The local recurrence rote is high after operation without chemotherapy or radiotherapy for lo-cally advanced rectal cancer. Recent random-control clinical phase Ⅲ studies suggest that the neoadjuvant ther-apy for locally advanced rectal cancer can improve local control rate obviously and ameliorate survival rate for pathologically complete response patients. In Europe and America, the neoadjuvant therapy has been regarded as the standard treatment for locally advanced rectal cancer. However the choice of chemotherapy agents, the application of hyperthermia and so on will be still requested further clinical trails.

Purpose: To evaluate the efficacy and the side effects of 3 D-conformal radiotherapy for malignant thoracic tumor. Methods: Between September 1999 and August 2002, 36 patients with malignant thoracic tumor were treated with 3D-conformal radiotherapy. Twenty-two patients had primary lung cancer, 12 patients had metastatic lung cancer, and 2 patients had malignant mediastinal tumor. All 36 patients were pathologically confirmed. Squamous cell carcinoma 16 cases, adenocarcinoma 15 cases, small cell carcinoma 2 cases, embryonal carcinoma 1 case, malignant thymoma 1 case and sarcoma 1 case. For the primary tumor, conventional radiotherapy was first used to 50Gy/25F/5W, followed by 3D-conformal radiotherapy 16-20Gy(4Gy per fraction, 3 fractions per week) with MLC or cone from 5 ~6 non coplanar or coplanar static ports. For metastatic tumor, using arc therapy to only 28-40Gy(4Gy per fraction, 3 fractions per week, 7-10 fractions) with cone from 1 ~ 4 arcs. Tumor volumes from 1. 85 cm3 to 104. 61 cm3 with a median of 24. 96 cm3 in 3D-CRT. Results: To evaluate the effects, thoracic CT scan was taken two months after completion of 3D-conformal radiotherapy. In 34 evaluated patients, 13 cases obtained CR, 14 PR, 5 NC, and 2PD. The overall 1 and 2-year survival rates were 74. 1% and 38.4%. Toxicity consisted of grade 1 acute radiation pneumonitis in 17 patients, grade 2 in 10 patients, grade 3 in 1 patients, and 2 patients dead of radiation pneumonitis ( with non coplanar technique), late complication was radiation pulmonary fibrosis, grade 1 in 20 cases, grade 2 in 8 cases. Conclusions: 3D-conformal radiotherapy as complement of conventional external beam radiotherapy for malignant thoracic tumor can obtain better short-term effects, although the survival is yet to be investigated. But attention must be given to the irradiation technique, the irradiation volume should not be too large and beams angles appropriately adjusted to avoid excessive irradiated volume in normal lung.

Objective:To investigate the traditional Chinese medicine(TCM) and its pathology relationship in IgA nephropathy(IgAN),so as to deduce the pathogenetic condition and prognosis,and guide the clinic therapy.Methods: 53 cases of IgAN were analyzed retrospectively,syndrome differentiations were concluded by the diagnosis criteria of TCM syndrome in the clinic research and guiding principe of the curment new herd in chronic nephritis in 2002 into deficiency of spleen and kidney qi,deficiency of liver and kidney yin,deficiency of both qi and yin,and the accompanied syndrome as affection of exogenous wind-heat,endoretention of damp-heat and blood stagnation.The relationship among pathological parameters,pathological stages and the above syndromes were observed.Results:Compared the three clinical syndromes of deficiency of spleen and kidney qi,deficiency of liver and kidney yin and deficiency of both qi and yin of 53 cases of patients,pathology change and pathological stage were the lightest in deficiency of spleen and kidney qi,on the contrary,the heaviest in deficiency of both qi and yin,P

