According to the medical history,imaging and pathological diagnosis,the advanced gastric cancer patients able to tolerate radiotherapy can be divided into the following three groups:(1) unresectable locally advanced or locally recurrent disease;(2) metastatic disease at primary diagnosis with stage Ⅳ;(3) patients experiencing severe tumor-related clinical symptoms.The role of palliative radiotherapy in patients with advanced gastric cancer would be discussed by reviewing 33 articles (8 in last five years,13 in ten years).

Chemoradiotherapy is an important part in the adjuvant regimen for locally advanced gastric cancer after radical resection. Adjuvant chemoradiotherapy has demonstrated a clear local control and survival advantage for locally advanced patients with less than D2 lymph node dissection. Thus, chemoradiotherapy is recommended as standard of care in the postoperative setting. However, the role of radiotherapy for patients with more extensive D2 lymph node dissections remains controversial. Three phase III random-ized clinical trials in Asia show that adjuvant chemoradiotherapy after D2 dissection is safe and feasible and may benefit certain groups of patients. The benefit of radiotherapy in the case of more extensive surgery still warrants well-designed, fully powered randomized controlled clinical trials for verification. More studies are needed to focus on the identification of patient subgroups that are at high risk for locoregional failure and may benefit from adjuvant chemoradiotherapy. Further optimization of target volume in the radiother-apy and exploration of new modalities of radiation techniques are also necessary.

Objective To compare the effects of different moist environment for treating severely burned patients.Methods From November 2009 to December 2014 in the Burn Unit of Hainan General Hospital, 170 hospitalized patients with severe burns were randomly equally divided into observation group and control group.The patients of control group were treated with the traditional wet therapy treatment, while of the observation group were given the closed moist therapy treatment.The wound healing, pain relief and adverse reactions were observed.Results All patients completed the treatment,and the cure rates at the 7th and 14th day of treatment in the treatment group were 80.0％ (68/85) and 97.6％ (83/85), significantly higher than those of the control group (52.9％ (45/85), 89.4％ (76/85), x2 =8.344,4.111, P ＜ 0.05).The number of dressing changes((7.44±2.39) times), cumulative dressing time ((45.98 ± 13.29) min) and wound healing time ((14.98±4.33)d) in the observation group were significantly less than those in the control group((11.76 ±3.14) times, (87.03 ± 14.99) min), (18.87 ± 5.13) d)), the differences were statistically significant (t =6.349,6.540,3.111, P＜0.05).After treatment, the pain scores were showed clear downward trend, with had significant difference compared before treatment (P＜0.05), while the pain scores at the 7th day((3.10± 1.34) scores) and 14th day((1.76±0.67) scores) of treatment in the treatment group were significantly lower than the control group((4.09±0.89) scores, (3.11±0.56) scores, P＜0.05).The incidence of adverse events during treatment in both groups were 5.9％, obviously improved after symptomatic treatment.Conclusion The moist environment conducive to the treatment of severely burned patients, and safety.Conclusion to traditional wet therapy, closed moist therapy has better cure rate of severe burns, can promote wound healing, relieve pain and shorten the dressing cycle time.

Objective To explore the expression and clinical significance of GSK-3β,PTEN and PLK1 in pediatric AML . Methods Experiment group was bone marrows of 33 cases incipient children with AML .Control group was 10 cases normal bone marrows .GSK-3β,PTEN and PLK1 gene expressions in BMMNC of the two groups were tested using semi quantitative reverse transcriptase polymerase chain reaction(RT-PCR)technique .GSK-3βprotein and P-GSK-3βexpressions were tested by ELISA .Re-sults The expression of GSK-3βmRNA ,GSK-3βprotein ,PLK1 mRNA in BMMNC of children with AML was higher than that of control group(P=0 .012 ;P= 0 .014 ;P= 0 .040);The expression of PTEN mRNA ,P-GSK-3β was lower than the control group (P=0 .012 ;P=0 .002);GSK-3βprotein had a negative correlation with PTEN mRNA (r= -0 .415 ,P=0 .016);GSK-3βmRNA , GSK-3βprotein had a positive correlation with PLK 1 mRNA(r=0 .388 ,P=0 .026;r=0 .427 ,P=0 .013) .The expression of GSK-3βprotein was high in which had high peripheral white blood cell counts ;both the expressions of GSK-3βmRNA and GSK-3βpro-tein were high in which had high risk ;but the expression of P-GSK-3βwere low .Conclusion In pediatric AML ,GSK-3βand PLK1 may play a role of oncogene and PTEN may play a role of tumor suppressor gene .

