Objective To evaluate the selective angiography and interventional management in nonvariceal gastrointestinal hemorrhage.Methods 94 cases with nonvariceal gastrointestinal hemorrhage were accepted for selective angiography.According the location and cause of hemorrhage finding by angiography,these patients were checked by arterial embolization and/or perfusion of vasoconstrictor substance.Results DSA revealed positive result in 58 cases(61.7%) of 94 cases.Meanwhile,13 cases accepted 99m Tc-labeled erythrocytes nuclear scan,11 cases(84.6%) showed hemorrage.Arterial embolization was carried out in 34 cases,the hemostasis and relapse rate was 91.2% and 8.8% respectively.Besides arterial embolization,8 cases were selected vasopressin infusion,the hemostasis and relapse rate of vasopressin infusion was 75.0% and 25.0% respectively.No severe complication such as intestinal necrosis occurred among the 42 cases with interventional therapy.Conclusion Selective angiography is a valuable method for the diagnosis of the nonvariceal gastrointestinal hemorrhage of unknown reasons.The()~(99m)Tc-labeled erythrocytes nuclear scan is more sensitive than selective angiography in detecting bleeding,however,as to find bleeding location accurately,it was inferior to selective angiography.

Objective To discuss the imaging manifestations of chordoma.Methods The imaging manifestations of chordoma in 42 cases proved by surgery and pathology were retrospectively analysed.Results The lesions located at the region of skull base in 23 cases(54.8%),at the sacrococcygeal region in 18 cases(42.9%) and one case(2.3%) outside the axial skeleton as an extra-axial chordoma or parachordoma.Bone destruction in the areas near skull base and sacrococcygeal region could be found on radiography.On CT,chordoma typically appeared as a expansile soft-tissue mass that arises from the clivus and sacrococcygeal region with associated extensive lytic bone destruction.MR imaging was considerably superior to CT in the delineation of lesion extent.Conclusion Chordoma has typically distribution and characteristic imaging manifestations,especially MRI.

Purpose: To study the clinical efficacy, toxicity of preoperative chemotherapy and survival time with Gemicitabine-Cisplatin combination in the treatment of stage Ma( N2) NSCLC. Methods: Thirty patients with stage IIIa( N2) NSCLC were included. Gemicitabine was administered on dl, 8 and 15 at a dose of 1000 mg/m" and Cisplatin at a dose of 100 mg/m on d2. The chemotherapy was repeated every 28days. Results: Thirty patients were evaluable for response. The overall response rate was 70%. Surgical'excision rate after preoperative chemotherapy was 93%. Total surgical excision rate was 70%. Median survival time was 15 months, one year survival rate was 67%. The main toxicity was hematological, thrombocytopenia of grade III-IV appeared in 46% course of treatment, but it did not lead to hemorrhage. Conclusions: Preoperative chemotherapy with Gemicitabine-Cisplatin combination is effective and well-tolerated in the treatment of stage IIIIa( N2) NSCLC. So it is worthy to be further studied and popularized.

The delineation of clinical target volume (CTV) is a critical step in planning conformal radiotherapy for rectal cancer.Several guidelines suggest different subvolumes and anatomical boundaries in radiotherapy for rectal cancer, potentially leading to a misunderstanding of CTV definition.This article reviews recent advances in the delineation of CTV in radiotherapy for rectal cancer.

Objective To discuss the way and effect of washing intestine and pelvic cavity to prevent the fistula of lo place close entrance's in carcinoma of rectum. Methods Cut the rectum and lymph node,used the tip large intestine to connect with washing machine tube. cut vermiform appendix and put urine tube enter ileocecal them use 500ml N.S to wash large intestine for sustained.After se the recturn and large intestine.Use two tube(0.8～1cm) pelvic cavity about 1～6 days. Results The improvement group(38 cases) had not occur leak of lo place cclose entrance, classical group (18 cases) had occur 2 cases (11.1%)leak of lo place close entrance, usestatistics to deal with, P

More than 20 studies published during the past 10 years concerning preoperative radiotherapy in rectal cancer were reviewed carefully. And we evaluated the role of IMRT being routinely used in preoperative treatment of rectal cancer.

