Twenty-four patients with parapharyngeal space tumors were treated from 1964 to 1999.There were 11 males and 13 females,ranging in age from 10 to 71 years old.Among 24 patients, benign tumors were 17(70.8%),malignant tumors 7(29.2%).The diagnosis of these tumors were biopsy and CT scaning .Pathologic results showed that the original tumors were salivary gland tissue in 11(45.8%),cranial nerve in 7(29.2%),vascular tissue in 2(8.3%)and the unidentified in 4(16.7%).The surgical approaches for these tumors were neck side incision in 19,through mouth in 5.Results showed that 4 malignant tumors were died in one year,3 cases did not clear;the prognosis of 17 benign tumors were well.

Objective To retrospectively analyze the therapeutic results of patients with initially di-agnosed metastatic nasopharyngeal carcinoma (NPC). Methods From January 1995 to December 1998, 46 NPC patients with distant metastases were treated in Fujian provincial cancer hospital. Among these pa-tients, 43 were single site metastasis and 3 were multiple sites metastases;The site of metastasis were 19 pa-tients in the liver, 11 in the bone, 7 in the lung, 1 in the brain, 6 in mediastinal nodes and 6 in axillary lymph nodes. All patients received standard radiotherapy to the primary site and cervical node region with a median dose of 72 Gy. Forty-one patients (89%) received 1-5 cycles chemotherapy (cisplatin and 5-flu-orouracil), and 23 (50%) received palliative irradiation to the metastatic site. Results The median surviv-al time was 20 months. The 1-, 2-, 3-year and 5-year overall survival rates were 66%, 47%, 30% and 19%, respectively. Irradiation to the metastatic sites and KPS were the significant prognostic factors. Pa-tients with palliative irradiation to the metastatic site had longer survival than those without (39 months vs. 13 months, X2=8.63, P=0.012). Patients with good performance status (KPS≥80) had better outcomes thanthose with poor performance status (26 months vs. 12 months, X2= 3.95, P=0.035) . Conclusions Active therapy may prolong the survival of patients with initially diagnosed metastatic NPC, especially for those who have good performance status. Under systematic chemotherapy, radiotherapy to the primary site and supportive care, the palliative irradiation to the metastatic site may also yield a good result.

Background and purpose:Both very important therapeutic targets of NSCLC,vascular endothelial growth factor (VEGF) and epidermal growth factor receptors (EGFR),are over expressed in non-small cell lung cancer (NSCLC).The aim of this study was to discuss the expression of VEGF and EGFR in NSCLC as well as its clinical significance.Methods:The expression of VEGF and EGFR was detected in 186 NSCLC samples using the immunohistochemical method.The expression of VEGF and VEGR in NSCLC patients with various pathological characteristics was observed and the correlation between them was analyzed.Results:The expression of VEGF in NSCLC was correlated with lymph node metastasis (P

Objective To evaluate the efficacy and safety of sublingual immunotherapy (SLIT) in patients with allergic asthma in order to provide reliable evidence for clinical application of SLIT.Methods To search published articles of randomized controlled trials (RCTs) in allergic asthma from CNKI,WANFANG,Pubmed and Medline databases.The methodological quality of trials was assessed by Jadadscale.The heterogeneity was examined by using Stata 11.0 software.Fixed effect model or random effect model was used to pool the data.The articles which could not be pooled were carried out by descriptive analysis.The Egger's and Begg's test were used to evaluate the publication bias.Results There were total 6 RCTs included in this text.Compared with control group,SLIT could significantly reduce asthma symptom scores (SMD =-0.89,95％ CI-1.36--0.43,P =0.000) and asthma medication scores (SMD =-4.53,95％CI-6.97--2.08,P =0.000),but not forced expiratory volume (FEV1) of lung function (SMD =0.19,95％ CI-0.02-0.41,P =0.078),neither serum sIgE levels (SMD =0.05,95％ CI -0.58-0.69,P =0.870).There were no obvious adverse events reported after treatment of SLIT.No publication bias were indicated by Egger's and Begg's tests.Conclusion SLIT significantly reduces asthma symptom scores and medication scores,suggesting that SLIT is a safe and effective approach of immunotherapy.However,it still needs more highly qualified studies of RCTs to prove.

