ObjectiveTo investigate whether the T1-weighted dynamic contrast-enhanced perfusion magnetic resonance imaging (DCEPMRI) technique can help to delineate the clinical target volume of brain glioma patients.MethodsThe DCE T1-weighted images from 28 glioma patients were collected after GdDTPA was injected.After the acquired images were processed and analyzed using modified Tofts-Kermode'two compartment analysis model and de-convolution method,the value and its pseudo mapping of quantitative parameter Ktrans related to microvascular permeability were obtained.The tumor size in the largest diameter slice measured both in routine enhanced MRI and Ktrans mapping of T1-weighted DCEPMRI were compared.ResultsThe vascular permeability and tumor infiltration was lower in low grade glioma,the difference of the tumor size between T1-weighted DCEPMRI and routine enhanced MRI reached 0.2％ -0.3％ there was significant difference of tumor size between T1 -weighted DCEPMRI and routine enhanced MRI ( grade Ⅰ and Ⅱ grade with 2.93 cm2∶2.46 cm2(t=6.90,P=0.000) and 4.18 cm2∶3.21 cm2(t=10.22,P=0.000) ).While in high grade glioma,the vascular permeability and the tumor infiltration were higher,the difference of the tumor size between T1-weighted DCEPMRI and routine enhanced MRI reached 25％ - 26％( the size of grade Ⅲ and Ⅳ were 6.46 cm2 vs 5.48 cm2 ( t =10.83,P =0.000) and 8.26 cm2 vs 6.52 cm2(t =18.53,P =0.000) ).ConclusionsThe pseudo mapping of quantitative parameter Ktrans related to microvascular permeability acquired by T1-weighted DCEPMRI reflect the infiltrating circumscription in glioma,T1-weighted DCEPMRI can provide more information in delineation the clinical target volume,and it can be used as a new method for tumor volume evaluation.

margin from CTV to PTV.

Objective To scrutinize the positioning accuracy and reproducibility of the cone-beam computed tomography system in combination with the six-degree couch table (Hexapod Robot Treatment Table, HRTT). Methods The mechanical stability of the X-ray volume imaging (XVI) system was tested,in terms of the reproducibility. And the influence of the moveable parts, including the KV panel and the source arm, on the accuracy of the XVI image registration was analyzed. The accuracy between the bone and grey value registration was compared using a head-and-neck phantom. The accuracy of the HRTT for translational, rotational, and a combination of translational and rotational corrections was investigated in consecutive measurements. Results The performance of XVI system itself was stable with translational and rotational error of below 0. 4 mm and below 0. 3°, respectively. The mean position accuracy of the XVI system in combination with the HRTT summarized over all measurements was below 0. 6 mm and below 0. 4° for translational and rotational corrections, respectively. The grey value match was more accurate than the bone match. Conclusions The XVI image acquisition and registration procedure were highly reproducible.Both translational and rotational positioning errors can be corrected very precisely with the HRTT. The HRTT is therefore well suited to complement CBCT to take full advantage of position correction in six degrees of freedom for image guided radiotherapy.

Objective To study the outcomes of nasopharyngeal carcinoma treated by late-course 3-dimentional conformal radiotherapy(3DCRT). Methods 37 primary nasopharyngeal carcinomas were involved into the CRT group. A total dose of 70 Gy to 74 Gy was delivered by using the conventional method (36 Gy) and late-course 3DCRT technique (34 ~ 38 Gy). This group was matched with a same number of patients who were treated with conventional method alone (Routing group). The treatment results and acute toxicity between the two groups were analyzed. Results The complete response (CR) rate of primary tumor was achieved 100 % in CRT group and 86 % in routing group, respectively. The CRT group had severe mucositis and peripheral neuropathy, but the difference was not statistically significant. There was no difference in the overall survival between the two groups. Conclusion Late-course 3DCRT is an effective method in the treatment of primary nasopharyngeal carcinoma.

