Objective: To observe the efficacy and safty of intensity-modulated radiation therapy (IMRT) plus concomitant and adjuvant chemotherapy of temozolomide (TMZ) for glioma patients with postoperative residual. The target dose distribution and the dose to organs at risk were analyzed by dosiology of radiotherapy. Methods: Twenty-one glioma patients with postoperative tumor residual were enrolled between April 2008 and June 2009, including 10 cases of grade II and 11 cases of grade III-IV within the WHO 2000 classification. All patients received IMRT with a total dosage of 59.92-64.20 Gy/ 28-30 fx and concomitant chemotherapy (oral TMZ 50-75 mg·m-1·d -1), followed by 6 cycles of adjuvant TMZ (150-200 mg·m -1·d-1, in a 28-d cycle) 4 weeks after IMRT. Results: There were 2 cases of complete response (CR), 17cases of partial response (PR), and 2 cases of stable disease (SD), and the overall response rate (CR+PR) was 90.5%. The overall response rates of patients with grade II and III-IV were 100% (10/10) and 81.8% (9/11), respectively. The one-year progression-free survival rate was 80.9% and the overall survival rate was 85.7%, which were both 100% in grade II, whereas 72.7% and 81.8% in grade III-IV, respectively. The dose of each critical organ in IMRT was obviously lower than the minimum tolerance dose in conventional radiation therapy, and the radiation-related toxicities were mild. All patients in this study could tolerate the regimen. Conclusion: IMRT combined with concomitant and adjuvant TMZ chemotherapy for gliomas has a higher short-term efficacy with less side effects, meanwhile the IMRT for protection of vital organs around the target has certain advantages.

Chronic Disease ; Humans ; Paranasal Sinus Diseases ; etiology ; Periapical Periodontitis ; therapy

Hypertension, which has variant of pathogenesis, is one of the most widely spread chronic diseases with serious complications. Antihypertensive drugs can reduce blood pressure and alleviate or reverse cardiovascular remodeling by affecting one or more processes of blood pressure adjusting system. This review focus on targets of antihypertensive drugs associated with Renin angiotensin system, Adrenergic system, Bradykinin Prostacyclin system, Endothelia factor relative system, iron channels and the progresses in the studies of gene therapy for hypertension.

A case of methamphetamine-related cerebral infarction was reported and the relevant databases of CBMdisc and Medline were searched.Among 14 cases of ischemic stroke , the ratio of male:female was 9∶5 and the age range 19-45 years.There were anterior circulation lesions ( n=13,92.8%) and 10 of them (71.3%) had cerebral vascular occlusion or stenosis.And the predominant manifestation was hemiplegia (85.7%);among 34 cases of hemorrhagic stroke ,the ratio of male: female was 12∶5 and the age range 16-60 years.And 28 cases (82%) were≤45 years.Cerebral hemorrhage was the most common (85%).The major manifestations were headache ( n =26, 76%) and disturbance of consciousness (n=21,62%).The methamphetamine-related stroke occurs frequently in young males.And ischemic stroke tends to involve anterior circulation and cause hemiplegia.Yet hemorrhagic stroke has extensive attack sites and headache and disturbance of consciousness are quite common.

Objective To explore intervention effect of retinoic acid(RA) on hyperoxic lung fibrosis in neonatal rat,and to observe the role of transforming growth factor-?1(TGF-?1)and ?-smooth muscle actin(?-SMA)in hyperoxic lung fibrosis.Methods The SD neonatal rats were randomly divided into 4 groups:air-exposed control group(group Ⅰ),air-exposed and RA-treated group(group Ⅱ),hyperoxia-exposed control group(group Ⅲ),hyperoxia-exposed and RA-treated group(group Ⅳ).The rats of group Ⅲ,Ⅳ were kept in chambers containing 850 mL/L oxygen,the other 2 groups were exposed to air.The rats of group Ⅱ,Ⅳ were intraperitoneally injected with RA [500 ?g/(kg?d)],group Ⅰ,Ⅲ were intraperitoneally given the same dose of oleum lini.At the end of exposure,the lung histophatholoical changes and radical alveolar counts(RAC) were observed by HE staining under light microscope,the degree of pulmonary fibrosis was evaluated by Masson trichrome method and fibrosis score.The protein expression of TGF-?1 and ?-SMA were determined by immunostaining.Results At 14 d of exposure,group Ⅲ resulted in a significant increase in fibrosis score and expressions of TGF-?1 and ?-SMA compared with group Ⅰ,Ⅱ and Ⅳ(Pa0.05).Conclusion TGF-?1 and ?-SMA may have important role in hyperoxic induced lung fiborsis injury,the earlier period intervention of RA can reduce lung fibrosis regeneration and exceptional alveolus development.

Objective To improve the level of diagnosis and treatment of the traumatic and hemorrhagic shock.Methods 50 cases of patients with sever traumatic and hemorrhagic shock treated in our department between May 2004 and May 2007 were analyzed retrospectively,and their age,shock severity scale,time to hospital after in- jury,operation,fluid resuscitation volume etc were analyzed to show the relationship between the factors and the out- come.Results The rescue success rate was 76%(38 cases),and traumatic mortality was 24%(12 eases).Conclu- sion Shock severity scale and incorreet resuscitation manipulation are the main factors affecting the result of resusci- tation and treatment of traumatic shock,and early surgery can effectively improve the result of severe trauma thera- py.

