Objective To observe the effect of docetaxel combination with nedaplatin in the treatment of patients with advanced stage of normmall-cell lung cancer.Methods 72 patients with advanced stage of nonsmall-cell lung cancer were collected and randomly divided into observation group and control group.Docetaxel combination with nedaplatin was used in observation group and docetaxel combination with cisplatin was used in control group.The curative effect,no advancement time,total live time and adverse reaction were observed in each group.Results The CR rate 8.3％,PR rate 38.9％,total remission rate 47.2％ in observation group had no significant difference with control group.There was no significant difference in no advancement time and total live time between these two groups.The rate of digestive reactions was significantly lower in observation group than in control group ( all P ＜ 0.05 ).Conclusion Docetaxel combination with nedaplatin was an effective method in the treatment of advanced stage of nonsmall-cell lung cancer.The toxic reaction was low and easily to tolerte.

Objective To analyze the clinical efficacy of gemcitabine plus oxaliplatin in treatment of relapsed or refractory non-Hodgkin's lymphoma(NHL).Methods 39 cases with relapsed or refractory NHL were treated by gemcitabine and oxaliplatin combination chemotherapy. After three cycles, its efficacy and adverse reactions　were observed. Serum lactate dehydrogenase(LDH) concentration was detected before and after treatment and all the　patients were followed up. Results The rate CR was 11cases (28. 1％ ), PR 16cases (41.03％), NC 7cases (17.95％),PD 5cases(12.82％).Thetotalresponserate(CR+PR) was 69. 23％. Conclusion Gemcitabineand oxaliplatin combination chemotherapy in treatment of patients with relapsed or refractory NHL was safe and effective.

Objectives To evaluate plain radiographs and computed tomography (CT) scans in respect of assessment of articular fragment displacements (step and gap) in displaced acetabular fractures. Methods A retrospective evaluation was done to analyze the CT scans and plain radiographs of 64 patients who had been treated for displaced acetabular fractures in our hospital from January 1998 to May 2003. Of them, 20 met the inclusion criteria. In a blind method, 3 independent reviewers measured step and gap deformities on plain radiographs and CT scans utilizing a standardized measurement technique. The sensitivity and specificity of plain radiographs in detecting step and gap displacements (2 mm and 4 mm) in comparison of those of CT scans were determined. Moreover, intraclass correlation coefficient and intraobserver reliability were also calculated. Results Compared with CT, plain radiographs showed poor sensitivity in detecting step deformity (sensitivity = 44.3%). As far as fracture type was concerned, plain radiographs were particularly poor at detecting step deformity in fractures involving a single column of the acetabulum (sensitivity = 0%). Excellent intraobserver and intraclass reliability existed among the 3 reviewers. Conclusions Compared with CT scans, plain radiographs are poorly sensitive in detection of step and gap deformities in patients with acetabular fractures, and particularly poor at detecting step deformities. Therefore, in treatment of displaced acetabular fractures, CT scans are essential and should not only be used together with plain radiographs in the preoperative evaluation but also be considered in the postoperative assessment of fracture reduction and predicting future outcomes.

Objective Establishing the scientific research competitiveness evaluation index system of Shanghai hospitals.Methods Delphi method and Analytic Hierarchy Process were applied.Results Thirty-four experts were invited to provide evaluation index and weighted scores.The positive coefficient from two rounds of expert's consultation were 88.24％ and 94％.The expert's opinion of authority coefficient of each indicator's was greater than 0.7.The degrees of coordinative consistency was high.Kendall concordance coefficient was increasing with the increasing of consulting times.After two rounds of Delphi expert consultation,2 level-one indictors,10 level-two indictors and 47 level-three indictors were confirmed.Conclusions After two rounds of Delphi expert consultation,using all objective indicators,an Index System for research competitiveness evaluation in the hospitals in Shanghai has been created and could be used with scientific,objectivity and feasibility.

Objective To establish induced pluripotent stem cells (iPSCs) in patients with azoospermia by non-integrated approach. Methods Using the commercially available serum-free medium (TeSR?2) and embryonic stem cell culture medium (Stem Adhere? Defined Matrix) to define the culture system, the iPSCs were established by using non-integrated Sendai virus infection in peripheral blood mononuclear cells of azoospermia patients. The immunofluorescence, karyotype analysis, embryoid body differentiation and teratoma formation were used to identify pluripotency, karyotype and differentiation ability of iPSCs. Results The established iPSCs showed the characteristics of human embryonic stem cells. Immunofluorescence analysis showed that octamer-binding transcription factor 4 (OCT4), SRY-related-box protein-2 (SOX2), stage-specific embryonic antigen-4 (SSEA-4) and tumor rejection antigen-1-60 (TRA-1-60) were positive for the expression of stem cell pluripotency markers. Karyotype analysis showed that they had normal karyotype. In addition, embryoid body and teratoma tests showed that the iPSCs had the ability to differentiate into three germ layers in vitro and in vivo. Conclusion The induction of pluripotent stem cell line is successfully constructed by non-integrated approach in azoospermia patients.

