ObjectiveTo study the effect of transcatheter hepatic arterial infusion (TAI) and stereotaxic radiotherapy (SR) for unresectable liver cancer. MethodsFrom June 1997 to July 1999, TAI and SR were used to treat 36 patients with unresectable liver cancer. The first step was interventional chemotherapy(TAI) which consisted of CF 300?mg,5-FU 1?000～1?500?mg, CDDP 60～80?mg, and ADM 60～80?mg (or MMC 10～20?mg). Stereotaxic radiotherapy was given after two sessions or between the two sessions of TAI. The planned target volume was encompassed by more than 70%～90% isodose line, tumor dose from 5?Gy to 8?Gy per fraction, total number was 5～8 fractions. ResultsThe total effective rate were 94% and 97% judged by CT at 3 and 6 months respectively. The 1-,2-year survival rates were 85% and 68%,respecctively. ConclusionCompared with radiotherapy alone and interventional chemotherapy alone, the combined therapy results in higher therapeutic effect and longer remission time in patients with unresectable liver cancer.

Objective To assess the early response and acute side effects of late course stereotactic radiosurgery (LCSR) for stage Ⅲ b lung squamous cell carcinoma. Methods From June 1997 to July 1999, 136 patients with stage Ⅲ b squamous cell carcinoma of lung were treated with the conventional radiotherapy of 40 Gy followed by LCSR to the residual lesion. Stereotactic radiosurgery was given in the 5～6th weeks, 5～8 Gy per fraction with the total doses ranging from 24 to 38 Gy. Results Five patients were excluded from this study due to distant metastases and acute complications. The remaining 131 patients were analyzed to evaluate the early responses and acute complications. Acute radiation induced esophagitis occurred in 41.2% of patients (Grades Ⅰ Ⅱ (RTOG), 4.4% Grade Ⅲ). Acute radiation induced pneumonitis was observed in 16.9 % of patients ( Grades Ⅰ Ⅱ (RTOG),5.2% Grade Ⅲ). The overall response rate (CR+PR) was 86.3% for the primary tumor, and 92.4% for metastatic mediastinal lymph nodes. Conclusions LCSR is well tolerated in most patients with stage Ⅲ b squamous cell carcinoma of lung. The early responses of LCSR in the of tumor are better than the conventional radiotherapy.Remote results await further follow up.

This paper deals with the problems existing in the making of textbooks in our universities in our country,and proposes the solutions and feasible measures to the problems

Objective To evaluate the clinical value of 18FDG PET/CT in the diagnosis of lymph node metastasis and evaluation of node staging for esophageal carcinoma. Methods A prospective study was performed to access whether 18F FDG PET/CT can improve the diagnostic accuracy in lymph node metastasis for patients with esophageal carcinoma, 30 patients underwent esophagectomy with extensive dissection of lymph nodes. PET/CT findings were compared with that of CT. Results The pathological examination confirmed metastasis in 22 patients and 49 out of 243 excised lymph nodes. In PET/CT analysis, the sensitivity in the detection of lymph node metastasis was 93.9%, specificity was 91.2%, with a diagnostic accuracy of 91.8%. The positive and negative predictive value was 73.0% and 98.3%, respectively. CT resulted in a sensitivity of 40.8%, specificity of 96.9%, accuracy of 85.6%, the PPV was 76.9% and NPV 86.6%, respectively. The difference of sensitivity (P

AIM　To study the effects of dexamethasone on expressing monocyte chemoattractant protein-1(MCP-1 ) mRNA in the rats with pulmonary fibrosis, elaborate the molecular mechanism of dexamethasone (Dxs) in pulmonary fibrosis therapy. METHODS　The model of pulmonary fibrosis was established by instilling bleomycin intratracheally. After treating with Dxsip, the levels of MCP-1 mRNA were determined by RT-PCR. The histological changes were observed and the numbers of inflammatory cells were counted in optical microscopy field. RESULTS　The accumulation of inflammatory cells decreased markedly, and the symptom of pulmonary fibrosis was alleviated. Furthermore, Dxs evidently inhibited the expression of MCP-1 mRNA in lung tissues with pulmonary fibrosis. CONCLUSION　The molecular mechanism of Dxs in pulmonary fibrosis therapy was associated with inhibiting the expression of MCP-1 mRNA.

