Objective To investigate the feasibility and efficacy of the intensity modulated radiotherapy (IMRT) with oral S-1 for locally advanced pancreatic cancer.Methods Forty-two patients with locally advanced pancreatic cancer were selected,and the patients were divided into 2 groups by random digits table method with 21 cases each.The patients in treatment group were treated by IMRT combined with oral S-1 40 mg/m2 twice daily from day 1 to day 14 of a 21-d cycle;the patients in control group were treated by IMRT combined with 30 min intravenous infusions of gemcitabine 1 000 mg/m2 on day 1,8,21 and 29.Radiation was concurrently delivered at a dose of 50.4 Gy (1.8 Gy/d,5 times per week,28 fractions).The dose of intensity modulated radiotherapy was 1.8 Gy/time (5 times/week,50.4 Gy/28 times).The recent curative effect and untoward reaction were assessed at the end of radiotherapy after 4 weeks.Results There were no statistical differences in efficient rate and disease control rate between treatment group and control group:57.1％ (12/21) vs.47.6％ (10/21) and 85.7％ (18/21) vs.76.2％ (16/21),P ＞ 0.05.The neutropenia rate and thrombocytopenia rate in treatment were significantly lower than those in control group:23.8％ (5/21) vs.57.1％ (12/21) and 28.6％ (6/21) vs.66.7％ (14/21),and there were statistical differences (P ＜ 0.05).There were no statistical differences in the incidences of anemia,nausea,vomiting,elevated aminotransferase and fatigue (P＞ 0.05).Conclusions The IMRT with oral S-1 for locally advanced pancreatic cancer is safe and effective.It is worthy of clinical promotion.

Objective To explore the risk factors in children with epilepsy and their effects on attack rate of epilepsy.Methods One hundred and sixty epilepsy patients(patient group,88 boys and 72 girls)and 150 healthy children(control group,72 boys and 78 girls)were selected.All children conformed epilepsy at the west China second hospital were consecutively included in the study for 6 months period.The range of age was from 1 month to 16 years[(7.0?4.7)years old] of patient group children.All children with epilepsy had no-causation seizure for more than twice time and were diagnosed by electroencephalogram.Neurologically normal children in same period,matched for age and sex,visiting the health care clinic were selected as controls.The range of age was from 2 month to 16 years [(6.3?4.5)years old] of control group children.The risk factors examined were febrile convulsions,head trauma,central nervous system infections,abnormal perinatal history,family history of epilepsy and parental consanguinity.The data of patients and controls were obtained from a questionnaire through personal interviews.Details on the patient,family history,and parental age at the time of childbirth were included.Medical records were then reviewed.According to the data type,the statistics were performed with ?2 test and the significance level was the P

ObjectiveToexplore the appearance ofmusclecrushinjuryatquantitative ultrasonographic elastography by supersonic shear imaging (SSI).MethodsThe animal experiment was done using a special balloon cuff device to create left hind leg crush injury with a force of 18.6 kPa.Twentythree New Zealand rabbits had crush injury of extremity and survived for 72 hours.SSI quantitative elastography was performed in crushed and no-crushed regions of each rabbit hind leg.Quantitative lesion elasticity was measured in terms of the Young modulus (in kilopascals) at 30 min,2 h,6 h,24 h and 72 h after the release of the crushing pressure.A receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.ResultsThe area of crushed region in left hind leg accounted for 2.6％ -3.0％ of body surface area in 23 rabbits.The crushed regions exhibited maximum elasticity values of (19.51 ± 6.74)kPa,(21.47 ± 5.54) Pa,(11.36 ± 5.35)kPa,(15.09 ± 3.31)kPa and (13.72 ± 3.74) kPa,and mean elasticity values of (12.44 ± 3.77)kPa,(13.20 ± 3.60)kPa,(6.80±2.86)kPa,(10.04 ± 2.95)kPa and (6.94 ± 0.97)kPa at 30 min,2 h,6 h,24 h and 72 h after the release of the crushing pressure.Comparing with those of no-crushed regions,they were higher obviously (P＜0.001).ROC curves showed that extremity crush injury was diagnosed by using elasticity value,and the greater the elasticity value,the greater the diagnostic value.Conclusions SSI provides quantitative elasticity measurements,thus adding complementary information that potentially could help in crush injury characterization with conventional ultrasonography.