Objective To retrospectively analyze the outcomes,adverse events,and prognostic factors in elderly patients initially diagnosed with nasopharyngeal carcinoma (NPC) who receive radiotherapy and chemotherapy.Methods From January 2004 to April 2007,202 patients (over 60 years of age) initially diagnosed with NPC received radical radiotherapy or chemotherapy.These patients included 165 males (81.7％) and 37 females (18.3％),with a median age of 65 years (range 60-86 years).Of all patients,1 had stage Ⅰ NPC,25 had stage Ⅱ NPC,120 had stage Ⅲ NPC,and 56 had stage Ⅳa/Ⅳb NPC,according to the AJCC staging system (6th edition).All patients received a radiation dose of ≥66 Gy,and 146 patients (72.3％) with locally advanced NPC also received chemotherapy.The Cox model was used for multivariate analysis.Results The follow-up rate was 100％.The 5-year local control rate,regional lymph node control rate,distant metastasis-free survival (DMFS) rate,disease-free survival rate,and overall survival (OS) rate were 93％,94％,82％,74％,and 67％,respectively.The multivariate analysis revealed that T stage,N stage,and age were prognostic factors for OS and DMFS (P =0.006,0.002,and 0.008 ;P =0.020,0.002,and 0.022).The severe acute toxicities included grade 4 radiation dermatitis (1 patient,0.5％),grade 4 radiation mucositis (2 patients,1.0％),and grade 4 bone marrow suppression (5 patients,2.5％).Conclusions The elderly NPC patients can tolerate radiotherapy and chemotherapy well.Multimodality therapy should be adopted for the patients aged 60-74 years who have advanced-stage NPC and good general conditions.

Objective To compare the prognostic value of the 7th edition of AJCC cancer staging system in nasopharyngeal carcinoma (NPC) patients treated with conventional radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT).Methods From January 2004 to December 2006,totally 1138 NPC patients were treated with CRT (790 patients) and IMRT (348 patients) in Cancer Hospital of Fujian province.The median ages were 47 and 45 years old for two groups ( x2 =1.49,P =0.222 ),respectively.There were 0,41,488,261 and 5,65,176,102 patients in stage Ⅰ,Ⅱ,Ⅲ,Ⅳ of the two groups after restaged with 7th edition of AJCC cancer staging system,respectively (x2 =64.78,P =0.001 ).The 3-year survival was analyzed according to T-category,N-category and overall stage.Results The follow-up rate at 3 years is 96.0％.The median follow-up were 32 months and 33 months for CRT and IMRT groups.N-category was found to be the prognostic factors for overall survival (OS,x2 =6.50,P =0.038 and x2 =13.60,P =0.004) and metastasis free survival ( MFS,x2 =7.78,P =0.009 and x2 =15.30,P =0.002) for CRT and IMRT groups.The clinical stage was prognostic factor for OS in conventional group ( x2 =6.70,P=0.035),and for MFS in IMRT group (x2 =9.12,P=0.028).Conclusions The T-calegory of 7th AJCC staging system shows poor predictive value for the long-term survival of NPC patients.The N-calegory of 7th AJCC staging system can well estimate the OS and MFS for NPC.

Objective To evaluate the impact of reducing clinical target volume (CTV) on the efficacy of intensity modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) . Methods Between August 2003 and March 2007, 380 NPC patients were treated with IMRT with reduced CTV.CTV1, defined as high risk region, included GTV +5 - 10 mm margin and the entire nasopharyngeal mucosa +5 mm submucosal volume; CTV2, designed for potentially involved regions, included the nasopharyngeal cavity (limited to the posterior part of nasal cavity only), maxillary sinus (limited to 5 mm anterior to the posterior nasal aperture and maxillary mucosa), pterygopalatine fossa, posterior ethmoid sinus,parapharyngeal space, skull base, anterior third of clivus and cervical vertebra, inferior spheniod sinus and cavernous sinus and internal group of retropharyngeal lymph nodal regions from the base of skull to cranial edge of the second cervical vertebra. The prescription dose was: GTV 66. 00 -69. 75 Gy/30 - 33 f, CTV1 60. 00 -66. 65 Gy,CTV2/CTVN 54. 0 -55.8 Gy. 308 patients with stage Ⅲ or Ⅳ diseases also received cisplatin-based neoadjuvant chemotherapy. Results The follow-up rate was 100%. 145 patients were followed-up to 3 years. The 3-year estimated local control, regional control, metastasis-free survival,disease-free survival and overall survival rates were 94. 9%, 97.4%, 86. 2%, 80. 9% and 89. 0%,respectively. Multivariate analysis revealed that N-classification was a significant prognostic factor for metastasis-free survival (x2 = 20. 80, P = 0. 001), N-classification (x2 = 18. 30, P = 0. 003) and age (x2 =7. 31, P =0. 004) were independent prognostic factors for overall survival. Grade 2 xerostomia was observed in 5.6% of the patients after two years of IMRT, no Grade 3 or 4 xerostomia was observed. Local, regional,and distant failures were developed in 4. 2%, 2. 6% and 12. 1% of the patients, respectively. Conclusions The IMRT approach with reduced CTV2 provids a favorable outcome for NPC with acceptable toxicities.

