Objective To evaluate the diagnostic value of MR urography(MRU) in the diagnosis of renal tuberculosis. Methods MRU features of 18 cases of renal tuberculosis,nonvisualized or poorly visualized in IVU,were analyzed and compared with pathologic findings. Results MRU provided high-resolution images of the kidneys and upper urinary tract in all patients.MRU features of renal tuberculosis and corresponding pathologic changes were summarized. Conclusions MRU has a great value in diagnosing renal tuberculosis when the kidneys are nonvisualized or poorly visualized in IVU.It can provide diagnostic evidence and is helpful with choice of the therapeutic strategy.

Objective:To explore diagnostic effects of 24h dynamic electrocardiogram (DCG) on pacemaker-induced rapid arrhythmias of different locations.Methods: Clinical data of 86 patients, who received pacemaker implantation in our hospital from Feb 2013 to Jan 2016, were retrospectively analyzed.According to ventricular electrode placement location, patients were divided into right ventricular septum (RVS) pacing group (RVS group, n=43) and right ventricular apex (RVA) pacing group (RVA group, n=43).The Tp-Te interval and occurrence of arrhythmias detected by 24h DCG were recorded and compared between two groups.Results: All patients received pacemaker implantation successfully, and pacemaker was fixed on RVS or RVA.There were no significant difference in pacing threshold, impedance and R wave amplitude between two groups, P>0.05 all.Compared with RVA group, there were significant reductions in Tp-Te intervals of V3 lead [(102.78±19.24)ms vs.(94.39±18.56)ms] and V4 lead [(96.39±13.11)ms vs.(85.87±14.59)ms] in RVS group (P=0.001 both).There were no significant difference in incidence rates of sinus arrest, II° sinoatrial block, atrioventricular block, atrial premature beats, transient paroxysmal atrial tachycardia and ventricular premature beats between two groups (P>0.05 all).Conclusion: The 24h DCG indicates that compared with RVA pacing, the Tp-Te interval of RVS pacing group significantly shorten, it may can better protect cardiac function.

Objective:To evaluate the radiotherapeutic strategy for the treatment of recurrent esophageal cancer after radical re-section and determine relevant prognostic factors. Methods:A total of 66 patients with esophageal carcinoma and exhibited recurrence after radical surgery were retrospectively reviewed from Jan 2007 to Jun 2010. The median interval of recurrence from the initial sur-gery was 10.6 months. Among the 66 patients, 50 suffered from loco-regional recurrences alone, and 16 developed distant metastases in addition to loco-regional recurrences. Among the 66 patients, 10 were treated with radiotherapy after recurrence, 23 were treated with chemotherapy alone, and 33 were treated with radiotherapy combined with chemotherapy. Among the 33 patients, 22 were initially treat-ed with chemotherapy and 11 were initially treated with radiotherapy. The median total dose of the external radiotherapy was 60 Gy with 6 MV X-ray of a linear accelerator. Results:The median survival period after recurrence was 14.3 months (95%CI=12.4~16.2 months). The 1-, 2-, and 3-year survival rates were 61.9%, 25.9%, and 16.5%, respectively. The median survival period after recurrence in the patients who were treated with chemotherapy alone, radiotherapy alone, and radiotherapy combined with chemotherapy were 11.4, 25.5, and 14.3 months, respectively. The patients who developed distant metastases treated with chemotherapy initially showed better survival outcome than those treated with radiotherapy (P=0.032). Univariate analysis results showed the following prognostic factors:tumor location before surgery;operation mode;whether or not recurrence was detected with distant metastases;and therapy af-ter recurrence. Multivariate analysis results showed that tumor location before surgery was an independent prognostic factor. Conclu-sion:Tumor location may indicate prognosis after recurrence. Patients with recurrent esophageal carcinoma and developed distant me-tastases treated with chemotherapy may initially benefit from a longer survival rate.

