Objective To analyze the effection of improved three-dimensional conformal radiotherapy (3D-CRT) to the dose of target area of local advanced non-small-cell lung cancer (NSCLC) and observe the therapeutic efficacy and toxity.Methods 81 patients with local advanced NSCLC were collected and treated.The diameter of tumor exceed 5 cm.52 patients were squamous carcinoma.24 patients were adencarcinoma.5 patients were adenosquamous carcinoma.63 patients were onstage of Ⅲ A,18 patients were Ⅲ B.The patients were randomized into two groups,the first group was unmodified planning of 3D-CRT group (T1 group,39 patients),the second group was modified planning of 3D-CRT group (T2 group,42 patients).The 31 patients of T1 group (79.5 ％) received radiotherapy and chemotherapy.Toties quoties was 2 Gy.The fractions were 26-30.The total dose was 52-60 Gy.The 31 patients of T1 group (73.8 ％) received radiotherapy and chemotherapy.Toties quoties was 2 Gy.The fractions were 30-35.The total dose was 60-70 Gy.Results The 1-,2-,3-year overall survive rates of T1 group were 56.4 ％,33.3 ％,28.4 ％,the 1-,2-,3-year local control survive rates were 38.4 ％,28.2 ％,20.5 ％,and the median survive time was 17 months.The 1-,2-,3-year overall survive rates of T2 group were 61.9 ％,35.7 ％,28.5 ％,the 1-,2-,3-year local control survive rates were 47.6 ％,40.4 ％,30.9 ％,and the median survive time was 19 months.The significant difference was found for the local control survive rates between T1 and T2 group (P ＜ 0.05).No significant difference was found for the overall survive rates and the median survive time between T1 and T2 group (P ＞ 0.05).Conclution Improved 3D-CRT can advance local control survive rate and living quality to local advanced NSCLC.Meanwhile,it also increases survive rate of 1-year,but can not increase long-time survival rate.

Objective To analyze the clinical features of patients with negative double balloon enteroscopy(DBE)findings.Methods A total of 115 patients with suspected small intestinal diseases underwent DBE examination from gastroenterology department of Wuhan University People's hospital on December 2005 to July 2009.The negative and positive cases were 32 and 83 respectively,then compared clinical data of negative group with that of positive group.Results 83 cases with small intestinal diseases were detected from 115 patients by DBE examination,and the daignosis rate was 72.2%(83/115).2 patients occurred acute pancreatitis and 1 occurred hyperamylasemia.The level of initial hemoglobin of negative group was higher than that of positive group(107.938?26.015 vs 93.518?32.367,P=0.016).meanwhile,there were significant difference in clinical symptoms(unexplained alimentary tract hemorrhage,obscure partial bowel obstruction,abdominal pain and diarrhea)between two groups(P=0.035).Moreover,the positive detection rate of unexplained alimentary tract hemorrhage(81.8%)was obviously higher than that of abdominal pain(57.7%)or diarrhea(40%).Conclusion DBE examination is an effective method in the diagnosis of small bowel diseases at present,however,patients with higher level of initial hemoglobin or the main symptoms as abdominal pain or diarrhea should be prudent to choose.

Objective To study the characteristics of EEG after tramsient ischemic attack and to offer reference for screening procedure of aircrew and astronaut selection. Method The dominant frequency uncertainty of alpha band EEG in 12 pilots(males; age 30±5) with transient ischemic episodes in middle cerebral artery(MCA) territories and in 20 normal healthy pilots was analyzed with frequency-fluctuation analysis. Result The dominant probability of the main frequency coinciding with sites affected by transient ischaemic attack(TIA) in patient pilots was higher than that in healthy pilots (P<0.01),and the dominant probability ratio logarithmic index I≥0 in all patient pilots with normal EEG, but I<0 in all healthy pilots. It was also found that not only I≥0, but the second component shifted to lower frequency(8 Hz) in patients with slight focal EEG alterations,i.e. slowing of frequency. The relative entropy values (percentage) were decreased significantly in pilots with TIA as compared with healthy pilots (P＜0.05). Conclusion The dominant frequency uncertainty analysis of alpha band showed clear superiority of computerized evaluation over routine visual assessment for the diagnosis of minor cerebral ischemia. It offers not only a possibility of studying pathophysiological functional parameter, but also the reference for screening procedure in aircrew and astronaut selection.

