From March 1980 to December 1987, 650 patients with non-small cell lung cancers were treated by radiotherapy alone, chemotherapy alone, operation alone, Chinese medicine therapy alone, radiotherapy combined with chemotherapy, operation with radiotherapy operation with chemotherapy. The survival rates of the patients who received operation were obviously higher than radiotherapy alone, chemotherapy alone and Chinese medicine therapy alone groups. No relationship was found between the survival rates and pathological classification, but there was a close relationship between the survival rates and stages.

Purpose: To study the clinical application of intensity modulation radiation therapy (IMRT) in patients with prostate cancer. Methods: From May 2000 to June 2001, 14 patients with prostate carcinoma were treated . 12 patients underwent orchiectomy before IMRT. All patients were treated by IMRT with PEACOCK-MIMiC system ( CORVUS 3. 0 NOMOS CORPORATION) and VARIAN 6MV-photons. The prescription dose-time- fraction was 2.5 to 3. 0 Gy per fraction, 5 times per week , the total was 25 to 30 fractions, the total IMRT dose was 72 to 77 Gy, 5 to 6 weeks. Results: 3 months after IMRT , PR: 10(71.4%), NC: 4 cases and 6 month after IMRT CR: 6,PR: 8 cases. The overall response( CR + PR) rate were 100% . No Grade Ⅲ ,Ⅳ gastrointestinal ( GI) and genitourinary ( GU) toxicity occurred in any of the patients. Conclusions: IMRT is an effective approach for patients with prostate carcinoma. The dose of 72 to 77 Gy was safe.

OBJECTIVE:To evaluate the economics of penehyclidine hydrochloride and atropine in the treatment of acute organophosphorus poisoning (AOPP).METHODS:The information of 118 AOPP patients were collected and divided into group A (59 cases) and B (59 cases) according to therapy plan.There were 22 cases of mild poisoning,20 cases of moderate poisoning and 17 cases of severe poisoning in group A.There were 21 mild cases,21 moderate cases and 17 severe cases in group B.Based on routine treatment,group A was given Penehyclidine hydrochloride injection intramuscularly with initial dose of 1 mg (mild),2 mg (moderate) and 4 mg (severe).Group B was given Atropine sulfate injection intravenously,with initial dose of 2 mg (mild),5 mg (moderate) and 10 mg (severe).Both received maintenance treatment according to patients condition and stopped taking medicine after symptoms disappeared.Clinical efficacies,the time of acetylcholinesterase recovery and ADR were observed in 2 groups.The economics of therapy plans for mild,moderate and severe poisoning were evaluated in 2 groups by cost-effectiveness analysis.RESULTS:There was no statistical significance in total response rate of mild poisoning or the time of acetylcholinesterase recovery between 2 groups (P＞0.05).Total effective rates of moderate and severe poisoning in group A were significantly higher than group B,and the time of acetylcholinesterase recovery was significantly shorter than group B,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR in mild,moderate and severe poisoning patients (P＞0.05).Cost-effectiveness ratio of penehyclidine hydrochloride was similar to that of atropine in mild poisoning patients;that of penehyclidine hydrochloride were significantly lower than that of atropine in moderate and severe patients.It was inline with the results of sensitivity analysis.CONCLUSIONS:Based on routine treatment,penehyclidine hydrochloride is similar to atropine in therapeutic efficacy of AOPP and the time of acetylcholinesterase recovery.For moderate and severe AOPP patients,penehyclidine hydrochloride is significantly better than atropine in improving therapeutic efficacy and the time of acetylcholinesterase recovery.The safety of 2 drugs are satisfactory;penehyclidine hydrochloride possesses cost-effectiveness advantage.

