Objective To study the therapeutic effect and complication of external beam radiotherapy (EBR) plus intracavitary brachytherapy (IB) on nasopharyngeal carcinoma(NPC). Methods 52 patients with stage T 1,T 2 NPC were divided into two groups, 26 patients treated by EBR and the other 26 patients treated by EBR plus IB (combined radiotherapy group). IB was given to the patients of combined radiotherapy group when the external radiotherapy dose amounted to 40Gy,50Gy and 60Gy, respectively. Results The 3-year local control rates of combined radiotherapy group and EBR group were 100% and 73.08%, respectively (P0.05). Conclusions External beam radiotherapy combined with intacavitary brachytherapy for stage T 1, T 2 NPC may rise the local control rates, and reduce the exteral beam radiation dose and the complication.

Objective To investigate the value of FDG PET-CT in the outcome assessment and prognostic evaluation for recurrent nasopharyngeal carcinoma (rNPC).Methods From January 2008 to December 2013,92 rNPC patients were treated in our center,who were histologically or radiologically diagnosed and re-staged according to the 2008 clinical staging system for nasopharyngeal carcinoma in China.The numbers of patients in stage Ⅰ,stage Ⅱ,stage Ⅲ,and stage Ⅳ were 8,11,39,and 34,respectively.According to the recurrent T stage (rT),the numbers of patients in rT1,rT2,rT3,and rT4 were 10,11,38,and 33,respectively.Twenty-eight patients had recurrence in the neck lymph nodes.All patients underwent pretreatment FDG PET-CT for the whole body or head/neck,and treated by radiotherapy with or without chemotherapy.The relationship of maximum standard uptake value (SUVmax) and clinical factors with clinical outcomes was analyzed.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),local recurrence-free survival (LRFS),regional recurrence-free survival (RRFS),and distant metastasis-free survival (DMFS).The log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox model was used for multivariate prognostic analysis.Results The 3-year OS,DFS,LRFS,RRFS,and DMFS were 33.6％,32.1％,32.8％,31.8％,and 33.7％,respectively.The median SUVmax was 8.35 (2.7-21.5).The SUVmax of 7.0 was taken as the optimal cut-off value for all patients.Patients with SUVmax ≤7.0 had a significantly higher 3-year OS rate than those with SUVm ax ＞7.0 (42.0％ vs.28.3％,P=0.019).The univariate analysis revealed that patient age,SUV and rN were significantly associated with OS (P=0.023,0.019,and 0.002).The multivariate analysis showed that SUVmax and rN were significant influencing factors for OS,DFS,and DMFS (HR=1.68,P=0.045 and HR=2.23,P=0.003;HR=1.67,P=0.042 and HR=2.39,P=0.001;HR=1.77,P=0.025 and HR=2.40,P=0.001).Conclusions SUVmax may be one of the useful prognostic factors for OS,DFS,and DMFS in rNPC patients.

Objective To observe the prevention and treatment of the total flavonoids from Litchi chinensis Sonn( TFL) on hepatic fibrosis induced by dimethylnitrosamine(DMN)in rats, and to explore its mechanism. Methods Ninety SD rats were randomly divided into six groups, normal control group, model control group, colchicine group, high-, medium- and low-dose TFL group(n=15).Expect for normal control group, the other groups were given intraperitoneal injection of 2 mL.kg-1 of 5% dimethylnitrosamine for 4 weeks as the model group. The rats in the normal control group and model control group were given 5 mL.kg-1of 0.9% sodium chloride solution, colchicine group was treated with 0.1 mg.kg-1 colchicine.High-, medium-and low-dose TFL groups were given 200, 100 and 50 mg.kg-1 of TFL.The rats were sacrificed and the livers were harvested and stained with HE and Masson staining to observe pathological changes and liver fibrosis in the same part 6 weeks after all the medicine was given to the rats each day. Immunohistochemistry and Western blotting were used to detect the expression of the transforming growth factor β-Ⅰ/type Ⅱ receptor ( TβRⅠ/Ⅱ) , collagen Ⅰ( Col Ⅰ) and Ⅲ collagen ( Col Ⅲ) . Results Compared with the normal control group, the semiquantitative score of liver fiber and the protein expression of TβRⅠ, TβRⅡ, ColⅠ and Col Ⅲ in the model control group were significantly increased(P<0.01).Compared with the model control group, the protein expression levels of TβR, TβRⅡ, ColⅠand ColⅢwere significantly decreased( P<0.01) in the high-,medium-and low-dose TFL group.The semiquantitative score of liver fiber was significantly decreased( P<0.01) with a dose-effect relationship. Conclusion TFL can inhibit formation of DMN-induced liver fibrosis in rats, which may be related with reduction of expression of TβRⅠ/Ⅱ of hepatic fibrosis promoting factor TGF-β1 , inhibition of the activation and increase of hepatic stellate cells, reduction of the collagen content.

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) is the integration of functional imaging and anatomic information,which is found to be particularly valuable in TNM staging,tumor volume delineating,post-treatment assessment,identification of recurrent and residual nasopharyngeal carcinoma (NPC).The combination of 18F-FDG PET-CT with other image technologies,different tracer agents,and specific molecular biomarkers can improve the application value of 18F-FDG PET-CT in NPC.

