Fouty-four patients with craniopharyngioma were admitted trom Junuary 1982 to February 1993 for post-operative radiotherapy. The 5-year survival was 78.9%. Among these 44 patients, 15 were adults and 29 were children. The children gave a higher 5-year survival rate but poorer quality of life as compared with the adults though without statistical significance in the survivals. Among the children, a dose of 56.1～60.0Gy gave better survival as compared with the 45～56Gy group without significance though causing obviously sequelae, eg: amenorrhea and hampered sex development (P

Purpose:To investigate the clinical applicati on and curative effect of salvage treatment for primary recurrence after definitiv e radiotherapy in patients with laryngeal cancer. Methods:52 patients with laryngeal cancer receiving definitive radiotherapy in the Cancer Center of Sun Yat-sen University between 1990 and 19 95 were reviewed retrospectively. Among them, 17 patients presented with primary recurrence. Salvage treatment after radiotherapy failure included palliative ch emotherapy (5 cases) and surgical salvage (12 cases). 6 patients were salvaged b y partial laryngectomy and 6 patients by total laryngectomy. SPSS 10.0 software was used to analyze the effects, complications and the differences between diffe rent salvage treatments. Results:The overall 3- and 5-year cumulative survival rates a fter salvage treatment for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy were 56.3% and 37.5% respectively. The patient s receiving palliative chemotherapy after radiotherapy failure survived between 8 and 26 months. The 3- and 5-year cumulative survival rate in patients receiv ing surgical salvage were 75% and 50% respectively. There was significant differ ence between them analyzed by Kaplan-Meier (Log Rank=8.14, P=0.004 3). More over, the 5-year survival rates in patients salvaged by partial laryngectomy an d total laryngectomy were all 50% and there was no statistical difference betwee n them (Log Rank=0.08, P=0.7782). 5 out of 12 (41.7%) patients salvaged by s urgery presented complication after surgery, mainly infection after surgery (25 %) and pharyngocutaneous fistula (25%). Conclusions:Surgical salvage for primary recurrence in patients with laryngeal cancer receiving definitive radiotherapy could be effective.Part ial laryngectomy could be used for early primary lesion (T 1 and T 2) in patie nts with primary recurrence. The complications after salvage surgery were mainly were infection and pharyngocutaneous fistula.

Based on summing up the mainstream opinion of the reasons of the failure of medical health reform and analyzing typical cases,this article promulgates the following content.The medical health reform' s failure are due to the clinical decision-made in seeking interest and the health policy of exuding the commercialization.The forming mechanism is the two reasons work together.The essence is the medical health service is not suited to people's healthy demand which grows day by day and the level of economic development.This refracts the absentation of the government responsibility ethics,which does not present or work.The basic goal of the medical health service to maxi mize the public benefit,which is the dominant value orientation in the medical health service.Certainly it is also the right orientation of the government responsibility ethics in medical health reform.

Objective To perform the main application of MRI arterial spin labeling (ASL) in cerebral blood flow (CBF) on hippocampus of patients with temporal lobe epilepsy for quantitative measurement,to assess the relationship between temporal lobe epilepsy occurrence and hippocampal perfusion and to explore the critical value of hippocampal CBF predict the temporal lobe epilepsy early.Methods Forty-two subjects by video EEG (VEEG) and conventional MR sequences screend were divided into 3 groups eventually,namely group of healthy control,the group with one temporal lobe abnormal discharge,that conventional MRI in hippocampus is not abnormal and the last group with one side hippocampus sclerosis confirmed by conventional MRI in temporal lobe epilepsy patients,then for the hippocampal 3D ASL examination.We provided six same size regions of interest (ROI) in the hippocampal head,body,tail respectively with the best level display to measure and record bilateral hippocampal cerebral blood flow values (CBF values) of every subject,and to explore the relationship between the cerebral blood flow value in the hippocampus and temporal lobe epilepsy.Results Mean cerebral blood flow (CBF) value of each subject's unilateral hippocampus was calculated.The average CBF value of the hippocampus in the healthy control group was 53.82 ± 0.98ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral abnormal discharge group with the ipsilateral and contralateral were 49.12 ± 5.31ml/(100g · min) and 55.99 ± 1.65ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral hippocampal sclerosis group with the ipsilateral and contralateral were 39.57 ± 2.08ml/(100g · min) and 48.06 ± 1.74ml/(100g · min).Then pairwise comparison of the unilateral hippocampal average CBF value among the 3 groups of experimenters in different groups was performed.The results showed that in the eight times,the first six times had statistically significant differences.Comparing between the healthy control group and epilepsy unilateral temporal lobe abnormal discharge group,to calculates the best critical point by the ROC curve,the cut-off value was 46.76.Conclusion Magnetic resonance arterial spin labeling (ASL) technique can evaluate the cerebral blood flow in the hippocampus of patients with temporal lobe epilepsy by quantitative measurement of hippocampal CBF value.The changes of hippocampal perfusion in patients with temporal lobe epilepsy should be preceded by the changes of imaging.ASL quantitative measurement of hippocampal CBF value is helpful for early diagnosis and treatment of temporal lobe epilepsy.

