Objective To compare the effect of Q-switch Nd ∶ YAG laser and intensive pulsed light on freckles.Methods 80 patients with freckles were divided into 2 groups randomly.One group of patients were treated with Q-switch Nd ∶ YAG 532 nm frequency-doubled laser,the interval was 8 weeks.The other group of patients were treated with 570 nm intensive pulsed light,the interval was 8 weeks.Results We used Mann-Whitney U test to compare the curative effect of the two groups (P ＜0.05),and the mean rank (34.00) of the Q-switch Nd;YAG laser treatment group was greater than that (47.00) of the intense pulsed light treatment group.Conclusions The curative effect of Q-switch Nd ∶ YAG laser is better than that of intensive pulsed light on freckles.

Objective To study the clinical characteristics of septicemia and septic shock in elderly patients with liver disease. Methods Fifty-two patients over 60 years old with liver disease and positive blood culture, admitted form 1999 to 2003, were enrolled for analysis. Results Septic shock was found in 8 patients (15.4%). The course of sepsis was complicated by progressive deterioration of hepatic and renal functions. 18 patients (34.6%) died or left the hospital in a critical condition. 52 strains of pathogenic bacteria were isolated, among which 71.2% were G +germ, 26.9% G -germ and 1.9% fungi. Conclusion Septicemia and septic shock can exacerbate liver disease. Early diagnosis and treatment should be emphasized to lower the mortality.

To investigate the protective effects of Zuogui Pill (ZGP), a compound Chinese herbal medicine, on retina ganglion cells (RGCs) in rats after optical nerve clipping injury.

Objective To study feasibility in extraction of calcific sign within pulmonary nodules with pattern classification.Meth-ods 49 cases with pulmonary nodules (benign in 16 and malignant in 33)confirmed by pathology or clinical follow-up were included in this study and all cases underwent chest CT examinations.CT images were interpreted double-blind by two associate chief radiolo-gists to draw a conclusion that there were any calcification within pulmonary nodules.Meanwhile,the calcifications in the regions of interest(ROI)on CT images were estimated with extraction of the sign of gray value,geometric and lung markings in ROI,and based on pattern classification algorithm at supporting vector machine(SVM).Results According to the results assessed by senior radiologists for classification within pulmonary nodules,the area under ROC curve was 0.95 which was extracted by automatic pat-tern classification algorithm,the extraction performance was stable(k=1),and was goodness fit with visual observation by doctors (k=0.939).Conclusion The ability of automatic pattern classification in detecting calcification within pulmonary nodules is about the same as that of visual assessment by senior doctors.

Objective To explore the changes ofintegrin α4β7 and L-selectin levels and the possible relationship between the changes and intestinal mucosal immune function in critical children with gastrointestinal dysfunction.Methods Forty-eight admitted critical children were divided into non-gastrointestinal dysfunction group (29 cases) and gastrointestinal dysfunction group (19 cases),and also compared with 25 healthy people (control group).The expression of integrin α 4β 7 and L-selectin was measured by flow cytometry.Results The expression of integrin α 4β 7 in gastrointestinal dysfunction group [(11.11 ± 1.15)％] was lower than that in non-gastrointestinal dysfunction group [(15.36 ± 1.26)％]and control group [(19.62 ±0.89)％] (P ＜0.05),but there was no significant difference between nongastrointestinal dysfunction group and control group(P ＞ 0.05).The expression of L-selectin in gastrointestinal dysfunction group [(60.68 ±3.72)％] was lower than that in non-gastrointestinal dysfunction group [(69.43 ± 1.52)％] and control group [(88.65 ± 2.41)％] (P ＜ 0.05),and there was significant difference between non-gastrointestinal dysfunction group and control group (P ＜ 0.05).Conclusion The expression of integrin α 4β 7 and L-selectin is decreased at the early stage of gastrointestinal dysfunction in critical childern,and integrin α 4 β 7 is decreased sharply.

