Objective:To investigate the effect of antidepressant therapy on cellular immunity and quality of life of patients with depression after thoracoscopic radical resection of esophageal cancer.Methods:Between June 2015 to March 2019, our hospital during the period of line thoracoscope comorbid depressive patients, 186 cases of esophageal cancer radical, according to the indicator method were randomly divided into treatment group and the control group (n=93), the treatment group after surgery for antidepressant treatment, the control group did not give any postoperatively in patients with depressive drugs treatment, routine for psychological counseling. Self-rating Depression Scale SDS and Generic Quality of Life Inventory-74 (GQoli-74) were used to evaluate the changes of depression status and Quality of Life in 2 groups before and after treatment. Flow cytometry was used to detect the levels of CD 4+ and CD 8+ subsets in peripheral blood to evaluate the changes of immune system function in 2 groups before and after treatment. Results:After treatment, the SDS score of the treatment group was significantly lower than that before treatment, the difference was statistically significant( P<0.05), while the SDS score of the control group was not significantly changed before and after treatment, the difference was not statistically significant( P>0.05). After antidepressant treatment, CD 4+ and CD 4+ /CD 8+ levels in the immune system in the treatment group were significantly increased, and CD 8+ levels were significantly decreased, with statistical significance ( P<0.05), while CD 4+ , CD 8+ and CD 4+ /CD 8+ levels in the control group were not significantly changed before and after treatment. There was no significant difference ( P>0.05). After treatment, the body function, psychological function, social function, material state and total score of quality of life of patients in the treatment group were significantly improved compared with before treatment, the difference was statistically significant ( P<0.05), while the score of quality of life of patients in the control group was not significantly changed before and after treatment, the difference was not statistically significant ( P>0.05). Conclusion:Antidepressant therapy can significantly improve the depression status of postoperative esophageal cancer patients, and improve the immune system function and quality of life.

Objective:To investigate the efficacy and safety of tirofiban combined with dual antiplatelet therapy for progressive stroke, and obtain the effective time and speed of intravenous tirofiban.Methods:The patients with progressive stroke from June to December 2018 in the Second Hospital of Liaocheng Affiliated to Shandong First Medical University were divided into 2 groups: 28 patients were treated with dual antiplatelet (dual antiplatelet group) and 22 patients were treated with tirofiban combined with dual antiplatelet (tirofiban group). The demographic characteristics, risk factors of cerebral infarction, new infarct location and possible pathogenesis were recorded. The beginning of tirofiban, National Institutes of Health stroke scale (NIHSS) score at different time points, complications, and intravenous infusion effective time, maintenance dose and speed were recorded. NIHSS score was recorded for 14 d and modified Rankin scale (mRS) score was recorded for 90 d after discharge.Results:After 14 d of continuous treatment in the dual antiplatelet group, the NIHSS score decreased (2.92±1.13) scores. One case had gastrointestinal hemorrhage, and there were no intracranial hemorrhage complications. After 14 days of continuous treatment in the tirofiban group, the NIHSS score decreased (3.46±1.71) scored. One case had skin and mucosa hemorrhage, and there were no intracranial hemorrhage complications. In tirofiban group, the effective time of intravenous infusion was 42.2 to 135.7 (86.6 ± 42.3) h, and the infusion speed was 0.15 to 0.45 (0.31 ± 0.12) mg/h. Compared with the dual antiplatelet group, the NIHSS score and 90-day mRS score of tirofiban group decreased significantly: (3.36 ± 1.71) scores vs. (4.75 ± 2.30) scores and (2.93 ± 1.04) scores vs. (3.52 ± 1.83) scores, and there were statistical differences ( P<0.05). Conclusions:Intravenous tirofiban combined with dual antiplatelet therapy for progressive stroke may be a relatively effective method.

Antiangiogenic target therapy has been a hot topic in cancer treatment recently.Apatinib is a category 1.1 new medication developed domestically.It effectively inhibits angiogenic and exhibits promising anti-tumor activity in preclinical studies.Apatinib has been successfully applied in clinical trials of multiple malignancies,such as gastric cancer,lung cancer and breast cancer with satisfactory safety and efficacy profile.However,its mechanism of action is still not fully understood. Further researches should be carried on to improve its safety,effectiveness and marketability.This review summarized the mechanism of action,pharmacokinetics,clinical efficacy,safety and biomarkers,discussed the recent progress,hot issues and clinical prospects of apatinib,