Objective To retrospectively investigate the clinical features of localized primary small bowel stromal tumors (SBSTs) and the impacting factors for prognosis.Methods The clinical and pathological data of 89 consecutive SBSTs patients,with pathologically confirmed,who underwent complete resection in Ruijin hospital between January 2003 and September 2007 were collected and analyzed.All patients were followed up for assessment of tumor recurrence and metastasis.The impacts of clinical and pathologic factors on rate of disease free survival (DFS) of the patients was evaluated.Results In total of 89 follow-up patients,15 patients were diagnosed with tumor recurrence and 9 of them died.The tumor size,mitotic index and pathological risk stratification were statistically related with DFS (P=0.000,P=0.006,P=0.000,respectively) by using Kaplan-Meier univaritate analysis.Tumor size and mitotic index were proved to be independent prognostic factors for tumor recurrence by multivariate analysis COX regression model.Conclusions Tumor size and mitotic index are related with tumor recurrence,and can be regarded as independent predictive factors of tumor recurrence.

Objective Through exploring the concordance of objective multi-parameters analysis and perceptual evaluation,to establish an objective multi-parameters evaluation protocol of voice disorder and to make the evaluation of voice objectification and quantification. Methods Voice samples from 271 patients ( 124 female and 147 male)with dysphonia and 69 control subjects with normal voice (37 female and 32 male)were recorded and assessed by a jury composed of 5 experts in phoniatrics from different hospitals.The jury was instructed to classify voice samples according to the G (grade) component of the GRBAS scale on a visual analogue scale secondarily transformed in a 4-point scale ranging from 0 for normal to 3 for severe dysphonia. The voice samples were unified sentences and ordered randomly 3 times,the mean of 3 evaluation scores were the final results.The objective parameters,including fundamental frequency ( F0),jitter,shimmer,fundamental frequency standard deviation (FOSD),normalized noise energy (NNE),harmonic-to-noise ratio (HNR) and maximal phonatory time ( MPT),were measured on a 2-second sustained vowel/a/ including its initial segment,using the software Dr.Speech for Windows.The data were analyzed using SPSS11.0.Results All objective parameters except for F0 had high correlation with G and the variance tendency of these parameters values was coherent with the extent of voice disorder.And there were statistical differences between adjacent voice disorder groups. Male and female objective multi-parameters protocols were established respectively consisting of jitter,shimmer,FOSD, NNE,HNR and MPT using discriminant analysis ( P ＜ 0.05 ). The concordance between perceptual evaluation and objective multiparameters evaluation was 81.6％ in male and 83.2％ in female.The concordance of evaluation of normal voice and severe voice disorder groups were better than that of mild and moderate voice disorder groups.All mis-grading voices were judged in the adjacent voice group.Conclusions The objective parameters of voice are able to reflect the characteristic of its perceptual evaluation and the concordance between perceptual evaluation and objective multi-parameters evaluation is good. The objective multi-parameters evaluation protocol we established could provide an objective and quantitative evaluation method for voice disorders.

Aged ; Bronchoscopy ; Esophageal Neoplasms ; complications ; Female ; Humans ; Male ; Middle Aged ; Stents ; Thyroid Neoplasms ; complications ; Tracheal Stenosis ; etiology ; therapy

Cerebral Palsy ; physiopathology ; Child ; Child, Preschool ; Humans ; Infant ; Motor Activity ; Posture ; Walking

Objective To investigate the specific expression of endoplasmic reticulum stress-related GRP78 and CHOP in podocyte of MKR mice with diabetic nephropathy (DN);To discuss the intervention effect of Zuogui Jiangtang Yishen Decoction (ZGJTYS). Methods 8-week old MKR mice were randomly divided into five groups:blank group, model group, ZGJTYS group, 4-Phenylbutyric acid group, gliquidone+benazepril group, and normal control group consisting of wild type C57BC/6 mice, 10 mice per group. All mice from model group and each treatment group received high-fat diet feed and unilateral nephrectomy to make the DN model. Mice from treatment groups received medicine intervention for four weeks. The levels of FBG were detected by electrochemical detection method, and the UmAlb was detected by ELISA. The expressions of GRP78, CHOP mRNA, and protein were detected by RT-PCR and Western blot. The morphological structure changes of the podocytes were observed by transmission electron microscopes. Results Compared with blank group, FBG and UmAlb in the model group increased significantly (P<0.01);the expressions of GRP78 mRNA and protein markedly decreased (P<0.01);the expressions of CHOP mRNA and protein increased (P<0.01). Compared with the model group, FBG and UmAlb in each treatment group significantly decreased (P<0.01);the expressions of GRP78 mRNA and protein in the ZGJTYS group and 4-Phenylbutyric acid group increased (P<0.01), the expressions of CHOP mRNA and protein decreased (P<0.01). The renal pathological lesions of each treatment group were significantly improved compared with model group. Conclusion ZGJTYS Decoction can effectively improve the damaged podocyte induced by endoplasmic reticulum stress, delay DN progress.

