Protons and heavy ion radiation therapy have proven highly effective against a wide range of cancers and in recent decades there have been rapid advances.Due to the physical characteristics of the Bragg-peak and superior biological properties,proton and heavy ion radiation is able to focus its energy on the tumor while minimizing exposure to surrounding normal tissues and organs,which is expected help enhance the tumor dose and reduce normal tissue damage.In recent years,many studies have explored the efficacy and safety of proton and heavy ion radiotherapy on various malignancies,such as head and neck cancer,lung cancer,esophageal cancer,and liver cancer.The results of these studies enable a better understanding of the characteristics and advantages of proton and heavy ion therapy.

Breast ; surgery ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Treatment Outcome

We have conducted a tireless practice and exploration in order to establish a solid,long-term and appropriate social practice basement for medical students,which is the platform for them carrying on social practice activities.Practice has proved that early preparation for basement construction is the basis,support from local government is the key,leaders' attention 、abundant fund and multi-sectional coordination are the guarantee,and that diverse forms as well as effective social practice activities is the fundamental way to promote basement construction.

Objective To investigate and analyze the relationship of the level of high-sensitivity C-reactive protein (hs-CRP) and carotid artery atherosclerosis with acute cerebral infarction (ACI).Methods Fifty-nine patients with ACI were assigned as experimental group and thirty healthy people as control group. The serum level of hs-CRP was measured, and the carotid plaques and the changes of carotid intimal-medial thickness (IMT) were examined by color Doppler ultrasonography.Then the relationship between the serum level of hs-CRP and the severity of disease was analyzed.Results The serum level of hs-CRP was higher in ACI group than in control group [(5.96± 1.52)mg/L vs. (1.78±1.02) mg/L, t=15.383, P＜0.01]. The detection rates of carotid plaques and the increased carotid IMT were higher in ACI group than in control group [77.97% vs. 36.67%, x2 =12.92, P＜0.01; (1.18±0.17) mm vs. (1.02±0.15) mm, t=4.544, P＜0.05]. The hs-CRP levels were higher in the severe cases [(15.68±1.45) mg/L] than in moderate cases [(4.16±1.39)mg/L] and mild cases [(1.88±0.34) mg/L, t=37. 217, 25. 243, both P＜0.01]. Conclusions The elevated levels of hs-CRP have overt clinical significances for the atherothrombotic cerebral infarction. Early determination of hs-CRP is helpful to evaluate patient's condition and prognosis.

[Objective]To evaluate the clinical outcome of the Ribbed anatomic cementless prosthesis.[Method]A total of 1436 hips in 956 patients undergone THR with Ribbed anatomic cementless prosthesis were reviewed.Between March 1997 and September 2005,1 249 hips in 832 patients were available for clinical and radiological follow-up.The mean follow-up period was 6.7 years with a minimum of 2 and a maximum of 10.5 years.The patients were evaluated with Harris Hip Score and radiographic analysis.[Result]The mean Harris Hip Score increased from 34.7 preoperatively to 91.5 postoperatively.Excellent and good functional improvement was seen in 96.3% of the operated patients.There was neither periprosthetic osteolysis nor evidence of loosening on follow-up radiographs.[Conclusion]Ribbed anatomic cementless prosthesis is found to be performing well with good clinical and radiological result.

Objective To investigate the effects of thiopentone and propofol on cerebral ischemia-reperfusion injury during open heart surgery under deep hypothermia circulatory arrest in infants and young children. Methods Twenty patients with VSD and pulmonary hypertension (13 male, 7 female), aged 3-23 months and weighing 4-11 kg were randomly divided into three groups: in group A thiopentone 5mg.kg was added in CPB machine when body temperature was reduced to 30℃ (n = 7); in group B propofol 2 mg.kg-1 was added ( n =8) and group C served as control ( n - 5). When rectal temperature was reduced to 20℃, CPB was stopped and intracardiac manipulation was started. Anesthesia was induced with midazolarn 0. 2mg.kg -1, fentanyl 20 ?g.kg1 and vecuronium 0. 1mg.kg1 . After tracheal intubation the patients were mechanically ventilated and anesthesia was maintained with O2-N2O-isoflurane and intermittent boluses of fentanyl and vecuronium infusion (70?g.kg-1.h1). Radial artery was cannulated and internal jugular vein (IJV) was retrogradely cannulated until bulb, and blood samples were taken simultaneously from artery and IJV before CPB (T1 ), during circulatory arrest (T2 ) at the beginning of reperfusion ( T3 ) and 24h after operation ( T4 ) for blood gas analysis and determination of plasma concentration of lactic acid (LA), creatine kinase-BB (CKBB) activity and neuron-specific endase (NSE). Cerebral arterial-venous O2 content difference (Ca-vO2) and cerebral O2 extraction ratio (CO2ER) were calculated. Results Plasma concentration of lactic acid was increased at T3 in all three groups and was the highest in group A. Cerebral O2 metabolism decreased at T2 in all three groups and was the lowest in group B and resumed at T4 CKBB activity was increased at T3 and NSE level was increased at T3 and T4 in all 3 groups. The increase in CKBB activity and NSE level was slightest in group B. Conclusion Propofol can protect brain from ischemia-reperfusion injury in infants and young children during open heart surgery under deep hypothermic circulatory arrest.

