Objective To compared intensity modulated radiation therapy (IMRT) with conventional radiotherapy(CR) for the left side breast cancer after breast-conserving surgery in regard to the homogeneity of dose in the target area, cardiac dose and irradiation volume in the target area. Methods Thirty-eight patients received inverse planning of IMRT with dynamic multi-leaf collimation (dMLC). Prescription dose was 46Gy in breast volume with X-ray, and added electron boost dose was 14Gy in the tumor bed, with a total dose of 60Gy. Clinical target volume(CTV) and heart were evaluated with dose-volume histograms(DVH) in the two plans, with the t test taken with SPSS 11.0. Results Average received dose of 95% breast volume(D 95) was (4541?34),(4517?62)cGy, volume of 105% of dose prescription(V 105%) was 17.5%?17.6%,29.4%?26.3%, while V 110% was 0.3%?0.8%,3.7%?8.2% with IMRT and CR, respectively. Received 30Gy by the heart(V 30) was 4.6%?4.3%,18.8%?12.2%(P

Objective To evaluate the diagnosis and therapy of solid pseudopapillary tumor of the pancreas (SPTP).Methods From January 2006 to October 2011,the clinicopathological data of 24 SPTP patients diagnosed and surgically treated at Tianjin Medical University Cancer Hospital were analyzed retrospectively.Results There were 22 women and 2 men,the median age was 27.5 years old,with a range from 12 to 51 years.The most common tumor localization were at the head of the pancreas ( 11 patients,45.7％ ),followed by the body (5 patients,20.8％ ),the tail (4 patients,16.7％ ),the body and the tail (3 patients,12.5％ ) and the neck (one patient,4.2％ ).Clinical symptoms were nonspecific and the preoperative diagnosis of SPTP depended on imaging study such as ultrasonography,CT and MR.All patients were treated surgically and the correct diagnosis was made according to pathology after surgery.In a follow-up ranging from 2 to 55 months( median 27.2 months),23 cases were alive with no evidence of disease recurrence,one patient was alive with tumor recurrence.Conclusions SPTP was a less common neoplasm with low-grade malignancy,occurring mainly in young women.Complete tumor resection results in satisfactory prognosis.

Anti-angiogenic drugs such as bevacizumab can effectively alleviate the patients′brain edema and clinical symptoms and improve the patients′life quality by reducing vascular permeability and the blood-brain barrier damage.Bevacizumab has got positive efficacy in the clinical,so that it is considered as an effective and safe treatment for malignant brain edema.

Objective To investigate the correlation between plasma-soluble urokinase plasminogen activator receptor (suPAR) levels and disease severity in psoriasis patients.Method 60 psoriasis patients and 60 healthy controls were enrolled from Jan.2013 to Dec.2015 in the hospital.The plasma suPAR of all objects were measured by ELISA.Kruskal-Wallis and Mann-Whitney U test were used to compared plasma suPAR in the difference groups.Correlation between clinical data and plasma suPAR were analyzed by Spearmans's rho method.Result The plasma suPAR of psoriasis patients (3.92± 1.74 ng/ml) were higher than controls (3.03 ± 1.08 ng/ml,Z=13.05,P=0.009).The plasma suPAR of mild patients (PASI＜ 10) were lower than moderate patients (10≤ PASI≤ 20,3.90 ± 1.67 ng/ml,Z =8.00,P =0.035) and severity patients (PASI＞20,4.55 ± 1.88 ng/ml,Z=48.5,P=0.031).Positive correlation were found between plasma suPAR and psoriasis area and severity dndex (PASI) score (r=0.264,P=0.041).The plasma suPAR of the patients with disease duration＞10years (n=35,4.43 ± 1.98 ng/ml) were higher than the patients with disease duration＜10 years (n=25,3.41 ± 0.69 ng/ ml,Z=-2.064,P=0.035).Conclusion There was a positive correlation between the plasma suPAR and psoriasis disease severity.The Plasma suPAR can be the biomarker of psoriasis disease severity.It facilitate the clinical diagnosis of psoriasis.

