Medical Picture Archiving & Communication System (PACS) and Radiology Information System (RIS) are the two embranchments of medical informatics developing most rapidly. The correlative legal issues of medical PACS and RIS should be paid attention to.

Purpose:To evaluate the treatment results of induction chemotherapy followed by radiotherapy in patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma.Methods:Fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma were treated by induction chemotherapy followed by definitive radiation therapy (CT/RT group). This group was matched with a group of fifty patients with stage Ⅲ and Ⅳ nasopharyngeal carcinoma treated with radiotherapy alone (RT group). Results: The 5 year loco regional control was 61.2% for the CT/RT Group and 68.7% for the RT Group; The 5 yera distant metastasis was 15.2% for the CT/RT group and 27.1% for the RT Group; The 5 year distant metastasis for the patients with stage N 2 and N 3 disease was 27.4% for the CT/RT Group and 43.8% for the RT Group respectively; The overall 5 year survival (OS) was 57.8% for the CT/RT group and 51.6% for the RT group( P =0 61); The 5 year OS of N 2 and N 3 patients was 60.6% for the CT/RT group and 26.3% for the RT group( P =0 033);The 5 year OS of T 3 and T 4 patients was 36.8% for the CT/RT group and 41.2% for the RT group ( P =0 80) respectively. There were no significant differences in the incidence of acute mucositis between the two groups during radiotherapy, the side effects in leukopenia, nausea, vomiting were higher in CT/RT group than in RT group. No Grade 3 or higher late complications were observed in both groups. Conclusions:Induction chemotherapy followed by definitive radiation therapy did not improve the 5 year survival and loco regional control for the stage Ⅲ and Ⅳ nasopharyngeal carcinoma, but reduced the distant metastasis for the stage N 2 and N 3 patients; The overall 5 year survival rate for the patients with N 2 and N 3 nasopharyngeal carcinoma was improved by induction chemotherapy followed by radiotherapy. [

Objective: To investigate the expression of midkine (MK) gene in childhood acute lymphoblastic leukemia (ALL) and the clinical significance of MK thereof. Methods: The real-time PCR was used to assay MK gene expression in bone marrow of 15 normal children and 124 childhood ALL patients, including 73 patients in progression and 51 patients in complete remission. Three stratifications of progressing patients were established by prognostic factors such as white blood cell count, age, immunopherotype and response to the 7-day prednisolone prephase. Results: The significant statistic difference in MK gene expression was found between the progression group, the complete remission group and the normal group (P< 0.01). The MK gene expression was over-expressed in B-ALL than that in normal group. Furthermore, there was statistic difference between B-ALL and T-ALL (P< 0.01). But there was no difference in MK mRNA expression between the normal control and T-ALL. The assay in risk stratifications showed that the levels of MK gene were higher in standard risk group and mid-risk group than that in high risk group (P< 0.01 and P< 0.05, respectively). There was no significant difference between standard risk group and mid -risk group (P = 0.32). No correlations were found between MK level and age, gender or lactate dehydrogenase level in serum. The expression of MK was significantly lower in the group with higher white blood cells(WBC≥ 25×10~9/L) than that with lower WBC (WBC<25×l0~9/L) in peripheral blood (P< 0.05). Conclusion: The high level of MK was a favorable prognostic factor in childhood acute lymphoblastic leukemia patients.