OBJECTIVE:To observe clinical efficacy and safety of Bifidobacterium triple viable capsules in the adjunctive treatment of Helicobacter pylori(Hp)positive chronic atrophic gastritis(CAG)complicated with anxiety-depression. METHODS:A total of 100 Hp positive CAG patients with anxiety-depression were divided into control group and observation group according to random number table,with 50 cases in each group. Control group was given standard triple therapy (rabeprazole+amoxicillin and clavulanate+levofloxacin). Observation group was additionally given Bifidobacterium triple viable capsules 0.42 g,tid. The treatment lasted for 14 d in both groups. Clinical efficacies,Hp eradication rates as well as HAMA and HAMD scores before and after treatment were all observed in 2 group. The occurrence of ADR was compared. RESULTS:Total response rate of observation group was 94.0%,and Hp eradication rate was 92.0%,which were significantly higher than 76.0% and 78.0% of control group, with statistical significance (P<0.05). Before treatment,there was no statistical significance in HAMA and HAMD scores in 2 groups(P>0.05). After treatment,HAMA and HAMD scores of 2 groups were decreased significantly,the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of ADR in observation group (4.0%)was significantly lower than control group(20.0%),with statistical significance(P<0.05). CONCLUSIONS:Adjunctive use of Bifidobacterium triple viable capsules can significantly improve Hp eradication rate,clinical symptom,anxiety and depres-sion,while reduce the incidence of ADR.

Objective To compare the dose volume and normal tissue complication probability (NTCP) of small intestine between intensity-modulated radiotherapy (IMRT) with dose constraints to the peritoneal space (PS) and the bowel loop (BL) in the treatment of rectal cancer,and to investigate the feasibility of placing a dose constraint to the PS instead of the BL in protection of the small intestine.Methods A total of 24 patients with rectal cancer undergoing postoperative adjuvant radiotherapy were enrolled as subjects.In the 24 patients,12 were treated in supine position an.d 12 in prone position.The weekly computed tomography (CT) scans from pre-treatment to weeks 1-4 of treatment were defined as Plan,1 W,2 W,3 W,and 4 W.Contours of PS and BL were delineated on all CT images.Based on the Plan CT images,two IMRT plans,PPS and PBL,were designed with dose constraints to the PS and BL,respectively.The method was applied to 1-4 W CT images.For each CT scan,the dose volume and NTCP of the small intestine were evaluated in PPs and PBL.Results A total of 109 sets of CT images were acquired from 24 patients,and 218 plans were designed and copied.The median volume of the PS and BL was 1339.28 and 250.27 cm3,respectively.For the Plan CT scans,V15 values of the PS in PPs plan and the BL in PBL plan were 918.96 and 199.57 em3,respectively.For all CT scans,the dose volume of the small intestine in PPs,in most cases,was lower than that in PBL,while V15 values in Ps and PBL were 170.07 and 178.58 cm3 (P=0.000).The dose volume of the small intestine was correlated with V15 (P=0.000).PPs had significantly lower NTCP of chronic and acute adverse reactions than PBL(2.80％ vs.3.00％,P=0.018;57.32％ vs.58.64％,P=0.000).In patients with prone and supine treatment positions,most of the dose volume and NTCP of the small intestine in Ps were significantly lower than those in PBL(P＜0.05 for V10,V15,V30,and NTCP of acute adverse reactions).Conclusions It is feasible to place a dose constraint to the PS instead of the BL for protection of the small intestine during IMRT for rectal cancer.V15＜830 cm3 can be referred to as the objective function of dose restraint.

Objective To study the clinical effectiveness of low cut and five dissector thyroidectomy to treat hyperthyroidism.Methods 337 cases of hyperthyroidism were randomly divided into study group(low cut and five dissector technique,223 cases) and control group(traditional technique,114 cases) according to the ratio of two:operating time,bleeding,complications,recur were compared between these two groups.Results The operating time of the study group and control group were(66.33?25.11)min and(121.27?42.35)min(t=12.75,P0.05).The rate of recurrence was marked(P

Objective To explore the relationship of plasma norepinephrine (NE) and epinephrine (E) level with TCM syndrome differentiation of attention deficit hyperactivity disorder (ADHD) in children. Methods Plasma NE and E levels in 80 ADHD children (Group A) and 32 normal volunteers (Group B) were measured by the method of high performance liquid chromatography_electrochemical detectio n (HPLC_ECD). Among 80 ADHD children, 49 were differentiated with kidney_yin def iciency and liver_yang hyperactivity syndrome (Group A 1) and 31 with heart_sp leen deficiency syndrome (Group A 2). Results Plasma NE and E levels in Gro up A we re higher than Group B (P 0.05 ). Conclusion Hyperactivity and impulsi veness in ADHD children may be related with the high levels of plasma NE and E. The exc essively sympathetic excitement in ADHD with kidney_yin deficiency and liver_yan g hyperactivity syndrome is uncertain.