Objective To explore treatment effect of recurrent nasopharyngeal carcinoma ( NPC) with threedimensional conformal radiotherapy (3DCRT). Methods 43 cases were selected to treat with 3DCRT. The radiation method was 5 times each week,2Gy one time,one time each day,the total doses was(60-70)Gy/(30-35) times. The treatment effect of patients in the near future ,2 years survival rate and radiation complication were observed. Results One month after 3DCRT, then re-check, the results showed that complete relief rate was 58.1% (25/43) , partial relief rate was 30.2% (13/43) ,the total relief rate was 88.4% ,and 2 years survival rate was 69. 8% ,the local control rate in target area was 92.2%. But 2 cases were deaf, 1 case had oral inflammation. Conclusion With 3DCRT, recurrent NPC patients had well near future treatment effect and survival rate,furthermore,the radiation injury was rather low.

Objective To investigate the efficacy and safety of induction chemotherapy(DDP + 5-FU)followed by concurrent chemo-radiotherapy(CCRT)in patients with locoregional advanced nasopharyngeal carcinoma (NPC).Methods 42 patients with locoregional NPC were enrolled in the study.Before CCRT,patients were assigned to receive two cycles of chemotherapy(DDP 20mg/m2 d1～5 ;5-FU 750mg/m2 d1～5)every three weeks.Then the same chemotherapy was given from the first day of standard radiotherapy.Results All patients completed planned treatment and were eligible for toxicity and response analysis.After induction chemotherapy,9 patients achieved complete response in nasopharynx and 12 patients achieved CR in regional nodes;Three months after radiotherapy,41 patients achieved CR in nasopharynx and 34 patients achieved CR in regional nodes.Induction PF was well tolerated and the most common acute high-graded toxicity of CCRT was grade Ⅲ mucositis(35.7％)and grade Ⅲ vomiting (16.7％).At median follow-up of 15 months,the overall survival rate was 100％,two-year cumulative local recurrence rate was 4.8％ and distant metastasis rate was 2.4％.Conclusion Induction PF chemotherapy plus concurrent chemo-radiotherapy was tolerable and satisfactory for patients with locoregional NPC.

Objective To investigate the clinical effect of three-dimensional conformal radiotherapy combined with XELOX program chemotherapy for postoperative abdominal lymph nodes metastasis of gastric cancer.Methods Seventy-one patients with postoperative abdominal lymph nodes metastasis were divided by random digits table method into treatment group (36 cases) who treated with three-dimensional confomal radiotherapy combined with XELOX program chemotherapy and control group (35 cases) who treated with XELOX program chemotherapy.The short-term efficacy,the control rate of symptoms,the long-term survival rate and adverse reaction were observed in two groups.Results The complete remission rate and objective response rate in treatment group and control group were 36.1％(13/36),20.0％(7/35) and 77.8％(28/36),60.0％(21/35),respectively,there were significant differences between two groups (P ＜0.05).The overall control rate of abdominal pain,bloating,low back pain in treatment group was 80.6％ (29/36),significantly higher than that in control group [51.4％(18/35) ](P ＜ 0.01 ).Followed up for 2 years,the followed up rate waa 97.2％(69/71 ).The 1,2-year survival rates in treatment group and control group were 42.9％ (15/35),22.9％(8/35) and 20.6％(7/34),5.9％(2/34),respectively,and the median survival time was 11.6 months and 4.9 months,there were significant differences between two groups(P ＜ 0.01 ).The incicdence rates of bone marrow suppression and gastrointestinal tract in treatment group were obviously higher than those in controlgroup (P ＜ 0.01 ),and the symptoms all were improved after treatment.Conclusions Postoperative lymph nodes metastasis of gastric cancer is sensitive to concurrent chemoradiotherapy.Concurrent chemoradiotherapy can improve the short-term efficacy and prolong survival time,but the adverse reactions increase.

