Objective To investigate the diagnosis and treatment of renal angiomyolipoma with hemorrhage. Methods Eighteen cases of renal angiomyolipoma with hemorrhage were diagnosed by imaging such as ultrasound and CT from June 2000 to December 2007.Open operations were adopted in 15 cases. Expectant treatment was adopted in 3 cases. Results Hemorrhage stopped in 3 cases with expectant treatment.All the operations succeeded.Pathological diagnosis after operations was renal angiomyolipoma.The follow-up time was 3 to 60 months.Ultrasound,CT and intravenous pyelography were mainly methods.There was no case of relapse or fistula.Tumor size of 3 cases with expectant treatment changed little. Conclusions Diagnosis of renal angiomyolipoma with hemorrhage should be based on clinic and imaging.CT and ultrasound have better diagnosis effect.Expectant treatment,selective embolization of renal artery,tumor excision and heminephrectomy are main methods.Nephrectomy can also be adopted when there is serious hemorrhage.

AIM: The effect of decreasing infarct area and stimulating angiogenesis of Shexiangbaoxin Pills in rat with coronary occlusion were studied. METHODS: 44 rats with ligation of the left coronary artery were randomly divided into 4 roups:11 rats were treated with small dose Shexiangbaoxin Pills (group 1), 11 rats were treated with high dose Shexiangbaoxin Pills (group 2), 11 rats were treated with Beifuji and heparin (group 3), 11 rats were treated with 0.9% normal saline (group 4). 18 rats were randomly divided into 2 control groups:10 sham operated rats (group 5) and 8 normal rats (group 6). Infarct area and vascular density in the edge of infarct section were measured after treating for 8 weeks. RESULTS: Infarct area in group 1,2 and 3 was obviously less than that in group 4. The difference was not significant between group 1 and group 3 but group 2 was better than group 3. The difference was significant between group 1 and group 2. The vascular density in group 1,2 and 3 were significanly increased in comparison with those in group 4. The difference was not significant between group 2 with 3. CONCLUSION: Shexiangbaoxin Pills could decrease infarct area and stimulate angiogenesis of the experimental myocardial infarction rat. The effect of Shexiangbaoxin Pills was equal to the group treated with Beifuji and heparin. Shexiangbaoxin Pills had a dose response relationship.

Objective:The stimulate angiogenes effect and mechanism of Shexiangbaoxin Pills on coronary collateral development in the hearts of experimental myocardial infarction rats were studied. Methods:24 myocardial infarction rats were randomly divided into 3 groups, 8 rats in group A were treated with Shexiangbaoxin Pills, 8 rats in group B were treated with Beifuji and heparin, and 8 rats in group C were treated with 0.9% normal saline as control. Infarct area, the contents of VEGF、bFGF and VⅢ factor, and vascular density in the edge of infarct section were measured after 6 weeks treating.Results: Infarct area in group A was obviously less than that in group C, the contents of VEGF、bFGF and VⅢ factor in the edge of infarct section and vascular density in group were significantly increased compared with those in group C. Conclusions: Shexiangbaoxin Pills could stimulate angiogenesis of the collateral branch of coronary artery in ischemic myocardium of rats and showed good protective on myocardial ischemia.

Objective To identify high-risk group among gastric cancer patients treated with curative resection and more than D1 dissection, and investigate the indications for proper adjuvant therapy.Methods 297 patients who met the following enrolled criteria were retrospectively analyzed:treated between January 2002 and December 2004, primary gastric or gastroesophageal cancer, underwent curative gastrectomy and more than D1 lymphadenectomy, pathologically staged as T3-4N0-1M0,or TxN2-3M0.The overall survival (OS), disease-free survival (DFS), local-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were calculated, and possible prognostic factors were analyzed.Results The median follow-up time was 61 months.The follow-up rate was 92.3%.The 5-year OS, DFS, LRFS and DMFS were 57.9%, 52.2%, 70.6% and 71.7%, respectively.Four independent prognostic variables identified for OS, DFS, LRFS and DMFS using multivariate analysis were Borrmann type (Ⅰ+Ⅱ/Ⅲ+Ⅳ), total number of dissected lymph nodes (>18/≤18), number of positive lymph nodes (0-3/≥4), and 6th AJCC TNM stage (Ⅱ+Ⅲ a/Ⅲ b+ⅣM0)(χ2=3.94-16.34,P<0.05).If one unfavorable prognostic factor was scored as 1, according to the total scores of the four prognostic factors, four risk groups were generated as low (score:0), low-intermediate (score:1), high-intermediate (score:2) and high risk group (score:3 or 4).The 5-year OS, DFS, LRFS and DMFS were 85.7%, 61.0%, 58.6% and 38.6%(χ2=31.20,P<0.01) in low risk group, 85.2%, 61.3%, 48.1% and 31.8%(χ2=31.88,P<0.01) in low-intermediate risk group, 94.4%, 77.8%, 64.4% and 57.2%(χ2=18.36,P<0.01) in high-intermediate risk group and 87.9%, 75.0%, 74.2% and 55.5%(χ2=19.30,P<0.01) in high risk group.Conclusions Even with R0 resection and more than D1 lymphadenectomy, the outcome was poor for gastric cancer patients with two or more unfavorable prognostic factors.Prospective study is warranted to evaluate the efficacy of adjuvant concurrent chemoradiotherapy for this group of patients.