Objective To investigate the effect of competitive N-methyl-D-aspartate (NMDA) receptor antagonist LY274614 [(?)-6-phosphonomethyl-decahydroisoquinolin-3-carboxylic acid] on the development of morphine tolerance and dependence.Methods Male Spraque-Dawley rats were rendered tolerant and dependent by subcutaneous injection of morphine(15mg/kg body weight) three times a day for 10 consecutive days. LY274614 (2, 4, 6 mg/kg body weight) was also given subcutaneously by subcutaneous injection. Antinociception was measured by tail-flick (TF) test. Tail was exposed to the heat source(a beam of high intensity light). The time from the beginning of exposure to removal of tail from the path of the heat source was taken as latency. The baseline TF latency without medication was 4-5 seconds. A ten-second maximum exposure to the heat source was used to minimize damage to tissue during the multiple measurements. Morphine prolonged TF latency. With the development of tolerance TF latency gradually returned to baseline value. Physical dependence on morphine was assessed by abstinence syndrome precipitated by subcutaneous injecting naloxone 10 mg/kg on the tenth day. According to method of Blasig, the number of jumping/30min after naloxone injection was recorded as an index pf abstinence syndrome. Rats were randomly divided into 8 groups (n=6-8). Each group received morphine 15 mg/kg or normal saline (NS) 1.5 ml/kg+LY274614 (2.0,4.0,6.0 mg/kg) or NS, group 1: morphine+NS; group 2: NS+NS; group 3:morphine+LY274614 (2mg/kg); group 4: NS+LY274614 (2mg/kg); group 5: morphine+LY274614 (4mg/kg); group 6: NS+LY274614 (4mg/kg); group 7: morphine+LY274614 (6mg/kg); group 4: NS+LY274614 (6mg/kg).Results LY274614 itself did not have analgesic action, but if used with morphine, it did inhibit the development of tolerance. In group 5 and 7 the decrease in TF latency was more gradual than that in morphine+saline group. 4 and 6 mg/kg LY274614 reduced the number of jumping/30min following naloxone injection.Conclusions LY274614 can inhibit morphine tolerance and dependence rendered by consecutive subcutaneous morphine injection.

Objective To evaluate the clinical effect,the changes of pulmonary hypertension,serum D-dimer and side effect of irbesartan combined with low molecular weight heparin in the treatment of pulmonary hypertension in COPD patients.Methods 49 patients of COPD were randomly allocated into two groups:the control group( n =22 )and the treatment group( n =27).The patients of the control group were treated with common treatments,for the treatment group,irbesartan 80mg qd combined with low molecular weight heparin 0.4ml IH bid were additionally administered for 14 days.To evaluate the clinical effect,the changes of pulmonary hypertension,serum D-dimer and side effects.Results The treatment group and the control group could reduce the pulmonary artery pressure.The clinical effects of the former were statistically significant better than the control(P ＜0.01 ).Side effect had no statistically significant difference between two groups.Conclusion Irbesartan combined with low molecular weight heparin have better clinical effects in the treatment of pulmonary hypertension in COPD patients and it was convenient,safe and worthy of extending in clinic.

ObjectiveTo investigate the clinical features of Chinese dysgraphia and then probe into its mechanisms in a patient with semantic dementia(SD).MethodsThe patient with SD finished the writing part of the Aphasia Battery of Chinese (Aphasia Battery of Chinese,ABC) and the Chinese agraphia battery (Chinese agraphia battery,CAB ) in addition to a series of other neuropsychological tests.Results( 1 ) On the Wechsler Adult intelligence scale,the patient performed poorly on information and vocabulary with scores of 6/29 and 8/80,respectively.He spoke out only 11 names totally on the category fluency test within 1 minute,while 25 names or more than were normal.Semantic features test showed he made 37 right answers of 60 questions,with scores of 8/20 on category,7/20 on function and 8/20 on nature features.(2)The writing disorder exhibited Chinese aphasia agraphia with obvious difficulty in forming characters,wrong characters of the same pronunciation or the same form or unrelated errors,and grammatical impairments.Its damage from serious to light occurred in picture writing( 6/40),writing sentences to convey meaning(1/10),dictation(11/40) and automatic writing(35/40).The transcription was relatively preserved (40/40 ). (3)He scored 20 and 19 points on MMSE and MoCA.Executive function was damaged significantly,while recent memory was preserved relatively.ConclusionThe patient with SD shows an impoverished store of general knowledge and poor comprehension of single-word.The nature of SD's dysgraphia presents Chinese aphasia agraphia,undoubtedly due to progressive deterioration in semantic memory.More importantly,its error types and distribution show apparent discrepancy from that of alphabetic script.Presumably because Chinese writing system is logographic in nature and the pathway of comprehension concerning syllable-orthography-morphemes mapping,while alphabetic writing system follows a principle of mapping graphemes on-to phonemes and letters themselves dont stand for any meaning.

