Objective To study the short-term curative effects and side effects of the three-dimensional conformal radiotherapy combined with chemotherapy in advanced esophageal cancer in Xinjiang provenience.Methods One hundred and twelve cases were divided into Kazak and Han nationality group according to the different nations.Chemotherapy was DF regime:5-Fu 1000 ms/m2+DDP 20 mg/m2,d1-4,21 days as a cycle,total 4-6 cycles.For both groups,3DCRT was carried out by conventional fractionation with total dose of 60-66 Gy/30-33frin 6-7w.Results The following-up rate was 100%.The number of pailents followed up at two years wero 23 and 27 in Kazak and Han nationality group,respectively.The immediate effective rates(CR(complete remission)+PR(partial remission))were 77%(34/44)and 85%(58/68)in ban and kazak group,respectively(X2=4.89,P=0.180).The 1-and 2-year survival rate were 75%,59%and 52%,40%(X2=1.71,P=0.191)in Kazak and Han group,respectively.The 3-4grade radioesophagitis were 5%(2/44)and 7%(5/68)in kazak group and han group,respectively(X2=1.66,P=0.435).The 3-4 grade radiopneumonia were 2%(1/44)and 1%(1/68)in kazak group and ban group,respectively(X2=0.99,P=0.608).The 3-4 grade haematolosical toxicity were9%(4/44) and 29%(20/68 in kazak and in han group,respectively(X2=6.57,P=0.037).Conclusions There was no significant difference in short-term curative effects between patients from han and kazak nationality with advanced carcinoma of esophagus who received the three-dimensional conformal radiotherapy combined with chemotherapy.but Kazak people showed better tolerance.

Objective To compare the treatment outcome and prognostic factors in patients with advanced cervical cervical cancer between Han and Uygur in Xinjiang district.Methods 204 patients with advanced cervical cancer were retrospectively analyzed.Eighty patients were Han 80 and 124 were Uyghur.100 patients received radiotherapy alone and 49 with concurrent radiochemotherapy,and 55 had brachytherapy followed by surgery.The survival rate was calculated by Kaplan-Meier method and the difference was compared by Logrank test.Multivariate analysis was performed using Cox regression model.Results The follow-up rate was 97.5％.The number of patients with at least 5 years of follow up was 102.The 1-,3-and 5-year overall survival rates in Han and Uygur patients were 81.2％,66.3％,51.4％ and 83.4％,62.8％,49.2％,respectively (x2 =3.21,P =0.273).Univariate analysis showed that parity,geographical distribution,pathological type,clinical stage,lymph node involvement and treatment were prognostic factors for overall survival (x2 =2.35,11.34,7.12,6.73,4.79,13.60,P=0.049,0.029,0.031,0.037,0.041,0.021).Multivariate analysis showed that parity,geographical distribution,pathological type,clinical stage,lymph node involvement and treatment were independent prognostic factors for overall survival (x2 =8.36,24.94,10.69,5.63,9.50,P =0.002,0.001,0.021,0.018,0.031).Conclusions There is no significant difference in overall survival rate of patients with advanced cervical cancer between Han and Uighur.Patients with parity more than or equal to 3 times,advanced clinical stage or adenocarcinoma have poor prognoses.