The thesis,from the aspect of professional guidance of education,focuses on the outstanding problems that exist in the work of professional guidance,analyzes the main reasons that caused those outstanding problems,and gives the feasible suggestions to professional guidance in current university education.

Five fractions,Ⅰ(R_f0.06)、Ⅱ(R_f0.21)、Ⅲ(R_f0.45)、Ⅳ(R_f0.60)、Ⅴ(R_f0.75)have been obtained after HT-toxin from race 1 of Exserohilum turcicum 99-2 isolated by TLC. In all of these fractions,only fractions Ⅱ had specific toxicity to the corn leaves with Ht1 gene. Then fractions Ⅱ-1、Ⅱ-2、Ⅱ-3 were isolated from fractions Ⅱ by HPLC purification,and the bioassay result showed only fraction Ⅱ-3 was toxigentic to corn leaves with Ht1 gene but non-toxigentic to corn leaves without Ht1 gene. Fractions Ⅱ-1、Ⅱ-2 and Ⅱ-3 were scanned by UV-Vis spectrophotometer. It was shown that the fractions Ⅱ-1 and Ⅱ-2 had analogous spectrum,and especially the fraction Ⅱ-3 had a special peak at 300nm.

Objective To investigate the efficacy and safety of intravitreous injection with triamcinolone acetonide (TA) for cystoid macular edema (CME) due to central retinal vein occlusion (CRVO). Methods Fourteen eyes of 14 patients with CME due to CRVO underwent intravitreous injection with 0.1 ml TA (40 mg/ml). Best-corrected visual acuity, intraocular pressure (IOP), slitlamp examination, fundus fluorescein angiography, and optical coherence tomography (OCT) were performed on the patients before and after the injection. The follow-up period was 10-22.4 months, with the mean of 15.9 months. Results The average visual acuity was 0.1 before the treatment; while 1 month and 3 months after the injection, the visual acuity of all of the patients improved, including ≥0.2 in 71.43% and 63.6% of the patients, respectively, and ≥0.5 in 42.9% and 27.3%, respectively. After then, the visual acuity of some patients decreased, and in the final visit, 4 eyes (28.6%) had a visual acuity of ≥0.2, and 1 eye (7.1%) of ≥0.5. Compared with that before the treatment, the visual acuity of 10 (71.4%) eyes improved and 4 (28.6%) eyes declined. One month after the treatment, the macular edema disappeared in 10 eyes (71.4%) and alleviated in 4 (28.6%). In the final visit, macular edema disappeared in 4 eyes, alleviated in 9, and aggravated in 1. In the follow-up duration, high IOP [22.3-40.1 mm Hg (1 mm Hg=0.133 kPa)]. In the final visit, posterior subcapsular cataract was found in 7 eyes. Conclusion Intravitreous injection with TA may be effective in reducing CME and enhancing the visual acuity in a short term with high IOP in some eyes. In the long-term follow-up period, the rate of recurrence of CME and incidence of posterior subcapsular cataract is high.

Objective To evaluate the clinical effects of surgical treatment for diabetic retinopathy (DR) with diffuse diabetic macular edema (DDME) and massive subretinal hard exudates (MSHE) with vitrectomy, endolaser photocoagulation to the retina under perfluorocarbon liquid and long acting gas tamponade. Methods Fifteen eyes of twelve patients with DR complicated with DDME and MSHE admitted from October 2001 to December 2003 were enrolled for study, in whom 9 eyes were in 7 males and 6 eyes in 5 females. The patients were aged from 36~65 years (mean 53.4). The best corrected visual acuity (BCVA), color fundus photography and fundus fluorescein angiography were recorded, and optic coherence tomography was performed preoperatively. Pars plana vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade were the therapeutic modalities used to treat the diseased eyes. Results Preoperative BCVA was finger counting to 0.05 in all 15 eyes. Improved vision was observed in eyes during 4~25 months of follow up period (mean 10.26 months), 0.03~0.04 in 2 eyes(13.3%), BCVA ≥0.09 in 13 eyes(86.7%), and 1 eye(6.7%)showed an improved vision from 0.04 to 1.0. Significant decrease in macular edema and retinal thickness were observed, and marlsed to complete absorption of intra-retinal and pre-retinal hemorrhage as well as MSHE was also seen. Conclusions Vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade may offer satisfactory effects in the treatment for DDME complicated with MSHE.

