Objective To explore the effect of three-dimensional conformal radiation dose fractionation treatment of advanced non-small cell lung cancer(NSCLC).Methods 75 NSCLC patients were treated with hypofractionated 3DCRT( observation group),while 73 cases were treated with conventional fractionated radiotherapy (control group).The efficacy and adverse reactions were observed;Survival after treatment were followed up in 1,2,3 years.Lung function was detected before and after radiotherapy treatment,including FVC,FEV1 and CLCO.Results The total effective cases of control group were 47 cases patients ( 64.4％ ),observation group's was 60 cases ( 80.0％ ),total effective rate had statistically significant difference ( x2 =4.50,P ＜ 0.05 ).Survival of control group after treatment in 1,2,3year were 50.7％,24.7％,8.2％,the median survival was 13 months,observation group's were 73.3％,45.3％,20.0％,and 19 months.The survival of these two groups was statistically different (x2 =8.07,6,94,4.22,all P ＜ 0.05 ).The patients blood system side effects of observation group were significantly lower than the control group ( x2 =4.73,P ＜0.05 ) ;acute radiation pneumonia,esophagitis of these two groups had no significant difference in the incidence( P ＞ 0.05 ).Conclusion Hypofractionated 3DCRT treatment of advanced NSCLC had good effect,and its adverse reactions was low,and it was worthy of clinical application.

Objective To investigate the clinical efficacy of postoperative three-dimensional conformal radiotherapy concurrent with paclitaxel +TS-1 chemotherapy in the treatment of advanced gastric carcinoma.Methods A total of 60 patients with advanced gastric carcinoma were randomly divided into treatment group and control group.In treatment group,30 patients received simultaneous three-dimensional conformal radiations therapy combined with paclitaxel +TS-1 chemotherapy.In control group,30 patients received paclitaxel +TS-1 chemotherapy.The long term survival rate,local recurrence rate and side reactions were observed in two groups.Results The 1,2-year survival rate in treatment group [93.1％ (27/29),75.9 ％ (22/29)] and control group [72.4 ％ (21/29),48.3 ％ (14/29)] had significant difference (P ＜ 0.05).The 1,2-year local recurrence rate in treatment group [6.9％ (2/29),13.8％ (4/29)] and control group [31.0％ (9/29),44.8 ％ (13/29)] had significant difference (P ＜ 0.05 or ＜ 0.01).The side reactions in two groups were mainly manifested as leukopenia,thrombocytopenia,anemia,nausea,vomiting,liver function damage and oral mucositis.The incidence rate of nausea,vomiting in treatment group was significantly higher than that in control group [83.3％ (25/30) vs.53.3％ (16/30)] (P =0.012).Conclusions Postoperative threedimensional conformal radiotherapy concurrent with paclitaxel +TS-1 chemotherapy in the treatment of advanced gastric carcinoma may improve the long-term survival rate,lower local recurrence rate.But the adverse reactions are increased.

Objective: To study the clinicopathological characteristics，diagnosis，multiple modality therapy and prognosis of accessory breast cancer. Methods: Clinical data of 38 patients with accessory breast cancer seen in our hospital between October 1985 and November 2007. Results: The 38 cases of accessory breast cancer accounted for 0.15% of all 26,078 breast cancer cases during the same period.Six patients of stage Ⅰ and 3 patients of stage Ⅱ underwent breast-conserving local wide excision of the tumor plus axillary lymph node dissection,with the resection margins pathologically negative.The other 9 cases of stage Ⅱ patients were treated with Auchincloss mastectomy.Stage Ⅲ and stage Ⅳ patients were treated with Auchincloss or Halsted mastectomy.The most common histological type of accessory breast cancer was infiltrating ductal Carcinoma for 18 patients(47.4%)，of which 3 cases were associated with adenoma of the nipple tube.There were 6 cases of carcinoma simplex，6 cases of intraductal Carcinoma，3 cases of adenocarcinoma with focal squamous cancer cells differentiation，3 cases of medullary carcinoma，and 2 cases of mucinous adenocarcinoma.The most common pathological stages(according to AJCC staging of breast cancer,2002.6th edition)were stage Ⅱ and Ⅲ in 12 cases(31.6%)，stage Ⅰ in 6 cases，and stage Ⅳ in 8 cases.All patients were followed-up for 1 to 23 years.The median follow-up time was 6 years and 7 months，and the follow-up rate was 100%.Until November 2008，12 patients died of metastasis and the other 26 patients were still alive.The 5-year overall survival rate was 35.3%.significantly lower than that of breast cancer patients(66.8%).The 3-year survival rate was 77.8%.The 5-year disease free survivaI rate was 28.6%and the 3-year disease free survival rate was 63.6%. Conclusion: Accessory breast cancer is rarely seen but is aggressive.The diagnosis mainly depends on clinical characteristics，postoperative pathology and imaging examinations.Early diagnosis is essential.Surgery combined with other adjuvant therapies can improve patient survival.

