A special method of clinical tumor radiation therapy,namely 3DCRT& IMRT,is described in this paper,including its design and clinical application.

Objective To evaluate the value of dual-phase spiral CT scanning in diagnosis of small pancreatic carcinoma.Methods 21 cases with small pancreatic carcinoma (≤2 cm) underwent plain CT scan and dual-phase eahanced spiral CT including arterial phase(20~25 s after infusion)and pancreatic phase(50~60 s after infusion)with a 100 ml bolus injection of contrast material at 3~6 ml/s.CTattenuation values of tumor and normal pancreas in all scanning phase were obtained.Results The mean CT value of tumor was(42?14) HU(arterial phase)and (48?18) HU(pancreatic phase),the mean CT value of normal pancreas was (105?15) HU(arterial phase)and (86?11) HU(pancreatic phase).The dens difference of tumor-pancreas was significantly on arterial phase (69?15) HU.Conclusion The maximum dens difference of tumor-pancreas can be obtained on arterial phase CT scan,it has advantages in diagnosing pancreatic carcinoma of early period and to judge the resectionability of pancreatic carcinoma.

Background and purpose:The morbidity of the elderly patients with hepatic portal cholangiocarcinoma is rising. Due to the characteristics of pathology,physiology and anatomy of the disease, most of the patients with cancer are not resectable, the main treatment consists of the diverting drainage and postoperative chemoradiation.We studied the clinical features and the effective therapeutic method for the elderly patients with hepatic portal cholangiocarcinoma. Methods:A retrospective analysis was performed in 28 cases of the elderly patients with hepatic portal cholangiocarcinoma who were treated between January 1995 and December 2005 in our hospital.Results:3 cases received surgery, 2 of them survived for over three years, another 3 cases were given operative exploration with 14 months of medium survival time. 22 cases were given internal or external drainage and received radiotherapy after operation, their survival time ranged from 5 months to 40 months.Conclusions:Surgery is the primary therapeutic method for elderly patients with hepatic portal cholangiocarcinoma. Internal or external drainage and radiotherapy could prolong survival time of the patients with unresectabke disease.

Objective To study the results of repeat hepatectomy,followed by transcatheter arterial chemoembolization (TACE) and percutaneous microwave coagulation therapy (PMCT),but with or without portal vein chemotherapy (PVC) in patients with recurrence of hepatocelluar carcinoma (HCC) after partial hepatectomy.Methods The data of 33 patients were analyzed retrospectively.All these patients received repeat hepatectomy.They were then divided into two groups:the PVC group (n =19) was treated with PVC + TACE + PMCT,and the non-PVC group (n =14) with TACE + PMCT.Results For the 33 patients,13 (39.4％) developed tumor recurrence ＞2 years from the initial resection while 20 patients (60.6％) developed recurrence within ≤ 2 years.The tumor recurrence consisted of local recurrence in 14 patients (42.4％),and heterochronous recurrence in 19 patients (57.6％).There was a significantly difference in the cumulative survival rates between the two groups (x2 =4.319; P =0.038).The 1y,3y,5y survival rates were 84.2％,42.1％,31.6％ in the PVC Group,and 71.4％,28.6％,14.3％ in the Non-PVC Group respectively.28 sessions of PMCT and 97 sessions of TACE were performed postoperatively (the medians were 1,0.5; 3,3 respectively,the mean ranks were 17.68,16.07; 15.05,19.64 respectively,and the P values were 0.612,0.163 respectively between the two groups).Conclusions For patients with recurrence of HCC after hepatic resection,after repeat hepatectomy PVC + TACE + PMCT gave better survival than those with TACE + PMCT but without PVC.

Objective To obtain the peptide mass fingerprintings(PMF)of serums of the patients with bone metastasis and with-out metastasis and to filtrate and identify the differential serum proteins of patients with bone metastasis after radical mastectomy . To establish diagnostic models for diagnosis of bone metastasis after breast cancer operation .Methods Two groups of serum sam-ples were analyzed by ClinprotTM MALDI-TOF MS and gain PMF ,18 samples from patients with merely bone metastasis and 18 samples from patients without metastasis .Characteristic protein peaks were analyzed and selected by analyses software within Clin-prot system .Every group was repeated 2 times .Results All serum samples were repeated after 5 days and the fingerprintings were similar to the former .4 protein peaks were selected randomly to compute coefficient of variation which are less than 30% .The Clin-prot system has excellent repeatability .No differential protein was detected by analyzing PMF (P>0 .05) .Conclusion No differen-tial serum protein exists in patients with bone metastasis and without metastasis and detecting differential protein in peripheral blood may be impossible .

