Objective To observe the therapeutic effects and toxicities of bone marrow-sparing intensity-modulated radiation therapy (BMS-IMRT) for postoperative cervical cancer.Methods From January 2011 to June 2012,totally 70 postoperative patients with cervical cancer were divided into BMS-IMRT group with 34 cases and IMRT group with 36 cases randomly.External whole pelvic intensitymodulated irradiation combined with chemotherapy was carried out for all patients.The planning target volume received a dose of 45 Gy/25 fractions in all patients.Delineation of the pelvis and limitation dose were carried out in BMS-IMRT group:the pelvis V30 ≤ 50％.All cases received chemotherapy with cisplatin (40 mg/m2) once a week concurrently with radiotherapy.Results Treatment was completed in 67 patients,as the other 3 patients stopped chemotherapy because of myelosuppression.There was no statistically significant differences between two groups for the 2-year local control survival(LCS)and overall survival(OS),alimentary tract toxicity and urinary toxicity.IMRT group had more serious hematologic toxicity than BMS-IMRT group,with statistically significant difference (x2 =14.355,P ＜ 0.05).Conclusions The postoperative cervical cancer patients with poor prognostic factors who undergo concurrent chemoradiotherapy,IMRT group has more serious hematologic toxicity than BMS-IMRT group.The short-term effect and other toxicities reaction are similar between two groups.

Objective To evaluate the imaging features,pathologic characteristics and diagnostic methods of gastrointestinal stromal tumor(GIST).Methods A retrospective study was performed to analyze the clinical pathological and imaging data of 14 GIST patients diagnosed by surgery and pathology.Results 14 cases of GIST were all solitary.10 cases were located in stomach and 4 cases in small intestine.Tumors were mostly round or oval,and a few of them were irregular lobulated.Immunohistochemistry analysis:12 cases were CDll7 positive and 9 cases were CD34 positive.Conclusion The imaging examination was important to the diagnosis and localization of GIST,but the final diagnosis of GIST depended on histopathological and immunohistochemical examination.

Objective To express human inducible eostimulator (ICOS) extracellular region and IgG Fc fusion protein, and analyze their function in allogenie lymphocyte proliferation in vitro and in vivo. Methods Human ICOS extraeellular region and IgG Fc fragment were cloned into a soluble expression vector. ICOS-Ig fusion protein was expressed and purified in CHO cells. To monitor primary MLR, Balb/c spleen T cells were isolated as responder cells, and irradiated C57BL/6 spleen cells as stimulator cells. 50 μg/ml ICOS-Ig or IgG was added to primary MLR cultures. The cells responsive rates were detected by 3 H-TdR methods. ELISA tested supernatants for eytokines (IL-2,IL-4, IL-10 and IFN-γ). T cells of each group in primary MLR were cultured as responder cells for secondary MLR, and irradiated C57BL/6 (donor) or C3H (third party) spleen cells as stimulator cells. Similar indexes were detected in secondary MLR. Then vital dye CFSE was used to study alloreactive T cell proliferation in vivo. CFSE-labeled C57BL/6 spleen cells were transferred to irradiated Balb/c mice. Mice were then intraperitoneally injected with 0. 2 mg IgG, ICOS-Ig or CsA each day.At the 3rd day after transfection, the spleen cells of the mice were harvested to detect CD4+ CFSE+ and CD8+ CFSE+ by FACS. Results In primary MLR, ICOS-Ig inhibited allogenic T-cell proliferation with inhibition rate being (58 ± 8)% in 50 μg/ml, and increased IFN-γ secretion. In secondary MLR, ICOS-Ig specifically inhibited the proliferation of donor spleen cells with inhibition rate being (42±8)%, and in ICOS-Ig group the levels of IL-4 and IL-10 were lower and the level of IFN-γ higher than in IgG group. However, ICOS-Ig didn't inhibit the proliferation of third-party spleen cells. In the CFSE dye assay, CFSE intensity of CD4+ and CD8+ T cells in ICOS-Ig and CsA groups was stronger than that in control group (P < 0. 05), while CFSE intensity in combined treatment group were even stronger than that in ICOS-Ig and CsA groups (P<0. 05). Conclusion ICOS-Ig could inhibit allo-reactive T cell proliferation in vitro and in vivo, and induce donor-specific T cell hyporesponsiveness specifically.

