Objective To investigate the clinical efficacy and side effects of sequential and concurrent chemoradiation in the treatment of colorectal cancer.Methods 90 patients with colorectal cancer were divided into ⅡAof 21 cases (Ⅱa group),Ⅲa of 24 cases (Ⅲa group),Ⅱb of 23 cases (Ⅱb group),Ⅲb of 22 cases (Ⅲa group) according to the stage of the disease.Group Ⅱa and Ⅲa were treated by sequential chemoradiation therapy,Ⅱb group and Ⅲb group were treated by concurrent chemoradiation therapy.The clinical efficacy and toxicity were observed and compared.Results All patients were followed up at 1 and 3 years,no one lost and died.1-year and 3-year OS and PFS between group Ⅱa and group Ⅱb had no significant differences (P ＞ 0.05).1-year OS had no significant difference between Ⅲa group and Ⅲb group (P ＞ 0.05),1-year PFS,3-year OS and PFS had significant differences (x2 =3.993,4.224,4.304,all P ＜ 0.05).The incidence rate of toxicities between Ⅱa group +Ⅲa group (28.89％) and group Ⅱb+ Ⅲb (51.11％) had significant difference (x2 =4.629,P ＜ 0.05) ; while for each system specific incidence rate of side effects had no significant difference (P ＞ 0.05).Conclusion Compared with sequential chemotherapy in the treatment of colorectal cancer,concurrent chemoradiotherapy can effectively prolong overall survival and progression-free survival time,and can reduce the costs of treating,although increasing the treatment toxicity,but still within the acceptable range of patients,it has better application value in clinical.

Objective: To investigate the factors related to the of disc displacement in temporomandibular joint disorder(TMD). Methods: The angles of disc anterior displacemen were measured on arthrography of temporomandibular joints in 90 patients with TMD, then the relationship between the angles and symptoms, signs, condyle positions, osteoarthrosis and mouth opening degree were analysed. Results: ①AOB angle in the patients with reducibility of anterior disk displacement(ADwR) was smaller than in those with non reducible anterior displacement (ADw/oR); ②Patients suffered from chronic ADw/oR had smaller degree of mouth opening and larger disc displacement than those with ADwR's. Conclusion: The disc anterior displacement and condyle displacement in glenoid fossa may be correlated with articular remodeling.Prolonging coursees may not always result in the changing of disc structures.

Objectives: To investigate the occlusion features in thre e dimensions in patients with temporomandibular disorders(TMD). Methods: Occlusal casts were obtained from 23 asymptom volunteers and 101 TMD pati ents and were analyzed in three dimensions by scores vertically, mesio-distally and labial-or buccal-lingually. Bilateral TMJs of each TMD patient was examin ed with Schuller's radiograph and tomograph, the sounding TMJs were examined wit h arthrography. The relationship between occlusion scores and the changes shown in X-ray images were analyzed. Results: 66.3% TMD patients had abnormal occlusion in vertical direction.Abnormal occlusion in vertical directio n was correlated with TMD symptoms(P 0.05 ). Conclusion: Abnormal occlus ion in vertical direction is correlated with TMD symptoms.

Objective To evaluate the application effect of evidence-based nursing in reducing ventilator-associated pneumonia (VAP) of patients with severe head injury. Methods 100 patients with severe head injury using mechanical ventilation were randomly divided into the control group and the observation group with 50 patients in each group.The observation group explored evidence from nursing of ventilator tube,oropharyngeal and sound sects care,airway care,balloon sleeves care to prevent biofilm on the endotracheal tube(ETT-BF) to fall off,enteral nutrition care,decubitus care,ward environment and the hand disinfection of medical staff and was given evidence- based nursing.The control group took routine care.The incidence of VAP,off-line time and mortality rate of the two groups were compared during the same time period. Results The incidence of VAP,off-line time,mortality rate showed significant difference between the two groups.The observation group showed better effect. Conclusions Implementation of evidence-based nursing can significantly reduce the off-line time of patients with severe traumatic brain injury using mechanical ventilation.It can decrease the incidence of VAP and mortality rate,improve the prognosis and reduce medical cost.

