Objective To evaluate the safety and efficaey of oxaliplatin plus capecitabine combined with concurrent radiotherapy in treatment of locally advaneed oesophageal squamous cell cancer (OSCC).Methods Between July 2003 and December 2008, 46 patients with locally advanced OSCC were irradiated with a dose of 60-64 Gy in 30-32 fractions. The target area included the primary tumor, the lymph nodes with short axis ≥ 10 ram, and the lymphatic drainage region. Two cycles of concurrent chemotherapy was given during radiotherapy, with the oxaliplatin of 85 mg/m~2 on d_1, d_(21), d_(41) and capecitabine of 850 mg/m~2 on d_(1-14) and d_(21-35), which was followed by two cycles of adjuvant chemotherapy. Results The complete re-sponse rate was 33% (14/46), and partial response rate was 56% (24/46), thus the response rate was 88%. Three patients (7%) had no response and 2 patients (5%) had progression. Obstruction relief rate was 90% ,and pain in the chest and back disappeared in 100% of patients. The 1-,2- and 3-year local con-trol rates and overall survival rates were 72% ,40%, 34% and 80%, 45%, 40%, respectively. Acute ra-diation-induced esophagitis rate was 100%, of which 19% was ≥ grade 3. Leuoopenia occurred in 65% of paients and 23% was ≥ grade 3. 23% of the patients had reduced hemoglobin, and 10% with ≥ grade 3.Hand and foot syndrome rate was 16%, and 4% was ≥grade 3. Conclusions Oxaliplatin plus capecit-abine combined with concurrent radiotherapy may be an effective and well-tolerated regimen in patients with locally advanced oesophageal cancer.

Objective To assess the value and complications of restaging laparotomy in women with presumed early ovarian cancer who have undergone inadequate initial staging procedures. Methods Between 1986 and 1996, 42 patients underwent restaging laparotomy in Cancer Hospital, Peking Union Medical College after receiving inadequate initial surgical procedure for presumed early ovarian cancer. Presumed stages from initial surgery include stage Ⅰa in 28 cases; Ⅰb in 1 case; Ⅰc in 12 cases; Ⅱa in 1 case. Histological distributions were as follows: epithelial cancer in 26 cases; malignant germ cell tumor in 9 cases; granulose cell tumor in 7 cases. Results Twelve patients (28.6%) had disease upstaged and eight (19.0%) had stage Ⅲ disease confirmed by restaging laparotomy. Positive findings at restaging laparotomy were mainly in omentum (16.7%) and pericolic gutters (33.3%). Peritoneal cytology was positive in 25.0 percent of patients. Three and five year survival rates for 30 patients with negative findings were 96.7% and 86.7%, respectively. Complications of restaging laparotomy included hemorrhage blood loss (50～ 1 100 ml, average 280 ml) and lymphocyst (7.1%). Conclusions Patients with presumed early ovarian cancer who had undergone inadequate staging procedures should undergo restaging laparotomy. Patients with negative findings have an excellent prognosis. Complications of restaging laparotomy were minor.

Objective To investigate the patterns of intrathoracic lymph node metastasis in nonsmall cell lung cancer (NSCLC) and to provide a theoretical basis for the delineation of radiotherapy target volume.Methods A retrospective analysis was performed on the clinical data of 314 NSCLC patients after operation.Our focus was to investigate the distribution characteristics and metastatic extent of intrathoracic lymph nodes and their relationship with tumor size,pathological type,and primary site.Comparisons between groups were made by one-way analysis of variance.Results The frequencies of metastases to lymph nodes at stations 4,5,7,10,and 11 were all above 12％,while those at stations 1,2,3,6,8,and 9 were all below 12％.The lymph node metastasis rate was similar on the primary tumor site (P =0.102).The patients with T3 and T4 NSCLC had a significantly higher frequency of N2 lymph node metastasis than those with T1 and T2 NSCLC (17.0％ vs.11.6％,P =0.002) ;the patients with adenocarcinoma had a significantly higher frequency of N2 lymph node metastasis than those with squamous cell carcinoma (34.5 ％ vs.23.2％,P =0.008).Conclusions For patients with T3 and T4 NSCLC of adenocarcinoma subtype,we should highlight the lymph nodes at stations 4,5,7,10,and 11 when delineating the radiotherapy target volume after operation.

In the Jinsong district of Beijing,345 patients with dyslipidemia were selected for study.Health management was implemented for one year,during which time,monitoring,analysis,and evaluation of the health of individuals and groups was conducted; health advice and guidance were given with regard to health risk factors.After the one-year intervention,the average daily dietary intake of salt,oil,and meat was reduced by 2,4,and 18 g,respectively,and the average daily intake of vegetables increased by 45 g.The average levels of body mass index,systolic blood pressure,diastolic blood pressure,total cholesterol,triglycerides,and low-density lipoprotein cholesterol were reduced by 0.47 kg/m2,3.0 mm Hg ( 1 mm Hg =0.133 kPa),1.6 mm Hg,0.76 mmol/L,0.83 mmol/L,and 0.42 mmol/L,respectively,while the average level of high-density lipoprotein cholesterol increased by 0.05 mmol/L.All the differences were significant.

