Aged ; Anion Exchange Protein 1, Erythrocyte ; metabolism ; Brenner Tumor ; metabolism ; pathology ; surgery ; Carcinoma, Transitional Cell ; metabolism ; pathology ; surgery ; Chromogranin A ; metabolism ; Cystectomy ; Female ; Humans ; Hysterectomy ; Membrane Proteins ; metabolism ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Urinary Bladder Neoplasms ; metabolism ; pathology ; surgery

Objective To discuss the features and surgical management of ectopic hyperparathyroidism.Methods Clinical data of 66 cases of ectopic hyperparathyroidism were retrospectively analyzed.Results There were 66 cases of ectopic hyperparathyroidism accounting for 11.5％ (66/575) of all ectopic hyperparathyroid cases admitted during the period from 1982-2010.Prevalence of mediastinal ectopic lesions was 71.2％ (47/66),among those 65.2％ (42/66) was in anterosuperior mediastinum,and 28.8％ (19/66) in the non-typical loci of the neck.Radionuclide imaging of parathyroid glands was the most sensitive (87.0％) method among all common positioning examinations.Average number of operation episode was 1.47,and all lesions were finally resected.After surgery 49 cases presented with transient hypocalcemia,and were cured by calcium administration.52 cases were followed up,with recurrent hyperparathyroidism in 1 case.Conclusions Diagnosis and treatment of ectopic hyperparathyroidism are dependent on the understanding of common locations of ectopic parathyroid glands.Preoperative correct location and surgical expertise are helpful for successful resection.

Objective To explore the application value of multi-ISO center planning method in intensity-modulated radiotherapy for carniospinal irradiation.Methods Ten patients treated with craniospinal irradiation with helical tomotherapy were selected.For these patients, new plans were designed with multi-ISO centers planning method on the treatment planning system (TPS) named Eclipse 11.0.Dose distribution to the tumor, OARs and normal tissue, the treatment time and the monitor units (MUs) of the two plans were compared.Results The plans designed in two groups satisfied all clinical requirements.For the tumor target (PTV) , the difference of D95％ between two groups was not statistical significant, while D9s ％ , D2 ％ and HI in HT group were superior to M-ISO group (t =2.822,2.333,4.743, P ＜0.05) , D50％ , D and CI in M-ISO group were superior to HT group (t =5.259,3.685,8.835 ,P ＜ 0.05).The dose of OARs such as cochlea, parotid, submandibular gland, thyroid gland and kidney in HT group was lower than M-ISO group (t =4.365,5.416,2.674,3.077,2.782,2.607,4.659,P ＜0.05) , and the dose of pancreas and small bowel was higher than M-ISO group (t =5.265,5.935, P ＜ 0.05).Differences were not significant for V5 of normal tissue between two groups;while V10, V20 and V36 of normal tissue in M-ISO group were lower than HT group (t =3.57,3.701,2.602, P ＜ 0.05).M-ISO group reduced 41.0％ of the treatment time by average and reduced 94.1％ MUs by average.Conclusions Intensity-modulated radiotherapy for carniospinal irradiation with multi-ISO centers planning method not only met the requirements of clinical dosimetry, but also shorten the treatment time, reduced the damage to the machine.Multi-ISO centers planning method might be promoted as a new design scheme.

In order to improve the efficacy of vibration expectoration and prevent secondary injury in patients with chest trauma,the body surface marking method was used in vibration expectoration.The exact injured locations and areas were identified via CT ot X-ray results.Then,the restricted and focused areas of expectoration were marked with red and green colors,which could guide the machines to avoid the fracture sites,reduce pain,prevent secondary injury and administrate effective expectoration in the areas of sputum and atelectasis.However,the dynamic CT or X-ray results must be used for reference to ensure the accuracy of the body surface marking.

Objective To evaluate the role of equivalent uniform dose (EUD) in planning optimization of intensity-modulated radiotherapy (IMRT) for prostate cancer.Methods Ten patients with prostate cancer were randomly selected who treated with IMRT.For these patients,the treatment plans were designed with dose-volume objectives.Based on these plans,new plans were designed through replacing the dose-volume objectives with maximum EUD for rectum,bladder and small bowel,while keeping the dosevolume objectives unchanged.Comparison was made between the new plans and the former cones by paired t-test.Results The conformity index of planning target volume was better with EUD optimization compared to dose-volume (1.00 ± 0.04 ∶ 0.94 ± 0.04,t =3.80,P =0.04).The D53,D30 and Dicm3 for rectum was better with EUD optimization compared to dose-volume (24.4 ± 2.7 ∶ 25.5 ± 2.6,t =-3.82,P =0.004,34.1 ±4.3∶39.1±2.1,t=-3.80,P=0.004 and51.4±1.0∶51.8±0.9,t=-2.42,P=0.039),with V10,V20 for bladder and V10,V20,V30,V40 for small bowel also better with EUD optimization (92.2 ±6.2∶99.4±1.1,t=-4.28,P=0.002;70.7±5.7∶78.7±6.3,t=-3.10,P=0.013 and 62.2±30.2∶74.7 ±30.0,t =-4.18,P =0.002;34.3 ±26.3∶46.5 ±30.9,t =-5.46,P =0.000;17.1 ±17.0∶25.1 ±22.6,t=-3.52,P=0.007;10.6± 11.5∶ 15.6± 16.1,t=-2.64,P=0.030).Conclusions The conformity index of planning target volume is better with EUD optimization compared to dose-volume.And the dose to rectum,bladder and small bowel can be reduced through optimization with EUD optimization compared to dose-volume.