Objective To investigate the feasibility of dose verification of intensity modulated planning of helical tomotherapy (HT) using three-dimensional semiconductor array (Delta4) and find a more time-consuming and accurate method to validate the delivery dose.Methods Delta4 detector array was used to verify the HT plan dose distribution of 10 patients.The precise setup of detector array was guided and registered by MVCT imaging.After the implementation of delivery,the measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system (TPS).According to the different acceptance criteria combination of dose difference or distance to agreement at different threshold level including 3％/2 mm,3％/3 mm,3％/4 mm,3％/5 mm at TH5,TH10,TH20,TH30,TH70,TH90,the γ analysis method was utilized to evaluate the dose verification.Results The dose distribution measured by the Delta4 was well consistent with that calculated by the TPS.The mean γpassing rates were all above 94.89％.Conclusions Delta4 detector array can get satisfying results when used in HT plan dose verification and is a viable tool to replace traditional film dosimetry system in clinical quality assurance work.

Objective To evaluate mini-percutaneous nephrolithotomy in treating superior segmental ureteral calculi. Methods Two Hundred and thirty-six patients underwent mini-percutaneous nephrolithotomy with holmium laser for superior segmental ureteral calculi from May 2005 to May 2008, 133 male and 103 female. Their age ranged from 17 to 76 years old with a mean of 47. 2 years. Of the 236 patients,141 compli-cated with calculi in the left side and 88 cases in the right side,7 in the both sides. The calculi diameter ranged from 0. 7 cm to 2.2 cm and the mean diameter was 1.4 cm. One hundred and ninety-three patients had undergone ESWL from 1～6 times. Results Of the 236 patients,217 were rendered stone-free at 1 pro-cedure. Residual calculi were found in 12 cases after operation and drugs were used for treatment. The resid-ual calculi were removed after 1 month. Seven cases with residual calculi were treated by ESWL and the cal-culi were removed. The total stone clearance was 91.9%. The mean operation time was 31.3 min(rang from 19～52 min), and the mean hospital stay was 9.5 days(rang from 6 to 12 days). The main complications following operation included: durative hematuria in 25 cases relieved by haemostasis and diuresis treatment within 24 to 48 hours,pnstoperative fever in 141 cases within 24 hours of which 103 were relieved by antiin-flammatory and fluid replacement treatment within 24 to 48 hours. Thirty-eight cases were relieved by anti-inflammatory treatwent depending on urine culture results within 3 to 7 days. The postoperative pain in all patients was light. Conclusion Minimally invasive percutaneous nephrolithotomy with holmium laser under ultrasound guidance is simple,safe and effective in treating proximal ureteral calculi.

Objective To investigate the value of mammography (MAM),ultrasound (US)and MRI in the diagnosis of breast tumors using a Meta-analysis.Methods A systematic search of relevant literatures was done from CNKI,CBM,VIP,EMBASE OvidSP,PubMed and The Cochrane Library databases.Some related literatures about MAM,US and MRI in the diagnosis of breast tumors and the quality was evaluated,and the available information was extracted.The Meta-analysis was then performed by a Meta-disc 1.4 software,and a Review Manager 5.3 software was used to calculate the summary receiver operating characteristic curves and the area under the curve.Results The diagnostic effect of the MAM+US+MRI was significantly higher than that of mammography or ultrasound (P <0.05).The MAM study heterogeneity among sources was affected by whether it based on BI-RADS diagnostic criteria,and US study heterogeneity was affected by average age of patients.However,the MRI heterogeneity between studies displayed by regression analysis was not affected by each covariate.The diagnostic sensitivity and specificity were 76% (95%CI:0.73-0.79)and 72% (95%CI:0.69-0.75)for MAM,85% (95%CI:0.82-0.87)and 70% (95%CI:0.67-0.73)for US,and 95% (95%CI:0.93-0.96)and 72% (95%CI:0.69-0.75)for MRI,respectively.And the area under curve (AUC)of summary receiver operating characteristic (SROC)curve was 82.0%,88.5% or 97.4%, respectively.Moreover,the AUC of combined three methods together was 98.3%.Conclusion The value of MAM,US and MRI in diagnosis of breast tumor is higher,and the highest one exists when the combined three methods together are used.

