0.05). The level of serum ? 2-MG and urine? 2-MG in the cocaine users(0.090?0.030)mg/L、(0.090?0.020)mg/L respectively were significantly higher than that in the controls(0.040?0.010) mg/L、(0.050?0.020)mg/L (P

Objective To report long term results of 30 patients with primary intracranial germinoma and evaluate the treatment policy. Methods After the tumor of these 30 patients was completely or partially removed they were routinely given radiation therapy with the conventional extenal irradiation. Of these 30 patients, 28 received prophylactic whole brain irradiation followed by the cone down technique to the local site to an effective dose except 2 patients who were treated locally without prophylactic irradiation.Nineteen patients received prophylactic spinal cord irradiation.Results The overall 5 ,10 , 15 ,19 year survival rates were 93.1%, 87.6% ,87.6% and 68.2%,respectively.The two patients who did not receive prophylactic whole brain irradiation (1 patient) or too low a dose of that (1 patient) developed metastasis in the brain and spinal cord were given a second course of radiotherapy. One survived for 17 years and the other is living now over 10 years. The overall response rate (CR + PR) was 95%.Conclusions While surgery is indicated to reduce the tumor volume, shunt the hydrocrania and obtain a pathologic diagnosis, radiotherapy is invaluable to cure germinoma. Prophylactic whole brain irradiation of 26～30 Gy is necessary and the curative local dose should be 50～55 Gy. Prophylactic spinal cord irradiation is not indicated routinely except some appropriate patients. For patients younger than 14 years, shielding of the pituitary is necessary while the prophylactic whole brain is being irradiated. The tumor dose at the sella turcica region should be limited to 56 Gy, and the spinal cord need not be irradiated prophylactically.

Objective To observe the effects of Three-in-one Acupuncture on hemiplegia after ischemic stroke. Methods 146 patients with hemiplegia after ischemic stroke were randomly allocated into trial group (n=73) and control group (n=73). The trial group accepted Three-in-one Acupuncture, while the control group accepted rehabilitation, for 4 weeks. They were assessed with Neurological Deficit Score (NDS), Functional Comprehensive Assessment (FCA) and Barthel Index (BI) before and 7, 14, 21 and 28 days after treatment. They were followed up for a year. Results The NDS decreased since 7 days after treatment in the trial group (P<0.05), while it decreased since 21 days in the control group (P<0.05). The NDS was less in the trial group than in the control group 7 and 14 days after treatment (P<0.05). The FCA score increased since 21 days after treatment in both groups, and the BI score increased since 14 days after treatment in both groups (P< 0.05). There was no significant difference between the trial group and the control group (P>0.05). The rate of improvement was 87.9% in the trial group, similar with 84.1% in the control group (P>0.05). The recurrence rate was 11.54% in the trial group, less than 25.49% in the control group in a year (P<0.05). Conclusion Three-in-one Acupuncture is as effective as rehabilitation on hemiplegia after ischemic stroke, more quickly and with less recurrence.

Objective To evaluate the clinical efficacy and adverse events of intensity-modulated radiotherapy ( IMRT ) in the treatment of intermediate risk localized prostate cancer, and analyze the significance of prostate-specific antigen ( PSA) level changes. Methods Clinical data of 66 patients with intermediate risk localized prostate cancer admitted to our hospital between 2007 and 2018 were retrospectively analyzed. Sixty patients were treated with endocrine therapy before radiotherapy. The radiation field covered the pelvic lymph node drainage area in 6 cases. Forty-seven patients received image-guided radiotherapy ( IGRT) . The median dose in the prostate and seminal vesicle was 78 Gy and 48 Gy in the pelvic lymph node drainage area. The survival rate was calculated using the Kaplan-Meier method. Results The median age was 77 years. The median follow-up time was 71. 3 months. The 5-year sample size was 47. The 3-and 5-year overall survival (OS) was 98％ and 90％.The 3-and 5-year cancer-specific survival (CSS) was 100％ and 93％.The 3-and 5-year biochemical relapse-free survival was 97％ and 86％. The mean time of PSA declining to the nadir was 5. 83 months. The median level of PSA nadir was 0. 06 ng/ml after IMRT. The incidence of grade I andⅡearly adverse events in the urinary system was 38％ and 6％. The incidence of grade I andⅡearly adverse events in the gastrointestinal system was 21％ and 3％. The incidence of grade I andⅡadvanced-stage adverse events in the urinary system was 9％ and 2％. The incidence of grade I advanced-stage adverse events in the gastrointestinal system was 5％. Conclusions IMRT yields high clinical efficacy in the treatment of intermediate risk localized prostate cancer with a low risk of adverse events in the early and advanced stage. The monitoring of PSA after IMRT contributes to the assessment of clinical prognosis.

