Purpose:To evaluate the therapeutic effects of 3-D conformal radiotherapy(3D-CRT) and concurrent chemotherapy in advanced non -small-cell lung cancer(NSCLC). Methods:38 stage Ⅲ NSCLC patients were given radio therapy to a total dose of 75~80 Gy(5-10 Gy/fraction;8-10 fractions)by using SCRT.And ea ch patient was given four cycles of concurrent chemotherapy(vinorelbine 25 mg/m ~2 on Days1,8;cisplatin 80 mg/m~2 on Days1;21 days for one cycle). Results:The response rate was 92.1%,of which 16 complete respo nders and 19 partial responders .The survival rate was 74.53%at 1 year, 37.45% at 2 years,the median survival time was 16 months. Conclusions:Stereotactic conformal radiotherapy and concurrent chemotherapy,as described here,is a well tolerated regimen with acceptable toxic ity.More effective treatment schemes are required to improve local disease contr ol and overall survival.

Objective To study the dynamic changes and potential impacts on the voice in postoperative pa-tients with different types of thyroid operation.Methods A total of 48 cases thyroidectomy,34 with thyroid isth-mus and lobectomy and 4 with total thyroidectomy,and 19 cases neck operation were included in this study for the examinations of electric laryngoscope,and acoustic voice analysis preoperative and postoperative,respectively.The characteristics of the acoustic parameters were analyzed.Results Vocal cord paralysis and cricothyroid joint disloca-tion in all the patients before and after operation were not observed.For male patients in the experimental group, postoperative parameter values of F0TD were higher than the day before surgery and 30 days after thyroidectomy. The difference was statistically significant (P <0.05 ).In female patients,postoperative parameter values of F0 were lower than the day before surgery and 2nd,7th,and30th day after thyroidectomy.Postoperative parameter values of Jitter for 30th day were lower than 1st day after the operation.The postoperative parameter values of F0TD for 1st,2nd,3rd,and 7th day were higher than the day before thyroidectomy.The parameter value of F0TD was lower than 1st day after surgery,and the postoperative parameter value of HNR for 30th day was lower than 3rd day after the thyroidectomy.The difference was statistically significant (P <0.05 ).Compared to the control group,there were no significantly differences in male patients of experimental group before and after the surgery(P >0.05).The parameter values of F0 in famale patients before the thyroidectomy,the 1st,2nd,3rd,7th day after the surgery and the parameter value of Jitter,Shimmer,HNR for 1st day after the operation were significantly dif-ferent(P <0.05).There were no significant differences in all parameter value of 30 days after thyoidectomy(P >0. 05).Conclusion Voice parameter values alter in a way after thyroid surgery without apparent recurrent laryngeal nerve injury,especially in the female patients.The improvement of voice acoustic parameters can be observed on the 30th day after operation.

Objective To investigate the relationship between the plasma NT-pro BNP level and the hear function in children pa-tients with heart failure.Methods 30 children patients with heart failure and 30 healthy children were selected as the patients group and the control group respectively.The plasma NT-pro BNP level was detected in the patients group before and after treatment and the control group.The changes of heart functional indexes and the clinical symptoms in the patients group were detected,the detec-tion results and the plasma NT-pro BNP levels were performed the correlation retrospective analysis.Results The plasma NT-pro BNP level before treatment in the patients group was significantly higher than that in the control group,there was the statistically significant difference between them(P <0.05 ).After treatment,the clinical symptoms in the patients group were obviously im-proved,the plasma NT-pro BNP level was significantly decreased and LVEF by ultrasound was also increased,the differences were statistically significant(P <0.05).The plasma NT-pro BNP level after treatment in the patients group was obviously higher than that in the control group with statistical difference between them(P <0.05).The plasma NT-pro BNP level before and after treat-ment in the patients group demonstrated a negative correlation with LVEF(r=-1.32,r=-1.78).Conclusion Detecting the plas-ma NT-pro BNP level in children patients with heart failure has the important clinical guidance significance for the diagnosis,disease condition evaluation,prognostic evaluation and cardiac function grading in the children patients with heart failure.

Objective To study the drug resistance situation of Mycobacterium tuberculosis strains isolated from the patients with HIV/AIDS complicating tuberculosis (TB).Methods One hundred and ninety-six inpatients with AIDS complicating TB in our hospital from January 2012 to December 2015 were collected.The drug resistance situation of Mycobacterium tuberculosis strains cultured from sputum/tissue fluid/fiber liquid and pathological tissue submitted samples in the patients with AIDS complicating active TB was analyzed.The BACTEC MGIT960 systems was adopted to perform the bacterial identification.The drug sensitivity test was conducted by using 960 culture testing system.Results One hundred and ninety-six strains of Mycobacterium tuberculosis were cultured,the total drug resistance rate of Mycobacterium tuberculosis was 26.02％.These cases were divided into the ＞100/μL and ≤100/μL groups according to different CD4+ T cells count.The drug resistance situation of Mycobacterium tuberculosis to 4 kinds of first line anti-TB drugs were compared between these two groups.The comparison results found that the resistance rate of Mycobacterium tuberculosis strains to the first line anti-TB drugs had no statistical difference between the two groups (P＞0.05).The resistance rates of first line anti-TB drugs from high to low were isoniazid,rifampicin,streptomycin and ethambutol.The drug resistance rate of Mycobacterium tuberculosis strains to 5 types of drug resistant TB had no statistical difference(P＞0.05).Conclusion The drug resistance rate in the initial patients with HIV complicating TB is consistent with the average initial drugresistance level of TB patients in our country.The TB drug resistance rate in the patients with HIV complicating TB has no correlation with CD4+ T cells count.