The primary causative factors of liver failure include direct damage and immune -mediated liver injury.Increasing evidence sug-gests that immune -mediated injury plays a pivotal role in the pathogenesis of liver failure.The new concepts concerning the mechanisms of immune -mediated liver injury in liver failure are reviewed with relevant basic and clinical studies in both humans and animals.The innate and adaptive immunity,particularly the interaction of various immune cells and molecules,as well as apoptosis -related molecules,are dis-cussed in detail.

Objective To investigate the application value of three-dimensional (3D) laparoscopic pancreaticoduodenectomy (LPD) and compare the clinical outcomes between 3D-LPD and open pancreaticoduodenectomy (OPD).Methods The retrospective cohort study was adopted.The clinicopathological data of 349 patients who underwent pancreaticoduodenectomy at the Affiliated Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between July 2014 and March 2016 were collected.Of 349 patients,146 undergoing 3D-LPD were allocated into the 3D group and 203 undergoing OPD were allocated into the OPD group.Observation indicators:(1) surgical situations:operation time,volume of intraoperative blood loss,cases of blood transfusion,number of lymph node dissected,resection margin and vascular resection and reconstruction,(2) postoperative situations:time of gastric tube removal,duration of intensive care unit (ICU) stay,duration of hospital stay,(3) complications:pancreatic fistula,delayed gastric emptying,intra-abdominal infection or abscess,bile leakage,hemorrhage,pulmonary infection or wound infection,(4) follow-up.All the patients were followed up by telephone interview to detect the tumor-free survival rate up to June 2016.Measurement data with normal distribution were presented as (x) ± s and comparison between groups was analyzed using the t test.Count data were analyzed using the chi-square test.Results (1) Surgical situations:all the patients underwent successful pancreaticoduodenectomy.Operation time,volume of intraoperative blood loss,cases of blood transfusion,number of lymph node dissected and positive resection margin were (334 ± 175)minutes,(254 ± 107)mL,29,13 ±8,1 in the 3D group and(320 ±91)minutes,(290 ± 101) mL,35,14 ±9,5 in the OPD group,respectively,with no statistically significant difference between the 2 groups (t =0.975,1.383,x2=0.390,t =12.155,x2=1.589,P ＞ 0.05).Vascular resection and reconstruction were respectively applied to 0 patient in the 3D group and 14 patients in the OPD group,with a statistically significant difference between the 2 groups (x2 =10.490,P ＜ 0.05).(2) Postoperative situations:time of gastric tube removal,duration of ICU stay and duration of hospital stay were (2.9 ± 1.9) days,(6.9 ± 2.1) days,(12.9 ± 7.2) days in the 3D group and (5.1 ± 1.7) days,(7.4 ± 1.2) days,(19.8 ± 7.1) days in the OPD group,respectively,with statistically significant differences between the 2 groups (t =11.350,2.814,8.903,P ＜ 0.05).(3) Complications:of 146 patients in the 3D group,40 had postoperative complications with incidence of complications of 27.40％ (40/146).Twenty-nine patients with pancreatic fistula (20 in grade A,9 in grade B and C) were improved by conservative treatment.Thirteen patients with delayed gastric emptying were cured by gastrointestinal decompression and enhancing gastric motility.Of 5 patients with postoperative hemorrhage,3 were improved by conservative treatment,and 2 were improved by small vein hemostasis behind the head of pancreas.One patient died of systemic inflammatory response syndrome.Partial patients were combined with multiple complications.Of 203 patients in the OPD group,60 had postoperative complications with incidence of complications of 29.56％ (60/203),including 39 patients with pancreatic fistula (31 in grade A,8 in grade B and C),25 with delayed gastric emptying,15 with intra-abdominal infection and 13 with systemic inflammatory response syndrome,and they were improved by conservative treatment.Of 8 patients with postoperative hemorrhage,4 were improved by conservative treatment,and 4 were cured by hemostatic therapy after ineffectual blood transfusion and interventional treatment.Two patients died of cardiopulmonary complication.Partial patients were combined with multiple complications.There was no statistically significant difference in the incidence of postoperative complication between the 2 groups (x2 =10.490,P ＞ 0.05).(4) Follow-up:all the patients were followed up at postoperative month 6.Tumor-free survival rate was 90.41％ (132/146) in the 3D group and 85.22％ (173/203) in the OPD group,with no statistically significant difference between the 2 groups (x2 =2.076,P ＞ 0.05).Conclusion Compared with OPD,3D-LPD can provide the more realistic visual effects and refinement of surgical procedures,with a good short-term outcome.