Objective To study the safety and feasibility of tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal-channel.Methods Eighty patients after conventional percutaneous nephrostolithotomy are selected and divided into two groups according to the principle of randomization.Control group adopts conventional percutaneous nephrostolithotomy calculi lithotripsy with renal pelvis drainage tube placement whereas the experimental group adopts tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal channel.Both experimental group and control group will be scientifically and statistically analyzed via the incidence and the dose of using sedative for alleviating pain after operation,hospital stay,level of hemoglobin,and the occurrence of complications such as continuate hemorrhage,infection,urinary extravasation,etc.Results The operation of both groups are successful in phrase Ⅰ.The incidence and the dose of using sedative in control group are obviously higher than that in experimental group(45％ vs 20％).However,the incidence of postoperative complications like infection and hemorrhage and hospital stay between two groups are undifferentiated in statistics(P ＞ 0.05).Neither the experimental group nor the control group has perinephric hematoma,and seven cases of control group have urinary leakage after remove of fistula.Conclusion Tubeless percutaneous nephrostolithotomy by hemostasis gel closure of mini-percutaneous renal-channel is safe and feasible and it can reduce the incidence of postoperative pain and avoid urinary leakage.

Objective To use helical tomotherapy ( HT ) for determining the difference between actual doses and planning doses to the target volume and organs at risk ( OARs ) in patients with nasopharyngeal carcinoma receiving radiotherapy, and to provide guidance for the clinical treatment. Methods Localization and delineation of the target volume and OARs were performed by computed tomography ( CT) in 21 patients with nasopharyngeal carcinoma receiving radical radiotherapy using HT. All patients underwent megavoltage CT ( MVCT) scan prior to treatment. The obtained MVCT images were used for dose reconstruction in the adaptive module of HT, in which the actual dose was obtained and the non?image?guided dose was simulated. Each single dose distribution and the corresponding CT image were sent to software MIM6. 0 for superimposition, and the overall dose was obtained. The initial plan, image?guided plan, and non?image?guided plan were named Plan?1, 2, and 3, respectively. The dose distribution in the target volume and OARs was compared between the three plans with t ? test or wilcoxon test . Results Compared with those in Plan?1, the D98 values for the planning gross tumor volume ( PGTV) and planning target volume ( PTV) in Plan?2 were significantly reduced by 1. 16% and 2. 3%, respectively ( P=0. 025;P=0. 043);the volumes of the left and right parotids in Plan?2 were significantly reduced by 46. 0% and 46. 5% on average, respectively ( P=0. 000);the distances between the midline and the center?of?mass for left and right parotids were significantly reduced by 6. 9% and 6. 5%, respectively ( P=0. 000);the V26 and Dmean for both parotid glands were significantly elevated by 32. 8% and 25. 2%, respectively ( P=0. 000) . Compared with those in Plan?1, the D98 values for PGTV, PTV?1, and PTV?2 in Plan?3 were significantly reduced by 2. 0%, 1. 9%, and 2. 4%, respectively ( P=0. 001;P=0. 007;P=0. 036);the V26 and Dmean for both parotid glands in Plan?3 were significantly elevated by 33. 6% and 25. 3%, respectively ( P=0. 000);Dmax to the spinal cord was significantly increased by 6. 9%( P=0. 005) . There was no significant difference in D2 to the spinal cord between Plan?2 and Plan?1( P=0. 392) . Conclusions The doses to both parotid glands increase during HT for nasopharyngeal carcinoma, which is closely associated with the shift of the parotid glands toward the midline. Image?guided radiotherapy does not enhance the dose to the target volume, but reduces the dose to the spinal cord.