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 theanalgesic efficiency and safety of patient-controlled intravenous analgesia (PCIA) with sufentanil, lornoxicam and sufentanil combined with lornoxicam after Han-uvulopalatopharyngoplasty (H-UPPP) surgery. METHODS Sixty patients after H-UPPP surgery for PCIA were randomly divided into three groups: group S (sufentanil 2.0 ?g/kg), group L (lornoxicam 0.5 mg/kg) and group SL (sufentanil 1.0 ?g/kg + lornoxicam 0.4 mg/kg). The efficiency of analgesia was assessed by VAS (visual analogue scale) and Ramsay score at 2, 6, 12, 24, 48 hours after PCIA. The MAP, HR, SpO2 and side effects were also recorded. RESULTS Group S and SL showed good pain relief and sedation. In Group L VAS score was higher but Ramsay score was lower than that of group S and SL at 2, 6, 12 hours after PCIA (P

Objective:To determine the effects of angiogenesis in c ervical lymph node metastasis and progression of squamous cell carcinomas of gin giva (GSCC), and the distribution and expression of vascular endothelial growth factor (VEGF) in GSCC.Methods: Paraffin sections of surg ically obtained GSCC samples from 42 patients were stained with CD34 monoclon al antibody by immunohistochemical S P method to demonstrate blood vessels. Exp ression of VEGF was tested with the S P method, and the microvessel density (M VD) was determined according to the percent of the neoplastic cells showing VEG F immunoreactivity and the degree of staining.Results: The MVD in GSCC was significantly higher than that in normal gingival tissue( P 0.05). MVD in VEGF positive samples of GSCC was sig nificantly higher than that in VEGF negative ones ( P

Objective To investigate the effect of different end-tidal PCO2 (PETCO2) on the quantitative electro-encephalogram (qEEG) and auditory evoked potential index (AAI) in patient undergoing elective general surgery under inhalation anesthesia. Methods Thirty-eight ASA Ⅰ-Ⅱ patients aged 22-48 yrs weighing 49-79 kg undergoing elective general surgery under inhalation anesthesia were studied. The intra-operative blood-loss was expected to be

Objective To evaluate the efficacy of calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi.Methods The severe hydrocalycosis was incised using electrocautery,then pneumatic lithotripsy was performed and the broken stones were taken out.For those patients with stenotic entrance to renal calyces without hydrocalycosis,we stabbed into the stones with the lithotriptic pole(1 mm in diameter) through renal parenchyma and took the broken stones out of the entrance.Results The renal pedicle were not blocked in 19 cases.The operation time was 90-150 minutes,with a mean of 120 minutes.There was no blood transfusion with the blood loss ranging form 100 to 250 ml.The procedures were successful in 17 cases without residual stones after operation;intraoperative residual sand-like calculi were found in 1 case and removed by irrigation and drainage through nephrostomy tube;intraoperative missing calyceal calculi occurred in 1 case and were cleared by extracorporeal shock wave lithotripsy(ESWL).A follow-up for 10-60 months(mean,18 months)in 15 patients showed recurrence in 2 ones,and the stones were removed by ESWL.Conclusions Calicecotomy combined with trans-renal parenchyma pneumatic lithotripsy for complicated staghorn renal calculi has the advantages of less blood loss and definite efficacy.

Ventral hernia is a very common surgical problem with its incidence gradually increasing due to aging population,and it has significantly threat to quality of life.Laparoscopic hernia repair is a kind of minimally invasive surgery based on tension-free hernia repair,which has become an effective way for treatment of ventral hernia after decades of development.Besides,the classic surgical approaches for adult inguinal hernia include intraperitoneal onlay mesh,transabdominal peritoneal and totally extraperitoneal repairs.However,some related complications including vascular injury and bleeding,postoperative pain,nerve damage,seroma,intestinal obstruction,infection and relapse have been increasingly reported with the extensive applications of laparoscopic ventral hernia repair.Surgeons still need to pay more attentions and take appropriate measures to prevent such events.Complications could be reduced by strictly following the indications of different laparoscopic hernia repair surgeries with a careful consideration of the advantages and disadvantages,understanding their pathogenesis,improving the laparoscopic operation techniques,getting familiar with the local anatomical structures and standardizing the surgical procedures.Establishing a correct and standard surgical training system will further shorten the learning curve of surgeons to promote the progression and development of hernia surgery in China.

