Objective:This paper will retrospectively analyze the long-term results of PORT for Completely Resected Stage Ⅲa(N2) NSCLC.The strategies of treatment are also to be discussed.Methods:92 cases with Completely Resected Stage Ⅲa(N2)NSCLC treated in our hospital from 1987 to 2004 were analyzed.Among them,46 patients received PORT(Group S+R),46 no PORT(Group S).39 of the entire patients。received chemotherapy.Median radiation dose was 56 Gy(40～64 Gy).The survival rates were analyzed and compared by Kaplan-Meier and Log-rank.Results:(1)The 5 and 10-year overall survival(OS) for all patients was 44.5% and 30.4%,respectively(.2)The 5 and 10-year OS of group S+R and S was 49.1% vs 36.5% and 36.3% vs 25.4%,respectively,with no significant difference(?2=0.83,P=0.65)(.3)For the patients with single station involved N2,PORT tends to improve the disease-free survival(DFS) but no reach significant difference.As for patients with multiple stations involved N2,PORT could improve the DFS,the 5 and 10-year DFS of group S+R and S was 40.6% vs.4.5%;21.2% vs.4.1%,respectively,(?2=4.35,P=0.03),meanwhile,it might increase the OS(.4) The survival rate treated with PORT from 1996 to 2004 was higher than that from 1987 to 1995,(?2=4.28,P=0.04)(.5)Recurrence was seen in 63% of patients.The total(both local/regional recurrence and distant metastasis)and local/regional recurrenc rate of group S+R was lower than that of group S,i.e.50.0% vs76.1%(?2=6.72,P=0.001)and 8.7% vs 32.6%(?2=8.03,P=0.001),respectively.Distant metastasis was found to be the main failure cause for both group S+R and S.Multivariate analyses showed that age and number of mediastinal lymph node station involved have influence on the survival of patients with Completely Resected Stage Ⅲa(N2)NSCLC.the DFS.But its value for patients with single station involved N2 was unclear and a further randomized clinical trail is still warrant.(2)Age and the number of mediastinal lymph node station involved are the two significant prognosis factors for patients with Completely Resected Stage Ⅲa(N2)NSCLC(.3)Condition of equipment and radiation technology used could have some influence on the result of PORT(.4)The fact that distant metastasis was the main failure cause for both group S+R and S might imply that patients with Completely Resected Stage Ⅲa(N2)NSCLC might benefit from chemotherapy.It suggests thus that chemotherapy should be considered for these patients.

Objective To investigate the application of noninvasive correction of congenital auricle defor-mity,and to analyze the cure rate and the causes of incidence of complications. Methods From January 2015 to December 2016,33 patients with unilateral or bilateral congenital auricle deformities were treated with non-surgi-cal correction technique in the Plastic Surgery Department of Guangzhou General Hospital. When the treatment was completed,the VAS score was used to assess the satisfaction of the patient's parents. Results From January 2015 to December 2016,33 patients(53 ears)received noninvasive treatment of the ear deformity correction system. The average age of the patients was(63.5 ± 41.3)days,the average treatment time was(41.6 ± 15.4)days,and the average parental satisfaction was 3.76 ± 0.93(total score:5 points). Significant difference was observedin auri-cle morphology data between pre- and post- treatment ,except for cranioauricular angle(P < 0.05). Conclusions In this study,the cure rate for non-surgical correction was good,however,the satisfaction of treatment decreased with age.The most common complication of treatment was auricle skin damage. The reasons of causing complica-tions maybe the age-induced reduction of ear cartilage elasticity which brought great pressure on the ear ,and the increase of the treatment time.

