Objective To evaluate the therapeutic effects of platinum alone chemotherapy combined with radiotherapy for esophageal carcinoma without operation.Methods Form April 2008 to February 2010,47 initial treatment patients with esophageal carcinoma were treated by platinum alone chemotherapy (cisplatin or nedaplatin 20 mg/m2,one times per weeks) and conventional fractionated radiation therapy (200 cGy per fraction,2 times per day,5 days per week,to a total dose of 6 000-7 000 cGy).Results 1-,2-,3-,4-year overall survival rates were 63.83 ％ (30/47),40.43 ％ (19/47),38.30 ％ (18/47),30.77 ％ (4/13).4-year survival rate of 13 cases with lymph node metastasis was 0,it was lower than that of cases without lymph node metastasis (40 ％,4/10),the difference was statistically significant (x2 =6.295,P =0.012).The 3-year survival rates in cisplatin or nedaplatin combined with radiotherapy group were 31.25 ％ (5/16) and 41.94 ％ (13/31),the difference was not statistically significant (x2 =0.510,P =0.475).Conclusion Low doses of platinum alone chemotherapy combined with radiotherapy for the treatment of esophageal cancer are safe,but long-term efficacy needs to be confirmed in larger clinical trials.

Objective To evaluate the clinical features of nasopharyngeal carcinoma with different sur英文摘要>=rival time and to analyze the factors associated with prognosis improvement.Methods Three hundred and fifty three patients with nasopharyngeal carcinoma treated in our hospital from January 2000 to April 2002 were analyzed retrospectively.They were divided into three groups based on their survival time.One hundred and forty five patients were divided into A groups whose overall survival time were less than five years.Sixteen patients were included in B group whose overall survival time were greater than or equal to five years and less than ten years,and the other one hundred and ninety two patients were divided into C groups whose overall survival time were greater than or equal to ten years.The clinical features were compared and factors associated with survival were identified.Results The 5 and 10 years overall survival rates of the 353 nasopharyngeal carcinoma patients underwent radiotherapy were 58.924％ and 54.391％ respectively.Curative effect of early nasopharyngeal carcinoma was better.Cox regression analysis identified age,N stage,combined with chemotherapy or not and complete remission rate of nasopharynx and neck lymph were independent prognostic factors.Conclusion For nasopharyngeal carcinoma patients,early detection,early treatment,rational comprehensive treatment and complete remission after treatment and complications prevention are important.

Objective: To investigate the undertected situation in gonococci culture of male urethral secretions. Methods: The 362 cases of male ureethral secreations were simultaneously detected with fluorescence quantitative PCR, germiculture and direct smear method. The results in three detections were statistically analyzed. Results: The fluorescence quantitative PCR positive rate was 29.56%, near to direct smear method (26.52%)（x2=0.83，P>0.05）; the germiculture positive rate(4.42%) was significantly lower than the positive rates of fluorescence quantitative PCR(x2=81.10,P<0.01) and direct smear method(x2=67.60,P<0.01). Conclusion The simple gonococci culture has high missed detection rate(>80%) in detecting male cases. Ensuring the quality of samples before analysis and detecting with two methods or above are the effective measures to improve the gonococci detection rate.

Objective To evaluate the clinical efficacy of platinum-based chemotherapy combined radiotherapy for cervical cancer.Methods From October 2008 to June 2010,61 patients with cervical cancer were treated by radiotherapy( conventional external radiation and after-loading brachytherapy,to a total dose of 8000- 8500 cGy)combined platinum-based chemotherapy (cisplatin or nedaplatin 20 mg/m2,one times per weeks) in our department.The clinical efficacy and side effects were evaluated.Results Among 61 patients,the short-term effective rate was 100％ ( 61/61 ) and 1-year survival rate was 85.2％ ( 52/61 ).There was no significant difference between cisplatin group and nedaplatin in 1-year survival rate ( 84.6％ vs.85.7％,x2 =0.014,P=0.095).Arrest of bone marrow at Ⅰ,Ⅱ,Ⅲ and Ⅳlevel occurred 5,24,5 and 1 patients in the cisplatin group,and 6,12,3 and 3 patients in the nedaplatin group.There was also no significant difference between these two groups in great mass side effects induced by chemoradiotherapy (x2 =6.402,P =0.171 ).Conclusion It is worth practising of platinum-based chemotherapy combined radiotherapy for cervical carcinoma.The side effects induced by chemoradiotherapy is low.

