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.

The proto-oncogene, c-kit gene, widely expresses on the mast cell, melanoeyte, haemopoietic stem cell, intestinal cell of cajal and germoeyte. Recent researches have revealed the relationship between the e-kit gene and the carcinogenesis, proliferation, infiltration and metastasis of some malignant tumor. This article aimed to make a review of its biological function, lab and clinical research advancement in the digestive tract tumor.

Cholesterol is an essential nutrient for human body.Dietary cholesterol comes from animal sources,including eggs,pork and others.A number of epidemiological and experimental studies showed that too much intake of cholesterol or consumption of more than 1 egg per day would slightly elevate blood cholesterol level.Results of studies in different areas and populations suggested that there is a lack of sufficient evidence to support the association between cholesterol intakes or egg consumption and cardiovascular disease incidence or deaths.

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 study the effects of treating limbs pain of patients with depression after cerebral apoplexy with self-designed hemiparalysis-washing formula.Methods 80 patients with limbs pain after cerebral apoplexy in our hospital from May 2013 to November 2013 were recruited into a control group and a treatment group randomly,40 patients in each group.The control group was treated with 30mg edamvone and 100ml 0.9％ sodium chloride or 0.5％ glucose injection,Ⅳ in 30min,and twice daily.Meanwhile,regular functional rehabilitation training was adopted for the patients.The treatment group was additional treated with self-designed hemiparalysis-washing formula on the basis of the control group.VAS,HAMD-24,MESSS,STREAM and therapeutic effects were evaluated in both groups after one month treatment.Results ① clinical therapeutic effects comparison:the total effective rate was 90％ and 70％ in the treatment group and the control group respectively,with statistical difference between the two groups (t=3.58,P＜ 0.01).② VAS,HAMD-24,MESSS,STREAM comparison:VAS,HAMD-24,MESSS,STREAM score was (2.28 ± 0.54)、(11.34 ± 3.02)、(13.49±4.27)、(44.76±20.71)in the treatment group respectively,and(2.90 ± 0.75) 、(14.24 ± 3.35)、(17.55 ±4.91) 、(34.56 ±15.56) in the control group respectively.Both groups showed obviously improvement than the before treatment,and the effects were better in the treatment group than the control group (all P＜0.05).Conclusion Self-designed hemiparalysis-washing formula improve limbs pain in patients with cerebral apoplexy and relieve their depression.

Objective To evaluate the value of magnetic resonance imaging in rheumatoid arthritis(RA) of the knee and compare with radiography.Methods 34 cases of RA of the knee were performed MRI and radiography.Enhanced MRI scans were obtained in 13 knees.Results On MRI there were bone erosion in 34 knees,subchondral sclerosis in 21 knees,meniscus destruction in 22 knees,cartilage damage in 15 knees,tibia movement in 10 knees,posterior cruciate ligament dragged in 8 knees.Pannus adhesion,proliferation synovium and joint effusion were showed on enhanced MRI in all of the 13 knees.On radiography bone erosion was showed in 1 knee,subchondral sclerosis in 11 knees,joint space stricture in 16 knees,tibia movement in 8 knees.Conclusion MRI is much better than radiolgraphy for diagnosis of RA of the knee.

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 investigate the effects of mechanicl ventilation with lower tidal volume and positive end-expiratory pressure (PEEP) on pulmonary function during laparoscopic surgery in patients with chronic obstructive pulmonary disease (COPD).Methods Forty patients with COPD,aged 60-82 yr,with body mass index of 16-29 kg/m2,undergoing elective laparoscopic surgery,were randomly divided into 2 groups (n =20 each) using a random number table:conventional ventilation group (group Ⅰ) and mechanical ventilation with lower tidal volume and PEEP group (group Ⅱ).Anesthesia was induced with midazolam,sufentanil,cisatracurium and propofol and maintained with iv infusion of propofol,cisawacurium and remifentanil.The patients were endotracheally ventilated and mechanically ventilated.In group Ⅰ,fresh gas flow was set at 2 L/min,VT at 10 ml/kg,and I∶E at 1∶2 during ventilation.In group Ⅱ,fresh gas flow was set at 2 L/min,VT at 6 ml/kg,I∶E at 1∶2 and PEEP at 6 cm H2O during ventilation.PErCO2 was maintained at 35-45 mm Hg in both groups.Airway peak pressure (Pp~),airway plateau pressure (Pplat),airway resistance (Raw) and dynamic lung compliance (Cdyn) were measured at 5 min after intubation (T1),45 min of pneumoperitoneum (T2),and 15 min after the end of pneumoperitoneum (T3).Arterial blood samples were obtained at T1,T2 and T3 for blood gas analysis.Alveolar-arterial oxygen gradiant (A-aDO2),oxygenation index (PaO2/FiO2),respiratory index (RI) and physiologic dead space fraction (VD/VT) were calculated.The extubation time and development of complications were recorded within 48 h after operation.Results Compared with group Ⅰ,Ppeak and Plat at T2 and Raw at T1,2 were significantly decreased,Cdyn at T2 and PaO2/FiO2 at T1-3 were significantly increased,RI,VD/VT and A-aDO2 were significantly decreased at T1-3,and the incidence of hyoxemia,atelectasis and rales was decreased within 48 h after operation in group Ⅱ (P ＜ 0.05).There was no significant difference in the extubation time between the two groups (P ＞ 0.05).Conclusion Mechanical ventilation with lower tidal volume (6 nl/kg) and PEEP (6 cm H2O) can improve the pulmonary function during laparoscopic surgery in patients with COPD.

Objective To evaluate the feasibility and safety of the modified panceaticojejunostomy called Kissing panceaticojejunostomy by animal experiment,and to explore the pathological process of primary healing between the pancreatic duct and the jejunal mucous.Methods The tolerance pressure at the anastomotic intestine was measured during surgery to ensure close contact suture of Kissing panceaticojejunostomy.Exploratory laparotomy,pancreatic ductography and pathology was performed at 2,4 weeks after panceaticojejunostomy.Results Kissing panceaticojejunostomy was performed successfully on 6 Beagle dogs.Tolerance pressure in all dogs was 90 cm H2O and above.No bleeding、fistula or contrast extravasation was found,and healing anastomosis was identified by laparotomy and pancreatic ductography.Cicatricial healing was found between pancreatic duct and jejunal mucosa 4 weeks after anastomosis.Conclusions Kissing panceaticojejunostomy is easy to perform,ensuring close-up cicatricial healing without hydrops or abscess between pancreatic duct and jejunal mucosa.

The concept and methods of evidence-based medicine(EBM)has been evolved to impact almost all fields of health care and policy since it first appeared in 1992.but in the field of dentistry or stomatology,many problems remain to be solved in carrying out EBM.The necessity and feasibility of implementing evidence-based dentistry education in China were discussed in this paper for chnical evidence-based decision making and clinical research.The contenk teaching approach and accreditation tools for EBM in dental education were also proposed.