Objective To observe the clinical effects of radiotherapy and/or chemotherapy in the treatment of nasal and Waldeyer ring natural killer (NK)/T cell lymphoma and to analyze the prognostic factors.Methods Between January 20,2000 and December 21,2010,109 patients with nasal NK/T cell lymphoma and 21 patients with Waldeyer ring NK/T cell lymphoma were admitted to our hospital; the diagnosis was confirmed by immunohistochemistry.According to the Ann Arbor staging system,116 patients were classified as stage Ⅰ E,and 14 as stage Ⅱ E.Thirty patients received radiotherapy alone;2 patients received chemotherapy alone; 98 patients received radiochemotherapy.Results The follow-up rate was 100％.Seventy-eight patients were followed up for at least 5 years.The complete remission (CR) rate was 89.2％ in all patients.The CR rates of stage Ⅰ E patients and stage Ⅱ E patients were 88.8％ and 92.9％,respectively (x2 =0.02,P =0.837).The CR rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 86％ and 96％,respectively (x2 =1.44,P =0.230).The five-year overall survival (OS) rate and disease-free survival (DFS) rate of all patients were 58.0％ and 57.2％,respectively.The five-year OS rates of stage Ⅰ E patients and stage Ⅱ E patients were 60.6％ and 36.3％,respectively (x2 =0.25,P =0.615) ;the five-year DFS rates of stage Ⅰ E patients and stage Ⅱ E patients were 59.7％ and 36.3％,respectively (x2 =0.21,P =0.648).The five-year OS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 70.0％ and 48.4％,respectively (x2 =0.01,P =0.933) ; the five-year DFS rates of patients receiving radiotherapy alone and patients receiving radiochemotherapy were 65.6％ and 48.4％,respectively (x2 =0.09,P =0.764).The grade 3-4 toxicity rates of radiotherapy alone and radiochemotherapy were 6.7％ and 54.1％,respectively (x2 =41.38,P=0.002).The radiation dose to the primary lesion and Eastern Cooperative Oncology Group (ECOG) score were correlated with OS (x2 =3.1 8,P =0.005 ; x2 =2.97,P =0.008).Conclusions The clinical effect of radiochemotherapy is similar to that of radiotherapy alone in the patients with stage ⅠE and ⅡE nasal and Waldeyer ring NK/T cell lymphoma,but radiochemotherapy has higher toxicity than radiotherapy alone.The radiation dose to the primary lesion and ECOG score are the influential factors for OS.

Purpose:To investigate the comprehensive treatment value on the malignant Tumor of lung transference.Methods:From January, 1993 to January, 1999, our hospital accepted 75 cases malignant tumor of lung transference in all. It was proved that the primary foci were lungs transference. There are 34 male cases and 41 female cases in the group. The average age is 47 years old the ages(between 27 to 71).Single primary foci reach 12 cases, and multiprimary foci reach 63 cases. Pure operation removals are 4 cases; operation with chemotherapy are 2 cases, and 6 cases are treated with plan radiotherapy before operation with chemotherapy after operation; 17 cases, radio and chemotherapy; 10 cases, only radiotherapy; 36 cases, only chemotherapy. 59 cases in 75 take additional traditional Chinese drugs.Results:The effective rate of nasopharyngeal carcinoma in lung transferring tumor (CR+PR) is 71.4% (20/28) MST is 9.5 month; the effective rate of lung cancer (CR+PR) is 53.3% (8/15) MST 8.5 month; breast cancer, 68.7% (22/32) MST 21 month. The total effective rate of this group (CR+PR) is 66.7% (50/75), CR rate is 36.04%, PR rate is 30.7%, NC rate is 25.3%, PD rate is 8%.Total MST is 13.5 month. Traditional Chinese medicine (TCM) can help the radiotherapy and chemotherapy in the function.Conclusions:The group of cases are for retrospect investigation, there are many disease type, but not many in each type, the analysis of the result shows that they are sensitive to radiotherapy and chemotherapy, the radiotherapy and chemotherapy is a kind of supplementary treatment to low degree malignant tumor of lung transference, it has definite clinical meaning if assisting with traditional Chinese medicine. [

