0.05). However, the 5-year local control rate appeared significantly different in three groups (?~2=7.239, P0.05). The 1-,3-,and 5-year disease-free survival rate among three groups were significantly different in the three groups (79.1%, 41.9% and 35.6% for CFR group, 85.7%, 57.1% and 38.1% for FHR group, and 95.4%, 62.8% and 58.1% for LAHR group) (?~2=6.60,P0.05). The incidence of loss of hearing, the radiation-induced temporomandibular joint lesion, and the radiation-induced brain injury was 31.3%, 41.9% and 9.3% in CFR group, and 25.0%, 35.7% and 7.1% in FRH group, and 22.7%, 35.7% and 7.0% in LAHR group, respectively. Conclusion A better 5-year local control rate and disease-free survival rate were achieved in patients in LAHR and FHR groups than those in CFR group. There are no differences in the incidence of late complications and overall survival rate among three groups.

This paper is to report the development of a rapid and sensitive method for the determination of s-oleylpropanolamide (OPA) in various tissues of rat (brain, heart, lung, liver, spleen, small intestine, kidney, adipose tissue and muscle), and to assess the applicability of the assay to tissue distribution. OPA was extracted by liquid-liquid extraction method with undecylenoylethanolamide as an internal standard. The concentrations of OPA were determined by LC-MS/MS after a single intragastric dose of 50 mg x kg(-1) at 4 time points (5 rats per group). With multiple reactions monitoring mode (MRM) the limit of quantification (LLOQ) was determined at 1 microg x L(-1). The calibration curve was linear from 1 to 2 x 104 microg x L(-1) (r > or = 0.999 0) for tissue homogenates. Validation parameters such as accuracy, precision and recovery were found to be within the acceptance criteria of the assay validation guidelines. The highest concentration was found in small intestine (the highest time point is 15 min) and heart (the highest time point is 90 min). The assay is rapid, sensitive and applicable to studying tissue distribution of OPA in rats.

This paper is to report the result of the surgical treatment of 12 cases of carcinoma of the hypopharynx and cervical esophagus in a period of 3 years.Ten out of the 12 cases were explored and resection of the tumor was perforr med on 8 cases. In 7 cases out of the 8. the esophagus was stripped out and the stomach was transposed without thoracotomy and total pharyngolaryngectomy was performed in addition on 3 of them. In the 8th resected case, the pharynx, larynx and the cervical esophagus were resected and then a segment of jejunum was isolated ar.d transplanted to reconstruct an esophagus.All the cases stood the operation rather well. Postoperatively 3 cases developed serious complications; one died of cardiac failure, one developed salivary fistula and the third one developed partial ischemic necrosis of the transposed stomach. The last patient was treated with intraluminal intubation and he could take soft food when he was discharged. Six cases were followed up for years;two died one year after operation and 4 are living.The operative indications, the method of approach, and the postoperative complications were discussed. It is concluded that carcinoma of the hypopharynx and cervical esophagus is not an uncommon disease with high resectability and better survival rate as compared with carcinomas of other sites, but early detection and prompt operation are imperative for a cure.

Objective To evaluate the curative effect of percutaneous compression plating system in treatment of intertrochanteric fractures of the elderly patients.Methods The clinical data of 18 elderly patients(aged 68-89 years)with intertrochanteric fractures were retrospectively analyzed.According to Evans classification,there were seven patients with type Ⅰ fractures,nine with type Ⅱ fractures and two with type Ⅲa fractures.Percutaneous compression plating system was applied to all patients from June 2007 to June 2009,and the therapeutic effect was evaluated by Harris hip function evaluation criteria.Results All the fractures were healed,with excellent results in 15 patients and good results in the rest three patients.Conclusions The percutaneous compression plating system is easy to manipulate with minimal invasion,has minor side effect and is beneficial to reducing surgical complications in the elderly patients with intertrochanteric fractures.

Objective: To preliminarily investigate the relationship between the baseline level of serum soluble ST2 (sST2) and 30-day MACE occurrence rate in patients with ST-elevation myocardial infarction (STEMI).
Methods: A total of 121 patients with confirmed diagnosis of STEMI in our hospital from 2015-05-01 to 2015-07-30 were consecutively enrolled. According to baseline sST2 level, the patients were divided into 2 groups:Low sST2 group, the patients with sST2≤56.68 ng/ml, n=61 and High sST2 group, the patients with sST2>56.68 ng/ml, n=60. Clinical condition and 30-day MACE (defined as death and new onset of congestive heart failure) occurrence rate were compared between 2 groups.
Results: ① The systolic blood pressure (SBP), Killip class≥II grade, blood levels of cTNI, NT-proBNP, hs-CRP and LVEF were different between 2 groups, all P<0.05. ② Baseline sST2 level was positively related to heart rate (r=0.271, P=0.003), Hs-CRP (r=0.359, P=0.000), cTNI (r=0.324, P=0.000) and NT-proBNP (r=0.425, P=0.000);negatively related to SBP (r=-0.226, P=0.013) and LVEF (r=-0.406, P=0.000).③30-day MACE occurrence rate was different between 2 groups (8.2%vs 30%, P=0.002). ④ Multivariate Cox regression analysis presented that sST2>56.68 ng/ml was the risk factor for 30-day MACE occurrence (HR=1.152, 95%CI 1.078-1.231, P=0.000).
Conclusion: Increased baseline level of sST2 implied the higher incidence of death and new onset of congestive heart failure in STEMI patients.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