Objective To evaluate the effect of neoadjuvant chemotherapy on advanced gastric cancer before laparoscopic radical gastrectomy.Methods 46 advanced gastric cancer cases in our hospital from January 2010 to January 2013 were included in experimental group who were given two courses of neoadjuvant chemotherapy with FOLFOX regimen prior to surgery,the responsives (38 cases) received two more courses of neoadjuvant chemotherapy before surgery,and those in whom the chemotherapy was judged as ineffective (8 cases),received radical gastrectomy 21 days later.As a control,36 diseasematched cases went on upfront surgery without neoadjuvant chemotherapy.All these 82 cases underwent successful laparoscopic gastrectomy.Results The overall effective rate of neoadjuvant chemotherapy was 59％.Before the operation,the differences of pathological staging between the two groups were significantly different; The difference in operation time,the intraoperative blood loss and harvested lymph node number between the experimental group and control group was not statistically different (P ＞ 0.05).The R0 resection rate in experimental group (63％) was higher than in the control group (36％),P ＜0.05.The recurrence rate and mortality rate in experimental group was lower than that in the control group,P ＜ 0.05.Conclusions In advanced gastric carcinoma preoperative neoadjuvant chemotherapy significantly improved the resection rate and reduced postoperative recurrence and mortality rate.

Background Conjunctivochalasis (CCh) is a common age-related ocular surface diseases.Researches showed that the inflammatory factors are upregulated in conjunctiva and tear of CCh patients,inferring inflammation participates in the pathogenesis of CCh,however,its mechanism is unclear now.Studies also showed that the expression of matrix metalloproteinases (MMPs) in CCh conjunctiva is elevated.However,the association between inflammatory factors and MMPs is unknown.Objective This research was to observe the effects of tumor necrosisfactor-α (TNF-α) and interleukin-1 β (IL-1 β) on the expression of MMP-1,MMP-3,tumor necrosis factor-stimulatedgene-6(TSG-6) and pentraxin-3 (PTX3) in cultured CCh fibroblasts.Methods Conjunctival fibroblasts wereisolated and cultured from CCh-derived and cataract-derived human conjunctiva explants.The cells were treated using20 ng/ml PBS,TNF-α or IL-1β for 4 hours,respectively.The expression levels of MMP-1,MMP-3,TSG-6 and PTX3genes and proteins were detected by quantitative real time PCR and Western blot assay,respectively.Results Thesecond-generation cells showed a long and fusiform shape with ovoid nucleus and radial agreement,and the cellprocessors connected each other.The differences of the relative expression levels of MMP-1,MMP-3,TSG-6 and PTX3mRNA in the cells were significantly different between CCh group and cataract group after being treated by PBS,TNF-αand IL-1 β (MMP-1 mRNA:Fgroup =2.611,P =0.116;Fi =161.564,P =0.000;MMP-3 mRNA:Fgroup =5.201,P =0.029;Fintervene =211.021,P =0.000;TSG-6 mRNA:Fgroup =47.209,P =0.000;Fintervene =119.340,P =0.000;PTX3 mRNA:Fgroup =40.512,P =0.000;Fintervene =93.935,P =0.000).Compared with the cataract group with PBS treatment,the expression levels of MMP-1,MMP-3,TSG-6 and PTX3 mRNA were significantly elevated in the CCh group with PBS treatment or the cataract group with TNF-α and IL-1 β treatment (all at P＜0.05).Compared with the CCh group with PBS treatment,the expression levels of MMP-1,MMP-3,TSG-6 and PTX3 mRNA were significantly elevated in the CCh group with TNF-α and IL-1β treatment (all at P ＜ 0.05).The differences of the relative expression levels of MMP-1,MMP-3,TSG-6 and PTX3 proteins in the cells were significantly different between CCh group and cataract group after being treated by PBS,TNF-α and IL-1 β (MMP-1:Fgroup =84.702,P =0.000;Fint =48.900,P =0.000;MMP-3:Fgroup =112.818,P =0.000;Fint =194.980,P =0.000;TSG-6:Fgroup =56.867,P =0.000;Fint =70.356,P =0.000;PTX3:Fgroup =1.488,P =0.231;Fint =89.872,P =0.000),and the expression changes of MMP-1,MMP-3,TSG-6 and PTX3 proteins were coincident with the genes among the groups with various treatments.Conclusions The expressions of MMP-1,MMP-3,TSG-6 and PTX3 in conjunctival fibroblasts are upregulated in CCh eyes.The interaction of TNF-α and IL-1 β with MMPs is probably involved with the pathogenesis and development MMPs probably.

