Cyberknife,a newly developed stereotactic operation platform in radiosurgery system,has many advantages such as accurate positioning,image-guided and hyperfractionated radiotherapy.It has made very good effect in the treatment of locally advanced pancreatic carcinoma.At the same time,it has been applied in the preoperation and postoperation treatment of pancreatic carcinoma,and the palliative treatment of metastatic pancreatic carcinoma.So it can be a very good option for patients with pancreatic carcinoma.

Primary systemic anaplastic large cell lymphoma (ALCL) is a subtype of rare and heterogeneous clinical entity, extremely rare in early stage of disease. There is no standard treatment yet. Based on retrospective studies, systematic chemotherapy followed by involved field radiation after chemotherapy is the mainstay of treatment. The role of radiotherapy in the treatment of early stage ALCL remains unclear due to lack of prospective studies. So do the optimal chemotherapy regimens and hematopoietic stem cell transplantation. The paper will review these issues.

Lymphoma is a group of malignancies that affect lymphatic system of the body,and often originates from the abnormal cloned proliferation of B,T or NK cell lineage.It contains mainly two categories:Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).The treatment options consist of chemotherapy,radiotherapy,immunotherapy and radioimmunotherapy,et al.It has been demonstrated that lymphomas are typically radiosensitive tumors and undergo apoptosis readily after radiation therapy(RT).RT produces very high local complete response rate for all lymphoma subtypes.This review will mainly focus on the role of RT in the treatment of aggressive lymphoma,indolent lymphoma,extranodal lymphoma and HL,as well as the application of modem RT techniques.

Objective: To conduct systematic evaluation on the dermatologic toxicity caused by targeted anti-cancer drugs in children and teenager to provide reference for future studies and clinical practice.Methods: Pubmed(http:∥www.ncbi.nlm.nih.gov/pubmed/), American Society of Clinical Oncology Annual Meetings' Online Abstracts Database(http:∥www.asco.org/) and ClinicalTrials.gov(http:∥www.clinicaltrials.gov) were searched for the clinical trials on the use of targeted anti-cancer drugs (single or combination) in children and teenager complicated with dermatologic toxicity.Methodological quality assessment was performed for the included studies, using Cochrane's risk of bias assessment tool for randomized controlled trials and methodological index for non-randomized studies (MINORS).Meta-analysis was performed for the outcomes including adverse event rate of skin rash, xerosis, pruritis and mucositis.Results: A total of 24 studies with 960 patients were included in this study.Various solid tumors and leukemia were investigated in the studies.The quality assessment revealed that the majority of included studies were with high quality.According to the results of meta-analysis, the pooled event rate and 95% confidence interval were 0.19[0.12-0.28],0.24[0.06-0.51],0.12[0.04-0.24] and 0.21[0.07-0.39] for skin rash, xerosis, pruritis and mucositis, respectively.Publication bias analysis indicated potential reporting bias for skin rash (Egger's P=0.007).Conclusion: Dermatologic adverse events occur in a part of children and teenager with cancer treated with targeted therapy, which may cause impaired quality of life and disability.Adequate attention should be paid to these events during clinical trials and real life practice.

ObjectiveTo evaluate the early response rate and radiation toxicity of cyberknife in the treatment of primary or metastasticretroperitoneal tumors.MethodsTwenty-eightpatientswith retroperitoneal tumors were treated with cyberknife.The total doses were 2000-6000 cGy ( median 4500 cGy) and biological effective doses were 3750-10080 cGy (median 7680 cGy) in 2-10 fractions (median 5).Of all patients,3 received three dimensional conformal radiotherapy (3DCRT) or intensity modulated radiotherapy (IMRT) boost,1 was treated as second-course radiotherapy,and others were treated with cyberknife only.The survival rates were calculated by Kaplan-Meier method and compared with Logrank test.ResultsThe complete response,partial response,stable disease and progression disease rates were 43％(12/28),6％ ( 10/28),18％ ( 5/28 ),4％ ( 1/28 ),respectively.The overall response rate was 96％.The number of patients who were followed up more than 1,2,3 years were 17,9,7,respectively.The 1-,2-and 3-year local control rates were 92％,86％ and 86％,respectively.The 1-,2-and 3-year overall survival rates were 60％,49％ and 49％,respectively.The difference between local progression-free survival and overall survival was not significant ( median 9.5 and 12.0 months,x2 =0.17,P =0.680).Moreover,if the patients did not have metastasis elsewhere and local treatment was effective,there was no significant difference between local progression-free survival and progression free survival (median 17 and 11 months,x2 =0.13,P=0.720).Acute radiation-induced side effects (≥ 2 grade) such as fatigue,anorexia,nausea,vomiting and epigastric discomfort occurred in 9,9,7,7 and 2 patients,respectively.Intestinal stenosis of 1 grade occurred in 1 patient.Conclusions Radiotherapy for retroperitoneal tumors with cyberknife has provided a high response rate with minimal side effects.It is a safe and effective local treatment method for retroperitoneal tumors.

