Early diagnosis,early treatment and the correct therapeutic approch are the keys for metastatic nasopharyngeal carcinoma(NPC) treatment.Currently,PET-CT is the best modality for distant metastasis staging of NPC.Cispalatin-based chemotherapy is the standard treatment method of metastatic NPC.Molecular targeted therapy is possible to further increase curative effect.When the lesions are limited,local palliative treatment may improve prognosis if patient's illness is controled by chemotherapy.

To seek the ideal replacing grafts of blood vessel,many different methods of tissue engineering blood vessel(TEBV)have been created,such as collagen gel-based,biodegradable scaffold-based,self-assembled vascular grafts,and peritoneal and pleural cavities as bioreactors to grow autologous vascular grafts,etc.Some TEBVs have partially or completely met the requirements for clinic,even have applied in clinic.In this article reviewed,the models with better characters in big animals and clinical tests,and discussed the current problems of TEBV and looked forward to future clinical application.

The apparent digestibilities of two preparations of corn as staples in men were estimated during March and April in 1979. Seven healthy adult men, who lived in this region for many years, were accustomed to eat corn as their staple diets. Each of the two preparations from the same batch of corn was used in the experiment. One preparation was "cooked corn meal" and the other was Jian-bing, the latter was considered the better way of cooking. Other ingredients of food in these two test diets were the same. During the test periods, the volunteers ate the test diets and drank boiled water ad lib, but the quantities were recorded. No other foodstuffs and drinks were allowed. The nutritive values of test diets were sufficient to meet the subjects' physiological needs. The 12 days period was divided into adaptative and testing periods of three days each for the two kinds of test diets. During the test periods, the total foodstuffs and the volunteers' faeces were analysed for the contents of water, anhydrates, total ni- trogen, crude fat, ash and fiber in the samples. From the data obtained, the apparent digestibilities of anhydrates, total nitrogen and crude fat ware calculated. Urine nitrogen was analysed and the nitrogen balance was calculated. The body weight at the beginning and the end of test periods were measured.The apparent digestibility (%) of anhydrates was 93.31?0.393 and 94.79 ? 0.578, total nitrogrn 84.60 ? 0.843 and 87.77 ? 1.080 and crude fat 86.32 ? 1.296 and 94.68 ? 0.838 in cooked corn meal diet and the corn flour Jian-bing diet respectively. The apparent digestibility in corn Jian-bing diet was higher statistically than that of cooked corn diet. Body weights fluctuated within the normal range. The nitrogen balances of all subjects were positive and the difference of nitrogen balance studies between the two test diets was not statistically significant.The results of the experiment suggest that, the differences of apparent digestibility between two diets was mainly due to the methods of preparation, Jian-bing being better than cooked corn diet in human nutrition.

A total of 1512 adult inhabitants were randomly recruited in Zhaiji district of Guiyang city in September2009.The levels of triglyceride (TG),systolic blood pressure,diastolic blood pressure,and the prevalences of abdominal obesity and hypertension increased significantly in the subclinical hypothyroidism group conpared to the euthyroid group (P＜0.05).The prevalences of high TG,low high density lipoprotein-cholesterol,and metabolic syndrome (MS) in the subgroup Ⅳ were higher than the subgroup Ⅰ (P＜0.05).Correlation analysis revealed that TSH was positively related to TG (P＜0.05).Logistic regression demonstrated that TSH was a risk factor for MS.Either in the euthyroid or total subjects serum TSH levels in the MS group were significantly higher than those in non-MS group(P＜0.05).

