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.

Objectives: To compare the efficacy of intensity-modulated radiotherapy (IMRT) alone and concurrent chemoradiotherapy (CCRT) for patients with stage T1-2N1M0 nasopharyngeal carcinoma (NPC) in an unendemic area. Methods: Between January 2010 and December 2015, 102 patients with stage T1-2N1M0 NPC who underwent radical radiotherapy were selected for a pair analysis. Survival rates and acute adverse reactions were compared between the two groups. Results: The 5-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) rates were 94.1%, 93.6%, 96.7%, and 90.9%, respectively. Compared with IMRT alone, CCRT failed to significantly improve the 5-year OS (95.9% vs. 92.2%, P=0.894), LRFS (94.1% vs. 93.3%, P=0.976), RRFS (95.8% vs. 97.6%, P=0.572) and DMFS (91.4% vs. 90.2%, P=0.716)rates. The incidence rates of vomiting, neutropenia, leukopenia, decreased hemoglobin levels, and mucositis were significantly higher in the CCRT group than in the IMRT-alone group. Conclusions: For patients with stage T1-2N0M0 disease, CCRT failed to improve the prognosis, but increased the incidence rates of acute toxicities.

ObjectiveTo explore the function of intraoperative monitoring by brainstem auditory evoked potential and free electromyography during the operation of large acoustic neuroma for improving the operation more accurately and safely. MethodsThe intraoperative monitoring of affected cranial nerve and brainstem function respectively by brainstem auditory evoked potential and free electromyography was performed in 26 patients with large acoustic neuroma. According to the monitoring result the strategy and method of surgery was adjusted. Facial nerve function was assessed using the House-Brackmann facial nerve grading system immediately after two weeks of surgery.Results23 cases (88 ％) achieved total resection,3 cases(12 ％)achieved subtotal resection. The facial nerve was preserved anatomically in 25 patients.According to the House-Brackmann facial nerve grading system,21 cases (80 ％) got preserve of facial nerve function in grade Ⅰ - Ⅱ, 3 cases(12 ％)got preserve of facial nerve function in grade ]Ⅲ-Ⅳ and 1 cases (4 ％) got preserve of facial nerve function in grade Ⅴ after two weeks of surgery.ConclusionIntraoperative physiological monitoring may increase the anatomical and functional preservation rate of affected cranial nerve and also may improve the operation more accurately and safely.

Objective To research the influence of docetaxel on radiosensitivity in papillary thyroid carcinoma TPC-1 cells.Methods 6 MV X-ray irradiation and deocetaxel were incubated separately or jointly with TPC-1 cells.Proliferation inhibition of docetaxel on TPC-1 cells was detected by CCK-8 method.Radiosensitization of docetaxel was measured by clone formation assay.Flow cytometry (FCM) was employed to analyze cell apoptosis and cycle progression.Western blot assay was applied to examine the expressions of Bax and Bcl-2 proteins.Results The proliferation inhibition effect depended on the concentration and treatment time of docetaxel with IC50 value of 6.06 (24 h),1.39 (48 h),and 0.09 μg/ml (72 h),respectively.The value of SF2,D0,Dq in the radiation treatment group combined with docetaxel were obviously lower than those in the radiation alone group.The SER of docetaxel was 1.53.Following treatment with 0.05 μg/ml docetaxel combined with radiation for 24,48,72 h,the ratios of apoptosis in TPC-1 cells were 31.67％,44.57％,70.20％,which were higher than that of radiation alone group(t =-146.56,-15.13,-19.15,P ＜ 0.05).FCM measurement showed that cell cycle arrest in G2/M phase in the cells treated with docetaxel and radiation was much more obvious than the group of radiation alone (t =-79.17,P ＜ 0.05).In addition,in the combination treatment group,the expression of Bax increased (t =93.56,P ＜ 0.05) while the expression of Bcl-2 decreased (t =41.02,P ＜ 0.05).Conclusions Docetaxel can enhance the radiosensitivity of TPC-1 cells by promoting cell cycle arrest,induction of apoptosis and formation of associated proteins Bax/Bcl-2.

Objective To investigate the clinical values of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) and magnetic resonance imaging (MRI) in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma.Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery.The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy.The gross tumor volume (GTV) and clinical target volume (CTV) determined by PET-CT and MRI were compared;the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test.Results Fourteen patients had residual lesions after surgery.The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI (92.86%, 94.87%, 86.67%, 97.37%, and 94.34% vs.57.14%, 76.92%, 47.06%, 83.34%, and 71.70%, all P<0.05);the specificity, positive predictive value, and accuracy of PET-CT in detecting lymph node metastases were also significantly higher than those of MRI (all P<0.05), except for the sensitivity and negative predictive value (P>0.05).For the 14 patients with residual lesions, GTVPET/CT was significantly smaller than GTVMRI(45.62±22.13 cm3 vs.60.61±23.12 cm3, P=0.034), so did CTV (125.54±17.53 cm3 vs.142.18±21.22 cm3, P=0.011).There was no significant difference between CTVPET-CT and CTVMRI in 39 patients without residual lesions after surgery (117.87±17.66 cm3 vs.128.05±20.65, P=0.099).Conclusions PET-CT is superior to MRI in detecting the residual lesions and lymph node metastases after surgery in patients with oropharyngeal squamous cell carcinoma, which provides valuable information for radiotherapy planning.