Objective To investigate the clinical characteristics and surgical management of adult presacral tumors.Methods The clinical data of 24 patients with adult presacral tumors from 2007 to 2012 were retrospectively analysed.All patients were diagnosed by digital rectal examination and imaging examination before operation.Seventeen patients with via sacrococcygeal approach,4 patients with via abdominal approach,and 3 patients with via combined abdominal and sacrococcygeal approach.Results The incision of 22 patients primary healing.There were 2 patients with postoperative incision infections,after dressing change cure.No patients died during perioperative period.Twenty patients were followed up for 3-17 months,1 patient with via abdominal approach recurrenced,and was healed after a second surgical resection.Conclusions Digital rectal examination and imaging examination are the main methods for diagnosis of adult presacral tumors.Most adult presacral tumors can be resected through sacrococcygeal route.

72 cases of treatments on insomnia were recorded in the medical books of Ming and Qing dynasties(A.D.1368～1911 years).The compatibility regularity of treating insomnia in these 72 cases were statistically analyzed with frequency and the R type cluster analysis methods. Combining the data and modern recognition, compatibility and medication regularity of treating insomnia was further analyzed.

Objective To demonstrate the result that progression of disease and prognosis of gastrointestinal cancer patients are correlated with the expression of the cluster and the abundance of lost goodwill target (LGT) fingerprint. Methods To research the period of survival and the time of death, 61 patients treated by SELDI (Surface enhanced laser desorption/ionization-time of flight-mass spectrometer)were involved in. According to the fingerprint spectrum obtained by SELDI and the appearance of fingerprints of LGT, these patients were divided into four groups namely non-peak, single-peak, double-peak, tri-peak and multi-peak groups. By means of Multi-factor analysis of variance and Cox regression analysis of risk, we compare four groups each other so as to find out one group in which patients have the greatest risk of death.Results Among the fingerprint spectrums of patients suffered from gastrointestinal cancer, which were obtained by SELDI, the patients with negative expression of LGT had low risk of death, which were lower than those of single-peak and double-peak groups, especially lower than those of tri-peak and multi-peak groups;the risk of death among the tri-peak and multi-peak groups were much higher than single-peak, the difference had statistical significance (P ＜0.05), and the death rate is rather high. Conclusion Among the serums from cancer patients tested by SELDI, the expression of LGT with tri-peak and multi-peak suggested that patient' s state of illness is about to deteriorate. This kind of fingerprint spectrum can be regarded as positive indicators,and the negative expression of LGT suggested that patient will have a good prognosis with a very low risk of death in the near future.

Objective To evaluate the acute side effects and efficacy of three dimensional conformal radiotherapy(3DCRT) combined with chemotherapy(CT) for locally advanced non small cell lung cancer(LANSCLC). Methods From Sept. 2000 to Dec.2001,24 patients with LANSCLC were treated with three dimensional conformal radiotherapy combined with chemotherapy navelbine+cisplatin NP. Results The overall response rate(CR+PR)was 91.7% for the primary tumor, and 100% for metastatic mediastinal lymph nodes.The leucopenia rate was 95.8%(54.2% grades 3,4). Acute radiation esophagitis occurred in 54.2% of patients(Grades 1,2). Acute radiation pneumonitis was observed in 12.5% of patients (Grades1,2). Conclusions 3DCRT combined with CT is well tolerated in most patients with LANSCLC. Its early responses are milder than the conventional radiotherapy combined with chemotherapy . Remote results await further follow up.