OBJECTIVE To investigate the antimicrobial susceptibility of Streptococcus pneumoniae isolated in Yantai and their mechanisms of resistance to macrolides.METHODS Antimicrobial susceptibility of S.pneumoniae was determined by agar dilution method.Phenotypes of macrolide-resistant S.pneumoniae were determined using double disk test with erythromycin and clindamycin disks.ermB And mefE genes were amplified by PCR.RESULTS Among 42 strains of S.pneumoniae,65.0% were intermediate to and no strain was resistant to penicillin.The resistance rates to erythromycin and clindamycin were 93.0%,respectively.Of 41 erythromycin resistantstrains,93.0% were constitutive resistant.ermB Was detected in 40 strains and mefE in 1 strain,both ermB and mefE genes were found in 9 strains.CONCLUSIONS The resistance rate of S.pneumoniae to penicillin is high in Yantai area,the resistance rates to erythromycin and clindamycin are very high.Target modification by ermB methylase is the predominant mechanism in macrolide-resistant S.pneumoniae in Yantai.

Objective To investigate the effects of Wuzhi capsules on tacrolimus concentration in heart transplant recipients and provide evidence for individualized dose optimization of tacrolimus.Methods Forty heart transplant recipients receiving Wuzhi capsules were enrolled in this study.Tacrolimus trough concentration was compared before and after coadminstration of Wuzhicapsules.Furthermore,polymorphisms of CYP3A4 * 1G and CYP3A5 * 3 were also detected to clarify correlations between genotypes and effects of Wuzhi capsule.Results Dose-normalized concentration of tacrolimus after coadministartion with Wuzhi capsules was 2.02-fold higher than before,the results of which was not associated with CYP3A4 * 1G and CYP3A5 * 3 genotypes.Wuzhi capsule could significantly decrease the total bilimbin (T-BiL),but not other hepatic and renal function.Conclusion Dose-normalized concentration of tacrolimus in heart transplant recipients is remarkably increased by Wuzhi capsule.The elevated trough levels rarely result in hepatic and renal toxicity.Wuzhi capsule is a safe,effective,and stable drug to increase the trough concentration of tacrolimus.

Background and purpose:Nasopharyngeal carcinoma usually occurs in people of states of the Southern China. Chemoradiotherapy plays an important role in the therapy of advanced nasopharyngeal carcinoma. However, chemoradiotherapy causes more toxic side effects than radiation therapy alone, which affects the therapy. Now symptomatic treatment and nutrition supports are common ways in the clinic in order to improve the tolerance of patients for the therapy, but with little effect. To evaluate the clinical significance of percutaneous endoscopic gastrostomy (PEG) in advanced nasopharyngeal carcinoma. Methods: From Oct. 2010 to Jun. 2012, a total of 71 patients with advanced nasopharyngeal carcinoma who received PEG before chemoradiotherapy were enrolled. During chemoradiotherapy, gastrostomy diet and nursing were supplied, adverse events, tolerance and nutrition indicators including weight and alcohol of human albumin were detected as well. Results:PEG were performed successfully on 68 patients, but failed in the other 3 patients. Of the 68 patients, 4 have not received concurrent chemotherapy because of liver metastases and liver function damage, 51 of the remaining 64 patients could completely ifnished 3 cycles of concurrent chemotherapy, with the completion rate of concurrent chemotherapy at 79.69%. The weight change ranged from-11.86%to 0.83%, with a mean value of-5.32%±2.99%. Paired-sample t test of human albumin before and after the treatment showed no significant difference (P=0.742). Grade Ⅱ radioactive oral cavity mucositis appeared in 60.29%patients (41/68), and 22.06%patients (15/68) suffered gradeⅢradioactive oral cavity mucositis.Conclusion:For patients with advanced nasopharyngeal carcinoma, preventative PEG improved the tolerance of chemoradiotherapy, reduce the incidence of adverse events. The period of therapy interruption caused by sever adverse event were shortened as well, PEG also increased the completion rate of concurrent chemotherapy. Nutritional status and living quality of patients are improved. In addition, PEG is a safe, economic and simple method.