Radiotherapy is the main treatment method of early lung cancer not undergoing surgery for medical reasons and advanced non-resectable lung cancer. The local regional control of lung cancer requires high-dose irradiation, but this treatment is restricted by normal tissue tolerance. The measurement and control of errors are crucial for safe implementation of lung cancer precision radiotherapy. Lung tumor radiotherapy error sources, the methods to control these errors, and the error development trend are discussed in this review.

Objective To investigate the significance of H.pylori infection on upper gastrointestinal rebleeding in patients with long-term (≥ three months) aspirin and clopidogrel combination therapy.Methods From September 2007 to September 2011,at Yijishan Hospital of Wannan Medical College 78 patients with upper gastrointestinal bleeding and receiving long-term (≥ three months) aspirin and clopidogrel combined therapy were selected and treated with esomeprazole.The results of rapid urease test and gastric mucosal biopsy Giemsa staining of selected patients indicated 55 patients were H.pylori positive (positive group) and the other 23 cases were in negative group.The patients of positive group were randomly divided into intervention group (28 cases) and control group (22 cases) by the random allocation table method.The patients of intervention group received H.pylori eradiation treatment and the situation of H.pylori eradication was checked by 14C breath test.After treatment all patients were followed up for six months and clinical symptoms and the situation of rebleeding were observed.Categorical variables were expressed as percentage,intentional analysis and in accordance with protocol analysis were performed separately and analyzed by chi-square test.Results One patient in negative group with gastric cancer withdraw from the study.Two patients in intervention group lost.And one patient in control group lost.H.pylori of intervention group was all eradiated.In accordance with protocol analysis,the rebleeding rates of intervention group and control group were 7.69％ (2/26) and 34.62％ (9/26),respectively,and the difference was statistically significant (x2 =5.650,P=0.017).There was no significant difference between negative group (18.18％,4/22) and intervention group and no significant difference between negative group and control group (both P ＞ 0.05).In intentional analysis,the rebleeding rates of intervention group and control group were 7.14％ (2/28) and 33.33％ (9/27),respectively,and the difference was statistically significant (x2 =5.893,P =0.015).There was no significant difference between negative group (17.39 ％,4/23) and intervention group and no significant difference between negative group and control group (both P ＞ 0.05).Conclusion Eradication of H.pylori can reduce the rate of upper gastrointestinal rebleeding in patients with long-term aspirin and clopidogrel combination therapy.

Objective To observe the effect of octreotide combined with percutaneous catheter drainage on pancreatic pseudocyst ( PPC ) .Methods 89 patients choosen with PPC were randomly divided into the octreotide combined with percutaneous catheter drainage group(observation group,n=43) and octreotide group (control group, n=46).The control group were subcutaneous injected octreotide 0.1mg q 8 h.The observation group were subcutane-ous injected octreotide 0.1mg q 8 h with ultrasound or CT-guided percutaneous drainage for 4 weeks to place more drainage tubes when there were multiple cysts,drainage not free when washing drainage tube and drainage tube posi-tion adjustment.After 4 weeks rechecked the pancreas CT and curative effect was analyzed.Results The observation group cure rate and total effective rate were 65%,100%,the average hospitalization time was (16.8 ±12.1) d.The control group were 39%,85%,(26.8 ±19.4) d,the differences between the two groups were statistically significant(χ2 =6.01,χ2 =7.10,t=2.89,P<0.05,P<0.01).Conclusion Octreotide combined percutaneous catheter drainage on PPC has good curative effect,small trauma,high success rate,less complications,shorter hospitalization time.It is the preferred method for the treatment of PPC.