BACKGROUND:There are many multimodal analgesia schemes in perioperative period of total knee arthroplasty, but there is no ideal scheme. OBJECTIVE:To explore the effects of multi-mode and preemptive analgesia on analgesic effect after total knee arthroplasty. METHODS:120 patients with severe osteoarthritis who underwent unilateral knee arthroplasty were enroled in this study. According to different analgesic effects, the patients could be divided into four groups (n=30). In the control group, no corresponding analgesic measures were found before and during replacement. In the preemptive analgesia group, celecoxib was oraly taken before replacement. In the cocktail analgesia group, cocktail was periarticularly injected during replacement. In the multimodal combined analgesia group, celecoxib was oraly taken before replacement + cocktail was periarticularly injected during replacement. After replacement, intravenous patient-controled analgesia pump was applied in each group. Active flexion range-of-motion, visual analogue scale score in the resting and active states and knee Keen Society Score were measured at various time points after total knee arthroplasty in four groups. Adverse reactions were recorded after replacement. RESULTS AND CONCLUSION:Active flexion range-of-motion, visual analogue scale score in the resting and active states and knee Keen Society Score were better in the preemptive analgesia, cocktail analgesia and multimodal combined analgesia groups than in the control group at various time points after replacement (alP < 0.05). Above indexes were better in the multimodal combined analgesia group than in the preemptive analgesia and cocktail analgesia groups (alP < 0.05). No significant difference in above indexes was detected between the preemptive analgesia and cocktail analgesia groups (alP > 0.05). No significant difference in the number of cases affecting nausea and vomiting was detected at 2 weeks after replacement in the four groups (P > 0.05). There was no deep venous thrombosis of double lower limbs or necrosis and infection of incision. These findings suggest that the effects of preemptive analgesia before total knee arthroplasty, local injection analgesia during replacement, and the combined analgesia of intravenous patient-controled analgesia pump after replacement were ideal. Adverse reactions did not increase, and the operation was safe. At present, multimodal combined analgesia has been accepted by us, but to achieve truly painless results after total knee arthroplasty stil needs more efforts.

Objective:To evaluate the effect of passive smoking on the incidence of children's asthma in our country and abroad.Methods: Based on the 3 Chinese major science literature databases and MEDLINE database,8 articles were selected among all the articles of case control study during 1994 to 2003.The results of 8 Logistic regression on the cause of children's asthma were analyzed by General Variance Based method of meta analysis. Results: The pools regression coefficient b G was 1.101,OR was 3.007, ? 2 was 22.49 ( P

Objective To explore the protective effects of peritoneal dialysis on tissue and organ damage induced by acute hemorrhagic necrotic pancreatitis (AHNP) . Methods Thirty-four AHNP patients were randomly divided into PD group ( n = 21) and control group (n=13). Control group was treated with conventional therapy, while PD group was treated with conventional therapy companied by intermittent peritonea] dialysis (IPD). Urinary and serum amylase, the plasma levels of TNF and IL-1, faecal occult blood test and serum leucocyte were examined. Functions of brain, kidney , liver and heart were observed. Results The protective effect was better in PD group than that in normal group (P

Objective In order to further improve the noninvasive measurement precision of human blood glucose and achieve clinical requirements,experiments were conducted to measure human blood glucose by a novel measurement method our group proposed.Methods The blood flow of the tested parts was stopped by pressure,and dynamic distribution of transmission spectra was measured by time-correlated single-photon counting (TCSPC) technology under the dual wavelength light incident.Oral glucose tolerance test (OGTT) was conducted on three human subjects,and the early arriving photons were selected by Laplace transform.Meanwhile,the human blood glucose concentration was measured using the Roche glucose meter.Results The best curve fitting was got when the Laplace parameter was 1Gs-1 (determining parameter R2=0.0922).Conclusions The experimental results showed that better measurement accuracy can be obtained by selecting appropriate Laplace parameter,and noninvasive measurement of human blood glucose under flow control of time gate was feasible.

Objective To investigate the movement and its influencing factors of the space-occup ying pancreatic lesions and provide a reference for the safe margin between CTV and PTV in accurate radio therapy.Methods Gold fiducials were implanted into the lesions of 16 pancreatic carcinoma patients by percutaneous punctures under B-uhrasonographic guidance.The movements of these markers were measured under the X-ray simulator system in the x,y and z axial directions,respectively.The relevant influencing fac tors were analyzed.Results The motion amplitudes of pancreatic lesions were 0.1-0.3 (mean 0.16 ± 0.06) cm,0.1-0.4 (mean 0.25 ±0.12) em and 0.5-1.6 (mean 0.88±0.24) cm in the x,y and z axi al directions,respectively.The movements were not associated with the height,weight,age,tumor location or tumor size.Conclusions The motion of the space-occupying pancreatic lesions is mainly influenced by the respiration,especially with the maximal amplitude in the z axial direction.Therefore,the motion in the z axial direction should be given more consideration when determining the PTV margin.