Primary lung cancer is one of the most common malignant tumors in China.The 2015 Edition of primary lung cancer diagnosis and treatment norms was updated based on 2010 Edition.This 2015 edition was published by the National Health and Family Planning Commission,which has referenced to the international authority of the lung cancer treatment guidelines and the actual situation of China.This paper mainly introduces the new content of lung cancer radiotherapy,including radical radiotherapy,palliative radiotherapy,adjuvant radiotherapy and preventive radiotherapy.

Radioactive esophagitis is one of the most common complications in thoracic tumor radiotherapy,biological factors such as single nucleotide polymorphisms (SNPs),miRNAs,and HIV infection may play key roles in the occurrence and development of radioactive esophagitis,and they have become an active field in protection areas of radiotherapy.We can identify the patients who may cause radioactive esophageal in high dose radiotherapy as early as possible,and modify the treatment plan to protect the esophagus.Therefore the biological factors of radioactive esophagitis are of important clinical significance.

Objective To evaluate the effects of preoperative sleep disturbance on the consumption of propofol during the period of general anesthesia and postoperative sleep quality.Methods Sixty-five patients scheduled for elective thyroidectomy surgery under general anesthesia were enrolled in the study.According to the preoperative Pittsburgh Sleep Quality Index (PSQI) score,the patients were divided into sleep normal group (n =33) and sleep disorder group (n =32).Anesthesia was induced and maintained with propofol given by closed-loop target-controlled infusion (CLTCI).The consumption of propofol during the period of general anesthesia,postoperative sleep quality in the evening of surgery and at 24 h after operation,and the painful levels of the patients at 1 d and 2 d after operation were compared between two groups.Results The totalconsumption of propofol in sleep disorder group [(1 024.33 ±213.02)mg] was more than that in sleep normal group [(892.25 ± 242.30) mg] (P ＜ 0.05),and the dosage of unit surface area per minute of propofol in sleep disorder group [(4.94 ± 0.80) mg/(min · m2)] was also more than that in sleep normal group [(4.45 ± 0.96) mg/(min · m2)] (P ＜ 0.05).Each group suffered from bad sleep quality in the evening of operation,and got improvement one day later (P ＜ 0.05).The sleep quality in sleep disorder group was improved after general anesthesia (P ＜ 0.05).Conclusions Preoperative sleep disturbance increased the consumption of propofol in the general anesthesia.General anesthesia can improve the sleep quality of the patients who suffered from sleep disorder.

Objective To review and summarize the experience of surgical treatment of primary cardiac tumors in children from a heart center of China.Methods The pathological studies of 11 cases of primary cardiac tumor (except myxoma) were retrospectively analyzed.Results The mean age for all patients was (23 ± 16) months,and the average weight was 3.1 ～ 15.3 (13 ± 5.7) kg at the time of the established diagnosis.The most common reason of admission was the heart murmur,and the most common pathological type of cardiac tumors was rhabdomyoma (5 cases),followed by fibrous tumor (3 cases),angiofibroma (2 cases),and fibrosarcoma (1 case).All of the patients underwent tumor resection due to the corresponding symptoms.One of them,the operation findings showed the aortic root,superior vena and sinoatrial node were involved into the tumor body,and therefore,the tumor debark resection was performed and the child died 2 years later due to the remained tumor progression.One of other children (pericardial fibrosarcoma) died 1 year late because of tumor recurrence.The others were followed-up for duration of 2 ～9 years and all kept in good condition.Conclusions The surgical resection is mandatory for children suffering with symptomatic primary cardiac tumors and the short-term and long term surgical outcomes for the majority are acceptable.