Based on the Hunan province research site, from the egalitarian concrete analysis of the province since the new reform of basic medical insurance of urban and rural reform and the fairness of the situation, think the current reform of insurance of primary medical treatment to a certain extent, promote the economy of the basic medical service accessibility and equity, but rural population and urban population in the benefit of insurance of primary medical treatment is still a gap, should be by advancing the basic medical insurance system of urban and rural integration manage-ment, gradually promote the fairness of health care among different populations.

OBJECTIVE To explore a more effective method of detecting sleep respiratory events in children. METHODS Thirty-eight children were tested with HypnoPTT and 31 with polysomnography (control). The test parameters and operative methods were compared. RESULTS In addition to the parameters comm.on to both HypnoPTT and polysomnography, inspiratory flow limitation and spontaneous microarousal can be measured using HypnoPTT and fewer electrodes were needed. CONCLUSION HypnoPTT is a convenient method characterized by less sleep disturbance and credible results, rendering it is especially suitable for pediatric cases. Pulse transit time is a useful parameter for diagnosing the sleep respiratory disease.

Objective To investigate the therapeutic effects of botulinum toxin type A (BTX-A) in elderly patients with primary intractable trigeminal neuralgia.Methods 27 elderly patients with primary intractable trigeminal neuralgia were treated with BTX-A local multiple point injection.The efficacy was assessed by visual analog scores (VAS) before and 1 week,2 weeks,1 month,3 months and 6 months after the treatment.Results VAS scores was (9.2±1.1),(5.8±3.0),(3.6± 2.3),(2.3±2.3),(3.2±2.9) and (4.6±3.2) before and 1 week,2 weeks,1 month,3 months and 6 months after BTX-A treatment respectively.VAS score was gradually decreased,reached the lowest at 1 month after BTX-A injection,and then was gradually increased.There were significant differences in VAS scores between between pre-and post-treatment (P＜0.05).The efficiency was 37.0％,85.2％,92.6％,70.4％ and 59.3％ at 1 week,2 weeks,1 month,3 months and 6 months after the treatment respectively.There were significant differences in efficacy between different time points after the treatment (all P＜0.05).3 patients had the transient numbness of mouth askew and incomplete eyelid closure and recovered spontaneously after 4-8 weeks.No severe adverse effects were found in the other 27 patients.Conclusions BTX-A is safe and effective in the treatment of primary intractable trigeminal neuralgia in elderly patients.

Objective To study the difference ofLeonurus japonicus germplasm resources and provide good materials for breeding.Methods Totally 20 wildLeonurus japonicus germplasm resources from different places of China were collected. Experiment was conducted in homogeneous garden in Quzhou City of Zhejiang Province. Phenological phase, cold endurance and habitat adaptability were observed; the plant height, fresh weight and dry weight in early flowering were measured; the contents of stachydrine hydrochloride and leonurine hydrochloride were determined in early flowering and out-of-season cultivation.Results Considering the habitat adaptability, dry plant weight in early flowering, the contents of stachydrine hydrochloride and leonurine hydrochloride separately in early flowering and out-of-season cultivation, it was believed that the germplasms from Linbao County, Sheqi County in Henan Province and Guidong County in Hunan Province were better, in which Linbao germplasm was the best: the dry plant weight was 30.6 g, the content of stachydrine hydrochloride and leonurine hydrochloride were 1.31% and 0.19% respectively in early flowering, and were 3.44% and 0.37% respectively under anti-season cultivation, and it can be well adapted in Zhejiang Province.Conclusion The germplasm ofLeonurus japonicas from Lingbao can be the best materials for breeding.

OBJECTIVE To evaluate the clinic feature and therapeutic principles and to improve curative effect of mucoepidemoid carcinoma originated in nasal cavity and nasal sinuses. METHODS A restrospective review of clinic features ,therapeutic methods and consequences was undertaken in thirty cases with nasal cavity and nasal sinuse mucoepidemoid carcinoma and treated at the 81st hospital of CPLA from 1990 to 2001. RESULTS Twenty patients received surgery、radiotherapy and chemotherapy, of which sixteen survived in five to ten years follow-up . Six patients received surgery and radiotherapy, of which four survived in five years follow-up. Only one out of two patients who received radiotherapy and chemotherapy respectively survived in five years follow-up. The total five years survival rate was 73 %(22/30). CONCLUSION CT or MRI scan may be helpful to evaluate the location and scale of mucoepidemoid carcinoma.Final diagnosis rely on histopathology examination. Early radical resection combined with radiotherapy and chemotherapy pre- or postoperatively could improve five-year-survival rate and reduce recurrence rate.

Intensity-modulated radiotherapy(IMRT)is the first-line treatment for nasopharyngeal carcinoma currently. Previous studies have shown that regression of primary tumor and metastatic lymph nodes or a decrease in body weight causes the contour of normal organs and head-and-neck to shrink during the course of radiotherapy, which may lead to underdose in primary tumor and overdose in organs at risk (OARs)and then adversely affect treatment outcomes. Replanning during the course of radiotherapy can maintain the dose to target volume and reduce the exposure of OARs, which improves outcomes in some patients. For replanning during the course of IMRT, however, the advantages have not been widely recognized and there is still a long way to go before widely accepted timing and frequency of replanning are set up. Further studies are needed to figure out how to identify patients appropriate for plan modification.