Objective Analyze the factors which have influenced the quality of life (QOL) of the patients with cancer, and then put up the corresponding nursing measures. Method Using the EROTCQOLQ- C30 and the social support scale to analyze 600 patients with cancer. Results The value which can indicate the QOL of patients with cancer was 83.00 ? 22.00. The factors which have influenced the QOL of patients with cancer were age, gender, occupation, marriage, cultural degree, social support, disease, and so on. Conclusion Using the positive methods and the social support to raise the QOL of cancer patients according to the concreted condition of them.

Objective To explore the diagnostic value of detecting serum DJ-1 protein combined with CA125 for epi?thelial ovarian tumors. Methods Double antibody sandwich method and electrochemiluminescence immunoassay were used to determine the serum levels of DJ-1 protein and CA125 in 82 cases of epithelial ovarian tumors and 80 non-ovarian tumor cases (control group). The clinical significance of detecting serum DJ-1 protein combined with CA125 was analyzed. Results The expression levels of DJ-1 and CA125 were significantly higher in ovarian tumor group than those in the con?trol group (P<0.05). The critical value of serum DJ-1 was 6.800μg/L and 6.965μg/L in ovarian cancer group compared with the control group and non-ovarian tumor group. The sensitivity of combined detection of DJ-1 and CA125 was higher than that of any marker alone. Conclusion The detecting serum levels of DJ-1 combined with CA125 are helpful to the diagnosis of ovarian cancer, which can be a good marker of ovarian cancer and may improve the early diagnosis rate of ovarian cancer.

Objective To assess the value of double balloon enteroscopy (DBE) in etiological diagnosis of small bowel ulcer.Methods The clinical and endoscopic data of patients undergoing DBE at the Department of Gastroenterology, Renmin Hospital of Wuhan University from January 2010 to January 2016 were reviewed.For patients with small bowel ulcer revealed by DBE, the etiologic diagnosis was retrospectively analyzed.Results One hundred and three patients with small bowel ulcer were included in the analysis.The initial diagnosis based on morphology of ulcer was Crohn's disease (58.3%, 60/103), intestinal tuberculosis (18.4%,19/103), etiology unknown (24.3%, 25/103).The final diagnosis comprehensively based on pathology, clinical data and disease outcome was Crohn's disease (44.7%,46/103), intestinal tuberculosis (18.4%,19/103), lymphoma (3.8%,4/103), eosinophils enteritis (1.9%,2/103), non-steroidal anti-inflammatory drug enteritis (1.9%,2/103), adenocarcinoma (1.0%,1/103), stroma tumor (1.0%,1/103),ischemic enteritis (1.0%,1/103), vascular malformation (1.0%,1/103), Henoch-Schonlein purpura (1.0%,1/103), etiology unknown (24.3,25/103).The accurate diagnosis rate and misdiagnosis rate for Crohn's disease by DBE were 73.3%(44/60)and 10.0%(6/60).The accurate diagnosis rate and misdiagnosis rate for intestinal tuberculosis by DBE were 14/18 and 2/18.Conclusion There are diversity and complexity in etiologic diagnosis of small bowel ulcer.The diagnosis should be based on the comprehensive analysis of morphology of ulcer, endoscopic and surgical pathology and clinical data.Follow up of small bowel ulcer by DBE may provide important information for etiologic diagnosis.

