstructive sleep apnea syndrome (OSAS) and metabolic syndrome (MS) in petrol field workers.Methods A total of 100 cases of OSAS patients of petrol field workers were enrolled as the study objects from March 2013 to August 2015 in emergency and respiratory department in Daqing Longnan Hospital and were divided into three groups:simple snoring group (Group A,n =26),mild OSAS group (Group B,n =42),and severe OSAS group (Group C,n =32).The comparison of dietetic status score,sleep status score and the patients with MS among 3 groups were carried out.The relationship between OSAS and MS was analyzed by using univariate and multivariable Logistic regression analyses were used.Results In Group C,sleep status score (8.3 ± 1.2) and dietetic status score (7.6 ± 1.4) and the rates of MS (23/32) were higher than those in the other two groups (P ＜ 0.05).Univariate and multivariable Logistic regression analyses,showed OSAS was the risk factorofMS [r=11.211 (OR =9.412,95％ CI:5.992～15.202)].Conclusions Dietetic status and sleep status were obviously influenced by OSAS in petrol field workers.The incidence of MS were more common in petrol field workersevere with OSAS and OSAS was a risk factor of MS.

Objective To assess the effectiveness of the combined treatment model for Wilms'tumor and to improve treatment results.Methods Fifty-five patients diagnosed with Wilms' tumor between July 1981 to June 2010 were analyzed retrospectively.Eighteen patients were diagnosed by preoperative ultrasound-guided fine needle biopsy,and 53 patients were confirmed by postoperative pathology results.Seven cases were in clinical stage Ⅰ,19 cases in clinical stage Ⅱ,21 cases in stage Ⅲ,six cases in stage Ⅳ and two cases in stage Ⅴ.Thirty-five cases had histopathological subtype,30 cases had the favorable type,and five cases had the unfavorable type.Among the 55 patients,kidney tumor resection was performed on 48 cases,wide edge partial nephrectomy was performed on two cases,tumor enucleation was performed on one bilateral renal tumor case,kidney tumor resection with pulmonary metastasectomy was performed on two cases,and two cases had no surgical procedures.Eighteen cases received preoperative chemotherapy,40 cases received postoperative chemotherapy,and 12 cases received postoperative radiotherapy.Patients were grouped according to age,stage,histological type,treatment model,treatment course and whether or not they had radiotherapy.The Kaplan-Meier method was used in the evaluation and comparison of over survival (OS),disease free survival (DFS) and relapse free survival (RFS) of the different groups to reveal the relationship between different grouping factors with the prognosis of Wilms' tumor. ResultsThe median of follow-up was 34 mon ( ranging from 3 to 355 mon).The 3-year OS,5-year OS and 2-year DFS were 77.6％,69.0％ and 52.4％,respectively.The differences of OS in different stages ( P =0.006 ),DFS between pure operation group and combined therapy group ( P =0.004 ) and RFS between radiotherapy group and no radiotherapy group ( P =0.03 ) were significant,P ＜ 0.05.ConclusionsThe normative multi-disciplinary treatment model for patients with Wilms' tumor can achieve good results and is well tolerated.

Objective To explore the essence of polycystic ovary syndrome of spleen-kidney yang deficiency,and to investigate the objective standardization of TCM syndrome diagnosis of the disease.Methods Among the 200 PCOS patients,the Chinese medicine syndrome pattern was differentiated as spleen-kidney yangdeficiency type (n=105 )and Non-spleen-kidney yang deficiency type (n=95).To measure and compare their levels ofBMI、WHR、sexual hormones、FINS、2 hINS,and HOMR-IR.Results The levels of BMI (24.4±2.8)、WHR (0.88±0.07)、LH/FSH (2.02±1.06)、E2 (55.84±23.87) pg/ml、HOMR-IR (2.95±1.52)、FINS (15.18±7.64) IU/ml、2hINS ( 59.53 ±40.61 ) IU/ml in the group of spleen-kidney yang deficiency type were obviously higher than those[ (22.2±2.2)、(0.80±0.06)、(3.50± 1.80)、(45.82±21.31) pg/ml、( 1.90± 1.50)、(9.93±6.59) IU/ml、(50.56±41.34) IU/ml respectively] in the group of Non-spleen-kidney yang deficiency type (P＜0.05＝,but T and FSH level showed no significant difference between two groups [FSH the group of spleen-kidney yang deficiency type=(6.46±0.95) IU/L、FSH the group of No-spleen-kidney yang deficiency type=(6.40±1.16) IU/L; T the group of spleen-kidney yang deficiency type=(0.81±0.15) μg/L、T the group of No-spleen-kidney yang deficiency type=(0.72±0.13) μg/L,P＞0.05].Conclusion BMI、WHR、LH/FSH、E2、FINS、2HINS,and HOMR-IR could be used as objective index in identifying the difference in between spleen-kidney yang deficiency type and Non-spleen-kidney yang deficiency type.