Objective To analyze the efficacy,complications and prognostic factors of three-dimensional conformal radiotherapy(3 DCRT)for locally advanced non-small cell lung cancer(NSCLC).Methods 56 patients who were treated either by radiotherapy alone(14 patients)or radiotherapy plus chemotherapy(42 patients)from Jan.2005 to Feb.2008 were enrolled.The patient cohort consisted of 36 men and 20 women,median age 62,median total dose 60 Gy.Results The following-up rate was 96%.The number of patients completed follow-up were 14 and 10,respectively at 3-year and 5-year.The response rate of 3DCRT was 70%.with complete mmission 9%and partial remission 61%.The 1-、3-、and 5-.year survival rates were 62%、25% and 17%,respectively,and the median survival time(MST)was 20 months.By logrank test,clinical stage,KPS perfomance,tumor volume,radiation dose,treatment regimen and response to treatment showed statistically dramatic impact on overall survival.By Cox muhivariable regression,the independent adverse prognostic factors by both univariate analysis and multivariate analysis were clinical stage,treatment type,and response to treatment.Grade 2 acute radiation pneumonitis was observed in 1 patient and grade 3 in 1 patient.Late grade 2 lung injury developed in 1 patient,and grade 3 in 1 patient.Acute grade 1 radiation esophagitis were observed in 20 patients.and above Grade 2 in 5patients.Acute grade 1+2 hematologic toxicity developed in 15 patients,and above Grade 2 developed in 4 patients.Conclusions 3 DCRT was feasible in the treatment of locally advanced NSCLC with acceptable normal tissue toxicity.Relative early stage.radio-chemotherapy with total radiation dosage≥60 Gy and good immediate tumor response are favorable prognostic factors for overall survival.

Objective To evaluate the therapeutic effects of three-dimensional conformal radiation therapy (3DCRT) in combination with transcatheter arterial chemoembolization (TACE) for stage Ⅱ primary liver cancer. Methods Eighty-one patients were retrospectively analyzed, including 36 received 3DCRT combined with TACE (Group A) and 45 received TACE alone (Group B). The short-term therapeutic effects and 1-, 2-, 3-year survival rates, average survival time of the dead patients, and side effects were compared between the two groups. Results The follow-up rate was 100%. The numbers of patients finished 1-, 2- and 3-year follow-up were 55,19 and 6,respectively. The reponse rates were 72% in group A, and 60% in group B, which were not significant different (χ~2= 1.32, P > 0.05). The 1-, 2- and 3-year survival rates of the dead patients were 83%, 63% and 25% in group A and 75%, 37% and 8% in group B. The corresponding average survival time was 21 months and 16 months, respectively. The differences of 2- and 3-year survival rates were significant between group A and B. (χ~2= 4.87, P < 0. 05 ). The incidence and se-verity of side effects did not differ significantly between the two groups. Conclusions In patients with stage Ⅱ primary liver cancer, 3DCRT combined with TACE, being more effective than TACE alone, can prolong the long-term survival without increasing the toxicities.

Objective To observe the effect of radiotherapy and chemoradiotherapy in patients with esophageal cancer and analyze the associated factors of surviving with esophageal patients.Methods 60 cases were retrospectively analyzed in the study.They were divided into two groups according to the treatment methods,radiotherapy(RT)group and chemoraidiotherapy(CRT)group.The group CRT was divided into concurrent chemoraidiotherapy(CCRT)group and sequence chemoraidiotherapy(SCRT)group.The group RT and group CRT all use 6mvX line conventional therapy,common fraction 200 Gy/f,DT 60 to 70 Gy,Group CRT combine the chemotherapy concurrent or after radiotherapy.Results The 1,2,3 year survival rate of the group CRT and the group RT are 73.30%,46.70%,16.67%and 60.30%,16.67%,6.67% respectively,2 year survival of group CRT is beaer than group RT(P＜0.05).(2)The 1,2,3 year survival rate of the group SCRT and CCRT are 88.89%,55.55%,22.22% and 84.21%,47.37%,15.79% respectively.The short-term side-effect is more serious,the patients could bear.The prognosis of the esophageal carcinoma is closely associated with treatment methods and clinical stage.Conclusion Chemotherapy combined with radiotherapy for advanced esophageal cancer improved the survival.Chemoradiotherapy is an effective treatment for advanced esophageal carcinoma,diagnosis and treatments in early stage are especially important.

ObjectiveTo determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC)treated with radical intent.MethodsWe searched The Cochrane Library,MEDLINE,EMbase,CBM,CNKI and VIP.The quality of the includedstudieswascriticallyevaluated.Dataanalyseswereperformed usingtheCochrane Collaboration's RevMan 5.1 software.ResultsFour randomized controlled trials involving 905 patients met the inclusion criteria.The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group ( x2 =1.98,P =0.000 ) ; but there is no evidence of 1-year overall survival (OS) benefit ( x2 =1.12,P =0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P =0.600) or ADL ( P =0.880) after PCI,but there was a significant decline in immediate recall (P=0.030) and delayed recall (P =0.008 ) at 1 year,At 1 year,there was no significant differences in QOL after PCI ( P =0.050).Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation.There is insufficient evidence to support the use of PCI in clinical practice.Where possible,patients should be offered entry into a clinical trial.