OBJECTIVETo prepare pulsed-release tablet (PTS) according to the rhythm of coronary heart disease based on efficacy material and the mechanism of compound Danshen.

METHODPTS were achieved by coating the core which contains drugs, CMS-Na, lactose, succinic acid and MCC with separation layer (Eudragit RL), swelling layer (HPMC E5), and controlled-release membrane (Eudragit RS-RL-EC).

RESULTThe results of in vitro experiments showed that no difference was observed among the profiles of Danshensu, protocatechuic aldehyde, ginsenoside Rg1, Rb1, notoginsenoside R1 release from the two-step release system. And it indicated that swelling was the basis and prerequisite for drug release from PTS, and the diffusion, organic acid-induced, and osmotic pumping mechanism were involved in drug release, but the latter they were the dominant factors.

CONCLUSIONSuccessfully obtained the PTS of a certain lag-time behind the rapid release which indicate that after bed time administration of such device, the drug plasma concentration-time curve CAN meet the requirements of chronotherapy of cardiovascular disease.

Benzaldehydes ; metabolism ; Catechols ; metabolism ; Chromatography, High Pressure Liquid ; Coronary Disease ; drug therapy ; Diffusion ; Drug Compounding ; methods ; Drug Delivery Systems ; Drugs, Chinese Herbal ; administration & dosage ; chemistry ; metabolism ; therapeutic use ; Ginsenosides ; metabolism ; Osmosis ; Salvia miltiorrhiza ; chemistry ; Tablets ; Time Factors

Objective:To investigate the clinical features of patients with Langerhans cell histiocytosis (LCH), and analyze the association between BRAF V600E mutation status and clinical features. Methods:A retrospective analysis was carried out for the clinical data of 60 patients with LCH at the Department of Pediatric Oncology, Sun Yat-sen Memorial Hospital between April 2013 and December 2019.Among them, 39 patients undertook BRAF V600E mutation testing, which in paraffin-embedded tissue samples were detected by quantitative real-time PCR (qRT-PCR), and in peripheral blood and/or bone marrow were tested by high-throughput sequencing, for analyzing the correlation between BRAF V600E mutation and clinical characteristics of LCH. Results:(1)Clinical characteristics: the age of 60 LCH patients was (4.08±0.45) years, with 43 male cases and 17 female cases.Patients at young age (≤2 years) and with risk organ (RO+ ) and central nervous system (CNS) risk lesions involvement were concentrated in the multisystem involvement (MS) group ( P<0.05). (2)Therapeutic response after induction therapy: the response to induction therapy was achieved in 28 of 60 treated patients (41.7%) and 32 (53.3%) did not.After excluding stratification factors of treatment regimen, MS ( OR=6.855, 95% CI: 2.077-22.622, P=0.002) and the age≤2 years ( OR=4.944; 95% CI: 1.601-15.275; P=0.005) were risk factors in poor chemotherapy response.RO+ ( OR=8.250, 95% CI: 1.617-42.090, P=0.005) was a significant risk factor for a poor chemotherapy response in JLSG-02 treatment group.Differently, RO+ had no dramatic effect on chemotherapy response in CCHG-LCH-2019 treatment group.(3) BRAF V600E mutation: 39 patients were determined BRAF V600E status, with the positive rate of BRAF V600E mutation in paraffin-embedded tissue samples reaching 70.3%(26 cases). BRAF V600E mutation was not associated with early treatment response, age, sex, MS and RO+ ( P>0.05). However, the positive rate of BRAF V600E in children with MS and CNS risk lesions was higher than the controls, with 76.0% (19 cases) vs.57.1% (8 cases) and 74.1% (20 cases) vs.58.3% (7 cases), respectively.Totally, 3 of 8 cases were positive in bone marrow, with 2 cases of MS, and 1 case of multiple bone invasions, and 1 of 5 cases was positive in peripheral blood, with liver and spleen being involved. Conclusions:LCH patients with age≤2 years, MS and RO+ exhibited a poor response to initial treatment, required for more aggressive treatment strategy.Lesion with activating BRAF V600E mutations suggests that LCH is a clonal disorder.There may be great variability between BRAF V600E mutations and MS as well as CNS risk lesions.In the mutation dataset, part of patients had positive BRAF V600E mutations in bone marrow/peripheral blood.This might suggest a different pathogenesis in such patients, has a certain clinical sense in some aspect.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.