China ; Forecasting ; Gaucher Disease ; diagnosis ; therapy ; Humans ; Rare Diseases

It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

ObjectiveTo observe the infection of continuous aspiration of subglottic secretion(CASS) for patients with ventilator associated pneumonia (VAP).MethodsOne hundred and fifty VAPpatients under mechanical ventilation whose basical information were recorded were divided into two groupsby random digits table method:control group(70 cases) and CASS group(80 cases).Conventional VAPprevention was taken in control group and CASS group,while CASS therapy was added to CASS group.ResultsSex,age,acute physiology and chronic health evaluation Ⅱ score,recent antibiotics usage,airpressure,time in ICU,hospital stay and mortality rate of two groups had no statistical significance(P ＞0.05 ).The time of ventilator treatment of CASS group was obviously shorter than that of control group [ (5.2 ±1.4) d vs.(7.8 ± 1.2) d,P =0.02 ],and VAP incidence was lower than that of control group [ 22.5％ (18/80)vs.32.9％(23/70),P =0.04 ].ConclusionCASS could reduce the incidence of VAP and short the time ofventilator treatment.

Objective To explore the effect and significance of propofol combined with a small dose of butorphanol in anesthesia abortion surgury.Methods Retrospective analysis of 2145 cases of the propofol combined with a small dose of butorphanol on the anesthesia abortion surgery of the anesthesia effect,side effects,anesthesia,surgery time,recovery time,discharge time,cost,etc.Results The excellent rate of narcotic analgesia was 99.9％,the satisfaction rate of the patients was 100％,4.5％ incidence of adverse events,mainly body movements and allergies.The average amount of anesthetic propofol was ( 95 ± 15) mg,the butorphanol was 0.6mg;the operative time was (5.4 ±1.6) min,the patients alert in ( 1.8 ± 0.6) min,and discharged from the hospital 0.5 to 1 hour after the surgery.Conclusion The propofol combined with a small dose of butorphanol used in anesthesia abortion surgery has good curative effects,safety,low incidence of side effects,cheap price.

Objective To investigate the mechanism by which electro-acupuncture (EA) promotes revascularization in the brain after focal cerebral ischemia and reperfusion.Methods The Sprague-Dawley rat model of focal cerebral ischemia was made by filament occlusion. The rats were randomly divided into a control group, a model group, and an EA group. The model and EA groups were each divided into 5 subgroups receiving reperfusion 1, 3,7, 14 or 21 days after ischemia. EA was given at the bilateral Hegn point (LI 4) in the EA group. The expression of stromal cell-derived factor-1α(SDF-1α) mRNA was detected using a RT-PCR in the 3, 7 and 14 day subgroups.The immunohistochemical method was employed to detect the expression of SDF-1α protein. Results Compared with the control group, expression of SDF-1α protein increased significantly in the model and EA groups. Compared with the model group, the expression of SDF-1α mRNA increased significantly in the 3, 7 and 14 day subgroups.SDF-1α protein expression and microvessel count increased slightly but not significantly in the 1d subgroup, but the increases were significant in the 3, 7, 14 and 21 day subgroups.Conclusions EA may promote angiogenesis in an ischemic area of the cortex by increasing the expression of SDF-1αmRNA and its protein after focal cerebral ischemia and reperfusion.

Objective To explore the indication of implant prosthesis immediately after removing polyacrylamide hydrogel for augmentation mammaplasty. Methods MRI and pathologic examinations were made in 226 patients with the postoperative complications of augmentation mammaplasty by injecting polyacrylamide hydrogel and with the specific conditions in operation to analyze the possibility of implant prosthesis while removing polyacrylamide hydrogel. Based on MRI examination, physical examination and specific conditions in operation, we chosen 61 cases who requested for implant prosthesis while removing polyacrylamide hydrogel. Results The patients who did the operation for simply removing polyacrylamide hydrogel recovered well and symptoms such as pain, sclerosis, mass and others disappeared almostly; the patients who did implanting at the same time were satisfied with the breast shape and had no side-effect occured. Conclusion With MRI examination, physical examination and specific conditions in operation, it can achive good effects to do implanting immediately after removing polyacrylamide hydrogel for those suitable and willing to implant prosthesis.

Since Guglielmi detachable coils used in the clinical practice, endovascular embolization of cerebral aneurysms is increasingly being accepted by doctors and patients.However, the relatively higher recurrence rate is still a matter of concern in the interventional treatment, The development and application of new coils have made some progress. This paper reviews the new coated coils and their advances in clinical application.