Objective To discuss the treatment of cervical cancer in different stages.Methods The treat- ment of 42 cases of cervical cancer in this hospital from January 2000 to December 2005 was analysed,and clinical treatment modalities were analysed too.Results(1)A total of 6 cases of uterine carcinoma in situ received hysterec- tomy plus bilateral salpingo-oophorectomy.(2)A total of 26 cases was inⅠb-Ⅱa stage,of which 15 cases with cer- vical cancer were treated with a simple radical hysterectomy;6 cases of cervical cancer were radiotherapied after radi- cal hysterectomy;7 cases of cervical cancer received radical hysterectomy plus radiotherapy.(3)A total of 10ⅡbⅣstage eases selected radiotherapy and chemotherapy.Conclusion Different treatment should be applied in differ- ent stages of cervical cancer,and the choice for treatment is important for patients' quality of life after treatment. Comprehensive treatment can improve the survival of patients with cervical carcinoma.

Objective To propose a new classification scheme of otitis media (OM). Methods By reviewing current internat ional classification systems of OM, we analyzed their disadvantages and the prog ress made in histopathologic studies of OM, then worked out a new classification scheme to apply it to clinic. Results In current internati onal classification systems of OM, those apparent clinical signs are regarded as main standards of classification. Their main disadvantage is that these signs c annot very well indicate the condition of pathologic and functional changes of i mportant hearing structure areas. We proposed a “Three-stage Scheme” of OM cl assification and applied in 1 160 cases of OM. The accuracy rate of diagnosis w as 82.4% in 348 cases of early-stage OM, 98.4% in 696 cases of chronic OM, and 95.2% in 116 cases of OM sequela. Conclusion The “Three-s tage Scheme” system is scientific, simple and practical. Its accuracy rate of d iagnosis is very high. It plays a guiding role in diagnosis and treatment of OM.

OBJECTIVE:To know the utilization of essential medicines in outpatient department of Sichuan Shuangliu Maternal and Child-care Hospital,and provide reference for the rational drug use. METHODS:The types,names,formulations,consump-tion sum and utilization of essential medicines in the outpatient department of the hospital from 2012 to 2013 were statistically ana-lyzed and ranked. The affordability of top 10 drugs in the list of DDDs was evaluated. RESULTS:Compared with 2012,the con-sumption sum proportion of essential medicines in the outpatient department of the hospital in 2013 was increased by 5.80%. The top 10 essential medicines in the list of consumption sum were mainly anti-microbial drugs,anti-anemia drugs and Chinese patent medicines. The relative daily wages of Kangfuxin solution and Amoxillin and clavulanate potassium tablets were respectively 2.12 d and 2.05 d,with poor affordability,and in 2012,they ranked the 5th and 8th in the list of DDDs;the relative daily wages of Xiao-er changweikang granule and Xingpi yanger granule were respectively 2.28 d and 2.14 d,with poor affordability,and in 2013, they ranked the 8th and 10th in the list of DDDs. CONCLUSIONS:The utilization of essential medicines in the hospital is basical-ly good,with a trend of increasing. However,the similar essential medicines with lower prices should be considered when essential medicines are used in the clinic.

Objective To explore the bio-effects of high single-dose irradiation on MDA-MB-231 xenografts under the same radiation dose.Method Female BALB/c-nu mice bearing 8-9 mm MDA-MB-231 xenografts were randomized into 5 groups:0Gy group (blank control group),high single-dose 8Gy group (8Gy/one fraction/day),high single-dose 10Gy group (10Gy/one fraction/ day),conventional radiation 2Gy × 4 group (8Gy/4 fraction/4d),conventional radiation 2Gy × 5 group (10Gy/5 fraction/5d).The volumes of gross tumors on nude mice were observed every three days.The tumor growth curve of transplanted tumor were also drawn.The 18F -FDG PET/CT imaging of mice bearing MDA-MB-231 xenografts from all radiation groups were performed with detecting the Ki-67 expressions of tumor ceils by immunohistochemistry at 7days and 14days after final irradiation.Results Compared to control group,the tumor growth of all radiation groups were delayed after radiation,especially single high-dose 10Gy groups (P ＜ 0.05).At 7days and 14days after final radiation,the SUVmax (the maximal standardized uptake value) of xenografts in high single-dose groups was lower than that in conventional fractional groups (P ＜ 0.05) under the same radiation dose.And the percent of Ki-67 positive cells after high single-dose irradiation were less than fractioned irradiation at 7,14days after final radiation (P ＜ 0.05).Conclusion At the same dose,high single-dose irradiation inhibits the growth of MDA-MB-231 xenografts more than conventional fraction irradiation.PET/CT also could evaluated the early changes of proliferation activities of MDA-MB-231 breast cancer cells after irradiation.