In order to provide anatomical basis for transoral approach (TOA) in dealing with the ventro lesions of craniocervical junction, and the design and application of artificial atlanto-odontoid joint, microsurgical dissecting was performed on 8 fresh craniocervical specimens layer by layer through transoropharyngeal approach. The stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationship of atlas and axis and correlative anatomical parameters of replacement of artificial atlanto-odontoid joint were observed. Besides, 32 sets of atlanto-axial joint in adults' fresh bony specimens were measured with a digital caliper and a goniometer, including the width of bony window of anterior arch of atlas, the width of bony window of axis vertebra, the distance between superior and inferior two atlas screw inserting points, the distance between two axis screw inserting points etc. It was found that the width of atlas and axis which could be exposed were 40.2+/-3.5 mm and 39.3+/-3.7 mm respectively. The width and height of posterior pharyngeal wall which could be exposed were 40.1+/-5.2 mm and 50.2+/-4.6 mm respectively. The distance between superior and inferior two atlas screw inserting points was 28.0+/-2.9 mm and 24.0+/-3.5 mm respectively, and the distance of bilateral axis screw inserting points was 18.0+/-1.2 mm. The operative exposure position through TOA ranged from inferior part of the clivus to the superior part of the C3 vertebral body. Posterior pharyngeal wall consisted of 5 layers and two interspaces: mucosa, submucosa, superficial muscular layer, anterior fascia of vertebrae, anterior muscular layer of vertebrae and posterior interspace of pharynx, anterior interspace of vertebrae. This study revealed that it had the advantages of short operative distance, good exposure and sufficient decompression in dealing with the ventro lesions from the upper cervical to the lower clivus through the TOA. The replacement of artificial atlanto-odontoid joint is suitable and feasible. The design of artificial atlanto-odontoid joint should be based on the above data.
Atlanto-Axial Joint/*anatomy & histology ; Atlanto-Axial Joint/*surgery ; Bone Plates ; Bone Screws ; Cadaver ; Cervical Vertebrae/*anatomy & histology ; Cervical Vertebrae/surgery ; Equipment Design ; Internal Fixators ; Joint Prosthesis ; Models, Anatomic ; Odontoid Process/*surgery ; Prosthesis Design

Objective To validate genetic suppression of metastastic capability of highly metastastic melanoma cells by endostatin transfection.Method pcDNA3.1-Endo eukaryotic expression vector contained insulin signal peptide sequence was transfected into highly metastatic mice melanoma cell strain B 16.The expression of endostain was detected by RT-PCR and Western blot experiment,melanoma cells were determined with adhere experiment,in vitro invasion and migration experiment and pulmonary metastasis experiment on C57BL/6 mice.Result Endostatin can obviously inhibit the capability of adherence,in vitro invasion and migration and pulmonary metastasis of melanoma cells.Among them,adhere inhibition ratio was 67.3%,in vitro invasion inhibition ratio was 48.4%,cell migration inhibition ratiowas 52.1%and pulmonary metastasis inhibition ratio was 67.3%.Conclusion Endostatin transfection can obviously inhibit the highly metastatie capability of melanoma cells.

Objective To screen and identify the differential expression genes on peripheral blood cells of mice based on the experimental animal model of radon exposure. Methods BALB/c mice were exposed in a type HD-3 multifunctional radon-room, with the accumulative doses of radon-exposure group at 105 WLM and control group at 1 WLM. Total RNA was extracted from peripheral blood cells and the methods of SMART for dscDNA synthesis and SSH for gene screening was applied. With the construction of the cDNA library enriched with differentially expressed genes, the pMD 18-T plasmid containing LacZ operator at the multiple cloning site was used to allow a blue-white screening. The TA clones were amplified by nested PCR and the reverse Northern blot was used to identify up and down regulation of the clones. The differently expressed cDNA was then sequenced and analyzed. Results The subtracted cDNA libraries were successfully constructed. A total of 390 recombinant white colonies were randomly selected. Among the 312 cDNA monoelones selected from bath forward- and reverse-subtracted libraries,41 clones were chosen to sequence for their differential expressions based on reverse Northern blot. Among the 41 sequenced clones, 10 clones with known function/annotation and 3 new ESTs with the GenBank accession numbers were obtained. Most of the known function/annotation genes were revealed to be related with cell proliferation, metabolism, cellular apoptosis and carcinogenesis. Conclusions The animal model of radon exposure was established and the cDNA library of peripheral blood cells was suceessfully constructed. Radon exposure could up- and down-regulate a series of genes. Differentially expressed genes could be identified by using SSH technique and the results may help exploring mechanisms of random exposure.

Objective To observe the intervention effects of Xintongfang on the expression of P-selectin (PS), P-selectin glycoprotein ligand-1 (PSGL-1), platelet-leukocyte aggregates (PLA) and platelet-monocyte aggregates (PMA) in patients of coronary heart disease with carotid artery plaque. Methods Sixty patients were randomly divided into Xintongfang group and the control group, with 30 cases in each group. Xintongfang group was given Xintongfang, the control group was given aspirin and atorvastatin calcium for two months. The expression of PS, PSGL-1, PLA and PMA were tested by flow cytometry before and after treatment. Results The expression of PS, PSGL-1, PLA and PMA in two groups were reduced (P<0.01). Xintongfang group had more obvious effects on the expression of PLA and PMA than the control group (P<0.05). Conclusion Xintongfang can reduce the degree of inflammatory in patients of coronary heart disease with carotid artery plaque by inhibiting platelet-leukocyte interaction.

