Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy (BMS-IMRT) for postoperative cervical cancer.Methods From January 2011 to June 2012,totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly.External whole pelvic intensitymodulated irradiation combined with chemotherapy was carried out for all patients.The planning target volume received a dose of 45 Gy/25 fractions in all patients.Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group:the pelvis V30 ≤ 50％.All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy.Results Treatment was completed in 67 patients,as the other 3 patients stopped chemotherapy because of myelosuppression.There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS),alimentary tract toxicity and urinary toxicity.IMRT group had more serious hematologic toxicity than BMS-IMRT group,with statistically significant difference (x2 =14.355,P ＜ 0.05).Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy,IMRT group has more serious hematologic toxicity than BMS-IMRT group.The short-term effect and other toxicities reaction are similar between two groups.

Bone Substitutes ; Facial Injuries ; surgery ; Fracture Fixation ; methods ; Humans ; Maxillofacial Injuries ; surgery ; Oral Surgical Procedures ; Surgical Flaps ; Tooth Injuries ; surgery

Objective To summarize the treatment experience of supraventricular tachycardia (SVT) after coronary artery bypass graft (CABG). Methods The clinical data of 136 patients who had occurred SVT after CABG between January 2008 and December 2009 were analyzed retrospectively. Results Among 136 patients,no perioperative mortality,atrial fibrillation (AF) occurred in 110 cases (80.88%),paroxysmal supraventricular tachycardia (PSVT) occurred in18 cases ( 13.24% ), atrial flutter occurred in 8 cases (5.88%),112 of 136 cases occurred in 1-3 days after surgery,accounting for 82.35% ,24 cases occurred in 4-7 days after surgery,accounting for 17.65%. Given amiodarone in the treatment of 105 cases,100 cases reverted to sinus rhythm (cardioversion rate of 95.24% ),given esmolol in the treatment of 11 cases, 9 cases reverted to sinus rhythm( cardioversion rate of 81.82% ), synchronous direct current cardioversion in 20 cases, all transferred to sinus rhythm, all patients with improved symptoms. The remaining failed to transfer to sinus rhythm, had got normal ventricular rate, and symptoms improved significantly. Conclusions It is necessary to take effective measures to prevent SVT within 3 days after CABG. Amiodarone, esmolol and synchronous direct current cardioversion can be used effectively and safely to control SVT after CABG.

Objective To compare and analyze the effect of laparoscopic surgery and open toperation of rectal can﹣cer in middle or lower positions. Methods 128 patients with middle or lower rectal cancer were randomly divided into observation group and control group, 64 cases in each one, Laparoscopic surgery for observation group and con﹣trol group using traditional open surgery. Operative time, blood loss, ambulation time, length of stay, postoperative complications, anus-preserving, the recurrence during follow-up were compared between the two groups. Results Blood loss, ambulation time, length of hospital stay, the observation group were significantly less than the control group (P< 0.05), operation time between the two groups have no obvious differences (P> 0.05). Nine patients in control group with complications, the rate was 14.1 %; postoperative complication were observed in 2 cases, the rate was 3.1 %; complication rate in observation group was significantly lower than the control group (P< 0.05). Anus-preserving rate was significantly higher in the observation group (P<0.05);followed up for 8-47 months with an av﹣erage follow-up (23.1 ± 6.4) months, relapse rates of the two groups have no significant difference (P> 0.05). Con﹣clusions Compared with open operation,laparoscopic surgery is safe and effective, can reduce the surgical trauma and complications, shorten hospitalization time, improve the anus-preserving rate, worth clinical promotion.

