Objective To explore the function of stereotactic radiation therapy (SRT) and wholebrain radiation therapy (WBRT) in treatment of multiple brain metastasis tumor.Methods Fifty-two patients with multiple brain metastasis tumor were retrospectively analyzed.The patients were divided into simple stereotactic radiation therapy group (22 cases) and whole-brain radiation therapy + stereotactic radiation therapy group (30 cases) according to the radiation therapy method.The median overall survival time and distant brain tumor recurrence rate in 1 year etc.were compared between 2 groups.Results There were no statistical differences in the median overall survival time and fatality rate between simple stereotactic radiation therapy group and whole-brain radiation therapy + stereotactic radiation therapy group:13.0 months (95％ CI 8.05-27.84) vs.13.4 months (95％ CI 8.57-19.48),86.36％ (19/22) vs.86.67％ (26/30),P＞ 0.05.The distant brain tumor recurrence rate in 1 year in simple stereotactic radiation therapy group was significantly higher than that in whole-brain radiation therapy + stereotactic radiation therapy group:45.45％ (10/22) vs.20.00％ (6/30),and there was statistical difference (x2 =3,861,P =0.049).Conclusion Stereotactic radiation therapy and whole-brain radiotherapy can achieved similar median overall survival time.

Objective To evaluate results of surgical treatment for patients with acute type A aortic dissection using Sun’s operation and triple-branched stent graft. Methods According to the operation mode, thirty-three patients with type A aortic dissection were divided into Sun’s operation group (n=22) and triple branches aortic arch stent-graft placement op?eration (triple-branched) group (n=11). Preoperative examinations included cardiac ultrasound, aortic CT angiography (CTA), hepatic and renal functions and blood routine test in all patients. Intraoperative monitoring included the index about cardiopulmonary bypass and blood loss. The perioperative hepatic and renal functions and complications were also recorded. Survival and recovery rates were evaluated by follow-up between two groups of patients. Results There were six periopera?tive death in Sun’s group, and three patients died in triple-branched group. In triple-branched group, the intraoperative blood loss was significantly increased than that in Sun’s group [(3 586.4±2 926.8) mL vs. (2 630.5±1 821.2) mL, P<0.05]. Postoperative echocardiographic examinations revealed that the left ventricular size (LVEDd) and the aortic diameter were decreased while the left ventricular ejection fraction (LVEF) was elevated after surgery in Sun’s group [(50.9±6.9) mm vs. (55.0±7.5) mm,(28.2±1.6) mm vs. (48.8±11.0) mm, 0.620±0.031 vs. 0.469±0.104, P<0.05]. Whereas, only the aortic diame?ter was decreased after surgery in triple-branched group [(28.6±3.9) mm vs. (50.9±9.2) mm, P<0.05]. Kaplan-Meier surviv?al curve showed that five-year survival rate of Sun’s group was similar with that of triple-branched group (Log-rank χ2=0.095,P>0.05). At 5 year after operation, there were no significant differences in the recurrence of new aortic dissection, the incidence of cerebral infarction and mortality between Sun’s group and triple-branched group (P>0.05). Conclusion Sun’s operation can significantly decrease patient’s intraoperative blood loss and improve cardiac function. But its survival rate and long term results need advanced observation.

Objective To investigate the metabolic rules of surfactant protein A and D(SP- A,SP- D )in bronchoalveolar lavage fluid(BALF)in human fetal lungs during gestational ages. Methods BALF with 30 mL saline was performed on clinically collected human fetus with induction of labor by water- bag Their BALF was respectively retrieved [total retrieval rate(85. 6% ? 13 1)% ]for analysis of protein content. The BALF SP - A and SP - D from fetus of various gestational ages or newboms were detected by RPHA and ELISA. Results The total protein in BALF gradually increased since 10th week to newborn peak during lung development. And SP - A and SP D were respectively updated from(0.34 ?0.07 ) ,(0.05?0.01) ng/L to newborn climax[ (6 42 ? 0 36),(1.22 ? 0 13)ng/L] .Conclusions The protein in BALF gradually increases with fetal growth and lung development. SP-A and SP- D may reach prenatal climax and become the main indicator of newborn lung maturity.

