Aim To develop a modified model of subarachnoid hemorrhage in rats. Motheds The SAH model was induced by injecting autologous blood into the cisterna magna without exposing the occipitoaxial ligament.The main modified point was a hole bored by a dental drill at the middle point of the boundary between the parietal bone and the occipital bone,then a catheter was inserted 8 mm to cisterna magna and the autologous blood was injected . Hemorrheological parameters were measured after the model was created.The intrinsic oversxidase method was used to show the microvessel of CA_1 region. The diameter, density ,and the aera of microvessel were measured and ananlyzed by Image-Pro Plus image analysis system. Results The total blood viscosity(?b) and erythroagglutation index(AL) in SAH model group increased significantly,however,the microvesse area and microvesse density in SAH model group decreased obviously. Conclusion The modified model of subarachnoid hemorrhage in rats is reliable and easy to operate on.

Objective In the previous study completed in Korea, early three-dimensional conformal radiotherapy concurrent with chemotherapy in rectal cancer after radical surgery demonstrated a better prognosis compared with late radiotherapy. However, with the report of MOSAIC trial, the adjuvant chemotherapy regimen had transferred from 5-Fu alone to combined 5-Fu and Oxaliplatin. We need more evidence to clarify the best radiotherapy timing during the whole period of adjuvant therapy . Methods Patients who met the following criteria were accrued in this study: 18-70 years old, lower anterior resection,pathologically proven rectal adenocarcinoma, stage T3-4 and/or N+, no evidence of distant metastases and KPS≥70. Three dimensional conformal Radiotherapy was started at the fourth week after surgery, which included 45 Gy whole pelvic radiation following by 6-10 Gy tumor bed boost. Oxaliplatin of 50 mg/m2 weekly and Xeloda 625 mg/m2 twice a day, every week from d1-5 were used concurrent with radiotherapy.Toxicity was evaluated and graded by common toxicity critera version 3. 0. The study was designed as Simon two-phase design, in the first phase, a total of 15 patients were accrued, and if more than or equal to 9 patients had grade 3 toxicity, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Otherwise, another 15 patients of the second phase were accrued, we would have 85% power to confirm the high toxicity of more than 50% if 18 out of 30 patients had grade 3 toxicity. Results From July 2008 to December 2008, 15 patients were treated with early radiotherapy concurrent with combined chemotherapy, Grade 3 gastrointestinal toxicity occurred in 12 patients and Grade 3 hematologic toxicity occurred in 2 patients. According to Simon design, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Conclusions For locally advanced rectal cancer patients, whole pelvic radiotherapy concurrent with oxaliplatin and xeloda had severe toxicities. Further studies are needed to decrease toxieities.

Objective To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T_3/ N +, staging Ⅱ - Ⅳ. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4.46, P = 0.000 ; t = - 3.45, P =0.000). Conclusions In the irradiation of post-operative gastric cancer, the maximum displacement of organ motions induced by respiration is in S-1 direction and the minimum in R-L direction under free breathing. The use of ABC can reduce the motions significantly in S-I and A-P directions, and the same changes exist in both inter-and intra-fraction treatment.

Objective To compare the dose distribution of the target and normal tissues in gastric cancers between three-dimension conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) plan when respiratory motion factors integrated in the plan. Methods From January 2005to November 2006, 10 patients with post-operatively radiation of gastric cancer were enrolled in this study.Planning CT were acquired conventionally with free-breath mode and the static treatment plans of the 3DCRT and IMRT were designed respectively. Probability distribution functions (PDF) were generated and convoluted with the static dose distributions from 3DCRT and IMRT plans to obtain the integrated plans. The dose distributions of the target and normal tissues were compared between 3DCRT and IMRT integration treatment plans, such as V45 of clinical target volume, V4o of liver and V15, V18 of left and right kidney.Results In the respiratory integrated treatment planning, the target volume coverage and homogeneity with IMRT are superior to those with 3DCRT ( ( V45 98%∶ 87% (t = -3. 35 ,P =0. 010) ,mean dose 46. 81 Gy ±0. 75 Gy∶45.99 Gy ± 1.12 Gy (t = -0. 31 ,P=0. 020) ). The V40 of teh liver in IMRT are smaller than those in 3DCRT ( 12%∶ 16% ;t=3.75,P=0.010). For the left kidney, the V15 and V18 in IMRT are smaller than those in 3DCRT ( (34%∶ 50% (t = 2. 17 ,P = 0. 050) and 27%∶46% (t = 3. 11 ,P = 0. 020) ),but for the right kidney, V15 and V18 in 3DCRT are smaller than those in IMRT ( ( 15%∶ 21% (t = - 2. 42,P=0.040) and 11%∶15% (t= -2.71,P=0.030)). Conclusions When respiratory motion factor integrated in the treatment plan, IMRT showed advantage both in target coverage and normal tissue sparing in the high dose region of liver and left kidney.

