Objective To investigate the influence and clinical effect of assisted three-dimensional conformal radiation therapy (3D-CRT ) on obstructive jaundice caused by malignant tumors .Methods 90 cases with obstructive jaundice caused by malignant tumors of liver ,gallbladder and pancreases were randomly divided into observation group and control group ,45 cases in each group . Patients in control group were given comprehensive measures ,including tumors exairesis ,assisted chemotherapy and stereotactic ra-diotherapy ,and patients in observation group were given 3D-CRT based on tumors exairesis and assisted chemotherapy .Clinical effect ,serum bilirubin were observed 2 months after treatment ,adverse reactions were recorded during the treatment ,and survival rate in 2-year follow up in two groups were observed .Results Total effective rate in observation group and control group were 75 .56% and 57 .78% (P<0 .05) ,respectively ,and adverse reactions rate were 37 .78% and 57 .78% (P<0 .05) ,respectively .After treatment ,serum total bilirubin and direct bilirubin in two groups were all lower than those before treatment (P<0 .05) .Serum total bilirubin and direct bilirubin in observation group after treatment were (26 .3 ± 6 .5)μmol/L and(18 .9 ± 3 .3)μmol/L ,and were (39 .3 ± 9 .5)μmol/L and(26 .9 ± 6 .7)μmol/L in control group ,and there were statistical difference between two groups (P<0 .05) . Observation group′s survival rate was higher than that of control group (P<0 .05) .Conclusion It has good clinical effect of trea-ting obstructive jaundice caused by malignant tumors by 3D-CRT ,and it prolongs the survival time ,decreases serum bilirubin and improves jaundice symptom ,so it has some guiding significance to its treatment .

Objective To study the feasibility of noninvasive detection of unstable plaques with 18F-Fluorodeoxyglucose (18F-FDG) PET/CT imaging. Methods Atherosclerotic plaques were induced in male New Zealand white rabbits. Animals were injected with FDG labeled with 18F,then examined with PET/CT. Aorta was explanted for photography with digital camera,and 18F-FDG uptake analysis. Thirty unstable plaques and 30 stable plaques were choosed so as to compare the quantitativly 18F-FDG uptake.The number of macrophages and smooth muscle cells was detected by immunohistochemical technique. Results Experimental group showed inconsistent uptake of 18F-FDG in the abdominal aorta. The results were confirmed in the ex vivo digital photo of the explanted aorta. The target to non target ratio(T/NT) and macrophages of unstable plaques were higher than stable plaques(P

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective To study the feasibility of noninvasive detection of unstable plaques with ~(18)F-Fluorodeoxyglu-cose (~(18)F-FDG) PET/CT imaging. Methods Atherosclerotic plaques were induced in male New Zealand white rabbits. Animals were injected with FDG labeled with ~(18)F, then examined with PET/CT. Aorta was explanted for photography with digital camera, and ~(18)F-FDG uptake analysis. Thirty unstable plaques and 30 stable plaques were choosed so as to compare the quantitativly ~(18)F-FDG uptake. The number of macrophages and smooth muscle cells was detected by immunohistochemical technique. Results Experimental group showed inconsistent uptake of ~(18)F-FDG in the abdominal aorta. The results were confirmed in the ex vivo digital photo of the explanted aorta. The target to non target ratio (T/NT) and macrophages of unstable plaques were higher than stable plaques (P<0.01) , but smooth muscle cells obviously reduced (P <0. 01). Correlation analysis showed that there was a positive correlation between T/NT and macrophage content (r=0. 815,P<0. 01), and a negative correlation between T/NT and SMC content(r=-0. 684,P <0. 01). Conclusion ~(18)F-FDG PET/CT can constitute an attractive imaging method for the noninvasive detection of experimental unstable plaques.

Objective: To study the expression of Fas, Fas ligand (FasL) and IFN ? in gastric cancer and its possible significance. Methods: Fifty eight gastric paraffin wax embedded cancer tissues and fifty three normal tissues adjacent gastric cancer were tested for the expression of Fas and FasL protein by immunohistochemistry and IFN ? mRNA by in situ hubridisation respectively. Results: The positive rate of Fas in cancer cells of gastric cancer tissues was significantly lower than that in gastric epithelial cells of the tissues adjacent cancer(19.0% and 64.2%, respectively; ? 2=23.46, P = 0.00). The positive rate of FasL in cancer cells of gastric cancer tissues was significantly higher than that in gastric epithelial cells of the tissues adjacent cancer(63.8% and 45.3%,respectively; ? 2=3.83, P =0.05). The positive rate of IFN ? in cancer cells of gastric cancer tissues was significantly lower than that in gastric epithelial cells of the tissues adjacent cancer(0.0% and 49.1%,respectively; ? 2=37.16, P =0.00). Conclusion: The Fas-FasL system was unbalanced, and the expression of IFN ? was low in gastric cancer cells in this study. These may be related to the carcinogenesis of gastric epithelial cells and might be responsible for the immune escape of these cells.