Objective:To evaluate effect of different induction chemotherapy on the clinical efficacy of concurrent intensity-modulated radiotherapy (IMRT) and chemotherapy and identify the prognostic factors in non-endemic locally-advanced nasopharyngeal carcinoma patients.Methods:Clinical data of 210 patients with stage Ⅲ-Ⅳ B(excluding stage T 3-4N 0M 0) nasopharyngeal carcinoma treated in our hospital from 2012 to 2017 were retrospectively analyzed. According to the efficacy of different induction chemotherapy, all patients were divided into the effective group (14 cases of complete remission and 165 cases of partial remission) and ineffective group (31 cases of stability and 0 case of progression). Survival analysis was performed by Kaplan- Meier method. Multivariate analysis was conducted by using Cox′s regression model. Results:Compared with the ineffective group, the 3-year overall survival (OS)(89.2% vs. 74.2%, P=0.005), recurrence-free survival (RFS)(93.0% vs. 81.9%, P=0.010) and progression-free survival (PFS)(80.2% vs. 58.1%, P=0.005) were significantly higher in the effective group, whereas the distant metastasis-free survival did not significantly differ between two groups (84.1% vs.69.7%, P=0.070). Multivariate analysis showed that the tumor response to induction chemotherapy was an independent prognostic factor for OS, RFS and PFS. Conclusions:Tumor response to induction chemotherapy might be a prognostic factor for non-endemic locally-advanced nasopharyngeal carcinoma patients. Clinical prognosis of patients with poor response to induction chemotherapy is even worse. More intensive treatment and closer follow-up may be needed for these patients.

Through feedback from questionnaire,relevant problems are summed up,further understanding of the status of medical students' clinical practice is found.then some problems,such as low positivity of students,week didactical consciousness of teachers and inflexibility of practice system,are researched to table some proposals for reformation of clinical practice.

Objective To investigate the efficacy of treatment on malignant intracranial gliomas with the chemotherapy of intracerebral implantation of 5-Fu biodegradable polymers combined with radiotherapy of interstitial implantation of 125Ⅰ after microsurgery resection. Methods Sixty-five patients with malignant intracranial gliomas who had underwent craniotomy microsurgical resection were intraoperatively implanted in the tumor bed around with 5-Fu biodegradable polymers and 125Ⅰ seeds. After first implantation (3 months to 1 year), stereotactic guided implantation was carried out 1 or 2 times again. The patients were followed up for 6-36 months to observe the efficacy, edema and adverse reactions, compared with follow-up of 40 patients with malignant intracranial gliomas treated by conventional radiotherapy and chemotherapy after microsurgical total resection. Results Within 1 week after the implantation the patients had headache significantly, WBC of cerebrospinal fluid was increased to some degrees, and edema was obvious compared with surgery alone. All patients were treated and discharged. Forty-four patients were completely followed-up and the survival period was significantly longer. Within 6 months, 1 year, 2 years and 3 years, there were 4 cases (9.1 %) of recurrence and no case of death, 14 cases (31.8 %) of recurrence and no case of death, 20 cases (45.5 %) of recurrence and 12 cases (27.6 %) of death and 29 cases (65.9 %) of recurrence and 20 cases(45.5 %) of death, respectively. No obviously adverse reactions were found and the quality of life was significantly improved. Conclusion Microsurgical total resection is the key of the treatment. It is an alternative treatment of human malignant gliomas in the safe and effective way that the local chemotherapy of intracerebral implantation of 5-Fu biodegradable polymers combined with local sensitivity radiotherapy of interstitial implantation of 125Ⅰ after microsurgical resection.