Objective To study the expression and the significance of phosphorylated P38(p-P38) and uPA in breast cancer tissues.Methods Immunohistochemistry(S-P) was used to test the protein expression of p-P38 and uPA in 60 specimens from 50 patients with breast cancer.Western blotting was adopted to detect the protein expression of p-P38 and uPA in breast cancer cells and uPA protein expression after incubation with SB203580,an specific inhibitor of P38 MAPK blocked P38 MAPK signaling pathway.Results The positive rates of p-P38 protein and uPA protein in breast cancer tissues were 56.7%and 60.0% respectively.The protein expression level of p-P38 and uPA in breast cancer tissues was significantly higher than that in adjacent normal tissues(P

ObjectiveTo investigate the inhibitory effect of 1-methyl-tryptophan (1-MT) on transplanted hepatocellular carcinoma in mice.MethodsHuman hepatocellular carcinoma subcutaneous tumor models were established in mice,and the mice were divided into hepG2 group,empty plasmid group,indoleamine 2,3-dioxygenase (IDO) saline group,IDO) 5-fluoropyrimidine (5-FU) group,IDO 1-MT group,and the group combining IDO 1-MT with 5-FU treatment (n=8 in each group).The tumor growth,tumor volume and pathological examination were observed and the expression of IDO in tumor tissues was determined by immunohistochemistry.ResultsCompared with hepG2 and the empty vector saline groups,IDO saline group had bigger tumor,faster growth,and the differences were statistically significant (P＜0.05).Compared with IDO saline group,5-FU group,1-MT group and combination treatment groups showed smaller tumor volume and weight,and the tumor inhibitory rates were 86.54％,79.95％,94.46％,respectively.There were significant differences between these groups (P＜0.05).However,there were no significant differences in tumor volumes between 5-FU group and 1-MT group (P＞0.05).HE pathological observation of ceils in each treatment group showed reduced density,increased necrotic area and significant decrease in peripheral blood alpha-fetoprotein (P＜0.05).ConclusionsIDO can promote the growth of liver cancer cells involved in immune escape.1-MT can inhibit the transplanted tumor growth in mice,and therefore may enhance the chemotherapeutic efficacy.

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.

[Objective] Expressions of human epidermal growth factor receptor 2(HER-2),p53,estrogen receptor (ER),and progesterone receptor (PR) in tissues of breast invasive ductal carcinoma are not only applied to determine the therapeutic regimen,but they may also be related to the prognosis.We investigated the levels of these proteins among different clinical stages and the correlations.[Method] One hundred and thirty-eight tissues from cases with breast invasive ductal carcinoma were tested with immunohistochemistry.New scoring standards and rank test were applied.The indices were digitalized and semi-quantified.[Results] In the tissues from high clinical stage,the expression of HER2 was significantly increased,while expression of PR was markedly decreased.[Conclusion] Expression of HER2 and PR might be better markers for predicting clinical stages and prognosis.

OBJECTIVE:To provide reference for promoting rational use of essential medicines. METHODS:Combined with the actual situation of our hospital,a set of risk prevention and control system on essential medicine was constructed on the basis of relevant laws and regulations and support of information,and then implemented. RESULTS:The implementation of the system greatly promoted cognition of all medical staffs on reasonable,economical and safe use of essential drugs,standardized medication behavior and improved essential medicine use more reasonable. After the implementation of risk prevention and control system on essential medicines,medicine ratio of whole hospital decreased from 34.62% to 32.64%,inpatient medicine ratio decreased from 33.02% to 27.89%;essential medicine ratio of whole hospital rose from 31.22% to 43.34%,inpatient essential medicine ratio in-creased from 23.46%to 39.17%;the proportion of outpatient antibiotics prescriptions decreased from 15.04%to 13.46%,the utili-zation of inpatient antibiotics decreased from 62.11% to 48.47%. Various early warning were sent out 104 times in total,and 23 medical staff were punished due to irrational drug use. The prescription form and rationality of drug use were improved gradually. CONCLUSIONS:The construction of risk prevention and control system on essential medicine is one of the keys to the success of health care reform. It is suggested to make full use of thesystem+technologymeans,establish long-term mechanism for risk pre-vention and control,and constantly improve the system.