Objective To observe therapeutic effect in the near future of the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and complications.Method According to symptoms,signs,myelography and CTM results to determine protrusion interspace and side type,applied the operation of vertebrascope in route of retreat to treat lumbar disc protrusion and perform functional exercises.Results 86 patients were followed up,and within these patients,58 appeared excellent (67% ),25 appeared good (29% ), 2 appeared not bad (2% ),and 1 appeared bad(1% ).Conclusion The technology has many advantages, such as little wound, little hemorrhage, little pain and fast restoration,which provide advantageous conditions for early functional exercises after operation.

Objective To assess the efficacy and safety of two different protocols of ketogenic diet (KD)-eating on demand or eating at regular intervals for refractory epilepsy in children.Methods Sixty children with refractory epilepsy were randomly divided into eating on demand group (n =30) and eating at regular intervals group (n =30) by random number table method.After taking the whole amount of KD,the capillary blood ketone and glucose level and urine ketone were monitored every 6 hours in 72 continuous hours.Seizure frequency and onset time were recorded.Antiepileptic efficacy and diet tolerability of the two groups were evaluated on 4 weeks,12 weeks,24 weeks and 48 weeks after initiating the diet.Adverse effects were monitored.Results After treatment of 4 weeks,the complete seizure remission rates of eating on demand group and eating at regular intervals group were 33.3％ (10/30) and 30.0％ (9/30) respectively,which suggested a comparable efficacy for two groups (P ＞ 0.05).The day when KD started to work was averaged (6.18 ± 2.42) d and (8.63 ± 2.63) d respectively.The group of eating on demand showed a faster onset of action (P ＜0.05).After treatment of 12 weeks,24 weeks and 48 weeks,complete seizure remission rates of eating on demand group were 30.0％ (9/30),34.8％ (8/23) and 36.8％ (7/19) respectively;the eating at regular intervals group were 33.3％ (10/30),30.4％ (7/23) and 44.4％ (8/18) respectively.The two groups had no significant difference (P ＞ 0.05).One year later,the treatment retention rates of the two groups were 63.3 ％ (19/30) and 60.0％ (18/30) respectively.There was no significant difference (P ＞ 0.05).The adverse effects mainly including transient gastrointestinal symptoms and metabolic disturbances were mostly tolerable and curable.Conclusion The two different protocols of KD-eating on demand and eating at regular intervals are both effective and well-tolerated for refractory epilepsy in children.While protocol of eating on demand is more easier to achieve ketotic state and the effect is more quickly,so it can be more easily received by children.Therefore in clinical practice,we can choose flexible eating time according to children's eating habits,which can improve the therapeutic compliance.

Objective In present study,we aimed to investigate the ictal and interictal electroencephalography (EEG) changes in patients with infantile convulsions with mild gastroenteritis,to understand the evolution of EEG and recurrence of convulsion by follow-up.Methods In this retrospective study,all patients with infantile convulsions with mild gastroenteritis visited our hospital from January 2005 to December 2009 were included,and were followed up for 3 to 7 years.All their clinical data were summarized and analyzed.Results Fist of all,we collected 128 interictal EEGs and 4 ictal (5 episodes) reports.Based on interictal EEGs,no discharge was observed in 63 subjects,and epileptic waves were discovered in other 65 patients.In most cases (48/65) epileptic waves were found to be located in the central area.For all 5 recorded ictal EEGs (2 were from same patient),epileptic waves were originated from different regions.Two months later,epileptic waves disappeared in 52/57 cases,but there were still discharge in 5 cases.Secondly,in the 103 cases who were successfully followed up,96 were seizure free,5 had recurrence during fever (3 cases) or gastroenteritis (2 cases),but remained seizure free for last 1.5 to 3.0 years.Overall,convulsion was recurred in 2 cases and finally diagnosed as epilepsy and then treated with antiepileptic drug,keeping seizure free for recent 1.5 to 2.5 years.Conclusion (1) Discharge can be found in nearly half of interictal EEGs in cases with infantile convulsion with mild gastrocnteritis,and most of them are located in central region.(2) All discharge come from local origin in ictal EEGs.(3) Seizure may recur in cases with infantile convulsion with mild gastroenteritis,especially in the presence of causative factors.Some children have risk of developing epilepsy.