Objective To investigate the distribution of pelvic recurrence in rectal cancer after radical resection and analyze the outcome and prognostic factors of pelvic recurrent rectal cancer treated with radiotherapy. Methods Ninety-three patients with pelvic recurrent rectal cancer who received radiotherapy from August 2000 to August 2006 were retrospectively analyzed. Of them, 21 patients received pelvic radiation alone;56 received pelvic radiation plus chemotherapy and 16 received pelvic radiation plus surgery and/or chemotherapy. Radiotherapy was delivered with 60Coγor 6/15 MV X ray to a median dose of 59. 4Gy (range,20-74 Gy). Conventional fractionation was used in 90 patients. Chemotherapy was given to 68patients with a median number of 3 cycles ( range, 1 - 8 cycles). Concurrent chemo-radiation with 5-FU based regimen was given to 42 patients. After radiotherapy, 16 patients underwent surgical resection, with 7R0 resection and 9 palliative resection. Results The entire cohort included 132 recurrent sites. The most common recurrent sites were peri-rectal region ( 31.8% ), pre-sacral region ( 30. 3% ) and internal iliac nodal region (20. 2% ). The follow-up rate was 92% for the entire cohort, 39 and 4 patients had minimum follow-up time of 2 and 5 years respectively. Overall clinical response ( complete and partial symptomatic relief) was achieved in 83% of the patients after radiation therapy. The 2-and 5-year local progression-free survival rates were 49% and 22% respectively, and the 2-and 5-year overall survival rates were 46% and 14% respectively. Multivariate analysis showed that treatment modality was the independent prognostic factor for local progression-free survival. Patients treated with radiation plus surgery and/or chemotherapy had better local progression-free survival than those treated with radiation plus chemotherapy or radiation alone.Recurrent tumors larger than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were independent unfavorable prognostic factors for overall survival. Conclusions Perirectal region, pre-sacral region and internal iliac nodal region were the most common pelvic recurrent sites in rectal cancer. Radiotherapy is an effective palliative approach for patients with pelvic recurrent rectal cancer.Radiotherapy plus surgery and/or chemotherapy was associated with better local progression-free survival,and recurrent tumors lager than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were unfavorable prognostic factors for overall survival of pelvic recurrent rectal caner.

Objective To investigate the value of one-stage lymphatics-venous anastomosis in radical mastectomy of breast cancer to prevent post-mastectomy upper limb lymphedema.Methods Ninety patients requiring radical mastectomy of breast cancer in Tangshan Tumor Hospital Affiliated to North China University of Science and Technology from March 2010 to May 2013 were collected as the objects.They were divided into the control group (45 cases) and the treatment group (45 cases) using block randomized grouping (concealment of allocation).Both groups underwent radical mastectomy of breast cancer, and the treatment group was treated with one-stage lymphatics-venous anastomosis on the basis of radical mastectomy.The operation times, amount of bleeding, hospitalization times, postoperative complications and the numbers of axillary lymph node dissection of the patients in the two groups were compared, and the postoperative upper limb lymphedema incidence rates of the patients in the two groups were compared.Results The operative times of the patients in the treatment group and the control group were (152.82 ± 18.76) min and (78.92 ± 10.33) min respectively, and amount of bleeding were (416.64 ± 94.65) ml and (250.84 ± 63.17) ml, with statistical significances (t =-20.39, P =0.00;t =-4.48, P =0.00).The average hospitalization times of the patients in the treatment group and the control group were (14.91 ± 5.44) d and (13.45 ± 2.36) d respectively, the numbers of axillary lymph node dissection were 14.63 ± 3.37 and 14.37 ± 3.18, the numbers of postoperative complications occurred were 9 cases (20.00％) and 5 cases (11.11％), with no statistical significances (t =-0.47, P =0.64;t =0.75, P =0.46;x2 =1.35, P =0.38).Compared with the control group, the treatment group has lower incidence of upper extremity lymphedema (13.95％ vs.40.91％) and lower swelling degree, with statistical significance (x2 =8.48, P =0.03).Conclusion One-stage lymphatics-venous anastomosis in radical masteetomy of breast cancer can effectively transfer lymph diversion to the venous circulation and reduce the incidence of limb lymphedema, which has significant preventive effect.

