Radiotherapy is an importment local treatment for non-small cell tung cancer. In recent years,with the development of molecular biology and radiotherapy technique and the update of equipment,radiation pattern with different doses segmentation and the concept of the combined therapy including radiotherapy and chemotherapy have been applied in clinic gradually,which get better effects.

The manifestation of clinical symptoms of cerebral small-vessel disease (SVD) is cognitive disorders. Its pathological changes are manifested as leukoaraiosis and/or lacunar infarction. However, it is not clear whether cognitive disorders caused by SVD is correlated with the severity of white matter damage. Magnetic resonance spectroscopy analysis can noninvasively detect metabolite concentrations of brain tissue in vivo and directly reflect cerebral metabolism; Diffusion-tensor imaging is a novel noninvasive technique for specific observation of white matter through different parameters such as mean diffusivity and anisotropy for quantitative evaluation of the abnormalities of fine structure of white matter. The combination of magnetic resonance spectroscopy analysis and diffusion-tensor imaging may more sensitively reveal the severity of white matter damage, and provide a research tool for cognitive disorders caused by SVD.resonance imaging

Objective To explore the effect of Ferroprotin 1 expression on tumorigenesis,invasiveness and survival of breast cancer.Methods In this study,100 breast cancer patients were enrolled.IHC SP was used to detect the expression of Ferroprotinl in paraffin-embedded tissues.The `association of Ferroprotin 1 expression and clinico-pathological parameters was evaluated by chi-square test.Survival analysis was calculated by Kaplan-Meier model and Log-rank test.Results The expression of Ferroprotin 1 was significantly higher in para-cancerous normal tissues (37/100,37％ ) than that in breast cancer tissues (24/100,24％ ;P =0.046 ).In these with positive axillary LN,there were more with low expression level of Ferroprotin 1 ( 36/40,90％ ) than those with high expression level ( 4/40,10％ ),P =0.007.More patients with low Ferroprotin1 were at advanced stage than those with high ferroprotin1 [Ⅲ 44/57 (77.2％) ;Ⅳ 17/18 ( 94.4％ )]( P =0.05 ).No significant association was found between ferroprotin1 and tumor grade,histology type,ER/PR,HER2,tumor size (P＞0.05).Ferroprotin1 has no significant effect on breast cancer survival ( P =0.591 ) by Kaplan-Meier curve and Log-rank test.Conclusions Low Ferroprotin 1 may lead to the tumorigenesis of breast cancer.Downregulated Ferroprotin1 promotes the LN involvement of breast cancer and accompanies with more advanced disease.However Ferroprotinl might not play an important role in the survival of breast cancer.

OBJECTIVE To discuss the management method of the Hospital OR Department to set up a highly cleaned and safe operating room (OR) environment to prevent nosocomial infection. METHODS As to the features of OR Department,the standardizd management of work process was reinforced. RESULTS The available resources in OR Department were made good use and infection control assured medical safety. CONCLUSIONS The setup and standardized management of Clean OR Department is in favor of the cleaniness of the OR Department and decreasing the infection rate.

Objective To evaluate the long-term effective rate,retention rate and tolerability of the ketogenic diet (KD) in pediatric drug-resistant epilepsies.Methods Data of 36 children who were treated in Department of Pediatrics,the Second Affiliated Hospital of Xi'an Jiaotong University from Nov.2011 to Dec.2013 and had continuous follow-up of at least 12 months after initiation of the KD were analyzed prospectively.Response was defined as 50％ seizure reduction.The effective rate,retention rate, outcome-predictive value of various clinical factors were also assessed.The causes of the patients withdrew from KD and side effects were recorded and analyzed.Results Thirty-six children(29 boys,7 girls; mean age of 2.84 years)were included.The effective rate was 50.0％,52.8％,47.2％ and 41.7％ at the 1,3,6,12 months;the retention rate respectively was 94.4％,91.2％,69.4％ and 52.8％.Seventeen cases withdrew from KD.Seven cases (41.2％)ceased KD becau~ of a lack of compliance,5 patients because of poor outcome,and 2 cases because of repeated infection.None of the age,disease duration,etiology and seizure type could be used as the predictor for the favourable treatment for outcome.The antiepileptic drugs before KD might be predicted the efficacy of the KD.The less amount of the antiepileptic drugs,the more opportunity of the KD might have to succeed.The side effects on the start-up period were drowsiness,week and digestive discomfort,hyperlipoidemia,hypoglycemia and hepatic dysfunction.The side effects on the maintenance period were digestive discomfort,susceptibility to infection,hyperlipoidemia,the deficiency of trace elements.Conclusions The KD is a safe and potentially effective method in treatment of refractory epilepsy patients who do not respond to customary medication therapies.

