Objective :To explore the curative effect of endoscopic sinus surgery (ESS) and the factors associ-ated with surgery effect for treating children with chronic sinusitis. Method :Thirty-one children with a medianage of 10 years (range 5～14 years) who suffered from chronic sinusitis or/and nasal polyps and were operatedvia ESS from May 1996 to January 1999 were retrospectively analyzed. Result:According to the therapeutic evalu-ation standard (ESS-199 7, Haikou ), twelve cases (38.7 ％ ) were completely cured, fifteen cases (48.4 ％0 ) wereinproved and four children (12.9 ％ ) showed no change with a general effective rate of 87.1 ％00 without any severeoperative complication. Conclusion:The results suggested ESS is a safe and effective method in the treatment ofchildren with chronic sinusitis or/and nasal polyps. Furthermore, meticulous postoperative endoscopic care andmedication are also important for securing optimal long-term results.

Objective To observe the temperature-time curve of Shenque(CV8) salt moxibustion and explore the temperature starting mechanism of Shenque moxibustion and itsclinical significance.Method In the subjects treated with Shenque salt moxibustion, periumbilical and umbilical bottom temperatures were measured simultaneously and recorded using a two-channel temperature logger, and the temperature-time curve was drawn and analyzed to preliminarily explore its temperature starting mechanism according to the experimental results.Result Periumbilical temperaturemeasurement showed that the temperature that every cone of moxa produced reached more than 43℃and the maximum temperature reached 44.9℃. The time that 43℃or more lasted was (4.50±2.36) min. The time that 40℃or more lasted was (8.03±2.63) min. Umbilicalbottom temperature measurement showed that the temperature reached more than 43℃at the seventh cone of moxa on average and the maximum temperature reached 44.7℃. The mean value of the maximum temperatures at the seventh to tenth cones of moxa was (43.44±1.05)℃. The time that 43℃or more lasted was (5.53±2.13) min. The time that 40℃or more lasted was(18.44±10.39) min.Conclusion Shenque salt moxibustion has the property of repeated warm stimulations, which can avoid the platform period brought about by stable warm stimulation and promote the maximization of moxibustion intensity to effectively increase clinical moxibustion quantity finally.

OBJECTIVE: To systematically review the efficacy and safety of taxane, cisplatin, and fluorouracil (Tax-PF) as induction chemotherapy for advanced head and neck cancer. METHOD: Literature about the efficacy and safety of Taxane-cisplatin-fluorouracil as induction chemotherapy for advanced head and neck cancer was retrieved from digital databases of PubMed, Embase, SpringerLink, MEDLINE and the Cochrane Library before February 2015. Data extraction and quality assessment of included studies were conducted by two reviewers independently. Stata 13.0 was then used to perform Meta-analysis. RESULT: A total 7 randomized controlled trials involving 2,702 were included. The 3-year OS rate [HR = 1.14, 95% CI (1.03, 1.25), P < 0.01], 3-year PFS rate [HR = 1.24, 95% CI (1.08, 1.43), P < 0.01], 5-year OS rate [HR = 1.30, 95% CI (1.09, 1. 55), P < 0. 01], 5-year PFS rate [HR = 1.39, 95% CI (1.14, 1.70), P < 0.01] and ORR to chemotherapy [OR = 1.66, 95% CI (1.35, 2.05), P < 0.01] of the patients in the Tax-PF group were statistically superior to those in the PF group. In terms of toxicities, the incidence of febrile neutropenia [OR = 2.36, 95% CI (1.62, 3.46), P < 0.01], alopecia [OR = 8.22, 95% CI (3.99, 16.92), P < 0.01], diarrhea [OR = 1.57, 95% CI (1.05, 2.36), P< 0.05] and leucopenia [OR = 2.79, 95% CI (1.86, 4.21), P < 0.01] was higher in the Tax-PF group than that in the PF group. CONCLUSION The Tax-PF induction chemotherapy improved PFS and OS, and the ORR was better as compared to PF-based therapy regimens at the cost of a higher incidence of adverse events.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bridged-Ring Compounds ; therapeutic use ; Cisplatin ; therapeutic use ; Fluorouracil ; therapeutic use ; Head and Neck Neoplasms ; drug therapy ; Humans ; Induction Chemotherapy ; Randomized Controlled Trials as Topic ; Taxoids ; therapeutic use