Objective To investigate the relationship of fetal total bile acid (TBA) concentration with the change of fetal pancreas endocrine secretion and its impact on fetal growth and development in intrahepatic cholestasis of pregnancy(ICP). Methods The concentrations of TBA, insulin, glucagon and glucose in the cord blood were measured in 30 fetuses with maternal ICP (case group) and 30 fetuses of normogravidas(control group) after elective cesarean section during the same period in the Department of Obstetrics of Xiangya Second Hospital of Central South University from March 2007 to February 2008. The cord blood TBA concentration was investigated by enzyme method and the concentrations of insulin and glucagon were investigated by radioimmunoassay. The glucose was measured by oxidase-superoxide method. The neonatal weight, length and the ponderal index (PI) were measured after parturition. Results (1) The cord blood insulin concentration (9.0±3.3) mU/L and the ratio of insulin over glucagon 0. 048±0. 028 in the case group was significantly lower than that of controls(10.1±3.7) mU/L,0.050±0. 020 (P<0.05). The concentrations of TBA(10.3±3. 8)μmol/L and glucagon(235±57) ng/L in case group were obviously higher than that in controls (4.1±1.3)μol/L, (205±34) ng/L(P<0.05). But no difference was shown in the glucose concentration in cord blood between the ease and control groups [(3.4±1.1) mmol/L vs (3.6± 1.2 )mmol/L, P > 0.05]. (2)The neonatal weight and length in case group were significantly lower than that of control [(3163±478) g vs (3498±393)g, (46.5±2.3) cm vs (49.3±1.9)cm, P<0.01]; while the Ponderal index in ease group was significantly higher than that of control group (3.13±0. 23 vs 2. 92±0. 29,P <0.01). (3) The cord blood TBA concentration respectively showed a linear relationship with the cord blood insulin concentration, the cord blood glucagon concentration and the ratio of insulin over glucagon in the case group. With the increase in cord blood TBA concentration, the cord insulin concentration and the ratio of insulin over glucagon decreased; meanwhile the cord blood glucagon concentration rose(P<0.01). The cord blood insulin concentration and the ratio of insulin over glucagon in case group were respectively positively correlated with the neonatal weight and length, and were negatively correlated with the PI (P<0.01); while the cord glucagon concentration was respectively negatively correlated with the neonatal weight and length, and positively correlated with the P1 (P < 0.01 ).Conclusions In 1CP fetus pancreas, there are hypoinsulinism, glucagon oversecretion, and decrease of the ratio of insulin over glucagon, which is closely correlated with fetal TBA concentration. The endocrine function of fetal pancreas affects the fetal growth and development.

Purpose To explore the role of tumor necrosis factor-α( TNF-α) in the process of temozolomide ( TMZ) reduce glioma in-vasiveness and its possible mechanism. Methods C6 glioma cells of logarithmic phase were randomly divided into TMZ treatment (10, 30, 60, 120, 180, 240 min group) (n=15), dynamic monitoring content of TNF-αin the culture medium was measured by ra-dioimmunoassay, expression of p53 protein in C6 cells was detected with Western blotting method, and cell apoptosis was used with AnnexinV-FITC. A glioma invasiveness model was established in vitro and glioma invasiveness was determined by crystal violet stai-ning. Results For C6 cells, contents of TNF-αin the nutrient fluid and expressions of p53 protein in C6 cells obviously increased af-ter TMZ treatment and they achieved the peak at 120 min (P<0. 01), followed by decrease gradually. Glioma invasiveness was re-duced after TMZ acted on glioma in vitro. Conclusion TMZ can reduce glioma invasiveness by TNF-α, which this role may be is TMZ promote C6 cells release of TNF-α and increased TNF-α due to glioma cells apoptosis.