Objective To evaluate the clinical features of local advanced glottic laryngeal cancer patients with beyond five years survival and to provide help for the treatment of advanced glottic laryngeal cancer patients.Methods The data of 129 cases of patients with local advanced glottic laryngeal cancer treated in our hospital from January 1999 to August 2005 were analyzed retrospectively.They were divided into two groups based on their survival time.Forty six patients with beyond five years survival were included in the first group and the other eighty three patients were in the second group.The clinical features were compared and factors associated with survival were identified.Results Compared with the group with under five years survival,the lymph node metastatic rate before treatment was lower,patients treated concurrently with operation were more,and complete remission rate after treatment were higher in the group with beyond five years survival.The differences between two groups had statistical significant.Cox regression analysis identified only operation and complete remission rate were independent prognostic factors.Conclusion For local advanced glottic laryngeal cancer,rational comprehensive treatment and complete remission after treatment and complications prevention are important.But they need to be validated by the large-scale clinical trials.

Objective To approach the therapeutic effects and complication of hyperfractionated radio-therapy for nasopharyngeal carcinoma. Methods From January 2000 to November 2002,283 patients with na-sopharyngeal carcinoma were treated with hyperfraetionated radiotherapy. For hyperfractionated radiotherapy,γ-ray from 60Co was performed and two fractions of 1.2 Gy were given daily,with an interval of≥6 h,5 days per week to a median dose of 72 Gy for nasopharynx and 68.4 Gy for neck. For some patients, carboplatin or cispla-tin and 5-fluorouracil were transfused. Results The incidence rate of≥3 grade acute mueositis was 12. 4%.The complete remission rate after treatment was 93.6%. The 1,2 and 5 year survival rate was 93.6% ,82. 7%and 60. 1% respectively. Conclusion patients treated with hyperfractionated radiotherapy have good tolerance and therapeutic effect. It provids a treatment means for nasopharyngeal carcinoma. But it must be validated by the large-scale clinical trials.

Objective To approach the therapeutic effects and complication of combined induction chemo-therapy and hyperfraetionated radiotherapy for nasopharyngeal carcinoma.Methods Form January 2000 to November 2002,101 patients with nasopharyngeal carcinoma were treated by combined induction chemotherapy and hyperfrac-tionated radiotherapy.For hyperfraetionated radiotherapy,y-ray from 60 Co were performed and two daily fractions of 1.2Gy were given,with an interval of≥6 hours,5 days per week to a median dose of 7255cGy for nasopharynx and 7201cGy for neck.For induction chemotherapy,carboplatin and 5-fluorouraeil were transfused.Results The inci-denee rate of greater than or equal to the third grade acute mucositis was 24.8%.The complete remission rate after treatment was 83.2%.The 1,2 and 5 year survival rate was 90.1%,82.2%-and 57.4%.Conclusion With this treatment schedule,patient's tolerance and therapeutic effect is good.It provids a treatment means for nasopharyngeal carcinoma.But it must be validated by the large-scale clinical trials.