ObjectiveTo explore the optimal method of protecting bone marrow in postoperative concurrent chemoradiotherapy of stage Ⅱ - Ⅲ rectal cancer by comparing two techniques of intensitymodulated radiotherapy (IMRT). MethodsFifteen patients with stage Ⅱ - Ⅲ rectal cancer after surgery had CT simulation. Clinical target volume, small bowel, bladder and bone marrow were contoured. Two IMRT treatment plannings with and without bone marrow-sparing (BMS-IMRT and IMRT) were separately designed. The dose distribution was compared based on that 95％ of the planning target volume received the prescribed dose. ResultsBMS-IMRT had an advantage over IMRT in terms of conformity indices ( 1. 06∶1. 04, t =- 2. 61, P =0. 023 ), but inferior to I M RT for homogeneity indices ( 0. 81 : 0. 75, t =- 2. 34, P =0.037)).Compared with IMRT, BMS-IMRT reduced the V5, V10, V20, V30, V40 of bone marrow (97.09％∶98.72％, t=-2.34, P=0.037;92.38％∶96.46％, t=-2.41, P=0.033;83.36％∶91.70％, t=-3. 18, P=0.008;51.47％∶69.65％, t=-4.92, P=0.000;36.34％∶49.57％, t=-2.66, P =0. 021 ). The doses received by small bowel and bladder were similar between BMS-IMRT and IMRT, except that the V20 of bladder was lower in BMS-IMRT (77. 32％∶92. 39％, t =-3.52, P=0. 004). Conclusions BMS-IMRT reduces low dose volume of bone marrow without increasing dose to other risk organs.BMS-IMRT might reduce acute hematologic toxicity and increase the feasibility of postoperative concurrent chemoradiotherapy in stage Ⅱ -Ⅲ rectal cancer.

Objective To explore the application value of Golgi protein-73 (GP73)and AFP in single and combining form in the diagnosis of primary hepatocelluar carcinoma (PHC).Methods Eighty PHC,65 liver cirrhosis,54 chronic hepatitis patients and 50 controls were selected in the First Afiliated Hospital in Xinjiang Medical University from May to September in 2011,GP73 was detected by ELISA and AFP was measured by clinical chemiluminescence.The sensitivity and specificity of each parameter in single and combining form were evaluated.Results Serum GP73 in PHC group 282.0(163.6-366.7) μg/L,liver cirrhosis group 211.8(107.5-295.7) μg/L,chronic hepatitis group 100.3(61.8-191.3) μg/L and control group 58.3(43.4-83.6) μg/L was tested by Kruskal-Wallis(H =106.6,P ＜0.01).GP73 in PHC group was further compared with liver cirrhosis group,chronic hepatitis group and control group using MannWhitney test,significance was found,(U was 1796.0,826.5,154.0,respectively,all P ＜0.01).In the single form,the sensitivity of GP73 [82.5％ (66/80)] was higher than AFP [66.3％ (53/80),x2 =4.65,P ＜0.05],but the specificity of GP73 [63.3％ (107/169)] was lower than AFP [88.7％ (150/169),x2 =28.91,P ＜0.05].There were 27 AFP negative cases in PHC group,but 22 of them were GP73 positive,making the positive rate of GP73 [81.5％ (22/27)] in PHC patients with AFP negative.There were 14 GP73 negative cases of in PHC group,but 9 of them were AFP positive,making the positive rate of AFP [64.3％ (9/14)] in PHC patients with GP73 negative.In series diagnostic test,the specificity of combining form [95.9％ (162/169)] was higher than AFP [88.7 ％ (150/169),x2 =6.00,P ＜ 0.05] ; in parallel diagnostic test,the sensitivity of combining form [93.8％ (75/80)] was higher than GP73 [82.5％(66/80),x2 =4.84,P ＜0.05].In PHC group,52 patients with HBV infection,10 patients with HCV infection and 18 patients without virus infection,GP73 was 309.5 (170.5-370.5) μg/L,351.0 (274.7-397.9) μg/L and 210.1 (156.8-306.7) μg/L,respectively,no significance was found (H =4.0,P ＞0.05).Conclusion GP73 and AFP have a complementary feature of sensitivity and specificity in the early diagnosis of PHC,some PHC cases with AFP negative can be avoided missing efficiently by parallel diagnostic test.

