AIM: To explore the frequency of drug injection of alloxan diabetes on the established model of rabbit.METHODS: Thirty-six healthy rabbits, weighing 2-2.5kg, were randomly divided into one time drug injection group (group A, n=12), two times drug injection group (group B, n=12) and three times drug injection group (group C, n=12). Each rabbit was injected with a total amount of 150mg/kg of alloxan. Fasting blood glucose was measured. The success rate and death rate of each group were also calculated.RESULTS: The success rate of diabetic rabbit model in group B was higher than that in group A (P<0.01) and its death rate was lower than that of group A (P<0.01); the success rate of diabetic rabbit model in group C was highest and the death rate was the lowest in three groups(P<0.01). CONCLUSION: Multiple administration of alloxan can improve success rate in establishing diabetic rabbit model with decreased death rate and increased stability.

Objective To analyze and compare the clinical application values of procalcitonin (PCT),leukocyte count (WBC) and C-reactive protein(CRP) in elder patients with infection.Methods In patients(age≥ 65 yrs,axillary temperature ＞38.0℃)with infection or suspected infection,PCT,WBC,CRP and other bacteriological examination were performed.The electronic medical records from the HIS system of our hospital were analyzed retrospectively in combination with medical history.Results Of the enrolled 219 patients,65 ones were in control group,48 ones SIRS,51 ones sepsis and 55 ones MODS.There was a positive correlation between the level of serum PCT and the infection degree.The Spearman correlation coefficient was 0.706 (95％CI:0.616-0.797,P=0.000).Based on the highest Youden index (sensitivity+specificity-1),the best cutoff point of diagnosis for PCT was ＞0.341 μg/L (sensitivity 84.5％,specificity 55.8％),a analysis of receiver operating characteristic(ROC) curve about PCT,WBC and CRP was carried.Area under the curve (AUC) of PCT to controlled infection was 0.916 (95％CI:0.864-0.967,P=0.000).Based on the highest Youden index (sensitivity+ specificity-1),the judging threshold of PCT to infection controlled or not was 0.73 μg/L (sensitivity 84.6％,specificity 88.0％).PCT level after treatment ＞0.73 μg/L showed the uncontrolled infection,＜ 0.73 μg/L controlled.Conclusions PCT has a higher specificity for elder patients with infection.The variation of PCT level can guide the application of antibiotics,avoid abuse and decrease the occurrence of drug-resistant bacteria.

ObjectiveTo analyze the prognosis of 784 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods,investigate the predictive value and deficiency of the clinical staging.MethodsFrom July 2003 to January 2009,784 patients with esophageal carcinoma received 3DCRT treatment.The prescribed doses ranged from 50 Gy-70 Gy with median dose of 60 Gy,1.8-2.0 Gy/fraction,1 fraction/day,5 fractions/week.65 patients received prescription dose of＜60 Gy and all the others'≥60 Gy.All the patients were divided into subgroups according to different T,N and TNM stages.Therapeutic effect was evaluated.ResultsThe follow up rate was 97.1％,503 patients were followed up for more than 3 years and 122 were followed up for more than 5 years.The 1-,3-,5-year local control rates and overall survival rates were 77.2％,54.2％,46.5％ and 69.5％,34.9％,23.9％,respectively,with median survival time of 21 months.There were significant differences of survival curves for different T stages,N stages and TNM stages.For the groups of stage Ⅰ,Ⅱ and Ⅲ,the 1-,3-,5-year survival rates were 86.4％,47.6％,45.1％ ;84.7％,46.3％,36.4％ and 64.0％,30.9％,19.1％,respectively ( x2 =29.34,P =0.000).There were 752 patients with squamous cell carcinoma ( 95.9％ )and 32 patients with non-squamous cell carcinoma (4.1％ ),the median survival time were 21 and 16 months,respectively ( x2 =4.44,P =0.035 ).There were significant difference of survival rates for the subgroups whose GTV volume ≤20 cm3,20 -40 cm3,40 -60 cm3 and ＞60 cm3 (54 months,29 months,21months and 14months,x2 =68.71,P =0.000).ConclusionsThe clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately,for patients with different pathology and GTV volumes,there were variance in the prognosis,so we advised the complement of the two factors in the draft of clinical stages.