Objective To analyze the correlation between 18F-FDG SUV and immunohistochemical index including GLUT1, Ki-67, MVD, survivin and cyclinA in non-snall-cell lung cancer. Methods Thirty-three patients with NSCLC underwent preoperative PET/CT examination and surgical operation. All patients were divided into two groups according to the size of tumor (cutoff=3 cm), metastasis of mediastinal or hilar lymph nodes or not, and histological types of the cancer, respectively. The expression of GLUT1, Ki-67, MVD, survivin and cyclinA were estimated with SP immunohistochemical technique, and were analyzed statistically to reveal the correlation to FDG SUV. Results The rate of positive expression of GLUT1, Ki-67 and CD34 were 66.67%, 72.73% and 100%, respectively. The mean value of CD34 in all 33 patients was 12.6±2.9 (12-56). The rate of positive expression of survivin was 84.85%, and the corresponding data of cyclinA was 27.27%. Conclusion There is linear correlation between FDG PET SUV and GLUT1, but not between FDG PET SUV and Ki-67, MVD, survivin and cyclinA. The expressions of GLUT1, Ki-67, MVD, survivin and cyclinA are not related with the size of tumor, nor metastasis of lymph nodes. The expression of GLUT1 and Ki-67 is related with histological types of the cancer, but not with MVD, survivin and cyclinA.

A novel electrogenerated chemiluminescence (ECL) sensor for the determination of metoclopramide was developed by employing ruthenium complex as an ECL signal producer and an ordered mesoporous carbon (OMC) material as modified material. The ECL sensor was fabricated by adsorption ruthenium complex into a mixture of OMC and Nafion, which showed good electrochemical and ECL behaviors. It was found that the ECL intensity of the sensor fabricated was greatly enhanced in the presence of metoclopramide. Based on this finding, a highly sensitive and reproducible ECL method was developed for the determination of metoclopramide. The result showed that the ECL intensity was linear with the concentration of metoclopramide in the range from 1.0×10-10 to 5.0×10-7M and the detection limit was 3×10-11M. The ECL sensor exhibited a long-term stability and a fine reproducibility with relative standard deviation of 1.0 % for 1.0×10-10M metoclopramide in 18 continuous determinations. The developed method has been applied to the determination of metoclopramide in tablet samples with satisfactory results.

Objective To reveal the therapeutic efficacy of scalp acupuncture plus rehabilitation training in treating spastic cerebral palsy, by evaluating the Comprehensive Function for the Disabled Children and modified Ashworth Scale (MAS) before and after the intervention.Method Sixty patients with spastic cerebral palsy were divided into a treatment group and a control group by following a single-blind randomized design, 30 cases in each group. The treatment group was intervened by scalp acupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The improvements of comprehensive function and muscle tension, as well as the correlation between age and therapeutic efficacy were observed respectively after 2-month and 4-month treatment. Result There were significant differences in comparing the muscle tension score between the two groups respectively after2-month and 4-month treatment (P<0.01); the total effective rate was 86.7% in the treatment group versus 63.3% in the control group, and the difference was statistically significant (P<0.05); in the treatment group, there was a significant difference in comparing the therapeutic efficacy between different age groups (P<0.05).Conclusion Scalp acupuncture plus rehabilitation training can produce a better result than rehabilitation alone in treating spastic cerebral palsy; the younger the patients, the better the prognosis.

Objective To study the pathology of primary neuroectodermal tumor (PNET),and its diagnostic standards and prognostic factors.Methods Expression of CD99,FLI-1,Syn,NSE,S-100,NF,and Vim was detected in PNET tissues stained with HE and immmunohistochemistry (En Vision method).Survival rate of 33 PNET patients with complete clinical information was analyzed with COX regression analysis method.Results The positive expression rate of CD99,FLI-1,Vim,Syn,NSE and s-100 was 88.57%,51.43%,91.42%,48.57%,45.71%,and 22.86%,respectively.The sensitivity of combined CD99 and FLI-1 was 100%.However,NF was not expressed in all PNET tissues.When other factors were unchanged,no difference was found in the effect of age on the survival rate of patients.However,a significant difference was observed in the effect of PNET site and its treatment modalities on the survival rate of patients (P

OBJECTIVE:To effectively prevent and treat antibiotic-associated diarrhea (AAD). METHODS: Take some clinical cases to analyse and summarize the result about multiple micro-ecological preparations such as probiotic yoghurt,lively bacterium preparation and prebiotics being used to prevent and treat AAD. RESULTS: It was showed by cases that probiotic yoghurt and lively bacterium preparations could effectively prevent AAD in patients with AAD risk factors,and the application of micro-ecological preparations exhibited a remarkable efficacy for the patients with AAD. CONCLUSION: Rational application of micro-ecological preparations is conducive to the prevention and treatment of AAD.