Objective To investigate the effects and toxic side effects of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy in nasopharyngeal carcinoma.Methods 141 patients of nasopharyngeal carcinoma divided into two groups randomly.All patients treated two-dimension exact radiotherapy and concurrent chemotherapy which combined DDP and 5-Fu intravenously for two circles,then experiment group started adjuvant chemotherapy 3 weeks later after above treatment,which intravenous DDP and 5-Fu for other three circles.Results All patients completed concurrent radiotherapy and chemotherapy,63 patients of treatment group completed adjuvant chemotherapy.The mainly toxic side effect was mucositis,leukopenia and low-platelet,and gastrointestinal reaction during therapy,there is no statistical significance in two groups.The regression rate of lymph nodes is 94.4 ％(n=67)and 87.3 ％(n=62)in nasopharynx and neck after 3 month of radiotherapy and concurrent chemotherapy.All patients followed up 3 years.The total survival rate of two groups were 94.3 ％,84.8 ％,78.6 ％ and 90.1％,75.0 ％,62.5 ％ respectly in 1,2 and 3 year,the mean survival period was 36 months and 27 months,and this differece was statistical significance(x2=7.356,P=0.007).The total survival rate of Ⅲ stage patients of two groups were 98.2 ％,92.5 ％,83.7 ％ and 93.0 ％,83.2 ％,68.2 ％ respectly in 1,2 and 3 year,the both mean survival period was 36 months,and this differece was statistical significance(x2=8.081,P=0.005).The total survival rate of Ⅳ stage patients of two groups were 81.3 ％、53.8 ％、42.9 ％ and 78.6 ％、36.4 ％ 、22.3 ％ respectly in 1,2 and 3 year,the meat survival period were 22 month and 14 month respectly,and this differece was statistical significance(x2=3.903,P=0.048).The progression-free survival rate of two groups were 90.0 ％、76.2 ％、68.8 ％,and 81.7 ％、60.3 ％、34.3 ％ respectly in 1,2 and 3 year,the meat progression-free survival period was 30months and 22months,and this differece was statistical significance as well(x2=13.616,P=0.000).Conclusion The therapy of concurrent radiotherapy and chemotherapy combined with adjuvant chemotherapy was obviously increased total survival rate and progression-free survival rate in nasopharyngeal carcinoma,especially to Ⅲ and Ⅳ stage patient of nasopharyngeal carcinoma.But the long period effects still remains unclear.

Objective To investigate the map and pattern of blood oxygen level dependent(BOLD)signal changes correlated to interictal epileptiform discharges(IEDs)with EEG-fMRI in patients with partial epilepsy and then to explore the pathophysiological mechanisms of epileptic discharges and their effect on brain function in partial epilepsy.Methods Through the method of EEG-fMRI,2 patients with parial epilepsy were studied.The relationship between the regions of BOLD signal changes linked to IEDs and the electroelinical localization of epileptogenic zone in patients with partial epilepsy were investigated.Results The epileptogenic areas localized by electroclinical findings in the 2 patients all showed maximal activation and 2 sites of significant activation were found in 1 of the 2 patients;Weak activation were also manifested in the opposite side corresponding to lesions.Conclusions IED-linked BOLD response in patients with partial epilepsy is mainly in epileptogenic zones and weak activation can also be seen in the corresponding contralateral areas of epileptogenic zoiles.Activation areas ale well concordant with epileptogenie areas localized by electroclinical findings.

Objective: To analyze the association between different sleep behaviors and overweight and obesity of junior high school students in Yangzhou City, and to provide a basis for policies and interventions related to adolescent health management. Methods: A total of 1 589 students in grades 7-9 from two middle schools in Yangzhou City were selected using the cluster sampling method and were administered with sleep time, bedtime, social jetlag difference, and sleep habits. Results: Totally 64.38% were sleep deprived during the school days, 86.78% went to bed too late, 46.51% had a social jetlag of ≥1 h, and 37.44% took a nap every day(Incluldes holidays and school days). Social jetlag length was statistically different between grades( F =6.97, P < 0.01 ). Girls[(0.95±0.65)h] shown significantly higher social jetlag than the boys[(0.76±0.59)h]( t=6.19, P <0.01). Later bedtime on weekends, later wake up time on weekends and poor sleep behavior were risk factors for overweight and obesity in junior high school students( OR=1.20, 1.14, 1.04, P <0.05). Conclusion Junior high school students had less sleep and later bedtimes with the increase of grade, and weekend bedtimes,wake up times and poor sleep behavior were independently associated with the risk of overweight and obesity in junior high school students. Parents and schools should be instructed to pay attention to their sleep health and carry out adolescent sleep health guidance.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

【Objective】 To explore the risk factors of transfusion-related acute lung injury (TRALI). 【Methods】 The clinical symptoms, signs, imaging examinations, and laboratory test results of two patients with TRALI after blood transfusion were retrospectively analyzed, and human leukocyte antigen (HLA) genotyping of the patient and HLA antibodies typing of the plasma donors were performed. 【Results】 The clinical manifestations and laboratory parameters of two patients were consistent with those of TRALI after blood transfusion. After timely clinical respiratory support treatment, all patients were improved. Blood donors produced high titers of HLA-Ⅱ antibodies after pregnancy, including antibodies that specifically recognize the patient′s HLA antigen. 【Conclusion】 Two patients developed TRALI after platelet transfusion from a female blood donor, which was caused by HLA-Ⅱ antibodies.