ObjectiveTo evaluate the inter-and intra-fractional clinical target volume (CTV) positioning errors of patients receiving postoperative simplified intensity-modulated radiotherapy (SIMRT) using cone beam computed tomography (CBCT).MethodsTwelve patients with liver tumors underwent postoperative SIMRT.CBCT images were acquired before and after the treatment.The clipbox volume for registration included the fiducial markers in the tumor bed and excluded the ribs and vertebral bodies.If any translational parameter of setup error before treatment exceeded 3 mm or rotational parameter exceeded 3°,the treatment couch was adjusted and a verification CBCT was acquired to assess residual setup error.Automatic bone match was used.A total of 214 acquisitions of CBCTs in 111 groups were analyzed.Inter-fractional translational CTV positioning errors in left-right (x),superior-inferior (y) and anterior-posterior (z) axis were calculated in 111 groups,and intra-fractional translational CTV positioning errors in 70 groups.Clinical to planning target volume (PTV) margins were calculated according to the formula:margin =2.0 ∑ + 0.7σ ( ∑ is systematic error,σ is random error).ResultsInter-fractional translational CTV positioning errors in x,y and z axis were -0.03 mm,-0.43 mm,1.02 mm,with systematic error ( ∑ ) of 1.50 mm,5.89 mm,1.97 mm,and random error (σ) of 1.76 mm,4.13 mm,2.42 mm,respectively.Intra-fractional translational CTV positioning errors in the x,y,z axis were 0.04 mm,0.86 mm,- 0.46mm,with systematic error (∑) of 0.46 mm,1.14 mm,0.31 mm,and random error (σ) of 0.95 mm,1.38 mm,0.91 mm,respectively.The calculate CTV to PTV margins were 4.5 mm,15.0 mm,5.8 mm in the x,y,z axis,respectively.ConclusionsThe CTV errors were inevitable when patients with liver tumors received SIMRT.Fiducial markers placed in tumor bed during operation were helpful for accurate positioning error analysis.

AIM:To observe the improvement in the endothelial function of patients with long-term use of Shexiang Baoxin Pill(Moschus,Ginseng extract,Calculus bovis,Cortex cinnamomi,Styrax,Venenum bufonis,and Borneolum Syntheticum)(SXBXP).METHODS:Eighty patients with CHD were randomly assigned into the SXBXP group and the control group.Two groups were controlled with the usual treatment.SXBXP 2 pills,po.tid.were taken in the SXBXP group and continued for at least 6 months.The ultrasound assessment of endothelial-dependent flow-mediated vasodilation(FMD)of the brachial artery was applied in the 3rd,6th and 18th and simultaneous determination of nirtogen oxides(NO),nitricoxide synthase(NOS),superoxide dismutase(SOD),endothelin(ET)was made.RESULTS:Follow-up checkups revealed that the level of FMD and SOD in the 3rd month,the level of NO,NOS and ET in the 6th month in SXBXP group were better than those in the control group at the significant level(P＜0.05).Patient keeping on taking SXBXP up to the 18th month,the obvious improvement in the level of FMD,NO,NOS and SOD was showed(P＜0.05).CONCLUSION:Administration of SXBXP could improve endothelial function in the CHD patients significantly.