Objective To study the effect of cyclooxygenase-2 (COX-2)selective inhibitor Celecoxib on the expression of P-glycoprotein(P-gp)in the brain of rats with status epilepficus,in order to assess the therapeutic value of intractable epilepsy.Methods Sixty adult male SD rats were randomly divided into blank control group,the epilepsy model group and Celecoxib intervention group.The status epilepticus was induced in rats by injecting Lithium pilocarpine.Forty-eight rats were included in the experiment.There were 16 rats in each of the blank control group,epilepsy model group and Celecoxib intervention group,respectively.Immunohistochemical method and Western blot method were used to detect the expression of P-gp in experimental group in the frontal cortex and hippocampus.Results Immunohistochemistry result showed that the expression of P-gp was significantly higher in epilepsy model group than the blank control group,and the difference was statistically significant (P ＜ 0.01);The P-gp expression in the Celecoxib intervention group was lower than that in the epilepsy model group,and the difference was statistically significant (P ＜0.01).Western blot results suggested that the expression of P-gp could be found both in the frontal cortex and hippocampus in each group.Compared with the blank control group,the P-gp expression was significantly higher than that in the epilepsy model group,and the expression of the P-gp was lower after the Celecoxib intervention than that in the epilepsy model group,and the difference was statistically significant (P ＜ 0.05).Conclusions COX-2 inhibitor Celecoxib could decrease the expression of P-gp in brain tissue with status epilepticus,which may provide a new method for the treatment of intractable epilepsy.

Objective: To compare the convergent sliding of bilateral pectoral myocutaneous lfap method and conventional method for treating the early stage median sternotomy wound dehiscence in patients after cardiac surgery. Method: A total of 36 relevant patients treated in our hospital from 2010-04 to 2014-04 were studied and they were divided into 2 groups: Conventional group, the patients received sufficient draining and dressing changes followed by interrupted simple suture,n=16 and Convergent sliding group, the patients received convergent sliding of bilateral pectoral myocutaneous lfap,n=20. The clinical conditions after treatment were compared between 2 groups. Results: There were 6 patients received re-suture after the ifrst debridement because of poor healing in Conventional group, no such event happened in Convergent sliding group, P<0.05. All patients were discharged and no death occurred. In Conventional group and Convergent sliding group, the open drainage time were (7.2 ± 3.2) days and (3.3 ± 1.1) days,P<0.05; hospital stay time from the first debridement and suture were (10.4 ± 5.4) days and (8.2 ± 1.9) days,P>0.05; the median hospital stay time from discovering wound problem to wound healing and discharge were 13.0 (10.75, 19.5) days and 12.0 (10.0, 13.0) days, P>0.05. Conclusion: Compared to conventional method, convergent sliding of bilateral pectoral myocutaneous lfap method may obtain the better success rate of wound debridement and suture by shorter time for treating the early stage median sternotomy wound dehiscence in patients after cardiac surgery.

Objective To evaluate the impact of gross tumor volume(GTV)on prognosis of three-dimensional conformal radiotherapy(3DCRT)in esophageal carcinoma.Methods From Jan.2004 to Oct.2007,131 stageⅠ-Ⅲb patients with unreseetable esophageal carcinomas who received 3DCRT with 60 Gy/ 30f/6w were analyzed retrospectively.The effectiveness of related prognostic factors on survival was evaluated by univariate and multivariate analyses.Results The following-up rate was 100%.By univariate analysis,the 1-,2-and 3-year local tumor control rates were 71%,64%and 60%for patients with GTV volume≤40 cm3,and 43%,32%and 28%for those with GTV volume>40 cm3(X2=13.16,P=0.000).respectively.The 1-,2-and 3-year local tumor control rates were 67%,59%,59%for T1+2 patients,62%,53%,50%for T3 patients,and 41%,28%,19%for T4 patients,respectively(X2=13.25,P=0.001).The 1-,2-and 3-year survival rates were 78%,53%,46%for patients of GTV volume≤40 cm3 and 45%.27%and 7%for patients of GTV volume>40 cm3(X2=21.55,P=0.000).The 1-,2-and 3-year survival rates were 71%,50%and 39%for patients with T1+2,68%,46%and 25%with T3,and 36%,18%and 15%with T4,repectively(X2=14.35,P=0.001).The 1-,2-and 3-year survival rates for patients with tumor length≤5 cm were 75%,50%and 44%,compared with 53%,35%and 18%with tumor length>5cm(X2=5.99,P=0.014).By multivariate analysis,GTV volume and T stage were likelv to be independent prognostic factors for local tumor control rates(X2=7.07,P=0.008;X2=6.63,P=0.036).Only the GTV volume was associated with the overall survival rate(X2=15.82,P=0.000).Conclusions GTV volume is independent prognostic factor.The larger the GTV volume is,the worse the prognosis will be.

