Concurrent chemoradiation therapy is currently a recommended treatment approach for locally advanced inoperable stage ⅢA and stage ⅢB non-small cell lung cancer (NSCLC).There is no consensus on the optimal treatment regimen.It is one of these options for the consolidation chemotherapy following concurrent chemoradiation therapy.To date,there is no sufficient evidence indicating that consolidation chemotherapy following concurrent chemoradiation therapy further improves survival rates.The benefit remains to be confirmed by more clinical test.

Objective To observe clinical efficacy of recombinant human erythropoietin(rhu-EPO)in sepsis with anemia.Method From June 2005 to December 2006,sixty sepsis with anemia patients in the Second Affiliated Hospital of Tianjin Medical University were divided into control group(n=30)and theatment with rhu-EPO group(n=30).The exclusion criteria was:renal imufficiency patients needing blood purification,patients with hemorrhage of digestive tract,and patients who used rhu-EPO before.Patients in the rhu-EPO group were hypodermically injected with rhu-EPO at 48 hours after admission,6000 units par time,and continued every other day for two weeks.When the hemoglobin Was lower than 80 g/L,patients received red blood cell(RBC)transfusion or received other treatment decided by doctor.The data were expressed as(x±s),and were analyzed using Student's t test and Fisher's exact test with SPSS 11.5.A P valLie less than 0.05 indicated statistical significance.Results There Was no significant difference on hemoglobin between the two groups before treatment (P＞0.05).After treatment,the hemoglobin of patients in rhu-EPO group was higher than that in control group [(105.87±11.48)g/L vs.(91.23 ±19.89)g/L,P＜0.01].The units of RBC transfusions was less in patients of rhu-EPO group compared with control group[(2.0 ±0.47)U vs.(2.63±0.43)U,P＜0.01].There was no significant difference on mortality between two groups(P＞0.05).Conclusions In sepsis with anemia patients,administration of rhu-EPO every other day can increase red blood cell level and reduce RBC transfusion.

X-ray repair cross-complementing group 1 gene ( XRCC1 ) serves as one key DNA repair gene. The polymorphism of XRCC1, resulting in the changes of corresponding amino acid and the effect of DNA repair, may contribute to the radiation injury of malignant tumor patients. Current studies have revealed that single nucleotide polymorphisms of XRCC1 may be involved in the radiation injury for patients with tumor. Nevertheless this correlation remains to be further investigated.

Objective To study far femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint transplantation and the use of GSH nail Methods Eleven cases with far femoral malignant bone tumor were administered tumor resection,transplanted with allogeneic heterotoeic bone half-joint,and fixed with GSH nail Results Nine out of the 11 cases were followed up.None of them had infection,rejection or heterotopic bone fracture.All of them can move with walking after 6 months.The effects of surgery was rated as excellent for 3 cases,fine for 4 cases andbad for 2 cases according to Mankin's rating criteria.Conclusion Salvage limb treatment for bone tumor can improve patients' quality of life.Allogeneic heterotopic bone,with rich source and acceptable joint surface,is a good graft for the treatment of bone defect after bone tumor resection.

Objective To explore effective nursing intervention through clinical analysis of middle ear function of children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Tympanogram was obtained from both pre-operation and post-operation in 413 OSAHS cases(the OSAHS group).Audiogram was conducted if the tympanogram was abnormal.There were 279 cases of normal children in the control group.The incidence of middle ear function loss of two groups were compared.Results 288 cases(328 ears) had some degree of middle ear dysfunction,accounting for 69.73％.69 cases had some degree of hearing loss,accounting for 16.71％.The incidences of middle ear dysfunction and degree of hearing loss in the OSAHS group were higher than 7.53％ and 1.43％ of the control group.The hearing ability was gained after operation in both groups.Conclusions The incidence of middle ear dysfunction is higher in children with obstructive sleep apnea hypopnea syndrome.But the bad influence alleviated with age.Therefore,early detection,timely treatment and effective nursing can achieve good effect.

Objective To evaluate the role of radiotherapy in the management of dermatofibrosarcoma protuberans. Methods Between 1995 and 1999, 18 patients with pathologically confirmed dermatofibrosarcoma protuberans were retrospectively analyzed. Nine patients were referred to our hospital for primary treatment and the remaining 9 patients came with recurrent disease. Fifteen of 18 patients received surgery followed by radiotherapy. Among them, 14 patients underwent complete resection and 1 partial resection. Majority of patients received 50～60 ?Gy. One patient received 37.5 ?Gy because he refrained from further treatment. Two patients received 52 ?Gy and 50 ?Gy due to unresectable extensive lesion. One of 18 patients was treated by total resection alone.Results The median of follow up time was 26 months with a range of 0.5～5 years. Sixteen patients (8.9%) are disease free. One patient developed local recurrence and one died of malignant progression. These two patients were treated with radiotherapy alone or surgery only. The local control rates were 100% (15/15) for patients who were treated with surgery and radiotherapy. Conclusions Postoperative radiotherapy is able to decrease the local recurrence rate in dermatofibrosarcoma protuberans.

