Objective To observe the effect of residual tumor after radiotherapy on survival rate of patients with nasopharyngeal carcinoma (NPC). Methods From Jan. 1989 to Dec. 1998, 108 of 304 NPC patients pathologically confirmed, had residual tumor after radical radiotherapy, of whom, 26, 68, 14 had residual lesion in the nasopharyngeal cavity alone, cervical lymph node alone, and nasopharyngeal cavity plus cervical lymph node. Results The overall 1 , 3 , 5 , and 10 year survival rates (OS) significantly decreased in the residual group. The highest OS was in the group with nasopharynx residual alone, and the lowest in nasopharynx plus residual lymph node group. The bigger the residual lesion, the lower the OS. Conclusions The overall survival rate decreases in patients with residual lesion after radiotherapy, especially in patients with both nasophrynx and regional lymph node residual. Tumor residual after radiotherapy can be a prognostic indicator for patients with NPC.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Female ; Humans ; Mental Disorders ; etiology ; Postoperative Complications ; Stents ; adverse effects

Objective To explore effects of sequel recanalization PCI therapy(primary coronary intervention,PCI) on cardiac function for the patients with acute ST segment elevation myocardial infarction(STEMI),and related factors.Methods 116 patients with STEMI enrolled were divided randomly into two groups:sequel recanalization PCI group(58 cases) and conventional PCI group(58 cases),and the patients of sequel recanalization PCI group were fully absorbed for thrombus before conventional PCI,then compared estoration of their cardiac function of the patients of two groups at once and 2 weeks after PCI procedure,respectively.Meantime to study the effect related-factors for cardiac function by Logistic regression analysis.Results There were significant differences between two groups in RESVmax(P =0.03) 、RESVmin(P = 0.00) 、REFmax(P = 0.00)、 REDVmax(P = 0.01) and the ratio of E/A(P =0.02)(all P＜0.05);it showed that the restoration of cardiac function of sequel recanalization PCI group was faster than that of conventional PCI group.If sequel recanalization PCI served as a variable for predicting REFmax being 50%,the results of logistic regression showed that OR(odds ratio) value was 3.47,95% CI(confidence interval) 1.39-9.75,P =0.04.Among other variables,as was time-to-recanalization(OR =4.59,P =0.01);infarct size(OR =4.59,P=0.01);Kiliip grades(OR = 3.99,P =0.02)and age(OR=2.75,P=0.04).Conclusion The sequel recanalization PCI could be better than conventional PCI for the patients with STEMI in restoration of heart function,but there should be some other effective factors.

Objective To detect the expression of a disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS4),Versican,and Aggrecan in hearts of myocardial infarction rats.Methods Male Wistar rats were chosen to make myocardial infarction model.Fifteen rats were randomly assigned into the myocardial infarction group and five rats into the sham-operation group.Rats were killed 3 d after surgery and the left ventricles were taken to produce frozen section.ADAMTS4,Versican,and Aggrecan protein expressions were detected by imnunohistochemistry method.Results ADAMTS4 expressed in myocardial cells at marginal zone of the infarcted area.ADAMTS4 expressed weakly while Versican expressed strongly in capillary endothelial cells of marginal zone of the infarcted area.Aggrecan showed no expression in the cardiac tissue and vascular endothelium of both myocardial infarction group and sham-operation group.Conclusions ADAMTS4 is involved in the inflammation after myocardial infarction.Degradation of ADAMTS4 to Versican exists in the vessels after myocardial infarction.Aggrecan is not involved in the pathophysiological process of myocardial infarction.

In handling crises in hospitals caused by natural disasters like earthquake, systemati cpractical measures of crisis management are needed, which include: early contact with top managements for support in counter disaster supplies, immediate organization of temporary first aid stations by hospital staff, logistic support by full time personnel to solve problems such as drugs and medical equipments as well as food and drinking water, and psychological consultation to patients and staff members.

ObjectiveTo investigate the effect of jin’s three-needle scalp electroacupuncture on Cyt-c and Caspase-3 expressions in the cerebral cortex in Intrauterine distress-induced HIBD rats and reveal the mechanism of its protective action on the brain. MethodThe abdomen was incised in a female SD rat at 21 days of pregnancy. Bilateral uterine horn blood vessels were tightly clamped with a hemostat for five minutes. An infant rat was then taken out by a cesarean section. A rat model of hypoxic-ischemic brain damage was confirmed by the use of a behavior test and braintissue sections. The rats were randomized into model and acupuncture groups. The model group was not needled. Acupuncture groups 1, 2, 3 and 4 began to be needled at 3, 5, 7 and 14 days after birth, respectively. Acupuncture treatment was given for seven consecutive days. The normal control group was naturally delivered, not used to make a model and not needled. All groups of rats were decapitated to take the brain tissue at 21 daysafter birth. Cyt-c and Caspase-3 expressions in the cerebral cortex were detected.ResultCyt-c optical density value decreased somewhat in the four acupuncture groups; there was a statistically significant difference between acupuncture group 1 or 2 and the modelgroup (P<0.05). Caspase-3 expression was significantly down-regulated in acupuncture group 1; there was a statistically significant difference compared with the model group (P<0.05).ConclusionThe protective effect of acupuncture beginning at 3 days after birthon the brain is related to the down-regulation of Cyt-c and Caspase-3 expressions in intrauterine distress-induced HIBD rats.