BACKGROUND: Whether antihypertesive remedy is given or not is not only according to the blood pressure grade, but also to its risk stratification. Recently the relation of syndrome types to hypertension grades and risk stratification in primary hypertension has been investigated at home. OBJECTIVE: To observe the relation of syndrome types to hypertension grades and risk stratification in primary hypertension by the method of syndrome differentiation in traditional Chinese medicine combining with achievements in modern medicine. DESIGN: Descriptive investigation. SETTING: Department of Traditional Chinese Medicine, Jing'an District Central Hospital of Shanghai City and Shanghai Dahua Hospital. PARTICIPANTS: Sixty-four patients, in different genders and ages, with primary hypertension from Department of Traditional Chinese Medicine of Jing'an District Central Hospital of Shanghai City METHODS: The primary hypertension was classified into four types of syndrome: up disturbing of wind-yang, up clouding of turbid phlegm, deficiency of qi and blood and yin deficiency of liver and kidney. The relation of syndrome type to hypertension grade and risk stratification in primary hypertension was investigated combining syndrome differentiation in traditional Chinese medicine (TCM) and disease differentiation in Western Medicine. MAIN OUTCOME MEASURES: The relation of syndrome types to the age, course, blood pressure grade and risk stratification in primary hypertension RESULTS: All 64 patients entered the result analysis. ① Relationship of syndrome type with the age, course and blood pressure grade: The age of patients in up-disturbing of wind-yang group was younger than those in both up-clouding of turbid phlegm and yin deficiency of liver and kidney groups [(59.0±10.9), (72.7±9.1), (71.6±10.1)years, P ＜ 0.01]; the disease course of patients in yin deficiency of liver and kidney group was longer than those in up-disturbing of wind-yang group and up-clouding of turbid phlegm group [( 160.50±143.51 ), (64.83±70.77), (80.56±108.69)months,P ＜ 0.05];the difference of systolic pressure among different syndrome types was not significant, but the diastolic pressure in up-disturbing of wind-yang group was higher than those in other groups [(99±8), (92±9),(89±11 ), (89±12)mmHg, P ＜ 0.05]. ② The relationship of syndrome type with blood pressure grade and risk stratification: The difference of blood pressure grades among patients with different syndrome types was not significant, but the risk stratification in up-disturbing of wind-yang group was lower than those in up-clouding of turbid phlegm and yin deficiency of liver and kidney groups (There were respectively 3, 7, 5 and 3 cases; 15, 1, 1and 1 cases; 16, 1, 2 and 1 cases at very high risk, high risk, medium risk and low risk, P ＜ 0.05). CONCLUSION: Different syndrome types in TCM may present differences in hypertension grade and risk stratification, which can provide basis for determining therapeutic principle.

Objective To compare the mast cells' property and the level of pelvic pain, urgency and frequency (PUF) scale in urinary bladder between interstitial cystitis (IC) patients and controls.Methods Eighteen cystoscopy biopsy specimens of interstitial cystitis patients and 12 controls were stained with 0.5% toluidine blue and immobilizated with Osmic Acid. Then the mast cells were observed and counted with light microscope and transmission electron microscope. The PUF scale and the number of mast cells between the 2 groups were compared. Results The mast cell's number of the interstitial cystitis samples(28-76 pieces/mm2) was significantly higher than that of the non IC persons' bladder tissues(7-15 pieces/mm2) (Z=3.927,P＜0.01). 75.3% mast cells were in a state of being activated degranulation. The PUF scale of IC patients( 17-35 scores)was significantly higher than that of the non IC persons' (0-8 scores) (t=14.736,P＜0.01). The PUF scale of the patient group did not have a linear IC relation with the mast cell's infiltrated number among the specimens (rs=-0.618,P=0.601). Conclusions Mast cell infiltration may be one of the characteristic pathological manifestations of IC. The association of mast cell infiltration and the PUF scale may be a new diagnosis criteria for IC.

BACKGROUND:The Notch signaling pathway is evolutionarily highly conserved and mediated by cel-cel interactions, which is widely involved in cel differentiation, proliferation and apoptosis. This critical transduction system participates in coordinating various functions of vascular endothelial cels, thus playing a vital role in the formation and remodeling of vascular network. OBJECTIVE: To elucidate the components of Notch signaling pathway and its impact on angiogenesis. METHODS: A computer-based online search of PubMed and CBM databases was performed. High-quality articles related to mechanism of angiogenesis regulated by Notch signaling were included, and repetitive studies were excluded. RESULTS AND CONCLUSION:Totaly 31 literatures were selectively included in this review. Angiogenesis is a complicated and muti-stage biological event and has been delicately regulated. Notch signaling participates in the regulation of every stage of angiogenesis directly or indirectly via the crosstalk with vascular endothelial growth factor, BMP-SMAD signaling and extracelular matrix molecules. Furthermore, consistent output of Notch signaling is essential for maintaining the stability and integrity of adult vascular system. This review wil thoroughly clarify the latest progress on angiogenesis regulated by Notch signaling and provide theoretical basis and a potential target for designing therapeutic methods against vascular disease.