Objective:This study aims to analyze the relationship between the effect of induction chemotherapy and the timing of radiotherapy in limited-disease or limited-stage small-cell lung cancer (LSCLC). Methods: Data from 148 LSCLC patients who re-ceived induction chemotherapy and radiotherapy between January 2009 and December 2012 were retrospectively analyzed. The effect of two to three cycles of induction chemotherapy was evaluated according to the RECIST version 1.1, which includes complete re-sponse (CR), partial response (PR), stable disease, and progressive disease. CR and PR were used to calculate response rate. The pa-tients were divided into early and late groups based on immediate radiotherapy after two to three cycles of induction chemotherapy. The survival rate was analyzed using the Kaplan-Meier method. Log-rank test and Cox regression model were used to evaluate the influenc-ing factors of the survival rate. Results: The median overall survival (OS) and progression-free survival (PFS) were 22.8 and 13.0 months, respectively. The early and late radiotherapy groups exhibited OS of 34.0 and 18.0 months, respectively, and corresponding PFS of 16.8 and 10.9 months. In the subgroup analysis, for the patients who responded to the induction chemotherapy, the early and late radiotherapy groups showed median OS of 18.0 and 19.5 months, respectively, and corresponding PFS of 19.4 and 11.7 months. For the patients who had no response to the induction chemotherapy, the early and late radiotherapy groups exhibited median OS of 18.0 and 9.5 months, respectively, and corresponding PFS of 12.4 and 10.3 months. Conclusion:All LSCLC patients who received two to three cycles of induction chemotherapy should receive radiotherapy as soon as possible after chemotherapy, regardless of their response to the induction chemotherapy.

Objective To explore the effect of Baihe Zhimu Tang(百合知母汤,BZT) on the airway inflammation in bronchial asthma rats.Methods Forty Wistar rats were randomized into control group,asthma model group,BZT group and dexamethasone (DX) group with 10 rats in each group.The bronchial asthma rat model was built by intraperitoneal injection of 10％ ovalbumin (OVA) and ultrasonic atomizing inhalation of 2％ OVA except for the control group.Thirty minutes before every ultrasonic atomizing inhalation,the BZT group was given BZT 3.68 g/(kg · d) by gastric perfusion;the DX group was administered DX injection 1.2 mg/(kg · d) by gastric perfusion;as for the control group and asthma model group,they were given normal saline of the same volume;all groups were intervened for 14 days.After that,HE staining was used to observe the pathological changes of lung tissue,the levels of interleukin-2 (IL-2) and interleukin-4 (IL-4) were measured,and the cell cycle and calcineurin (CaN) activity were observed in separated peripheral blood lymphocytes.Results For the asthma model group,there was a lot of inflammatory cell infiltration in the bronchial wall under light microscope,the content of IL-4 in the plasma was higher than that in the control group,while the content of IL-2 decreased,the proportion of G0/G1 phase lymphocytes decreased,the proportion of S phase and G2/M increased,and the CaN activity of lymphocytes increased significantly (P ＜ 0.05).For the BZT group,there was only a small amount of inflammatory cell infiltration in the lung tissue under light microscope,the IL-4 level in the plasma was lower than that in the asthma model group,while the IL-2 content increased,the proportion of G0/G1 phase lymphocytes increased,the proportion of S phase and G2/M decreased significantly,and the CaN activity of lymphocytes decreased significantly (P ＜ 0.05).Conclusion BZT could reduce lymphocyte proliferation,decrease IL-4 level and reduce airway inflammation by reducing CaN activity in peripheral blood lymphocytes of bronchial asthma rats.

