Objective The purpose of this study was to assess the value of prenatal ultrasound diagnosis for fetal ear auricle malformations.Methods The coronal and sagittal planes of fetuses ears were obtained prospectively in 6239 singleton fetuses in the First Affiliated Hospital of Shantou University Medical College for the period from 2012 February to 2015 December,the ultrasound images and pregnancy outcomes were analyzed in 11 cases of fetuses ear auricle malformations diagnosed prenatally.Results Eleven Cases of fetuses ear auricle malformations include with 7 cases of microtia,3 cases of low-set ears and 1 case of anotia.Eleven cases were combined with other structural malformations were as followings,3cases with craniocerebral congenital malformation,5 cases with dentofacial deformity,5 cases with malformation of heart,3 cases with limb deformity.Cordocentesis was performed in 7 cases among which 6 with abnormal karyotype,including 2 cases of trisomy 21,2 cases of trisomy 13,2 cases of trisomy 18,1 case of 22ql 1 abnormalities.Compared with the postpartum facial examination,prenatal ultrasound correctly diagnosed 10 cases of fetal ear auricle malformations,missed diagnosis 1 case of microtia.Conlusions Fetus with ear auricle abnormalities have characteristic prenatal ultrasound imaging;prenatal ultrasonography can provide reliable information in the diagnosis of this disease.This study suggests that antenatal ear auricle length measurements might be a promising sonographic screening method for the detection of abnormal karyotype in pregnancy.

Objective To retrospectively analyze the value of postoperative adjuvant therapy in the treatment of stageⅢthoracic esophageal squamous cell carcinoma ( ESCC) . Methods From 2008 to 2011, a total of 395 patients with stageⅢthoracic ESCC undergoing radical resection were enrolled as subjects. In those patients.97 received surgery alone (S).212 postoperative adjuvant chemotherapy (POCT),and 86 postoperative radiotherapy (PORT).Comparison of categorical data was made by chi?square test. The survival rates were calculated by the Kaplan?Meier method. The log?rank test was used for between?group comparison and univariate analysis. Results All patients were followed up for at least 3 years.125 cases were followed up for at least 5 years. The 5?year overall survival ( OS) rates in patients treated with S,POCT and PORT were 17. 1%,29. 2% and 36. 4%,respectively (P=0. 000).POCT and PORT could mainly increased OS in patients of males.upper?and middle?segment,severe ahhesion at surgery.well?or middle?differentiation,stageⅢa andⅢb(P=0. 000?0. 049);whenever ages.tumor lesion,two?/three field esophagectomy.and the number of removal lymph nodes. PORT could improved OS also (P=0. 001?0. 047).POCT could also improve OS in patients of ages≤60, tumor lesion<6 cm and removal lymph nodes<10 ( P=0. 002?0. 049 ) . The 5?year progression?free survival (PFS) were 19. 0% with S,28. 8% with POCT,36. 4% with PORT,respectively (P=0. 012).PORT could improve PFS (P=0. 012);especially for patients of males,ages ≤60,upper?and middle segment ESCC,tumor lesion ≥6 cm,severe ahhesion at surgery,removal lymph node<10 and ≥10,well or middle differentiation,stageⅢa andⅢb(P=0. 001?0. 042).But POCT could not increased PFS (P=0. 119) . Conclusions In the treatment of patients with stage Ⅲ thoracic ESCC undergoing radical resection,both POCT and PORT can improve the OS rate, particularly in patients with stage Ⅲa or Ⅲb middle and upper thoracic ESCC, severe adhesion formation during surgery. and moderately or well differentiated squamous cell carcinoma. The DFS rate is improved in patients treated with PORT,but not in those treated with POCT.