Objective To investigate the role of mesenchymal stem cells in the repair of radiation induced liver injury.Methods 12 female SD rats were irradiated with 20 Gy 6 MV X-rays on the right lobe of the liver,to establish the model of radiation induced liver injury.The rats were divided randomly into two groups as invention group and control group,and transplanted with 1 ml male mesenchymal suspension or 1 ml normal saline in 4 hours after radiotherapy.The morphological changes of liver were observed.The existence of sex determining gene Y(SRY)and the level of alpha-smooth muscle actin (a-SMA) were detected.Results Some injury of right lobe liver in two groups were observed,and the injury degree of right lobe liver in intervention group were lower than that of control group.The amount of SRY positive cells in the right lobe liver of intervention group was higher than that in the left lobe liver(t ＝ 3.77,P ＜0.05).The positive expression rate of a-SMA in right lobe liver of intervention group was lower than that of control group.Conclusions Acute radiation induced liver injury could lead BMSCs＇ homing in order to decrease the degree of liver fibrosis.

Objective To investigate the inhibitive effect of mesenchymal stem cells (MSCs) on the immunological rejection in rats after liver transplantation. Methods The recipients and donors were female SD rats and Wistar rats. All rats were randomly divided into 3 groups (28 rats in each group). Rats in group A were infused with normal saline; rats in group B received FK506 (0.25 mg/kg) every 2 days for 2 weeks after liver transplantation; rats in group C were injected with MSCs from male Wistar rats during liver transplantation. The pathological changes, expression of TGF-β1 and IL-10, Y chromosome location, changes of liver function and the survival of the recipients were detected on postoperative day 10. The levels of ALT and AST were analyzed by com-pletely randomised design analysis of variance, and the difference among the 3 groups were analyzed by LSD. Ridit was used to analyze the pathological grading. The survival was analyzed by Log-rank test after the Kaplan-Meier survival curve was drawn. Results The values of ALT and AST were (756±104)U/L and (635±134)U/L in group A, (197±49)U/L and (331±78) U/L in group B, (103±31)U/L and (150±38) U/L in group C, respectively. The difference in the level of ALT and AST among the 3 groups had statistical significance (F = 158, 265, P < 0.05). The liver function of rats in group B and C was better than those in group A (P < 0.01), and the liver function of rats in group C was better than those in group B. The mean values of ridit in group A, B and C were 0.8333, 0.4583 and 0.2083, respectively. The expression rates of TCG-β1 in group A, B and C were 18%±5% , 69%±20% and 85%±24% , with statistical difference among the 3 groups (F=191, P <0.01). There was a significant difference in IL-10 expression among group A (21%±5%), group B (75%±14%) and group C (91%±21%) (F=672, P<0.01). The TCG-β1 and IL-10 had strong positive expression in group B and C, and the expression of TCG-β1 and IL-10 was much stronger in group C than in group B; while the expres-sion of TCG-β1 and IL-10 was weak positive in group A. MSCs cells with Y chromosome were positively stained and were concentrated at the portal area in group C. The 50-day survival rate of rats in group A, B and C were 0, 10% and 90% , respectviely, with significant difference (χ~2=36, P < 0.01). The median survival time of rats in group C was 63 days, which was longer than that in group A and B. Conclusion Simultaneous injection of MSCs from donors during liver transplantation can inhibite the immunological rejection of recipients to the liver graft.