Laser ablation of hard tissue allows very precise pre-programmed incisions with complete free geometry and it has advantage of leaving no tissue damages. Those disadvantages of thermal side effects and low cutting rates had been overcome by introducing ultra-short pulses and ultra-power laser systems. This review highlights the recent advances in the laser ablation of hard tissues.

Chest?regional recurrence and metastasis are the main modes of treatment failure after surgery for patients with esophageal cancer. As one of the primary approaches for local therapy, radiotherapy has a satisfactory efficacy in the reduction of postoperative chest?regional recurrence in patients with esophageal cancer. Right now, the value of postoperative adjuvant therapy for patients with positive lymph nodes has been widely recognized by clinicians. Postoperative adjuvant chemoradiotherapy has become a standard treatment mode. However, there is no consensus on whether adjuvant radiotherapy should be performed in patients with negative lymph nodes. To determine whether patients with stage pN0 esophageal cancer should receive postoperative adjuvant therapy, this paper reviews the current research advances in possible evidence for the necessity of postoperative adjuvant radiotherapy for patients with stage pN0 esophageal cancer, current related reports, and the effects of different surgical methods on treatment outcomes of postoperative adjuvant therapy.

Ojective To study the diagnosis and treatment of upper extremity edema after radical mastectomy. Methods Diagnosis depended on B type ultrasoundgraphy, CT, lymphography, venography, biopsy and axilla exploration. Lymphaticovenous anastomosis (LVA) with microsurgery technology was used for the treatment of simple lymphoedema. Results In 40 cases of lymphoedma after radical mastectomy, 7 patients were diagnosed as metastasis of cancer. 3 patients were diagnosed obstrcution of lymphatic and vein. 30 patients with simple lymphedema were treated with LVA. Short term efficacy was observed in all patients.The efficacy at 3～12 years was 83.3%. Conclusion The diagnosis of upper limb edema after radical mastectomy is essential. Metastasis and obstruction of vein are the causes. Biopsy conducted under high frequency B type ultrasoundgraphy may be a good method for the diagnsosis of matastasis, but a few patients were diagnosed only by axilla exploration. LVA may be given first priority to the theraphy of lymphedema after radical mastectomy.

Objective To evaluate the diagnosis and therapy of intestinal lymphangiectasia.Methods In this study 15 patients were admitted in our hospital during recent 7 years.Clinical manifestations included hypoalbuminemia,symmetrical edema,emaciation,diarrhea and lymphopenia.Lymphangiography,lympanscintigraphy and biopsy were performed for diagnosis.Therapy conducted included conservative therapy,low-fat and medium-chain triglycerides(MCT)diet,albumin infusions,diuretics,total parenteral nutrition and octreotide.Surgical therapy ineluded thoracic duct-vein anastomasis and segmental resection.Results In this group 8 patients receiving conservative therapy were followed-up from 1.5 to 7 years(average 2.5 years).Symptoms were alleviated in 6 patients.Seven patients underwent operative therapy,among them,4 patients received thoracic duct-exterior jugular vein anastomasis and followed-up from 1 to 5 years,with symptoms mitigated in 2 patients.3 patients underwent local intestinal resection,follow-up from 1 to 3 years found one patient was cured,one was improved,and 1 patient died 3 months afterthe operation. Conclusion Intestinal lymphangiectasia is rather rare and there was no definite and effective therapy.

Objective To evaluate the prognostic significance of 3 clinical stage system in 3-dimensional conformal radiotherapy (3DCRT) for esophageal squamous cell carcinoma. Methods From January 2004 to August 2007, 179 cases of esophageal squamous cell carcinoma were treated with 3DCRT.Before radiation, each patient was staged with UICC 2003 TNM stage, stage of Chinese esophageal cancer cooperation group (cooperation group' stage), and Zhu's clinical stage respectively. Concordance of each clinical stage and prognosis was analyzed with SPSS 11.5. Results In 179 cases of esophageal cancer,Concordance was better in T stage ( Kappa = 0. 271 ) than in TNM stage ( Kappa = 0. 167 ) between cooperation group' stage and Zhu's stage. Among them, 98 cases was staged with UICC stage, concordance of T stage was better between UICC-T and cooperation group' T stage (Kappa =0. 261 ) than between UICCT and Zhu's T stage (Kappa = 0. 045 ) ;concordance of TNM stage was better between UICC-TNM and Zhu's TNM stage ( Kappa = 0. 597 ) than between UICC-TNM and cooperation group' TNM stage ( Kappa =0. 299 ). With multivariate analysis, T ( χ2 value is 11.58, 26. 00 and 51.05, all P ＜ 0. 01 ), N ( χ2 value is 15.28, 16. 10 and 16. 10,all P＜0. 01), M (χ2 value is 5.59, 27.78 and 27.78,all P＜0. 01), and TNM (χ2 value is 15.77, 34,35 and 51. 10,all P＜0. 01 ) stage in 3 kinds of clinical stage were independent prognostic factors. In UICC stage, T1-T3 was difficult to definite and the prognosis was not significantly different in T1 -T3 stage. Conclusions In this study, 3 kinds of clinical stage could evaluate prognosis of esophageal cancer after radiotherapy;cooperation group' stage and Zhu's stage need further application, with further accuracy needed.

