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.

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.

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 investigate the diagnosis and treatment characteristics of pure red cell aplasia (PRCA)caused by human parvovirus (HPV)B19 infection after renal transplantation.Methods Two cases with PRCA caused by HPV B19-induced after renal transplantation,who were treated in the Department of Organ Transplantation,Nanfang Hospital,Southern Medical University,were summarized.Combined with literature review,the clinical characteristics,diagnostic method,course of treatment and prognosis of such disease were investigated.Results Two renal transplant recipients developed severe anemia early after transplantation with progressive deterioration and failed transfusion therapy.Other causes of anemia were ruled out and two patients were diagnosed as PRCA caused by HPV B19 infection according to bone marrow aspiration and biopsy as well as HPV DNA detection by fluorescent polymerase chain reaction (PCR).The symptoms of anemia were improved significantly after adjustment of immunosuppressive treatment protocol and intravenous immunoglobulin (IVIG).Conclusions For patients with unexplained and progressed anemia early after renal transplantation,especially those complicated with reticulocyte deficiency,the possibility of PRCA caused by HPV B19 infection shall be considered.The results of bone marrow aspiration and fluorescent PCR are the main bases for diagnosing PRCA.Immunosuppressive agents reduction and application of IVIG are the major treatment measures.Most of patients have great prognosis after treatment,but this disease is likely to recur.

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.

Objective To evaluate the roles of positron emission tomography (PET) with N-methyl [11C]2-(4' -methylaminophenyi-6-hydroxybenzathiazole) (11C-PIB) in the early diagnosis of Alzheimer's disease (AD).Methods Six AD patients,7 mild cognitive impairment (MCI) patients and 6 normal controls (NC) were diagnosed and assessed with brain PET with 11C-PIB.The emission images obtained at 5,25 and 45 min after 11C-PIB administration were analysed.Results Using visual analysis to summarize the characteristics of the imagings of each group: comparing to NC,the AD patients show high 11C -PIB up take,and low clearance rate of 11C-PIB at 45 min.The imagings of MCI group show heterogeneous,overlapping with AD and NC group.The statistical analysis shows: in AD group,the standard uptake value (SUV) ratio of parietal lobe,frontal lobe,temporal lobe,occipital lobe and hippocampal at 45 min was 1.91±0.21,2.09±0.41,1.92±0.35,1.66±0.41,1.55±0.28 respectively,and were higher than that of NC group (value being 1.48±0.53,1.57±0.64,1.36±0.53,1.27±0.40,1.17±0.33) with statistical significance,t=8.114,5.620,5.705,3.650 and 2.866,P=0.0001,0.0002,0.0002,0.0045 and 0.0170 respectively.In MCI group,the SUV ratio of parietal lobe,frontal lobe,temporal lobe,occipital lobe and hippocampal at 45 min was 1.48 ± 0.53,1.57 ± 0.64,1.36±0.53,1.27 ± 0.40,1.17±0.33 respectively,and were higher than that of NC group,but there was no statistical significance.Conclusion 11C-PIB PET imaging can differentiate AD patients from normal and anticipate the transformation of MCI patients.