Objective To compare the difference of immune responses to hepatitis B virus (HBV) vaccine in human immunodeficiency virus (HIV)-1-infected patients with different CD4+ T-lymphocyte counts.Methods HIV-1-infected patients who visited clinic at the Public Health Clinical Center of Chengdu were enrolled and divided into two groups according to CD4+ T-lymphocytes counts.CD4+ T-lymphocytes ＜200/μL,which were and ≥200/μL.All patients were injected intramuscularly with 20 μg of HBV vaccine at month 0,1 and 6,respectively.Vaccination responses were measured at1 and 7 months after first dose.The serum anti-hepatitis B sarface antigen titers of ≥ 10 mIU/mL were considered positive.The serum anti-HBs positive rates was compared by Chi-square test and anti-HBs titers was compared by Mann-Whitney test.Results Ninety-five HIV-1-infected patients were finally enrolled into the analysis,with 55 patients in group of CD4+ T-lymphocytes ＜200/μL and 40 patients in group of CD4+ T-lymphocytes ≥200/μL.The serum anti-HBs positivity rates at 1 and 7 months after first dose in group of CD4+ T-lymphocytes ＜200/μL were 40.0％ (22/55) and 50.9％ (28/55),respectively,which were 47.5％ (19/40) and 75.0％ (30/40) in group of CD4+ Tlymphocytes ≥200/μL.There was no significant difference of serum anti-HBs positivity rates between two groups after 1 month (x2 =5.652,P=0.017).But a significant higher positivity rate was found in group of CD4+ T-lymphocytes ≥200/μL than in group ofCD4+ Tlymphocytes＜200/μL after 7 months (x2=0.531,P=0.466).The median titers of anti-HBs at 7 months were 10.44 mIU/mL in grouP of CD4+ T-lymphocytes ＜ 200/μL and 222.73 mIU/ml in group of CD4+ T-lymphocytes ≥200/μL.There was significant difference of anti-HBs titers between two groups (Z=-3.600,P＜0.01).No patients experienced side effects to HBV vaccine.Logistic regression model analysis indicated that only CD4+ Tlymphocytes was related to anti-HBs positivity after HBV vaccination.Conclusions HIV-1-infected patients with CD4+ T-lymphocytes ≥200/μL have higher serum anti-HBs positivity rates and higher anti HBs titers than patients with CD4+ T-lymphocytes ＜200/μL.However,patients with CD4+ T lymphocytes ＜200/μL also have relatively low immune response.Thus,HBV vaccination should be conducted in all these patients at high risk.

BACKGROUND: Many study results proved that electroacupuncture can cause change of endogenous opioid peptide system.OBJECTIVE: To observe the change of blood sugar and blood lipoprotein (a) in rats with diabetes mellitus after electroacupuncture therapy and probe into the effect of opioid peptide system in the treatment for diabetes with electroacupuncture.DESIGN: Randomized controlled trial with experimental animals as the subjects.SETTING: The experiment was conducted in the Department of Pathophysiology, Medical College of Shandong University.MATERIALS: The experiment was completed in the Department of Pathophysiology, Medical College of Shandong University from July 2004 to December 2004. Totally 140 male Wistar rats were involved.METHODS: Ten Wistar rats were collected randomly as the blank control group. The other 130 rats were given 20 g/L streptozotocin 50 mg/kg intraperitoneally and the rats in blank control group were given the same volume of saline intraperitoneally. Three weeks later, the tails were cut off and the blood sugar was measured 2 hours after food intake. The rats with obvious rapid sugar tolerance were given foods with high calories for 28 days as the model rats. There were 64 rats were successful models and they were classified into 3 groups randomly, namely model control group( n = 20), electroacupuncture therapy(n=22) and electroacupuncture with naloxone groups( n = 22) . The blood sugar and blood lipoprotein(a) were detected after treatment for the diabetic rats with streptozotocin.MAIN OUTCOME MEASURES: Blood sugar level and blood lipoprotein(a) of each rat after the final therapy.RESULTS: Totally 74 rats entered the result analysis. Electroacupuncture therapy could reduce the blood sugar and blood lipoprotein(a) of diabetes mellitus rats, while rats with naloxone injection before therapy were insensitive to electroacupuncture. [The blood sugar value were(13.91 ± 3.79),( 10.33 ± 2.36), (12.96 ± 2.23)mmol/L in the model control group, electroacupuncture therapy group, electroacupuncture with naloxone group respectively; while the level of blood lipoprotein(a) were(13.75 ±2.69),( 10.81 ± 2.96), (13.01 ± 3.23)mg/L respectively].CONCLUSION: Electroacupuncture therapy can reduce the level of blood sugar and the risk of atherosclerosis in rats with diabetes mellitus. Although the mechanism can not be explained through the meridian theory, according to the experimental result that blood sugar and blood lipoprotein(a) were no longer intervened by electroacupuncture therapy after injecting naloxone, it is presumed that electroacupuncture therapy can exert its intervention effect on blood sugar and blood lipoprotein(a)through opiate system.