Objective To investigate the manifestations of esophageal motility disorders and evaluate the association between them and dysphagia, laboratory tests and other accessory examinations in patients with Sj(o)gren's syndrome (SS). Methods Esophageal manometry was performed in 31 patients with SS and 18 healthy volunteers by the step pull-through method. Results Decreased upper esophageal sphincter pressure was detected in 19 of the 31 patients (61%) with SS, while 4 of 18 (22%) in controls. The frequency was significantly higher in patients than in healthy controls (P=0.008). Fifteen of 31 patients (48%) showed various patterns of esophageal dysfunction including ineffective esophageal motility in 6 patients, nutcracker esophagus in 3 patients and nonspecific dysmotility in 6 patients. No major differences were found in esophageal parameters (peak amplitude, wave duration and velocity) when comparing primary SS with secondary SS. These esophageal abnormalities were not correlated with clinical manifestations, laboratory examinations and other auxiliary examinations. Conclusion Patients with SS may have esophageal motility disorders, which can presents with different patterns.

Objective:To explore the clinical effectiveness of a self-designed robot reduction system for femoral intertrochanteric fractures.Methods:A retrospective study was conducted to analyze the 57 patients with intertrochanteric fracture who had been treated at Department of Orthopedics, The Fourth Affiliated Central Hospital of Tianjin Medical University from June 2022 to February 2023. The patients were divided into a robot group (using the self-designed robot reduction system to assist intramedullary nailing) and a traction bed group (using a traction bed to assist intramedullary nailing) based on their fracture reduction method. The robot group: 31 patients, 11 males and 20 females, with an age of (78.7±9.3) years; 16 left and 15 right sides; 17 cases of type 31-A1, 12 cases of type 31-A2 and 2 cases of type 31-A3 by the AO/OTA classification. The traction bed group: 26 patients, 12 males and 14 females, with an age of (78.7±7.7) years; 13 left and 13 right sides; 16 cases of type 31-A1, 9 cases of type 31-A2 and 1 cases of type 31-A3 by the AO/OTA classification. The 2 groups were compared in terms of reduction and operation time, intraoperative blood loss, fluoroscopy frequency, reduction quality, and VAS and Harris score at preoperation, 1 week and 6 months postoperation.Results:The 2 groups were comparable due to insignificant differences in their preoperative general data ( P>0.05). The robot group was significantly better than the traction bed group in reduction time [(4.4±2.2) min versus (9.4±3.2) min], operation time [(29.0±13.5) min versus (49.3±13.3) min], intraoperative blood loss [(76.5±30.5) mL versus (115.0±38.4) mL], fluoroscopy frequency [(10.2±2.6) times versus (14.8±3.2) times], and good/excellent rate of reduction [80.6% (25/31) versus 50.0% (13/26)] ( P<0.05). All patients were followed up for (6.8±0.3) months. Respectively, the VAS scores at preoperation and 6 months postoperation was (6.2±1.3) and (2.4±0.8) points for the robot group, and (6.3±1.3) and (2.7±0.8) points for the traction bed group, showing no statistically significant differences between the 2 groups ( P>0.05). However, the VAS score was (3.3±1.2) points for the robotic group and (4.8±1.5) points for the traction bed group at 1 week postoperation, showing a statistically significant difference between the 2 groups ( P<0.001). Respectively, the Harris scores at preoperation and 6 months postoperation were (35.3±3.0) and (88.7±3.4) points for the robot group, and (35.6±2.9) and (87.2±3.5) points for the traction bed group, showing no statistically significant differences between the 2 groups ( P>0.05). However, the Harris score was (57.3±3.7) points for the robotic group and (46.7±2.8) points for the traction bed group at 1 week postoperation, showing a statistically significant difference between the 2 groups ( P<0.05). The patient satisfaction rates in the robot and traction bed groups were 96.8% (30/31) and 92.3% (24/26), respectively, showing no statistically significant difference ( P>0.05). Conclusion:Our self-designed robot reduction for femoral intertrochanteric fractures can effectively shorten reduction and operation time, reduce bleeding and fluoroscopy frequency, and enhance anatomical reduction.