Objective To analyze the efficacy of salvage therapy for postoperative recurrence or metastasis in patients with stage T3 N0 M0 thoracic esophageal squamous cell carcinoma ( ESCC ) and its influencing factors. Methods A retrospective analysis was performed in 108 patients with postoperative recurrence or metastasis in stage T3 N0 M0 thoracic ESCC who were admitted to our hospital from 2008 to 2009. In those patients, 59 had locoregional recurrence ( LR) , 26 distant metastasis ( DM) , and 23 both LR and DM. After recurrence, 53 patients received supportive therapy, 32 salvage radiotherapy, 9 chemotherapy, and 14 chemoradiotherapy. The overall survival ( OS) rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The univariate and multivariate prognostic analyses were performed using the log?rank test and the Cox regression model, respectively. Results The follow?up rate was 100%. In all patients, the 1?, 3?, and 4?year OS rates were 29?9%, 16?5%, and 14?4%, respectively;the median OS time was 6 months. The univariate analysis showed that recurrence pattern and salvage therapy were associated with OS after recurrence ( P=0?017;P=0?000) . The multivariate analysis showed that salvage therapy was the only independent factor for OS after recurrence ( P=0?000) . Compared with supportive therapy, the risk of death after chemotherapy, radiotherapy, or chemoradiotherapy was reduced by 76?7%, 76?7%, and 86?1%, respectively. Conclusions The treatment outcomes are poor in patients with postoperative recurrence of stage T3 N0 M0 thoracic ESCC. Salvage therapy can substantially improve OS after recurrence.

Objective To evaluate the efficacy of three-dimensional conformal radiotherapy (3DCRT) and prognostic factors for stage Ⅲ non-small cell lung cancer (NSCLC).Methods From 2000 to 2010,474 patients with stage Ⅲ NSCLC undergoing 3DCRT were enrolled as subjects.Those patients,consisting of 382 males and 92 females,had a median age of 63 years.In those patients,211 had stage ⅢA NSCLC and 263 had stage ⅢB NSCLC;165 were treated with radiotherapy alone and 309 with chemoradiotherapy;55 were treated with conventional radiotherapy plus 3DCRT,340 with 3DCRT,and 79 with intensity-modulated radiotherapy;the median equivalent dose was 60 Gy (44-77 Gy).The Kaplan-Meier method,log-rank test,and Cox model were used for survival rate calculation,univariate analysis,and multivariate analysis,respectively.Results The follow-up rate was 96.6％.In all patients,the 1-,3-,and 5-year overall survival rates were 63.0％,24.9％,and 17.8％,respectively;the median survival time was 18 months.The univariate analysis showed that sex,age,immediate response,radiotherapy method,fractionation scheme,chemotherapy,and radiation pneumonitis (RP) were prognostic factors (P=0.004,0.001,0.000,0.007,0.004,0.009,0.049).The multivariate analysis showed that sex,age,immediate response,radiotherapy method,and RP were independent prognostic factors (P=0.006,0.000,0.000,0.003,0.048).Patients with radiation doses of 60-66 Gy had the best prognosis of all.Conclusions In patients with stage Ⅲ NSCLC undergoing 3DCRT,female patients,patients at a young age,patients with satisfactory immediate response,patients treated with full-course 3DCRT,and patients with grade 0-1 RP have better prognosis than others.3DCRT combined with chemotherapy improves survival in patients.A radiation dose of 60-66 Gy is recommended.

Objective:To investigate the damage effect of bisphenol A (BPA)on the testis tissue of adult mice, and to reveal the reproductive toxicity of BPA in the body of animal and mechanism.Methods:40 KM mice aged 8 weeks were randomly divided into control group (according to the weight ratio of corn oil gavage), low dose of BPA group (100 mg·kg-1BPA),moderate dose of BPA group (200 mg·kg-1 BPA),and high dose of BPA group (400 mg·kg-1 BPA).4 weeks laster,the testis tissue was taken.The apoptotic rates in the testis tissue were detected by flow cytometry;the distribution and expression of Fas and FADD were measured by immunohistochemistry.Results:Compared with control group,the apoptotic rate,the expression rates of Fas and FADD in testis tissue of the mice in low dose of BAP group had no changes (P>0.05),while the apoptotic rates in the testis tissue and the positive expressions rates of Fas and FADD in moderate and high doses of BPA groups were increased (P<0.05).Compared with low dose of BPA group,the apoptotic rates and the positive expression rates of FAS and FADD in tests tissue of the mice in moderate and high doses of BPA groups were significantly increased (P<0.05).Compared with moderate dose of BPA group,the apoptotic rate and the positive expression rates of FAS and FADD in testis tissue of the mice in high dose of BPA group was significantly increased (P<0.05).The overexpression of Fas and FADD was positively correlated to the apoptotic rate in testis tissue in moderate dose of BPA group (r=0.430,P<0.05;r=0.238,P<0.01)and high dose of BPA group (r=0.637,P<0.01;r=0.359,P<0.01).Conclusion:BPA with content dose can increase the apoptotic rates of cells in testis tissue and the expressions of Fas and FADD.BPA’s reproductive toxicity may be closely associated with the activation of Fas signal pathway and resulting in massive apoptosis.

