ObjectiveTo study the effect of transcatheter hepatic arterial infusion (TAI) and stereotaxic radiotherapy (SR) for unresectable liver cancer. MethodsFrom June 1997 to July 1999, TAI and SR were used to treat 36 patients with unresectable liver cancer. The first step was interventional chemotherapy(TAI) which consisted of CF 300?mg,5-FU 1?000～1?500?mg, CDDP 60～80?mg, and ADM 60～80?mg (or MMC 10～20?mg). Stereotaxic radiotherapy was given after two sessions or between the two sessions of TAI. The planned target volume was encompassed by more than 70%～90% isodose line, tumor dose from 5?Gy to 8?Gy per fraction, total number was 5～8 fractions. ResultsThe total effective rate were 94% and 97% judged by CT at 3 and 6 months respectively. The 1-,2-year survival rates were 85% and 68%,respecctively. ConclusionCompared with radiotherapy alone and interventional chemotherapy alone, the combined therapy results in higher therapeutic effect and longer remission time in patients with unresectable liver cancer.

Objective To evaluate the clinical value of 18FDG PET/CT in the diagnosis of lymph node metastasis and evaluation of node staging for esophageal carcinoma. Methods A prospective study was performed to access whether 18F FDG PET/CT can improve the diagnostic accuracy in lymph node metastasis for patients with esophageal carcinoma, 30 patients underwent esophagectomy with extensive dissection of lymph nodes. PET/CT findings were compared with that of CT. Results The pathological examination confirmed metastasis in 22 patients and 49 out of 243 excised lymph nodes. In PET/CT analysis, the sensitivity in the detection of lymph node metastasis was 93.9%, specificity was 91.2%, with a diagnostic accuracy of 91.8%. The positive and negative predictive value was 73.0% and 98.3%, respectively. CT resulted in a sensitivity of 40.8%, specificity of 96.9%, accuracy of 85.6%, the PPV was 76.9% and NPV 86.6%, respectively. The difference of sensitivity (P

Objective To assess the early response and acute side effects of late course stereotactic radiosurgery (LCSR) for stage Ⅲ b lung squamous cell carcinoma. Methods From June 1997 to July 1999, 136 patients with stage Ⅲ b squamous cell carcinoma of lung were treated with the conventional radiotherapy of 40 Gy followed by LCSR to the residual lesion. Stereotactic radiosurgery was given in the 5～6th weeks, 5～8 Gy per fraction with the total doses ranging from 24 to 38 Gy. Results Five patients were excluded from this study due to distant metastases and acute complications. The remaining 131 patients were analyzed to evaluate the early responses and acute complications. Acute radiation induced esophagitis occurred in 41.2% of patients (Grades Ⅰ Ⅱ (RTOG), 4.4% Grade Ⅲ). Acute radiation induced pneumonitis was observed in 16.9 % of patients ( Grades Ⅰ Ⅱ (RTOG),5.2% Grade Ⅲ). The overall response rate (CR+PR) was 86.3% for the primary tumor, and 92.4% for metastatic mediastinal lymph nodes. Conclusions LCSR is well tolerated in most patients with stage Ⅲ b squamous cell carcinoma of lung. The early responses of LCSR in the of tumor are better than the conventional radiotherapy.Remote results await further follow up.

This paper deals with the problems existing in the making of textbooks in our universities in our country,and proposes the solutions and feasible measures to the problems

AIM　To study the effects of dexamethasone on expressing monocyte chemoattractant protein-1(MCP-1 ) mRNA in the rats with pulmonary fibrosis, elaborate the molecular mechanism of dexamethasone (Dxs) in pulmonary fibrosis therapy. METHODS　The model of pulmonary fibrosis was established by instilling bleomycin intratracheally. After treating with Dxsip, the levels of MCP-1 mRNA were determined by RT-PCR. The histological changes were observed and the numbers of inflammatory cells were counted in optical microscopy field. RESULTS　The accumulation of inflammatory cells decreased markedly, and the symptom of pulmonary fibrosis was alleviated. Furthermore, Dxs evidently inhibited the expression of MCP-1 mRNA in lung tissues with pulmonary fibrosis. CONCLUSION　The molecular mechanism of Dxs in pulmonary fibrosis therapy was associated with inhibiting the expression of MCP-1 mRNA.

Objective To establish a pulmonary allergic inflammation model with C57BL/6 mice.Methods C57BL/6 mice were divided into control group and treatment group.The mice of treatment group were sensitized by intra peritoneal injection of house dust mite extracts at day 1,3,5,7,9 and 11.Then they were exposed to aerosolized allergen at day 13,16,19,20 and 21.Physiological saline instead of house dust mite extracts was used in control group.All mice underwent pulmonary lavage in 24h after the final exposure to aerosolized allergen challenge.Pathological manifestation of the lung,cell counts and classification were studied and IL-4 and IFN-? levels in BALF were detected by ELISA.Cells from spleen were cultured for 3 d with house dust mite extracts,IL-4 and IFN-? in supernatants was measured by ELISA.Results There was pulmonary eosinophilic inflammation in the mice treated with house dust mite extracts.Compared with control group,total cells,lymphocytes,eosinophils and the level of IL-4 in BALF from treated mice increased significantly,while IFN-? in BALF decreased.The level of IL-4 in cultured splenocyte supernatants also significantly increased,while IFN-? in supernatants decreased.Conclusion A pulmonary allergic inflammation model of is established by sensitizing and challenging C57BL/6 mice with house dust mite Der f.