Objective To investigate the prognostic significance of postoperative radiotherapy (PORT) for locally advanced pulmonary adenocarcinoma with micropapillary pattern(MPPAC).Methods A total of 45 completely resected pN2-3 cases that occured from January 2012 to December 2014 at Tianjin Medical University Cancer Hospital were retrospectively analyzed.All of them were diagnosed with MPPAC by pathological diagnosis.Based on whether receiving PORT, patients were divided into radiotherapy and non-radiotherapy groups.General characteristics, overall survival and disease-free survival characteristics of the two groups were compared, respectively.Results The median overall survival (OS) of patients was 19.8 months, 1-year and 2-year overall survival rate was 79.4％ and 30.3％ , respectively.The median disease free survival (DFS) of patients was 13 months, 1-year and 2-year, and the disease free survival rate was 59.3％ and 28.9％ , respectively.The radiotherapy and non-radiotherapy groups exhibited median OS of 22.3 and 11.4 months,respectively (x2=13.329, P＜ 0.05) , and corresponding D FS of 16.2 and 10.4 months(x2 =7.972 ,P ＜0.05).The epidermal growth factor receptor gene (EGFR) mutation rate of patients was 57.14％ (20/35), In the subgroup analysis, for patients with EGFR mutation, the radiotherapy and non-radiotherapy groups showed median OS of 25.6 and 18.4 months, respectively(x2 =9.268,P ＜ 0.05) , and corresponding DFS of 21.6 and 12.6 months (P ＞ 0.05).For patients with wildtype EGFR, the radiotherapy and non-radiotherapy groups showed median OS of 21.8 and 10.6 months,respectively(x2 =9.595,P ＜ 0.05) , and corresponding DFS of 15.2 and 6.6 months(x2 =4.538,P ＜0.05).Conclusions PORT could improve survival of patients with pN2.3 MPPAC.For patients with locally advanced MPPAC after curative resection, PORT is still an integral part of treatment.

Objective To evaluate the efficacy and adverse effects of radical three-dimensional conformal radiotherapy (3DRT) alone or combined with chemotherapy in elderly patients (≥70 years) with esophageal cancer.Methods The clinical data of 116 esophageal cancer patients who were aged 70 years or older and received radical 3DRT ± chemotherapy from 2008 to 2013 were retrospectively analyzed.Of the 116 patients,32 received concurrent chemoradiotherapy,24 received sequential chemoradiotherapy,and 60 received radiotherapy alone.Overall survival (OS) and progression-free survival (PFS) rates were determined using the Kaplan-Meier method,and survival difference analysis and univariate prognostic analysis was performed using the log-rank test.Multivariate prognostic analyses were performed using the Cox proportional hazard model.Results The follow-up rate was 100％.The 2-and 3-year sample sizes were 102 and 77,respectively.The 1-,2-,and 3-year OS rates were 59.1％,38.4％,and 23.2％,respectively,and the PFS rates were 61.9％,37.9％,and 0％,respectively.The median OS for the patients treated with concurrent chemoradiotherapy,sequential chemoradiotherapy,and radiotherapy alone were 22.3,18.0,and 12.4 months,respectively (P =0.044).The median OS was significantly different between patients treated with 60 Gy and ＜60 Gy in radiotherapy (24.7 vs.10.9 months,P =0.036),but not significantly different between those treated with 60 Gy and ＞ 60 Gy (24.7 vs.18.7 months,P =0.938).Multivariate analysis indicated that sex,presence or absence of combined chemotherapy,and radiotherapy dose were independent influencing factors for OS (P=0.003,0.042,and 0.037,respectively).Conclusions Radical 3DRT ± chemotherapy are well tolerated in elderly patients with esophageal cancer and equally effective as in those younger than 70 years.Patients treated with radical concurrent chemoradiotherapy have a better prognosis than those treated with sequential chemoradiotherapy and radiotherapy alone.Radiotherapy with a dose of 60 Gy effectively improves the survival compared with doses less than 60 Gy,which suggests that 60 Gy is the optimal dose in radiotherapy.

31 patients with cysticercosis of cerebral ventricles verified by operation or pathological investigation were reported. All patients were between 7 and 64 years of age and 14 were females. All had a single cyst. Since 29 patients (94%) were without a history of intestinal taeniasis, it was proposed that most patients of cysticercosis of cerebral ventricles were caused by hetero-infection and the entrance of Cysticercus into brain ventricle was through choroid plexus along the cerebro-spinal fluid. This is probably the reason why it occurs mostly in the 4th ventricle. The clinical manifestation of cysticercosis of cerebral ventricles were paroxysmal headache and vomiting caused by increased intracranial pressure. Ventricu-lography and CT scanning have considerable diagnostic value. Removal of Cysticercus by surgical operation is successful (Figs. 1 - 8).

