Objective To evaluate the effects of three-dimensional conformal radiation therapy (3DCRT) on the local control and survival of patients with local recurrence or metastasis in colorectal cancer. Methods Twenty-three patients with local recurrence or metastasis in colorectal cancer were irradiated by 3DCRT. The regimen was: total dose 40-45?Gy, 5-7?Gy/f, 1f/2d. Results Of the 23 patients, 8 achieved CR and 9 PR with a total response rate of 74%(17/23). The overall 1-, 2-and 3-year survival rates were 78%,52% and 30%. Conclusion 3DCRT is able to prolong the survival and improve the life quality of patients with local recurrence or metastasis in colorectal cancer.

Objective　To investigate the correlation between the expression of Cyclin D1,Rb and clinicopathologic parameter in bile duct carcinoma(BDC), and evaluate the potential prognostic value. Methods The expression of Cyclin D1, Rb in BDC was detected by immunochemical staining(S-P method). Results　Of 42 samples, 22 cases exhibited Cyclin D1 positive expression(52.38%), correlated with histological grade(P=0.044), hepatic invasion(P=0.0046), clinic stage(P=0.0001) and survival time(P=0.0011). The Rb positive rate was 57.14%(24/42), while the expression was related to histologic grade(P=0.0052), clinic stage(P=0.0042), and lymphatic metastasis(P=0.0068). Conclusions　Ccylin D1 and Rb are correlated with some clinicopathologic parameter of BDC, and Cyclin D1 is a valuable prognostic marker of BDC.

Objective To study the risk of recurrence after a first unprovoked seizure and analyze the potential predictors of recurrence. Methods 150 patients with one or more recently unprovoked seizures who attended our hospital from October, 1998 to June, 2000, which included 66 patients having a first unprovoked seizure, were followed up for 2 years. Recurrence rate was estimated by Kaplan-Meier curves. Univariate and multivariate analyses of the potential predictors of recurrence were performed for the first unprovoked seizure patients using the Cox proportional hazards model.Results All the 150 patients had 109 relapses in 2 years, Kaplan-Meier estimate of recurrence rate was 73%(?3.6%), while 66 first unprovoked seizure patients had 36 relapses, with the recurrence rate 54%(?6.1%). Cox Univariate and multivariate analyses showed that symptomatic etiology increased the risk of recurrence, and other predictors of recurrence included abnormal electroencephalogram, the occurrence of seizures during sleep and first seizure lasting longer than 10 minutes, whereas an age of 3 to 12 years decreased this risk.Conclusion The recurrence risk after the first unprovoked seizure is lower than those who have two or more recent seizures. Several factors enable us to predict the recurrence risk after a first unprovoked seizure.

Objective To explore the causes,clinical characteristics and new measurements concerning with diagnosis and treatment of hypophosphatemic rickets.Methods Thirty children with hypophosphatemic rickets had been diagnosed and treated in our hospital from 1996 to 2005.Clinical data were retrospectively analyzed,including family history(the attack rates of parents and styles of inheritances),clinial characteristics(the attack ages and severity of skeletal developing malformation),serum biochemistry(plasma calcium,phosphate and alkaline phosphatase level),and X-ray in bones and treatment methods.Results All these patients presented with typical manifestations and signs of rickets.The minimum age of definitive diagnosis of hypophosphatemic rickets was 1.5 years old;the maximal age was 10 years old.All of 30 cases had failed to conventional treatment of vitamin D(VitD) deficient rickets for 6 months.Early supply of phosphate,VitD and calcium could effectively improve the outcomes of patients.Patients diagnosed and treated before 2 years old had better prognosis,while that diagnosed and treated later than 5 years old would be result in severe skeletal malformation.Conclusions It is difficult to distinguish hypophosphatemic rickets from VitD deficient rickets.It is very important that misdiagnosis of this disease usually leads to severe skeletal malformation.Early diagnosis and treatment can effectively improve the skeletal development of patients.

Objective To study the change of glutamate transporter (GluTs) function of hippocampus in seizures rats induced by KA, and explore the role of GluTs in the mechanism of epilepsy.Methods 60 adult male Wistar rats were randomly divided into two groups: KA group(Ⅰ group) and control group(Ⅱ group). Each group was randomly divided into five subgroups according to different time after kindling, including 4 h, 24 h, 48 h, 5 d,and 7 d after injection. GluTs function was studied by means of assay of 3H-L-glutamate uptake in synaptosomes and tissue sections of hippocampus.Results The function of GluTs in synaptosomes was singnificently decreased at any time (all P

Objective To investigate the clinical and electromyographic features of peripheral nerve involvement in MS. Methods The clinical and electromyographic (EMG) data of 29 MS patients were evaluated retrospectively.Results 18 (62.1%) patients showed clinical and/or electromyographic abnormalities of peripheral nerves. The clinical symptoms included extremity numbness in 16 cases (88.9%), limb inertia in 11 cases (61.1%), radicular pain in 5 cases (27.8%), autonomic nerve disorder and dysphagia in few patients. Signs included decrease of tendon reflex in 11 cases (61.1%), periphery or root form hypoesthesia in 9 cases (50%), muscle weakness in 7 cases (38.9%), myatrophy in 4 cases (22.2%), and reduced pharyngeal reflex in 1 case (5.6%). There was no difference in age of onset, course of disease, neurologic impairment and prognosis between the patients accompanied with peripheral neuropathy and the patients without peripheral neuropathy. The electromyographic abnormalities included spontaneous potential in 4 cases (13.8%), increased motor unit potential in 8 cases (27.6%), slow MCV in 15 cases (51.7%), slow SCV in 13 cases (44.8%), low amplitude in 9 cases (31.1%), and prolonged distal latency in 5 cases (17.2%). The neuropathies improved by treatment with corticosteroid in the all patients except one.Conclusions Some MS patients may accompany with peripheral nerve abnormalities, which may improve with the recovery of MS. EMG is useful to evaluale the site and degree of peripheral nerve damage.