Objective To study the changes of Young's modulus value of the renal cortex,vertebral body and sinus when there was a different degree of acute renal artery stenosis.Methods 10 Japanese white rabbits were used for this study.The left renal artery was dissected.An ultrasound probe was placed on the left kidney,Young's modulus of the renal cortex,vertebral body and sinus were recorded using shear wave ultrasound elastic imaging technique during three stages:when the renal artery was intact (0％ stenosis),tied with a suture (＞ 50％ stenosis),and ligated (100％ stenosis).Renal tissue elasticity with different degrees of renal artery stenosis were compared.Pathological study was carried out in the kidneys,each with either 0％,＞ 50％ or 100％ renal artery stenosis.Results The mean values of Young's modulus from the renal cortex,vertebral body and sinus with different degrees of renal artery stenosis were as follows:0％ stenosis,(16.31 ±1.70) kPa,(13.38± 1.63) kPa,and (12.75±2.26) kPa;＞ 50％ stenosis,(14.16±2.34) kPa,(11.49±2.70) kPa,and (10.72±2.56) kPa;100％ stenosis,(11.35 ± 1.48) kPa,(8.39± 1.29) kPa,and (7.08 ± 1.52) kPa.The mean value of Young's modulus from the renal cortex was significantly higher than those from the renal vertebral body and sinus (P ＜ 0.05).The mean values of Young's modulus from different parts of the kidney decreased progressively with an increase in renal artery stenosis (P ＜ 0.05).The pathological study demonstrated that with the increase in the severity of renal artery stenosis,glomerular volume,renal interstitial capillary diameter and red blood cells decreased.When renal artery stenosis reached 100％,there was patch degeneration and inflammatory cell infiltration within the renal interstitium,and mild degeneration of tubular epithelial cells with obscure cell borders.Conclusions The value of Young's modulus from the renal cortex was higher than those from the renal pyramid and sinus in rabbits.The values of Young's modulus from the renal cortex,pyramid and sinus decreased with an increase in the severity of renal artery stenosis,which suggest that,in the study of the elasticity of the kidney,the renal artery blood flow dynamic state can obviously affect the value of the elasticity of the kidney.

Objective To investigate the correlation between thrombocytosis and the progress of gastric cancer. Methods The clinical data of 276 gastric cancer patients who had been admitted to Tianjin Cancer Hospital from August 2002 to January 2004 were retrospectively analyzed. Of all patients, 75 were with thrombocy-tosis and 201 were with normal level of platelet. Data were analyzed by chi-square test, and the prognostie factors for gastric cancer were analyzed by Cox regression model. The accumulative survival was determined by Kaplan-Meier method, and the difference in survival between patients with and without thrombocytosis was analyzed by Log-rank test. Results The 1-, 3-, 5-year survival rates of gastric cancer patients with normal level of platelet were 82.4%, 50.5% and 41.9%, and the 1-, 3-, 5-year survival rates of gastric cancer patients with thrombocy-tosis were 74.7%, 37.3% and 25.3%. There was a significant difference in 5-year survival rates between patients with or without thrombocytosis (χ~2= 7.358, P<0.05). Thrombocytosis was correlated with the depth of invasion, distal metastasis, TNM staging and the tumor size (χ~2=6.946, 5.625, 14. 925, 4.028, P<0.05). The result of multivariate analysis indicated that the content of platelet was not the independent factor of good prog-nosis in gastric cancer. Conclusions There is a close relationship between thromboeytosis and clinieopathological factors of gastric cancer. Thrombocytosis may be used as a reference indicator for the prognosis of gastric cancer.

Objective To analyze the risk factors of liver metastasis from gastric cancer. Methods The clinical data of 225 patients with liver metastasis from gastric cancer who had been admitted to our hospital from January 1996 to December 2001 were retrospectively analyzed. Synchronous liver metastasis was observed in 123 patients and metachronous liver metastasis in 102 patients. The risk factors of liver metastasis from gastric cancer were evaluated. Results The gender of patients, location and size of gastric cancer foci, differentiation and invasion depth of gastric cancer, Lanren classification, lymph node metastasis and lymph node metastasis in region Ⅷ, vascular invasion, extrahepatic metastasis, ascites and peritoneal metastasis were the significant factors associated with liver metastasis from gastric cancer (X2 = 43.560-263. 907, P<0.05). All the factors except the size of gastric cancer foci, extrahepatic metastasis and ascites were found to be the significant factors associated with different types of liver metastasis from gastric cancer (X2 = 6.673-26. 555, P < 0.05 ). Logistic regression analysis demonstrated that the gender of patients, lymph node metastasis and peritoneal metastasis were the factors that determined the types of liver metastasis from gastric cancer. Conclusion The gender of patients, lymph node metastasis and peritoneal metastasis are the important factors to evaluate the occurrence of different types of liver metastasis from gastric cancer.