Objective To establish a pulmonary allergic inflammation model with C57BL/6 mice.Methods C57BL/6 mice were divided into control group and treatment group.The mice of treatment group were sensitized by intra peritoneal injection of house dust mite extracts at day 1,3,5,7,9 and 11.Then they were exposed to aerosolized allergen at day 13,16,19,20 and 21.Physiological saline instead of house dust mite extracts was used in control group.All mice underwent pulmonary lavage in 24h after the final exposure to aerosolized allergen challenge.Pathological manifestation of the lung,cell counts and classification were studied and IL-4 and IFN-? levels in BALF were detected by ELISA.Cells from spleen were cultured for 3 d with house dust mite extracts,IL-4 and IFN-? in supernatants was measured by ELISA.Results There was pulmonary eosinophilic inflammation in the mice treated with house dust mite extracts.Compared with control group,total cells,lymphocytes,eosinophils and the level of IL-4 in BALF from treated mice increased significantly,while IFN-? in BALF decreased.The level of IL-4 in cultured splenocyte supernatants also significantly increased,while IFN-? in supernatants decreased.Conclusion A pulmonary allergic inflammation model of is established by sensitizing and challenging C57BL/6 mice with house dust mite Der f.

AIM To study the effects of dexamethasone on expressing monocyte chemoattractant protein 1(MCP 1 ) mRNA in the rats with pulmonary fibrosis, elaborate the molecular mechanism of dexamethasone (Dxs) in pulmonary fibrosis therapy. METHODS The model of pulmonary fibrosis was established by instilling bleomycin intratracheally. After treating with Dxs ip , the levels of MCP 1 mRNA were determined by RT PCR. The histological changes were observed and the numbers of inflammatory cells were counted in optical microscopy field. RESULTS The accumulation of inflammatory cells decreased markedly, and the symptom of pulmonary fibrosis was alleviated. Furthermore, Dxs evidently inhibited the expression of MCP 1 mRNA in lung tissues with pulmonary fibrosis. CONCLUSION The molecular mechanism of Dxs in pulmonary fibrosis therapy was associated with inhibiting the expression of MCP 1 mRNA.

Objective To explore the characteristics of oxygen uptake efficiency (OUES) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and analyze the relationship between OUE and severity of disease.Methods Pulmonary function test,polysomnogram and cardiopulmonary exercise testing were performed in 35 patients with OSAHS and 25 age-matched healthy volunteers.Their successive breathing respiratory exchange parameters were collected and analyzed.And t and x2 tests were used for 2 sample comparison.Correlation analysis was performed by Pearson correlation test.Results Significant differences in peak VO2 and peak VO2 ％ pred existed between OSAHS and normal control groups [(18±4) vs.(28 ±6) L/min,P＜0.01;(68±14) vs.(84±16) ％,P＜0.01].Compared with normal control group [(2.3 ±0.5) L · min-1 · lg-1 ; (36 ±4) ml/L; (36 ±4) ml/L],OUES,OUEP and OUE@AT of OSAHS group [(1.8 ± 0.4) L · min-1 · lg-1 ; (31 ± 5) ml/L; (30 ± 5) ml/L] were significantly lower (t =3.78-4.49,all P ＜0.01).And OUES,OUEP and OUE@AT in OSAHS patients were correlated (r =0.53-0.67,all P ＜0.01) positively with exercise tolerance (peak VO2％ pred) while negatively with apnea hypopnea index (AHI) (r=-0.67--0.54,all P ＜0.01).Conclusion The oxygen uptake efficiency of patients with OSAHS is significantly reduced compared to that of normal subjects.And it is correlated negatively with severity of disease.