Objective To explore the role of Beclin 1 and PTEN in gastric caicinoma genesis and the effects on prognosis.Methods The expression of Beclin 1 and PTEN in 199 gastric caicinoma specimens and corresponding adjacent noncancerous tissues were examined by tissue microarrays and immunohistochemistary,and the relation with gastric cancer was analyzed.The rate of Beclin 1 and PTEN expression in 15 fresh gastric carcinoma samples and corresponding adjacent noncancerous tissues were detected by Western blot.All the samples were from Changzheng Hospital.Results The Results of immunohistochemistary showed that the rates of Beclin 1 and PTEN positive expression in cancinoma tissues were 47.2％ (94/199) and 55.8％ (111/199),both were lower than that of adjacent noncancinoma tissues (94.5％,188/199 and 92.5％,184/199; P ＜ 0.01).The lower expression of Beclin 1 and PTEN in gastric carcinoma were associated with gender,differentiation degree,depth of tumor invasion,lymph node metastases and disease stage(P＜0.05).There was a positive correlation between Beclin 1 and PTEN expression in gastric carcinoma tissues (r =0.680,P＜0.01). The survival analysis indicated that Beclin 1 and PTEN were independent factors in determining the prognosis of gastric cancinoma patients.The 5-year survival rate of Beclin 1 positive patients was 67.0％ (63/94),and of negative patients was 33.3％ (35/105).The 5-year survival rate of PTEN positive patients was 71.2％ (79/111),and of negative patients was 21.6％ (19/88) ( all P＜0.001).The Results of Western blot indicated that the expression of Beclin 1 and PTEN in gastric carcinoma tissues were significantly lower than that in the adjacent noncarcinoma tissues ( all P＜0.001).Conclusion The abnormal expression of Beclin 1 and PTEN may be related to carcinogenesis and the development of gastric carcinoma.

Objective To assess the diagnostic value of CT spectral imaging using quantitative iodine-based material decomposition images in the evaluation of pulmonary embolism. Methods Fifty-three patients underwent CT angiography with spectral imaging mode on a GE Discovery CT750HD scanner. Iodine distribution in the lung parenchyma using the iodine-based material decomposition images was quantitatively measured by post-processing. Monochromatic CT angiographic images were reconstructed from the same data sets and thee images were reviewed for the identification and localization of pulmonary embolism as well as the degree ( partial or complete) of the embolic occlusion. The number and location of perfusion defects were recorded. The iodine content of perfusion defects and normal lung parenchyma on the iodine maps were measured by one reader using an ROI analysis. Comparative analyses were obtained using the Chi-square test for categorical data. Two independent samples rank test and 2 related samples signed-rank test were used to compare iodine densities between different groups. Results CT angiography showed no pulmonary embolism in 33 patients, and iodine distribution was homogeneous. A total of 93 clots with lobar ( n = 26), segmental (n = 54) and sub-segmental (n=13) distribution were detected in 19 patients; Fifty-one clots were occlusive and 42 clots were non-occlusive. The iodine-based material decomposition images of all occlusive clots showed lobar, segmental or sub-segmental iodine distribution defects; whereas eleven of 42 non-occlusive clots had evidence of iodine distribution defects. There was significant difference ( x2 = 39. 94,P＜0. 01 ) in the perfusion defects between occlusive and non-occlusive clots. There was a significant difference in iodine content between normal lung parenchyma [ (1.92 ±0. 54) g/L] and perfusion defects [ (0. 30 ± 0. 20)g/L] (Z= -5.63, P ＜ 0. 01 ). There was a significant difference in the iodine content of peffusion defects before [ (0. 26 ± 0. 23 )g/L] and after anticoagulation [ (0. 94 ± 0. 50 )g/L ] ( Z = -3.93,P ＜ 0. 01 ). Conclusion With the ability of iodine mapping, CT spectral imaging is areliable method in the evaluation of pulmonary embolism both qualitatively and quantitatively, and may be a useful tool in providing information regarding the severity of PE and monitoring therapeutic efficacy.

Objective To evaluate maximum intensity projection(MIP) images and apparent diffusion coefficient(ADC) values of MR diffusion weighted imaging with background body signal suppression (DWIBS) on pulmonary diseases.Methods Sixty-one patients with pulmonary diseases underwent DWIBS.The findings in three dimensional(3D) MIP image were observed and the ADC values of diseased region were measured.The diagnostic value of DWIBS on pulmonary diseases was evaluated.Results Lung cancer and inflammatory disease were all demonstrated as dense intensity area on DWIBS.The mean ADC value of central lung cancer was (1.05±0.23)×10-3 mm2/s.The mean ADC value of peripheral lung cancer was(1.10±0.17)×10-3 mm2/s.The mean ADC value of the inflammatory disease was(1.69±0.29)×10-3 mm2/s.The mean ADC value had significant difierence between peripheral lung cancer and the inflammatory disease (P＜0.05). The MR sensitivity,specificity and accuracy in diagnosing the pulmonary diseases with DWIBS(86.84%,82.60%,85.24%,respectively) was higher than conventional MRI(78.94%,78.26%,and 78.68%,respectively).Conclusion DWIBS can demonstrate clearly the lesion's shape with 3D display.The quantitative measurement of ADC values iS feasible.DWIBS may be a potential diagnostic method for differentiation on pulmonary diseases.