Objective To evaluate the respiration-induced target volume motion in 3D-CRT for mid-thoracic esophageal carcinoma in order to guide the radiation oncologist to choose the expansion marginfor ITV.Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CTsimulator respectively in free breathing(FB),breath.hold after normal inspiration and expiration(IBH and EBH)with the same scanning range.Then the CT images of three series were transfefred to the treatmentplanning system.The target volume was outlined following the same standard.The motion of the centerpoint of GTV,the center point of each slice of GTV and the edge of the GTV in selected slice weremeasured respectively to obtain the comprehensive value of GTV motion。in order to find the appropriate IMvalue according to the 95％confidence interval of the GTV motion.Results①The GTV motion betweenIBH and EBH was(0.19±0.16)cm in the left.right direction,(0.54±0.19)cm in the cranial andcaudal irection.and(0.16±0.14)cm in anterior.posterior directions for the center of GTV,.For thecenter point of each slice of GTV.they ere(0.19±0.15)cm,(0.54±0.16)cm,(0.16±0.13)cm in three directions above.respectively.For the edge of the GTV in selected slice.they were(0.26±0.19)cm,(0.54±0.18)cm,(0.24±0.19)cm,respectively.The comprehensive value of GTV motion between IBH and EBH was(0.23±0.17)cm,(0.54±0.17)cm,(0.21±0.17)cm.respectively.The 95％confidence interval was 0.21-0.25 cm.0.53-0.56 cm and 0.19-0.22 cm in three directions.②The direction of GTV motion：No motion was noticed in 8.2％.while 73.3％to the right side and 18.5％to the left side in the left-right direction when IBH were compared with EBH.100％were moved to caudal in the the cranial and caudal direction[(0.54±0.17)cm].In the anterior-posterior direction,no motion was noticed in 8.2％,while 16.6％to the posterior and 75.2％to the anterior when IBH were compared with EBH.③The GTV motion was correlated with the vafiance of 1ung volumes in IBH-EBH(r=0.683,P=0.032)and not with GTV volume and length.Conclusions Respiration can induce target volume motion in 3 DCRT for mid-thoracic esophageal carcinoma.Compared to EBH.the GTV tends to move to the caudal,the anterior and the ight side in IBH.

Objective To evaluate the respiration-induced dosimetric variance in 3DCRT for midthoracic esophageal carcinoma, in order to guide the radiation oncologist to choose the expansion margin. Methods Ten patients with mid-thoracic esophageal carcinoma were scanned by multi-spiral CT simulator respectively in free breathing ( FB), breath-hold after normal inspiration and expiration ( IBH and EBH )with the same scanning range. Then the CT images of three series were transferred to the treatment planning system. The target volume was outlined following the same standard. Plan1 was designed in the images of FB and transported completely to the images of IBH and EBH as Plan2 and Plan3 respectively to observe the dosimetric variance in target volume. Results For GTV, there was a statistical difference only in V100 of the three plans ( H = 6.423, P = 0.040 ) and no significant difference was found in other indexes. For CTV, the V100 and V95 were better in Plan1 (F=3.992, P=0.030; H=9.920, P=0.007) and no significant difference was found in other indexes. While ()TV, the Dmin, V100 and V95 was better in Plan1 ( F = 3.677, P = 0.039; F = 4.539, P = 0.020; H = 6.846, P = 0.033 ) and no significant difference was found in other indexes. There were no significant differences in all the indexes for the spinal cord and lung in the three plans. Conclusions The change in dose distribution was not so much with the standard expansion. It can meet the needs of clinical treatment.