ObjectiveTo explore the application of diffusion-weighted magnetic resonance imaging (DWMRI) in precise radiotherapy of esophageal carcinoma.MethodsThirty-seven patients with biopsy proven esophageal cancer from March 2010 to January 2011 were included.To delineate the gross tumor volume (GTV) using CT and DWMRI images,each patient was examined by DWMRI and CT scan using the same position before radiotherapy.To compare the maximum diameters and volumes of tumor between CT and DWMRI. The tumor lengths measured by esophagogram,esophagoscope,CT and DWMRI were compared.ResultsTumor lengths under esophagogram,esophagoscope,CT and DWMRI were 5.70 cm,6.06 cm,7.97 cm and 5.79 cm respectively. The lengths between CT and esophagogram,CT and esophagoscope,CT and DWMRI had statistical significance respectively (F=4.88,P=0.003).The maximum diameters of tumor shown on CT and DWMRI were 3.79 cm and 3.81 cm respectively ( t =-0.32,P=0.751 ).The GTV were 45.75 cm3 and 38.05 cm3 in CT and DWMRI respectively (t=5.30,P =0.001 ).53 lymph nodes were assessed positive on both CT and DWMRI.DWMRI excluded 25 positive lymph nodes assesed by CT; also confirmed 15 negative lymph nodes excluded by CT,6 of which were paraesophageal lymph nodes.The addition of DWMRI information altered the clinical stage in 6 patients.ConclusionsTumor lengths measured on DWMRI and esophagogram had the optimal approximation.It was easy to find paraesophageal lymph nodes via DWMRI.With the addition of DWMRI information,the target range and clinical stage were alerted in some patients.

Objective To observe the acute side effects, local control rate and survival rate of concurrent chemoradiotherapy (CC) and radiotherapy alone (R) for patients with esophageal carcinoma.Methods From June 2006 to February 2009, 209 patients with esophageal carcinoma were observed, 105 of them were treated with CC.Of all the patients, 117 received three-dimensional conformal radiotherapy, 92 received intensity modulated radiotherapy, the median prescription dose was 60 Gy.The regimen of LFP (5-FU, cisplatin and calcium folinate) was selected for this study, side effects, local control rate and survival rate were observed and subsets analysis were performed.Results The overall follow-up rate was 99.0%,there were 99 and 44 patients whose follow-up time was more than 2 and 3 years, respectively;for the CC group, the data were 45 and 14, respectively;and for the R group, 54 and 30, respectively.The 1-,2-,3-year local control rates of CC group and R group were 88.1%,69.2%,66.2% and 81.0%,64.0%,54.9%(χ2=2.31,P=0.128), respectively.The 1-,2-,3-year overall survival rates of CC group and R group were 84.4%,52.9%,45.6% and 75.2%,50.7%,37.0%(χ2=1.57,P=0.210),respectively.Subset analysis indicated that for the patients of N0 group and whose length of GTV>7 cm, the local control rate of CC was significantly higher than that of radiotherapy alone (χ2=5.11,7.66;P=0.024, 0.006).For N0 group, the survival rate of CC was higher than that of R alone.(χ2=5.07,P=0.024).The incidence of WBC, PLT and HGB reduction for the two groups were 81.9% and 49.0%(χ2=36.45,P=0.000),14.3% and 1.9%(χ2=10.54,P=0.006),and 24.8% and 2.9%(χ2=22.95,P=0.000),respectively.The incidence of nausea, vomiting and constipation for the two groups were 63.8% and 7.7%(χ2=71.52,P=0.000), respectively.The incidence of ≥2 grade esophagitis of CC group and R group were 48.57% and 38.46%(χ2=2.17,P=0.141), respectively.The incidence of ≥2 grade radiation pneumonitis of CC group and R group were 15.24% and 7.69%(8/104)(χ2=2.93,P=0.087),respectively.ConclusionsCompared to radiotherapy alone, the local control rate and overall survival rate of concurrent chemoradiotherapy were not improved significantly, the patients with N0 may be the conspicuous beneficiary.About side effects, only marrow depression and gastrointestinal tract reaction were significantly different between the two groups,the value of addition of concurrent chemoradiotherapy for esophageal carcinoma needs further investigation.