Objective　To summarize the experience in diagnosis and treatment of rare type of hepatic benign tumor and tumor-like lesions.Methods　The clinical data of 58 cases of uncommon benign hepatic tumor and tumor-like lesions admitted to Changhai Hospital from January 1980 to June 2000 were retrospectively reviewed. Results　Of the 58 cases, 26 were inflammatory pseudotumors, 8 focal hyperplastic lesions, 7 hepatocellular adenomas, 7 lipomatous tumors, 5 cystadenomas, 3 tuberculosis, 1 harmatoma and 1 neurofibroma. 82.8% of the cases had symptoms, 17.2% without obvious symptoms. Single lesion was found in 93.1%, multiple lesions in 6.9%. Operative procedures as follows: 30 local resections of the lesion, 14 hepatic segmentectomies, 9 hepatic lobectomies, 2 hepatic artery ligations, 1 hepatic artery ligation plus drainage of cyst, 2 liver biopsies. No operative mortality and no serious morbidity were noted. Conclusions　With popularization of advanced imaging techniques, the incidences of the benign tumor and tumor-like lesions of the liver have been increased in recent years. However, current imaging studies lack specificity, and differential dignosis of these lesions remains difficult. So we should be familiar with the clinical behavior, presentation of imagings and management of the diseases mentioned above.

Objective To evaluate the influence of the resolution of medical grayscale LCD over the detective efficiency of pulmonary nodule.Methods By reviewing PACS, 93 on-line chest DR images were collected.These radiographs included 23 normal images that had no nodule confirmed by CT, 32 doubtful images that also had no nodule confirmed by CT,and 38 positive images that had nodules confirmed by CT.These nodules didn't show obvious calcification and their diameters were from 0.30 to 1.90 cm. Nine patients had multi-nodules.Three residents or postgraduates, three attending physicians, and three associate professors or professors interpreted the 93 chest images by using three types of displays: Barco Z-2261, Barco Z-3620 and Barco Z-5620.All observers evaluated their confidence of the presence of pulmonary nodule with five-point level rating scale : ( 1 ) definitely positive, ( 2 ) probably positive, ( 3 ) uncertain, (4) probably negative, (5)definitely negative.SPSS 11.5 software was used to analyze the results ,including to draw the ROC curves and to perform Z test.Results The areas under the ROC curves of 2 M display, 3 M display and 5 M display were 0.774,0.784,0.816 for experienced radiologists; for instructors were 0.754,0.764,0.768 ;for teaching assistants were 0.695,0.754,0.774.However, for the detection of pulmonary nodules,there was no significant difference between observers with different ranks using the same modality of display,and no significant difference was found between the different modalities of displays used by observers with the same rank.Conclusion It's equivalent for detection performance with 2,3 and 5 M medical grayscale LCD display in detecting pulmonary nodule; Experienced radiologists can get more information using 5 M display;By reasonably matching displays, we could improve the cost-efficacy.

[ABSTRACT]OBJECTIVETo investigate the clinic significance of nasal septal swell body by observing and measuring it in the normal and deviated nasal septum on CT images.METHODSThe locations of the nasal septal swell bodies on horizontal CT images in 50 normal subjects and 30 patients with deviated nasal septum were studied, and their length, width and the thicknesses of the mucosa of the both sides were measured. The data were analyzed with SPSS.RESULTSSeptal swell bodies were observed in most of CT images. The swell body was fusiform and located anterior to the middle turbinate, with mean(SD) width of (10.30±1.27) mm and length of (31.35±5.18) mm. There no marked difference in thickness of the nasal septal swell body between two sides of the nasal septum in normal nasal septum, but the thickness of the nasal septal swell body in camber side was thicker than that in the other side of the deviate nasal septum.CONCLUSIONThe shape and location of spetal swell body suggests its potential capacity may be to alter the nasal airflow. Additional study is required for its clinical significance.

Metastasis to liver is the most happened distant metastasis and is the leading cause of death in patients with colorectal cancer.Complete surgical resection of liver metastases from colorectal cancer is major curative method for resectable metasrases.Other methods such as chemotherapy, targeted therapy, hepatic ar-tery intervention, radiotherapy, radiofrequenly ablation or cryo-ablation should be considered.Both systemic and local treatment are.important for liver metastasis from colorectal cancer.

18F-2-fluro-D-deoxy-glucose (18F-FDG) is used by positron emission tomography/computed tomography (PET/CT) examination as an imaging agent,by observing the uptake of the agent of the lesion to determine its metabolism,and make a diagnosis.It can provide anatomical and functional at the same time,not only qualitative but also position and can significantly improve the accuracy of diagnosis.Currently PET/CT has been widely used in the clinical aspects of the differential diagnosis of benign and malignant tumors,prognostic assessment and so on.The property of pleural effusion is important to the treatment and prognosis of the disease.

Obstetrics and Gynecology Hospital, Capital University of Medical Science, Beijing 100026, ChinaAbstract Objective To observe the change of lipid metabolic parameters, sex hormone and bone mineral density(BMD) in patients with endometriosis before and after oral administration of gestrinone. Methods Fifty-six patients with endometriosis, aged from 20 to 45, were treated with gestrinone 2.5 mg two times a week for 6 months one week after operation. Serum total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C), low density lipoprotein-cholesterol(LDL-C),ApoA_1,ApoB,follicle stimulating hormone (FSH), luteinizing hormone(LH),E_2 and BMD were determined before taking gestrinone, after taking for 6 months and withdrawal for 6 months. Results After administration of gestrinone for 6 months, serum HDL-C and ApoA_1 decreased significantly (P