Purpose:To study the influence of chemotherapy on radiotherapy in locally advanced nasopharyngeal carcinoma. Methods:96 patients with histologically proven nasopharyngeal carcinoma in stages Ⅲ,Ⅳ were divided randomly into two groups. Radiotherapy group (48 cases) only received radiotherapy with DT66—76Gy in nasopharynx and DT50—70Gy in the neck. Chemoradiotherapy group (48 cases) received chemotherapy with cisplatin and 5 fluorouracil before the same radiotherapy as the radiotherapy only group. Results:The 1,3,5 year survival rates were 94.2%,72.9%,65.7% in chemoradiotherapy group and 89.1%,56.8 %,46.8% in radiotherapy group respectively, with significant difference between the two groups ( P

C erbB 2 is overexpressed in 20%～30% of human breast cancers,this oncoprotein plays an important role in predicting response to chemotherapy in breast cancer.Overexpression of c erbB 2 in breast cancer is associated with resistance or sensitivity to certain chemo therapeutic drugs, c erbB 2 can be expected to be a biological marker to direct chemotherapy in the treatment of breast cancer.

Tumor microvessel including two modes,as one is classic vascular structures surrounded with vascular endothelial cells and the other is vasculogenic mimicry( VM) surrounded with cancer cells.Recent studies suggested that anti-angiogenic drugs can inhibit classic microvessel structure significantly, but can not inhibit VM formation and even promote VM formation further more.This is one of the reasons affecting its clinical effica-cy.However,basic research has shown that traditional chinese medicine,gene therapy and drugs which is targeting for VM formation have an unique advantage in anti-VM.In this review, we summarize the progress of cancer therapy on targeting vasculogenic mimicry,and provide a basic for the development of new drugs for cancer thera-py through targeting both angiogenesis and VM formation.

Objective To evaluate the impact of mesoreetal margin micrometastasis on local recurrence of rectal carcinoma after total mesorectal excision, and the relation between mesorectal margin mierometastasis and local recurrence. Methods Mesorectal margin specimens from 52 cases of rectal cancer after total mesorectal excision were studied by reverse transcriptase-polymerse chain reaction (RT-PCR) to detect the expression of CK20 mRNA. These patients were divided into CK20 mRNA positive and negative group and followed up for 3 years until local recurrence developed. Results In 52 patients with rectal cancer,21 cases were found to express CK20 mRNA in mesorectal margin, the expression rate of CK20 mRNA in Dukes A,B and C was 17% ,30% and 54% (P<0.05), respectively. The positive rate of well differentiated, moderately differentiated, poorly differentiated and undifferentiated carcinomas were 43%, 38% ,40% and 50% ,respectively(P>0.05 ). The incidence of local recurrence in CK20 mRNA positive and negative group was 24% and 3% , respectively. The difference was statistically significant between the two groups (P <0.05 ). Conclusion Detection of mesorectal margin CK20 mRNA as micrometastasis by RT-PCR in rectal carcinoma patients was a sensitive and effective way in predicting local recurrence. It is necessary for patients with positive mesorectal margin CK20 mRNA to undergo postoperative radiotherapy after total mesorectal excision.

Objective To discuss the value of ABCD2 score in predicting medium and long-term prognosis in patients with ischemic stroke.Methods 184 patients with ischemic stroke admitted to department of neurology from March 2014 to December 2014 were selected as the research object.According to the ABCD2 score points prior to admission, the patients were divided into 3 groups: 40 cases in the low risk group, 76 in the moderate group and 68 in the high risk group based on whether or to what extent he was able to do self care.The phone call reviews were made for the clinical symptoms of patients discharged from the hospital after six months..According to the modified Rankin scale classification standard, the patients discharged from the hospital after six months were divided into 2 groups: 126 cases in the self-care group and 56 cases in care-needing group.The groups were compared in terms of conditions.Results The self-care rate in the low risk group was 90.00%, the moderate group 77.63% and the high-risk group 45.59%.The care needing rates in the three groups was 5%, 19.74% and 48.53%, respectively.The care needing rate in the low risk group was obviously lower than that in the moderate-risk group and the high risk group (P<0.05).The care needing rate in the moderate risk group was obviously lower than that in the high risk group (P< 0.05).The self-care rates in the low risk group and the moderate group were higher than that in the high risk group (P<0.05).Conclusion The ABCD2 score has a higher predictive value for medium and long-term prognosis in patients with ischemic stroke.

Objective To study the effects of percutaneous liver tumor injection combined with the clinical efficacy of transcatheter hepatic artery chemoembolization in the treatment of advanced liver cancer,and to provide ref-erence for clinical treatment.Methods 22 patients using percutaneous liver tumor injection combined with transcath-eter arterial chemoembolization for treatment were selected,with which 1 month follow-up after discharge.Situation of patients with percutaneous liver tumor injection and transcatheter hepatic artery chemoembolization was analyzed,and the changes of the patients in the following -up of survival time,tumor volume and clinical symptoms were also ana-lyzed.Results Among the patients of postoperative recheck after 6 weeks,6 cases were complete remission,there were partial remission in 8 cases,6 cases of stable,2 cases of progress.Follow up to 2013 December,the patients'sur-vival time was 17-82 months,the average survival time was (55.71 ±13.47)months.After treatment,4 cases of patients'tumor diameter reduced 1 -3cm,18 cases of tumor diameter reduced 3 -5cm,19 cases of liver area pain symptoms for more than half a year of remission,3 cases of liver area pain relief time less than half a year.During the follow -up period,12 patients died of multiple organ failure.Conclusion The development of percutaneous liver tumor injection combined with transcatheter hepatic arterial chemoembolization therapy can delay the development of the disease in patients with advanced HCC,and prolong the survival time.

