Objective To study the characteristics and differential diagnosis of obsolete pulmonary tuberculosis accompanied withperipheral lung carcinoma.Methods CT findings of obsolete pulmonary tuberculosis accompanied with peripheral lung carcioma in 20 cases were retrospectively analysed.Results In 20 patients ,12 cases were diagnosed correctly because of them with typical CT findings of peripheral lung carcinoma,while 8 cases were misdiagnosed because of atypical CT findings of lung carcinoma.Conclusion Obsolete pulmonary tuberculosis accompained with peripheral lung carcinoma is common seen,atypical lung carcnioma is easily misdiagnosed.

Objective To investigate the effects of different reperfusion sequence on hepatic warm ischemia-reperfusion injury and its related mechanisms.Methods Ninety-six healthy male Sprague Dawley rats were randomly divided into 6 groups by using random digits method(n=16,each): Sham operation group,only shammed operation for negative control;the other 5 groups were all experimental groups,which were divided according to different reperfusion sequences of portal vein and hepatic artery: reperfusion first through the portal vein for 1 min with subsequent full reperfusion group,reperfusion first through the portal vein for 2 min with subsequent full reperfusion group,reperfusion first through the hepatic artery for 1 min with subsequent full reperfusion group,reperfusion first through the hepatic artery for 2 min with subsequent full reperfusion group,simultaneous reperfusion through the portal vein and hepatic artery group.Each group was further randomly divided into two subgroups(n=8,each) for sample collection at 2,4 hours after reperfusion respectively.Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST) and malondialdehyde(MDA),superoxide dismutase(SOD) and glutathion(GSH) in hepatic tissue were detected respectively.HE staining of histopathologic slides was used to observe the morphological changes of hepatic tissue.TUNEL method was used to assess the apoptosis index(AI) of hepatocytes.Results The liver of rat was approximately normal in the sham operation group with lower levels of ALT,AST,MDA and AI,and higher levels of SOD and GSH as compared with all the experimental groups(P

From 1975 to 1976,in Linxian county of Henan province,52 patients with early stage easophageal carcinoma were treated by radiotherapy alone. After 10-year follow-up, the 5-and 10-year surving rates were 73.1%(38/52) and 50.0%(56/52), respectively. Local recurrence was considered as the major cause of death and distance metastasis as the minor. We believe that it is very important to do the "three early "(find early, diagnose early and treat early ) and D T5000～5500cGy/5～5.5wks may be the best dose for radiotherapy alone for early easophageal carcinoma.

Objective The value of using partial spleen embolization (PSE) in the treatment of hyper-splenism. Methods Using mixed antibiotic 60% meglucamine diatrizoate, we injected tiny gelatinsponges as embolus to 34 cases of hypersplenism for making spleen artery embolization between 1989 and 2001. Results In the 34 cases of hypersplenism who used PSE, the 26 cases had gained CR(76.5%)and the 6 cases had gained PR(17.6%). The overall effective rate was 94.1%. Tracing the 26 cases who had gained CR, there were 7 cases relapsed. And the recurrence rate was 26.9%. Conclusion The using areas of PSE are wide. And the curative effect is exact. PSE can completely replace the operation of splenectomy with mastering skill and attending complication.

Scientific research process evaluation is important for scientific research management in Traditional Chinese Medicine (TCM) universities. We suggested the classification and refinement of the assessment form and the modifications of the evaluation index system, which could help improve the research process evaluation index for the TCM universities. Examples are provided to illustrate the effectiveness of the improved system. This provides reference for TCM universities to carry out the research process evaluation.

