Purpose:To investigate the influence of MRI on the Chinese 1992 staging system of nasopharyngeal carcinoma(NPC).Methods:From Oct.1992 to Jan.1996,86 patients with NPC who had MRI and CT prior to radiotherapy were retrospectively analyzed.The total dose to the primary tumor was 60.4～85.0 Gy(median,72.5 Gy).The fractionation schedule used was five daily fractions of 1.8～2.0 Gy per week.The survival rates were estimated by the Kaplan-Meier method.Log-rank was used to identify the prognostic factors.Results:The loco-regional control rate at 5 year was 84.2%,distant metastasis-free survival 80.1%,disease-free survival 73.9% and overall survival 82.7% with a median follow-up interval of 65.5 months(range 2～108 months).According to the Chinese 1992 staging system,there were 25 vs 14(25 by CT and 14 by MRI) patients with T_(1),21 vs 8 with T_(2),31 vs 42 with T_(3) and 9 vs 22 with T_(4) lesions.As a result,42.9%(12/28) of cervical nodal and 28.6%(8/28) of retropharyngeal lymphadenopathy alone should downstage from N_(0) to N_(1).Conclusions:The influence of MRI on the Chinese 1992 staging system was significant and the authors observed a worse distribution of patient numbers as well as poorer separation of survival curves among different stage groups.

Objective To ensure medical safety,standardize the management of medical consumables and guarantee clinical work and scientific research.Methods Various regulations are perfected and specific measures are taken.Results The quality of medical consumables is guaranteed and the hospital infection is avoided.Conclusion The standardization of management can facilitate the safety of medical consumables effectively.

Objective To study retrospectively the outcome and failing factors of nasopharyngeal carcinoma(NPC) treated with late-course unconventional fractionation radiotherapy(LCUCFR). Methods From January 1996 to December 2000, 133 such patients were analyzed retrospectively. All had been confirmed by histopathology as poorly differentiated squamous cell carcinoma, including 101 males and 32 females. All were treated by LCUCFR. The nasopharyngeal lesion radiation schedule was as follows; 1.An initial conventional fractionation 34.5Gy/18f for face and neck port, with 1.92Gy per daily fractionation;2.The above regimen was followed by 1.25-1.50Gy per fraction twice daily in 6-8 days for pre-auricular port;3.The above regiment was then followed by conventional boosting dose 1.90Gy and 1.30Gy(morning 1.90Gy and afternoon 1.30Gy) twice daily(with interval of 6-8 hours) in 6-8 days. The whole course was 5 fractions per week with the median of 78Gy over a median of 47days. The positive and negative lymph node in the neck were treated by conventional radiotherapy with a median of 67Gy and a dose of 50-55Gy in median interval of 43 days. Results The 5-year nasopharyngeal lesion and neck metastasis lymph node control rate was 92.9% and 96.4%, respectively. T1,T2,T3 and T4 stage local control rate was 100%,96.6%,96.6% and 78.4%,respectively. The overall 5-year survival and disease-free survival rate was 73.3% and 70.8%,respectively. The 5-year distant-free metastasis rate was 80.2%. Fourteen varietes were used to analyze the prognosis. Both univariate and multivariate analyses revealed that the distant metastasis, lower neck and superclavicle area as well as both neck lymph node metastases and local recurrence were prognostic factors for 5-year survival rate(Logrank test all P

0.05). For all patients, the WR relapse rates were 0%(0/43) in Group A and 1.6%(1/63) in Group B and for the core patients, these rates were 0%(0/34) and 2.2% (1/46),respectively.Conclusions WR prophylactic irradiation is not advisable in treatment of cervical primary NHL, especially when chemotherapy was combined. It is to protect the major salivary glands from radiation damage and improve the patient's quality of life. However, it is extremely important to routinely examine WR by CT scan,pharyngorhinoscopy and WR biopsy to rule out primary WR NHL.