Objective To explore the value of linear blending and non-linear blending images of dual-energy CT in improving the image quality of portal venography.Methods 60 patients clinically confirmed as liver cirrhosis with portal hypertension and gastric fundus esophageal varices were enrolled in the study.The patients underwent dual-energy (Sn140/80 kVp) scans in the portal phase, and four groups with 80 kVp and 140 kVp were defined as group A (linear blending images with M=0.3), B (linear ones with M=1.0), C (non-linear ones with c=150 and w=200) and D [non-linear ones with c=(CThepatic portal+CThepatic parenchymal)/2 and w=(CThepatic portal-CThepatic parenchymal)/2, and the CThepatic portal and CThepatic parenchymal were measured on M=0.3 image].The in portal vein enhancements, image noise, signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and CT value difference between portal vein and liver parenchyma among four groups were compared by one-way ANOVA analysis of variance test.VRT imaging quality among four groups were assessed by Kruskal-Wallis test and Mann-Whitney U test.Results In four groups, the SNR and CNR of portal vein,and the CT value difference between portal vein and liver parenchyma(14.36 HU±3.23 HU,9.78 HU±2.39 HU,107.66 HU±21.28 HU) of group D were the highest (F=34.94,68.10 and 162.43,all P<0.01),and VRT image quality score of group D(4.78±0.42) was the best when compared to others (all P<0.01).Conclusion Non-linear blending technique of group D can improve the image quality of CT portography, which may be used in clinical practice.

Background With the widely application of phacoemulsication for cataract,dry eye-associated symptoms,such as foreign body sensation and burning frequently occur after cataract surgery in some patients.Objective This study was to evaluate the repair effects of recombinant human epithelial growth factor (rhEGF) on ocular surface injuriy after phacomulsification. Methods This was a prospective study,and informed consent was obtained from each subject before the experiment.One hundreds and twenty eyes of 89 consecutive patients after phacomulsification for age-related cataract were collected and randomized into rhEGF group,hyaluronic acid group and control group and 40 eyes for each.RhEGF drops and hyaluronic acid drops were topically administered 4 times per day for consecutive 4 weeks after surgery in corresponding group,and no drops mentioned above was used in the control group.The 0.3％ ofloxacin eye ointment and tobramycin+dexamethasone drops were used as the element drops in all patients of each group.Corneal fluorescein staining score,tear film break-up time ( BUT),Schrimer Ⅰ test without topical anesthesia were performed 1 day before surgery and 1 day,1 week,2 weeks and 1 month after surgery.Results The demography and the relevant surface examinational outcomes were no significantly different among the rhEGF group,hyaluronic acid group and control group in preoperation (age:F =3.74; gender:x2 =0.615; corneal fluorescein staining:F =0.247 ; BUT:F =0.579 ; Schrimer Ⅰ test:F =0.475 ; all P＞ 0.05 ).With the prolong of the time,the corneal fluorescein staining scores and Schrimer Ⅰ test values appeared a early ascent and latterly decline,and the BUT value showed a early shorten and latterly restore,with a statistically significant differences among various time points( F时间 =6.754,6.079,6.233,P＜0.01 ).Meanwhile,statistically significant differences were found in the corneal fluorescein staining scores,Schrimer Ⅰ test values and BUT among these 3 groups (F分组 =4.953,4.511,4.071,P＜0.05 ).The corneal fluorescein staining scores in the rhEGF group were significantly lower than those in the hyaluronic acid group at 2 weeks and 1 month after operation(P=0.039,0.014),and the BUT values in the rhEGF group were significantly longer than ones in the hyaluronic acid group at 1 week and 2 weeks after operation (P =0.019,0.007).The Schrimer I test values were significantly reduced in the rhEGF group compared with hyaluronic acid group at 1 week,2 weeks and 1 month after operation (P=0.022,0.003,0.019). Conclusions RhEGF promotes the repair of the ocular surface injury in the patients with age-related cataract after phacomulsification.