Purpose:To evaluate the acute side effects an d efficacy of three-dimensional conformal radiotherapy(3-DCRT)combined with hype rthermia for locally advanced non-small-cell lung cancer(LANSCLC). Methods:From Jan.2001 to April.2003,35 patients with LANSCLC we re treated with three-dimensional conformal radiotherapy(3-DCRT) combined with hyperthermia. Results:The overall response rate(CR+PR)was 91.4%for the primar y tumor. Acute radiation esophagistis occurred in 48.6%of patients(Grades Ⅰ,Ⅱ ). Acute radiation pneumonitis was observed in 8.6% of patients (Grades Ⅰ,Ⅱ). Grade Ⅰ-Ⅱ bone marrow suppression occurred in 8.6%(3/35)of patients and Grade Ⅰ-Ⅱ myocardical injury was present in 14.3%(5/35) of patients. The median fo llow-up duration was 24(6-28) months. Conclusions:Hyperthermia combined with 3-DCRT is well tolerate d in most patients with LANSCLC. Its early responses are milder than the convent ional radiotherapy. Remote results await futher follow-up.

Purpose:To evaluate ~(18)F-deoxyglucose dual-head tomography with hPET in the detection of suspected recurrence in non-small cell lung cancer, as compared with CT/MRI imaging. Methods:21 patients with clinically suspected recurrences in non-small-cell lung cancer underwent ~(18)F-FDG hPET and CT/MRI imaging. The final diagnosis of recurrence was proved by pathology or clinical following-up. Results:The ~(18)F-FDG hPET sensitivity, specificity,accuracy,postive predictive value in defining local recurrence were 94.1%,75%,90.5 %,94.1%,respectively ; and those of CT/MRI were 60%,66.7%,61.9%,81.8%, respectively. Conclusions:In comparison with CT/MRI,~(18)F-FDG hPET possesses a higher sensitivity、specificity and accuracy in detecting recurrence in non-small-cell lung cancer.~(18)FDG hPET is quite valuable methd to define the tanget in the radiotherapy of recunent non-small-cell lung cancer,and is less expensive than PET.It is thus recommended for clinical use.

Objective To investigate the change of high sensitivity c-reaction protein( hs-CRP)on carotid artery plaque. Methods A total of 5 852 individuals were selected as our subjects who randomly stratified from the health examination survey participants in Tangshan Kailuan Company community during 2006 - 2007. A total of 5 440 people(age above 40 years old,free of stroke,transient ischemic attack(TIA)and myocardial infarction ) were qualified and enrolled in the final analysis. A questionnaire survey,blood biochemical analysis and carotid artery ultrasound examination were finished by trained medical staff. According to the hs-CRP 3 mg measurements at the first and third times health examinations,all subjects were divided into four groups,including continued decreasing group(hs-CRP < 3 mg/ L),decreasing group(hs-CRP decreased from≥3 mg/ L to < 3 mg/ L ),increasing group((hs-CRP increased from < 3 mg/ L to≥3 mg/ L)and continued high group((hs-CRP ≥3 mg/ L). Multiple logistic regression analysis was used to test the impact of change of hs-CRP on carotid artery plaque. Results Incidence of carotid artery plaques in continued decreasing, decreasing,increasing and continued high groups were 33. 6%(1 308 / 3 577),44. 7%(178 / 398),45. 1%(186 / 412)and 54. 9%(151 / 275),respectively. The dependent variable was named based on carotid artery plaque(1 = plaque and 0 = no plaque),and in dependent variable was named based on hs-CRP value change (0 = continued decreasing group;1 = decreasing group;2 = increasing group;3 = continued high group). Multiply factors logistic regression analysis showed that the risk of carotid artery plaques for women increased compared to decreasing group( RR = 1. 17,95% CI:1. 01 - 1. 35,P = 0. 035). After adjusting gender,age,smoking,low density lipoprotein cholesterol,fasting blood-glucose,baseline lg( hs-CRP)and body mass index,the risks of developing carotid artery plague in increasing group and continued high group were increased compared to decreasing group among the women and whole population(for all subject:RR = 1. 33,95% CI:1. 04 - 1. 70,P =0. 023;for women subject:RR = 1. 63,95% CI:1. 08 - 2. 46,P = 0. 021). Conclusion Increasing hs-CRP is a risk factors of incidence of carotid artery plaque possibly.

Objective To analyse risk factors for bile leakage after liver resection.Methods Between January 2011 and December 2012,469 patients underwent elective hepatectomy.We prospectively collected and retrospectively analyzed demographic data,pathological variables,and perioperative variables.Univariate analysis screened the related factors of bile leakage after liver resection.Multivariate analysis identified the independent risk factors of postoperative bile leakage.Results 469 patients were included in the analysis.The prevalence of bile leakage was 22.6％ (n =106).Univariate analysis identified the following risk factors as male gender,portal hypertension,steatosis,cirrhosis,ChildPugh grade,ascites,operative time,intraoperative transfusion,intraoperative blood loss,portal triad clamping,microwave solidification,lymphadenectomy,number of tumor,tumor margin,tumor capsular,diameter of tumor,portal vein invasion or portal branch thrombosis,number of abdominal drains.Multivariate analysis identified 4 independent risk factors for postoperative bile leakage:Cirrhosis [OR =13.2 (2.3,76.9),P =0.004],steatosis [OR =73.1 (17.7,301.5),P ＜ 0.001],infusion volume of the surgery day [OR=1.0 (1.0,1.0),P=0.019] and diameter of tumor [OR=1.2 (1.1,1.3),P=0.003].Conclusions Cirrhosis,steatosis,transfusion volume of the surgery day,and tumor size were risk factors for bile leakage after major liver resection.

