Objective To investigate the efficacy and the side-effects of concurrent chemoradiotherapy combined with consolidation or induction chemotherapy for locally advanced non-small cell lung cancer(NSCLC).Methods64 patients with stage ⅢA and ⅢB NSCLC were divided randomly into the CCT group(concurrent chemoradiotherapy followed by consolidation chemotherapy) and the ICT group(induction chemotherapy followed by concurrent chemoradiotherapy).All patients were deliverd to thoracic planning target with total dose of 54~66Gy(median dose 60Gy)in 6~7 weeks.CCT group started to irradiate by conformal radiotherapy technique on day 1,and ICT started on day 43 with single fraction dose 200 cGy and 5 fractions every week.ResultsThe response rate in CCT and ICT group was 60.0% and 58.8% respectively(P=0.924),with no statistic significance between the CCT and ICT group.The side-effects were mainly granulo-cytopernia,radiation espohagitis and radiation pneumonitis.ConclusionConcurrent chemoradiotherapy combined with consolidation or induction chemotherapy for locally advanced NSCLC is well tolerated.The sequence of adjuvant chemothreapy to concurrent chemoradiotherapy produced no significant difference for NSCLC in recent response.

Objective To investigate the effect of sorafenib in ameliorating renal fibrosis and its possible mechanisms.Methods Rats were subjected to unilateral ureteral obstruction (UUO ) and intragastrically administered sorafenib.NRK-52E cells were treated with transforming growth factor-β1 (TGF-β1)and sorafenib. HE staining was used to visualize renal fibrosis.α-SMA and E-cadherin expressions in kidney tissue and NRK-52E cells were performed using immunofluorescence.The cell cycle of NRK-52E cells was determined by flow cytometry analysis.Smad3 and p-Smad3 protein expressions in NRK-52E cells were detected by Western blot analysis. Results HE staining showed that kidney interstitial fibrosis,tubular atrophy,and inflammatory cell infiltration in the sorafenib-treated UUO groups were significantly decreased compared with the vehicle-treated UUO group (P<0.05).Compared with those in UUO and TGF-β-stimulated NRK-52E groups,the expression of a-SMA decreased but E-cadherin expression increased in the UUO kidneys and NRK-52E cells of the sorafenib-treated groups (P<0.05).After 24 h stimulation with TGF-β1 5 ng/mL,the number of cell cycles arrested in G0/G1 phase was significantly increased and the number of cells that entered G2 ,S phase decreased (P<0 .0 5 ).Compared with that in TGF-β-stimulated NRK-52E groups, p-Smad3 decreased in the sorafenib-treated groups (P<0.05). Conclusion Our results suggest that sorafenib may be useful for the treatment of renal fibrosis through suppressing TGF-β/Smad3 signaling.

Objective: To investigate the changes in serum CD44v6/v EGF(sCD44v6/sVEGF)levels after concurrent chemoradiotherapy in patients with inoperable non-small cell lung cancer(NSCLC)patients and to analyze the correlation of serum markers with patients'prognosis. Methods: The sCD44v6/v EGF levels were detected by ELISA in 50 inoperable NSCLC patients before and after concurrent chemorediotherapy. Results: The sCD44v6 and sVEGF levels before treatment was significantly higher than that in the control group.The pre-treatment sVEGF level was closely related to cTNM stage.metastasis,cell differentiation and primary tumor size,but was not correlated with histological classification,lymph node status,age or gender.The pre-treatment sCD44v6 level was closely correlated with cTNM stage,metastasis,cell differentiation,and primary tumor size,but was not correlated with histological classification,age or gender.Patients'sCD44v6 before treatment(570.89±63.30 ng/L)was significantly higher than that after treatment(281.44±74.28 ng/L).Patients'sVEGF before treatment(241.09±85.96 ng/L)was significantly higher than that after treatment(133.64±67.69 ng/L).PD patients had the highest level of sCD44v6 and sVEGF and CR patients had the lowest sCD44v6 and sVEGF level.The sVEGF level was highly correlated with sCD44v6(r=0.291,P<0.05).Conclusion:The sCD44v6 and sVEGF levels might be helpful for evaluation of the biological behavior and prognosis of NSCLC.

0.05). Conclusions For patients with locally advanced non-small cell lung cancer, concurrent conformal radiotherapy and chemotherapy followed by consolidation chemotherapy can improve the progression-free survival, but have few effects on overall survival and toxicity. Multicenter clinical trial with more patients should be carried out to confirm the benefit from the additional consolidation chemotherapy.