BACKGROUND: Researches suggest that transient ischemic attack (TIA)can induce cognitive dysfunction, and cerebral blood flow and its distribution are hypothesized to be closely related to cognitive activities.OBJECTIVE: To investigate the alteration of cognitive function and provide insights into its relations with cerebral perfusion in TIA patients.DESIGN: A case-control study.SETTING: Departments of Geriatrics, Electrophysiology and Magnetic Resonance of Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 35 male right-handed TIA patients aged 45-78 years with an average of (68.1±8.4) years were selected from the inpatients and outpatients in the Department of Geriatrics, Urumqi General Hospital of Lanzhou Command of Chinese PLA between January 2002 and June 2003. Another 33 healthy right handed male subjects aged 45-77 years with an average of (67.8±8.6) years coming for physical examination were recruited to serve as the control group.METHODS: Patients and control subjects were tested with event-related potentials (ERPs) and the scale of elderly cognitive function (SECF) to examine the orientation, learning and memory, span, recall 1 (association),long-term memory, naming of animals, calculation, classification, copying,language and recall 2 (relation). According to the T score transformation table, the original scores were transformed into T scores relative to the age to eliminate the impact of age, and also into T'score to eliminate the interference by the patients'education, so that cognitive function of the patients could be evaluated with T'score, and the lower the score, the poorer the cognitive function. Cases in the two groups were all tested, and TIA patients were also examined with magnetic resonance angiography (MRA).MAIN OUTCOME MEASURES: Results of ERPs, SECF and MRA.RESULTS: Of the 35 TIA patients and 33 control subjects all completed the trial. Examination of ERPs reveled significantly prolonged latency of P300 components of ERP in the TIA group [(336.2±34.2) ms] than that in the control group [(311.3±44.2) ms, P ＜ 0.05]. The scores of span, recall 1,long-term memory, naming of animals, calculation, and recall 2 in SECF in TIA group were all lower than those in control group (39.7±11.9 vs 47.4±12.0; 54.5±14.8 vs 61.8±14.5; 61.1±7.8 vs 64.7±1.7; 59.4±11.0 vs 64.7±8.8; 50.0±14.7 vs 58.1±14.2; 44.6±15.4 vs 53.2±17.8, t=4.151 0-7.292 8, P ＜ 0.05-0.01). MRA identified abnormalities in 33 of the 35 TIA patients (94%), manifested mainly by stenosis and occlusion involving the vertebral artery (54%, 19/35), bilateral anterior, middle and posterior cerebral arteries (40% ,28/70;59% ,41/70;47% ,33/70), basilar artery (5.71%, 2/35) and bilateral internal carotid artery (5.71%, 4/70) respectively.CONCLUSION: TIA patients are characterized by prolonged P300 latency with multiple cognitive impairments especially in memory and cerebral artery stenosis and occlusion as shown by MRA, suggests that TIA patients have persistent low cerebral perfusion and frequently, cognitive dysfunction in the presence of local blood supply disorder in the hemispheres.

Objective To analyze clinical and radiological characteristics of intracranial hemorrhage in hematological diseases to improve the recognition of them. Methods Thirty-one clinical data of intracranial hemorrhage cases with hematological diseases were reviewed. The basic diseases, clinical and radiological manifestations, and risk factors of mortality were analyzed. Results Intracranial hemorrhage usually occurred in patients with acute myeloid leukemia (AML) or idiopathic thrombocytopenic purpura (ITP),and 13 and 6 cases, respectively, in this group. Most patients presented with headache, restlessness, nausea,vomiting, conscious disturbance and no localization sign by physical examination. CT or MRI images often revealed focus of errlysis. Compared with CT scan, a higher detection rate of ICH could be realized by MRI scan. The total mortality in this group of ICH patients was 71% (22/31). Fever, white blood cell ＞5×109/L,platelet ＜50×109/L, hyperimmunoglobulinemia and disturbance of blood coagulation were risk factors for ICH of this group of patients. The mortality was higher in patients with no less than 2 risk factors[86.4 % (19/22)vs 33.3 % (3/9)] (x2 = 8.718, P = 0.003). Conclusion ICH is a serious complication for hematological patients. MRI scan is good at improving the diagnosis of ICH. It is of high risk of death in patients with no less than 2 risk factors such as fever, white blood cell higher than 5×109/L, platelet less than 50×109/L,hyperimmunoglobulinemia and disturbance of blood coagulation.

