Neuroendocrine tumor liver metastases (NETLM) is a uncommon advanced tumor disease.Patients with unresectable NETLM have a poor outcome.The management of unresectable NETLM is a clinical dilemma.However,Yttrium-90 radioembolization is a safe and effective treatment for NETLM patients.The median disease control rate is 87.1％ (64.7％ ～ 100％);the median overall survival time is 34.4 months;and the median overall survival rate of 1,2,and 3 years are 79.8％ (63％～100％),62％ (57％ ～62.5％),45.5％ (45％ ～ 46％),respectively.Although there is good result of Yttrium-90 radioembolization in treatment of unresectable NETLM,the safety and effectiveness should be further verified.

BACKGROUND: An epidemic outbreak of poliomyelitis occurred in Pizhou City, Jangsu Province, 15 years ago. It is important to appraise the daily living and function of those survived children.OBJECTIVE: To investigate the physical status of the survived children and propose appropriate suggestions on rehabilitation.DESIGN: Case-based cross-sectional study based on patients.SETTING: Department of Rehabilitative Medicine of First Hospital Affiliated to Nanjing Medical University.PARTICIPANTS: Totally 545 patients with poliomyelitis sequela, which was onset in 1989, were found in Qizhou, and 333 of them were randomly selected from the local"New Hope" nursing house and its surrounding areas.All patients were assayed in one week.METHODS: The survey included 333 polio victims in the nursing house or from the surrounding areas. The study was conducted by five research groups, with two physiatrists and one therapist in each group. Assessment included muscle strength, joint rang of motion, limb deformities, activities of daily living, previous surgical interventions and orthosis. The distance was measured from the anterior superior iliac to medial malleolus and from nave to the medial malleolus, respectively. Anatomic length and functional length were also measured.MAIN OUTCOME MEASURES: Major outcomes included the forms,shapes, or functions of foot, pelvic, hip, knee and ankle joints.RESULTS: According to intention-to-treat analyses, 333 patients with poliomyelitis sequela entered the final analysis. Most of them aged from 15 to 17 years old, which accounted for 97%. Totally 135 patients(40.5% )walked independently and 148 (44.4%) walked with-orthsis and/or crutches. The discrepancy was between 0. 5 cm to 13.0 cm. Patients with paraplegia were 112(33.6% ), which was lesser than those with monoplegia (211, 65.8% ). There were 3 cases with quadriplegia and 2 cases with upper limb involvement. Another 46 sufferers had already underwent the scoliosis prthomorphia. There were 254 subjects with orthosis, including 110 knee ankle feet orthosis for both legs and 131 knee ankle feet orthosis for one leg,with 62 at left and 79 at right. Only three ankle-foot orthosis were employed.CONCLUSION: Besides the factor of muscle strength, limb teratism is the key factor that causes walking disorders. Physical functions maybe improved through surgical intervention, orthosis modification, and rehabilitation training. Every child who received survey required further rehabilitative therapy. A multi-disciplinary team is essential to achieve a better outcome.

60 cm 3). Primary tumor volume was found to be an independent prognostic factor of local control in multivariant analysis without any statistical significance to predict the disease-free survival or distant relapse-free survival rates. Conclusion The greater volume disparity with the same T stage and the data extension overlap with different T stages are demonstrated and the primary tumor volume may be considered as a prognostic factor in the treatment of nasopharyngeal carcinoma.

Objective To explore the effect of bio-resonance on walking efficiency in healthy youths. Methods Ten young male participants were involved in this study (age 16 ± 2 years, height 1.73 ±:0. 1 m and weight 56. 1 ± 7 kg). The time-space data were collected using a motion analysis system, and oxygen cost was meas-ured with a Cosmed K4b2 portable gas analysis system. Walking at a self-selected, comfortable walking frequency was recorded through three dimensional gait analysis. Each participant walked at 100% , 80% and 120% of their comfortable walking frequency. Results The average 100% , 80% and 120% comfortable walking frequencies were 107.60 ± 1.78, 85.80 ± 7.45 and 128.60 ±10.46 steps/min, respectively. Oxygen consumption at the three frequencies was significantly different (P≤0.01), and the oxygen costs were 0. 140 ± 0.011, 0. 193 ± 0. 049 and 0. 192 ± 0. 035 ml/m/kg, respectively. Above or below the self-selected pace, oxygen cost increased significantly (P ≤0.05). Conclusion There is an inherited bio-resonance in human walking, and walking with this natural rhythm is reflected in the lowest oxygen cost. Any change from the natural walking rhythm may result in increased en-ergy expenditure and decreased efficiency.