Objective: To study the imaging performance and pulmonary function of pneumoconiosis patients at stage three. Methods: 89 cases of pneumoconiosis patients at stage three for high thousand volt back chest, chest CT, pulmonary function, analysis the relationship of high thousand volt back chest, chest CT manifestations and pulmonary function. Results: In patients with chest X-ray progressive massive fibrosis range of 2.31-102.95 cm², divide patients according to the X-ray performance into three groups, the difference of each group pulmonary function index FVC、FEV₁、PEF、MEF_75%、MEF_50%、MEF_25%、MVV is statistically significant (P<0.01) , the difference of FEV₁/FVC%、RV/TLC、DLCO is no statistical significance (P>0.05) . Checked by related, in pneumoconiosis patients at stage three, the X-ray manifestations and pulmonary function index FVC、FEV₁、FEV₁/FVC%、PEF、MEF_75%、MEF_50%、MEF_25%、MVV、DLCO showed a negative correlation (r=-0.326, -0.438, -0.251, -0.344, -0.317, -0.337, -0.425, -0.347, -0.230) . With the deterioration of the X-ray imaging findings, pulmonary function index FVC、FEV₁、FEV₁/FVC%、PEF、MEF_75%、MEF_50%、MEF_25%、MVV、DLCO is a trend of decrease (P<0.05) . The X-ray changes is not associated with RV/TLC. By linear regression analysis, FVC、FEV₁、FEV₁/FVC%、PEF、MEF_75%、MEF_50%、MEF_25%、MVV、DLCO regression equation are meaningful. The RV/TLC regression equations is meaningless. The volume of the patients with chest CT progressive massive fibrosis range of 4.86~179.74 cm³, divide patients according to the chest CT performance into three groups, the difference of each group pulmonary function index FVC、FEV₁、PEF、MEF_75%、MEF_50%、MEF_25%、MVV、RV/TLC is statistically (P<0.05) , the difference of FEV₁/FVC%、DLCO is no statistical significance (P>0.05) . Checked by related, in pneumoconiosis patients at stage three, chest CT manifestations and pulmonary function index FVC、FEV₁、FEV₁/FVC%、PEF、MEF_75%、MEF_50%、MEF_25%、MVV showed a negative correlation (r=-0.360, -0.419, -0.256, -0.432, -0.366, -0.326, -0.254, -0.405, ) , It is not associated with the RV/TLC、DLCO. With the deterioration of the chest CT imaging findings, pulmonary function index FVC、FEV₁、FEV₁/FVC%、PEF、MEF_75%、MEF_50%、MEF_25%、MVV is a trend of decrease (P<0.05) . By linear regression analysis, FVC、FEV₁、FEV₁/FVC%、PEF、MEF_75%、MEF_50%、MEF_25%、MVV regression equations are meaningful. The RV/TLC、DLCO regression equations are meaningless. Conclusion It is correlated with chest X-ray, chest CT manifestations and pulmonary function in pneumoconiosis patients at stage three, that could help guide clinicians comprehensive evaluation in patients with pulmonary function status.

Shared decision-making is a new way for doctors, nurses and patients to participate in decision-making. This study reviews the overview of shared decision-making model, the application status and effect of shared decision-making model in breast cancer patients, with a view to providing reference for the establishment of shared decision-making model for breast cancer patients.

Objective To investigate the clinical effects of the stent-laparoscopy approach in treatment of elderly patients with malignant colorectal obstruction.Methods Clinical data of 55 elderly hospitalized patients with colorectal cancer-induced bowel obstruction in Wenzhou Central Hospital from January 2009 to January 2014 were evaluated retrospectively.All patients were treated with expandable metallic stents for remission of bowel obstruction.Patients were divided to laparoscopy surgeryobservation group (n =14) receiving laparoscopic surgery after decompression and the laparotomy surgery-control group (n=41) receiving conventional open colorectal cancer operation.The intraoperative information,postoperative complications and long-term curative effect were compared between the laparoscopy surgery-observation vs laparotomy surgery-control group.Results During laparoscopy surgery period,two patients operated by laparoscopy surgery were converted to laparotomy surgery.Surgical time was significantly longer in the laparoscopy surgery-observation group than in laparotomy surgery-control group[(178 ± 33) min vs.(145 ± 31) min,t =3.384,P =0.001],and bowel function recovery and postoperative hospital stay were significantly shorter in the laparoscopy surgery-observation group than in laparotomy surgery-control group[3.1 ± 0.9) d vs.(4.3 ± 1.3) d and (7.1±1.3) d vs.(12.6±5.7) d,t=3.193 and t=2.911,P=0.002 and P=0.005].Intraoperative blood loss was less in the laparoscopy surgery-observation group than in the laparotomy surgery-control group[(63 ± 29) ml vs (86 ± 37) ml,t =2.11,P =0.04],with no significant differences in postoperative complications between the two groups (0.0 vs 9.76 ％,x2 =1.47,P=0.225).Fifty-five patients were followed up for 2 years.All patients survived in the laparoscopy surgery-observation group,but one patient died from the cerebrovascular accident in the laparotomy surgery-control group.Conclusions The stent-laparoscopy approach to treat colorectal cancer (CRC) patients with acute colorectal obstruction is a safe,effective,recovery quick and minimally invasive option for elderly patients.Emergency surgery may be converted to a limited operation by this method.Laparoscopic radical surgery with one-stage anastomosis is feasible.