Objective To assess the efficacy of different internal fixations of palatal fracture.Methods Seventy-four patients with palatal fracture admitted between October 2007 and October 2013 were reviewed retrospectively.Through out-patient follow-up,postoperative occlusion and palatal complications were examined and fracture healing was evaluated using CT scan.Results Palatal type Ⅰ-Vfractures involved in 8 patients (11％),14 patients (19％),26 (35％),12 patients (16％),6 patients (8％),and 8 patients (11％) respectively.Forty-three patients were available to follow-up,including 31 patients with good or acceptable occlusion.All wounds healed without palate associated infections,plate exposure or oronasal fistula.Of the 27 patients classified as type Ⅱ,Ⅲ and V sagittal palatal fractures,both nasomaxillary and zygomatico-maxillary struts fixation (n =17) and isolated zygomatico-maxillary struts fixation (n =10) had insignificant differences in success rate as to occlusion assessment (82％ vs 80％,P ＞0.05).Whereas compared with isolated vertical buttress fixation (n =15),additional immobilization of horizontal alveolar buttresses (n =12) had significantly higher success rate (100％ vs 67％,P ＜ 0.05).Conclusion Complete rigid fixation at early stage,including vertical buttress fixation,in particular the zygomatico-maxillary struts,and horizontal alveolar buttress fixation can achieve satisfactory outcome.

Objective To investigate the expression of hepatocyte nuclear factor-1α (HNF-1α) and hepatocyte nuclear factor-4α (HNF-4α) in human hepatocellular carcinoma (HCC) and explore the function of HNF-1α and HNF-4α during HCC carcinogenesis and development. Methods Twenty-six specimens of hepatocellular carcinoma were collected. The expressions of HNF-1α and HNF-4α in HCC tissues and adjacent non-cancerous tissues were detected by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry staining. Results The mRNA levels of HNF-1α and HNF-4α were significantly lower in HCC tissues than that in adjacent non-cancerous tissues (0.818±0.371 vs. 0.383±0.102 for HNF-1α, P＜0.05;0.846±0.384 vs. 0.397±0.105 for HNF-4α, P＜0.05).The positive rates of HNF-1α and HNF-4α protein were significantly lower in HCC tissues than in adjacent non-cancerous tissues (92.3% vs. 42.3% for HNF-1α, P＜0.05;96.2% vs. 50.0% for HNF-4α, P＜0.05). The mRNA and protein expressions of HNF-1α and HNF-4α were correlated with tumor differentiation (P＜0.05). There was a negative correlation between HNF-1α and HNF-4α mRNA expressions in HCC tissues.Conclusion The expressions of HNF-1α and HNF-4α are down-regulated in HCC, which might be related to carcinogenesis and development of HCC.

BACKGROUND: Expectant treatment for intertrochanteric fractures in elderly patients with osteoporosis and other chronic diseases can easily lead to complications of lying in bed.OBJECTIVE: To evaluate the results of percutaneous compression plating system (PCCP) for intertrochanteric fractures in elderly patients. METHODS: Thirty-two cases of elderly intertrochanteric fractures treated with PCCP admitted from June 2007 to June 2009 and 40 cases of elderly intertrochanteric fractures treated with dynamic hip screw system (DHS) were reviewed. The operative bleeding, operative time and curative effect were compared.RESULTS AND CONCLUSION: The operative bleeding and operative time in the patients receiving PCCP were significantly lower than those in the patients receiving DHS. There was not statistical significance between the curative effects about the two methods. PCCP applied in elderly patients with intertrochanteric fracture can get satisfactory effects, and the system is operated simply with minimally invasive surgery, which is beneficial to reduce surgical complications.

Objective To investigate the CT imaging features of solid pseudopapillary tumor of the pancreas (SPTP) and to improve the preoperative diagnostic accuracy. Methods A retrospective analysis was performed on the CT manifestations of 21 cases of SPTP confirmed by pathology and surgery. Results In the 21 cases of SPTP, 19 were young and middle-aged female (range: 9～29 years old). The lesions were located in the pancreatic head and neck in 13 cases, and in the pancreatic body and tail in 4 cases each. The maximum diameter of tumor was 3 ～ 15 cm (mean 7.5cm). CT showed a single, round-like, cystic and solid mass in the pancreas. Eighteen cases had a complete capsule, and 3 cases had poorly defined margin with surrounding tissue. 5 cases of tumor were encapsulated or appeared scattered calcification in the center, only 1 case had pancreatic duct dilation (about 5mm in diameter), and no patient had bile duct changes. After enhanced scanning, the tumor capsule and the solid part were mildly to moderately enhanced during arterial phase, and they were significantly enhanced during portal venous phase and equilibrium phase. The cystic part was not enhanced, but the capsule was significantly enhanced. Conclusions CT manifestations of solid pseudopapillary tumor of the pancreas have certain characteristics, and when combined with clinical and imaging manifestations, accurate diagnosis generally can be made.