Objective To explore the clinical manifestations,diagnosis,misdiagnosis and treatment of primary hyperparathyroidism.Methods The clinical data of 36 patients with primary hyperparathyroidism admitted into the First Affiliated Hospital of Chongqing Medical University from January 2009 to October 2014 were reviewed and analyzed retrospectively.Results The manifestations of primary hyperparathyroidism were various and atypical.Primary hyperparathyroidism was often misdiagnosed as other diseases by 25.0％ (9/36).Among the patients,the ratio of male to female was 1:1,and median age was 58 years old.Of all patients,there were 9 persons with joint pain,digestive system symptoms in 7 cases,cervical mass discovered in 6 cases(3 cases were found when B ultrasonic examination),urinary calculus in 5 cases,fatigue symptoms in 4 cases,osteoporosis and urinary calculus in 2 cases,1 case with fracture,2 cases without any symptoms.Their calcium and parathyroid hormone level were increased by various degree.The accuracy rates of level diagnosis of Color Doppler ultrasound combine with CT or 99Tcm-MIBI were improved obviously,85.2％ and 93.1％ respectively.Twenty-eight patients received surgical treatment and pathology examination confirmed the accurate pathological types after surgery.There were 23 cases of parathyroid adenoma,1 case parathyroid hyperplasia,1 case parathyroid carcinoma,2 cases of parathyroid adenoma with nodular goiter,parathyroid adenoma merged thyroid carcinoma in 1 case.Serum calcium and parathyroid hormone level declined obviously after operation.The other 8 patients received non-surgical treatment,7 cases were alleviated and 1 case died due to irreformable high blood calcium crisis.Conclusion There should be pay attention to recognize primary hyperparathyroidism,check the blood calcium,and about suspected cases should be performed as early as parathyroid tested,neck color Doppler ultrasound.Early surgical treatment can significantly improve the prognosis and quality of life.

Objective To analyze the clinical and CT characteristics of pancreatic metastasis to improve the correct diagnosis rate.Methods The clinical and CT data of 14 patients with pancreatic metastasis were reviewed retrospectively.Results Among the 14 patients,the primary malignancy was lung cancer in 6 cases,renal carcinoma in 3 cases,colon carcinoma in 2 cases,laryngeal cancer in 1 case,gastric cancer in 1 case and ovarian carcinoma in 1 case.Pancreatic metastases from renal carcinomas often developed a long period after initial nephrectomy and survived for a relatively long time.Abdominal CT plain scan and enhanced scan was performed in all cases.Four cases were of solitary type,9 cases were of multiple types and 1 was of diffuse type.Totally 28 lesions were found,which were usually located in the neck and body of the pancreas,the diameter of 28 pancreatic lesions was ranging from 0.5 cm to 11 cm,with a mean diameter of 2.3 cm.On CT plain scan,there were 19 hypodense lesions,7 slightly hyperdense lesions and 2 isodense lesions,5 necrotic lesions.On enhanced CT,the lesions showed moderate enhancement in 7 cases,circular enhancement in 6 cases,moderate and circular enhancement in 6 lesions,obvious enhancement in 8 lesions and no enhancement in 1 lesion.All patients had extra-pancreatic metastases,and 2 cases had peripheral vascular invasion.Conclusions Pancreatic metastases are rare,often accompanied with multiple lesions and extra-pancreatic metastases.The CT features of pancreatic metastases from renal carcinomas are slightly hyperdense and obvious enhancement; in other metastases,there are hypodense,morderate and/or circular enhancement lesions.Accurate diagnosis can be achieved by knowledge of patients' medical history.

Epithelial-mesenchymal transition (EMT) is a major mechanism in tumor metastasis.As the key regulatory factor,Twist gene plays an important role in EMT,and it can be induced by radiotherapy,chemotherapy and a variety of cytokines.Researches show that tumor cells can get stem cell-like properties via EMT,which can lead to chemo-radiotherapy resistance,tumor angiogenesis and distant metastasis.EMT has a great influence on the prognosis of tumor,and it is expected to become an important target for tumor treatment.

Objective To investigate the influence of self-management and education on behaviors of medical compliance of patients undergoing vitrectomy combined with tamponade.Methods Sixty-four patients undergoing vitrectomy combined with tamponade were randomized equally into the control group and observation group in the order of admission.The control group received routine care and health education,while the observation group received self-management education follow-ups besides the routine nursing.The two groups were compared in terms of the cumulative time of the correct position,compliance behavior and the incidence of postoperative complications.Results The cumulative time of the correct position of observation group was longer than that of the control group after operation.The observation group did better in compliance behavior than the control group and the incidence of postoperative complications in the former group was lower than the latter(P<0.05).Conclusion Self-management and education can enhance patients’behaviors in medical compliance and decrease postoperative complications and promote the success of the surgery.