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.

Objective To evaluate the application of interferon-γ release assay T-SPOT.TB in diagnosis and efficacy assessment of pulmonary tuberculosis. Methods T-SPOT.TB assay was used to determine spot-forming cells (SFCs) formed by T-cells when stimulated by Mycobacterium tuberculosisspecific antigens in 55 patients with active tuberculosis,14 patients with non-tuberculosis lung diseases and 12 healthy controls. Meanwhile 20 sputum culture-positive and qualitative assay-positive pulmonary tuberculosis patients were tested with T-SPOT.TB before and at 2-month and 6-month after treatment.Kruskal-Wallis H and Mann-Whitney U test were used in group comparison.Wilcoxon test was used in comparison between pre- and post-treatment.Results The positive rate of T-SPOT.TB was significantly higher in patients with tuberculosis (85.5％,47/55 ) than that in patients with non-tuberculosis lung diseases (2/14) and the healthy controls (1/12) (x2 =40.926,P ＜0.05).The SFCs of hole A in response to ESAT-6 and hole B in response to CFP-10 in pulmonary tuberculosis group were 70.00 (27.00 -125.00) and 80.00 ( 17.00 - 180.00),respectively,which were all significantly higher than those in nontuberculosis lung diseases group and the healthy controls (x2 =35.376 and 30.485,P ＜ 0.05 ).The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in diagnosis of smear-positive tuberculosis were 88.6％,88.5％,91.2％ and 85％,while in diagnosis of sputum smearnegative tuberculosis,the sensitivity was 80％,specificity was 88.5％,positive predictive value was 84.2％ and negative predictive value was 85.2％ ( P ＞ 0.05 ).SFCs of hole A and hole B in 20 patients with sputum culture-positive and qualitative assay-positive pulmonary tuberculosis were 75.50 (41.25 -116.25 ) and 56.25 ( 105.00 -225.00) before the treatment.After 2-month antituberculosis treatment,the SFCsofhole A and hole B were 41.0 (18.0-68.75) and 72.50 (42.25- 158.75),which were significantly lower than those before treatment (Z =- 3.213 and - 3.622,P ＜ 0.05 ).Ater 6-month antituberculosis treatment,the SFCs of hole A and hole B were 25.00 (5.75 - 52.25) and 55.00 (6.25 -122.50),which were significantly lower than those before and 2-month after antituberculosis treatment (vs.before treatment:Z =- 3.921 and - 3.923,P ＜ 0.05 ; vs.2-month antituberculosis treatment:Z =- 3.926 and - 3.884,P ＜ 0.05 ).Conclusions T-SPOT.TB assay possess satisfactory sensitivity and specificity in diagnosis of tuberculosis infection,especially for sputum-negative pulmonary tuberculosis.It is also of value in monitoring antituberculosis treatment.

Objective To explore the clinical feature and diagnosis of the X linked adrenal hypoplasia congenital (X-AHC). Methods The clinical data and gene detection results of one case of AHC were retrospectively analyzed. The related literatures were reviewed. Results Two-month-old male infant was suffered with slow weight gain, vomiting, and salt craving of adrenal insufifciency after birth. Gene detection found a new missense mutation on NROB 1 gene. The diagnosis of X-AHC was conifrmed. Conclusions X-AHC is a kind of rare disease and is diagnosed by clinical manifestation, laboratory testing, and NROB 1 gene detection.

Aim Through interfering the expression of survivin with short hairpin RNA(shRNA) technology,to investigate the effect of downregulation of survivin on cell apoptosis and chemosensitivity to docetaxel in breast cancer MCF-7 cells.Methods(1) Using MCF-7 cells as a model system,three groups were set up transfected with lipofectamine,RNAi control plasmid and survivin RNAi plasmid,respectively.The expression of survivin in MCF-7 cells was measured at transcriptional and translational level by using RT-PCR and Western blot methods.(2) The effect on the cell cycle and apoptosis was analyzed with flow cytometry.(3) The viability of cells applied with different doses of ducetaxel was determined by using the method of 3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide reduction(MTT method).Results(1) RT-PCR and Western blot demonstrated that survivin expression was significantly decreased by transfection with RNAi targeting plasmid;the expression proportion was reduced by nearly 75.4% and 79.8%(P