Objective: To summarize and analyze the early outcomes and clinical experience in 1198 patients undergone off-pump coronary artery bypass (OPCAB). Methods: This multi-center report covers 15 different institutes in China from October 1996 to May 2002. The ratio of OPCAB to conventional coronary artery bypass grafting (cCABG) was 85.2%. The mean age was (61.6?9.0) years. 77.3% patients were male and 22.7% were female. There were 34.6% patients with myocardial infarction, 58.2% with unstable angina pectoris, 18.7% with left main lesion, 76.9% with triple-vessel disease, 1.5% was redo surgery, and 9.9% emergent or urgent surgery. The mean left ventricular ejection fraction was 0.56?0.17. Results: The number of distal anastomosis was 3.1?0.9. IMA was used in 65.6% patients and radial artery was used in 18.0%. 13.5% OPCAB was combined with TMLR. IABP was used in 5.2% patients. The hospital mortality was 1.2%. The morbidity included 0.4% peri-operative myocardial infarction, 0.3% heart failure, 1.2% fatal arrhythmia, 2.0% pulmonary complications, 1.2% neurotic disorder, 0.7% renal dysfunction, 1.0% reopen for bleeding, and 0.6% delayed wound healing. Conclusion: OPCAB surgery is a safe and feasible procedure with good early results. Its late outcomes need further follow-up. OPCAB requires certain special skills and methods in practice so a specific training course should be designed.

0.05).[Conclusion]Lateral-anterior fixation with use TSRH not only has effective result in strength, rigidity and stability of the spine, but also is superior to the control group in loading-bearing ability and stability of the spine. There is no significant difference between the TSRH group and Z-plate group. But TSRH is relatively simple to operate and is cheaper than Z-plate, and has exact clinical ontcome.

Alveolar Epithelial Cells ; metabolism ; pathology ; Animals ; Apoptosis ; physiology ; Cell Survival ; physiology ; Cells, Cultured ; Epithelial Cells ; cytology ; physiology ; Genes, bcl-2 ; genetics ; Genes, p53 ; genetics ; Oxidative Stress ; genetics ; Rats

Objective To discuss effect of serum immunoglobulin M (IgM) and superoxide dismutase (SOD) by percutaneous epidural steroid injections in patients with lumbar disc herniation.Methods 137 patients with lumbar disc herniation were selected in Central of Hospital of Wuhan,all patients were randomly assigned joint group and O3 group, all patients were given ozone (O3) injection treatment, before treatment the joint group was given percutaneous epidural steroid injections, the joint group on the basis of O3 injection method was divided into multi-way group and routine group, followed up for 6 months, analyzed all patients therapeutic effect and recurrence rate,used enzyme-linked immunosorbent method to detect patients with serum IgM, SOD level, Pearson analysis method was used to analyze the relationship between the two groups.Results The joint group treatment effective rate was 91.89%, O3 group treatment effective rate was 79.73%, the former was higher than the latter, the difference was statistically significant ( P<0.05), The joint group serum IgM, SOD level was better than O3 group(P<0.05), In six months, multi-way group recurrence rate was 10.81%, routine group recurrence rate was 18.92%,O3 group recurrence rate was 31.08%, multi-way grou P