Objective To characterize 15 months later the quality of life (QOL) and depression of those with spinal cord injury (SCI) suffered during the Wenchuan earthquake,and to identify the influence factors.MethodsA sample of 27 individuals who sustained SCI during the Wenchuan earthquake were surveyed using face- to-face interviews.QOL was measured using the brief version of the World Health Organization's Quality of Life Assessment instrument.Depression was measured using the patient health questionnaire depression module 9.Stepwise multiple linear regression was employed to determine the factors most closely related with QOL and depression. ResultsStepwise linear regression showed a significant correlation of overall QOL with literacy and age.The younger or illiterate victims showed a lower overall QOL.General health was also associated with ability in the activities of daily living and with pain.Victims with better daily ability and less pain may have had better general health.Depression correlated with literacy and secondary condition.Illiterate patients or patients influenced more by a secondary condition displayed more serious depression than the others.Additionally,social participation was significantly associated with the physical health,psychological health and social relationships domains of QOL.ConclusionThe QOL of long-term SCI victims caused by the earthquake is closely related to age,literacy,pain,participation and physical independence.Depression is associated with illiteracy and secondary conditions.Attention should be paid to these correlations in designing long-term rehabilitation strategies.

Objective To study the efficacy of combining Entecavir with TACE to treat patients with primary hepatocellular carcinoma with undetectable levels of HBV-DNA.Methods From Aug 2011 to Sep 2013, patients with HBV-related hepatocellular carcinoma but with undetectable levels of HBV DNA who underwent TACE were divided into the treatment group (treated with Entecavir antiviral therapy) and the control group.The endpoints of the study were HBV reactivation rates, liver function, and survival rates.Results Using our predefined inclusion and exclusion criteria, 64 patients with primary liver cancer were divided into the treatment group (n =32) and the control group (n =32).The transaminase and bilirubin levels were raised and the albumin level was reduced at 5 days after TACE.However, there were no significant differences between the 2 groups (P ＞0.05).At 12-month follow-up after TACE, 8 (25.0％) patients developed HBV reactivation in the control group and 2 (6.3％) in the treatment group, the difference was significant (P ＜ 0.05).The level of transaminase was significantly higher in the HBV reactivation group when compared with the no HBV reactivation group (P ＜ 0.05).The overall 6-and 12-month survival rates in the treatment group and the control group were 93.8％ and 84.4％ vs 90.6％ and 59.4％ respectively.There were significant differences in the 12-month survival rates (P ＜ 0.05).Conclusion Entecavir combined with TACE to treat patients with HBV-related primary liver cancer with undetectable HBV-DNA effectively reduced HBV reactivation and improved survival at 12 months.

Objective To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T_3/ N +, staging Ⅱ - Ⅳ. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4.46, P = 0.000 ; t = - 3.45, P =0.000). Conclusions In the irradiation of post-operative gastric cancer, the maximum displacement of organ motions induced by respiration is in S-1 direction and the minimum in R-L direction under free breathing. The use of ABC can reduce the motions significantly in S-I and A-P directions, and the same changes exist in both inter-and intra-fraction treatment.

Gallbladder-duodenal fistula is a rare disease in clinical practice, and difficult to diagnosis. One patient with high suspicion of gallbladder-duodenal fistula in preoperative examination was performed with percutaneous transhepatic gallbladder drainage due to could not tolerate surgical operation, and gallbladder-duodenal fistula was diagnosed with the gastric and intestinal fluids extracted from the drainage tube. In the later of fistula repair and the patient′s nutritional support management, the jejunal nutrition tube is inserted through the bile duct, and then the nutrition support was performed through this jejunal nutrition tube. This patients was recovered well.

Objective To establish a HPLC method for the simultaneous determination of artemisinin,arteannuin B,chrysosplenetin and chrysosplenol-D in the water extract of Artemisia annua L.Methods The analysis was performed on Agilent ZORBAX SB-C18(250 mm×4.6 mm,5 μm)column with a mobile phase of acetonitrile(A)-water(B)and the flow rate of 0.8 mL·min-1 in a gradient elution manner.The column temperature was 30℃.The injection volume was 10 μL,and the detection wavelength was 210 nm.Results Artemisinin,arteannuin B,chrysosplenetin and chrysosplenol-D were correlated well linearly with peak area in their respective ranges 1.608 8-16.088 μg(r=0.999 9),0.014 1-0.141 4 μg(r=1),0.185 1-1.850 9 μg(r=0.999 9),0.144 1-1.441 4 μg(r=0.999 9),the average recovery rate(n=6)were 102.44%,97.82%,95.07%,95.55%,and the RSD values were 1.12%,1.44%,1.29%,1.53%.Conclusion This method is convenient and accurate.It has good stability and repeatability,and can be used to simultaneously determine the content of artemisinin,arteannuin B,chrysosplenetin and chrysosplenol-D in the water extract of Artemisia annua L.