Objective To explore the preliminarily clinical value of strain rate parameters using velocity vector imaging (VVI) evaluating left ventricular regional endocardial systolic function in patients with coronary artery heart disease (CAD).Methods A total of eight six inner subjects who were suspected as CAD was enrolled in the study.Patients with the vascular stenosis rate ≥ 50％ were defined as the CAD group,patients with the vascular stenosis rate ＜ 50％ were defined as the coronary atherosclerosis group,and patients with the completely normal angiographic results were included in the control group,according to the results of angiography.The left ventricular endocardial systolic strain rate parameters of VVI were obtained in standard long axis views (apical two,three,and four-chamber view) and short axis views (at the level of the mitral valve,papillary muscles,and apex).The strain rate parameters were global longitudinal endocardial systolic strain rate in the apical two,three,and four-chamber views (A2-GLSRs,A3-GLSRs,and A4-GLSRs),global radial endocardial systolic strain rate in short axis view of the mitral valve level,papillary muscles,and apex (MV-GRSRs,PM-GRSRs,and AP-GRSRs),and global circumferential endocardial systolic strain rate in short axis view of the mitral valve level,papillary muscles,and apex (MV-GCSRs,PM-GCSRs,and AP-GCSRs).The parametric differences were compared among three groups.Results All the subjects included in the present study had normal left ventricular ejection fraction (LVEF) and there was no significant difference in LVEF across three groups.Compared to other groups,the control group had significantly higher E/A ratio.The LV endocardial systolic strain rate parameters were all significantly reduced in the CAD group compared to the control group and the coronary atherosclerosis group (all P ＜ 0.05).Compared to the control group[(-1.37 ± 0.25)/s],the coronary atherosclerosis group [(-1.12 ± 0.42)/s] had significantly lower MV-GCSRs (P ＜0.01).Conclusions VVI is useful for quantitative assessment of the left ventricular systolic function in CAD.MV-GCSRs might have the potential to predict early left ventricle (LV) systolic dysfunction in subjects with coronary artery stenosis ＜ 50％.

Objective To investigate the effects of low-dose,sustained release oral theophylline on the chronic obstructive pulmonary disease (COPD) patient.Methods Fifty-six patients with stable COPD were randomly divided into two group:theophylline group (n =35) that was treated with slow-release theophylline(100 mg,twice daily),and control group (n =21) that was given with placebo.A series of parameters including lung function,quality of life scores,body mass index,airflow obstruction,dyspnea,and exercise capacity index (BODE) score,exercise tolerance,exacerbations,satisfaction with treatments and adverse effects were tested before and 12 weeks after the treatments.Results Forty two patients completed the study,25 cases in the slow-release theophylline group,and 17 cases in the placebo group.The differences of two groups before the treatment were not prominent except the age (P ＞ 0.05).After treated with slow-release theophylline,the forced expiratory volume in one second (FEV1),forced vital capacity (FVC) and the symptom score were slightly increased,but there were no statistically significant differences (P ＞0.05).After theophylline therapy,the quality of life score,including activity ability score,disease activity score and total score,and BODE index score were significantly decreased(P ＜0.05),but 6 minutes walk test (6 MWT) differences were no significant (P ＞0.05).The differences in pulmonary function test,the quality of life score,BODE index score and 6 minutes walk test were no significant between before and after the treatment with the placebo (P ＞ 0.05).Compared to the cases who treated with the placebo group,the patients in slow-release theophylline group reduced the frequencies of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (3/25 vs 7/17,x2 =4.748,P ＜0.05),and increased the efficacy satisfaction (Z =-2.579,P ＜ 0.05).Slightly adverse reaction was observed in 3 cases in slow-release theophylline group,but it could relieve by oneself,and not affect the common treatment.There was no adverse reaction in the placebo group.Conclusions Low dose,sustained release oral theophylline was efficient in improvement of the quality of life scores and BODE index score.

Objective To investigate the level of the red blood cell (RBC) distribution width and other related indicators to predict the prognosis in patients with chronic heart failure elderly.Methods Retrospective analysis was performed in the patients with chronic heart failure elderly which died in our hospital (experimental group) and 100 patients were selected randomly that with heart failure elderly being improved by treatment (control group).The difference was compared in the level of the RBC distribution width (RDW),high-sensitivity C-reactive protein (hs-CRP),homocysteine (Hcy),D-dimer (DD),and amino-terminal pro-brain natriuretic peptide (NT-proBNP) in two groups.Results The level of RDW,hsCRP,Hcy,DD,and NT-proBNP in experimental group were significantly higher than that in control group (P ＜0.01).Conclusions Chronic heart failure was common clinical critically ill in the elderly.There were important clinical significance and important predictors to detect the levels of RDW,hs-CRP,Hcy,DD,and NT-proBNP in predicting prognosis and evaluating the effect of treatment.