Objective To investigate the effect of acute exposure to cadmium combined with bacitracin on the endoplasmic reticulum stress (ERS) in testes and ovaries of rats and its regulation by nuclear factor erythroid-2-related factor 2 (Nrf2). Methods According to the 4×2 factorial design model, 48 specific pathogen free adult SD rats were divided into four groups: the control group and the low-, medium- and high- dose cadmium chloride exposure groups. Each group was further divided into with- or without bacitracin combined subgroup. There were six rats in each subgroup with 3 males and 3 females. The low-, medium- and high- dose groups were intraperitoneally injected with 5, 10, 20 mg/kg body weight of cadmium chloride solution, respectively. The control group was intraperitoneally injected with the same amount of 0.9% sodium chloride solution. Among them, rats in the bacitracin combined subgroup were given a one-time intraperitoneal injection of bacitracin at a dose of 20 mg/kg body weight two hours before cadmium chloride exposure. After 48 hours, the rats were sacrificed. The mRNA expression of glucose regulated protein78 kD (Grp78), protein kinase R-like endoplasmic reticulum kinase (Perk), Nrf2 in testes and ovaries of rats was determined using quantitative real-time polymerase chain reaction. The protein expression of GRP78, PERK, NRF2 was determined using Western blotting. Results The mRNA expression of Grp78, Perk, Nrf2 and the protein expression of GRP78, PERK, NRF2 in testes and ovaries of rats in the no bacitracin combined subgroups of the three dose groups showed different degrees of up-regulated changes compared with the no bacitracin combined subgroup of the control group (all P<0.05). Among them, the expression of the three kinds of mRNAs and proteins in the testes and ovaries of rats in the no bacitracin combined subgroups of the high-dose group was up-regulated (all P<0.05), and most of them were higher than those in the no bacitracin combined subgroups of the low- and medium-dose groups (all P<0.05). The expression of most of the three kinds of mRNAs and proteins in testes of rats showed different degrees of down-regulated changes (all P<0.05), but the expression of the three kinds of mRNAs and proteins showed different degrees of up-regulated changes in ovaries (all P<0.05) in the bacitracin combined subgroups of the three doses groups than that in the bacitracin combined subgroups of the control group, and especially in the bacitracin combined subgroups of the high-dose subgroup. The expression of the three kinds of mRNAs and proteins in testes and ovaries of rats in the bacitracin combined subgroups of the three doses groups showed different degrees of changes (all P<0.05) compared with the no bacitracin combined subgroup in the same group, and the expression in the bacitracin combined subgroups of the medium- and high-dose groups showed mainly down-regulated changes (all P<0.05). Conclusion Acute exposure to cadmium can induce different degrees of ERS, activate PERK/NRF2 signaling pathway, and improve the toxicity to testis and ovary. Bacitracin can inhibit cadmium-induced ERS, thereby inhibiting the activation of PERK/NRF2 signaling pathway, and enhancing the synergistic effect of cadmium on testis and ovary toxicity. The higher the exposure dose of cadmium, the more obvious the inhibitory effect.

Objective To evaluate the clinical application of open reduction and internal fixation and bone grafting on treatment of pilon fractures of tibia.Methods Forty cases with Pilon fractures of Ⅱ,Ⅲ tibia who underwent open reduction and intemalfixation and bone grafting treatment were selected as our subjects.Those 40 cases were performed follow-up for 8.0-60.0 months,and average was 31.5 months.The ankle joint symptoms and functional Mazur scoring system were used to evaluate the function of ankle joint.Results Of the 40 patients,15 cases were with excellent ankle function,and 19 cases were good,4 cases were poor and 2 cases were worse.The excellent and good rate was 85％ (34/40).Conclusion Open reduction and internal fixation and bone grafting is proved as the effective treatment on Ⅱ,Ⅲ tibia pilon fractures.

Objective To study the prevention and treatment of intra- or post- operative complications of radiofrequency ablation (RFA) for hepatic malignancy. Methods A series of 353 patients with primary hepatic carcinoma or secondary hepatic malignancy verified by pathological examinations and clinical manifestations underwent 452 times of RFA between October 1999 and March 2003, including 344 cases of percutaneous RFA and 9 cases of RFA during open surgery. There were 198 cases of primary hepatic carcinoma previously unoperated, 81 cases of recurrent hepatic carcinoma after surgery, and 74 cases of secondary hepatic malignancy. All the patients were followed up to make out short- or long-term surgical complications. Results Complications happened in 12 cases: skin burn by the electrode (2 cases), pneumothorax (1 case), right hydrothorax (1 case), vena cava thrombus (1 case), right bile duct injury and stricture (1 case), gastric external fistula (1 case), bile leakage in the left lateral lobe of the liver (1 case), hepatic abscess (1 case), external fistula of the ascending colon resulted from hepatic abscess (1 case), internal fistula of the duodenum, liver and right thorax resulted from hepatic abscess (1 case), and intra-abdominal hemorrhage (1 case). The incidence of complication was 2 65% (12/452) and the complication-related mortality was 8 33% (1/12). Conclusions RFA is a kind of minimally invasive procedure. But RFA especially percutaneous RFA may involve some risks for patients with the tumor located at the porta hepatic or the surface of the liver, or adhered to hollow organs, especially those who had a history of abdominal operation and adhesions of hollow viscera to the liver. Some complications can be prevented and effectively treated in the event of proper selection of patients, careful performance during the surgery, intensive postoperative care, effective hemostasia and efficient infection prevention.

The earliest and the most common metastasis of hepatocellular carcinoma (HCC) occur in the intrahepatic portal venous system, which indicates its worst prognosis. In 28 HCC patients with intraportal tumor thrombus, we employed 2 procedures, ie. the transcatheter hepatic arterial embolization(THAE), transcatheter superior mesenteric or splenic arterial infusion (TSAI) and portal vein embolization (PVE) in 12 cases, and THAE alone in 16 cases. In the former group, tumor size reduced more than 50% in 8 cases (partial remission PR), in particular tumor thrombus disappeared in 3 and decreased in size in 8; whereas in the latter group, PR was achieved in 3 only, without change size of the intraportal tumor thrombus in all 16 cases (P