Objective To investigate the clinical significance of changes in vascular endothelial cells during the development of glucocorticoid-induced avascular necrosis of femoral head(GANFH),and the preventive and therapeutic effects of "Cugusu Keli",a mixture of traditional Chinese medicines,on GANFH in rabbit.Methods Forty-eight New Zealand white rabbits were randomly assigned to four groups,12 in each,as control group,model group,therapy group and prevention group.The contents of plasma von Willebrand's factor(vWF),6-keto-prostaglandin F1?(6-keto-PGF1?)and the activity of plasminogen activator inhibitor 1(PAI-1)were determined at the 2nd,4th,6th,8th and 12th week after treatment.Meanwhile,rabbits were sacrificed at the 4th,8th and 12th week,and both femoral heads of all rabbits were obtained for histopathological examination.Results Compared with control group,the level of vWF and activity of PAI-1 in model group were elevated since the 4th and the 2nd week,while the level of 6-keto-PGF1? increased since the 4th week(P0.05).Compared with the model group,the level of vWF and activity of PAI-1 in therapy group was lowered,while the level of 6-keto-PGF1? increased(P

Objective To compare the clinical efficacy and the adverse reaction of transcatheter arteri-al chemoembolization( TACE)alone and combined with stereotactic body radiation therapy( SBRT)in patients with primary hepatic carcinoma by a Meta-analysis. Methods PubMed,Cochrane Library,EMBase,Ovid, MEDLIN,CNKI,CBMdisc,VIP and Wanfang were searched to identify the controlled clinical trials of TACE and SBRT for primary hepatic carcinoma. The obtained data were analyzed using Review Manager version 5. 2 provided by Cochrane Collaboration. To analysis the short-term effect of TACE alone or combined with SBRT, the rate of local tumor control and the difference of one,two,three and five-year survival rate. Results A total of 1 143 patients from 10 controlled clinical trials were involved according to the inclusion criteria. The Meta-analysis showed that TACE and SBRT group significantly increased the short-term effective rate,the rate of local tumor control,l-,2-,3-and 5-year overall survival rates(RR=1. 43,95%CI:1. 32-1. 56,P﹤0. 000 01;RR=2. 09,95%CI:1. 63-2. 69,P﹤0. 000 01;RR=1. 31,95%CI:1. 21-1. 42,P﹤0. 000 01;RR=1. 46, 95%CI:1. 23-1. 72,P﹤0. 000 01;RR=1. 76,95%CI:1. 14-2. 71,P=0. 01;RR=2. 29,95%CI:1. 22-4. 32, P=0. 01). There was no statistically significant difference between the two groups on adverse events such as leucopenia(RR=0.97,P =0. 61),thrombocytopenia(RR =0. 99,P =0.85),hemoglobin decrease(RR =0. 95,P=0. 63),nausea and vomiting(RR=1. 00,P=0. 98),liver function damage(RR=0. 98,P=0. 87). Conclusion Compared with TACE,TACE combined with SBRT can increase the short-term effective rate,the rate of local tumor control,the 1-,2-,3-and 5-year overall survival time of the patients,and does not increase the incidence of adverse reaction. However high-quality trials with large sample sizes are still needed to verify the long-term efficacy and safety.

Objective To study the expression of P57kip2 and its clinical significance in hilar bile duct adenocarcinoma.Methods The expressions of P57kip2 in hilar bile duct adenocarcinoma tissues (37 cases) and normal bile duct tissues (32 cases) were determined by immunohistochemical SP methods.The relations between the expression levels of P57kip2 with clinicopathologic parameters were analyzed.Results The positive rate of P57kip2 was 43.2％ (16/37) in bile duct adenocarcinoma,while it was 87.5％ (28/32) in normal duct tissues (P ＜0.01).The expression level of P57kip2 in adenocarcinoma showed no significant association with gender,age or CA19-9 level (P ＞0.05),but they were significantly related with lymph node metastasis,invasion and degree of differentiation (P ＜ 0.05).Conclusions P57kip2 is associated with the occurrence and development of hilar bile duct adenocarcinoma.It may play an important role in invasion and metastasis of hilar bile duct adenocarcinoma.The P57 protein can be used as an index to diagnose hilar bile duct adenocarcinoma.