Objective To investigate the major clinical manifestations and their effect on prognosis in patients with posterior circulation stroke (PCS).Methods The clinical data of 129 consecutive hospitalized patients with acute PCS confirmed by clinical and imaging were registered prospectively,and they were followed up for 3 months.The patients were divided into a good prognosis group (modified Rankin scale [ mRS] score ≤ 2) and a poor prognosis group (mRS score ≥ 3) according to their mRS scores.Results 90.7％ patients had 4 to 12 symptoms and signs,only 1 presented an isolated symptom.The most common symptoms and signs were unilateral.Crossed paralysis (1.6％) or quadriplegia (0.8％ ) was rare.Univariate analysis showed that the symptoms of unilateral limb weakness (relative risk [RR] 1.262,95％ confidence interval [ CI] 1.030-1.546; P =0.030),slurred speech (RR 1.434,95％CI 1.133 - 1.816; P=0.004),dysphagia (RR 2.216,95％ CI 1.131 -4.341; P =0.017),and the signs of decreased unilateral muscle strength (RR 1.288,95％ CI1.047-1.583; P=0.021),central facial/tongue paralysis (RR 1.467,95％CI 1.164- 1.850; P=0.002),dysarthria (RR 1.468,95％CI 1.154- 1.867; P=0.002),ocular motor dysfunction (RR 3.073,95％CI1.346 - 7.017; P =0.005),and conscious disturbance (RR 5.736,95％ CI 1.268 - 25.946; P =0.023) were the risk factors for poor prognosis,while ataxia (RR O.478,95％ CI 0.284 -0.804; P =0.002) was associated with good prognosis.Multivariate logistic regression analysis demonstrated that after adjusted for all risk factors,the baseline National Institutes of Health Stroke Scale (NIHSS) (odds ratio [ OR] 1.513,95％ CI1.107-2.066; P=0.009),dysarthria (OR,7.11,95％ CI 1.207-41.877; P=0.030),ocular motor dysfunction (OR 8.653,95％ CI 1.230- 60.887; P=0.030),and large-artery atherosclerotic stroke (OR5.482,95％ CI 1.008 -29.803; P =0.049) were the independent risk factors for poor prognosis in patients with PCS,while ataxia (OR 0.251,95％ CI 0.067- 0.941; P=0.040) was independently associated with good prognosis of the patients.Conclusions The clinical manifestations in patients with PCS are complex,the majority of their symptoms and signs are unilateral.Most of the patients showed a variety of symptoms,and the isolated symptoms axe rare.Some symptoms and signs may indicate the prognosis of patients.

Background The pathogenesis of diabetic retinopathy (DR) involves a variety of biological pathways.Recently,inflammation factor has been thought to paly an important role in the pathogenesis of DR.Studies show that the concent of tumor necrosis factor-α (TNF-α) is increased in high-glucose environment,which leads to the abnormality of tight junction protein and follows by blood-retinal barrier (BRB) damage.Polysaccharides of dendrobium candidum (PDC) can inhibit the overexpression of TNF-α,but its effect on TNF-α in early DR procedure has been unelucidated.Objective This study was to investigate the effects of PDC on permeability of BRB and its mechanism in daibetic rats.Methods Fifty clear adult SD rats were divided into normal control group,diabetic model group and low-(100 mg/[kg · d]),moderate-(200 mg/[kg · d]) and high-dose (300 mg/[kg · d]) PDC groups,10 rats for each group.Streptozotocin was intraperitoneally injected to establish diabetic model in 40 rats,expect for normal control group.PDC at the concentrations of 100,200 and 300 mg/(kg · d) was intragastrically administered in the low-,moderate-and high-dose groups respectively at 6 weeks after modeling,and normal saline solution was used at the same way in the normal control group and diabetic model group.Evans blue was perfused via cardic chamber and eyes were obtained.Evants blue leakage was measured to evaluate the BRB permeability.The relative expressions of TNF-α,zonula occludens-1 (ZO-1),occludin and claudin-5 proteins were detected by Western blot;TNF-α contents in the retina and serum of the rats were detected by ELISA.Results The leakage concents of Evans blue in the retinas were (12.68±1.30),(30.45±2.60),(22.12±1.15),(17.99±1.00) and (21.49±1.00) in the normal control group,diabetic model goup and low-,moderate-and high-dose PDC groups,respectively,and the retinal leakage concents in the diabetic model group were significantly higher than those in the normal control group,and the retinal leakage contents in the low-,moderate-and high-dose PDC groups were lower than those in the diabetic model group (all at P ＜ 0.01).Western blot showed that the relative expression level of retinal TNF-α was significantly higher in the diabetic model group compared with the normal control group(1.12±0.10 vs.0.27±0.03),and that in the diabetic model group was significantly higher than that in the normal control group;while the relative expression levels of retinal TNF-α in different doses PDC groups were significantly lower,and the relative expression levels of retinal ZO-1,occludin and claudin-5 were significantly higher than those in the diabetic model group (all at P＜0.05).ELISA showed that the concentrations of retinal and serum TNF-α were higher in the diabetic model group compared with the normal control group,and those in the different doses of PDC groups were lower than those in the diabetic model group (all at P＜0.05).No significant differences were found among various doses of PDC groups (all at P＞0.05).Conclusions PDC can improve the permeability of BRB by down-regulating the expression of TNF-α and up-regulating the expressions of tight junction proteins in the retina of diabetic rats,which is probably related to suppressing the development of early DR.