Objective To evaluate the quality of life (QOL ) of chronic hepatitis B (CHB) patients and to explore its related factors .Methods SF‐36 questionnaire was used to evaluate the QOL of 626 CHB patients visited or hospitalized in China‐Japan Friendship Hospital from July 2014 to June 2015 .And the residents around the hospital were included as control group .Sociological characteristics ,clinical data , health related behaviors and nutritional status were collected .Logistic regression analysis was used to analyze the factors related to quality of life . Results Six hundred and twenty‐six participants were enrolled in each group ,including 424 males and 202 females .The average age of CHB group and control group were 44 .2 ± 13 .9 and 44 .2 ± 13 .9 ,respectively .The average QOL score of the CHB patients was 72 .25 ± 16 .06 ,and 8 dimensions and 2 domains of CHB group were lower than those of control group (both P < 0 .05 ) . In multivariate analysis , factors independently associated with higher physical component summary (PCS) score were younger age (18—45 years old:OR=0 .27 ,95% CI:0 .13—0 .54 ;45—60 years old :OR= 0 .47 ,95% CI:0 .23—0 .95) ,high‐quality sleep (OR= 0 .20 ,95% CI:0 .12—0 .33) ,frequent exercise (OR=0 .37 ,95% CI:0 .19—0 .73) or occasional exercise (OR=0 .49 ,95% CI:0 .30—0 .77) ,and mild hepatitis symptoms (mild:OR=0 .19 ,95% CI:0 .05 -0 .76 ;moderate :OR=0 .20 ,95% CI:0 .06—0 .68 ) , while disease duration was associated with lower PCS score ;factor independently associated with higher mental component summary (MCS) score was high quality sleep (OR=0 .25 , 95% CI:0 .16—0 .41) ,while longer duration (OR= 14 .04 ,95% CI:1 .81—109 .38) and lower weight (OR=2 .72 ,95% CI:1 .48—4 .98) were associated with reduced MCS score ( all P<0 .05) .Conclusions The QOL of CHB patients is damaged universally .More attention should be paid to the health related life behavior and nutritional status of CHB patients in the future management .

Objective To investigate the correlation among expression of serum VEGF without operation between pre-and post-chemoradiotherapy in non-small cell lung cancer (NSCLC) patients, to explore the correlation of markers on prognosis and effect. Methods The serum vascular endothelial growth factor (VEGF) were detected in 50 patients without operation between pre-and post-chemoradiotherapy with NSCLC by ELISA method. The group t-test was played into before concurrent chemoradiotherapy and normal control. The paired t-test was played into before and after concurrent chemoradiotherapy. Results The prechemoradiotherapy serum VEGF ( 241.09 ± 52.45 ) ng/L in NSCLC patients was significantly higher than those in normal control patients (103.72 ± 39. 22) ng/L (t = 2. 50,P ＜0. 05 ). The pre-chemoradiotherapy serum VEGF in NSCLC patients was closely related to pTNM stage, distant metastasis, grade of cell differentiation and the size of the primary tumors ( t = 9. 61 - 14. 94, all P ＜ 0. 05 ), but not to the histological classification, type of the tumor, lymph node status, age, gender of the patients or smoking or not (t =0. 58 - 1.84, all P ＞ 0. 05 ). The pre-chemoradiotherapy serum VEGF ( 24 1.09 ± 52. 45 ) ng/L was significantly higher than that of the post-chemoradiotherapy ( 133.64 ± 33.62) ng/L ( t = 12. 20, P ＜ 0. 01 ). The post-chemoradiotherapy serum VEGF decreases to the pre-was the biggest in the CR patients (( 92.35 ± 37.48ng/L) ,t =3.79,P ＜0. 01 ) ,the smallest in the PA patients ( (276.32 ±47.98) ng/L,t = 1.32,P ＞0. 05) ) ,and bigger in the PR patients and the NC patientspatients ( ( 113.10 ± 39. 20) ng/L,t = 13.58,P ＜0. 01 and ( 198.10 ± 42.68 ) ng/L, t = 4. 78, P ＜ 0. 05 ) ), respectively. Conclusions Elevation of serum VEGF exists in patients with NSCLC . The serum VEGF in patients with NSCLC might be helpful to evaluate the biological behavior of lung cancer. Detection of VEGF expression maybe helpful for predicting the prognosis of NSCLC patients.

Objective To describe the pathological unit and octagonal en bloc resection for the treatment of ossification ligamentum flavum(OLF)in thoracic spine with spondylotic myelopathy.Methods Ninety-five patients from January 2002 to January 2007 were diagnosed as thoracic OLF,61 males and 34 females with an average age of 53.9 years(range,31-78 years).There were upper thoracic spine OLF in 32 cases,middle thoracic spine OLF in 24 cases and lower thoracic spine OLF in 39 cases.Single-segment OLF was found in 53 cases,double segments OLF was found in 38 cases and three segments OLF was found in 4 cases.CT scan multiplanar co-localized reconstruction was employed to detect the structure of spine with OLF.The Japanese Orthopaedic Association(JOA)lower limb motor function score,sphincter function score and motor function improvement rate were used to evaluate the outcomes.Results CT scan was engaged to observe 141 OLF pathological unite.The OLF pathology unit was defined as all the spine structures between the extension lines of the lower margin of the OLF two adjacent pedicles.Each OLF associates with an OLF pathology unit.The mean follow up duration was 38.3 months(range,24-60 months).Among 86 patients with sensations disturbance before operation,67 totally recovered and 19 relieved after operation.Trunk restrictions in 69 cases before operation were completely recovered after operation.Postoperative JOA sphincter function score was 2.651±0.334,comparing with preoperation score(2.262±0.561),and the difference was statistically significant.Postoperative JOA motor function score was 3.694±0.429,which was significantly increased than preoperative score 1.539±0.873,and motor function recovery rate was 87.57%.There was excellent in 71 cases,good in 17 cases and fair in 5 cases.The excellent and good rate was 94.74%.Conclusion The octagonal en block resection is relative safe for treatment thoracic OLF with myelopathy.Pathological unit of OLF in thoracic spine is more accurate to summarize the pathological contents and features of the OLF and its adjacent structure.