Objective To evaluate the availability and sensitivity of MR whole body diffusion weighted imaging (DWI) in searching primary tumors in patients with metastases.Methods Thirty-four patients with symptoms of metastases and unknown primary leasions were scanned by whole body DWI.All the metastases cases were diagnosed by CT,single photon emission computed tomography(SPECT) or MRL For the cases of suspected primary tumors,apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively.For the cases with primary lung cancers and metastases proved by pathology of biopsy or surgical specimens,statistics analysis of ADC values of primary and metastatic lesions was performed with paired samples t-test.The detection rate and sensitivity of this technique for screening primary tumors were evaluated.Results By whole body DWI,24 cases were found with suspected primary lesions,in which 23 cases were proved primary tumors,and 1 case was proved benign lesion.Ten cases were not identified with primary lesions on whole body DWI,but in which 2 cases were proved primary malignant tumor by biopsy later,and the other 8 cases remained unknown within follow-up of half a year to one year.For the 14 definite cases of lung cancers,the average ADC values of primary and metastatic lesions was (1.24±0.18)×10-3 and(1.16±0.27)×10-3mm2/s,respectively (t=1.28,P>0.05).The detection rate and sensitivity of whole body DWI for searching primary tumors was 67.6% (23/34) and 92.0% (23/25),respectively.Conclusion The sensitivity of whole body DWI for searching primary tumors is relatively high,and it can be used to search primary tumors in patients with metastases.

Objective To investigate the influence of perioperative continuing aspirin therapy on tooth extraction surgery in elderly patients with coronary heart disease.Methods A total of 926 patients with coronary heart disease who required tooth extraction were enrolled in this study.Among them,241 patients discontinued aspirin therapy before tooth extraction,685 patients continued aspirin therapy before tooth extraction.The entering rate of operation was evaluated.100 patients continuing aspirin and 100 patients discontinuing aspirin were randomly selected.Systemic pressure,diastolic pressure and heart rate before and after tooth extraction were detected.100 matched healthy elderly patients were selected as normal control group.Multivariate logistic regression analysis was used to estimate the risk for tooth extraction.Results The entering rate of operation was 67.9％ (131 cases) in 193 patients with angina pectoris discontinuing aspirin therapy and 82.1 ％ (312 cases) in 380 patients with angina pectoris continuing aspirin therapy (x2 =14.77,P＜0.01).The entering rate of operation was 41.7％ (20 cases) in 48 patients undergoing coronary revascularization and discontinuing aspirin therapy,and 80.7％ (312 cases) in 305 patients undergoing coronary revascularization and continuing aspirin therapy (x2=33.95,P＜0.01).The changes in systolic blood pressure before versus after dental extraction had a significant difference between the discontinuing aspirin group and control group [(15.9±5.5) mmHg vs.(12.2±4.7)mmHg,P＜0.05,1 mmHg=0.133 kPa],while had no significant difference between the continuing aspirin group and control group [(13.6±4.5) mmHg vs.(12.2±4.7) mmHg,P＞0.05].There were no significant differences in changes in diastolic blood pressure and heart rate in the intraoperative period between the patients and controls (P＞0.05).The bleeding rate in patients continuing aspirin therapy was not significantly different as compared with control group (P＞ 0.05).Multivariate logistic regression analysis revealed that perioperative discontinuing aspirin therapy remained the second significant risk factor for tooth extraction.Conclusions Preoperative administration of aspirin should be continued in dental extraction surgery in elderly patients with coronary heart disease.

Objective To compare the outcomes of powered-assisted septoplasty with CO_ 2 laser-assisted septoplasty. Methods Thitry patients with limited deviation of nasal septum were analyzed retrospectively. Among 30 patients, 18 underwent powered-assisted septoplasty and the rest underwent CO_ 2 laser-assisted septoplasty. The surgical results were assessed by the visual analogue scale (VSA) and acoustic rhinometry. Results VSA scores significantly improved in both groups after surgery (P

AlM: To study the therapeutic effect of external-route microsurgery forrhegmatogenous retinal detachment.
METHODS: ln 55 patients ( 55 eyes ) with rhegmatogenous retinal detachment, drainage of subretinal fluid, examination of locating the holes, sclera cryotherapy, scleral buckling, and vitreous cavity injection of filtrated air were performed under surgical microscope.
RESULTS:The retinal reattachment occurred in 50 cases after the primary surgery. The final rate of reattachment was 91% during 6 - 12mo follow - up. The retinal reattachment occurred in 1 case ( recurrent retinal detachment) after the secondary surgery and in 4 cases ( recurrent retinal detachment ) after vitrectomy. The eyesight was improved with different degrees in 55 cases.CONCLUSlON: The external- route microsurgery for rhegmatogenous retinal detachment is simple, safe and effective.