Background and purpose:The clinical relevance of HBV infection with respect to diffuse large B cell lymphoma(DLBCL) patients and immune patterns of T lymphocyte subsets during chemotherapy remains unclear. This study aimed to identify the characteristics of T-cell mediated immunity in DLBCL patients with HBV infection, thereafter, to explore the possible cell-mediated immune mechanisms of HBsAg positive HBV infection on the survival of DLBCL. Methods:A total of 294 newly diagnosed DLBCL patients were enrolled in this cohort study. Four-color flow cytometric method was used to enumerate the absolute number of CD3+, CD4+, CD8+T lymphocytes and the CD4+/CD8+ratio in peripheral blood samples, at the onset of disease, 2-4, 4-6 and 6-12 months after the initiation of chemotherapy, individually. Results:The absolute number of CD3+, CD4+, CD8+T lymphocytes in both groups were similar at the onset of disease;the count of CD4+lymphocytes was lower in HBsAg positive group during 2 to 4 months after the initiation of chemotherapy, compared with that in the HBsAg negative group. During 4 to 12 months after chemotherapy, the CD4+/CD8+ratio in peripheral blood samples was significantly lower in HBsAg positive group. Conclusion:For newly diagnosed DLBCL patients who received chemotherapy, the dynamic nature of cell mediated immune response was characterized as a low counts of CD4+T lymphocyte during the ifrst several cycles of chemother-apy followed by a decreased circulating CD4+/CD8+ratio. Depressions of cell immunity after chemotherapy in HBsAg positive DLBCL patients were greater and prolonged.

Objective To explore the technique and effect of selected three-field lymphadenectomy by left thoracotomy in treatment of thoracic middle or lower section esophageal squamous carcinoma. Methods From Jun. 2005 to Mar. 2009, 213 patients with thoracic middle or lower section of esophageal carcinoma received esophagectomy, bilateral mediastinal lymphadenectomy and pleural membrane resection.Group 1 -5, 7 - 12a, 16al, and 19 were performed to dissect abdominal lymph node and extended thoracic and abdominal lymphadenectomy and only lymph node extraction of mesoesophagus in neck field. Results 14197 lymphatic nodes(LN) were detected in 213 case. The average number of resected LN was 66. 65 ±24. 73. The metastatic lymph node was detected in 105 cases. The metastatic rate was 49.05% (105/213).There were 423 metastatic lymph nodes. The lymph nodes metastasis was 2. 97% (423/14197) of all dissected lymphatic nodes. No remnant carcinoma in the upper and lower cutting edge was found in pathological examination. The operation time ranged from 2. 92 ～ 4. 67 ( 3. 37 ± 0. 42) hours. Blood transfusion during perioperative period was 0 ～ 6u ( 1.08 ± 0. 93 ) u. Perioperative plasma transfusion was 0 ～ 1400( 103.77 ± 184. 89) ml. The hospital-time was 14 ～ 39 ( 17.64 ±4. 12) days. There were no anastomotic leakage and recurrent laryngeal nerve injury. One case died from respiratory failure, the mortality was 0. 04% ( 1/213). Conclusion Surgical approach in the management of left thoracotomy in the sixth intercostals could extend resection of chest-field lymph node dissection, decrease neck field lymph node dissection. Abdomen-field lymph node dissection reached selected D3. The selected lymphadenectomy procedure had the advantages of small traumas and few complications.

Objective To summarize the experience in surgical management of bile duct injury. Methods The clinical data of 683 patients with bile duct injury who were admitted to the Hunan People's Hospital from August 1990 to December 2008 were retrospectively analyzed. Of all the patients, seven received hepatectomy +T tube drainage, two received liver repair + T tube drainage, four received external biliary drainage + hepatectomy,27 received liver repair or hepatectomy + silicone support, 233 received temporary portal triad clamping + gelatin sponge hemostasis, 72 received biliary repair + T tube drainage, 248 received hepatobiliary basin Roux-en-Y anastomosis, 22 received external biliary drainage, 61 received long arm T tube drainage, two received pancreaticoduodenectomy and five received hepatectomy + T tube drainage. The surgical outcomes were evaluated by analyzing the results of the follow-up. Results The surgical outcomes were ranked excellent, good and poor according to the condition of patients and the results of imaging examination. Six hundred and twelve patients were followed up for 8 months to 19 years, and the surgical outcomes were excellent in 337 patients (55.1%), good in 214 patients (35.0%) and poor in 61 patients ( 10.0% ). Conclusion The surgical outcome of bile duct injury could be satisfactory if the approach of the surgery is properly selected.

Human enterovirus 71 (EV71) is one of the major etiological agents for the hand, foot, and month disease (HFMD) and is causing frequent, widespread occurrence in the mainland of China. The single positive-stranded RNA genome of EV71 is translated into a single polyprotein which is autocleavaged into structural and nonstructural proteins. The functions of many nonstructural proteins characterized in the life cycle of virus are potential targets for blocking viral replication. This article reviews the studies of the structures and functions of nonstructural proteins of EV71 and the anti-enterovirus 71 drugs targeting on these nonstructural proteins.