Objective To investigate the value of endoscopic carbon nanoparticles labeling technique assisted in situ resection after neoadjuvant chemoradiotherapy(nCRT)for middle and low locally advanced rectal cancer(LARC).Methods From January 2020 to January 2023,46 cases of middle or low LARC were selected for endoscopic injection of carbon nanoparticles suspension to label the lower edge of the tumor before nCRT,and laparoscopic anterior resection of the rectum was performed after nCRT.The main observations were the visualization of carbon nanoparticles marker during the operation,the length of each area(primary tumor area,tumor regression scar,distal resection margin,and regression area of lower edge of tumor)of surgical specimens and the positive rate of distal resection margins.Results The median interval between injection of carbon nanoparticles suspension and surgery was 105(77-182)d in the46 cases.Carbon nanoparticles remnants were observed on the rectal mucosal surface in all the patients after nCRT by endoscopy.During laparoscopic anterior rectal resection surgeries,carbon nanoparticles marker exposure on the surface of the rectal intrinsic fascia observed in 41 cases(89.1%),of which38 cases were judged as good exposure(the width of marker area≤1.5 cm,which assisted the operator accurately determining the distal surgical margins)and 3 cases were judged as inferior exposure(a larger range of black staining whereas in situ resection of the tumor still achievable).In another 5 cases,the carbon nanoparticles marker could not be observed and were judged as exposure failure.Intraoperative cryopathology showed that all distal resection margins were negative.Measurement of 30 surgical specimens with identifiable primary tumor area showed that the length of resected intestinal canal was 17.9(10.1-25.7)cm,the diameter of primary tumor area was(4.3±0.8)cm,the diameter of scar after tumor regression was 2.5(0.8-4.8)cm,and the length of regression of tumor lower margin was 1.0(0-2.9)cm.The length of distal resection margins in middle rectal cancer(n =17)was3.4(1.5-4.3)cm and in low rectal cancer(n =13)was1.6(0.5-2.8)cm.Conclusion Application of carbon nanoparticles labeling technology before nCRT for rectal cancer can effectively mark the lower margin of the primary tumor in a long time and assist surgeons to precisely remove the primary tumor area.

Background Bromadiolone is the second-generation anticoagulant rodenticide widely used all over the world. Exposure to bromadiolone in early life stage can lead to neurodevelopmental toxicity, but its toxic mechanism of neurodevelopment is not clear so far. Objective To investigate the developmental neurotoxicity and mechanism of bromadiolone to zebrafish embryos. Methods Zebrafish embryos were randomly divided into four groups: a solvent control group (dimethylsulphoxide) and three bromadiolone exposure groups (0.39, 0.78, and 1.18 mg·L⁻¹). The exposure period was from 4 h to 120 h post-fertilization. The number of spontaneous movement per minute was recorded at 24 h post-treatment. The locomotor ability of zebrafish larvae and the activity of acetylcholinesterase (AChE) were tested at 120 h post-treatment. The relative expression levels of neurodevelopment-related genes (elavl3, gap43, mbp, and syn2a) were measured by fluorescence quantitative PCR. Results Compared with the control group, the number of spontaneous movement per minute at 24 h decreased significantly in the 1.18 mg·L⁻¹ bromadiolone exposure group (P<0.05). Compared with the control group, the total distance travelled of the zebrafish larvae in the 0.78 and 1.18 mg·L⁻¹ bromadiolone exposure groups decreased by 60% and 69% respectively (P<0.05, P<0.01), and the total movement time decreased by 34% and 65% respectively (P<0.05, P<0.01). The AChE activity in the 1.18 mg·L⁻¹ bromadiolone exposure group increased by 36% when compared with the control group (P<0.05). The fluorescence quantitative PCR results showed that compared with the control group, the expression levels of neurodevelopment-related genes elavl3, syn2a, and mbp were significantly down-regulated by 66%, 69%, and 65% in the 1.18 mg·L⁻¹ bromadiolone exposure group respectively (P<0.01), the expression level of gap43 was up-regulated by 56% in the 0.78 mg·L⁻¹ bromadiolone exposure group (P<0.01) and down-regulated by 34% in the 1.18 mg·L⁻¹ bromadiolone exposure group (P<0.05). Conclusion Bromadiolone exposure could inhibit spontaneous movement and locomotive behavior, down-regulate the expression levels of neurodevelopment-related genes, hinder the release of neurotransmitters, and result in neurodevelopmental toxicity in the early-staged zebrafish.