Objective To explore the curative effect of extracorporeal lipoprotein filter from plasma Delipid Plus(DELP) system therapy on acute cerebral infarction(ACI). Methods 36 patients with ACI were divided into DELP group (12 cases) and control group (24 cases). All of them received basic treatment including Aspirin and Pravastatin sodium etc. The DELP group also treated by DELP therapy twice. The scores of National Institute of Health Stroke Scale (NIHSS),Barthel Index (BI) and Modified Rankin Scale (mRS),and the levels of plasma fibrinogen (Fib),blood lipid and the indexes of hemorheology were compared pre and post treatment in the two groups.Results The reduction value of NIHSS between pre and post treatment in DELP group was bigger than this in control group(P

0.05).(2)The plasma GMP-140 levels of both groups was remarkably increased immediately and a decreased trend 24 h after PCI,but did not return to normal(P

Purpose: To evaluate the influence of lung corrections on the target volume dose in radiation treatment of esophageal carcinoma by TPS HEVAPLAN. Materials and Methods: Three radiation field technique to middle esophagus were used as the model of this investigation .target volume doses were calculated with photons in different energies to compare with the divergence when the lung density were set to 1.0(without lung correction) 0.33 and 0.2 (with lung correction).Results: If no lung correction was performed, the actual radiation dose in target volume were 24%～28%, 18%～21%, 13%～15% and 7%～9% which were radiated with 60 Co, X-ray of 5MV, 8MV and 19MV. Conclusion: The lung density must be corrected in treating 60 Co unit.

The treatment of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is difficult in ICU. In addition to traditional methods, immunologic therapy has been used recently to treat SIRS and MODS through adjusting inflammatory responses and redressing abnormal responses. This article reviews the progress in treatment of SIRS and MODS,including blocking inflammatory activation, modifying the activation of inflammation, giving gene therapy and combination therapy of TCM and western medicine.

5 ml groups were 95.5% and 81.1% respectively. This difference was statistically significant (P5 ml groups were 4.5 % and 32.1%, respectively (P50 Gy was increased statistically, but the occurrence of complications was also increased. Conclusions Stereotactic radiosurgery improves the outcome of the elderly patients with brain metastases. Radiation dosage and tumor volume are significantly related with the therapeutic efficacy and the occurrence of complications.

Objective To evaluate the radiation method and resuh of 450 patients received TBI(total body irradiation).Methods Single-dose Measurement was used to mark dose of TLD(thermo luminescence dosimeter).The values of actual dose in body midline were evaluated by calculating and correcting mean dose of incidence and emergence.Radiation methods:In four-field Irradiation.diagonals of fields coinside with the longitudinal axis of the patients,patient in supine and lateral positions received two pairs of parallel opposite radiation.Scheme of TBI came from a preparative radiation about one week before,and this four-field and equal-in-dose(about 10%of TBI)preparative radiation offered US the optimal scheme with aminimal dose non-uniformity by adjusting different dose proportion of supine and lateral position.In small field irradiation,patients received one pair of parallel opposite radiation from lateral side sitting on a special stool with backrest,the stool can be rotated CW or CCW,pedals can be move forward or backward and fixed.In opposite lateral irradiation,similar to four-field irradiation,patients received one pair of horizontal opposite radiation only in supine position.Five of these patients received FTBI(Fractional TBI). Results The average non-uniformity in midline of patients in four-field irradiation group(87 patients).small field irradiation group(91patients)and opposite lateral irradiation group(272 patients)is respectively ±8.1%,±7.4% and ±4.9%. Conclusions It iS a important process for QA and Qc to measure the dose of incidence and emergence real-timely with TLD or semiconductor dosimeter.We can adopt small field irradiation when the field iS not large enough to contain the patient from head to foot,and it showed advantages over four-field irradiation in treatment process and outcomes.We found the uniformity in body midline would be much better in supine position with diagonal＞180 cm than that in four-field irradiation and small field irradiation with diagonal＜110 cm.We compared supine position irradiation with opposite lateral irradiation,only to find which has its strong point.And actually we considered that FTBI treatment booth can be used more often in anterior and posterior parallel fields irradiation,patient semi-sitted,repeatedly received forward and backward radiation. In spit of not possessing radio-biological advantages as FTBI,STBI(Single TBI)is still a practical form of TBI.