Objective To evaluate the clinical characteristics,treatment,outcome and complications of child and adolescent nasopharyngeal carcinoma (NPC). Methods From January 1970 to April 1997, the records of 145 NPC patients younger than 21 years of age were reviewed. The clinical stages according to 92'Chinese NPC Staging System were :stageⅠin 1, Ⅱin 8, Ⅲ in 79 and Ⅳ in 57. All patients were treated with external beam radiotherapy. Before 1988, parallel opposed lateral pre-auricular portals were chiefly used in 75 patients and after 1988, parallel opposed lateral facio-cervical portals were adopted in 70. The radiation dose to the primary tumor ranged 45-80?Gy: 70?Gy in 50 cases and 32 of them also received chemotherapy. Results Distant metastasis developed in 26 cases, while local and/or regional recurrence in 14. The actuarial overall survival rates of 1-, 3-, 5, and 10-years were 96.3%, 79.9%, 76.5% and 69.4%, respectively. Among 45 dead cases, 16 did so of metastasis, 11 of local and/or regional recurrence and 18 of other reasons. Univariate analysis suggested that clinical stage, size and site of involved lymph nodes, skull base involvement were significant prognostic factors of survival, whereas sex、age、dose、therapeutic method and chemotherapy were not. Conclusions 1. Even though the majority of pediatric and adolescent NPC were advanced, it signifies a relatively good survival. 2. As the normal tissue of pediatric and adolescent patients tolerates radiation poorly, prudence should be meticulously practiced in deciding the radiation dose and radiotherapeutic fields.

Objective To evaluate the clinical results of three dimensional conformal radiotherapy (3DCRT) for esophageal carcinoma. Methods From May 1999 to May 2001, 104 patients with pathologically confirmed esophageal carcinoma were randomly divided into conventional radiotherapy (CT) and three dimensional conformal radiotherapy(3DCRT) groups, with 52 patients in each arm. The patients in CT group received conventional radiotherapy in 2.0?Gy/f, 5 fractions a week to a total dose of 70?Gy in 7 weeks. The patients in 3DCRT group were first treated by the same fractionation in CT group to the dose of 40?Gy, and then treated by 3DCRT in 3.0?Gy/f, 5 fractions a week to the total dose of 70?Gy in 6 weeks. Results The 1-and 3-year local control rates were 80.2% and 60.5% in 3DCRT group and 61.6% and 31.7% in CT group(?2 = 4.87, P

Objective To evaluate the clinical effect of mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap to repair palatomaxillary defects. Methods From March 2008 to March 2011,nine patients with palatomaxillary defects following malignant tumor ablation,were repaired with mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap. According to Brown's classification for the maxillectomy defect,eight cases were type Ⅱ B and 1 case was type Ⅱ C. There were 6 males and 3 females with an average age of 57 years(range,34-68 years). Results All the 9 osteomuscular flaps and forearm flaps survived.The patients were followed up for 12 to 24 months with an average of 14 months. The patients acquired satisfactory appearance and complete functional restoration except 1 case of chondrosarcoma of recurrence was encountered 6 months after operation. Conclusions Palatomaxillary defects were reconstructed by mandibular osteomuscular flap pedicled with temporalis and radial forearm free flap immediately.It is easy to elevate,safe,and there were no donor site problems.This is an ideal method of repairing the palato maxillary defects.