Objective To investigate the influence of plasma exchange with acupuncture point injection therapy on liver fibrosis indexes in patients with severe hepatitis. Methods Sixty patients with severe hepatitis were randomly divided into group A with 29 cases receiving plasma replacement and group B of 31 cases receiving astragalus injection at Zusanli point in addition to plasma replacement. Changes of liver fibrosis indexes including serum hyaluronic acid (HA), laminin (LN), collagenⅣ(Ⅳ-C), typeⅢpre-collagen (PCⅢ) were observed, which were compared with those from group C with 30 healthy subjects. Results Before treatment, there was no statistical significance in comparison of liver fibrosis index in group A and B (P>0.05), but all the indexes were higher than those in group C (P<0.001). After treatment, the level of each index in group A and B was down with a more significant change in group B and the comparison of both groups indicated statistical significance (P<0.05 or P <0.001);Compared with those in group C, changes ofⅣ-C, PCⅢin group B showed no significant difference (P>0.05). Conclusion Plasma exchange with astragalus injection at Zusanli point can effectively improve liver fibrosis indexes in patients with severe hepatitis and then improve the prognosis of patients.

ObjectiveTo observe the clinical efficacy of plasmapheresis plus acupoint injection in treating severe hepatitis. MethodSixty patients with severe hepatitis were randomized into a treatment group of 31 cases and a control group of29 cases. The two groups both received plasmapheresis in addition to the comprehensive internal medicine treatment, while thetreatment group simultaneously received acupoint injection withHuang Qi(Radix Astragali) at Zusanli (ST 36). After the intervention, the symptoms, signs, liver function, blood coagulation, and blood ammonia were observed in the two groups.ResultAfter the intervention, the symptoms, signs, and biochemical indexes were significantly improved,and theindexes in the treatment group were significantly different from that in the control group (P<0.05,P<0.01), and the total effective rate of the treatment group was markedly higher than that of the control group (P<0.05).ConclusionPlasmapheresis plus acupoint injection can effectively improve the short-term condition of the patients, enhance therapeutic efficacy, with fewer adverse reactions.

Objective To explore radiation-induced esophagitis and its related factors in the patients with local advanced non-small cell lung cancer ( NSCLC ) which were treated with three-dimensional conformal radiation therapy (3D-CRT). Methods From January 2001 to December 2008, 203 patients who suffered from stageⅢNSCLC were achieved, including 163 males and 40 females, with a median age of 63 years old, while 79 cases were in stageⅢa and 124 in stageⅢb . The equivalent median dose of tumor was 62 Gy( range of 50-78 Gy) . Among them, 74 cases were administered with radiotherapy alone, 45 with sequential radiotherapy and chemotherapy, 87 cases with concurrent radiochemotherapy. Radiation esophagitis was evaluated with RTOG standard. The dosimetric parameters was estimated from dose volume histogrma ( DVH ) . The clinical and dosimetric parameters of radiation esophagitis were evaluated by spearman correlatived univariate and Logistic multivariable analysis. Results After radiotherapy, out of 203 patients, 87 had acute radiation esophagitis(RE), 47 in grade 1, 37 in grade 2, and 3 in grade 3 RE. According to spearman correlatived analysis, the correlatived factors included ages, chemotherapy, GTV, PTV, the mean doses of PTV and lung, the max and mean dose of esophagus, V40 , V45 ,V50 ,V55 ,V60 , length of esophagus( total circumference) treated with 45 Gy ( LETT45 ) , and LETT50 ( r=-0. 162-0. 235,P<0. 05). All the 14 factors had good correlation with RE in univariate analysis. But for other factors,such as gender, site of tumor, smoking, T, N, clinical stage, equivalent dose of tumor, style of radiation, the mean dose of GTV, LETT55 and LETT60 , there were not correlation with ≥grade 2 RE with univariate analysis(r= -0. 106-0. 122, P>0. 05). There were 21 factors, such as gender, age, smoking, clinical stage, site of tumor, chemotherapy, GTV, PTV, mean dose of PTV and lung, max and mean dose of esophagus, V40 -V60 of esophagus, LETT45-60 , incorporated into multivariable analysis, only chemotherapy and V45 of esophagus were independent predicted factors(Wald=4. 626, 9?882, P<0. 05). Conclusions In local advanced NSCLC after 3D-CRT, chemotherapy ( especially concurrent radiochemotherapy) could increase radiation-induced esophagitis. The parameter of DVH could also be used to predict radiation-induced esophagitis, V45 of esophagus may be the most valuable predictor.