Objective To investigate the expression and significance of Survivin and Fhit protein in colorectal benign and malignant disease.Methods Test the expression of Survivin and Fhit proteins in 20 cases normal colorectal mucosa,30 cases low grade colorectal intraepithelial lesion,30 cases high grade colorectal intraepithelial lesion and 68 cases colorectal adenocarcinoma by immunohistochemical staining S-P method.Results The unexpression of Survivin in normal colorectal mucosa,postive expression rates of Survivin in low grade colorectal intraepithelial lesion,high grade colorectal intraepithelial lision and colorectal adenocarcinoma were 43.3%,76.7% and 91.2%(P

Objective To study the effects of Qingjinkangkuoyin (QJKKY) on TNF-α and NE in rats with bronchiectasis.Methods Models were established by intrabronchially injecting with pseudomonas aeruginosa,and divided into 5 groups by random:the QJKKY high dose treatment group (given high dose of QJKKY into stomach),the QJKKY low dose treatment group (given low dose of QJKKY),the levofloxacin group (given levofloxacin),the model group (given normal saline),and the normal contrast group (given normal saline).After 2 weeks of treatment,the histopathology of lung tissue,the levels of TNF-α and inflammatory cells in peripheral blood and NE in rats' lung tissue were detected.Results Compared with the model group (160.425±9.9293)ng/L,QJKKY could decrease the level of TNF-α in blood significantly [high dose of QJKKY treatment group was (137.133±6.1646)ng/L,P＜0.05]; the expression of inflammatory cells in serum were decreased significantly by QJKKY [high dose of QJKKY treatment group was (1.106± 0.3580) 109/L,P＜0.05].Low dose of QJKKY treatment group was (1.086 ±0.2433) 109/L,(P＜0.05) ; the expression of NE in lung tissue were decreased remarkably by QJKKY [high dose of QJKKY treatment group(80.697 ±4.5877)ng/L,P＜0.05]; low dose of QJKKY treatment group is (80.747±3.6925)ng/L,(P＜0.05); and the histopathologic change of lung tissue in QJKKY treatment groups were ameliorated under light microscope by HE staining.Conclusion Qingjinkangkuoyin could cure bronchiectasis by decreasing the expression of TNF-αin peripheral blood and NE in rats' lung tissue.

Objective To study the effect of E1A gene on the radiosensitivity of nasopharyngeal carcinoma (NPC) cells and its mechanism. Methods Ad-E1A gene was transfected into human NPC cells (CNE2), then the positive clones (CNE2-Ad-E1A) were identified by RT-PCR. CNE2 cells, CNE2 cells transfected with Ad-β-gal (CNE2-Ad-β-gal) and CNE2-Ad-E1A cells were irradiated with 0 Gy,2 Gy,4 Gy,6 Gy and 8 Gy respectively using 6 MV X-ray. Clone forming assays were carried out, cell survival curves were drawn and the sensitivity enhancing ratio (SER) was calculated. The redistributions of cell cy-cle were analyzed by flow cytometry. RT-PCR was used to detect the expression of wtp53. Results RT-PCR confirmed that E1A gene had been integTated into positively transfected cells and stably expressed. Cell survival curves showed that the SER of D0,Dq and SF_2 value was 1.37, 1.95 and 1.46 in CNE2-Ad-E1A cells. The D_0,D_q and SF_2 value was 1.57 Gy,1.82 Gy, 0.89 in CNE-2 cells and 1.53 Gy,1.78 Gy,0.82 in CNE2-Ad-β-gal cells, respectively. The G_2/M arrest was shown in CNE2-Ad-E1A cells. Moreover, the expression of wtp53 gene was markedly enhanced in Ad-E1A-CNE2 cells. Conclusions E1A gene can ef-fectively enhance the radiosensitivity of human NPC cells, which may be associated the enhancement of wt-p53 expression and G_2/M arrest.

