Combined small cell lung cancer (C-SCLC) is a special subtype of small cell lung cancer (SCLC),which has a low incidence and diagnostic rate.However,the incidence and diagnostic rate appear an increasing tendency recently.The clinical features of C-SCLC are similar to the pure SCLC,while it has a relatively limited stage.The main treatment pattern of C-SCLC is multimodality therapy,though the response to chemotherapy in C-SCLC is relatively poor.Survival between patients with C-SCLC versus SCLC is similar.KPS,stage,composite components,tumor location and diameter,surgery margin are prognostic factors.Radiotherapy can benefit for the patients with ⅢA/ⅢB disease,positive lymph nodes,or with more metastatic lymph nodes after surgery.

Animals ; Apoptosis ; Extremities ; blood supply ; Intestine, Small ; cytology ; pathology ; Ischemic Preconditioning ; Male ; Rats ; Rats, Wistar ; Reperfusion Injury ; pathology

Radiation therapy is one of the main treatment methods for cancer. Machine learning can be used in all aspects of clinical practice in radiation therapy, including clinical decision support, automatic segmentation of target volumes, prediction of treatment efficacy and side effects. Despite the challenges of lacking structured data and poor interpretability of models, the application of machine learning in radiotherapy will become increasingly profound and extensive. This review contains three aspects: introduction of machine learning, the clinical application of machine learning in radiotherapy, challenges and solutions.

Lateral thoracic flap is a free flap for the reconstruction of soft tissue defects and has been previously used in oral and maxillofacial surgeries. We reported a case involving a huge soft tissue defect on the parotid region caused by the resection of parotid epithelial myoepithelial carcinoma. We discussed the anatomy and application of the lateral thoracic flap.
Carcinoma ; Free Tissue Flaps ; Humans ; Middle Aged ; Parotid Region ; Reconstructive Surgical Procedures ; Surgical Flaps

This study was aimed to evaluate the efficacy and safety of free-frying granules of traditional Chinese medicine(TCM) on treatment of chronic prostatitis. A total of 120 chronic prostatitis patients that were diagnosed with the dampness-heat and blood-stasis syndrome and kidney-deficiency syndrome were divided into the TCM group and western medicine group by random digit table. Category II and ⅢA chronic prostatitis were treated with oral administration of Levofloxacin Mesylate Tablets (0.2 g, bid) and the category ⅢB chronic prostatitis was treated with oral administration of Terazosin Hydrochloride Tablets (2 mg, qd). In the TCM group, the dampness-heat and blood-stasis syndrome was treated with Tongluo Qingjie formula ( which was self-made formula containing Rhizoma Dioscoreae Hypoglaucae, Herba Patriniae, Semen Plantaginis, and etc.) and the kidney-deficiency syndrome was treated with Jiawei Wuzhi Yanzong pills (which containing Semen Cuscutae, Chinese Wolfberry, Radix Rehmanniae Preparata, Fructus Rubi and Schisandra chinensis, and etc.). Four weeks was one course of treatment. The results showed that the total effective rate of TCM group was better than that of western medicine group (P< 0.05). Effect of TCM group was obviously better than that of western medicine group in the improvement of prostatitis NIH-CPSI score, the quality of life and symptoms of the patients. TCM may increase lecithin corpuscle in prostatic fluid of ⅢA chronic prostatitis (P< 0.05). Meanwhile, no obvious toxiferous and side reactions were found. It was concluded that the free-frying granules of TCM have good efficacy and safety in the treatment of chronic prostatitis.