Objective To analyze the reliability and validity of an established Research Hospital Competitiveness Evaluation System.Methods To evaluate the research competitiveness of 34 tertiary hospitals and their departments in Shanghai using above system.The reliability and validity of the indicator system were analyzed with the Cronbach's alpha coefficient, and confirmatory factor analysis based on the structural equation model.Results After adjusting for structure of the index system via item parceling, the CFI, MFI, RMSEA AND IFI were 1.000, 1.009, 0.000 and 1.028, the Cronbach's alpha of whole set indicators system was 0.768.Conclusions The results suggested that the measured reliability and validity are both in good degree, survey results can reflect the actual competence of evaluated hospitals.

BACKGROUND:Vascularuzed fibular graft is one of the effective methods for repair of large segmental bone defects in the extremities OBJECTIVE:To explore the clinical effects of vascularized fibular graft for repairing large segmental bone defects in the extremities. METHODS:Twenty-eight non-malignant patients who received vascularized fibular graft for repairing large segmental bone defects in the extremities and were folowed up for more than 20 months were enroled. After lesion removal, vascularized fibula bone graft was used to repair the bone defects. If cases combined with soft tissue defects, fibula flap or anterolateral thigh flap was adopted. RESULTS AND CONCLUSION: Al patients were folowed up for 20 months to 6 years. The grafted bones were healed with the surrounding bone at 3-8 months after fibula bone grafting. The grafted bone was enlarged near to the diameter of recipient bone at 10-22 months after grafting. Based on the Enneking system, the average score of large segmental tibia bone defects was 24.2 points with 81% limb function recovered and 94.1% patient satisfaction; the average score of large segmental femur bone defects was 26.3 points with 87.7% limb function recovered and 100% patient satisfaction; the average score of large segmental bone defects of the distal radius and ulna was 21.75 points with 72.5% limb function recovered and 100% patient satisfaction. These findings reveal that vascularized fibular graft for repairing large segmental bone defects in extremities can effectively promote bone healing and reduce disability, infection, amputation rate; moreover, patients are satisfied with the postoperative recovery of limb function.

BACKGROUND:For the patients with proximal humeral fractures or serious complications, internal fixation is the effective method that cannot influence the activity of the shoulder with few trauma. OBJECTIVE:To investigate the biomechanical characteristics of percutaneous plate combined with anatomical locking plate fixation for the treatment of proximal humeral fractures. METHODS:Seventy-five patients with proximal humeral fractures were selected from Department of Orthopedics, the Third Affiliated Hospital of Guangzhou Medical University between March 2007 and December 2011. The healing after the locking plate fixation and the shoulder joint score after internal fixation were observed. The biomechanical advantages of locking plate fixation in the treatment of proximal humeral fractures were analyzed. RESUTLS AND CONCLUSION:Al the 75 patients were fol owed up for 6-24 months, average 13.3 months. The X-ray film after treatment showed al the screws were in correct position with satisfactory fracture reduction, and the fractures were healed without neurovascular injury and humeral head necrosis;one case had infection and healed after treatment, 72 cases had no shoulder pain, while three cases had occasional shoulder pain. The Neer score was excel ent in 57 cases, good in 11 cases, moderate in seven cases and poor in none, and the excel ent and good rate was 90.7%. Compared with other fixation implants, the locking plate fixation in the treatment of proximal humeral fractures has the advantages of high fixation strength and satisfactory effect, becoming the first choice for the clinical treatment of proximal humeral fractures.

In order to improve the speed and accuracy of cone beam CT image quality assurance, an automatic image quality assurance software based on feature extraction is designed and implemented. This paper introduces how the software can realize the positioning of Catphan500 phantoms and the selection of ROI in each module through Canny algorithm and Hough transform circle detection. For the different modules in the Catphan500 phantom, this paper describes the calculation methods of HU accuracy, spatial linearity, HU uniformity and spatial linearity in the software. Finally, the article verifies the feasibility of the software through experiments.
Algorithms ; Automation ; Cone-Beam Computed Tomography ; Phantoms, Imaging ; Quality Control ; Software

Aiming at the problem of timeliness of CBCT reconstruction, a CBCT fast short scan reconstruction method is proposed. At the same time, the image reconstruction process in which a new attenuation compensation algorithm is applied to improve image quality. When performing FDK three-dimensional reconstruction of a single-frame acquisition image, the Parker-weighted image is calculated in real time, and a new attenuation compensation algorithm is applied in the back projection process to complete the short scan Parker-weighted reconstruction. This method simulates the CBCT synchronous acquisition and reconstruction process by establishing collection and reconstruction threads. Under the premise of satisfying the reconstruction quality, the reconstruction can be completed within 1 to 2 seconds after the patient collection is completed, which achieves the purpose of real-time.
Algorithms ; Cone-Beam Computed Tomography ; Humans ; Image Processing, Computer-Assisted ; Spiral Cone-Beam Computed Tomography