Objective To analyze the effect of endophytic renal tumor growth characteristic on the short-term outcomes of robot-assisted laparoscopic partial nephrectomy (RALPN).Methods From March 2015 to October 2016,23 RALPN cases of endophytic renal masses and 68 RALPN cases of intermediate and exophytic renal tumors were retrospectively analyzed.There were no significant differences in age,gender,tumor side,history of abdominal surgery,benign and malignant cases of the two groups of patients (P ＞ 0.05).Patients with a completely endophytic mass had smaller tumors [(2.4 ± 0.5) cm vs.(3.9 ± 1.1) cm],and higher overall R.E.N.A.L.score (P ＜ 0.05).The differences of perioperative period and postoperative follow-up results were analyzed.Results All 91 RALPN cases were successfully done without conversion to open or radical nephrectomy.There were no significant differences in intraoperative blood loss,postoperative Hb decrease,intraoperative and postoperative blood transfusion rate,hospital days,positive tumor margins,and the incidence of Clavien-Dindo grade Ⅲ or above in the two groups (P ＞ 0.05).The endophytic group showed longer operative time [(95.6 ± 19.4) min vs.(75.3 ± 16.9) min],and longer renal warm ischemia [(25.2 ±5.4)min vs.(17.6 ±7.0)min].In the postoperative follow-up of 3 months to 22 months,all patients got disease-free survival.Conclusions RALPN for completely intraparenchymal renal tumors can be safely and effectively performed in experienced institutes.However,the long-term period of follow-up is still missing.

Objective:To observe the locoregional recurrence and survival of stageⅢA-N2 non-small cell lung cancer (NSCLC) after in-duction chemotherapy and surgery, to analyze the prognosis influenced by nodal downstaging, and to explore the necessity for postop-erative radiotherapy. Methods:A total of 116 cases of stageⅢA-N2 NSCLC were treated with induction chemotherapy and surgery be-tween January 2009 and June 2014. These cases underwent R0 resection. Kaplan-Meier method was employed to calculate the local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) of the patients. Log-rank test was con-ducted to compare the differences between groups. Cox models were used to perform multivariate analysis. Results:The median fol-low-up of the patients was 24.42 months. The numbers of patients with pN0, pN1, and pN2 were 40 (34.5%), 16 (13.8%), and 60 (51.7%), respectively. The 3-year local recurrence rates of patients with pN0, pN1, and pN2 were 27.5%, 56.2%, and 51.7%, respectively. In the group treated with adjuvant chemotherapy, the 3-year local-recurrence rates of patients with pN0, pN1, and pN2 were 26.9%, 58.3%, and 46.2%, respectively. Multivariate analysis revealed that the significant predictor of LRFS was pN0 during the surgery. The LRFS of patients with pN0 was greater than that of the patients with pN1 (P=0.048). The LRFS of patients with pN1 was not significantly associated with that of patients with pN2 (P=0.314). The 5-year OS rate of the groups was 46.6%. The multivariate analysis also demon-strated that pT1, pN0-1, and induction chemotherapy effects were associated with OS. The patients with pN2 yielded a poorer OS than those with pN0 and pN1 (P<0.05). The patients with pN0 did not significantly differ from those with pN1 in terms of OS (P=0.412). Conclu-sion:Although the occurrence of pathologic downstaging is a well-known positive prognostic indicator after stageⅢ-N2 NSCLC is sub-jected to chemotherapy, the local-recurrence rate of nodal-downstaged patients remains high, even when they receive adjuvant che-motherapy. Therefore, new postoperative strategies after induction chemotherapy and surgery should be developed.