At present,intensity modulated radiation therapy has been the main treatment of nasopharyngeal carcinoma.In the course of 6-7 weeks,most physicians use the initial formulation of the radiotherapy plan.Studies have indicated that the reduction of primary tumor and lymph nodes,as well as the reduction of normal tissue and body surface profile due to the weight loss,will affect the dose distribution of the target and the organs at risk,so as to influence the therapeutic effect of some patients.Therefore,it is necessary to reset and modify the target volumes during the radiotherapy for nasopharyngeal carcinoma.

Objective:To explore the SPECT detection method of quality control in detection of main performance index. Methods: according to the 2007 edition of SPECT performance measurementof the NEMA (the United States Electrical Manufacturers Association) standard, and the corresponding model of intrinsic spatial resolution, intrinsic spatial non-linearity, intrinsic non-uniformity, characteristic count rate, system planar sensitivity, system spatial resolution, fault spatial resolution and other indicators. Results: after quality control testing, have deviation more index hospitals SPECT results. Conclusion: the hospital should detect quality control as far as possible in nuclear medicine and nuclear medicine imaging equipment, ensure the normal operation of equipment, and improve the quality of image.

Objective To evaluate the effect and patient 's tolerance on late-course high-dose radiotherapy (LCHDRT) combined with concurrent chemotherapy for locally advanced non-small cell lung cancer (NSCLC).Methods 73 NSCLC patients were entered into this study from May 2000 to May 2006.The treatment regime consisted of conventional radiotherapy first (40 Gy,20 f,4 w),followed by LCHDRT (24-30 Gy,6 f,2 w,tumor α/β =10 Gy,BED =81.6-93 Gy) combined with concurrent chemotherapy.Conventional irradiation field encompassed the primary lesion,hilum of lung and mediastinal lymph drainage region.LCHDRT focused on the primary lesion only,with ≥95 ％ isodose curve covering the planning target volume (PTV) and the target dose was prescribed to PTV.Supraclavicular metastases lymph node was treated by 6 MV X-ray and electron beam to a total dose of 65-70 Gy.Chemotherapy regime consisted of vinorelbine (25 mg/m2,d1,8 iv) and cisplatin (30 mg/d,d1-3,iv gtt) in the lst and 5th weeks.Results Leukopenia and radiation-induced pneumonitis,as shown by the WHO staging system were the most common acute toxicities.In V20≤25 ％,17.2 ％ (5/29) patients happened radiation-induced pneumonitis only.But in V20 ＞ 25 ％ and ≤ 30 ％,65.9 ％ (29/44) happened radiation-induced pneumonitis (x2 =16.63,P ＜ 0.01).It showed that patients accompany increment of V20,the happening rate of radiation-induced pneumonits probability was increased.The other acute toxicities such as nausea,fever,radiation-induced esophagitis,hemoglobin decrease and thrombocytopenia were mainly grade 1 or 2.After symptomatic treatment,all patients completed the planned treatment without interruption except 4 patients above 70 old years of grade 3 radiation-induced pneumonitis.Late lung radio-fibrosis was 34.3 ％ (25/73).Before the end of the second month after treatment,the complete response (CR) and partial response (PR) rates were 17.8 ％ (13/73) and 69.9 ％ (51/73),respectively,with CR+PR rate of 87.7 ％.The 1-,3-,5-year local control and overall survival rates as monitored by the x2 test method were 82.2 ％,60.3 ％,50.7 ％ and 57.5 ％,23.3 ％,13.7 ％,respectively.Conclusion LCHDRT combined with concurrent chemotherapy shows a promising results,but the rational time-dose-fraction model still need further observation.

OBJECTIVETo investigate the application of microsurgical technique in the replantation of amputated ear.

METHODS7 cases of amputated ears were analyzed from June 2009 to April 2015 in our department. We used microsurgical technique to anastomose about five vessels and nerves. The blood supply of auricle was restored within three to six hours. All subjects underwent treatments including anti-freezing, anti-spasm and anti-infection treatment after the emergency surgery.

RESULTS7 amputated ears were all survived after replantation. The patients were followed up for one month to six months ( average for 28 months). The appearances of survived ears body were fully recovered without any significant atrophy or pigmentation. The sensory function of ears recovered to normal after 1 year.

CONCLUSIONSThe application of microsurgical technique in the replantation of amputated ear can expect the high success rate of ear replantation. However, skilled and high-quality anastomosis technique of small vascular are required.

Amputation, Traumatic ; surgery ; Anastomosis, Surgical ; methods ; Ear Deformities, Acquired ; surgery ; Ear, External ; blood supply ; innervation ; Graft Survival ; Humans ; Microsurgery ; methods ; Replantation ; methods

OBJECTIVETo characterize the effect of omeprazole on the spectrum of gene expression in the cultured human umbilical vein endothelial cell (HUVEC) line (EA.hy926), and explore the underlying molecular mechanism.

METHODSAffymetrix U133 plus2.0 oligonucleotide microarray was used to detect the alteration in the gene expression profiles induced by 1×10(-5) mol/L omeprazole in HUVECs. Real-time PCR was employed to verify the results of selected differentially expressed genes, and Western blotting was performed to test the expression levels of the related proteins.

