Primary mediastinal large B-cell lymphoma (PMBCL) has specific phenotypical features, pathological features and clinical presentation.PMBCL patients are predominantly female and typically present early stage disease and mediastinal involvement.Due to the lack of randomized studies, most patients with PMBCL usually receive combination chemotherapy with consolidation IF-RT.Considering IF-RT can improve the complete remission rates and recurrence-free survival, the combined therapy achieved good results.The different chemotherapeutic regimens were used in clinical practice of different institutions and clinicians, including CHOP or CHOP-like, intensive chemotherapy or the third-generation regimens.Recent studies have showed promising outcomes when rituximab is added to doxorubicin-containing chemotherapy.Patients treated with R-CHOP with radiotherapy had significantly better local control rates compared with R-CHOP without radiotherapy, especially for bulky diseases.Intensity-modulated radiation therapy offers excellent target coverage, favorable outcome and minimal toxicity in PMBCL.Although the majority of patients with PMBCL receive radiotherapy following chemotherapy, few studies have specifically addressed the role of consolidation radiotherapy for the treatment of PMBCL.The prognostic importance of rituximab and radiotherapy has not been clearly defined in patients with PMBCL.Heterogeneous treatment options and small number of patients have made it difficult to draw definitive conclusions about the potential advantages of rituximab and radiotherapy in patients with PMBCL.

In this paper, industry development and market tendency, supervision and standardization of nanomaterial-contained medical devices are overviewed comprehensively based on a large number of reference data including national and international information. Furthermore, the consideration about standardization of biological evaluation for nanomaterial-contained medical devices is discussed by combined some works performed in our laboratory.
Device Approval ; Equipment and Supplies ; standards ; Nanostructures ; standards

There has been great interest in NiTi alloy in medical domain si nc e Buehler found its memory effect in 1963. In the recent 30 years, a lot of basi c and clinical researches of the alloy have been reported in the world. From the biomechanical viewpoint, the ossification and resorption of bone are related to the stress. Different stresses are required in the different kinds of fracture healing. Many measurements have been used to test the biomechanical properties o f the Nitinol orthopedic instruments. The clinical applications of the instrumen ts in hand surgery started in China in 1980's and resulted in satisfactory outco mes. This article summarizes the progress made in the basic researches of the ni tinol orthopedic instruments and their clinical applications in hand surgery.

Objective The goal of this work is to evaluate the dosimetric characteristics of a new 2D diode array (Mapcheck from Sun Nuclear Corporation,Melbourne,Florida) and assess the role it can play in routine IMRT QA. Methods Fundamental properties of the Mapcheck such as reproducibility and linearity were studied for high-energy photon beams. Clinical performance of the MapCheck for relative and absolute dosimetry was demonstrated with head and neck IMRT plans,and compared with plan dose distribution. Absolute dose measured by Ion chamber and Mapcheck are compared with the one given in TPS. Results The Mapcheck offers the dosimetric characteristics required for performing both relative and absolute dose measurements. Conclusion Mapcheck can provide the verification of absolute dose and relative dose. Its use in the clinic can simplify and reduce the IMRT QA workload.

Objective To investigate the protection of superior parathyroid glands by improving dissection procedure of thyroid superior pole in total thyroidectomy surgery.Methods 136 consecutive cases undergoing two-step dissociating procedure of thyroid superior pole(the improved group) in total thyroidectomy plus central compartment dissections from Sep.2012 to Oct.2015 were retrospectively analyzed.Intraoperative observation of superior parathyroid and incidences of postoperative hypoparathyroidism were compared with conventional surgical methods (the conventional group) containing 113 cases from Jun.2009 to Sep.2012.All operations were performed by the same treatment group.Results Intraoperatively,249 (249/272,91.5％) superior parathyroid glands were identified in the improved group and 215 (215/226,95.1％) superior parathyroid glands were identified in the conventional group.The difference had no statistical significance (P＝0.114).Whereas,among identified superior parathyroid glands,242 (242/249,97.1％)of them were conserved in situ in the improved group and 198 (198/215,92.0％) were conserved in situ in the conventional group.The difference had no statistical significance (P＝0.013).Among superior parathyroid glands conserved in situ,225 (225/242,93.0％) had good blood supply in the improved group and 170(170/198,85.9％) in the conventional group.The difference had statistically significance (P＝0.001).28 (28/136,20.5％) patients displayed temporary hypoparathyroidism and 2 (2/136,1.5％) cases suffered permanent hypoparathyroidism in the improved group after surgery.Whereas,in the conventional method group,a higher incidence was observed in 37 (37/113,32.7％) cases of temporary hypoparathyroidism and 7 (7/113,6.2％) cases of permanent hypoparathyroidism respectively.The difference had statisticall significance (P＝0.003).Conclusions Two-step dissociating procedure technique offers protective effect on superior parathyroid glands function.It is worthy of popularization.

