Objective To evaluate the effct of full increase of three-dimensional conformal radiotherapy on esophageal carcinoma.Methods 86 Esophageal cancer patients which has been pathologically confirmed were randomly divided into study group and control group.The control group showed in tumor invasion scope simulator under barium meal positioning,with three fields outside irradiation;Total dose of DT with 63～70 Gy,35 times,seven weeks to complete.Study group showed that full use of additional 3D treatment planning system design individualized treatment programs,90% of the dose contains all planned target volume,future confonnal irradiation DY 44～50 Gy,after the wild-shrinkage increases to a total dose DT66～75 Gy,30 times,completed six weeks.Results The study group and the control group after radiotherapy in a local control rates were 86.4%and 64.3%(x2=4.5420,P＜0.05).Overall response rate(CR+PR)in two group were 93.2%and 76.2%(x2=3.6014,P=0.0577).Two toxicity of the difference was not significant.Conclusion The increase in full three-dimensional conformal radiotherapy of esophageal emleer in the near future is better than conventional methods.

Objective To discuss the feasibility of double-low technique applied in aortic MSCTA.Methods Totally 70 patients with BMI not more than 25 kg/m2 were divided into a routine group and an experimental group randomly and equally,and then went through aortic MSCTA.Iohexol (350 mgI/ml) was injected with the velocity of 4 ml/s.The routine group had the parameters as 120 kV,120 mAs and 1.5 ml/kg contrast agent,and the experimental group had the parameters as 90 kV,120 mAs and 1.0 ml/kg contrast agent,while the other scanning parameters were kept the same in the two groups.The radiation doses,contrast agent doses and iodine contents were recorded in the two groups,and the image quality was assessed with double-blind method objectively and subjectively.Results The experimental group had the CT dose index volumes (CTDIvol),dose length product (DLP) and effect dose (ED) significantly lower than those in the routine group (P＜0.05).The two groups had the consistency of subjective scores (Kappa＞0.6) and image quality scores (not lower than 2) meet the desired requirements,and there were no significant differences between the scores (P＞0.05).Objective evaluation showed that the signal values of aortic trunk and major branch vessels as well as image noise SD of the experimental group were obviously higher than those in the routine group (P＜0.05).There were no statistical differences between the signal noise ratios (SNR) and contrast to noises (CNR) in the two groups (P＞0.05),The iodine content in the contrast agent of the experimental group was significantly lower than that in the routine group (P＜0.05).Conclusion Double-low technique applied in aortic MSCTA of the patient with BMI not more than 25 kg/m2 reduces the radiation dose and iodine content in the contrast agent,has the image quality meet the desired requirements,and thus is of great value for clinical application.

Objective To investigate the clinical effects of surgical treatment of acute deep vein thrombosis (DVT) in the lower limbs. Methods Twenty four cases with DVT were treated with a 2～3cm incision at the cross of superficial and deep femoral veins to take the thrombasis out. Moulding thrombasis were pulled up with ova circular tongs, and fragmented thrombi were spilled out of the incision with the prelum arteriol winding from foot to thigh. The artery was rinsed with heparinized saline for three minuets till the femoral vein was completely unobstructed. The vein was sutured, and the wound was drained under negative pressure. Results The near future effects: Limb swelling and pain disappeared in seventeen cases, conditions turned for the better in six cases, and there was no improvement in one case. The long term effects: Twenty one were followed up for an average of one year and three months. All patients had excellent walking and standing except two cases who suffered lower limb swelling and pain occasionally. Conclusions The operation of vein thrombectomy is a simple, easy and excellent approach to treat DVT, especially within six days after the the condition.

Objective To strengthen the understanding of the imaging features in congenital aberrant left pulmonary artery (CALPA). Methods All 4 patients underwent chest film and Doppler echocardiography. Thres cases were examined by enhanced spiral CT examination. In addition, MRI and DSA were performed in 2 cases respectively. Thres cases were proven by surgery or autopsy. Results (1) appearances on chest films included cardiomegaly, pulmonary overvascularity, left hilum a little lower than the right one, emphysema, atelectasis, and pneumonia. (2) bronchography showed stenosis of trachea and/or bronchia. (3) Barium esophagram showed an imprint on the left anterior wall of esophagus. (4) Contrast-enhanced spiral CT and MRI showed marked dilatation of main pulmonary artery (MPA) and the root of MPA extended backward to become right pulmonary artery (RPA), the left pulmonary artery (LPA) arose from the RPA directly. (5) echocardiography indicated LPA arose from RPA. (6) DSA showed MPA was marked dilated, and LPA arose from RPA. (7) other abnormalities included 3 PDA, 2 PLSVC, and ~1 ASD. Conclusion CT and MRI are the best methods to diagnose CALPA.