Objective To investigate the volume of prophylactic irradiation to the neck for stage N0 nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT).Methods Retrospective analysis was performed on the clinical records of 270 patients with stage N0 NPC (based on the 6th version of AJCC/UICC staging system),who underwent IMRT as the initial treatment in our center from 2003 to 2008.Among all the patients,171 received prophylactic upper-neck irradiation,and 99 prophylactic whole-neck irradiation.All of them received 6-MV X-ray IMRT to the primary focus of NPC and the lymphatic drainage area in the upper neck (Levels Ⅱ,Ⅲ,and Ⅴ A lymph nodes) at doses of 68 Gy/30fractions and 54 Gy/30 fractions over 6 weeks.In addition,the patients receiving prophylactic whole-neck irradiation had the lower neck and supraclavicular fossae treated by anterior neck semi-field conventional technique at a dose of 50 Gy/25 fractions.Results The median follow-up was 65.1 months (range 4-106months),and the follow-up rate was 93％.The patients undergoing prophylactic upper-neck irradiation and prophylactic whole-neck irradiation had 5-year disease specific survival rates of 95.3％ and 91.9％ (x2 =0.76,P =0.384),relapse-free survival rates of 99.4％ and 99.0％ (x2 =1.18,P =0.278),and distant metastasis-free survival rates of 98.8％ and 94.9％ (x2 =2.31,P =0.128).The 5-year distant metastasisfree survival rate was significantly higher in patients without retropharyngeal lymph node (RLN) metastasis than in those with RLN metastasis (99.4％ vs.93.7％,x2 =8.96,P =0.003).Grade 1-2 mucositis and pharyngitis were the most common acute adverse reactions in patients.At 24 months after IMRT,no grade 3 or 4 xerostomia and trismus were developed.Conclusions Prophylactic irradiation to the upper neck may be feasible for stage N0 NPC patients treated with IMRT.It is reasonable in the 7th version of AJCC/UICC staging system that NPC with negative cervical lymph nodes and positive RLNs is reclassified to stage N1.

Objective To investigate the expression and the clinical significance of meningioma-association protein（MAC30）mRNA and protein in colorectal carcinomas.Methods MAC30 was immunohistochemically examined in 130 primary tumours,73 distant normal mucosa specimens and 34 lymph node metastases from rectal cancer patients＇paraffin embedded blocks.MAC30 mRNA expression was detected by RT-PCR in primary tumors,adjacent and distal normal mucosa of 50 rectal cancer patients underwent colectomy.Results MAC30 cytoplasmic expression level in colorectal primary tumors and lymph node metastases was significantly higher than that in distant normal mucosa.MAC30 mRNA expression was upregulated in primary tumor,and the expression level was related to the histologic type of the tumor.Three-year survival rate of the colorectal carcinomas patients with strong expression of MAC30 was significantly lower than that of the patients with weak MAC30 expression（P 0.05）.Conclusion MAC30 overexpression might be involved in the development of colorectal carcinomas and seemed to be a prognostic factor.

Objective To evaluate the long-term outcomes of patients with advanced N-stage nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) and the effects of IMRT combined with different chemotherapies on the patients' prognosis.Methods A retrospective analysis was performed on the clinical data of 179 patients with advanced N-stage NPC who were admitted to our hospital from January 2001 to January 2008.Of the 179 patients,33 received IMRT alone,and 146 received chemoradiotherapy (CRT).Among the 146 patients,71 received concurrent chemoradiotherapy (CCRT),66 received induction chemotherapy (IC) plus CCRT,and 9 received CCRT plus adjuvant chemotherapy (AC).Results The follow-up rate was 96.5％,and 133 patients were followed up for at least 5 years.The 5-year overall survival rate was 69.0％.The patients receiving IMRT alone and patients receiving CRT had 5-year overall survival rates of 47.7％ and 73.7％ (x2 =13.91,P =0.000),5-year distant metastasisfree survival (DMFS) rates of 49.2％ and 68.3％ (x2 =4.97,P =0.026),relapse-free survival rates of 74.5％ and 92.4％ (x2 =9.87,P =0.002),and progression-free survival rates of 37.5％ and 65.1％ (x2 =11.65,P =0.001).Among the patients receiving CRT,those receiving CCRT,IC plus CCRT,and CCRT plus AC had similar survival rates.IC plus CCRT resulted in a significantly higher DMFS than IMRT alone (x2 =4.65,P =0.031).Conclusions The distant metastasis rate is still high in patients with advanced N-stage NPC after IMRT,for whom IC plus concurrent chemotherapy and IMRT may be a better treatment regimen.