Objective To assess the therapeutic efficacy and prognostic factors in elderly patients with stage Ⅲ non-small cell lung cancer (NSCLC) after three-dimensional conformal radiotherapy (3DCRT).Methods A retrospective analysis of 124 stage Ⅲ NSCLC patients aged 70 or over who had received treatment with 3DCRT was conducted retrospectively in this study.There were 99 male and 25 female patients,with a median age of 74 years(range:70-84).The median dose was 60 Gy(range 50-72 Gy).Eighty-three patients were treated with radiotherapy alone,27 with sequential and 14 with concurrent radiochemotherapy.Results The end date of follow-up was August 30,2013.After 3DCRT,the 1-,3-and 5-year overall survival (OS) were 61.1％,23.8％ and13.2 ％,respectively,and the median survival time was 18 months.Univariate analysis revealed that gender,obstructive pneumonia,dosage,method of therapy and immediate effect were related to OS(x2 =3.957,6.398,7.147,12.307 and 11.035,respectively;P=0.047,0.011,0.008,0.002 and 0.001,respectively).Multi-variable analysis indicated that age,gender,obstructive pneumonia,dosage and method of therapy were independent prognostic factors for OS.The OS time was longer inpatients who were female,aged over 75,with no obstructive pneumonia or dosage≥ 60 Gy.Compared with radiotherapy alone,sequential radiochemotherapy increased OS while concurrent radiochemotherapy decreased OS.Conclusions Sex,age,obstructive pneumonia and dosage affect the survival of elderly stage Ⅲ NSCLC patients treated with three-dimensional conformal radiotherapy.Concurrent radiochemotherapy should be considered with caution

ObjectiveTo investigate the expression of miR-155 in whole blood of patients with breast cancer and explore the possibility of miR-155 in whole blood as a marker of beast cancer. Methods65 cases (breast cancer:47 cases, non-breast cancer:18 cases) in Thyroid and Breast Surgery Department of No.1 People's Hospital of Huai'an from Dec 2010 to Apr 2011 were enrolled according to the selected criteria.Two milliliters anticoagulant blood were sampled to isolate total RNA.The expression level of miR-155 in whole blood was measured by real-time quantitative polymerase chain reaction (real-time qPCR)analysis.The relationship between the expression level of miR-155 in whole blood and the clinical pathological fearutres was analyzed.ResultsThe expression level of miR-155 in breast cancer patients was up-regulated compared with that in non-breast cancer patients(P ＜ 0.05).The expression level of miR-155 in patients with positive lymph nodes was up-regulated compared with that in patients with negative lymph nodes( P ＜ 0.05).The expression level of miR-155 in stage Ⅲ breast cancer was up-regulated compared with that in stage Ⅰ & Ⅱ breast cancer( P ＜ 0.05 ).The expression level of miR-155 in patients with positive ER and PR was down-regulated compared with that in patients with negative ER and PR breast cancer.Conclusion The study demonstrates that the expression of miR-155 in whole blood is related to clinical pathological features of patients with breast cancer and can be used as a potential marker of breast cancer.