Objective To explore the clinical characteristics,imaging features and the cause of misdiagnosis and mistreatments of nasopharyngeal cancer in children.Methods There were 12 cases of children with comfirmed nasopharyngeal cancer in this study.The clinical charactersitics,imaging features,the causes of misdiagnosis and mistreatments and defined diagnostic methods were analyzed retrospectively.Results In majority of patients,the first symptoms were neck mass(8 cases),headache(6 cases),epistaxis(5 cases),tinnitus and lower hearing(4 cases),face-ache(3 cases),poor,double vision and strabismus(3 cases).Some of the children existed two or more symptomsprobably(8 cases).On the images,the nasopharyngeal tissue was invaded in varied degrees and appeared as irregular mass,cervicallymphadenectasis,skull base or intracranial invaded.Tumors had enhancement variantly.Among 10 misdiagnosed cases,4 patients weremisdiagnosed as cervical lymph node tuberculosis,3 cases as angioneurotic headache,2 cases as nasosinusitis,1 case as otitis media.Conclusion Imaging examinition was an important method in diagnosing of nasopharyngeal cancer in children.Main misdiagnostic causes are not enough understanding this disease in children and atypical symptoms at beginning

Objective To investigate the correlation between behavioural and psychological symptoms and cerebral white matter lesions (WMLs) in patients with Alzheimer's disease (AD). Methods Sixty patients with AD aged more than 60 years (AD group) and 40 age-, sex-matched subjects with normal cognitive function (control group) were recruited. data of cerebral CT were analyzed blindly. The sum of WMLs in 8 regions, such as bilateral frontal region, parieto-occipital region, temporal region, and subtentorial region, etc were used as the total score of WMLs, and the cerebrovascular lesions revealed on CT were detected. The AD group was assessed with the Neuropsychiatric Inventory (NPI). Results There were significant differences in total WML score (1. 450 ±2. 310 vs. 9. 640 ± 1. 566, P =0. 000), left frontal WMLs (0. 340 ± 0. 340 vs. 1. 720 ± 0. 248, P = 0. 001), fight frontal WMLs (0. 310 ±0. 560 vs. 1. 680 ±0. 312, P =0. 001), left parieto-occipital WMLs (0. 240 ±0. 360 vs. 1. 550 ±0. 244, P =0. 012), right parieto-oecipital WMLs (0. 140 ±0. 230 vs. 1. 450 ± 0. 231, P = 0. 006) and cerebrovascular lesions (0. 120 ± 0. 330 vs. 2. 230 ± 0. 378, P = 0. 002) hetwsen the AD group and the control group. Spearman correlation analysis showed that NPI was correlated with the total WML score (rs =0. 487, P = 0. 016), left frontal WMLs (rs =0. 490, P = 0. 014), right frontal WMLs (rs = 0. 502, P = 0. 014), left parieto-occipital WMLs (rs =0. 507, P =0. 012) and right parieto-occipital WMLs (rs =0. 521, P = 0. 014), and it was not correlated with the cerebrovascular lesions (rs = 0. 132, P = 0. 590).Conclusions WMLs and cerebrovascular lesions are essential in the onset of AD and disease development. WMLs are closely correlated with the behavioural and psychological symptoms in patients with AD.

Objective　To further investigate the balance (relative presence) of Th1 and Th2 subsets at the sites of rheumatoid inflammation,and to understand how about the expression of IL-18 in patients with rheumatoid arthritis (RA),and what the relationship exists between expression of IL-18 and rate of Th1/Th2 in RA,and between IL-18 level and activity of the disease.Method　Expression of IFN-γ,IL-4,and IL-18 mRNA in peripheral blood mononuclear cells (PBMC) from 16 patients with RA and 15 healthy subjects was detected by semi-quantitative RT-PCR.Results　① PBMC from patients with RA was found to contain greater levels of IL-18 mRNA than that from healthy subjects (P＜0.01).② IL-18 mRNA levels were correlated with IFN-γ mRNA (relative coefficients:r＝0.836,P＜0.05).③ IL-18 mRNA levels were associated with the disease activity as assessed by levels of erythrocyte sedimentation rate (r＝0.753,P＜0.05).Conclusion　IL-18 is among a matrix of inflammatory cytokines produced abundantly in patients with RA and is associated with induction of IFN-γ and activity of the disease.