Objective To evaluate the role of postmastectomy radiotherapy in four subgroups of high-risk breast cancer patients, who were grouped by the status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (Her-2). Methods A total of 437 invasive breast cancer patients with T3-4N1 or N2-3 and available immunohistochemistry results of ER, PR and Her-2 were retrospectively analyzed. Patients were classified into 4 subgroups according to hormone receptors (ER or PR, Rec) and Her-2 status:Rec-/Her-2-(triple negative), Rec-/Her-2 +, Rec +/Her-2 + and Rec +/Her-2-. Rec-was defined as ER-and PR-. Rec + was defined as ER + and/or PR +. Her-2 positive was defined as Her-2 + + or Her-2 + + +. End points were isolated locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS) and overall survival (OS). Results The median follow up time was 48 months. Sixty-nine (15. 8%) patients were Rec-/Her-2-, 62 (14. 2%) Rec-/Her-2 +, 89 (20.4%) Rec +/Her-2 + and 217 (49.7%) Rec +/Her-2-. 480(93.4%) patients received chemotherapy and 352(80. 5%) received radiotherapy. Radiotherapy significantly reduced the 5-year LRR rates of all the four subgroups (Rec-/Her-2-: 13.1% vs. 33. 3%, Rec-/Her-2 + :9. 3% vs. 21.2%, Rec + /Her-2 + :9. 7% vs. 47.0%, Rec +/Her-2-:3. 2% vs. 15.4%). Radiotherapy significantly lowered the 5-year DM rates (26. 7% vs. 49.4%, 27.6% vs. 67. 5%, 18.4% vs. 100%) and improved the 5-year DFS rate (66. 7% vs. 33. 3% , 67.7% vs. 33. 3% , 72. 6% vs. 0%) as well as OS (73.9% vs. 25.2% ,69. 8% vs.41.5%, 91.0% vs. 32. 8%) of patients with Rec-/Her-2-, Rec-/Her-2 + and Rec +/Her-2 +. Conclusions In high-risk breast cancer patients, all subgroups of patients grouped by ER, PR and Her-2 status can benefit from postmastectomy radiotherapy.

Objective The aim of this study is to evaluate the feasibility of using orthogonal kilo voltage fluoroscopic imaging(OKVFI)for setup correction in image guided radiotherapy of the liver.Methods After positioned the patients with liver cancer implanted with silver rings on the accelerator equipped with kilo voltage X-ray volume imaging(XVI),averaged OKVFI and cone beam CT(CBCT) volumetric images were acquired.A total of 90 datasets of averaged OKVFI and 90 datasets of volumetric images for 10 patients were obtained.The couch shifts obtained by the matching between OKVFI and digitally reconstructed radiograph were compared tu those achieved by the registration between CBCT and 4D reference average CT.On the comparison of the two different matching metheds.the Pearson coefficient was used to analyzed the correlation and Bland-Altman analysis to discern the consistence.Results The Pearson coefficient of correlation for the patient position shifts were R2=0.821.0.771 and 0.909 in the left-right (LR),anterior-posterior(AP)and superior-inferior(SI)directions respectively.95% CI were-2.30 -1.53(LR),-2.06-3.01(AP)and-2.69-1.53(SI)respectively.Within a±3 mm tolerance were 97.78%.95.56%and 96.67%respectively.Conclusions OKVFI has hish correlation and consistence with CBCT image on the setup correction.It is feasible to implement position correction with OKVFI in clinic practice.

Objective: To investigate the effect of Shexiangbaoxin Pills on morphosis and function of left ventricle after myocardial infarction in rat. Methods: The rat myocardial infarction models induced by ligaturing coronary artery were randomly divided into the myocardial infarction control group, Shexiangbaoxin Pill group and captopril group. The hemodynamic parameters and cardiac functions in 2 or 6 weeks after treatment were determined. Meantime, the morphological parameters of left ventrile (left cardiac chamber size, attenuation proportion of ventricular wall of infarction area, and expansion index of left ventrile), were studied. Results: Shexiangbaoxin Pills could reduce the distention of left ventrile and expansion of infarction area of rat in 6 weeks after infarction. It could obviously improve the contraction function of left ventrile after myocardial infarction. Conclusion: Shexiangbaoxin Pills can improve left ventricular reconstitution after myocardial infarction.

Objective To investigate the effect of gut bacteria under chronic colitis on the progression of hepatoma in mice.Methods 22 hepatitis B virus (HBV) -transgenic mice ( male, 8 weeks) were randomly divided into two groups, one group (n =10) was fed the drinking water containing 2% dextran sodium sulphate(DSS)to induce chronic colitis and the control group(n =12)was fed with normal drinking water.In order to investigate the effect of gut microbes, 7 male HBV-transgenic mice(8 weeks, with no detectable hepatoma under microscopy) were cohoused with 4 mice with hepatoma for 16 weeks.Results No significant liver cell damage was observed in the group of the mice fed with 2% DSS-containing drinking water.By the 22 -week old,9 of the 10 mice(90.0%) fed with 2% DSS-containing drinking water, 2 of the 12 mice(16.7%) fed with normal drinking had hepatoma.Both the hepatoma incidence and the tumor numbers in the group of mice fed with DSS-containing water were significantly higher than that in the controls (P =0.002 and P =0.028respetively).Compared to controls, the bacteria family Prevotella (P =0.022) and Anaeroplasma (P =0.014) reduced significantly in the mice with induced chronic colitis.All the mice (n =7) cohoused with the mice with hepatoma had the liver tumor developed at 24 -week-old.Conclusion Alterations of gut bacteria under chronic colitis may promote the development of liver cancer.