Objective To investigate the relationship between arsenic in drinking water and skin lesions in endemic arsenism area in Shanyin County of Shanxi Province,in order to provide epidemiologic data for further arsenism research.Methods One hundred and eighty-nine endemic arsenism patients and 59 controls were randomly selected in 17 endemic amenism countries in Shanyin County of Shanxi Province.The content of arsenic in drinking water which wa8 collected indoom was half-quantitatively screened by a kit made by Chinese Center for Disease Control and Prevention,then quantitatively determined by HPLC-ICP-MS.Patients of endemic arsenism were diagnosed by "The Standard of Diagnosis for Endemic Amenism"(WS/T 211-2001).Results There were 64.9% (87/134)samples above the arsenic level(50μg/L)of drinking water and the median value of arsenic in drinking water was 91.43 μg/L in 134 water samples.The OR(95%CI)value between arsenic in drinking water and hyperkeratosis,hyperpigmentation,depigmentation was 2.46(1.22-4.94),3.34(1.50～7.44)and 2.86(1.50-5.46),respectively.The prevalence of hyperkeratosis,hyperpigmentation and depigmentation increased,as the arsenic in drinking water increased(≤10,≤50,≤200,＞200μg/L),especially in＞200μg/L group(OR=6.15,13.96,11.41,P＜0.05).The arsenic level in drinking water of Ⅲ degree of depigmentation patients(318.300μg/L)was higher(P＜0.05)than that of 0,Ⅰ and Ⅱ degree groups(86.670,131.800,1 10.590μg/L,P＜0.05).Conclusions Shanyin County is a medial arsenic pollution area. Arsenic in drinking water is considered as a risk factor of skin lesion. The degree of skin lesions increased,as the arsenic in drinking water increased.

Objective To explore the possible association of single nucleotide polymorphism (SNP) rs3738435 of muscarinic acetylcholine receptor subtype M3 gene (cholinergic receptor, muscarinic 3, CHRM3) with risk of type 2 diabetes mellitus (DM) and metabolic disturbance. Methods The genotypes of T-149C variant of CHRM3 gene were determined by PCR-RFLP in 573 Chinese individuals in Shanghai, including 220 newly-diagnosed type 2 DM patients without taking any drug and 353 subjects with normal glucose tolerance (NGT). In the subjects, height and weight were measured for body mass index(BMI), waist, hip and femoral circumstances for waist-to-hip ratio (WHR) and waist-to-femur ratio (WFR), and serum lipid level including total cholesterol, triglyceride, high-density and low-density lipoprotein cholesterol, blood pressure, plasma glucose levels both at 0 and 120 minute during oral 75 g glucose tolerance test (OGTT) were also determined. Results (1) There was no statistical difference in the gene frequency between groups of type 2 DM and NGT. (2) In the group of type 2 DM, significant differences were observed between TT genotype carriers and TC+CC genotypes carriers for BMI, with an obvious increase in TY genotype carriers [(26.99±3.59vs25.34±3.48)kg/m2, P=0.001]. (3) In the subgroup of type 2 DM with BMI≥25 kg/m2, total cholesterol was higher in TT genotypes than in TC+CC genotypes[(5.75±1.26vs5.27±1.14)mmol/L, P=0.030], so was the low-density lipoprotein cholesterol. Conclusion The genetic variation T-149C in the CHRM3 gene seems to attribute to weight regulation and lipid metabolism of patients with type 2 diabetes mellitus in Chinese population.

Objective Explore the change of IL-1β and IL-18 expression in pulmonary hypertension induced by monocrotaline.Methods Divide the mouses into two groups, control group and experimental group (n=10).Establish rats pulmonary hypertension model induced by monocrotaline.Detect the model by ultrasound, myocardial cells HE dyeing and tunnel test;ELISA was used to detect the serum biological markers NF-κB, COX2, IL-6, IL-1β, TNF-α and NO;Immunohistochemical was used to detect the expression level of IL-1β and IL-18 in the lung tissue;the protein change of NLRP3 in the lung tissue was detected by Western blot.Results Serum biological markers of NF-κB, COX2, IL-6, IL-1β, TNF-α and NO are significantly increased in PAH rats(P<0.05);The expression of IL-1β, IL-18 in the lung tissue increased obviously(P<0.05);The NLRP3 protein expression was significantly higher in experimental group.Conclusions Changes of NLRP3 effect increase expression of IL-1β and IL-18and which may play an important role in pulmonary hypertension induced by monocrotaline.