Objective To investigate the changes of plasma free carnitine (FC) concentrations in preterm infants supplemented with L-carnitine, and to provide a reference for routine preterm infants L-carnitine supplements. Methods A total of 99 preterm infants supplemented with 10 mg/(kg·d) L-carnitine on days 2 and 5 after birth, and 65 full term infants from Department of Neonatology, the Fifth People′s Hospital of Dongguan during July 2014 to December 2015 were recruited in this study , and filter-paper blood spots were collected by heel prick on days 1, 3 and 7. FC was measured using electron spray ionization (ESI) tandem mass spectrometry (MS-MS). Results Concentrations of FC decreased steadily from day 1 to day 7 in full term infants , while it remained the same level during the first week after birth as at birth. Additionally, concentrations of FC were significantly higher in preterm infants than full term infants on day 1 after birth. Conclusions The reasonable L-carnitine supplements may keep the levels of plasma FC at the levels at birth , which is important for fatty acid metabolism in preterm infants.

Objective: To study the effects and safety of Shixinyatong buccal tablets in the treatment of gastropyretic toothache (perico-ronitis). Methods: Randemized, double-blinded, double-imitated, parallel-controlled and multi-center clinical study was employed. 120 cases of gastropyretic toothache (pericoronitis) was enrolled in the experimental group( SBT group) and another 120 in control group(CBD group). Pericoronal pocket rinsing was performed for each case at the first visit, then the patients in SBT group were treated by Shixin buccal tablets(SBT) , 0. 6 g×2, 4/d and oral adiministration of the vehicle of cow-bezoare detoxicating tablets,0.3 g×3, 3/ d. The patients in CBD group were treated by oral adiministration of cow-bezoare detoxicating tablets ( SBD), 0. 3 g×3, 3/d and the vehicle of SBT, 0.6 g ×2, 4/d respectively. Pain, gingiva contagious tumefaction, pyorrhea of periocoronal pocket and limitation of mouth opening were scored by 0, 2, 4 and 6 as the major physical signs and symptoms(MAS); periocoronal flap and pocket, facial swelling, hot and foul breath, costipation, lymphadenectasis, thirsty and desire of cold drinks, fever by 0, 1,2 and 3 as the minor (MIS). Treatment was continued for 5 days and data were statistically analysed with SAS6. 12 software. Significant effectiveness was i-dentified by the decrease of total score of all the physical signs and symptoms(TS) ≥70% .effectiveness 30%～69% and ineffectiveness ≤29%. Routine examinations of blood, urine and stool, function of liver and kidney and electrocardiogram were conducted before and after treatment. Adverse events(AE) were observed. Results: 3 cases divorced from SBT group and 2 from CBD group. The demographic data and all the scores before treatment were not statistically different between groups (P>0.05). 3 and 5 days after treatment theTS, TSMA and TSMI were decreased(P= 0.000) in both groups, in SBT group decreased more than in CBD(P<0.001). Significant effectiveness ratio of SBT group was higher than that of CBD (P=0. 000). 5 days after treatment TS of MASs and the scores of each MAS in SBT group decreased more than in CBD( P<0.05). Vital signs were in normal range and not statisticaly different between groups(P>0.05). The clinical lab examinations showed no abnormal changes. Drug-related AE were observed in 3 cases, 1 with moderate AE in SBT group recovered after drug withdrawal, 2 with mild AE in CBD group recovered without aditional treatment. Conclusion; Shixinyatong buccal tablet is more effective in the treatment of gastropyretic toothache (pericoronitis) than cow-bezoare detoxicating tablets and with similar safety.

BACKGROUND:Vascular endothelial growth factor is a potent angiogenesis and permeability inducible factor. Vascular endothelial growth factor 165 and vascular endothelial growth factor 121 are mainly expressed in vivo, with a strong role of angiogenesis.
OBJECTIVE:To observe the feasibility of vascular endothelial growth factor 165 gene transfected bone marrow mesenchymal stem cel s to differentiate into vascular endothelial cel s.
METHODS:Bone marrow derived mesenchymal stem cel s were isolated and col ected from 50 g Sprague-Dawley rats,and identified by flow cytometry. The plasmid pGLV-EF1a carrying a vascular endothelial growth factor 165 gene was transfected to the mesenchymal stem cel s using lentiviral. Expression of green fluorescent protein was observed under a fluorescence microscope.
RESULTS AND CONCLUSION:After 12 hours of transfection, expression of green fluorescent protein was observed, increased at 48 hours, peaked at 72 hours and gradual y declined thereafter. Results prove that vascular endothelial growth factor 165 gene transfected bone marrow mesenchymal stem cel s have the expression of green fluorescent protein, indicating successful transfection. It is feasible to induce bone marrow mesenchymal stem cel s to differentiate into vascular endothelial cel s.

