Objective To explore the relationships of quality of life ( QOL ) and functional status in patients with malignant bone tumors after operation. Methods European organization for research and treatment of cancer quality of life questionnaire C30 (EORTC-QLQ-C30), social support revalued scale (SSRS) and Karnofsky performance scale (KPS) were used to investigate the levels of QOL, social support and functional status. The correlations between them were explored. Results The overall score by QOL was (58.33 ± 18.94). The score by KPS was positively related to somatic function, role function, social function, and general health status (P<0.01), but negatively related to tiredness, pains, insomnia and financial burden (P<0.01). Conclusions The QOL in patients with malignant bone tumors after operation is at a lower level and the function is at a medium level. Nurses should assess the function and make out interventional measures for them so as to improve their QOL.

Objective Evaluate the diagnostic value of PET/CT in the preoperative advanced gastric carcinoma comparing with mult;-slice spiral computed tomography. Methods Thirty-nine advanced gastric carcinoma patients taking PET/CT and abstract 40 advanced gastric carcinoma patients performing MSCT before operation,were done the TNM staging, and the Results were compared with the operation histopathology. Results For diagnosing primary lesions, regional lymph nodes, N3 lymph nodes ,PET/CT was accurate in 92.3% , 66.7% and 100.0%.Instead, MSCT was accurate in 82.0% , 50.0% and 62.5%. Conclusions (1) PET/CT and MSCT have high accuracy in diagnosing primary lesions and regional lymph nodes. But for detecting the N3 lymph nodes and distant metastasis, PET/CT has higher accuracy than MSCT. PET/CT combining abdominoscopy may decrease or avoid exploratory laparotomy.

Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5％.Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the existing poorprognosis.Recently,compounds from naturalsources receive ample attention as anti-cancer agents.Overwhelming in vitro evidence and clinical trials suggest that curcuminn,isothiocyanate,capsaicin,catechin may reduce the incidence of cancer.

Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits.Methods From October 2014 to June 2015,36 male rabbits (weighing 1.8-2.4 kg,10-14 months of age) were randomly divided into experimental group and control group,18 in each group.Produced by surgical testicular torsion model (720° counterclockwise rotation of the left side testicle),every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water,all the testicles were observed no significant improvement in colors,and no fresh blood flow after opening tunica albuginea,then all the testicles were retained and fixed.Low molecular dextran(5 ml/kg,ear marginal vein injection,1/d),papaverine(1.5 mg/kg,intramuscular,3/d) and low molecular weight heparin sodium (200 IU/kg,subcutaneous,l/d) were applied to promote testicular revascularization for 5 days in experimental group,and penicillin (40 000 U/kg,intramuscular,1/d) for 7 days.Control group was only given penicillin (40 000 U/kg,intramuscular,1/d) to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0,1,2,3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened,according to color,texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened,to determine whether the testicle was alive.The testicle was ruddy,flexible,and fresh blood was observed,which could prove testicular survival.Results In experimental group,the testicular blood flow siganals:0 class 4 cases,1 class 3 cases,2 class 4 cases,3 class 7 cases.In control group,the testicular blood flow siganals:0 class 9 cases,1 class 2 cases,2 class 4 cases,3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group,which was significantly difference (P ＜ 0.05).Conclusions The combined application of low molecular dextran,papaverine,low molecular weight heparin sodium can promote the recovery of testicular blood after reduction of testicular torsion,and improve testicular survival rate.

Clinical medicine is a comprehensive discipline integrating natural science and hu-manities and social science. Lemology is closely related with basic medicine and medical microbiology and medical immunology are the basis of lemology. Therefore, in the process of cultivating postgradu-ates of lemology, we should not only should attach importance to the cultivation of basic medical knowl-edge and clinical professional quality, but also pay more attention to the development of the intelligence factors and non-intelligence factors. Meanwhile education on humanity, social sciences and relevant laws and regulations should be enhanced to cultivate doctors' professional quality. Reverse thinking and lateral thinking in the clinical diagnosis should be strengthened to achieve the training objectives of cultivating international medical talents.