Breast cancer is the most common disease in women worldwide, which not only threatened the women’s survival time, but also inlfuenced their quality of life as well. Within this challenge, it’s important to optimize the current multidisciplinary treatment stratagem for breast cancer. Radiotherapy is one of the most important treatment modality for patients with breast cancer, with the trend to shrink the irradiated volume and shorten the total fraction times in recent years. Intraoperative radiation therapy (IORT) as a fast and convenient procedure has the ability to deliver a high, single-fraction radiation dose to tumor beds with minimal exposure of surrounding tissues (lung, heart, etc.), which could be displaced or shielded right after the tumor removal during the surgical procedure. Right now, IORT has been either integrated as a boost technique in multimodal approaches using postoperative EBRT in the treatment of early breast cancer patients undergoing breast conservation surgery or used as a single dose accelerated partial breast irradiation technique for these patients. This review discussed the rationale of IORT, the beneifts and limitations of IORT, the indication and the clinical results of this procedure, including treatment related side-effects as well in order to provide the preliminary evidence based approach for early breast cancer patients.

Objective To observe the clinical features and treatment outcomes of presumed tubercular retinal vasculitis.Methods This is a retrospective non-comparative interventional clinical research.A total of nine patients (11 eyes) with major presentation of retinal vasculitis were included in this study.Patients first consulted the eye clinic and were diagnosed presumed tubercular retinal vasculitis.The patients,seven males and two females,aged from 19 to 66 years,with an average of 43.89 years.The time interval from symptoms to diagnosis ranged from two weeks to six months with an average of 76.27 days.Visual acuity,slit lamp ophthalmoscopy,fundus fluorescein angiography (FFA),optical coherence tomography (OCT),hematological and tuberculosis related investigations were examined and analyzed.All patients had standard anti-tuberculosis treatment.Treatment outcomes were followed for six to 37 months with an average of 14.11 months.Results Baseline visual acuity ranged from hand movement to 0.8 with an average of 0.28.Among 11 eyes,six presented mild to moderate vitritis,five presented as retinal vein occlusion with no obvious vitirits.Fundus examination showed six cases with retinal hemorrhage,four cases with macular edema,two with macular epiretinal membrane,and two with vitreous hemorrhage.FFA revealed 11 cases with leakage of vessels,11 with nonperfusion area,four with macular edema,three with retinal neovascularization,and two with choroidal lesions.OCT of nine eyes suggested six eyes with retinal edema,three with macular edema,three with macular epiretinal membrane.TST of seven patients were all strong positive.T-SPOT.TB of four patients were all positive.Three of eight patients who had chest X-ray or chest CT were suggested tuberculosis infection.Four to six weeks after the start of anti-tuberculosis treatment,vitritis,exudates,retinal and macular edema subsided.During follow up,inflammation was stable with no recurrence observed.The visual acuity of last follow-up ranged from 0.15 to 0.8 with an average of 0.51.Conclusions The main presentations of presumed tubercular retinal vasculitis are vitritis,retinal vein occlusion,and retinal hemorrhage.Standard anti-tuberculosis treatment can improve inflammation and retinal hemorrhage.