RESULTSA total of 282 genes were found to show at least 1.5-fold changes in EA.hy926 cells after treatment with omeprazole for 48 h, including 236 up-regulated and 46 down-regulated ones. These genes were involved in the regulation of transcription, inflammatory response, immune response, cell adherence, anti-apoptosis, and signal transduction.

CONCLUSIONOmeprazole modulates the function of endothelial cells by regulating the gene expression profiles of multiple pathways.

Cell Line ; Computational Biology ; Human Umbilical Vein Endothelial Cells ; drug effects ; Humans ; Oligonucleotide Array Sequence Analysis ; Omeprazole ; pharmacology ; Transcriptome ; drug effects

OBJECTIVETo compare the effects of clopidogrel combined with dihydropyridine calcium-channel blockers (CCBs) or non-dihydropyridine CCBs on coronary artery disease (CAD) in elderly patients.

METHODSThe study cohort was defined as all patients ≥60 years old hospitalized for CAD with the prescription of clopidogrel between January 2001 and February 2011. The primary endpoint was death of all causes, and the secondary endpoints were nonfatal myocardial infarction (MI), hospitalization for unstable angina, stroke, transient ischemic attack, or repeat revascularization (PCI or coronary artery bypass graft).

RESULTSA total of 1021 patients were enrolled, among whom 402 patients were prescribed with clopidogrel and 619 with clopidogrel combined with CCB (dihydropyridine in 547 and non-dihydropyridine in 72). In clopidogrel group and clopidogrel with CCB group, the incidence density of death was 50.55 per thousand and 42.02 per thousand, respectively. The crude RR was 0.83 (95%CI: 0.55-1.26), and the multivariable-adjusted RR was 0.47 (95%CI: 0.14-1.6), showing no statistical significance in the rate of deaths of call causes between the two groups (P>0.05); the incidence density of composite thromboembolic events showed no significant difference between the two groups, either (P>0.05). After weighting of the propensity score, the patients with clopidogrel coadministered with non-dihydropyridine CCB showed a significant increase in composite thromboembolic events than those taking dihydropyridine CCB, with a SMRW-adjusted OR of 1.97 (95%: 1.2-3.23, P=0.007). No significant difference was observed in death or composite thromboembolic events between Pgp-inhibiting CCBs and non-Pgp-inhibiting CCBs.

CONCLUSIONCompared with clopidogrel without CCB, clopidogrel with CCB does not increase the mortality or composite thromboembolic events in elderly CAD patients, but clopidogrel combined with non-dihydropyridine CCB is associated with significantly increased composite thromboembolic events in comparison with dihydropyridine CCB.

Aged ; Aged, 80 and over ; Calcium Channel Blockers ; therapeutic use ; Cohort Studies ; Coronary Artery Disease ; drug therapy ; Drug Therapy, Combination ; Humans ; Middle Aged ; Propensity Score ; Retrospective Studies ; Ticlopidine ; analogs & derivatives ; therapeutic use

Objective To report our first clinical experience with a novel modified culotte technique for the treatment of true coronary bifurcation lesions. Methods The novel modified culotte technique (the mono-ring culotte) stenting was done in which the side branch (SB) stent was deployed firstly followed by ex vivo wiring of a most proximal cell of SB stent with the hard end of main branch (MB) wire. Secondly, the MB stent was deployed through the most proximal cell of SB stent. The procedure was ended with kissing balloon dilation. From June 2014 to March 2015, 15 patients with true coronary bifurcation lesion were treated with mono-ring culotte stenting in our center. Results The procedures were successful in all cases without procedural complication and in-hospital major adverse cardiovascular events. The procedural time was (34. 3 ± 9. 6) min, fluoroscopic time was (18. 1 ± 3. 8) min, and contrast volume was (112. 0 ± 24. 5) ml, respectively. Post-procedurally, the residual stenosis of the main and the side branch were (10. 0 ± 2. 5)% and (10. 2 ± 5. 3)% , respectively. Conclusions The mono-ring culotte stenting is safe and feasible for treatment of true coronary bifurcation lesions, and may be superior to the conventional culotte stenting.

OBJECTIVE: To investigate the long-term effect of nasal airflow deprivation on nasal dimensions after total laryngectomy. METHOD: Thirty-two patients with total laryngectomy were enrolled in the study. Acoustic rhinometry was used to measure the minimum cross-sectional area (MCSA) and the volume of the nasal cavity after laryngectomy, compared with the normal control group. In addition, patients underwent endoscopic nasal examinations and answered questionnaires postoperatively, symptoms between the different levels to compare the results of acoustic rhinometry. RESULT: At both within 1-year and more than 1-year follow-ups, the mean MCSAs and the mean nasal volumes were significantly expanded than the control values (P < 0.05). The nasal MCSA, nasal cavity volume was no significant difference between more than one year and less than 1 year group (P > 0.05). The endoscopic examinations revealed only a deterioration in the appearance of the nasal mucosa over the long term. Survey showed that the postoperative patients had varying degrees of nasal obstruction flu, nose dry, hyposmia, etc. The nasal MCSA, nasal cavity volume was of the largest when moderate nasal obstruction flu,or severe dry nose or severe hyposmia. CONCLUSION The structure was atrophic nasal change, the nasal MCSA, nasal cavity volume were larger, the results of acoustic rhinometry was different among the varying degrees of symptoms after total laryngectomy.
Aged ; Case-Control Studies ; Female ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Postoperative Period ; Rhinometry, Acoustic