Objective To investigate the safety,diagnostic value and clinical impact of double balloon enteroscope (DBE) in elderly patients (aged ≥75 years).Methods Clinical data and DBE findings of elderly patients in the Department of Gastroenterology in Remin Hospital of Wuhan University from January 2010 to January 2013 were retrospectively analyzed and compared with those of younger patients.Results The diagnostic rate,complication rate and clinical impact rate were 69.0％ (29/42),0％ (0/42) and 76.2％ (32/42) in elderly patients.There were no statistically significant differences on those parameters between elderly patients and younger patients (all P＞0.05).For elderly patients,the leading causes of obscure gastrointestinal bleeding (OGIB) were tumor (30.0 ％,9/30) and ulcer (16.7 ％,5/30),while angiectasis (6.7 ％,2/30) was uncommon.Conclusions DBE is an effective and safe method for diagnosis of small bowel disease in elderly patients.Tumor is the most common cause of OGIB,while angiectasis was uncommon.

Objective To observe the dynamic changes of heme oxygenase 1,NAD(P)H:quinine oxidoreductase 1 and Nuclear factor-E2-related factor 2 in the lung tissue of acute H2S-intoxicated rats and intervention effects of ulinastratin(UTI).Methods A total of 96 SD rats of clean grade were divided randomly(random number)into four groups:normal control group(NS group,n =8),UTI control group(UTI group,n =8),H2S-intoxicated model group(H2S group,n =40,rats were exposed to H2S(200 × 10-6)for 1 h to establish the H2S-intoxicated model)and UTI treatment group(H2S +UTI group,n =40,rats were intraperitoneal injected with the dose of UTI 105 U/kg).H2S group and H2S + UTI group were sacrificed 2,6,12,24 and 48 h after modeling.The activity and mRNA expression of HO-1 and NQO-1 in the lung tissue were measured by ELISA and RT-PCR methods,and the expression of Nrf2 mRNA and protein in the lung tissue was detected by RT-PCR and Western Blot methods.Pathological changes of lung tissue were observed by lightmicroscope and the lung injury score was used to evaluate inhalation injury.Results The pulmonary HO-1 activity and mRNA expression in rats of H2S group at 2,6,12 h(P ＜ 0.01)after intoxication were markedly increased than that in NS group:In comparison with H2S group,the pulmonary HO-1 activity and mRNA expression increased at 6,12,24,48 h(P ＜0.01).The pulmonary NQO-1 activity and mRNA expression in rats of H2S group at 2,6,12,24 h(P＜ 0.01)after intoxication were markedly increased than that in NS group; In comparison with H2S group,the pulmonary NQO-1 activity and mRNA expression increased at 6,12,24,48 h(P ＜ 0.01).The pulmonary Nrf2 mRNA and protein expression in rats of H2S group at 2,6,12 h(P ＜0.01 or P ＜0.05)after modeling were markedly increased than that in NS group and reached peak 2 hour after modeling; In comparison with H2S group,the pulmonary Nrf2 mRNA and protein expression increased at 6,12,24,48 h(P ＜0.01).At 24 h after modeling,the degree of lung damage were also decreased in H2S group compared with H2S + UTI group in the lightmicroscope.Histopathological examination showed that the degree of lung injury in H2S + UTI group was less severe than that in H2S group especially in the 12,24 and 48 h (P ＜0.01).Conclusions HO-1,NQO-1 and Nrf2 are involved in the pathogenesis of acute lung injury induced by H2S-intoxicated in rats.UTI may improve the imbalance in redox and activate HO-1,NQO-1 and Nrf2 can reduce lung injury and protect the lung injury induced by H2S in rats.