Objective To explore the clinical and MRI features multiple system atrophy (MSA) and the significance of diagnosing its clinical subtypes.Methods Clinical data and MRI features of 28 patients with MSA were retrospectively analyzed and compared.Results Cerebellar signs (75.0%) were dominant clinic features in olivopontocerebellar atrophy (OPCA). Brain MRI showed atrophy of pontine (91.7%) and cerebellar vermis (91.7%), fourth ventricle dilatation (83.8%) and T2WI high intensity in pontocerebellar region (63.6%). Extrapyramidal signs (80.0%) were found in striatonigral degeneration (SND) with apparent basal ganglia changes such as putamen atrophy (60.0%) and lineal T2WI high intensity of the lateral margin of the putamen (putamen slit) (80.0%). Shy-Drager syndrom (SDS) presented mainly with autonomic nerve system (81.8%), and autonomic nerve system failures appeared earlier and more severe than the other two subtypes of MSA. Conclusions MRI examination may be useful in diagnosis of MSA and its subtypes. Pontine atrophy, T2WI high intensity, especially pontine cross sign may support diagnosis of OPCA. However, putamen atrophy and putamen slit are the specific imaging signs in SND.

Objective To observe the mitochondrion and nucleus ultrastructural damage and caspase-3 expression in hippocampal CA_3 neurons during kainic acid(KA) induced status epilepticus(SE) in rats.Methods SE was induced for 2 h with KA in adult male Wistar rats.3,12 and 24 h later the rats were killed and the hippocampal CA_3 subareas were taken out to make brain sections.The neuronal damage on the whole with light microscope and the ultrastructure of mitochondrion and nucleus with electron microscope.Caspase-3 expression of the same area was examined with immunohistochemical staining.Results 24 h after SE,by the light microscope examination,the KA group showed that the neurons put scattered disorder and nucleus shrink firmly.3 h after SE,electron microscope examination showed swelling cristae and ruptured membrane of mitochondria.The change of nucleus were significant margination of chromatin 24 h after SE.Compared to normal control group,the caspase-3 expression increased 12 h after SE,the average number of positive cell and the gray scale were obviously higher(all(P

Objective To investigate Guillain Barre syndrome (GBS) combined with demyelinating neuropathy in central nervous system(CNS), and explore the possible mechanism and the relationship between the two.Methods 3 cases GBS combined with demyelinating neuropathy in CNS were observed clinically and the datum of laboratory were analysed.Results Case 1, a 28 year old man had symptoms of general flaccid paralysis and coma.The result of blood gas analysis was normal. CSF showed an albuminocytological dissociation, delayed nerve conduction velocity and missed F waves. Brain MRI showed multifocal T 2 Wight Image high signs in white matter of bilateral brain and cervical spinal cord. The patient is getting recovery by treatment with plasma and immunoglobulin. Case 2 , a 5 year old girl with progressive weakness of her limbs and respiratory arrest, appeared confusion,dully light reflex and absent corneal reflex, at last she died because of rejecting treatment.Case 3,a 12 year old boy with progressive weakness of his limbs and the difficult of relieving the bowels.Brain MRI was normal.Spinal MRI showed multifocal T 2 weight imagine hight signs from T 5 to L 4.CSF showed an albuminocytological dissociation.EMG showed a delayed nerve conduction velocity.Conclusion GBS combined with disorders of consciousness are mostly severe, the pathological mechanism is unclear. It is suggested that auto immunoreaction caused by P 1 myelin basic protein can relate to around and CNS demyelination.

Objective To analyze the change of the shear stress in atherosclerotic carotid artery of rabbits and its effect on the plaque and intimia-media pathological morphology. Methods Totally 36 male Japanese White rabbits were randomly divided into blank control group (n=6), sham operation control group (n=6) and the surgery group (n=24). The blank control group was fed by normal diet. The sham operation control group was fed by the high-cholesterol diet. The surgery group was fed by high-cholesterol diet and treated by air-drying. In the 2nd, 4th, 8th and 12th week after operation, the hemodynamic parameters were measured using Color Doppler Flow Imaging. Blood viscosity was determined and the degree of artery stenosis was showed by digital subtraction angiography (DSA). The stenosis rate, mean shear stress, intimia-media ratio and mean integrated optical densities (IOD) of media smooth muscle cells (SMC) were calculated respectively. Results The typical atherosclerotic plaque was presented in surgery group. The thickness of media and mean IOD of SMC were increased at the 2nd week after operation. However, following the increase of the stenosis rate and shear stress, the flow field was changed on the stenotic artery. The pathological morphology showed the character of vulnerable plaque such a large lipid core, thin fibrous cap, and plaque rupture at 4th, 8th week after operation. The media showed atrophy and became thin, mean IOD of SMC was decreased. Statistic analysis showed significant difference in the 2 week group compared with other group. Conclusion Following the increase in the degree of stenosis, the flow shear stress is increased, turbulent flow presents, and flow field changes on the stenotic artery. Thus the plaque become unstable , and the vessel occurs remodeling.