Objective To evaluate the diagnostic value of ultrasonic elastography (UE) in benign and malignant thyroid nodules by Meta analysis. Methods Computer was used to search China national knowledge infrastructure(CNKI), Wanfang database, and relevant Chinese articles about UE in assessing diagnostic accuracy of benign and malignant thyroid nodules were collected. According to the diagnostic test criteria recommended by Cochrane Screening and Diagnostic Test Group, the literatures were screened and feature information was included in the study. The quality evaluation tool of diagnostic test accuracy(QUADAS-2) was used to assess the quality of the literatures; Meta analysis was performed with Meta-DiSc 1.4 software, and receiver operating characteristic curve(SROC) was drawn. Results According to the key words, two hundred and thirty-one articles were retrieved initially, and finally 16 articles were included after screening; the quality of five articles was grade A; eight was grade B; and three was grade C. Sixteen articles contained 1 325 patients with 1 641 thyroid nodules. The pooled sensitivity and specificity were 0.87 [95%confidence interval (CI): 0.84 - 0.89] and 0.84 (95%CI: 0.82 - 0.86), respectively; the pooled positive and negative likelihood ratios were 5.85 (95%CI:4.47-7.65) and 0.17(95%CI:0.13 - 0.21), respectively; the area under the curve of SROC was 0.93, standard error(SE) =0.01. Conclusion The results of meta-analysis suggest that UE has high value in the diagnosis of benign and malignant thyroid nodules.

BACKGROUND: The surgical resection rate of pdmary hepatic carcinoma is low, thus, the local treatment arose more attention. Microwave coagulation therapy can inactivate rather than kill the hepatic carcinoma ceils. Slow-release chemotherapy has been used in treating primary hepatic carcinoma because it can form local high concentrations and last for a long time. OBJECTIVE: To observe the therapeutic effect of epirubicin-loaded chitosan microspheres combined with microwave coagulation on treating hepatocellular carcinoma in mica. METHODS: Epirubicin-loaded chitosan microspheres were prepared by using emulsion-chemical cross linking technique. The surface morphology and particles size of chitosan microspheres were observed by scanning electron microscope. Ultraviolet speotrophotometer was used to analyze the entrapment efficiency, entrapment efficiency and cumulative release rates of epirubicin-loaded chitosan microspheres. Totally 24 mice with transplanted subcutaneous H22 HCC were divided into 4 groups, which were respectively treated by microwave coagulation therapy, intratumoral injected with physiological saline after microwave coagulation therapy, intratumoral injected with epirubicin after microwave coagulation therapy, intratumoral injected with epirubicin-ioaded chitosan microspheres after microwave coagulation therapy. The tumor inhibitory rate was calculated. RESULTS AND CONCLUSION: The average diameter of chitosan microsphere was 105 μm, with uniformed particle diameter. The ratio of drug loading was 11% and the entrapment was 80%. The in vitro drug cumulative release rate was 84% after 2 weeks. The tumor inhibitory rates of the microwave coagulation combined with physiological saline, epirubicin, and drug carried microspheres groups were 8%, 20%, and 47%. It suggested that chitosan microsphere is a safe and effective slow-release dosage form, which exhibits strong anti-tumor effect when combined with microwave treatment.

Objective To evaluate the operative techniques and the methods of the renal function protection in laparoscopic nephron sparing surgery for the treatment of renal tumors.Methods Thirty-six renal tumor patients accepted transperitoneal laparoscopic partial nephrectomy at the 70 degree lateral decubitus position.There were 17 tumors in the upper pole,13 in the lower pole and 6 in the center of kindey.The mean tumor diameter was 2.6 cm(from 0.8 to 4.0 cm).Peke forceps were used to clamp the renal artery and achieve warm ischemia.Cold scissors was used to resect tumors and Hem-o-lok was used to clamp and control the artery bleeding in surgical bed instead of ligature when suturing the kidney parenchyma.Ulinastatin was used to prevent and relieve the ischemical reperfusion injury.The operative time,estimated blood loss,warm ischemia time,intraoperative and postoperative complications and the operative efficacy were recorded.Results All operations were completed successfully,no case was converted to open surgery.The mean operative time was 128 min(95 to 186 min),mean estimated blood loss was 130 ml (40 to 600 ml),mean warm ischemia time was 21 min(16to 28 min).There was no hemorrhage and urinary leakage after surgery.The post-operative renal function was normal in all the cases.The histopathological examination showed that 36 cases were renal cell carcinoma including 31 pT1a,cases and 5 pT1b cases.There was no positive surgical margin.The mean follow-up time was 16 months (from 6 to 30 months).There was no recurrence and metastasis found and renal function was normal in all cases during the follow-up.Conclusions Laparoscopic nephron sparing surgery for renal tumors is a safe and feasible treatment option.This procedure can resect tumor safely and preserve renal function efficiently.The use of Hem-o-lok instead of ligature can significantly reduce the operative time.Ulinastatin can help reducing the ischemical reperfusion injury and thus preserve renal function.