Objective Toexploretheclinicalefficacyandtoxicityofintensitymodulatedradiationtherapy(IMRT)combined with high intensity focused ultrasound(HIFU) for inoperatable recurrent hepatic carcinoma after operation and TACE .Methods Total 60 patients with inoperatable recurrent hepatic carcinoma after operation and TACE were randomly divided into two group ,30 patients in observation group received IMRT and HIFU ,while 30 patients in control group received only IMRT .For both groups , the same radiotherapy technic was given with IMRT in 6 MV X‐ray ,the total dose was 54 -70 Gy/6 -7 weeks .In observation group ,HIFU was carried out concurrently with IMRT (5 days/week ,6-7 weeks) .Results The difference of the short‐term effi‐cacy between the observation group and the control group was statistically significant (P<0 .05) ,there was no significant difference in acute radioactive toxicity between the two groups (P>0 .05) .The one and two year overall survival rate 89 .9% ,78 .9% in obser‐vation group ,while 72 .8% ,36 .2% in control group ,the differnces were statistically significant (P<0 .05);the one and two year progression‐free survival rate were 85 .9% and 50 .9% in observation group ,while 64 .3% and 28 .1% in control group ,the differ‐ences between two groups were statistically significant (P<0 .05) .The medium survival time was 36 months in observation group , and 24 months in control group;the medium progression‐free survival was 27 months in observation group ,and 17 months in control group .Conclusion For recurrent unresectable or reject surgery after TACE in patients with primary hepatic carcinoma ,the efficacy of IMRT combined with HIFU treatment is effective ,the toxicity can be tolerated ,and has certain application value .

Objective To explore the Padua risk assessment model for the application of the prevention of VTE in medical inpatients. Methods A cross-sectional surgery research method was used. A total of 3 990 patients were interviewed of a hospital between June and August in 2017. The Padua assessment model was used to screen patients for VTE risk assessment. Results 3990 patients were interviewed, in which,a high VTE risk was found in 757 cases, accounting for 18.97%. The number and ratio of patients with high risk of VTE in Respiration department (158/32.18%), Endocrinology department (48/7.00%), Neurology department (91/20.31%), Nephrology department (102/18.58%), Gastroenterology epartment (41/8.63% ), Cardiology department (139/29.45% ), Hematology department (69/ 17.12% ) and Medical oncology department (109/23.40% ). Patients with high risk VTE in 11 risk factors were (246/32.5% ), (58/7.66% ), (531/70.15% ), (4/0.53% ), (92/12.15% ), (493/64.99% ), (74/9.78% ), (89/11.76% ), (131/17.31% ), (25/3.30% ), (72/9.51% ), two groups compare between age≥70 and <70 was statistically significant (χ2=952.20, P=0.00), two group compare between mobility and reduced mobility was statistically significant (χ2=1832.28, P=0.00). Conclusions Medical inpatients have a high risk of VTE, it is suggested that include VTE in clinical quality evaluation standard, establish an effective system of VTE risk management. The Padua risk assessment model has been easy to use. Some medical department should be special attention, and has been great significance to early screening and prevention.

Objective To analyze the characteristics of the F waves,H-reflex and nerve conductions and its diagnostic value in the patients with Guillain-Barré syndrome(GBS)onset within 4 weeks.Methods The electrophysiological data of the 40 patients with GBS were analyzed retrospectively.These patients were divided into 2 groups according to the duration of illness including in 2 week' s group and over 2 week' s group.The results of the F waves,H-reflex,the motor nerve conduction velocity (MCV),and the sensory nerve conduction velocity(SCV)of these patients were analyzed.Results The abnormality rate of the F waves was 17/20 and 7/18 respectively in less 2 week' s group and over 2 week' s.The H-reflexes were 13/20 and 12/19.The MCV was 28.4％(25/88)and 32.9％(26/79).The distal motor latency was 40.9％(36/88)and 36.7％(29/79).The compound muscle action potential amplitude was 35.2％(31/88)and 32.9％(26/79)respectively in these two groups.The abnormality rate of the SCV was 11.2％(10/89)and 25.2％(24/95)respectively in the two groups.The higher abnormality rate of these tests was the F waves and H-reflex in both the groups.The abnormality rates of the F waves(x2 =8.657,P =0.003)and SCV(x2 =6.002,P =0.014)were significantly different between the two groups.There were no significant differences in the other tests.Conclusion The electrophysiological tests are valuable in the diagnosis of GBS.The F waves and H-reflex are more significant for early diagnosis of GBS.