Objective To investigate the efficacy and side-effect of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).MethodsEighty-six patients with histologically confirmed locally advanced NSCLC were randomized into induction chemotherapy followed by concurrent chemoradiotherapy (ICCRT)arm or concurrent chemoradiotherapy (CCRT) arm. Both arms were treated with intensity-modulated radiation therapy. Induction and concurrent chemotherapy regimen consist of docetaxel and cisplatin. Results Follow-up rate of the whole group is 100％.The response rate in the CCRT arm and ICCRT arm is 70％ and 80％ ( χ2 =1.26,P =0.261 ),respectively; and 1-,2-,3-year survival rate is 65％ and 85％,40％ and 50％,33％ and 44％ (χ2 =3.90,P=0.048),respectively; the median survival time and time to progression is 17.5 and 22.0 months and 14.0 and 19.0 months respectively.Major adverse effects are leukopenia (43 and 32 cases,χ2 =3.48,P =0.062),radiation esophagutis (26 and 20 cases,χ2 =0.12,P =0.730),anemia (26 and 16 cases,χ2 =2.34,P =0.126) and radiation pneumonitis (13 and 9 cases,χ2 =0.37,P =0.541 ).ConclusionsICCRT for locally advanced NSCLC can improve the overall survival rate and time to progression,induction chemotherapy did not increase side-effects.There was no difference in response rate between CCRT and ICCRT arm.

Objective To introduce the surgical strategy of enlarged laminectomy (with partial facet joint dissection to expose the nerve root), and to discuss its benefit for cervical ossification of the posterior longitudinal ligament(OPLL) with myelopathy. Methods Totally 82 patients with cervical OPLL were treated by enlarged laminectomy from January 1998 to December 2005. There were 47 males and 35 females, with an average age of 57 years (ranged, 39-84 years). Among them, there were 31 cases of the solitary type, 40 cases of the continuous type, and 11 cases of the mixed type. JOA scoring system and the visual analogue scale (VAS) scoring were applied to evaluate the neurological function and neck/shoulder pain respectively.Ishihara method was employed to measure cervical curvature index(CCI). The degree of spinal cord backward expanding and displacement were calculated in MR1. Results The mean decompression length was 5.2 (4-6) segments. The mean follow-up duration was 41 months (ranged, 13-58 months). JOA score has improved from 10.9(7-15) preoperatively to 13.9(11-17) postoperatively (t=14.65, P＜0.01). The excellent and good rate was 98.7%. The palsy of C5 nerve root occurred in only 2 patients, both recovered after surgery. Zhe mean postoperative VAS score was 1.4(1-3), comparing with the preoperative score of 5.3 (4-6). The pain in neck/shoulder was alleviated obviously (t=15.46, P＜0.01 ). CCI decreased from 18.8% to 10.5%(t=5.03, P＜0.01 ),but did not follow by neuron function deterioration. MRI indicated that the cross-sectional area at the level of maximum compression of the dural sac increased from 85.4 mm2 preoperatively to 153.8 mm2 postoperatively (t=16.33, P＜0.01), and the mean spinal cord posterior shift was 6.2 mm (t=15.35, P＜0.01). Conclusion The enlarged laminectomy is proved to be effective in treating cervical OPLL, in terms of significant posterior shift of the spinal cord, relief of cervical/shoulder pain, lower rate of the palsy of C5 nerve root, with no recurrence of spinal cord compression symptom.

Objective To evaluate the surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation. Methods This study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation. There were 21 males and 16 females with an average age of 42 years (19-58). Distraction-flexion stage 3(DFS 3) were found in 24 cases and DFS 4 in 13 cases. All the cases were diagnosed by X-ray, CT and MRI and confirmed during the surgery. Decompression via posterior-anterior approach and anterior fixation had been adapted as the surgical strategy. The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury. The ASIA grading was used for evaluation the spinal cord function and the recovery rate. The X-ray and CT were used to observe reduction and bone fusion. Results The mean operative time was (4.5:±0.5) h, and the mean amount of blood loss was 360 ml (200-500 ml). All the incision healed. The two segments fixation was used in 23 cases, 3 segments fixation in 13 cases, and 4 segments fixation in 1 case. The mean follow-up period was 32 months (16-45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4-8 months, without graft displacement, or failure of implants. Spinal cord function did not aggravate, and sensory recovery ranged from 7 to 20 levels (averaged, 12.7). The ASIA grade were improved with an average of one grade. Conclusion To treat fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation, the posterlor-anterior approach and anterior fixation/fusion was benefit to preservation the cervical spinal cord function and reconstruction biomechanical stability of the cervical spine.