Objective:To investigate the effect of enteral nutrition support by CT-guided percutaneous gastrostomyon the nutritional status of patients with esophageal cancer complicated with dysphagia during radiotherapy.Methods:Therewere46 cases of esophageal cancer patients with dysphagia treated with CT-guided percutaneousgastrostomy.Others 43 cases of esophageal cancer by oral feeding in patients with dysphagia as control groupduringthe sametimein our hospital radiotherapy center.Patients in the observation group were ingested daily through the gastrostomy,and the nutritional intake of the control group included oral ingestion and intravenous infusion.All patients were measuredthe body height,body weight (BW).body mass index (BMI),Serum levels of serum albumin (ALB),pre-albumin (PA) and hemoglobin (HB) before and after radiotherapy.We also observed the incidence of acute radiation esophagitis and the completion of the treatment plan during radiotherapy in both groups,and to observe the two groups of patients the incidence rate of radiotherapy and treatment plan during the completion of acute radiation esophagitis.Results:There was no significant difference in BW,BMI,ALB,PA,HB before radiotherapy between the two groups (t =0.84,0.63,-1.07,-0.81,1.48,P ＞ 0.05).The BW,BMI,ALB,PA and HB of the observation group were significantly higher than those of the control group at the end of radiotherapy,which werestatistically significant (t=3.30,4.65,6.82,43.56,31.91,P ＜ 0.01).During the radiotherapy,the total incidence of acute radiation esophagitis in the observation group was significantly lower than that in the control group,(x2=3.971,P＜ 0.05).In addition,the completion rate of the observationgroup was significantly higher than that of the control group (x2 =6.811,P ＜ 0.01).Conclusion:To the Patients with dysphagia of esophageal cancer,enteral nutrition byCT guided percutaneous gastrostomy,can improve the malnutrition,the immune function of the patients and reduce the acute radiation esophagitis during radiotherapy and ensure the successful completion of the treatment plan.

Objective To evaluate the effects of different right ventricular pacing sites on left ventricular systolic synchrony using tissue Doppler imaging(TDI).Methods A tota[of sixty-nine patients with indications for permanent pacemaker implantation were enrolled sequentially by Pace-ROAD study(Pacemaker-right ventricular outflow tract and apex study,a randomized control study).They were randomized to RVOT pacing group(group A)or RVA pacing group(group B).Echocardiographic study with TDl was performed before and after 3 month follow up,and the data were analysed off-line.The peak velocity(Vs),the time to the peak of S wave(Ts)of all 12 basal and middle segments of left ventricle were measured,and then the standard deviation of Ts(Ts-SD),the average of Vs(Vs-M)were calculated.Results Thirty-six patients were randomized to group A,while the other 33 patients to group B.In each group,one patient was rejected due to non-pacing rhythm during follow-up.After 3 month pacing,the Ts-SD of group A was significantly shorter than that of group B[(23.63±2.32)ms vs(31.54±2.93)ms.P=0.0387-].In the patients with the basal Ts-SD longer than 32.6 ms(group A2 and group B2),the Ts-SD was significantly shortened than the baseline in group A2 during follow-up,while no significant difference was found in group B2.And the follow-up Ts-SD of group B2 was significantly longer than that of group A2 r(38.19±18.34)ms vs(28.55±16.93)ms,P=0.0290].Conclusions RVOT pacing is associated with favorable left ventricular systolic synchrony than RVA pacing,especially in patients with worsened baseline systolic synchrony.

Objective: To investigate whether combination chemotherapy with cisplatin, etoposide, and irinotecan was better than topotecan alone as second-line chemotherapy in patients with sensitive relapsed small cell lung cancer (SCLC). Method: Between September, 2014 and September, 2017, the patients'data were collected in Jilin Province Cancer Hospital. All patients were diagnosed with sensitive relapsed SCLC. Thirty-six patients received combination chemotherapy containing cisplatin plus etoposide plus irinotecan, and 42 patients received topotecan alone. Combination chemotherapy consisted of five 2-week courses of intravenous cisplatin 25 mg/m2 on days 1 and 8, intravenous etoposide 60 mg/m2 on days 1-3, and intravenous irinotecan 90 mg/m2 on day 8. Topotecan therapy consisted of at least one course of intravenous topotecan 1.5 mg/m2 on days 1-5, every 3 weeks. The primary endpoints were progression-free survival (PFS) and overall survival (OS), and safety was assessed in all patients who received at least one dose of drugs. Results: PFS was significantly longer in the combination chemotherapy group [median 5.3 months, 95% confidence interval (CI) 4.3-5.8] than in the topotecan group (3.2 months, 95% CI: 2.7-4.0;P=0.0030); OS was also significantly increased in the combination chemotherapy group (median 16.3 months, 95% CI: 13.8-19.1) than in the topotecan group (13.1 months, 95% CI: 10.2-15.4; P=0.0097). The most common grade 3/4 adverse events were neutropenia [31 (86.1%) patients in the combination chemotherapy group vs. 28 (66.7%) patients in the topotecan group], anemia [26 (72.2%) vs. 10 (23.8%)], leucopenia [29 (80.6%) vs . 21 (50.0%)], and thrombocytopenia [13 (36.1%) vs . 11 (26.2%)]. One treatment-related death (febrile neutropenia with pulmonary infection) occurred in the combination chemotherapy group, and none occurred in the topotecan group. Conclusions:Combination chemotherapy with cisplatin plus etoposide plus irinotecan could be considered a treatment option in second-line che-motherapy for selected patients with sensitive relapsed SCLC. However, the combination chemotherapy group had a higher incidence of adverse events than the topotecan group, and appropriate drug dosages should be explored.

Objective To explore the effect of follow-nursing model in the nutritional conditions of allogeneic hematopoietic stem cell transplantation(allo-HSCT)patients. Methods Eighty patients who underwent allo- HSCT from January 2015 to December 2016 were enrolled and divided into the observation group(40 cases)and the control group(40 cases)by random digit table.The observation group was treated with follow-nursing model, while the control group was treated with regular nursing. The Subjective Global Assessment (SGA), hematologic indexes and other body measurement indexes of the two cohorts were assessed three months later. Results The incidence of malnutrition in the observation group was 52.5%(21/40),compared to the control group with 77.5%(31/40)(χ2=4.451,P<0.05).The indexes including body mass index, triceps skin fold, arm muscle circumference, albumin, prealbumin and hemoglobin in the observation group were obviously higher than the control group with statistical significance (t=2.599-36.481, P<0.05 or 0.01). Conclusions The follow-nursing model may improve the nutritional conditions and some other body indexes of allo-HSCT patient compared to regular nursing model.