Objective To evaluate the efficacy and safety of S-1 combined with synchronous three-dimensional conformal radiotherapy in the treatment of elderly patients with esophageal cancer.Methods 80 elderly patients with esophageal cancer were randomly divided into control group and the combination group,40 cases in each group.Three-dimensional conformal radiotherapy was applied in the two groups with a total dose of DT 60-64 Gy/ 30-32f.Patients in the combination group received S-1 chemotherapy concurrent with the radiotherapy on the first day.S-1 was orally given 80mg/m2 daily after meals from d1 to d14,21 days as a cycle and treated for 2 cycles.Results The total effective rate (CR + PR) of the combination group was 87.5％,that was 62.5％ of the control group,and there was statistically significant difference between the two groups (x2 =6.667,P =0.01).The one year overall survival rate of the two groups was 77.5 ％ and 57.5 ％,respectively,the difference was not significant (P =0.056).The incidence rate of hematological toxicity was higher in the combination group than that in the control group,but the toxic reaction was mild and tolerable.Conclusion The short-term curative effect of S-1 combined with three-dimensional conformal radiotherapy is feasible for elderly patients with esophageal cancer,and the toxicity is tolerable.

Objective To explore the value of 3.0T diffusion weighted imaging (DWI)in predicating and evaluating the efficacy of concurrent chemoraidotherapy (CCRT)in esophageal car-cinoma.Methods A total of 46 patients with esophageal carcinoma were divided into group A (with complete disappearance of high signal intensity)and group B (with incomplete disappearance of high signal intensity)based on the complete disappearance of high signal intensity of esophageal lesion and metastatic lymph node after 1 to 3 months of CCRT so as to measure the changes of esophageal lesion length and apparent diffusion coefficient (ADC)value of normal and lesion tissues, and were divided into T1-3 group (without affection)and T4 group (with affection)to analyze the differentiation of ADC values in both groups,according to the affection of esophageal lesion to sur-rounding tissues and organs distinguished by DWI.Additionally,all patients were divided into N0 group (without metastasis)and N1 group (with metastasis)on the basis of metastasis of medi-astinum lymph node determined by DWI,so as to analyze the differentiation of ADC values in both groups.Results After CCRT,esophageal lesion length decreased evidently than treatment before and the difference was statistically significant.ADC values in groups A and B were obviously lower than that in the esophageal normal tissues before and after treatment,while ADC value increased markedly in all groups after treatment compared with the treatment before,and ADC value was ap-parently higher in group A than that in group B.However,there was no significant difference be-tween T1-3 and T4 groups.Moreover,N0 group was obviously higher than N1 group in ADC value,and the difference was significant.Conclusion CCRT can obviously shorten esophageal lesion and increase ADC value in malignant lesion tissues of tumor,which suggested that ADC value can re-flect the internal metabolism changes and concurrent chemoraidotherapy of tumor earlier and more accurately.

Objective To explore the value of 3.0T diffusion weighted imaging (DWI)in predicating and evaluating the efficacy of concurrent chemoraidotherapy (CCRT)in esophageal car-cinoma.Methods A total of 46 patients with esophageal carcinoma were divided into group A (with complete disappearance of high signal intensity)and group B (with incomplete disappearance of high signal intensity)based on the complete disappearance of high signal intensity of esophageal lesion and metastatic lymph node after 1 to 3 months of CCRT so as to measure the changes of esophageal lesion length and apparent diffusion coefficient (ADC)value of normal and lesion tissues, and were divided into T1-3 group (without affection)and T4 group (with affection)to analyze the differentiation of ADC values in both groups,according to the affection of esophageal lesion to sur-rounding tissues and organs distinguished by DWI.Additionally,all patients were divided into N0 group (without metastasis)and N1 group (with metastasis)on the basis of metastasis of medi-astinum lymph node determined by DWI,so as to analyze the differentiation of ADC values in both groups.Results After CCRT,esophageal lesion length decreased evidently than treatment before and the difference was statistically significant.ADC values in groups A and B were obviously lower than that in the esophageal normal tissues before and after treatment,while ADC value increased markedly in all groups after treatment compared with the treatment before,and ADC value was ap-parently higher in group A than that in group B.However,there was no significant difference be-tween T1-3 and T4 groups.Moreover,N0 group was obviously higher than N1 group in ADC value,and the difference was significant.Conclusion CCRT can obviously shorten esophageal lesion and increase ADC value in malignant lesion tissues of tumor,which suggested that ADC value can re-flect the internal metabolism changes and concurrent chemoraidotherapy of tumor earlier and more accurately.

OBJECTIVETo evaluate the efficacy and safety of wheat cellulose particles (testa triticum tricum purify, Fiberform) in the treatment of internal hemorrhoid.

METHODSA multicenter randomized controlled clinical trial was adopted. From October 2015 to July 2016, 60 patients with internal hemorrhoid were enrolled from three medical centers, including Department of Anorectum, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Department of Anorectum, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Anorectum, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine. Enrollment criteria: Patients aging from 18 to 65 years old; being diagnosed with the second or third grade internal hemorrhoid; having good communication skills and being able to complete the records and follow-ups according to the research program requirements.

EXCLUSION CRITERIAPatients combined with other anal diseases, or whose anus tube or rectum suffering occupying lesions; patients currently using other methods and defecation drugs in the treatment of their hemorrhoids; patients in pregnancy or with diseases of heart, liver, kidney or metabolic disorders; patients suffering from constipation due to other diseases and drugs, and long-term laxatives abusers. According to the random number table method, 60 patients were randomly divided into the combined treatment group [30 cases, wheat cellulose particles 1 bag each time, 2 times per day; Diosmin tablet 2 pills, 2 times per day] and the single treatment group [30 cases, Diosmin tablet 2 pills, 2 times per day]. The treatment courses for both groups were 7 days. According to the four-grade scoring method, the efficacy evaluation would be made on six indicators, which were the degree of hematochezia or bleeding, the degree of pain, hemorrhoid prolapse, the shapes and properties of stool, the defecation frequency and the defecation duration. The higher the score a participant got, the more severe the symptom was. The effectiveness was evaluated by the scoring reduction rate, and marked effectiveness and effectiveness were both found to be effective. Incidence of adverse events was compared between two groups before the treatment, and on postoperative 3-day and 7-day respectively.

RESULTSThere were no significant differences between two groups in gender, age, internal hemorrhoids gradings, disease course, and onset time as well as the baseline data, such as the degree of hematochezia or bleeding before the treatment, the degree of pain, hemorrhoid prolapse, the shapes and properties of stool, the defecation frequency and the defecation duration (all P>0.05). After the seven-day treatment, there was significant difference in effective rate between combination group and single group [96.7%(29/30) vs. 66.7%(20/30), Z=-4.376, P=0.000]. Meanwhile, the scores of combined group and single group in hematochezia or bleeding were 0(0, 1) and 0(0, 2) (Z=9.241, P=0.002); in shapes and properties of stool were 0(0, 1) and 0(0, 1) (Z=5.364, P=0.021); in defecation frequency were 0(0, 1) and 0(0, 2) (Z=7.552, P=0.006); and in defecation duration were 0(0, 1) and 0(0, 2) (Z=4.425, P=0.035), whose differences were all significant. The scores of pain degree and hemorrhoid prolapse of two groups also decreased, but the difference was not statistically significant (P>0.05). During the treatment, abdominal pain, diarrhea and other adverse reactions were not observed in participants of two groups.

CONCLUSIONCombination therapy of wheat cellulose particles (testa triticum tricum purify, Fiberform) can significantly improve the efficacy of internal hemorrhoid with safety and tolerance.