OBJECTIVE:To compare therapeutic efficacy and safety of different chemotherapy regimens in the treatment of small cell esophageal cancer. METHODS:In retrospective analysis,58 patients with small cell esophageal cancer were divided into group A(18 cases),B(26 cases)and C(14 cases)according to chemotherapy regimens. Group A was given Cisplatin injection 75 mg/m2 intravenously,d1-3+Paclitaxel injection 175 mg/m2,d1-3. Group B was given Cisplatin injection 30 mg/m2 intravenously,d1-3+Et-oposide injection 100 mg/m2,d1-3. Group C was given Vinorelbine tartrate injection 25 mg/m2 intravenously,d1-3+Gemcitabine hydro-chloride for injection 1000 mg/m2,d1-3. A treatment course of 3 groups lasted for 21 d,and they all received 2 cycles of treatment. Clinical efficacies,1,2,3-year survival rate and the incidence of Ⅲ-Ⅳ degree toxic reaction(cough,fever,expectoration,short-ness of breath,fatigue,chest pain,bone marrow suppression,gastrointestinal reactions) were compared among 3 groups. RE-SULTS:Total response rate and 1,2,3-year survival rate were in descending order:group C>group B>group A;the incidence of Ⅲ-Ⅳ degree cough,fever,expectoration,shortness of breath,fatigue,chest pain were in ascending order:group C0.05). CONCLUSIONS:Therapeutic efficacy and 1,2,3-year survival rate of vinorelbine combined with gemcitabine are significantly higher than those of cisplatin combined with paclitaxel or etoposide with better safety.

Background and purpose:To date, it mainly depended on imaging examination for detection of residual lesions, recurrence and distant metastasis, evaluation the sensitivity of radiotherapy and chemotherapy, and prognosis in nasopharyngeal carcinoma (NPC). Thus, searching for new tumor markers for NPC early diagnosis and individualized treatment is still merited. This study was aimed to investigate the expressions of serum macrophage inflammatory protein (MIP)-3α and cystatin A in patients with NPC before and after treatment, and to explore two markers’ value in NPC diagnosis, clinicopathological characteristics and clinical outcome assessment. Methods:The serum levels of MIP-3αand cystatin A in 140 primary NPC patients without distant metastasis before and after treatment were detected by enzyme-linked immunosorbent assay (ELISA) and compared with those in 100 healthy controls. Results:The sensitivity of MIP-3αand cystatin A were 92.1%and 42.1%, respectively;and the specificity of MIP-3αand cystatin A were 86.0%and 85.0%, respectively. All 140 NPC patients had complete remission (CR) or partial remission (PR). Serum levels of MIP-3αand cystatin A in pre-treatment patients with NPC were higher than those in post-treatment patients and controls. Serum MIP-3αand cystatin A levels were associated with overall stage of NPC, and MIP-3αwas also associated with T classification of NPC. The serum MIP-3αlevel in NPC with CR after treatment reduced to the level in control group, and that was still significantly higher in NPC with PR than in control group. No significant difference was found in the serum cystatin A level between NPC with CR or PR after treatment and control group. During 1-year follow-up, the post-treatment serum levels of MIP-3αand cystatin A were significantly higher in patients with distant metastasis than in patients without distant metastasis and controls. There was found statistically significant correlation between MIP-3α and cystatin A.Conclusion:MIP-3α may be a potential marker of NPC serological diagnosis. The detection of serum MIP-3αand cystatin A may contribute to the NPC staging and prediction of short-term clinical outcomes.

Objective To evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in differentiating tumor, edema, and normal brain tissue, and in classification of cerebral gliomas. Methods Using Philips Achieva 1.5T super conduct MR scanner, 46 patients with gliomas underwent conventional MR imaging and DWI. The ADC of regions of interest ( ROI ) were measured with two different b values, 0s/mm2 and 1000s/mm2. ROIs were manually placed over areas of tumor,edema, and normal brain tissue. Results The signals of DWI and ADC map in tumor tissue were respectively higher and lower than those in normal brain tissue. The ADC values in tumor were 1.68 ± 0.18,1.65 ± 0.20,1.29 ±0.16,1.21 ±0.21 for grade Ⅰ、Ⅱ、Ⅲ、Ⅳ gliomas, respectively; the corresponding figures in edema were 1.74 ±0.22,1.72 ±0.19,1.35 ±0.20,1.28 ±0.19, respective. The ADC values in tumor were not significantly different from the values in edema (P ＞0.05); however, both values were significantly different from those in normal brain ( P ＜0.05 ). The ADC value of low grade ( grade1-2 ) gliomas was significantly higher than that of high grade (grade3-4) glioma (P＜0.05). Conclusion ADC values can aid in distinguishing tumors from normal tissues, but can not distinguish tumors from adjacent edema. Individually, ADC values overlapped considerahly. ADC value is associated with cellularity of gliomas. DWI can help characterizing the malignancy of gliomas.