Objective To analyze the dosimetfic benefits, clinical effect and side-respond of whole breast using intensity modulated radiotherapy for early breast cancer after conservative surgery. Methods From Oct.2004 to Aug. 2005,103 patients received the whole breast intensity modulated radiation therapy (IMRT). A dosimetric comparison of IMRT with conventional radiotherapy (CR) was performed on each patient. The cosmetic results, clinical effect and side-respond were observed. Results The average volume proportion of 95% and 107% prescribed dose was 95.8% ± 4.90% and 84.0% ± 20.7% (t = 9.60, P < 0.01) with IMRT and CR in clinical target volume, respectively. The V20 (lung volume of aceepted> 20 Gy/all lung volume × 100%) of the ipsilateral lung were 15.70% ± 4.64% and 23. 11% ± 7.88% (t = - 13.3, P < 0.01). The V30of the heart were 4.44% ±3.93% and 15.55% ± 10.89%(t = - 11.3, P< 0.01) with IMRT and CR respectively for sixty-three left side breast cancer patients. The 1- and 2-year excellent rate of good cosmetic outcome was both 100%. The 1-, 2- and 3-year local control rate was 99% ,99% and 98% ,respectively. The 1-, 2- and 3-year disease-free survival rate was 99% ,99% and 96% ,respectively. The Grade 1 and 2 acute radiation skin reaction rate was 95.1% and 4.9%, respectively. Conclusion Compared with conventional radiotherapy, IMRT improves dose distribution of CTV and reduce the dose of normal tissue around CTV;but with better clinical effects and lower side-respond for early breast cancer patients after breast conservative surgery.

Objective To explore the occurance and risk factors of recurrence and metastasis of gastric cancer after gastrectomy.Methods From January 2001 to December 2004, the clinic pathological data of 141 patients with recurrence and metastasis after radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively.The possible clinic pathological factors which may affect tumor recurrence were analyzed.Results After the surgery, the 1, 2, 3 and 5-year cumulative recurrence rates were 58.2%(82/141) 、80.1%(113/141)、89.4%(126/141) 、97.9 % (138/141)respectively.The results of multivariate analysis indicated that the tumor size,invasive depth, lymph node metastasis were independent factors which affected recurrence and metastasis after radical gastrectomy (P = 0.017, 0.003, 0.000).Invasive depth, lymph node metastasis and tumor differentiation degree were independent factors which affected early recurrence and metastasis after radical gastrectomy (P=0.042, 0.000, 0.039).Conclusions The tumor size,invasive depth, lymph node metastasis are the independent risk factors to predict the recurrence and metastasis after radical gastrectomy.Most of the recurrences and metastasis is found within 2 years after radical gastrectomy.Invasive depth, lymph node metastasis and tumor differentiation degree are the independent factors to predict early recurrence after radical gastrectomy.

Objective To study the effect of heterogeneity in different parts of acute and chronic deep venous thrombus on the ultrasound shear wave elasticity value.Methods Fifteen Japanese rabbits were used to create an inferior vena cava (IVC) thrombus model via IVC ligation.Young's modulus of the thrombus head,body and tail were measured using ultrasonic shear wave elasticity technique on the fifth day (acute phase) and 14th day (chronic phase) of thrombus formation.Pathological sections were obtained from the IVC thrombus in five rabbits at the two points of time mentioned above.Pair t-test and one-way analysis of variance (ANOVA) were used to compare the data between groups.Results On the fifth day,Young's modulus values of the thrombus head,body and tail were (5.73 ±0.47)kPa,(7.82±0.63)kPa and (4.76±0.45)kPa respectively.ANOVA showed significant difference among three parts (F=134.468,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the head and tail (both P ＜ 0.01),and the value of the head was significantly higher than that of the tail (P ＜ 0.01).On the 14th day,Young's modulus values of the thrombus head,body and tail were (12.46 ± 2.59)kPa,(15.08 ±2.71)kPa and (10.03 ± 2.02)kPa,respectively.ANOVA analysis also showed significant difference among three parts (F=10.539,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the tail (P ＜ 0.01),and also higher than that of the head,although the difference was not significant (P ＞ 0.05).There was no significant difference between the head and tail (P ＞ 0.05).Young's modulus values of the thrombus head,body and tail in the chronic phase were significantly higher than those in the acute phase (t=-7.456,-7.989 and-8.159,respectively,all P ＜ 0.01).Pathological results showed that there was significant difference in thrombus structure and composition among different parts of the thrombus and among the thrombi in different individuals at corresponding points of time following thrombus formation.Conclusion There is significant heterogeneity among different parts of the same thrombus and among different thrombi at corresponding points of time after thrombus formation.Continual monitoring of the thrombus with ultrasound elasticity imaging may help to improve the accuracy of thrombosis staging.