Objective To compare the efficacy and adverse reactions of intensity-modulated radiation therapy (IMRT) and conventional pelvic field radiation therapy for middle and advanced cervical cancer. Methods A total of 144 patients with stageⅡB-ⅢB cervical cancer from October 2007 to September 2012 were divided into IMRT group (72 cases), and routine radiotherapy group (72 cases) by using random number table method. The IMRT group was exposed to the 6 MV-X line 7 field, a dose of 46-50 Gy for planning target volume (PTV), 54-60 Gy for gross tumor volume (GTVnd) simultaneously integrated boosted, in 25-28 fractions. The central block of lead 4 cm was changed to 4 fields irradiation, adding to 46-54 Gy for the conventional group after 30-40 Gy of the whole pelvic field. The total dose for the two groups of patients was 30-45 Gy, after completed 30 Gy in vitro exposure, to the cavity irradiation, 5-7 Gy/fraction, and synchronous cisplatin (DDP) sensitization chemotherapy was done synchronously. Results The recent complete remission, partial remission, overall survival ratio of two groups were compared respectively, and the difference was not statistically significant (P > 0.05). The difference in 1 year survival rate of IMRT group and routine radiotherapy group was not statistically significant (χ2= 1.455, P> 0.05). The difference in 3 and 5 year survival rate was statistically significant [76.4 % (55/72) vs. 59.7 % (43/72); 72.2 % (52/72) vs. 55.6 %(40/72), P< 0.05]. Acute radiotherapy major adverse reactions included the digestive system, urinary system, skin response and haematological toxicity (bone marrow suppression). The incidence and degree of skin response in IMRT group was lower than that in routine radiotherapy group (P<0.05). The adverse effects of late radiotherapy were mainly rectal, bladder, skin response and hematological toxicity (bone marrow suppression). The incidence rectal and skin response in IMRT group was lower than that in routine radiotherapy group (P< 0.05). Conclusion The IMRT can improve the survival rate of advanced cervical cancer patients for 3-5 years, reduce the adverse effects of acute and terminal radiotherapy, and improve the quality of life.

0.05).Conclusion The serum cTnT is not useful for diagnosing the severity of anthracycline induced cardiactoxicity.

Aim To study the effect of activating Sonic hedgehog( Shh) pathway on the function of endothelial progenitor cells ( EPCs ) in type 1 diabetic mice. Methods EPCs were isolated and cultured by density gradient method from diabetic mice. The effects of Shh N-terminal peptide and agonist SAG on EPCs prolifera-tion were evaluated by using the MTT colorimetric as-say. EPCs migration was measured by Transwell meth-od. EPCs tube formation ability was estimated by Matrigel . EPCs senescence activity was determined by β-galactosidase staining. Results Compared with control mice, the function of EPCs in type 1 diabetic mice was impaired. The proliferation, migration and tube formation of diabetic EPCs could be promoted by Shh peptide and agonist SAG. The senescence of dia-betic EPCs could be decreased by Shh peptide and ag-onist SAG. Conclusion Activating Shh signaling pathway can improve the impared function of diabetic EPCs in type 1 diabetic mice.

Objective To analyze the clinical and pathological factors that affect the prognosis of gastric cancer patients after radical resection,and study the relationship between biological behavior of gastric cancer and clinical so as to provide clues to the basis for clinical diagnosis and treatment.Methods The clinical and pathological data of the gastric cancer patients who underwent radical resection from January 1999 to December 2009 were retrospectively analyzed.Of the 581 eligible patients were followed up in 179 cases.A database was established for SPSS 13.0 software analysis.Results Single factor analysis showed that the prognosis influencing factors in gastric cancer patients after radical resection were age,tumor location,tumor size,gross type,histological type,depth of invasion,TNM stage,surgical procedure,the cancerous remains of specimen surgical margin and the number of lymph node metastasis (P ＜ 0.05 or ＜ 0.01),no correlation was found between gender and prognosis (P ＞ 0.05).Multiple Cox regression analysis showed that TNM stage and number of lymph node metastasis were independent gastric cancer prognostic influencing factors,and the number of lymph node metastasis was found to be the more significant factor.Conclusions TNM stage and the number of lymph node metastasis are independent prognostic influencing factors in gastric cancer,and the number of lymph node metastasis is the more important factor in gastric cancer prognosis.Therefore,Union for International Cancer Control lymph node staging of gastric cancer is a better indicator for gastric cancer prognosis.