According to the current meditech conditions in China,we combined the domestic and overseas first aid modes and the problems in severe trauma together and inducted the methods of model study into the procedure of traumatic first aid.The purpose of the study is to establish the procedure of inner-hospital first aid in severe trauma.Through the investigation and practice in Daping Hospital,Third Military Medical University,on the basis principles of organizing first aid with high efficiency,shortening preoperative time and enhancing achievement ratio of remedy,we established the procedure of inner hospital first aid with the typical character of time-control mode.This method can effectively enhance achievement ratio of remedy,decrease the ratio of disability.Moreover,it may promotes the process of entirety,systematization and specialization of inner-hospital first aid in severe trauma.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

Objective To compare the efficacy and safety of two concurrent chemoradiotherapy regimens between paclitaxel plus fluorouracil( TF) and cisplatin plus fluorouracil ( PF) in the treatment of locally advanced esophageal squamous carcinoma. Methods 103 patients with locally advanced esophagus carcinoma were treated in Affiliated Hospital of Jiangnan University from December 2014 to February 2016, and randomly assigned to either study group ( TF ) or control group ( PF ) according to random number table, of which 52 patients in the TF group while 51 patients in the PF group. The primary outcome was overall survival(OS), and secondary outcomes include progression-free survival(PFS), local progression-free survival( LPFS) and side effects. Results The 1-year OS for TF group was 76. 9％ versus 74. 5％ for PF group( P>0. 05 ) , and the 2-year OS for TF group was 59. 6％ versus 56. 9％ for PF group ( P >0. 05). The 1-year LPFS for TF group and PF group were 71. 2％ and 66. 7％ respectively(P>0. 05), and the 2-year LPFS for TF group and PF group were 61. 5％ and 58. 8％ respectively(P>0. 05). The 1-year PFS for TF group was 63. 5％ versus 62. 7％ for PF group ( P>0. 05 ) , and the 2-year PFS for TF group was 51. 9％ versus 39. 2％ for PF group ( P>0. 05 ) . The incidence rate of serious ( grade 3- 4 ) leukopenia for TF group was 36. 5％ versus 17. 6％ for PF group(χ2 =4. 642, P<0. 05). The incidence rate of serious (grade 3-4) acute radiation pneumonitis was 15. 4％ in the TF group, higher than that in the PF group with the rate of 3. 9％(χ2 =3. 859, P<0. 05), while the incidence rate of severe nausea and vomiting for PF group was 17. 6％ versus 1. 9％ for TF group(χ2 =7. 262, P <0. 05). The difference between the two groups was statistically significant. Conclusions Patients who were treated with two concurrent chemoradiotherapy regimens showed no difference in OS, PFS and LPFS. The regimen on the basis of Paclitaxel has higher risk of adverse effects incidence rates of hematological toxicity and acute radiation pneumonitis, while digestive system toxicity must be concerned when concurrent chemoradiotherapy is performed on the basis of cisplatin plus fluorouracil.

Objective:To analyze the correlation between the Naples prognostic score (NPS) after preoperative neoadjuvant chemoradiotherapy in locally advanced rectal cancer (LARC) and evaluate the prognostic value of NPS in LARC.Methods:136 patients with LARC meeting the recruitment criteria from 2015 to 2020 were selected. Serum albumin, total cholesterol (TC) were collected and neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio were calculated. All patients were scored and graded according to the NPS rule. The survival rate was calculated with Kaplan- Meier method. Multivariate prognostic analysis was performed by Cox models. Results:There was no significant correlation between NPS score and tumor regression or pathological complete response (pCR) of LARC patients after neoadjuvant therapy ( P=0.192, P=0.163). However, Cox multivariate analysis showed that NPS was an independent risk factor for overall survival (OS) and disease-free survival (DFS) of LARC ( P=0.009, P=0.003), and hierarchical analysis suggested that LARC patients with lower NPS score obtained better prognosis. Besides NPS, tumor size was also an independent risk factor for OS, and tumor size and N stage were the independent risk factors for DFS. Conclusion:NPS has no correlation with tumor regression or pCR for LARC after neoadjuvant chemoradiotherapy, whereas it could serve as an effective predictor for long-term prognosis of LARC.