Objective To master the area scope and epidemic situation of Kaschin-Beck disease (KBD) in Harbin,and to accumulate data and information for the midterm examination and evaluation of the 12th Five-Year Plan of the National Endemic Disease Prevention and Control.Methods In the original 10 counties (districts,cities) of Harbin with KBD,2 surveys were carried out from 2011 to 2015,5 townships were extracted in each county (district,city),3 villages were extracted in each township,clinical investigation and X-ray examination of 7-12 years old children were carried out;according to the criteria for Diagnosis of Kaschin-Beck Disease,a clinical survey was conducted in 2013 in the 10 counties (districts,cities) with KBD.According to the KBD prevalence and X-ray examination results in each county (district,city),reference to Criteria for Control of Kaschin-Beck Disease Areas,Criteria for Delimitation and Classification of Kaschin-Beck Disease Area,Evaluation Methods for Endemic Diseases Control and Elimination,the types of the disease areas,control and eliminating situation were determined;organization and management of the control and prevention measures were evaluated.Results Currently,there were 10 counties (districts,cities),373 villages,6 969 patients with KBD in Harbin.According to the KBD area division and control standard,369 villages were light KBD areas (prevalence of clinical degrees Ⅰ and above patients or detection rate of 7-12 children by X-ray for local residents ≤ 10％) and 4 villages were medium KBD areas (prevalence of clinical degrees Ⅰ and above patients or detection rate of 7-12 children by Xray for local residents ＞ 10％-≤20％).Clinical census showed that the people under 20 years had no cases with degree Ⅰ and above in each village,X-ray detection rate was 0 in 7-12 years old children,in line with the standards of history KBD areas.There were no clinical KBD cases in 7-12 years old children in all villages of KBD areas,positive detection rate of children by X-ray was 0 in the sampling KBD area villages,in line with the standards of eliminate technical standards of KBD area village.The management index scores of KBD were from 85 to 95 points in every area county (district,city),getting to the eliminating requirement which was more than 85 points.Conclusion The KBD areas have narrowed down and prevalence has declined significantly in Harbin,which has reached the area eliminating standards and the index of basically eliminating KBD proposed by the 12th Five-Year Plan.

Objective In order to accumulate data for the final evaluation and acceptance of the Twelfth Five-Year Plan of National Endemic Disease Prevention and Control,we investigated the endemic scopes and basic situation of Keshan disease (KD) in Harbin.Methods According to the Criteria for Diagnosis of Keshan Disease (WS/T 210-2011),we conducted clinical survey of KD prevalence in 10 KD endemic counties in Harbin in 2013.2011-2015,we detected and searched for cases in 10 ward counties of Keshan disease.According to the Delimitation and Classification of Keshan Disease Areas and the Evaluation of Endemic Disease Control and Elimination,we determined the regional type,the situation of control and elimination of the disease,at the same time all KD patients were positioned by global positioning system (GPS).Results There were 2 KD endemic counties,12 endemic townships,and 37 KD patients in Harbin.All 12 townships were the light endemic regions of KD.Other townships were conformed to be the history regions with KD.The management index scores of KD reached the elimination requirements which were more than 85 points in every region county (city).Ten region counties got to technical standards for KD elimination.Harbin basically reached the index of KD elimination.The GPS satellite positioning of KD patients were concentrated in the 45.1-45.5 degrees north latitude,and 127.7-128.3 degrees east longitude.Conclusion The regions of KD endemic areas have narrowed down and the prevalence rate has declined significantly in Harbin,which have reached the basic elimination standards of KD by the 12th Five-Year Plan.