Objective To discuss the expression and significance of platelet ultrastructure and platelet acti-vating factor(PAF)relationship in patients with acute cerebral infarction.Methods 40 patients with cerebral infarc-tion were chosen onset in 6-24 hours as the observation group,while at the same time 20 cases of healthy adults were selected as the control group.The observation group was given 1-7d of aspirin enteric-coated metformin hydrochloride 300mg,qd,and 8-14d had worship of aspirin enteric-coated metformin hydrochloride 100mg,qd.And before and 1,7, 14 days after treatment,control group and observation group respectively preclude the use of transmission electron microscopy ultrastructure of platelets,before and 1,14 days after treatment automatic blood cell analyzer test was used to analyze the average platelet volume (MPV),platelet count (PLT),platelet volume distribution width (PDW)of the two groups.And 1,2,3,7,14 days after treatment,enzyme-linked immunosorbent determination of double clamp method was used to test the concentration of PAF.Results Before treatment,MPV,PDW and PAF in peripheral blood of the observation group were (9.22 ±1.30)fL,(17.89 ±1.23)%,(211.31 ±11.22)pg/mL,which were sig-nificantly higher than those of the control group (8.68 ±1.03)fL,(16.06 ±1.03)%,(155.49 ±8.70)pg/mL(t =2.082,2.563,14.401,all P <0.05),while PLT was (173.22 ±63.40)×109 /L,which was significantly lower than that in the control group (231.22 ±56.76)×109 /L(t =3.048,P <0.05).After treatment in patients with acute cer-ebral infarction,the MPV,PDW of peripheral blood were (8.43 ±1.28)fL,(16.66 ±1.11)%,which were signifi-cantly lower than before treatment (9.22 ±1.30)fL,(17.89 ±1.23)% (t =1.937,3.320,all P <0.05),while PLT (195.33 ±61.45)×109 /L was significantly higher than before treatment (173.22 ±63.40)×109 /L(t =1.915, P <0.05).PAF peaked in the treatment of 3 days,which was (240.12 ±13.78)pg/mL,and gradually declined after 7 days,which was (215.33 ±16.43)pg/mL,and that after 14 days was(170.27 ±11.40)pg/mL,compared with before treatment (211.31 ±11.22)pg/mL,the difference was statistically significant (t =16.24,P <0.05).Before treatment,platelet shape had irregular,increased pseudopodia,several visible platelet aggregation,and was blend together.And after 14 days treatment in the observation group,platelet ultrastructure greatly recovered.Conclusion Monitoring of MPV,PDW,PAF and PLT in peripheral blood of patients with acute cerebral infarction before and after treatment has important clinical value for disease diagnosis and treatment.

Aim: To establish a method for the determination of pantoprazole sodium and its related substances. Methods: A column packed with octadecylsiance bonded silica gel (250 mm × 4. 6 mm, 5 pjn) was used. The 0. 01 mol/L monopotassium phosphate solution( adjusted with phosphoric acid to pH 7. 0) -acetonitrile were adopted as the mobile phase, a gradient elution was programmed as follows: 0→30 min(90:10-60:40), 30→45 min(60: 40→15: 85); the detection wavelength was 289 nm; the column temperature was 40 ℃; the flow rate was 1. 0 mL/min. Results: Pantoprazole sodium, the intermediates and its related substances could be well separated. A good linear relationship was obtained over the range of 6. 96-48. 72 μg/mL( r =0. 999 9). The limit detection and quantisation of pantoprazole sodium were 8.51 ng and 17.0 ng, respectively. Conclusion: This method can be applied to control the related substances of pantoprazole sodium and determine pantoprazole sodi-um.

Objective To analyze the medical and audiological features of trauma induced stapes fracture ,and to summarize the key diagnostic points and to observe the effects of surgical treatment .Methods Five patients with trauma induced stapes fracture confirmed by the surgical exploration from January 1995 to October 2013 were retro_spectively reviewed .Ossicular chain reconstruction was performed on each patient .The preoperative and postopera_tive pure-tone thresholds were compared to judge the effects of surgical treatment .ResuIts The surgical explora_tion revealed 4 cases of stapes feet fracture ,1 case of stapes neck fracture with temporal bone fracture and peripheral paralysis of the facial nerve .Different types of ossicular reconstruction were performed according to the exploration results:2 cases with autogenous stapes remodeling ,1 case with allogenous stapes remodeling ,1 case with bone piece of external acoustic meatus ,and 1 case with artificial auditory ossicle(TORP) implanting .Additionally ,the case of peripheral paralysis of the facial nerve received facial nerve decompression .After the operation ,5 patients felt that their hearing was improved .The mean postoperative pure-tone threshold was 30 .7 dB HL ,and the mean ABG(air-bone-gap) was 18 dB HL while the mean preoperative pure-tone threshold was 61 dB HL(t=6 .725 ,P<0 .05) and the mean ABG was 38 .7 dB HL(t=3 .616 ,P<0 .05) .The facial nerve functions of the case with facial paralysis recovered to House-Brackmann Grade I three months after receiving facial nerve decompression .ConcIu_sion Stapes fractures are rare .Being different from the general conductive hearing loss ,patients with stapes fracture usu_ally have the acoustic stapedius reflex .Through ossicular reconstruction ,we can yield a satisfying hearing recovery .