AIM To study the effects of dexamethasone on expressing monocyte chemoattractant protein 1(MCP 1 ) mRNA in the rats with pulmonary fibrosis, elaborate the molecular mechanism of dexamethasone (Dxs) in pulmonary fibrosis therapy. METHODS The model of pulmonary fibrosis was established by instilling bleomycin intratracheally. After treating with Dxs ip , the levels of MCP 1 mRNA were determined by RT PCR. The histological changes were observed and the numbers of inflammatory cells were counted in optical microscopy field. RESULTS The accumulation of inflammatory cells decreased markedly, and the symptom of pulmonary fibrosis was alleviated. Furthermore, Dxs evidently inhibited the expression of MCP 1 mRNA in lung tissues with pulmonary fibrosis. CONCLUSION The molecular mechanism of Dxs in pulmonary fibrosis therapy was associated with inhibiting the expression of MCP 1 mRNA.

Objective To investigate the diagnosis and treatment characteristics of pure red cell aplasia (PRCA)caused by human parvovirus (HPV)B19 infection after renal transplantation.Methods Two cases with PRCA caused by HPV B19-induced after renal transplantation,who were treated in the Department of Organ Transplantation,Nanfang Hospital,Southern Medical University,were summarized.Combined with literature review,the clinical characteristics,diagnostic method,course of treatment and prognosis of such disease were investigated.Results Two renal transplant recipients developed severe anemia early after transplantation with progressive deterioration and failed transfusion therapy.Other causes of anemia were ruled out and two patients were diagnosed as PRCA caused by HPV B19 infection according to bone marrow aspiration and biopsy as well as HPV DNA detection by fluorescent polymerase chain reaction (PCR).The symptoms of anemia were improved significantly after adjustment of immunosuppressive treatment protocol and intravenous immunoglobulin (IVIG).Conclusions For patients with unexplained and progressed anemia early after renal transplantation,especially those complicated with reticulocyte deficiency,the possibility of PRCA caused by HPV B19 infection shall be considered.The results of bone marrow aspiration and fluorescent PCR are the main bases for diagnosing PRCA.Immunosuppressive agents reduction and application of IVIG are the major treatment measures.Most of patients have great prognosis after treatment,but this disease is likely to recur.

Objective To explore the characteristics of oxygen uptake efficiency (OUES) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and analyze the relationship between OUE and severity of disease.Methods Pulmonary function test,polysomnogram and cardiopulmonary exercise testing were performed in 35 patients with OSAHS and 25 age-matched healthy volunteers.Their successive breathing respiratory exchange parameters were collected and analyzed.And t and x2 tests were used for 2 sample comparison.Correlation analysis was performed by Pearson correlation test.Results Significant differences in peak VO2 and peak VO2 ％ pred existed between OSAHS and normal control groups [(18±4) vs.(28 ±6) L/min,P＜0.01;(68±14) vs.(84±16) ％,P＜0.01].Compared with normal control group [(2.3 ±0.5) L · min-1 · lg-1 ; (36 ±4) ml/L; (36 ±4) ml/L],OUES,OUEP and OUE@AT of OSAHS group [(1.8 ± 0.4) L · min-1 · lg-1 ; (31 ± 5) ml/L; (30 ± 5) ml/L] were significantly lower (t =3.78-4.49,all P ＜0.01).And OUES,OUEP and OUE@AT in OSAHS patients were correlated (r =0.53-0.67,all P ＜0.01) positively with exercise tolerance (peak VO2％ pred) while negatively with apnea hypopnea index (AHI) (r=-0.67--0.54,all P ＜0.01).Conclusion The oxygen uptake efficiency of patients with OSAHS is significantly reduced compared to that of normal subjects.And it is correlated negatively with severity of disease.

Objective To evaluate the effect of late course hypofractionated stereotactic radiotherapy (LCHSRT) on locally advanced non small cell lung cancer. Methods From October 1997 to June 1999, 106 patients with locally advanced non small cell lung cancer were randomized into conventional radiotherapy group (CRT) and LCHSRT group. Ninety one patients with complete data were analyzed including 43 patients in CRT group and 48 patients in LCHSRT group. In CRT group, 18 patients were staged Ⅲa and 25 Ⅲb; whereas 19 patients were staged Ⅲa and 29 Ⅲb in LCHSRT group. The initial median dose of 43.5?Gy was given in CRT group to the primary tumor, ipsilateral hilum and mediastinum using AP PA fields with 1.8 2.0?Gy per fraction, then 21.7?Gy was boosted to the residual primary and metastatic regional lymph nodes to the median total dose of 65.2?Gy. In LCHSRT group, after the first 44.4?Gy to the primary tumor, ipsilateral hilar region and mediastinum by AP PA fields with a dose fraction of 1.8 2.0?Gy, noncoplanar arc hypofractionated stereotactic radiotherapy was delivered to the residual primary and metastatic lymph nodes to the total dose of (22.8?5.5)?Gy with 4 7?Gy per fraction treated every other day. Results The radiation pneumonitis rates were 11.6% and 14.6% in CRT group and LCHSRT group, respectively. The radiation pulmonary fibrosis rates diagnosed by CT scan 6 months after radiotherapy were 48.8% and 66.7% in CRT group and LCHSRT group, respectively. The complete regression (CR) rates evaluated by CT scan 3 months after treatment in CRT and LCHSRT group were 30.2% and 63.5%, respectively ( P