Objective To evaluate the effectiveness of the current measure of Oncomelania hupensis control in Jiangsu Province. Methods The snail control was carried out with molluscicides in the high transmission areas every year. Some snail habitat areas were modified. The snail areas within three years were re-treated with molluscicides in the maintenance phase. The snail survey was carried out every spring, and the data were analysed with SAS software. Results From 1995 to 2001, 14519.17 hm 2 of snail habitats were molluscicided, 2768.57 hm 2 were modified, and 8803.64 hm 2 were re-treated with molluscicides in the maintenance phase. The coverage rates of snail control areas dropped by 19.14% every year. The snail areas increased by 6.25% every year from 1995 to 2002. In which, the areas of infected snails increased by 18.52% every year. The correlation analysis showed that the areas of infected snails increased with the increasing of the total snail areas. At the same time, the areas of infected snails increased with the fall of the coverage rates of snail control areas. The analysis of the snail distribution showed that the main problem was poor snail control. Conclusion In recent years, the rise of area of snail habitats is serious in Jiangsu Province. The present measures of the snail control have not effectively stopped the spreading and increasing of snails. The research on the new molluscicides, the new methods of snail control and the better policies are very important.

Objective To identify the trend of endemic situation among surveillance sites in Jiagsu Province from 2000 to 2002. Methods Twelve schistosomiasis surveillance sites were es-tablished ,and the longitudinal, surveillance was carried out. Results The related index of snail increased in most of surveillance sites, the rates of positive snails rose rapidly in marshlands. The infection rates of Schitosoma janponicum of cattle decreased and infection rates of human were relatively steady. However, there was still the danger of heavy endemic. Conclusion Current control strategies can not effectively adapt to the endemic situation of schistosomiasis, although which have some effects on control of morbidity. We need to study the new characteristics and rule of the endemic of schistosomiasis, and make out more effective control strategies which can suit with the current society, economies and nature environment.

Objective To analyze the safety and effectiveness of photoselective green-light laser vaporization of the prostate(PVP)in treatment of large prostate with volume more than 80 ml. Methods Retrospective analysis was performed in 25 benign prostatic hypertrophy patients undergoing the PVP treatment,whose prostate volume was more than 80 ml.Results Twenty-five patients with prostate mean volume of 151.8(84.0-270.0)ml were treated by PVP and 23 cases were finished successfully.One operation was suspended because of bleeding and the other because of damaging orifice.No blood transfusion was needed and no“transurethral resection(TUR)syndrome”happened.Five cases had acute retention and 2 of them needed second PVP.In a mean of 7.9(3.0- 12.0)months follow-up,maximal urinary flow rate(Qmax),international prostate symptom score (IPSS),quality of life score(QOL),and prostate-specific antigen(PSA)level were improved significantly.The volume of prostate reduced after PVP than before PVP but no significant difference was found.Conclusions PVP is feasible in treating large prostate even the volume is more than 80 ml,although it needs better skill.Catheterization for some time is helpful in reducing the incidence of early postoperative acute urinary retention.

12E7 Antigen ; Antigens, CD ; metabolism ; Bone Neoplasms ; metabolism ; pathology ; surgery ; Cell Adhesion Molecules ; metabolism ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Hemangiopericytoma ; pathology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Pneumonectomy ; methods