Objective To observe the changes of blood sugar following use of recombinant human growth hormone (rhGH) in patients with severe burn. Methods A total of 140 patients with severe burn but with no history of diabetes were randomly and equally divided into Group A ( 18-44 years old) and Group B ( ≥45 years old) according to WHO criteria. Then, two groups were randomly divided Group B0 (treated with normal saline), 35 patients per group. Change of blood sugar and amount of insuline for control of blood sugar were observed and analyzed. Results Of 140 patients in four groups,128 patients accomplished the test, with no statistical difference upon general conditions between groups (P ＞0.05 ). Within four weeks after test, the amount of insuline used for control of blood sugar was (2908.0 ± 153.5) IU and (724.1 ± 31.1 ) IU respectively in Groups A1 and A0, (3725.9 ± 88.4) IU and (801.8 ±22.2) IU respectively in Groups B1 and BO. The results showed that the patients needing insulin to control blood sugar in Group B were more than that in Group A ( P ＜ 0.01 ). The time for blood sugar recovering to normal range in patients with high blood sugar with no use of rhGH in Group A1 and Group B1 was (5.21 ±0.64) d and (5.03 ± 1.01) d respectively (P＞0.05). Conclusions The blood sugar of patients with severe burn will rise after use of rhGH. The age of the patients is positively correlated with changes of blood sugar. Standard use of rhGH does not induce diabetes.

Objective To investigate the therapeutic effect of the ultra-early stent-assisted coil embolization of the ruptured intracranial aneurysms. Methods The clinical data of 13 patients with ruptured intracranial aneurysm treated by ultra-early stent-assisted coil embolization were analyzed retrospectively. The preoperative Hunt-Hess gradeⅠ-Ⅱ was in 7 cases,gradeⅢ was in 4 cases,and grade Ⅳ was in 2 cases. The patients were treated with stent-assisted coil embolization under the general anesthesia with endotracheal intubation within 24 h of aneurysm rupture. The postoperative embolization was assessed according to the Raymond grading standard. The postoperative complications and the assessment of the follow-up results from 1 to 6 months after procedure according to the modified Rankin scale (mRS ) scores were observed. Results All 11 patients recovered well,1 case had postoperative hemiplegia,1 case had postoperative bleeding,and none of them died. During the follow-up period,no patients had rebleeding, 1 had recurrence,and DSA revealed that the patient was embolized completely at 2 months after reembolization. Conclusion The method of ultra-early stent-assisted coil embolization of ruptured intracranial aneurysms is feasible. It may improve the cure rate of the ruptured aneurysms and improve the prognosis of patients.

Objective To investigate the safety and feasibility of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy. Methods 45 patients who were suitable for retroperitoneoscopic partial nephrectomy from February 2013 to February 2014 were collected and randomly divided into V-Loc group and the control group. 23 cases of V-Loc barbed absorbable suture line were chosen by suture kidney in V-Loc group.There were 22 cases of coated vicryl plus antibacterial suture and Hem-o-lok clip in the control group. The differences of operative time, blood loss, warm ischemia time, suture time, hospital stay and suture material costs were compared respectively between the two groups. Results All 45 cases of retroperitoneoscopic partial nephrectomy were successfully performed, without conversion to open surgery and important intraoperative complications. Postoperative pathology report showed that there were 37 cases with renal clear cell carcinoma, 3 cases with papillary renal cell carcinoma, 2 cases with chromophobe renal cell carcinoma with negative surgical margin, 3 cases with renal angiomyolipomas. In the V-Loc group and the control group, the average operative time were (90.8±9.6) and (96.9±9.1) min (P>0.05), the mean blood loss were (80.4±24.2) and (99.5±24.8) ml (P>0.05), the mean warm ischemia time were (21.5±3.4) and (25.3±1.9) min (P<0.05), suture time were (10.8±1.7) and (16.8±3.1) min (P<0.05), respectively, postoperative hospital stay were (5.7±1.7) and (7.1±1.9) d (P>0.05), the average cost of renal parenchymal suture material were (1 215.5±101.4) and (2 073.5±301.8) yuan (P<0.05). The warm ischemia time,suture time and suture material costs in the V-Loc group were significantly lower than those in the control group (all P<0.05). Conclusion The application of barbed absorbable suture line in retroperitoneoscopic partial nephrectomy can shorten warm ischemia time and suture time, and save hospitalization costs, with favorable safety and feasibility.

