Objective To analyze the long-term results of fractionated stereotactie radiotherapy(FSRT)for the local residual lesion after the first course of radiotherapy for nasopharyngeal carcinoma.Methods From July 1997 to July 2002,46 patients were treated with FSRT.According to the 1992 Fuzhou staging system,the number of patients was 1,6,30 and 9 with stage Ⅰ,Ⅱ,Ⅲ and Ⅳ disease,respectirely;3,11,27 and 5 with T1,T2,T3 and T4 tumor,respectively;14,16,12 and 4 with N0,N1,N2and N3 disease.Radiotherapy was delivered to tumors with the total of dose 68-70 Gy in 7-8w.Chemotherapy(2 cycles of PVF or POF)was given to the patients with stage Ⅲ and Ⅳ a disease.FSRT was given to the residual disease with the total dose of 18-24 Gy in 3 fractions with an interval of 3-7 days.The reference dose line was 70%-90%.Resuits CR and PR rates in this group were 61%and 39%,respectively.The overall survival rates of each year from 1- to 5-year were 100%,87%,83%,78%and 76%.The 1-,3- and 5-year disease-free survival rates were 100%,93%and 89%;The distant metastasis-free survival rates were 100%,85%and 79%;The local-regional control survival rates were 100%,94%and 91%.Seventeen patients who died during the follow-up period were 1 for local cervical lymph node recurrence,2 for fatal nasopharyngeal hemorrhage,4 for local nasopharynx recurrence,and 10 for distance metastases. Conclusions Fraetionated stereotactic radiotherapy is safe and effective for the patients with residual lesion of nasopharyngeal carcinoma at the primary site after radiotherapy.The optimized fractionation and total dose requires the further investigation.

Objective To study and estimate the effective dose of interventional employees in the common cerebralvascular, cardiovascular and liver interventional diagnosis and treatment.Methods The absorbed doses of tissue or organ of anthropomorphic phantom in these three procedures were estimated by the anthropomorphic phantom experiment.The effective doses were calculated by the tissue weight factor which was given by International Commission on Radiological Protection publication 103.Results The effective doses to high, medium and low group were 24.0, 9.7,6.8 μSv for cerebralvascular interventional diagnosis and treatment, and 36.3, 29.3, 17.8 μSv for cardiovascular interventional diagnosis and treatment, and 23.9, 11.3, 5.5 μ Sv for liver interventional diagnosis and treatment, respectively.Conclusions The effective doses of high, medium and low group of interventional employees in cardiovascular interventional procedure are higher than those of cerebralvascular and liver interventional procedures.

Background and purpose:The greastest diameter of cervical cancer with stage Ⅰ_(b2) disease was more than 4 cm in diameter. surgery as the fi rst priority was diffi cult in these patients, bleeding was the most frequent adverse effect. This article studied the effect of the cervical cancer with stage Ⅰ_(b2) disease underwent neoadjuvant chemotherapy with gemcitabin plus cisplatinum(DDP). Methods:23 cases (A groups) stage Ⅰ_(b2) cervical cancer were treated with gemcitabin 1.5 g/m2 iv infusion at d1, plus cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3. The interval between the two cycles was two weeks.19 cases (B groups) were treated with cisplatinum(DDP) 20 mg/m2 iv infusion at d1-3,plus VCR 1.5 g/m2 iv infusion at d1, and BLM 10 mg/m2 im at d1-3, The interval between the two cycles was three weeks. The assessment for clinical effect and side effect were conducted for the patients with completion of at least two cycles of chemotherapy. Results:42 cases were enrolled in this trial. There was signifi cant(P=0.004) difference between the two groups with the shrinkage of the greatest diameter after neoadjuvant chemotherapy. The main toxicities were myelosuppression. There was signifi cant (P

Objective To analyze the therapeutic outcomes and adverse effects of high-dose intravenous immunoglobulin (hd-IVIg) in the treatment of some severe skin diseases (toxic epidermal necrolysis, drug hypersensitivity syndrome, connective tissue disease, autoimmune bullous disease, acute graft-versus-host disease). Methods Twenty-five cases of severe skin diseases were treated with hd-IVIg (0.4 g/kg/day for a course of 5 days). Results The therapeutic outcomes were different from each other. Of all the cases, 21 improved, especially those of acute onset of toxic epidermal necrolysis and drug hypersensitivity syndrome; 1 adult dermatomyositis and 2 elder bullous pemphigoid were not relieved. A patient with acute graft-versus-host disease died. Three patients presented with minor adverse effects (headache and blood pressure rising). Conclusions hd-IVIg is effective and safe in the treatment of some severe skin diseases. More importantly, it has a substantial effect on shortening disease course and decreasing the dosage of glucocorticoids and immunosuppressants as well as on preventing infections.

Objective To study whether the uremic toxins accumulated long-term in uremia patients may be involved in oxidation of protein by forming advanced oxidative protein products (AOPPs). Methods Malonylaldehyde (MDA), hippuric acid (HA) and p-cresol were used as the representatives of uremic toxins. Human albumin serum (HSA), plasma specimens from normal or uremia patients were incubated respectively with MDA (10 retool/L), HA (20 mmol/L) and p-cresol (10 retool/L) or PBS (20 retool/L, pH 7.4, as control groups) at 37℃ for 30 minutes or 24 hours, respectively. Those indices such as AOPPs, protein thiol groups (Pt-SH) and dityrosine were used as biomarkers of protein injury. High performance liquid chromatography (HPLC) was employed to identify the aggregation and cross-links of modified proteins. Results AOPPs levels in all groups containing poison compounds were significantly increased by 121.5%(P<0.05) compared to that in control groups. Uremic toxins also resulted in over 14.7% loss in Pt-SH (P< 0.05) and 119.2% increment in dityrosine, respectively (P<0.05). Meanwhile, the formation of HMW-AOPPs in a time-dependent manner was observed by HPLC and cross-linked protein levels were significantly increased by 148.45%～333.3% in comparison with control groups. Conclusion Uremic toxins can directly mediate the damage of proteins by inducing the formation of HMW- AOPPs in a time-dependent manner, which is also one of the mechanism of AOPPs production in vivo besides the activation of the myeloperoxidase-H2O2-Cl pathway.