Objective To explore the influence of platelet aggregation rate, platelet response index in patients with coronary heart disease by domestic and imported aspirin and clopidogrel and its safety. Methods The date of 100 cases patients with coronary heart disease for angina pectoris from November 2012 to November 2013 were retrospectively analyzed in this study, according to different drug sources, they were divided into import group and domestic group, 50 cases each. Import group was treated with imported aspirin and clopidogrel, the domestic group was treated with domestic aspirin and clopidogrel. MPA, PRI before medication, medication discontinuation after 1, 2 weeks and 6 h, 12 h and 1 d after discontinuation between two groups were compared, treatment of cardiovascular and adverse drug reactions occur within 1 year were observed. Results There was no significant difference between two groups for MPA and PRI before treatment (P>0.05); MPA, PRI after treatment 1 week, 2 weeks in import group were lower than that in domestic group (P<0.05). 6 h after the drug was stopped, MPA had no difference between two groups (t=1.209, P=0.229>0.05), 12 h and 1 d after drug withdrawal, MPA in import group were higher than that in domestic group ( P<0 . 05 ); Discontinuation after 6 h , 12 h , PRI in domestic group were significantly higher than that in import group (P<0.05), after the withdrawal of 1 d, there was no statistical significance (t=1.332, P=0.186>0.05). The incidence of cardiovascular adverse events in import group were lower than that in the domestic group, with statistically significant differences (P<0.05). Team rash, abdominal pain, bruising rates in import group were lower than that in domestic group, the differences were statistically significant (P<0.05). Conclusion Compared with domestic, aspirin combined with clopidogrel plays a positive and effective role in resistting platelet clotting in patients with coronary heart disease for angina pectoris, and platelet function can be quickly restored after the drug is stopped, can significantly reduce the recurrence of myocardial infarction, angina pectoris, heart cerebrovascular accident prevention, reduce mortality.

Objective To summarize the therapeutic experience of thoracoscopic thoracic sympathectomy in treatment of 22 patients with palmar hyperhidrosis.Methods Clinical materials of 22 patients with palmar hyperhidrosis were analyzed retrospectively.Results Totally 22 patients completed surgery successfully.After the operation,the palmar temperature increased with (2.1 ± 1.1)℃,and symptoms relieved or disappeared.The mean operating time was (61.1 ± 18.1) min,and the average hospital stay was (7.4 ± 2.6) d.There were 2 cases of compensatory hyperhidrosis during the perioperative period,and all of them were relieved within 6 months.Conclusion Thoracoscopic thoracic sympathectomy is effective in treatment of patients with palmar hyperhidrosis.

Objective To summarize the therapeutic experience of thoracoscopic thoracic sympathectomy in treatment of 22 patients with palmar hyperhidrosis.Methods Clinical materials of 22 patients with palmar hyperhidrosis were analyzed retrospectively.Results Totally 22 patients completed surgery successfully.After the operation,the palmar temperature increased with (2.1 ± 1.1)℃,and symptoms relieved or disappeared.The mean operating time was (61.1 ± 18.1) min,and the average hospital stay was (7.4 ± 2.6) d.There were 2 cases of compensatory hyperhidrosis during the perioperative period,and all of them were relieved within 6 months.Conclusion Thoracoscopic thoracic sympathectomy is effective in treatment of patients with palmar hyperhidrosis.

Objective:To evaluate the survival and prognostic factors of radiotherapy in patient with Ⅳ stage esophageal squamous carcinoma treated with radiation or chemoradiation.Methods:The medical records of 608 patients with stage Ⅳ esophageal squamous cell carcinoma who met the inclusion criteria in 10 medical centers in China from 2002 to 2016 were retrospectively analyzed. The overall survival and prognostic factors of all patients at 1, 3 and 5 years were analyzed.Results:The 1-, 3-, 5- year overall survival (OS) rates was 66.7%, 29.5% and 24.3% in stage ⅣA patients, and 58.8%, 29.0% and 23.5% in stage ⅣB patients. There was no statistical difference between the two groups ( P=0.255). Univariate analysis demonstrated that the length of lesion, treatment plan, planned tumor target volume (PGTV) dose, subsequent chemotherapy, and degrees of anemia, radiation esophagitis, radiation pneumonia were related to the prognoses of patients with Ⅳ stage esophageal carcinomas after radiotherapy and chemotherapy ( P<0.05). Multivariate analysis demonstrated that PGTV dose ( OR=0.693, P=0.004), radiation esophagitis ( OR=0.867, P=0.038), and radiation pneumonia ( OR=1.181, P=0.004) were independent prognostic factors for OS. Conclusions:For patients with stage Ⅳ esophageal squamous cell carcinoma, chemoradiotherapy followed by sequential chemotherapy is recommended, which can extend the total survival and improve the prognosis of the patients. PGTV dose more than 60 Gy has better efficacy.

Objective:To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients.Methods:The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed.Results:The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively ( P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively ( P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm 3, the median survival time of SIB and No-SIB group was 34.7 and 30.3 months ( P=0.155), respectively. In the patients whose GTV volume>50 cm 3, the median survival time of SIB and No-SIB group was 16.1 and 20.1 months ( P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group ( P<0.001). Conclusions:The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.