Objective: To evaluate the effectiveness of recombinant Mycobacterium tuberculosis fusion protein skin test (EC-ST) in screening for latent tuberculosis infection (LTBI) among HIV/AIDS patients, so as to provide insights into the applicability of EC-ST in LTBI screening among HIV/AIDS patients. Methods: From April to June 2023, HIV/AIDS patients under management and treatment in Yangzhou City, Jiangsu Province, were selected as study subjects. Basic information was collected through questionnaire surveys. LTBI was screened by EC-ST and interferon-gamma release assay (IGRA). Taking IGRA results as the diagnostic standard, the positive rate, sensitivity, specificity and consistency rate of EC-ST, and the impact of CD4+T lymphocyte (CD4) counts on the screening effect of EC-ST were analyzed. Results: A total of 523 HIV/AIDS patients were screened, including 458 males (87.57%) and 65 females (12.43%). The median age was 48.00 (interquartile range, 21.00) years. The positive rate of EC-ST was 7.27% and the positive rate of IGRA was 7.46%, with no statistically significant difference (P>0.05). The consistency rate of the two methods was 94.84%, and the Kappa value of 0.621 (95%CI: 0.489-0.752, P<0.05). The sensitivity of EC-ST was 64.10% and the specificity was 97.31%. Comparing the groups with CD4 counts <500 and ≥500 cells/μL, the consistency rates of the two methods were 95.32% and 94.44%, and the Kappa values were 0.568 and 0.650, respectively (both P<0.05). There were no statistically significant differences in the positive rates, sensitivity, and specificity of EC-ST (all P>0.05). Comparing the groups with CD4 counts <200 and ≥200 cells/μL, the consistency rates of the two methods were 96.55% and 94.62%, and the Kappa values were 0.648 and 0.619, respectively (both P<0.05). There were no statistically significant differences in the positive rates, sensitivity, and specificity of EC-ST (all P>0.05). Conclusion The effectiveness of EC-ST in screening for LTBI among HIV/AIDS patients is consistent with that of IGRA and is not affected by CD4 counts.

OBJECTIVEThis study aims to observe the expression of Sclerostin during movement of orthodontic teeth and determine the effect of this protein on remodeling of periodontal tissues.

METHODSTwenty-four Wistar rats were chosen. Orthodontic forces were applied between the bilateral incisor and first molar to achieve mesial movement. Rats in each group were executed at different time points (0, 1, 3, 5, 7, 14 d). Morphology of periodontal tissue was observed by hematoxylin-eosin (HE) staining. The number of osteoclasts were observed by tartrate-resistant acid phosphatase (TRAP) staining. Sclerostin expression were observed by immunohistochemical staining.

RESULTSHE staining revealed that the resorption of alveolar bone intensified with prolonged movement. Results of immunohistochemical and TRAP staining revealed that Sclerostin expression and number of osteoclasts were related to duration of movement of orthodontic tooth. After staining for 5 days, the number of osteoclasts and Sclerostin expression reached their peak and then began to decline. The numbers of osteoclasts and the expression level of Sclerostin were higher at the compressive side than those at the tensive side.

CONCLUSIONSclerostin affected orthodontic tooth movement by inhibiting the Wnt signaling pathway and by indirectly or directly controlling bone morphogenetic protein.

Animals ; Bone Morphogenetic Proteins ; metabolism ; Genetic Markers ; Incisor ; Molar ; Movement ; Osteoclasts ; Periodontal Ligament ; metabolism ; Periodontium ; Rats ; Rats, Wistar ; Tooth Movement Techniques

Objective To detect plasma interleukins-35 (IL-35 )level in the patients with active tuberculosis complicated with bronchiectasis and to analyze its clinical significance.Methods Peripheral blood of patients with active tuberculosis from depart-ment of Dongguan 6th People′s hospital were collected,assigned to the active tuberculosis complicated with bronchiectasis group and active tuberculosis group.The healthy volunteers served as the control group.The plasma IL-35 level was measured by ELISA, and peripheral blood neutrophils and lymphocytes were detected by hematology analyzer.Results The levels of plasma IL-35 signif-icantly increased in both patients with active tuberculosis complicated with bronchiectasis and patients with active tuberculosis.The level of plasma IL-35 of patients with active tuberculosis complicated with bronchiectasis was significantly higher than that of the patients with active tuberculosis.The absolute value and percentage of peripheral blood neutrophils of patients with active tubercu-losis complicated with bronchiectasis were significantly higher than those of healthy volunteers.However,the percentage of periph-eral blood lymphocytes of patients with active tuberculosis complicated with bronchiectasis was significantly lower than that of healthy volunteers.Pearson correlation analysis showed that the absolute value of peripheral blood neutrophils of patients with ac-tive tuberculosis was positively correlated to the level of plasma IL-35.Conclusion IL-35 may play an important role in the progres-sion of active tuberculosis complicated with bronchiectasis.The determination of IL-35 may be helpful to the diagnosis of patients with active tuberculosis complicated with bronchiectasis.