Objective To investigate effective treatment modalities and the related factors influencing prognosis of patients with gallbladder cancer.Methods The clinical data of 76 gallbladder carcinoma patients admitted to the Department of General Surgery,PLA Nanjing General Hospital from January 2005 to October 2015 were analyzed retrospectively.Follow-up was carried out via telephone or outpatient service until January 2016.Cox regression and Kaplan-Meier models were performed for survival analysis.Results 69 patients were treated with surgery and/or postoperative adjuvant chemotherapy.The remaining 7 patients with liver or distant metastases who did not undergo surgery received chemotherapy.24 patients died from cancer relapse,37 patients died from disease progression after giving up treatment,and 7 patients were lost to follow-up.The remaining 8 patients were still alive at the time of follow-up.The depth of cancer invasion (HR =2.736),the type surgical procedure (HR =2.207),and adjuvant chemotherapy (HR =0.603) were significant impact factors of survival for GBC patients.Adjuvant chemotherapy was a protective factor.The average survival in the chemotherapy-naive group was (10.6 ± 1.9) months,the single chemotherapy group (18.5 ± 2.8) months,and the combined chemotherapy group (26.9 ± 6.4) months.There were no significant differences among these groups.Conclusions The depth of cancer invasion,types of surgical procedure particularly radical cholecystectomy,and adjuvant chemotherapy were significant factors of survival in patients with GBC.Radical cholecystectomy combined with arterial and intravenous chemotherapy using gemcitabine and oxaliplatin showed benefits in survival in GBC patients.

Objective To discuss the application of combined probiotics pretreatment and late triple therapy with helicobacter pylori infection in children.Methods 300 children with helicobacter pylori infection were randomly divided into three groups according to the way of random table.Group A was treated with standard triple therapy, omeprazole,amoxicillin and clarithromycin treatment,and 10 d was 1 treatment course.B group was given probiotic pretreatment,prior to the triple therapy using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.In group C,triple therapy before using compound lactobacillus acidophilus piece 1 piece /time,cold water to take after meals,taking 2 weeks,follow -up treatment with triple therapy for 10d.To take one week after the completion of compound lactobacillus acidophilus piece 1 piece /time,cold water after meals.The clinical therapeutic effects were recorded.Results The helicobacter pylori clearance rate of group A was 55.00%,that of group B was 86.00%,that in group C was 89.00%,the helico-bacter pylori clearance rate of group B and group C was significantly higher than that in group A,the difference was statistically significant (χ2 =23.103 7,28.670 6,all P <0.05).The treatment effect between group B and group C had no statistically significant difference (χ2 =0.411 4,P >0.05 ).In A group,nausea and vomiting occurred in 5 cases,2 cases of diarrhea,abdominal distension abdominal pain in 4 cases,skin rash in 5 cases.In group B,nausea and vomiting occurred in 2 cases,0 cases of diarrhea,abdominal distension abdominal pain in 1 case,skin rash in 1 case.In group C,nausea and vomiting occurred in 1 case,0 cases of diarrhea,abdominal distension abdominal pain 0 cases,skin rashes in 1 case.The incidence rate of adverse reactions in group B and group C was lower than that in group A,the difference was statistically significant (χ2 =11.965 8,8.000 0,all P <0.05).The incidence rate of ad-verse reactions between group B and group C had no statistically significant difference (χ2 =0.687 3,P >0.05). Conclusion Joint probiotics pretreatment and late triple therapy application in helicobacter pylori in children can promote helicobacter pylori clearance,reduce the triple therapy drug adverse reactions,it is worthy of popularization and application in clinic.

Objective To investigate expression level of endoplasmic reticulum stressmarker GRP78 in the testicular tissue in rats with different phases of morphine-dependence. To explore the role of ERS in morphine-de-pendence. Methods SD rats were divided into 6 groups: morphine (mor) -withdrawal group, mor-extinct group, mor-kindling group and their control groups, normal saline (NS)-withdrawal group, NS-extinct group, NS-kindling group. The experimental rats were injected with morphine subcutaneously on increasing dosage to establish the con-ditioned place preference (CPP) model. The rats in control groups were injected NS. Then the rats were suffered from withdrawal for 48 h, extinction and kindling by morphine, separately. The GRP78 expression level in testicular tissues of rats in the time point mentioned above were measured using Western Blot. Results The time of rats in the paired-box was (528.0 ± 81.0) s, which was significantly higher than that in the NS control group (P<0.001). It was (396.8 ± 116.9) s after extinctive phase, which was significantly higher than that the withdrawal phase of rats (P < 0.001). Also it was (396.8 ± 116.9) s after kindling with morphine which was significantly higher than that the extinctive phase of rats (P < 0.001). These changes of the time indicated that the animal models of extinction and kindling were established in the study. The GRP78 levels were down-regulated in 48 h after withdrawal (P <0.05), and increased a bit afterextinctive phase, but up-regulated highly after kindling with morphine (P < 0.01). Conclusion ERS may be related in the morphine dependence and it might play an important role of testicular dys-function in male drugabuser.