OBJECTIVE: To establish reference values of acoustic rhinometry, rhinomanometry and rhinospirometer in healthy adults in Tianjin area, analyze the effects of age,sex and side on the value, investigate the correlation of the measure values, offer the diagnosis date for test nasal ventilation function in Tianjin area. METHOD: Four hundred and sixty-six healthy adults in Tianjin area were tested. A1 acoustic rhinometry was used to measure the minimum cross-sectional area (MCA), distance of the minimal cross-sectional area to the nostril (DCAN) and the nasal volume from 0-5 cm, 2-5 cm (V5, V2-5); At 150 Pa, 75 Pa and broms, NR6 Rhinomanometry was used to measure unilateral nasal inspiratory resistance (IR)and expiratory resistance (ER), bilateral nasal inspiratory and expiratory resistance (TIR and TER), and differences of the bilateral nasal resistance can be calculated; NV1 Rhinospirometer was used to measure unilateral inspiratory capacity (IC) and expiration capacity (EC), and the nasal partitioning ratio (NPR) can be calculated. Practical measure the distance of nostril to ahead of the inferior turbinate and compare with DCAN. Make the correlational analysis on different index of three exam. RESULT: Reference values of acoustic rhinometry: MCA was (0.45 +/- 0. 16) cm2 for male, (0.44 +/- 0.16) cm2 for female; V2-5 was (3.52 +/- 1.38) cm3 for male, (3.36 +/- 1.22) cm3 for female, V5 was (5.10 +/- 1.47) cm3 for male, (4.86 +/- 1.12) cm3 for female; DCAN have two distance, (2.22 +/- 0.398, 0.53 +/- 0.625) cm was for male, (2.10 +/- 0.37, 0.67 +/- 0.15) cm was for female. No significant gender, side and age differences were shown in MCA, V5, V2-5. Significant gender differences were shown in DCAN but no side and age differences. Reference values of rhinomanometry: Significant gender but no side and age differences were shown in IR, ER, TIR, TER. Reference values of rhinospirometer: IC was (2.06 +/- 1.10) L/20 s for male, (1.37 +/- 0.34) L/20 s for female, EC was (2.15 +/- 1.23) L/20 s for male (1.39 +/- 0.58) L/20 s for female. NPRi was 0.11 [0.05, 0.23],NPRe was 0.11 [0.05, 0.19]. Significant gender but no side and age differences were shown in IC and EC. No gender and age differences were shown in NPRi and NPRe. There was significant correlation found between MCA and IR/ER/IC/EC, IR and IC, ER and EC, Rlr and NPRi/ NPRe. CONCLUSION Acoustic rhinometry,rhinomanometry and rhinospirometer can be useful reference values to evaluate nasal ventilation function, more value will be found if use the three together.
Adolescent ; Adult ; Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; physiology ; Nasal Mucosa ; physiology ; Nose ; physiology ; Reference Values ; Respiration ; Rhinomanometry ; standards ; Rhinometry, Acoustic ; standards ; Young Adult

ObjectiveTo systematically evaluate the safety of Tianzhi granules used in the treatment of mild-to-moderate vascular dementia. MethodA randomized， double-blind， double-simulated， positive drug/placebo parallel controlled multi-center phase Ⅳ clinical trial and an open multi-center phase Ⅳ clinical trial of Tianzhi granules in the treatment of mild-to-moderate vascular dementia were conducted. Safety data of 1 492 patients were included and analyzed according to inclusion and exclusion criteria. The main evaluation measures were the incidence rate of adverse events/adverse reactions， laboratory indicators， vital signs， and electrocardiogram （ECG） results. ResultA total of six adverse events possibly related to the test drug occurred in 520 patients of the double-blind trial， and the symptoms were all mild and recovered. The incidence of adverse events was not statistically different among Tianzhi granules， donepezil， and placebo groups. Nine adverse events possibly related to the test drug were observed in 972 patients of the open trial， and the symptoms were mild and recovered. Laboratory tests （blood routine， urine routine， liver function， kidney function， and coagulation） and vital signs were compared before treatment （baseline） and after treatment of 12 and 24 weeks， respectively. There was no statistical significance in the main indicators before and after treatment. In the double-blinded trial， there was no significant difference in safety indicators between different groups before and after treatment. The most frequent adverse reaction was gastrointestinal discomfort， with an incidence rate of 6.64‰. ConclusionAdverse reactions occasionally occur in patients using Tianzhi granules， and it is safe to use Tianzhi granules to treat mild-to-moderate vascular dementia clinically.