BACKGROUND:At present, some neurological imaging methods, including MRI, fMRI, 2-(1-(6-[(2-[18F]fluoroethyl)(methyl)amino]-2-naphthyi) ethylidene) malononitrile (18F-FDDNP) positron emission tomography (PET), are helpful but not specific for the diagnosis of Alzheimer disease (AD). 18F-FDG is a special marker of beta-amyloid (Aβ), thus AD can be diagnosed by 18F-FDDNP PET at early period.OBJECTIVE: To evaluate the role of 18F-FDDNP PET in the diagnosis of AD, and establish reliable clinical biological indexes for the diagnosis of AD patients.DESIGN: A controlled analysis.SETTINGS : Department of Geriatric Neurology and Department of Nuclear Medicine, the General Hospital of Chinese PLA. PARTICIPANTS: Patients visiting the General Hospital of Chinese PLA from May 2004 to March 2005 were selected. Informed consents were obtained from all the participants. ① AD group (n =7): (74.88±12.03) years old; Accorded with the criteria related to diagnosis of AD in NINCDS/ADRDA (National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disease Association) and revision of Diagnostic and statistical Manual (DSM-Ⅳ, 4th ed.); brain CT or magnetic resonance imaging (MRI) examination displayed that inter-uncus distance of temporal lobes was ≥ 30 mm. ② Vascular dementia group (n =6): (73.83±4.75) years old; Accorded with the diagnostic criteria of NINDS-AIREN (National Institute of Neurological Diseases and Stroke, USA) and DSM-Ⅳ for vascular dementia; Inter-uncus distance of temporal lobes ＜ 30 mm. ③ Control group (n =6): (71.17±3.71) years old; Without rarefaction of white matter; Intelligence examination was normal.METHODS: PET was performed in all the subjects. PET scanner type was SEIMENS ECAT EXACT HR. The tracer selected was 18F-FDDNP which had radiochemical purity higher than 95% and error of radioactivity measurement lower than 10%. The images were collected at 5, 25 and 45 minutes after injection of 18F-FDDNP. Horizontal and coronary tomograms of brain were obtained after reconstruction.MAIN OUTCOME MEASURES: Characteristics of 18F-FDDNP brain PET images.RESULTS: ① In the control group, signs of obvious atrophy of brain were not seen. At about 45 minutes, the radioactivity in cortex and subcortical nucleus groups was essentially cleared and the structures of brain could not be differentiated clearly. ② In the vascular dementia group, brain atrophy and enlargement of ventricular system to various degrees could be seen. The clearance of radioactivity at three time points was similar to that in the control images. ③ In the AD group, the brain was obviously atrophied and the ventricular system was enlarged. The clearance of radioactivity at the three time points was significantly different from the images of other two groups. The radioactivity in cortex and hippocampus was cleared slower. At 45 minutes, the gray matter could still be clearly differentiated from the white matter, but the radioactivity in corpus striatum and thalamus was not higher than that in cortex and much radioactivity retention could be seen in cortex and hippocampus.CONCLUSION: 18F-FDDNP PET brain images can differentiate AD and vascular dementia, and it is an effective imaging index for the diagnosis of AD.

Objective To explore the influence of different delineators and different delineating time on target determination of the whole breast and to explore intrafraction and interaction target displacements of the breast on moderate deep inspiration breathing hold (mDIBH) assisted by active breathing control (ABC) after breast conservative surgery. Methods Twenty patients received primary CT-simulation assisted by ABC to get five sets of CT image on the three breathing condition which included one set from free breath ( FB), two sets from mDIBH and two sets from deep expiration breathing control (DEBH). After radiotherapy with ten to fifteen fractions, the repeat CT-simulation was carried out to get the same five sets of CT image as the primary CT-simulation. The whole breast target were delineated at different time by the same delineator and delineated respectively by five delineators on the first set of CT images got with mDIBH from the primary CT-simulation,and to compare the influence of delineator and delineating time on the whole breast target. The total silver clips in the cavity were marked respectively on the two sets of CT images got with mDIBH from the primary CT-simulation, and to compare the intrafraction displacement of geometric body structured by the total of silver clips. The two ribs near the isocentric plane of the breast target were delineated respectively on two sets of the mDIBH CT image from the primary CT-simulation and on one set of the mDIBH CT image from the repeat CT-simulation, and comparing the movement of the point of interest (POI) of the ribs delineated to get the value of intrafraction and interfraction thoracic expansion. Results There was not statistically significant between the four volumes of whole breast targets delineated by the same delineator at different time, but with statistics significant between the volumes of whole breast target delineated by the different delineators(F = 19.681, P = 0.000). There was not statistically significant between the intrafraction displacements of the POI of the geometric body at each direction, and with no statistically significant between intrafraction displacements of the POI of the ribs delineated on the same mDIBH condition. There was not statistically significant between the interfraction displacements of the POI of the ribs delineated. Conclusions The influence of different delineators on the whole breast target is statistically significant. The difference of displacement of the breast target with the same mDIBH eondition assisted by ABC at the different direction is not statistically significant.