Objective To investigate the correlations between plasma indoxyl sulfate and p-cresyl sulfate in the pathogenesis of cardiovascular complications in maintenance hemodialysispatients.Methods A total of 145 maintenance hemodialysis patients were selected.The researchers measured the physiological parameters of the subjects,including pre albumin,albumin,hemoglobin,blood urea nitrogen,creatinine,uric acid,calcium,phosphorus,alkaline phosphatase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density fat cholesterol,intact parathyroid hormone,C-reactive protein,apolipoprotein,lipoprotein,homocysteine,beta 2-microglobulin,sulfuric acid indoxyl,sulfuric acid cresol,serum iron,transferrin,ferritin,and N-terminal pro brain natriuretic peptide carrier.Subjects underwent cardiac ultrasound examination.Results The researchers used heart structure and function as the dependent variable.The single factor Cox regression analysis showed that the risk of heart structure and function changes increased with the increase of systolic blood pressure,N-terminal B-type natriuretic peptide,and left ventricular mass index.This study also showed that the risk of heart structure and function changes in patients with previous history of coronary heart disease also increased.The researchers took the systolic blood pressure,coronary heart disease history,N-terminal brain natriuretic peptide,and the left ventricular mass index as the dependent variables.Multifactor Cox regression analysis showed that the history of coronary heart disease,the high left ventricular mass index and the change of the heart structure and function of the patients with acute coronary heart disease were the independent predictors of the change of heart structure and function.The researchers used cardiovascular complications as the dependent variable.Cox regression analysis showed that,with the increase in patient's age,dialysis duration,elevated high C-reactive protein and sulfuric acid p-cresol,patients suffering from the risk of fatal cardiovascular complications rise.The researchers used the complications of cardiovascular deaths as dependent variable,age,duration of dialysis,C-reactive protein,and sulfuric acid p-cresol as covariates,multivariate Cox regression analysis of the results showed that with increasing age,dialysis duration increased,high sulfate of cresol and C-reactive protein,patients suffering from the risk of death from cardiovascular complications rise.Conclusions The history of coronary heart disease,left ventricular mass index,systolic blood pressure,indoxyl sulfate,Nterminal brain natriuretic peptide,age,dialysis age,high C-reaction protein,and p-cresol sulfate are the independent risk factors for cardiovascular complications.The relationship between indoxyl sulfate and sulfuric acid serum concentration of p-cresol and adverse cardiovascular events is most closely.

Objective To explore the correlation between the serum levels of interferon (IFN)-γ,interleukin (IL)-18,IL-10 and recurrent spontaneous abortion (RSA).Methods Enzyme-linked immunosorbent assay was used to detect the serum levels of IFN-γ,IL-18 and IL-10.There were 40 patients with RSA (RSA group) and 40 normal early pregnant women (control group) enrolled in this study.After 2 months,those serum cytokines in two groups of non-pregnant state were detected again.Results Compared to control group,the serum levels of IFN-γ and IL-18 of RSA group were significantly higher (P ＜0.01),the serum level of IL-10 was significantly lower (P ＜ 0.01).Two months after termination of pregnancy,there was no significant difference in the serum levels of IFN-γ and IL-10 between the two groups.The serum level of IL-18 maintained a high level in the RSA group after termination of pregnancy.Conclusions In patients with RSA,the serum levels of IFN-γ and IL-18 were elevated,the serum level of IL-10 was decreased.The serum levels of IFN-γ,IL-18 and IL-10 were closely related with RSA.

Objective To explore the effects of isoflurane on blood plasma metabolites (BPM) and its correlation with cognitive dysfunction.Methods Thirty female Sprague-Dawley (SD) rats were randomly divided into two groups:rats in the control group (n =10) received 80％ oxygen for 2 hours (h);and rats in the isoflurane-treated group (n =20) were anesthetized with isoflurane and 80％ oxygen for 2 h.Cognitive functions were examined using a Y-maze test to explore the learning times of rats.The level of blood plasma metabolites was detected through gas chromatography-mass spectrometry (GCMS).Results The learning times of rats in the isoflurane-treated group was more than the learning times of rats in the control group [(70.75 ± 15.30) vs (45.40 ± 11.21),P ＜ 0.05].D-fructose,arabinofuranose,n-butylamine,and inositol significantly increased (P ＜ 0.05),respectively.Whereas,L-analine and L-proline significantly decreased (P ＜ 0.05) in isoflurane-treated rats when compared to those in the control rats (P ＜ 0.05).Moreover,plasma concentrations of d-fructose,arabinofuranose,n-butylamine,inositol,and L-proline were positively correlated with the degree of cognitive dysfunction in the isoflurane-treated rats.Conclusions Changes of plasma concentrations of inositol,and d-fructose in aged rats are useful in predicting the occurrence and progression of post-anesthesia cognitive dysfunction.