Objective: To observe the behavior therapy efficacy in dental fear patients for dental extraction using video eyewear and N_2O inhalation. Methods: 100 patients were divided into two groups, one group only used N_2O and other group used N_2O with video eyewear. Compared two groups′ Frankl behavior rating scale and Houpt scale after dental extraction. The HR and SpO_2 were measured during dental extraction. Results: Using video eyewear and N_2O showed a significant good sedative effect on patients with dental fear. There were statistical difference in the Frankl behavior rating scale and Houpt scale between experiment group and control group(P<0.01). There were no significant changes in heat rate and SpO_2 before and after in two groups. Conclusion: Video eyewear and N_2O inhalation sedation is good for dental fear patient during dental extraction.

Objective To evaluate the reliability and validity of hepatocellular carcinoma (HCC)using the liver imaging reporting and data system (LI-RADS).Methods By using the LI-RADS v2013.1,two radiologists evaluated 1 62 patients with cirrhosis or with a risk of HCC according to an inclusion criteria.The Kappa value was used to evaluate the consistency between two different diagnoses and was compared with pathological and follow-up results.The accuracy of the LI-RADS was assessed including sensitivi-ty,specificity,positive predictive value,negative predictive value,positive likelihood ratio,negative likelihood ratio and accuracy rating.Results In all 1 62 patients,there were HCCs in 97 patients including 7 patients belonging to the LR3,benign diseases in 50,and other kinds of malignancy in 1 5.The Kappa value was 0.882 (P =0.000)between two observers on LI-RADS grading. The sensitivity,specificity and accuracy rating of LI-RADS grading in diagnosing HCC was 100.00%,91.30%,and 97.06%,re-spectively.Conclusion The LI-RADS has high consistency and stability in evaluation and diagnosis of HCC by enhanced CT.LR3 di-agnosis should be cautious because of a susceptible development to HCC,which can be improved through the combination of clinic and laboratory examination.

Objective In embryology, the pancreas is formed by fusion of the ventral pancreas(VP) and the dorsal pancreas(DP) during the seventh week of gestation. The aim of this study was to clarify whether there were differences in the clinicopathological characteristics of the carcinoma of pancreatic head(PhCa) arising from the VP and DP. MethodsResected specimens from 43 cases with PhCa were studied histologically and immunohistochemically. The VP and DP were distinguished by islet shape and amount of cells producing pancreatic polypeptide(PP) in normal pancreatic parenchyma adjacent to the main tumor. ResultsThere were 20 cases of PhCa from VP(VP-group) and 23 cases of DP (DP-group) in this study. The prognosis of the 20 patients in VP-group was significantly better than that of the 23 in DP-group ( P

Objective To assess the efficacy and safety of the carbon ion radiotherapy for stage Ⅰ non-small cell lung cancer (NSCLC).Methods We searched multiple electronic bibliographic databases,including the Cochrane library,PubMed,EMBASE,China Journal Full-text Database,Chinese Biomedical Database,and the Wanfang Database to assemble the available studies of carbon ion radiotherapy for stage Ⅰ non-small cell lung cancer.MetaAnalyst Beta 3.13 and STATA 12.0 software were used to combine the extracted data.Results Ten studies (seven trials) were included.The overall survival rates of 1,3 and 5 years were 95.1％,68.5％ and 45.9％,respectively.The local control rates of 1,3 and 5 years were 90.2％,76.7％ and 81.2％,respectively.The cause specific survival rate of 1,3 and 5 years were 82.9％,58.5％ and 57.3％,respectively.The rate of primary recurrence and total recurrence were 45.8％ and 11％,respectively.The rates of total death and death from lung cancer were 52.4％ and 28.3％,respectively.There were differences observed between T1 stage and T2 stage in regards to five year overall survival rate,total recurrence,lung cancer death,and grade 1 and grade 2 skin toxicities.Conclusions Available data demonstrate that carbon ion radiotherapy,in general,is a safe and feasible treatment modality for stage Ⅰ NSCLC.Although current results are promising,more evidence is required before carbon ion radiotherapy can become the international standard treatment for lung cancer patients.