Objective To investigate the long-term survival of esophageal squamous cell carcinoma (ESCC) patients of different ages after three-dimensional conformal radiotherapy (3 DCRT).Methods From July 2003 to September 2008,769 patients with stage Ⅰ-Ⅲ ESCC were eligible for the analysis.All patients were treated with 3DCRT.The prescribed dose was 50-70 Gy (median,60 Gy),1.8-2.0 Gy per fraction,5 fractions per week.The Kaplan-Meier method was used to calculate overall survival (OS) and local control (LC) rates; the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 98.3％.For all patients,the 1-,3-,and 5-year LC rates were 76.3％,52.8％,and 48.5％,respectively,and the 1-,3-,and 5-year OS rates were 70.1％,36.2％,and 23.0％,respectively.The 1-,3-,and 5-year OS rates were 71.2％,38.8％,and 24.9％,respectively,for patients aged 45-74 years,versus 69.6％,26.6％,and 15.4％ for patients aged 75-89 years (P =0.008).Multivariate prognostic analysis showed that age was also a prognostic factor in ESCC patients after 3DCRT.A total of 620 patients died.Patients aged 45-74 years had a significantly higher proportion of individuals that died of distant metastasis (23.9％ vs.14.2％,P =0.009),while patients aged 75-89 years had a significantly higher proportion of individuals that died of non-cancer diseases (14.1％ vs.4.9％,P=0.000).Conclusions Survival varies between ESCC patients of different ages after 3DCRT.The survival of elderly ESCC patients is poor,and the relatively high mortality from non-cancer diseases may be an important reason for poor survival.

Objective To observe the relationship between computed tomography-gross tumor volume (GTV) and non-surgical T stage in patients with esophageal squamous cell carcinoma (ESCC) and the survival rates of patients with different GTVs,and to investigate the impact of GTV on the prognosis of ESCC after three-dimensional radiotherapy.Methods A retrospective analysis was performed on 223 ESCC patients without lymph node metastasis and distant metastasis who were hospitalized from July 2003 to January 2009.The prescribed doses of three-dimensional radiotherapy ranged from 50-70 Gy.These patients were divided into 3 or 4 groups according to different percentile intervals of GTVs.The Spearman rank correlation analysis was used for investigating the relationship between non-surgical T stage and GTV.The Kaplan-Meier method was used for calculating survival rates,and the log-rank test was used for survival difference analysis.Results The follow-up rate was 98.2％.A total of 163 patients were followed up for at least 3 years.The median GTVs of patients with T1 +2 ESCC,T3 ESCC,and T4 ESCC were 19.31 cm3,33.69 cm3,and 41.25 cm3,respectively,exhibiting a positive correlation between non-surgical T stage and GTV (P =0.000).The 5-year survival rates were 59％,43％,and 24％ (P =0.000) in 3 GTV-based groups and were 55％,51％,31％,and 24％ (P =0.004) in 4 GTV-based groups.The primary cause of death for the patients with GTVs of ≤35 cm3 and ＞35 cm3 was failure of local control (57.9％ vs 52.1％) ; 21.9％ and 13.8％ of the patients with a GTV of ＞ 35 cm3 died of uncontrol and excessive bleeding,versus 9.4％ and 3.1％ of the patients with a GTV of ≤ 35 cm3 (P =0.046 ; P =0.029) ;2 of the patients with a GTV of ＞ 35 cm3 died of grade 5 radiation pneumonitis.Conclusions GTV is positively correlated with nonsurgical T stage in esophageal cancer patients who receive radiotherapy.The 3-level and 4-level grading of GTV can be used for prognostic evaluation,and the 3-level grading of GTV is more closely related to prognosis.The patients with a larger GTV have higher incidence of uncontrol and bleeding and risk of treatment-related death than those with a smaller GTV after radiotherapy.

Objective To explore the regulatory effects of hyd ro gen sulfide (H 2S) on hypoxic pulmonary hypertension and pulmonary vascular rem odeling in rats. Methods Twenty-four rats were divided into 3 groups: control group(n=8), hypoxia group(n=8), and hypoxia +NaHS group( n=8). After 21 days of hypoxia, the mean pulmonary artery pressure (mPAP) wa s measured. The weight ratio of right ventricle. left ventricle +septum (R/L+S r atio) was measured. The microstructure and ultrastrcture changes in pulmonary sm all arteries were examined. The contents of proliferating cell nuclear antigen (PCNA) and Bc l-2 protein expressions were detected by immunohistochemical assay.Resu lts Compared with rats in the control group, the mPAP increased by 45.6 % (P

0.05);2.Withdrawal and social scores of the CBCL were significantly higher in rural girls than those in the urban ones(t=3.42,3.41 P_a

Air Pollutants, Occupational ; analysis ; Coke ; Fatty Liver ; epidemiology ; Humans ; Logistic Models ; Male ; Occupational Exposure ; adverse effects ; Risk Factors