Objective To evaluate the indication,operation pattern and therapeutic effect of ano-saving surgery for lower rectal carcinoma. Methods Retrospective analysis on the clinical feature of 320 patients with lower rectal carcinoma (postoperative time ≥5 years)treated by ano-saving surgery, the 5-year survival rate, local recurrence rate, and mortality were compared in the various operations. Results The success performed rate of ano-saving operation for lower rectal cancer was 58.5%(320/547).Among them, anastomotic leakage after surgery occurred in 4 cases (1.25%), and 26 cases had anastomostic narrowness (8.13%) within 1 year after surgery.The defecation function after surgery, in patients received colonic J pouch or transverse coloplasty pouch was much better than that in patients received coloanal or colorectal anastomosis. 5-year survival rates, and anastomostic recurrence rates were as follows:In ultra-low anastomosis were 63.24% and 10.27%. Park′s operation 66.67% and 5.13%, local resection 89.46% and 10.71%, respectively. 5-year recurrence rate in the pelvic soft tissue was 3.44%(11/320).Two cases died after operation. Conclusions Lower or ultra-low colon-rectum anastomosis becomes the main operative pattern in preserving anal sphincter in lower rectal cancer.Local resection of lower rectal tumor might be considered if the indecation is selected strictly. Colonic-J-pouch or transverse coloplasty pouch is good for improving the defecation function after ano-saving surgery for lower rectal cancer.

Abstract： Arsenic and arsenic compounds have been listed as one of the toxic and harmful environment pollutants, and drinking, seafood intake, use of skincare products and inhalation of tobacco smoke are main routes of exposure to human arsenic exposure. The adverse effects of arsenic on pregnant outcomes have been paid much attention. Prenatal exposure to high-level arsenic has been found to increase the risk of spontaneous abortion among pregnant women. Based on national and international epidemiological studies on the correlation between arsenic exposure and spontaneous abortion during the period between 1992 and 2020, we review the association between arsenic exposure and spontaneous abortion and describe the mechanisms underlying spontaneous abortion caused by arsenic exposure, so as to provide insights into early prevention of spontaneous abortion.

AimTo study the effects of glipizide and met formin on the serum IGF-1,IGF-2 in patients with type Ⅱ diabetes mellitus; Methods The effect of glipizide(n ＝ 40) and metformin(n ＝ 25) on serum IGF-1, IGF-2 in patients with type Ⅱ diabetes mellitus were compared with self- controlled study. Results In metformin-treated patients ,there were not significantly changes in fasting IGF-1 and IGF-2 concentrations, In glipizide-treated patients, there were markedly increased IGF-1 concentrations(181.8+ 104.5) vs (209.0+ 88.2) ng· ml-1(P＜0.05) while serum IGF-2 was not change. There was a significant reduction of blood glucose in two groups at the end of treatment(both P＜0.01), but C-peptide level was markedly increased(P＜0.05) only in glipizide-treatedpatients.Conclusion The changes of IGF-1 is markedly different between metformin-treated and glipizide-treated patients with type Ⅱ diabetes mellitus.

Objective To compare the effective dose deposited in patients between helical tomotherapy (HT) and multi-ISO radiotherapy (M-ISO) in carniospinal irradiation (CSI).Methods Nine children with craniospinal irradiation were selected .For these patients , new plans were designed with HT and M-ISO centers planning method on the treatment planning system ( TPS) .The effective dose of the nine patients from 18 treatment plans were calculated ,and the difference of the effective dose between HT and M-ISO was compared using paired t-test.Results The plans designed in two groups were both satisfied all clinical requirements .For the planning target volume ( PTV ) , no statistically significant difference was found in D95% between two groups ( P>0.05 ) , while D98%, D2% and homogeneity index (HI) in HT group were superior to M-ISO group (t=2.762, 2.413, 4.563, P<0.05), D50%, Dmean and CI in M-ISO group were superior to HT group (t=5.259, 3.685, 7.815, P<0.05).HT and M-ISO had different advantages in the protection of the OARs .The effective dose of patients in M-ISO group was superior to HT group (t=5.921, P<0.05).Conclusions HT and M-ISO have different advantages in CSI.The low dose area has greater influence on the effective dose in HT group compared to M-ISO group. The low dose area should be concerned while designing the treatment planning for CSI .

Objective To investigate the dose and mechanical properties of medical electron linear accelerators in grass-roots radiotherapy units in Sichuan Province,China via sampling and inspection.Methods A total of eight radiotherapy units in Sichuan Province were selected by sampling,and the tests were performed for the dose and mechanical properties of the medical electron linear accelerators in use.Among these accelerators,there were 5 imported accelerators and 3 domestic accelerators.The test items and methods were determined according to the requirements in GB15213-94.Results Among the 14 test items,the items related to the flatness,symmetry,and overlap of radiation field.The other tests of dose accuracy and mechanical precision achieved good results.Conclusions There is a need to strengthen the daily quality control work for dose and mechanical accuracy of medical electron linear accelerators in grass-roots radiotherapy units in Sichuan Province and perfect the allocation of professional equipment and personnel and training of related personnel.With the support of Sichuan Radiotherapy Quality Control Center,quality control supervision and guidance should cover the whole province.