Objective To compare the effects of sevoflurane and propofol anesthesia on inflammatory response and pulmonary function during perioperative period in patients undergoing lung cancer resection．MethodsThirty ASA Ⅰ or Ⅱ patients(23 male，7 female) aged 41-64 yr having a body weisht index of 22-30 kg/m2 undegoing elective left lower lobe resection were randomlydivided into 2 groups(n=15 each)：sevoflurane group (group S) and propofol group(group P)．Anesthesia was induced with 6％-8％ sevoflurane or propofol 2 mg/kg and fentanyl 4-6 μg/kg．Intubation with double lumen catheter was facilitated with vecuroniunl 0．1 mg/kg． Anesthesia was maintained with 1％-3％ sevoflurane/propofol infusion(6-10 mg·kg-1·h-1)and intermittent iv boluses of fentanyl and vecuronium．Radial artery was cannulated．Swan-Ganz catheter was placed via right internal jugular vein．The patients were mechanically ventilated．During one lung ventilation(OLV)I：E and VT were adjusted to maintain airway pressure <30 cm H2O．Arlerial and mixed venous blood samples were collected for blood gas analysis before induction of anesthesia(T0)，before OLV(T1)，at the end of OLV(T2)，when the chest was closed(T3) and at 24 h after operation (T4)．PA-aO2，Qs/Qt and respiratory index(RI，PA-aO2/PaO2) were calculated. Serum matrix metallo-proteinase-9 (MMP-9) and MDA were measured at T0, T3 and T4. Dynamic lung compliance (Cd) was calculated at T1-3 .Results PA-aO2, RI and Qs/Qt at T1-3 and serum MMP-9 and MDA concentrations at T3 were significantly increased as compared with the baseline values at T0 in both groups. In group S, Cd was significantly lower at T3 than at T1.PA-AO2, and serum MMP-9 and MDA concentrations at T3, RI at T2,3 and Qs/Qt at T1-3 were significantly higher in group S than in group P. Conclusion The inflammatory response is lower and the injury to pulmonary function is lighter during propofol anesthesia than sevoflurane anesthesia in patients undergoing lung cancer resection.

Objective To discuss the efficacy of intravesical instillation of sodium hyaluronate for the treatment of cystitis glandularis after transurethral resection.Methods 85 patients (9 male and 76 female,age range 37-70 years,mean age 51) who were diagnosed as CG in China-Japan Union Hospital of Jilin University underwent transurethral resection.After the operation they were divided into three groups randomly according to different intravescal instillation:sodium hyaluronate for group A,epirubicin for group B and no medicine for group C.The group A started to instill with sodium hyaluronate 40mg once a week for four weeks,and then once a month for four months.The group B did the same way of intravesical instillation of epirubicin.All the patients were followed-up for 12 months.The cystoscopy was done every three months to detect recurrence and the clinical symptom score was evaluated at 1,3,6 and 12 months.Results No patients in group A treated by sodium hyaluronate relapsed but 6 cases and 9 cases in group B and group C respectively.Recurrence rate of group A is significant low compared with group B and C (P ＜ 0.05).The scores of clinical symptom score appendix after 1,3,6 and 12 months for group A were (3.18 ± 1.44),(1.29 ±0.66),(1.25 ±0.65) and (1.21 ±0.63),respectively.It was (3.37 ±1.62),(3.33 ±1.59),(1.37±0.74) and (1.30±0.61) for group B,and (3.47±1.81),(3.40±1.52),(3.27±1.41) and (3.23 ± 1.19) for group C.Compare the score of clinical symptom in the same group,there were significant differences for the score after 3 months compare with the score after 1 month in group A (P ＜ 0.05).But in group B,the significant differences showed after 6 months (P ＜ 0.05).There was no significant difference in group C (P ＞ 0.05) in the whole year.Conclusions Intravesical sodium hyaluronate therapy can effectively decline the recurrence rate of cystitis glandularis after transurethral resection.It could also significantly improve the urinary tract symptoms.