Purpose Bronchial arterial embolization is the preferred hemostasis method for hemoptysis when medical treatment is invalid. This paper aims to discuss the safety and efficacy of inferior phrenic artery (IPA) embolization in the treatment of hemoptysis of tuberculosis when IPA is involved. Materials and Methods Twenty-eight patients who were confirmed that IPA got involved in the hemoptysis due to pulmonary tuberculosis by IPA angiography underwent embolization. CT scan was performed before the procedure and IPAs arteriography were performed during the interventional procedure. Once the blood supply was identified, catheterization and embolization was carried out with gelatin sponge particle, sodium polymannuronate microsphere or microcoil according to the patients' conditions. After the procedure, the IPA angiographic manifestations, clinical efficacy and complications were evaluated. Results Thirty-three IPAs were identified as getting involved in the blood supply in the 28 patients. Among those patients, 12 had left IPA involved, 11 had right IPA involved and the rest 5 had IPAs involved in both sides. The selective IPA angiography showed IPAs had enlargement, with numberous and disordered branches and hypervascularity. IPA-pulmonary artery shunt was found in 22 cases. None of the cases was found extravasation of contrast medium. The hemoptysis reoccurred in 4 patients on the second day, sixth day and 6 months after the first embolization, thus the procedures were performed three times in 1 patient and twice in the other 3 patients. Nine patients had fever as complication, 19 patients had chest pain and 5 suffered from mild dyspnea. These complications usually disappeared in 3-7 days after symptomatic treatment. Conclusion IPA embolization is technically feasible and safe, whose complications are likely to be few and self-restrictive.

Objective To evaluate the clinical effectiveness and the major toxic effect of radiotherapy combined with docetaxol and cisplatin respectively in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods 98 patients with locally advanced NSCLC were randomly divided into two groups.All of the patients were treated with 3D-CRT.One group was treated combined with docetaxel,20mg/m2,every week,totally 6 times.The other group was treated combined with cisplatin,30mg/m2,every week,totally 6 times.The total dose was 60 ～66Gy,2Gy/F,5 times each week for 5 ～7 weeks.The clinical effect and the major toxic effect between two groups were compared.Results The median survival time in group that treated with docetaxol was 17.2 months,median progression-free survival time was 13.5 months,and the 1,2 and 3-year survival rates of the patients were 78.6％,35.7％ and 19.5％ respectively.The median survival time in group that treated with cisplatin was 16 months,median progression-free survival time was 16.5 months,and the 1,2 and 3-year survival rates of the patients were 74％,34％ and 20％ respectively.The differences between two group were not stetisticelly significant( P ＞0.05 ).However,the side effect of the stomach and intestine and late radiation complication in group treated with docetaxol were slighter than those in group treated with cisplatin.Conclusion The clinical effect of radiotherapy combined with docetaxol in the treatment of locally advanced NSCLC was equal to radiotherapy combined with cisplatin.But radiotherapy combined with docetaxol has a slighter and acceptable toxic effect,which was worth the clinical application.

Objective To evaluate the efficacy and safety of induction chemotherapy and three-dimensional conformal radiation (3D-CRT) combined with endostar in the treatment of locally advanced non-small cell lung cancer (NSCLC).Methods Thirty patients with locally advanced NSCLC were enrolled and divided into observation group (15 cases) and control group (15 cases).In the observation group,the patients received induction chemotherapy and 3D-CRT combined with endostar.Chemotherapy:Vinorelbine 25mg/m2 on day 1 and 8,DDP 30mg/m2 on day 2 to 4.Endostar 7.5mg/m2 on day 1 to 14,which was used again after 7 days for 2 to 4 cycles.In the control group,the patients received induction chemotherapy and 3D-CRT at the same dosage.All patients were treated with 3D-CRT and the prescription dose was 60 ～ 68Gy per fraction.The responses were evaluated according to WHO criteria.The shortterm efficacy between the 2 groups was compared.Results The overall effective rate of the two groups were 66.7％ and 60.0％,respectively (P ＞ 0.05).The median progression-free survival time was 12 months in the observation group and 10 months in the control group.The median survival time was 20 months in the observation group and 18 months in the control group.The 1 year overall survival rate was 80.0％ in the observation group and 73.3％ in the control group(P ＞ 0.05).The main toxicities in the two groups were marrow suppression,gastrointestinal symptoms,acute radiation pneumonitis and acute radiation esophagitis.There was no significant difference between the two groups (P ＞ 0.05).Conclusions The combination of endostar with induction chemotherapy and 3D-CRT can improve the short-term efficacy rate of locally advanced NSCLC,the adverse events of which are tolerable,but the improvement is not significant in both groups.The result pending further randomized multi-center phase Ⅲ clinical study.