Objective To observe the clinical efficacy of Huoxue Rongluo Particles combined with acupuncture in the eight confluent points of spastic cerebral infarction paralysis and its effects on Glu and Asp levels of serum. Methods Totally 60 patients were divided into two groups: the experimental group and the control group. Both groups received basic Western medicine treatment, and the experimental group received Huoxue Rongluo Particles additionally, one dose a day for two times orally taken; Acupuncture was on eight confluent acupoint, every two days. 15 d is a treatment course, with 6 courses in total. Clinical spasticity index (CSI) and TCM symptom scores before treatment and the treatment of half month, 1 month, 3 months were observed. The levels of Glu and ASP in serum were detected, and TCM clinical efficacy was observed. Results The CSI score, levels of Glu and Asp in serum and TCM symptom scores of the patients after half-month, one-month, and three-month treatment were lower than those before treatment (P<0.05, P<0.01). There was no statistical significance in CSI score after half month treatment between the two groups (t=0.329, P=0.743). The CSI score in the experimental group after one-month and three-month treatment was lower than the control group (t=-2.636, P=0.024; t=-4.213, P=0.021). There was statistical significance in the levels of Glu and Asp between the two groups after half-month and one-month treatment (P<0.05, P<0.01). There was no statistical significance in the levels of Glu and Asp in the two groups after three-month treatment (P>0.05). The TCM symptom scores in experimental group was lower than the control group after half-month, one-month and three-month treatment (P<0.05). The total TCM effective rate was 86.67% (26/30) in experimental group, and 80.00% (24/30) in the control group, with the experimental group better than the control group (P<0.05). Conclusion Huoxue Rongluo Particles combined with acupuncture eight confluence acupoints in the treatment of spastic cerebral infarction paralyzed patients can relieve spasm degree, improve TCM clinical symptoms, which mechanism may be related to reducing serum excitatory neurotransmitters.

Objective:To investigate the role of planning risk volume (PRV) in estimating the radiation dose for various cardiac substructures (CS). Methods:The CS of 23 patients with left-sided breast cancer who underwent postoperative intensity-modulated ra-diotherapy (IMRT) was delineated. PRV was expanded from CS with an additional margin determined by the mean amplitude of cardi-ac motion. Two IMRT plans were designed. The volume, mean dose, maximal dose (D2%), and standard deviation of CS and its PRV were calculated. Results:In comparison to the volume of CS, the PRV of the heart, specifically the left ventricle, increased by 50%to 80%, whereas the PRV of the main coronary arteries and sub-branches increased by 18.7 times to 42.6 times. In the two IMRT plans, the mean dose to the heart, anterior myocardial territory, anterior descending artery, and their corresponding PRVs ranged from 9.4 Gy to 11.4 Gy, 11.0 Gy to 17.5 Gy, and 22.6 Gy to 27.8 Gy, respectively. The D2%to CS and its PRV was 24.5 Gy to 36.2 Gy, 28.2 Gy to 38.8Gy, and 36 Gy to 45 Gy. The mean dose and D2%to the coronary arteries, including both left and right main coronary arteries, right marginal artery, and left circumflex artery, were 8.6 Gy to 14.9 Gy and 12.5 Gy to 23.7 Gy, respectively. The difference of the mean dose and D2%to CS and its corresponding PRVs was 2.5%to 12.5%and 8.0%to 43.1%, respectively. Compared with the stan-dard deviation of the radiation dose to CS, majority of the standard deviation to PRVs increased significantly. Conclusion:The radia-tion dose difference between CS and its corresponding PRVs is<12%.