Objective To compare the dosimetric effects of systematic MLC leaf position errors on flattening filter (FF) and flattening filter-free (FFF) IMRT for nasopharyngeal carcinoma (NPC).Methods In totaly of ten patients with NPC were enrolled in the current study.FF IMRT and FFF IMRT plans were designed for each patient, and in-house software was developed to modify the corresponding MLC files.Briefly, three kinds of systematic MLC error presented with 0.5 and 1 mm magnitudes error were simulated.The modified MLC files were re-imported into IMRT plans for dose recalculation, and differences in the dosimetry trends between FF-IMRT and FFF-IMRT plans were analyzed using a dosevolume histogram.Results Upon closed MLC, the average changes in D95％ of PTV and D of parotid glands in FFF-IMRT plans were more sensitive than in FF-IMRT plans (t =3.298-4.793, P ＜ 0.05).Otherwise, when MLC are shifted in the same direction, changes in D95％of PTV, D of PGTV, PTV as well as D of left parotid gland in FFF-IMRT plans were also more sensitive (t =2.372-6.844, P ＜ 0.05), whereas average changes in D of right parotid gland presented with less sensitivity (t =-4.049,-3.378, P ＜ 0.05).Conclusions For out-of-field or large organs, FFF-IMRT plans are more sensitive to leaf position error than FF-IMRT plans.

Objective To discuss the clinical application of percutaneous transhepatic cholangiopancreatic drainage (PTCD) combined with CT-guided microwave ablation in treating hepatic hilar cholangiocarcinoma. Methods The clinical data of 29 patients with inoperable Ⅲ and Ⅳ type hilar cholangiocarcinoma complicated by obstructive jaundice, who were admitted to authors’ hospital during the period from December 2012 to August 2014, were retrospectively analyzed. The diagnosis of bile duct adenocarcinoma was confirmed by pathology in all patients. Of the 29 patients, both internal and external biliary tract drainage was employed in 19, external biliary tract drainage in 4, and bilateral (both left and right side) bile duct drainage in 6. CT-guided microwave ablation was carried out when the liver function became improved. A total of 46 procedures of microwave ablation were completed in the 29 patients with a mean of 1.5 times per patient. Hepatic function tests, enhanced CT or MR scan were performed 4-8 weeks after treatment. According to mRECIST criteria the therapeutic results were evaluated; the serum bilirubin levels were recorded; the disease progress and the patient’s survival time were followed up. Results One month after the treatment, complete response (CR) was obtained in 15 patients (15/29, 51.7%), and partial remission (PR) in 17 patients (17/29, 58.6%), with the overall efficacy (CR﹢PR) being 82%. After the treatment, one patient developed hepatic metastasis and another one had pulmonary metastasis. Postoperative serum bilirubin levels showed an obvious decrease in all 29 patients. The 6-month, one-year and two-year survival rates were 68.9% (20/29), 31.0% (9/29) and 6.8% (2/29) respectively; the median survival time was 8.9 months and the overall survival time was 11.7 months. Conclusion For the treatment of hepatic hilar cholangiocarcinoma, PTCD combined with CT-guided microwave ablation is minimally invasive, clinically safe and effective.

Objective To investigate the relationship of serum cholinesterase(CHE) level with the severity and prognosis in patients with acute cerebral infarction. Methods A total of 325 patients with acute cerebral infarction were recruited as patients group,and another 101 healthy sub?jects were selected as control group. Velocity method was employed to detect the level of serum CHE. Patients with acute cerebral infarction were then divided into different groups according to the infarcts diameter and the modified Rankin scale(mRS)at 1 year post stroke. The collected data were analyzed statistically. Results The level of serum CHE in small and medium area infarction group was higher than control group(P<0.01);the level of serum CHE in large area infarction group was lower than control group(P<0.01);the level of serum CHE was negatively correlated with infarct size,NIHSS and the mRS score(r=-0.302,-0.232,-0.455,P<0.001). The level of CHE,age,NIHSS and infarcts diameter was identified as independent influence factors for prognosis of acute cerebral infarction. Conclusion Early phase of serum CHE level is closely related with the infarct size and illness severity index in patients with acute cerebral infarction,which could be an independent factor affecting the prognosis of cere?bral infarction.