Objective: The present study investigates the effects of Tanreqing injection, a compound Chinese herbal medicine, on the proliferation of leukemia cells in vitro and discusses the potential mechanisms. Methods: Tanreqing injection was diluted to a series of concentrations (1:2, 1:4, 1:8, 1:16, 1:32, 1:64, 1:128, 1:256 and 1:512) by volume and then independently applied to treat chronic myeloid leukemia K562 cells and T cell acute lymphocytic leukemia Molt4 cells at the proliferative stage. Cell growth was observed at different time intervals under a microscope. Cell proliferation was determined by cell counting kit-8 assay and the survival curve was delineated. The inhibitory rate and the half inhibitory concentration (IC50) were calculated. Molt4 cells were stained with propidium iodide (PI) and PI/Annexin V and then the cell cycle and apoptosis were analyzed by using flow cytometry. In addition, a real-time quantitative polymerase chain reaction was subjected to detect the expressions of apoptosis-related genes (bcl-2 and caspase-3) after Tanreqing treatment. Results: Tanreqing injection had inhibitory effects on the proliferation of K562 cells and Molt4 cells. The most toxic concentrations were observed between 1:2 and 1:16 where cells were almost necrotic. The inhibitory effect manifested in a concentration- and time-dependent manner. The IC50 of K562 and Molt4 was 1:333 and 1:142, respectively. After 1:32 Tanreqing injection treatment for 72 h, the number of Molt4 cells in the S phase significantly decreased (P<0.05), and the apoptosis rate markedly increased (P<0.05). In addition, increased caspase-3 expression and decreased bcl-2 expression were also observed (P<0.05). Conclusion: Tanreqing injection can both inhibit the proliferation and promote the apoptosis of leukemia cells in vitro, whereby the potential mechanism seems to be mediated in part by decreasing S phase ratio, down-regulating bcl-2 expression and up-regulating caspase-3 expression.

Objectives To provide reference for the improve of health care system and healthcare insurance con-trolling method, through researching on the value-based healthcare paying system in South Korea. Methods The basic characteristics of the Korean health care system was researched, Specifically, its reform experiences of value-based health insurance review and assessment paying system,which government took. Results South Korea’s health care pay-ing system had achieved both good social and policy effects. Conclusions Value-based health care paying system is the main reason for the reducing of health care expenditures and making of scientific health policy.

Objective To observe the effect of cinobufotalin freeze-dry powder on heart rate ( HR ) and electrocardiogram ( ECG) of SD rats and to provide experimental basis for monitoring its adverse effect on heart in clinical application. Methods The drug was administered into external jugular vein at constant speed throughout the whole experiment;standard-Ⅱ limb lead monitored the HR and ECG, and then the changes in HR and ECG before and after administration of cinobufotalin were compared. Results Thirty minutes after administration of cinobufotalin injection and cinobufotalin freeze-dry powder at middle dose and high dose, HR of the rats was significantly increased as compared with blank control group[(469±40) bpm, (466±29) bpm and (484±40) bpm vs. (411±17) bpm] (P<0. 05), but soon afterwards, it returned to normal. A small number of rats also developed arrhythmia. In addition, administration of cinobufotalin significantly shortened the P-R interval[blank control group: (46. 90±3. 90) ms, cinobufotalin injection administration group: (39. 70± 2. 54) ms;middle dose of cnobufotalin freeze-dry powder administration group: (37. 70±3. 77) ms; high dose of cinobufotalin freeze-dry powder administration group:(39. 30±7. 12) ms] and Q-T interval[blank control group:(61. 29±9. 46) ms;middle dose of cinobufotalin freeze-dry powder administration group: (55. 13±4. 67) ms; high dose of cinobufotalin freeze-dry powder administration group:(51.75±11. 53) ms] (P<0. 05), but QRS and S-T were unchanged (P>0. 05). Conclusion Cinobufotalin freeze-dry powder has some side effects on rat heart and can increase HR, even lead to arrhythmia.

Objective To discuss the 3D reconstruction dual-source CT angiography (DSCT) in diagnosing nutcracker syn-drome,Methods 24 cases with known or suspected "nutcracker" syndrome were underwent with DSCTA and 3D recon-struction, left renal vein (LRV) were demonstrated and measured. Results Among 24 cases, 16 cases were diagnosed with "nutcracker" syndrome; the imaging demonstrated LRV were compressed. The angle between SMA and AO of 24 cases with "nutcracker" syndrome was abnormally acute(<45°). The angle A was 14°～38°, the average angle was 28.12°±7.92°. The angle A' was 11°～21°, the average angle was 16.46°±3.42°. Conclusion The 3D reconstruction DSCTA may be the most useful tool in diagnosing nutcracker phenomenon.

Objective To study the effects of oxidants on the structure of albumin. Methods Using both AOPPs and protein carbonyl content as indices. The oxidative stress level in normal controls and uremia patients was evaluated. Albumin in plasma was purified by HPLC and then was subjected to amino acids composition assay. Results Both AOPPs level and protein carbonyl content in uremic patients were significantly higher than those in controls (P