Objective To investigate the neural mechanism of inhibitory control in sensation seeking by using the event-related potential(ERP) technique. Methods High and low sensation seekers( 16 people in each group ), who were selected according to their sensation seeking scores, performed a Go/Nogo task in which the stimuli possessed two levels of difficulty. Electro- encephalogram(EEG) signals were recorded continuously by a set of 32 Ag/AgCI electrodes. Results For two types of stimuli ( Congruent, Incongruent) :( 1 )The amplitude(FCZ) of Nogo N2 and Nogo P3 were( (1.61 ±4.25)μV,(-2.32±4.55)μV)and((16.44±5.74)μV,(17.00±5.71)μV). (2)There was no significant main effects of group for the Nogo N2 amplitude( F (1.30) =0.31, P=0. 59,η2=0. 01;F(1.30) =0.07,P=0.80,η2=0.002) ,the N2d amplitude( F(1.30) =1.18,P=0.29,η2=0.04;F(1.30) =0.004, P=0.95, η2 ＜ 0.001 ) ,the Nogo P3 amplitude( F (1.30) =0.13, P=0.72, η2 =0.004;F(1.30)=0.28, P=0.60, η2 =0.009) and the P3d amplitude( F(1.30) =0.08, P=0.50, η2 =0.02; F (1.30) =0.56,P=0.46, η2 =0.02). (3)Neither of main effects for the N2 and P3 latency was significant (P＞0.05). Conclusion The inhibitory control is similar across high and low sensation seeking groups,indicating that there is no relationship between the sensation seeking behaviors and the individual inhibitory control.

Objective To analyze the outcomes and prognostic factors of esophageal carcinoma treated with three-dimensional eonformal radiotherapy (3DCRT). Methods From January 2001 to August 2007, 209 patients with esophageal carcinoma treated with 3DCRT were retrospectively analyzed. The local control rotes, the survival rates and the related prognostic factors were evaluated with SPSS 11.5 software. Results The follow-up rate was 98. 1% by December 2008. The number of patients followed up for 1,3, 4 and 5 years was 209,131,95 and 56, respectively. The 1-, 3- and 4-year local control rates were 74. 9%, 50. 4% and 45. 8%, respectively. The 1-, 3-and 4-year overall survival rates were 64. 6%, 30. 8% and 23.6%, respectively, with a median survival time of 18 months. Univariate analysis showed that the significant prognostic factors included the degree of dysphagia, tumor site, lesion length in barium esophagogram and CT image, the largest diameter of lesion in CT image, T stage, N stage, clinical TNM stage, short term effect, and degree of acute esophagitis. Multivariate analysis revealed that the degree of dysphagia, primary tumor site, clinical stage, and radiotherapy technique (3DCRT or late half course 3DCRT) were independent prognostic factors. Conclusions Three-dimensional conformai radiotherapy is effective and feasible in the treatment of esophageal cancer. The degree of dysphagia, primary tumor site, and clinical stage are independent prognostic factors for survival of patients treated with 3DCRT.