ObjectiveTo analyze the correlation between primary tumor volume (PTV) and prognosis of nasopharyngeal carcinoma ( NPC ) treated by intensity-modulated radiotherapy ( IMRT ).Methods330 NPC patients treated by IMRT were included.Pretreatment computerized tomography image were input into tree-dimensional treatment-planning system,in which the primary tumor volume were calculated automatically.The receiver operating characteristic curve was used to determine the best cut-off point of PTV.Within the framework of UICC 2002 T stage,The PTV was divided into four groups:V1 ＜ 10cm3,V2 10-25 cm3,V3 ＞ 25-50 cm3 and V4 ＞ 50 cm3.Kaplan-Meier and Logrank test was used to analyze the survival,Cox proportion risk regression model were used to analysis the correlation between PTV and prognosis.ResultsThe mean PTV for all NPC patients was ( 34.2 ± 27.1 ) cm3 with the range of 0.4- 153.7 cm3.The 3-year overall survival for V1,V2,V3 and V4 stage were 88.6％,90.0％,91.2％ and 74.2％,respectively (x2 =12.83,P =0.005 ).There was no significant difference among V1,V2 and V3in terms of overall survival ( x2 =1.96,P =0.376).The 3-year distant metastasis-free survival and diseasesfree survival or overall survival were decrease in PTV ＞50 cm3 and PTV≤50 cm3 (77.4％:89.9％,x2 =7.24,P=0.007and 64.5％:85.1％,x2 =13.95,P=0.000 or 74.2％:90.3％,x2 =11.76,P=0.001).Multivariate analysis revealed that PTV was a adverse prognostic factors for overall survival (x2 =0.00,P =2.580).ConclusionOur data showed that the primary tumor volume had significantly impacted on the prognosis of NPC patients treated by intensity modulated radiotherapy.

Objective To compare the prognostic value of the 7th edition of AJCC cancer staging system in nasopharyngeal carcinoma (NPC) patients treated with conventional radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT).Methods From January 2004 to December 2006,totally 1138 NPC patients were treated with CRT (790 patients) and IMRT (348 patients) in Cancer Hospital of Fujian province.The median ages were 47 and 45 years old for two groups ( x2 =1.49,P =0.222 ),respectively.There were 0,41,488,261 and 5,65,176,102 patients in stage Ⅰ,Ⅱ,Ⅲ,Ⅳ of the two groups after restaged with 7th edition of AJCC cancer staging system,respectively (x2 =64.78,P =0.001 ).The 3-year survival was analyzed according to T-category,N-category and overall stage.Results The follow-up rate at 3 years is 96.0％.The median follow-up were 32 months and 33 months for CRT and IMRT groups.N-category was found to be the prognostic factors for overall survival (OS,x2 =6.50,P =0.038 and x2 =13.60,P =0.004) and metastasis free survival ( MFS,x2 =7.78,P =0.009 and x2 =15.30,P =0.002) for CRT and IMRT groups.The clinical stage was prognostic factor for OS in conventional group ( x2 =6.70,P=0.035),and for MFS in IMRT group (x2 =9.12,P=0.028).Conclusions The T-calegory of 7th AJCC staging system shows poor predictive value for the long-term survival of NPC patients.The N-calegory of 7th AJCC staging system can well estimate the OS and MFS for NPC.

Aim To isolate and purify a novel plasminogen activator(PA)from Gloydius brevicaudus venom(GBV)and study characterization and biological activities of GBV-PA.Methods Affinity chromatography in Benzamidine Sepharose 6B(AC)and Lichrospher C-18 4.6/250 reversed phase chromatography(RPC)were used for isolation and purification;SDS-PAGE was used to detect molecular weight(MW);Disc polyacrylamide gel eletrophoresis was used to measure the point of isoelectric(pI);Chromogenic substrate method was used to observe the biological activities.Results A novel GBV-PA which its purification reached the homogeneity level was isolated and purified from GBV by AC and RPC;The MW of the novel GBV-PA was 3.26?104 and the pI was 5.2;The novel GBV-PA activated human plasminogen specifically and the special activity was 2.87 t-PA IU?mg-1;Moreover,our results indicated that this novel GBV-PA was a serine proteinase which had no affinity to fibrin.Conclusion A novel GBV-PA that can be isolated and purificated from GBV by AC and RPC was proved to be a serine protease and has no affinity to fibrin.

Objective To observe the nasal flush combined budesonide suspension liquid atomizing inhaled treatment of allergic rhinitis in infants,explore the allergic rhinitis treatments in infants. Methods 137 cases diagnosed as allergic rhinitis were collected and randomly divided into 70 cases as the treatment group and 67 patients as the control group. The patients in control group were washed the nasal cavity with 2.8% warm sodium chloride solution using 50ml and 0.5% metronidazole injection 30ml by turn. At the first week, 1 time/d, then one time every other day,while according to age,body mass the patients were given to loratadine, 1 time/d. Treatment group were used budesonide nasal inhalation of 1 ml at the base of treatment of the control group. Before and after the treatment , nasal congestion,sneezing, flow clear nose, sleep snoring and sleep quality score index were observed and compared.Results 70%of the treatment group the nasal congestion,sneezing,flow clear in 3 times after treatment with ease.The children sleep quality improved and the snoring fewer over night,only 56.7% of the control group of these symptoms improved. After the treatment the efficiency evaluation of treatment group and control group respectively was 95.1% and 77.7% ,there was statistically significant difference( x2 =9.83 ,P ＜0. 01 ). 137 cases of patients without a side effects. Conclusion curative effect of nasal flush combined budesonide suspension liquid nasal spray inhaled treatment of allergic rhinitis was distinct,infant effect-acting quickly,without side effects,easy to use.