Objective To compare the transplant-related toxicity and the efficacy of busulfan/fludarabine (Bu/Flu) and busulfan/cyclophosphamide (Bu/Cy) as conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia(AML) in the first complete remission (CR1).Methods Totally 32 AML-CR1 patients underwent allo-HSCT were divided into Bu/Cy (Bu 3.2 mg· kg-1 · d-1,7-4 days before transplantation; Cy 60 mg · kg-1 · d-1,3-2 days before transplantation) and Bu/Flu (Bu 3.2 mg · kg-1 · d-1,5-2 days before transplantation; Flu 30 mg · m-2·d-1,6-2 days before transplantation) groups.The regimen-related toxicity (RRT),incidence and severity of graft-versus-host disease (GVHD),3-year cumulative relapse rate,non-relapse mortality (NRM),3-year event-free survival (EFS) rate and overall survival (OS) rate were compared between the two groups.Results The median follow-up duration was 617.5 (6-1261) days.All patients achieved successful engraftment on 30 day after transplantation.There were no significant differences in the median time to neutrophil engraftment (P =0.121) and platelet engraftment (P =0.171) between the two groups.The median duration of neutrophil count under 0.1 × 109/L and platelet count under 20 × 109/L in the Bu/Cy group were significantly longer than those in the Bu/Flu group (P =0.000 and P =0.047).The incidence of grades Ⅱ-Ⅳ RRT were 68.8％ and 25.0％ (P =0.032) in the Bu/Cy and the Bu/Flu groups,respectively.There were no significant differences in the incidence of acute GVHD (P =0.149),chronic GVHD (P =0.149),incidence of NRM (P =0.333),3-year cumulative relapse rates (P =0.834),3-year EFS rate (P =0.362) and OS rate (P =0.111) between the two groups.Conclusion Compared with Bu/Cy,Bu/Flu is a myeloablative condition regimen with milder bone marrow suppression and lower RRT incidence rate in allogeneic HSCT for AML-CR1 patients without compromising the efficacy.

ObjectiveTo investigate the therapeutic effects of the conditioning regimen with or without total body irradiation on allogeneic hematopoietic stem cell transplantation in acute leukemia.Methods We retrospectively evaluated clinical outcomes in 287 allo-HSCT recipients with acute leukemia (ALL- 105,AML-129,and AUL-53) who received myeloablative conditioning regimen with or without total body irradiation from January 2002 to August 2011.Two hundred and six patients obtained complete remission (CR) and 81 non-remission (NR) before transplantation.One hundred and ninety-nine patients received conditioning with total body irradiation (TBI+ Cy group,9 Gy given over 2 days),and 88 patients received busulfan (BuCy group,3.2 mg·kg-1 ·d-1 ),both followed by cyclophosphamide.ResultsThere were no statistically significant differences in hematopoietic reconstitution,regimen-related toxicity (RRT),graft-versus-host disease (GVHD) and relapse between two groups.For patients with AML and AUL,there was no significant difference in the 5-year survival between the two regimens (P＞ 0.05),while for ALL-CR patients,the TBI + Cy regimen had a higher over survival rate (52.0％ vs.31.3％,LogRank=4.249,P＜0.05) and DFS (50.4％ vs.27.8％,LogRank =4.445,P＜0.05) than BuCy.In TBI + Cy group and BuCy group,the proportion of CD19+ B cells at the first month after HSCT was (4.04 ± 1.86)％ and (1.47 ±0.99) ％ (P＜0.05),that of NK cells at 12th month after HSCT was (23.38 ± 12.19) ％ and (13.11± 7.99) ％ (P＜0.05),and that of CD4+ CD45RO+ cells at 9th month after HSCT was (14.63 ±6.17)％ and (9.07 ± 3.12)％ (P＜0.01),respectively.ConclusionUsing TBI-containing regimen was more effective for treating ALL-CR patients than busulphan-containing regimen,but no difference was found for long-term outcomes in patients with AML and AUL between the two regimens.The 9 Gy TBI-based regimens may not affect recipients' thymic function,T-cells reconstitution and immune tolerance,coming out a non-increase of GVHD.

Objective To investigate the value of CEUS in differential diagnosis of benign and malignant renal focal hyperechoic lesions.Methods Data of conventional ultrasound (US) and CEUS of 56 patients with single renal focal hyperechoic lesion were retrospectively analyzed,and differential diagnosis of benign and malignant lesions was performed with US and CEUS,respectively.Taking pathological diagnosis as golden standard,the diagnostic efficacy of US and CEUS were calculated and compared.Results The sensibility,specificity,positive predictive value (PPV),negative predictive value (NPV) and accuracy of US was 70.00％ (14/20),75.00％ (27/36),60.87％ (14/23),81.82％ (27/33) and 73.21％ (41/56),while of CEUS was 80.00％ (16/20),94.44％ (34/36),88.89％ (16/18),89.47％ (34/38) and 89.29 ％ (50/56),respectively.The accuracy,specificity and PPV of CEUS were higher than those of US (all P＜0.05).The consistency of CEUS and pathology was good (Kappa=0.761),while of US and pathology was ordinary (Kappa=0.435).Conclusion CEUS can improve differential diagnostic efficacy of renal focal hyperechoic lesions.