Objective To evaluate the optimal dosage of misoprostol administered in the rectum for dilation of the cervix. Methods Two hundred and forty women at 40-60 day gestational age without vaginal delivery history were randomly divided into three groups,with 80 cases in each group. Patients received 200,400 or 600μg of misoprostol rectally one hour before electrical vacuum abortions in group A,B and C,respectively. Cervical dilation,blood loss,and drug side effects in the three groups were compared. Venous blood samples were taken before vein anesthesia,and misoprostol acid concentration in the serum was tested by liquid chromatography-mass spectrometry. Results The analgesic rate was 100. 00%in all three dose groups, and cervical dilation rate was 23. 75%,46. 25%and 70. 00%in groups A,B and C,respectively. The severity of drug side effects such as vaginal bleeding and abdominal pain is dose-dependent. Blood concentration of misoprostal acid was(117±65),(206± 98),and(303±149)pg·mL-1 ,in groups A,B and C,respectively. Conclusion The recommended dose of misoprostol is 400 μg administered in rectum. Rectal administration of misoprostol is cheap,safe,and convenient,and therefore could be widely applied.

Objective To analyze and evaluate the role of IABP in the treatment of patients with acute myocardial infarction.Methods The clinical data of all patients with acute myocardial infarction treated with IABP admitted into the Peking University First Hospital from January 1st 2000 to December 31st 2006 were collected.The treatment effects of IABP were analyzed with statistical methods.Results A total number of 48 patients with acute myocardial infarction were treated with IABP in the past 6 years and 26 of them were presented with cardiogenic shock at the time of admission.The short-term condition was stabilized in 81.3%(39/48) of the patients with IABP treatment which was demonstrated by restoration of stable heart rate and blood pressure,increase in urine volume,symptoms relief and decreasing need of vasoactive drug.The in-hospital mortality was lower in patients received revascularization therapy in additional to IABP compared with patients who had IABP support alone(37.5% vs.93.8%,P

Objective To investigate the anti-proliferation effect of triptolide-eluting stent, as well as its effectiveress, dose-effect relationship and safety. Methods Experimental stents were divided into 4 groups with 10 stents each, namely bare stent group, sirolimus-coated stent group, 5.6 ?g triptolide-coated stent group and 56 ?g triptolide-coated stent group. By morphometric and histopathologic analysis,we compared 5.6 ?g and 56 ?g triptolide-eluting stents with bare metal stents and sirolimus-eluting stents 28 days after stenting in rabbit iliac models of restenosis. Results The neointimal area of 5.6 ?g triptolide-eluting stents was similar to that of bare metal stents, but larger than that of sirolimus-eluting stents. The neointimal area of 56 ?g triptolide-eluting stents was smaller than that of bare metal stents and 5.6 ?g triptolide-eluting stents, but was similar to that of sirolimus-eluting stents. In all the groups, proliferation on both edges of the stents was insignificant. No toxic effect had been found in the experimental animals related to triptolide-eluting stent. Conclusion Triptolide-eluting stents may inhibit neointimal proliferation. The effect of inhibiting neointimal proliferation is dose dependent and with no adverse effect. These results suggest that triptolide-eluting stent can prevent restenosis within four weeks.

Objective To evaluate MRI in diagnosis and follow-up of Achilles tendon rupture. Methods From April 2003 to May 2005, 24 cases of closed Achilles tendon rupture were examined in our department with MRI. It was performed through sagittal T1WI, T2WI, GE-STIR and axial TME imaging. Four cases were followed up with MRI after 4 to 8 weeks. Results MRI could determinate the severity and exact location of Achilles tendon rupture by demonstrating signal changes of Achilles tendon. In this series, complete rupture of Achilles tendon mostly occurred at the median part, with augmentation and high signal on T2WI. MRI demonstrated high signal on T2WI in partial rupture of Achilles tendon. The signal intensity in the four cases followed up by MRI was shown to decrease. Conclusion MRI is a valuable tool for clinical diagnosis and follow-up of Achilles tendon, because it provides enough information through signal changes at the tendon.