Objective To investigate expressions of microRNA-21 (miR-21),PTEN,NF-κB,and caspase-9 in colon carcinoma and their possible mechanisms in progression of tumor.Methods Expressions of above-mentioned indexes and percentage of apoptotic cells in colon carcinoma,colon adenoma,and normal tissue specimen were detected.Results Expressions of miR-21,PTEN,N F-κB,and caspase9 in normal tissue were 0.39 ±0.02,50％,25％,and 50％.Expressions of them in colon adenoma were 0.62 ±0.06,50％,35％,and 55％,and those in colon carcinoma were 0.88 ±0.04,30％,75％,and 20％.Percentage of apoptotic cells were (24.64 ± 7.66) ％,(15.86 ± 1.44) ％,and (6.20 ± 2.57) ％,respectively.The above P-values were all less than 0.05.Expression of miR-21 was positively correlated with TNM stage,depth of infiltration,differentiated level and expression of NF-κB while inversely correlated with PTEN and caspase-9 expressions and percentage of apoptotic cells.The r-values were 0.647,0.297,0.259,0.519,-0.299,-0.388,and-0.931,respectively.Conclusions Hyperexpression of miR-21 participated in progression of colon carcinoma probably through down-regulating expressions of PTEN and caspase-9 and up-regulating expression of NF-κB and then suppressing cell apoptosis.

Objective To compare the effect of myomectomy and uterine artery embolization in the treatment of uterine fibroids .Methods 158 patients who were pathologically diagnosed uterine fibroids were randomly divided into the uterine artery embolization group and myomectomy group ,79 cases in each group .The blood loss 3 days after operation,pelvic pain and pressure symptoms ,hospitalization time,follow-up and time of normal activity were recorded and compared.Results The pelvic pain,pressure symptoms,hospitalization time,cure rate,incidence rate of compli-cations and recurrence rate of the two groups had no statistically significant differences ( t=1.21,0.97,1.06,χ2 =0.98,1.21,1.32,all P>0.05).The postoperative bleeding score ,time of return to normal activity in the uterine artery embolization group were (5.8 ±0.5) points,(9.8 ±1.8) d,which were better than those of the myomectomy group[(4.9 ±0.4)points,(25.9 ±5.1)d](t=3.76,5.98,all P<0.05).Conclusion The effect of the myomec-tomy and uterine artery embolization treatment for uterine leiomyoma is similar ,and both have high efficiency and safe-ty,but the uterine artery embolization treatment has less impact on the body of patients .

Objective To study the effect of three different kinds of intervenient measures for TB control on the disease burden of TB patients. Method The estimating method of disability adjusted life years(DALY) as recommended by the WHO was used to assess the disease burden of TB patients. Result The average disease burden of new and retreated TB patients covered by the international TB program(ITP) was the lightest, with the loss of 0.31 DALY and 0.62 DALY respectively; the average disease burden of new and retreated TB patients covered by the national TB program(NTP) was intermediate, with the loss of 0.42 DALY and 0.59 DALY respectively; and the average disease burden of new and retreated TB patients from areas using conventional TB therapy(CTT) was the heaviest, with the loss of 0.61 DALY and 0.91 DALY respectively. From a social perspective, the average yearly loss of DALY per thousand TB patients in the ITP, NTP and CTT areas was respectively 16.42, 33.6 and 37.36, with the loss in the NTP areas being 2.05 times as much as that in the ITP areas and the loss in the CTT areas being 2.28 times as much as that in the NTP areas. Conclusion ITP was far superior to NTP and CTT in reducing the disease burden of TB patients, achieving better results both from the perspective of TB patients and the society.

Objective To study the effect of different intervenient measures for TB control on disease financial burden. Method A survey was conducted of the expenses incurred on 1 700 new and retreated TB patients from areas covered by the World Bank project, the Ministry of Public Health project, and non project areas where intervenient measures were also taken. The method of economic estimation was used to explore the disease financial burden carried by the patients families and society. Result The average family disease financial burden is as follows: 1 735 yuan for a new case and 2 755.99 yuan for a retreated case in the international TB program(ITP); 2 669.27 yuan for a new case and 3 530.17 yuan for a retreated case in the national TB program(NTP); and 6 787.02 yuan for a new case and 7 276.10 yuan for a retreated case in the non project areas using conventional TB therapy(CTT). The average social disease financial burden is as follows: 4 735.55 yuan in ITP; 6 471.91 yuan in NTP; and 10 919.96 yuan in CTT. Conclusion The disease financial burden was the lowest in ITP, highest in CTT, and intermediate in NTP.