Objective To investigate the effects of direct peritoneal resuscitation (DPR) with sodium pyruvate from hemorrhagic shock (HS) on intestinal injury in rats.Methods Fifty SPF male Sprague-Dawley rats,weighing 200-250 g,were used in this study.The animals were anesthetized with 1％ pentobarbital sodium 40 mg/kg,tracheostomized and mechanically ventilated.Femoral artery was cannulated for mean arterial pressure (MAP) monitoring,blood-letting,blood sampling and fluid infusion.HS was induced according to the method described by Wiggers.MAP was maintained at 35-40 mm Hg for 60 min.The animals were then randomly and equally divided into 5 groups:sham operation group (group S) ; conventional resuscitation group (group CR) ; DPR with different fluid groups (DPRt-3 groups).In group CR,at 1 h after HS,the animals were resuscitated with infusion of the blood withdrawn and normal saline (the volume was 2 times volume of blood loss).In DPR1-3 groups,conventional resuscitation was performed,at the same time,1.5 ％ glucose-based peritoneal dialysis solution containing lactate,1.5％ glucose-based peritoneal dialysis solution containing lactate (40.00 mmol/L),and 1.5％ glucosebased peritoneal dialysis solution containing high lactate (80.00 mmol/L) 20 ml were infused intraperitoneally over 30 min,respectively.MAP was recorded before blood letting,at 5,30 and 60 min of HS,and at 5,30,60,90 and 120 min after the end of resuscitation.At 120 min after the end of resuscitation,the lactate level in the arterial blood was measured.The animals were then sacrificed.Small intestinal samples were obtained for determination of malondialdehyde (MDA) content,myeloperoxidase (MPO) activity and tumor necrosis factor-α (TNF-α) expression,and for microscopic examination.The damage to the small intestinal mucosa was assessed and scored.Results Compared with MAP before blood letting,MAP during HS was significantly decreased,and no significant change in MAP was found after resuscitation in CR and DPR1-3 groups (P ＜ 0.05).The lactate level in the arterial blood,MDA content,MPO activity,TNF-α expression and intestinal mucosal damage scores were significantly higher in CR and DPR1-3 groups than in S group (P ＜ 0.05 or 0.01),while lower in DPR1-3 groups than in CR group (P ＜0.01),and in DPR2,3 groups than in DPR1 group (P ＜ 0.05 or 0.01).The lactate level in the arterial blood,MDA content and TNF-α expression were significantly lower in DPR3 group than in DPR2 group (P ＜ 0.05 or 0.01).Conclusion Direct peritoneal resuscitation with sodium pyruvate can reduce the intestinal injury induced by HS and inhibition of lipid peroxidation and inflammatory responses is involved in the mechanism in rats.

To investigate the main factors influencing the quality of life and the relationship between quality of life and basic syndromes of traditional Chinese medicine (TCM) in patients with post hepatitic cirrhosis.

By reviewing the practice of informed consent,the authors analyzed the elements,forms of informing and consent,main parts,contents,informing process,signing,and saving of the informed consent and put forward some suggestions which are useful for the medical scientific resesxchers and management personnel.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Neural Conduction ; physiology ; Paraplegia ; diagnosis ; physiopathology ; Sural Nerve ; physiopathology

Objective To observe the efficacy of combination of pranoprofen and artificial tears in treatment of dry eye syndrome after recovery from acute conjunctivitis. Methods This study involved 206 eyes of 157 consecutive patients who had recovered from acute conjunctivitis after routine treatment between July 2008 and September 2010. All cases were randomly divided into artificial tears group (79cases,104eyes) : artificial tears eye drops alone and combination group(78cases,102eyes) : pranoprofen combined with application of artificial tears eye drops. All patients'symptoms, signs such as tear film break 2 up time (BUT ) ,Schirmer I test (SIT) , corneal fluoresce staining (FL) score at 3,7,14days after treatment Were observed. Results All patients finished the trial at the end of the follow-up duration. There were significant differences in symptoms, BUT and corneal fluoresce staining between the two groups after treatment,combination group was superior to artificial tears group in BUT and FL. Conclusion Pranoprofen combined with artificial tears eye drops is superior to artificial tears eye drops alone