Objective To evaluate the efficacy of preoperative and postoperative intravesical instillation of pirarubicin for the prevention of postoperative recurrence of non-muscle invasive bladder cancer (NMIBC). Methods From September 2012 to March 2014, 120 patients who were diagnosed as NMIBC and accepted trans-urethral resection of bladder tumor (TUR-Bt) were collected and randomly divided into two groups, including treatment group (60 cases) and control group (60 cases). 30 minutes before the operation, instillation of pirarubicin (40 mg) was performed in the treatment group, then pirarubicin perfusion was given within 24 h after operation, once a week for 8 weeks, and once a month for 10 months after operation. In control group, instillation of pirarubicin (40 mg) was given within 24 h after operation, and other treatments were the same as the treatment group. The differences of lesion detection probability, the 2-year recurrent rate and the adverse reaction rate were compared between the two groups. Results The lesion detection rates were 42.70 % (38/89) and 1.85 % (2/108) in the treatment group and control group, respectively (χ2=50.303, P<0.05). 119 patients were follow-up for 24 months. The 2-year recurrence rates were 8.47%(5/59), 21.67% (13/60) in treatment group and control group respectively (χ2= 4.033, P< 0.05). The adverse reactions mainly included hematuria (3 cases in treatment group, 3 cases in control group), urinary tract irritation (3 cases in treatment group, 2 cases in control group) and urethral stricture (1 case in treatment group, 1 case in control group). The difference of the adverse reaction incidence between the two groups was not significant statistically [11.86 % (7/59) vs. 10.00 (6/60), χ 2 = 0.106, P > 0.05]. Conclusions The preoperational intravesical instillation of pirarubicin can fix and diagnose malignant lesions in the bladder without adverse reactions, which will improve the rate of tumor resection and prevent postoperative recurrence of tumors.

Objective To evaluate the efficacy and feasibility of 125I radioactive seed interstitial implantation for the local advanced urinary tract epithelial carcinoma without total resection.Methods The clinical data of 21 patients with local advanced urothelial carcinoma without completely surgical resection who were treated by 125I radioactive particles implantation were retrospectively analyzed.The patients were divided into two groups and received preoperative plan.In group A, 14 patients received implants during operations, including 7 bladder transitional cell carcinoma patients who underwent a transurethral resection surgery or partial bladder resection and another 7 ureteral carcinoma cases who underwent semi urine road resection.After these operations, all of patients had tumor residues.After furthest resection of the tumor, the 125I seeds were implanted at the residual suspicious tumors and their surroundings.In group B, 7 patients were implanted under the guidance of color ultrasound or CT.According to the evaluation criteria of solid tumor in 2009, the tumor remission rate, survival rate, distribution and the mobile information of the particles were observed.Results The operations were successfully completed in all of 21 patients, and serious complications did not appear during the operation.Particle distribution and lesions were basic coincidence.A total of 2 particles displaced, but every patient had no adverse reactions.There were 2 patients with local fever after operation within 4 months, while the rest of patients had no adverse reactions.After median follow-up for 36 months (3-75 months) , the 1-year survival rate was 100.0 ％ (21/21), the 2-year survival rate was 90.5 ％ (19/21), and the 3-year survival rate was 61.9 ％ (13/21).The tumor remission rate of group A was 85.7 ％ (12/14) after 6-9 months, and was 42.9 ％ (6/14) after 12 months.The bladder was preserved in 7 cases with bladder tumors with the 2-year survival rate of 100.0 ％ (7/7) and the 5-year survival rate of 71.4 ％ (5/7).The tumor remission rate of group B after 6-9 months was 71.4 ％ (5/7), and was 42.9 ％ (3/7) after 12 months.Conclusion 125I seed implantation is a good choice for locally advanced urothelial carcinoma with high local tumor control rate, which is expected to be applied in the individual treatment of advanced urothelial cancer.