Objective To analyze the demand for home care service and its influential factors among elderly in Tianjin city.Methods A total of 254 residents aged 60 and above from Tianjin city were investigated with a self-designed questionnaireDemand for Home Care Service,Katz index of independence in Activities of Daily Living(ADL) and Lawton Instrumental Activities of Daily Living (IADL) scale.Results The mean score for home care service has been revealed (2.40±0.67),as the ranking demonstrated:public welfare (3.61±1.04),social participation (2.69±1.32),medical service (2.56±0.90),rights safeguard by law (2.37±1.54),mental need (2.26±0.99),and need for daily life care (1.73±0.69).Multiple linear regression analysis showed that income,education level,activity of daily living and the convenience degree of seeking treatment were major factors affecting demand for home care service among elderly,which explained 16.3％ of the variance.Conclusions Oriented by demand,further progress shall be achieved multidimensionally,under which circumstances,individualized service ought to be de-livered.Simultaneously,the vulnerable elderly groups require more attention.

Objective To explore the change of 25 hydroxyvitamin D level and its correlation with glucose metabolism and bone mineral density in elderly men with type 2 diabetes mellitus(T2DM).Methods Hospitalized 53 elderly male patients with T2DM (T2DM group) and 51 patients without T2DM (NDM group) were chosen.Blood.biochemical indexes and 25 hydroxyvitamin D level were measured.Bone mineral density of lumbar (L2_4),left proximal femur was measured by dual energy X-ray.Results The serum 25 hydroxyvitamin D level in T2DM group was lower than that in NDM group [(12.38 ±5.12)μg/L vs.(17.35 ± 5.52) μ g/L],and there was significant difference(P＜ 0.05).The serum 25 hydroxyvitamin D level was negatively associated with fasting blood glucose level and glycosylated hemoglobin (r =-0.225,-0.499,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with fasting insulin and homeostasis model insulin resistance index (r =-0.050,-0.082,P ＞ 0.05).The incidence of osteoporosis in T2DM group was higher than that in NDM group [30.19％(16/53) vs.11.76％(6/51)],and there was significant difference (P ＜0.05).The serum 25 hydroxyvitamin D level was positively associated with bone mineral density of femur neck,greater trochanter of femur and Ward triangle(r =0.773,0.762,0.812,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with bone mineral density of lumbar (L2_4)(r =0.116,P ＞ 0.05).Conclusions The prevalence of vitamin D deficiency is found in elderly men with T2DM.Vitamin D level can affect blood glucose control and increase the risk of the occurrence of osteoporosis.Therefore,T2DM patients,especially elderly patients,should be routine vitamin D testing.Vitamin D supplementation to the patients of vitamin D insufficiency in time may be beneficial to glucose metabohsm and the prevention and treatment of osteoporosis.

Objective To evaluate the value of serum tumor markers in diagnosis of over 80 years old patients with colorectal cancer.Methods Serum CA199,CA242 and CEA of 68 cases senile patients with colorectal cancer and 35 cases senile patients with benign large intestinal diseases were detected by ELISA.Results Serum levels of CA199,CA242 and CEA in patients with colorectal cancer were (37.95 ± 15.95 ) U/ml,( 50.08 ± 24.20 ) U/ml,( 22.34 ± 17.35 ) μg/L respectively and were significantly higher than that in patients with benign large intestinal diseases CA199 ( 10.73 ± 6.27 ) U/ml,CA242 ( 8.00 ± 3.52 ) U/ml,CEA(2.32 ± 1.01 )μg/L.In addition,the level of these three markers was increased with the progress of colorectal cancer and the sensitivity of diagnosis was related with the stages of colorectal cancer.Parallel combined testing methods increased the diagnostic sensitivity to 83.6％,and serial combined testing increased the diagnostic specificity to 88.7 ％.Conclusions Serum tumor markers showed certain values in the diagnosis of the senile patients with colorectal carcinoma.Furthermore,the combined determination of tumor markers is helpful for early diagnosis of colorectal cancer and increases the sensitivity and specificity in diagnosing of colorectal carcinoma.

Invasion and metastasis are critical determinants on cancer morbidity.Genes and molecules participating in these steps have been demonstrated as potential prognostic factors.Growth factors and their receptors,cell-cycle regulators,cell-adhesion molecules and m trix-degrading enzymes are potentially used as prognostic factors.However,increased understandings for molecular mechanisms underlying carcinogenesis and its implementation in the treatment of gastric cancers have recently been focused on the development and incorporation of targeted agents with chemotherapy.