Objective To observe the effects of ulinastatin on the expressions of tumor necrosis factor-α (TNF-α) in the lung tissues of rats with acute lung injmy induced by phosgene, and to explore the mechanism of ulinastafin in treating acute lung injury. Method Sixty-four clean grade healthy male SD rots were randomly divided(random number) into eight groups with eight in each group. Group A1 in which rats were exposed to air. Group A2 in which rots wereexposed to air and treated with saline. Group A3 in which rats were exposed to air and treated with dexamethasone. Group A4 in which mrs were exposed to air and treated with ulinastatin. Group B1 in which rots were exposed to phosgene without treatment. Group B2 in which rats were exposed to phosgene and treated with saline. Group B3 in which rats were exposed to phosgene and treated with dexamethasone. Group B4 in which rats were exposed to phosgene and treated with ulinastatin. The expressions of TNF-α in the lung tissues were measured by using immunohistocheistry. Lung tissues were observed grossly and under 200-fold light microscope to identify the positive expressions in kytoplasm. Results In group B1 and group B2, the wet weight, dry weight and wet/dry weight ratio og right lower lobe of lung were higher thai those in group A1 and group A4( P <0.01 ), and those in group B4 and group B3 were significantly lower than those in group B1(P<0.01 ), but still higher than those in group A1 and A4(P<0.01). The gross observation suggested that the surfaces of lung tissues in group A1and group A2 were slick and rose pink without congestion, dropsy or infarction; the surfaces of lung tissue in groups B1 and B2 appeared with congestion, dropsy and many petechia. The surfaces of lung tissue in groups B3 and B4 were similar to those in groups B1 and B2. Under the light microscope, the structure, of lungs in groups A1 and A2 were clear without congestion, effusion or inflammatory cell infiltration. In groups B1 and B2, the engorgement of lung capillary vessels, congestion and tiny thrombosis were found and there abundant edematous fluid and inflammatory cell infiltration in lung stroma and alveolus with focal pulmonary atelectasis in some lung tissue section. The tissues in groups B3 and B4 showed congestion, dropsy, tiny thrombosis and inflammatory cell infiltration, but these changes were slighter than those in groups B1 and B2. The expressions of TNF-α in groups B1, B2, B3, and B4 were significantly higher thanthose in groups A1 and A2( P < 0.01 ), but the expressions of TNF-α IN group B4 was lower than that in groups B1 and B2(P<0.01). Conclusions Ulinastatin could lessen the lung injury by reducing the expressions of pro-inflammatory cytokines such as TNF-α.

Objective To investigate the effects of inhibition of MDC1 protein expression on xenografted tumors in nude mice,and to observe the histopathological and cellular changes in nude mice.Methods Three pairs of effective and control short hairpin RNA targeting MDC1 mRNA were designed and cloned into the pSIH1-H1-copGFP vector.Real-time PCR and Western blot were used to determine the mRNA and protein expression of MDC1.After selection by copGFP reporter gene,cells were divided into negative transfection group (ECA109-N) and MDC1 transfection group (ECA109-M).The transfected cells were injected into nude mice.The mice were divided into ECA109 group,ECA109-N group,and ECA109-M group.Each group was divided into irradiation subgroup and non-irradiation subgroup.The changes in tumor size after irradiation were evaluated in each group.Western blot was used to measure the expression of CHK1,CHK2,and CHK2T68 in xenografted tumors.Flow cytometry was used to analyze the cell cycle distribution and apoptosis of tumor cells in nude mice.The variance analysis was used to compare the mean of multiple groups,and the SNK-q test was used in the two two groups.Results The pMDC1-shRNA plasmid was successfully constructed and used to transfect ECA109 cells.ECA109-M cells were obtained by stable transfection with the recombinant plasmid.All inoculated nude mice survived with visible xenografted tumors at the underside of the paw in about one week.There was no swelling and wound in inoculation sites.There was no significant difference in tumor size between different groups (P＞0.05).The tumor growth in the ECA109 group and the ECA109-N group significantly slowed down after irradiation with a dose of 15 Gy (P＜0.05).Compared with the other two groups,the ECA109-M group had a significant smaller tumor size,significantly slower relative tumor growth,and significantly higher growth inhibition (all P＜0.05).The q value of the ECA109-M group was 1.36.In the ECA109-M group,there were no significant changes in the protein expression of CHK1 and CHK2 after irradiation (P＞ 0.05);however,the phosphorylation of CHK2T68 protein was significantly reduced after irradiation (P＜0.05).There were no significant differences in cell cycle distribution or the proportion of apoptotic cells in tumor tissue between the three groups (P＞0.05).Conclusions Inhibition of MDC1 protein expression by RNA interference can effectively inhibit the growth of xenografted tumors after irradiation in the nude mice by increasing their radiosensitivity.

Objective To investigate temperature changes in prefrontal cortex and hippocampus of heroin addicts with magnetic resonance spectroscopy (MRS).Methods 18 heroin addicts in the withdrawal state and 18 healthy volunteers (control group) were performed with MRS scan.First, resting-state MRS scan was performed on all subjects, and then did MRS scan again under visual stimulation while subjects were asked to carefully watch the heroin-related cue images.Measurements of NAA of the identified regions (the prefrontal cortex, bilateral hippocampus) were obtained from all subjects.Brain temperatures were calculated by the modified brain temperature-chemical shift equation.Results In resting state, the temperature of prefrontal cortex in heroin addicts group was higher than the control group, the difference was statistically significant (P<0.05),and the brain temperature was positively correlated with total dose of heroin (P<0.05).The prefrontal cortex/hippocampus temperature of heroin addicts group did not showed statistical significance between resting state and visual stimulation state (P>0.05).Conclusion MRS can be used to measure brain temperature noninvasively.Temperature change of brain may be helpful for exploring the mechanism of drug addiction and craving.