Background and purpose: Cervical nodal metastasis in nasopharyngeal carcinoma plays an important role in the definition of radiotherapy area and clinical staging, it is also one of the main factors influencing prognosis. So this study was designed to explore the pattern of metastatic lymph nodes for patients with nasopharyngeal carcinoma, which may provide a basis for clinical treatment and research. Methods: From Jun. 2005 to Sep. 2007,779 histologically diagnosed nasopharyngeal carcinoma patients had routine MRI scan before radiation therapy at Fujian Provincial Cancer Hospital. Diagnostic radiologists and radiation oncoiogists together assessed the nodal distribution according to the guideline CT-hased delineation of lymph node levels. Then, Chi-sqnare test was used to analyze the correlation between T stage and nodal metastasis rate and between nodal diameter and nodal extracapsular invasion. Results: Of 779 patients, 592(76.0%) had nodal involvement. The distribution was as follows: 1 in level Ⅰ,384 in level Ⅱa, 499 in level Ⅱ_b, 184 in level Ⅲ, 33 in level Ⅳ, 67 in level V_a, 21 in level V_b, 597 in retropharynx.In these patients, a total of 1 479 postive nodes, including 973 (65.79%) extracapsular spread nodes, were detected.The rate of nodal extracapsular invasion was higher when the axial diameter increased. Leap metastasis rate was 1.0%. No significant correlation was found between T stage and nodal involvement. Conclusion: The level Ⅱ and retropharyngeal node were the most frequently involved regions, they had similar metastatic rate and were both the first echo node to metastases of nasopharyngeal carcinoma. Level Ⅰ metastasis was lower. The proportion of extracapsular spread of metastatic lymph nodes increased with axial diameter of lymph nodes-dependent. The cervical node involvement of nasopharyngeal carcinoma was spread orderly down the neck, and the incidence of skip metastasis is rare. The relationship between T stage and nodal involvement has no statistical significance.

Objective To carry out a comparative study between the Chinese 2008 and'92 staging system of nasopharyngeal carcinoma (NPC). Methods A total of 777 patients presented with untreated nondisseminated NPC who had received MRI scan of nasopharynx and neck were studied retrospectively. The clinical materials and information of imaging were collected. All patients were restaged according to the Chinese 2008 and 92 staging system of nasopharyngeal carcinoma. Distribution of T, N stage, survival and prognostic value were compared. 513 patients of the 777 cases were treated with conventional radiotherapy,264 cases with intensity modulated radiation therapy. Results The 3-year follow-up rate was 97.6%. The consistency of T stages was 95.0%. T, N and clinical stage distributions in two systems were similar ( Kappa = 0. 93, P = 0. 000; Kappa = 0. 58, P = 0. 000; Kappa = 0. 74, P = 0. 000). Local failure-free survival and disease specific survival were also similar. There was no difference of distant metastasis between N0 and N1(x2 = 1.94,P=0. 164), and a marginal difference between N1 and N2(x2 =3.83,P=0.051) in the Chinese'92 staging system. However, although there was also no difference of distant metastasis-free survival between No and N1a(x2 =0. 07,P =0. 797), ) the difference of overall survival among N1b, N2, and N3 were significant ( x2 = 4. 95, P = 0. 026; x2 = 6. 74, P = 0. 009) in the Chinese 2008 staging system. Conventional radiotherapy or intensity modulated radiation therapy was not a prognostic factor for survival ( x2 = 3.60,P =0. 058). It is reasonable for the Chinese 2008 staging system integrated lymph node characteristics such as laterality, level and extranodal neoplastic spread into the N staging criteria ( x2 = 6. 59, P = 0. 010; x2 =4.78,P=0. 029;x2=9.32,P=0. 002). Conclusions For the Chinese 2008 staging system, it was reasonable to simplify the previous T stage. The N stage showed a better predictive role of distant failure.The role of retropharyngeal lymph node in stage system needs further investigation.