Objective To discuss the radiological characteristics and improve the diagnostic ability of SARS in children. Methods The clinical data and X-ray findings of 35 SARS cases who hospitalized during Jan, 2003～Apr, 2003 were retrospectively analyzed. Results Chest X-ray features were as follows: massive consolidation (27 cases, 77.1%), pulmonary interstitial infiltration (6 cases, 17.1%), and mixed pattern (2 cases, 5.7%). There were two patients with emphysema, but no patient with lung abscess or pleural lesion. The radiological dynamic changes showed that the lesions of lung appeared early, the severest period was between the fifth day and the seventh day, the X-ray findings were not consistent with physical sign, and the absorption of lesion was slower than the clinical process. Conclusion There are some certain radiographic characteristic in children with SARS. A correct diagnosis can be made by closely combining the X-ray findings with clinical and laboratory results.

Objective To study the effects of pulmonary function training on the lung function and surgical tolerance of lung cancer patients with different degrees of obstructive ventilatory defect.Methods Pulnonary function training was performed with 103 lung cancer patients with obstructive ventilatory defects (26 mild cases,53 moderate cases,24 severe cases).The duration of the intensive training was 5-7 days.Vital capacity (VC),vital capacity percentage (VC％),forced vital capacity (FVC),forced vital capacity percentage (FVC％),forced expiratory volume in one second (FEV1),percentage of the forced expiratory volume in one second (FEV1％),maximum voluntary ventilation percentage (MVV％),peak expiratory flow percentage (PEF％),fraction of the forced expiratory volume in one second (FEV1/FVC),and maximum mid-expiratory flow percentage (MMEF％) were measured before and after the training.Any postoperative complications were recorded.Results The average MMEF％ improved significantly among the moderate patients after their training.Eventually 19/26 patients (73.08％) in the mild group,34/53 patients (64.15％) in the moderate group,and 8/24 patients (33.33％) in the severe group met the requirements to undergo lung operations.These were significant differences among the groups.Among those operated on,27 (44.26％) suffered from postoperative complications,a significantly higher percentage than among the normal controls (20.00％).Conclusion Lung function exercises can improve the operation tolerance of lung cancer patients with obstructive ventilation dysfunction,but the risk of operating is still much higher than for patients with normal ventilation function.

Objective To develop a rapid method with high sensitivity and specificity to detect 4 mycobacterial species(M. tuberculosis, M. avium, M. intracellulare and M. kansasii) which are the most common opportunistic Mycobacteria in AIDS patients. Methods The sensitivities and specificities of PCR were determined with different primer pairs targeting various mycobacterial genes. Multiplex PCR with combination of 4 primer pairs was used to detect the template mixtures of either 1, 2 or 3 mycobacterial DNA. Sensitivities of multiplex PCR were measured. Results Specific DNA fragments of 4 mycobacterial species mentioned above could be detected by PCR and sensitivities ranged from 1 ? 101 ~ 1 ? 102 cells/mL, while the other 17 mycobacterial strains were all PCR-negative. Multiplex PCR could amplify the corresponding 1, 2 or 3 DNA fragments, depending on the number of template DNA added, and sensitivities of multiplex PCR ranged from 1 ? 102 ~ 1 ? 103 cells/mL. Conclusions Multiplex PCR is a rapid, sensitive and specific method for differentiation and detection of Mycobacteria.

Objective To develop a PCR-RFLP method for the identification of eight mycobacterial species. Methods PCR was performed targeting the gene encoding 65-kDa heat shock protein which was common to all mycobacteria. Two restriction enzymes, BstE Ⅱ and Hae Ⅲ, were used to digest the PCR products, and specific restriction patterns of different mycobacteria were obtained. Results The specific restriction patterns of different mycobacteria were identical to the data previously reported. Conclusion We could differentiate M. avium, M. intracellulare, M. kansasii, M. tuberculosis, M. scrofulaceum, M. marinum, M. fortuitum and M. chelonae in one experiment by PCR-RFLP.

Since the development of civil basic medical insurance, it exerts subtle influence on medical conduct. The medical insurance economically affects the medical conduct. And medical ethics is one of the important factors which influence medical conducts greatly. Therefore, it is very important for the medical insurance enterprise's development to discipline the medical conducts by medical ethics.