ObjectiveTo analyze the characteristics of magnetic resonance diffusion tensor imaging(DTI)and diffusion tensor tractography (DTIT) in patients with cerebral infarction, and explore the diagnosis values and prognosis of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) in patients with cerebral infarction in different stages. Methods58 patients with cerebral infarction in different stages and 25 healthy volunteers were examined by magnetic resonance imaging(MRI), including conventional T1 and T2 weighted imaging, DWI and DTI. Fractional anisotropy (FA) images were reconstructed. The values of FA and apparent diffusion coefficient (ADC) were measured in the infarcted regions, corresponding contralateral normal regions and corresponding normal regions in normal control group. Results①DWI and DTI showed size of infarction focus was more accurate and clearer than that of conventional MRI; ②The FA and ADC values of the infarcted regions during superacute stage, acute stage, subacute stage and chronic stage were (0.24±0.02, 0.31 ±0.11), (0.20±0.02, 0.32±0.12), (0.18±0.02, 0.34±0.11) and (0.16±0.02, 0.37±0.13), respectively, lower than those in the contralateral corresponding regions which were (0.40±0.03, 0.70±0.21), (0.37±0.03, 0.71±0.21), (0.39±0.03, 0.72±0.22) and (0.40:±0.03, 0.72±0.23), respectively. The differences were statistically significant (P＜0.05). The FA and ADC values had no significant differences between the uninjured sides in patients with cerebral infarction and the corresponding regions in the normal control group (P＞0.05); ③The FA and ADC values in brain tissues changed regularly with the time of infarction after cerebral infarction. The FA values in the affected sides had no consistent changes as compared with the contralateral sides in the superacute stage. They increased or decreased slightly, then (during acute stage, subacute stage and chronic stage) decreased irreversibly. The ADC values in the affected sides changed with time regularly, they decreased significantly, gradually returned to normal, and then increased again. Conclusion DTI and DTT examination contribute to the diagnosis of cerebral infarction. The combination of the FA and ADC values may more accurately conduct clinical staging and evaluate the time of the occurrence of cerebral infarction.

Objective To study the characteristics of diffusion tensor imaging (DTI) in brain tumor and it's diagnosis and differential diagnosis value.Methods Thirty-nine patients with brain tumors proven by pathologically (10 meningioma,17 glioma,12 metastatic tumors) were enrolled,by using Philips Achieva 1.5 T MRI,conventional MRI and DTI were underwent on them,fractional anisotropy (FA) maps,apparent diffusion coefficient (ADC) maps and three dimensional white matter fiber bundle map were reconstructed in the workstation.The core substance of the tumor area and the contralateral mirror area were selected as the region of interest,and FA and ADC values of them were measured,and t test was performed.Results The FA values of meningioma,metastases tumors and gliomas were 0.36 ± 0.08,0.28 ± 0.03,0.18 ± 0.06,respectively,and the differences among them were significant( P ＜ 0.05).The ADC values of meningioma,metastases tumors and gliomas were 1.72 ± 0.10,1.52 ± 0.22,1.34 ± 0.14,respectively,and the differences among them were significant( P ＜ 0.05).Conclusion DTI has high clinical value in identification of meningiomas,metastatic tumors and glioma.

Objective To study the value of MR diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)in differentiating benign and malignant lesions of prostate.Methods Twenty-two patients with prostate cancer and 17 patients with benign prostatic hyperplasia confirmed by pathology or biopsy,and 20 healthy volunteers were underwent prostate plain MRI,DWI and enhanced MRI,and measuring the value of ADC in the regions of interest in the workstation,and the ADC values of prostate cancer,benign prostatic hyperplasia,normal prostate were analyzed statistically.Results The ADC of prostate cancer,benign prostatic hyperplasia,normal prostate in central gland and peripheral zone were 1.08 ±0.23,1.43 ±0.27,1.51 ±0.26 and 1.26 ±0.47,1.72 ±0.40,1.75 ± 0.28,respectively,the ADC of prostate cancer was significantly lower than that of benign prostatic hyperplasia and normal prostate,and there was significant difference(P＜ 0.05),but there was no significant difference between benign prostatic hyperplasia and normal prostate(P ＞0.05).Looking the ADC was 1.30 and 1.60 in central gland and peripheral zone as the threshold to distinguish benign and malignant lesions of prostate,had high sensitivity and specificity.Conclusion The application of DWI combined with ADC,has improved the capability of diagnosis and differential diagnosis in benign and malignant lesions of prostate greatly.

Objective To observe CT features of struma ovarii (SO) in comparison of pathologic findings. Methods CT features of 9 patients with pathologically confirmed SO were analyzed retrospectively and compared with pathological findings. Results All tumors were unilateral and had smooth margins, 3 were cystic and 6 were cystic-solid lesions, 5 were high attenuation lesions in the cyst portion of the mass on contrast CT. The cyst wall moderately (n=3) or markedly (n=5) enhanced after administration of contrast medium. Scattered, stripe-like or ring-like calcifications were found in 6 patients. On pathology, most of cystic portions were filled with high proteinaceous gelatinous fluid of eosinophiclic colloid, and the solid portion of tumors consisted of the thyroid tissue and stoma containing abundant blood vessels and fibrous tissue. Conclusion SO appears as a smooth marginated multicystic mass with calcification, high attenuation lesionin plain CT, and marked solid part enhancement on contrast CT.