Objective To compare and analyze DMLC(Sliding Window,SW)and SMLC(Step and Shoot,SS)for delivering IMRT.Methods 5 patients with nasopharyngeal carcinoma were treated with radical intensity modulated radiation therapy using Varian 23EX and Helios tool on a Varian Eclipse system.Different modalities to deliver IMRT were considered for Sliding Window(SW) and Step and Shoot(SS) techniques using a different number of intensity levels(e.g.5,10 and 20).The total beam-on-time,total delivery time and a number of dose-volume parameters regarding PTV and OARs were considered.Results Comparing with the DVH,it was found that SW was the best of the four modalities in the dose distribution of PTV,but SS was better when considering the protection of OARs.The total beam-on-time(MUs) requirement for SS was 9～23% less than SW,but the total delivery time(in minutes)was about twice as long.Conclusion With the number of intensity level of 10 or more,no differences between SS and SW can be appreciated in the dose distribution of PTV and OARs sparing.Referring to the quality assurance,only leaf position needed to be checked in SS,whereas both leaf position and leaf speed need to be checked in SW,so it is proposed to use SS10 for delivering IMRT.

[Objective] To observe the curative effect of integrated Traditional Chinese Medicine and western medicine on the disease of cystic hyperplasia of breast.[Method] The 214 cystic hyperplasia of breast cases were randomly divided into two groups.125 cases in the integrated Traditional Chinese Medicine and western medicine group(observed group).Control group(89 cases)were treated in common practiced western medicine.[Result]In observed group,70 cases fully recovered from illness,40 cases were excellent,6 cases were effective,9case were ineffective.Total effective rate was 92.8%.In control group,27 cases were fully recovered from illness,22 cases were excellent,20 cases were effective,9 cases were ineffective.Total effective rate was 77.4%.The differences between two groups were significant(P

Heart rate variability(HRV)analysis and its circadian rhythm(CR)were determined in 58patients with type 2 diabetes mellitus with lower extremity neuropathy(diabetic neuropathy group), 59 patients with type 2 diabetes mellitus without lower extremity neuropathy(diabetes group), and 50 healthy controls according to 24-hour Holter recording. Frequency domain parameters of HRV were significantly decreased in both diabetes groups. Frequency domain parameter of HRV in healthy controls,and daytime/nighttime difference were statistically significant. CR of HRV was changed in diabetes group and disappeared in diabetic neuropathy group. Impaired and seriously impaired autonomic nervous function developed in type 2 diabetes mellitus without and with lower extremity neuropathy respectively.

Hypofractionated conformal radiotherapy is capable to deliver much higher doses to the cancer than is possible with standard techniques. Recently there is data suggesting that the early stage nonsmall cell lung cancer ( NSCLC) which is not suitable to surgery is likely to benefit from this regimen, with low lung toxicity. Manyphase Ⅰ-Ⅱ studies showed that the patients with locally advanced NSCLC are well-tolerated to hypofractionated conformal radiotherapy. The model of radio-physic and relative clinical studies suggest that hy-pofractionation would not increase the risk of radiation pneumonitis compared to standard therapy.

[Objective]To discuss the surgical technique and clinical effects of open reduction and internal fixation with T style plate in the treatment of Die-punch fracture of distal radius.[Method]From August 2003 to October 2007,twenty-nine patients diagnosed as Die-punch fracture according to X-ray and computerized tomography were treated with open reduction through volar approach and internal fixation with T style plate and bone-grafts to support the articular surface of impacted fractures.There were 20 males and 9 females,with an average of 40.5 years(range 19-62 years).The fractures were caused by falling(n=23),traffic(n=4) and by athletics(n=2).There were 6 cases of open fracture.Eighteen cases were in the right wrist,and 11 in the left wrist.The displacement of articulatzons was from 1.5 to 3.5 mm.[Result]Twenty-six patients were followedup for 9 to 45 months,with an average of 28 months.Posteroanterior and lateral radiographs were taken periodically and fracture healing occurred all within 12 weeks.According to ADL standard and radiographs,21 cases were excellent(ADL scores:38-40),3 cases were good(scores:35-37).The excellent to good rate was 92.3%.No infection occurred.[Conclusion]Open reduction and internal fixation can help restore the smoothness of the articular surface and reduce the incidence of traumatic osteoarthritis.It is effective against the Die-punch fractures of distal radius.