Objective To examine the effect of epigallocatechin gallate (EGCG) at different concentration (0,10,25, 50 and 100μmol/L ) on proliferation rate and apoptosis of nasopharyngeal carcinoma cell line C666-1 in vitro, and elucidate the role of silent information regulator 1 (SIRT1). Methods The proliferation rate in vitro of C666-1 cells stimulated by EGCG at increasing concentrations (0,10,25,50,and 100 μmol/L)for 24 h or at concentration of 50μmol/L for 0,6,12 h and 24 h were detected by cell counting kit-8 (CCK-8) assays. Cell were treated with EGCG at concentration of 0,25, 50 and 100 μmol/L for 24 h, cell apoptosis was anylysed by TUNEL assay and expression levels of SIRT1 protein was detected by western blotting. Results EGCG suppressed cell proliferation of C666-1 cell line in a concentration-dependent manner at concentration of 0 ,10,25,50,and 100μmol/L, and in a time-dependently when treated with 50 μmol/L for 12 to 24 h(P<0.05). After treated for 24 h with different concentration of EGCG at 0、25、50、100 μmol/L, cell apoptosis increased at concentration of 50 to 100μmol/L and expression of SIRT1 decreased in a concentration-dependently (P<0.05). Conclusion EGCG induced cell apoptosis of C666-1 cells by down-regulating SIRT1 expression.

We have reformed our patterns and methods of graduation examination of the medical majors. That is the multi-stage comprehensive graduation examination of the clinical interns, which consists of 70% close written test of clinical theories,20% practical test of clinical skills and also oral test of related theories, and 10% writing of the medical documents. It has proved that these measures have improved the interns' attitude toward practice, aroused their initiative and positivity, and led the practitioners to attach more importance to the combination of clinical practice and theories, thus leading to better clinical education.

Fetal alloimmune thrombocytopenia (FAIT) is a severe perinatal complication, which can seriously affect fetal development, and may even lead to intrauterine hemorrhage and intrauterine death. There are controversies in the clinical diagnosis and treatment of the disease due to its low incidence and limited treatment experience. This paper reviews the progress to date in understanding the condition, incidence, screening of high-risk factors, prenatal and delivery management of FAIT based on domestic and foreign guidelines, in order to help obstetricians in the clinical management of FAIT.

Objective To explore diagnostic value of multi-slice spiral CT imaging features with respect to pancreatic neuroendocrine tumors (pNET) of different histological grades. Methods A retrospective analysis of preoperative abdominal plain CT and dual-phased contrast-enhanced CT was performed in 21 patients (median age, 47 years;12 males and 9 females) with pathologically proven pNET. age, gender, endocrine function, location and size of lesion, cystic change or necrosis, completeness of capsule, calcification, dilation of pancreatic duct were evaluated.CT attenuation-related parameters (plain CT value, relative density index, and CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase) of each tumor were measured or calculated. All tumors were pathologically classified into three histological grades (G1, G2 and G3) based on mitotic count and ki-67 index. Kruskal-Wallis test was performed to compare differences of age, gender, endocrine function, morphological features among different grades. CT attenuation-related parameters were evaluated using Kruskal-Wallis or one-way analysis of variance (ANOVA). Results Twenty four pNET foci [grade G1 (n=13), G2 (n=7) and G3 (n=4)] were seen in the 21 patients. The difference of age, gender among different grades demonstrated no statistical significance (P>0.05). Nine lesions of G1 and 1 lesion of G2 demonstrated endocrine function, and the difference of endocrine function among three grades was statistically significant (χ2=8.355,P=0.012). For G1, G2 and G3, 11, 5 and 2 lesions were seen in uncinate process, pancreatic head and neck, respectively while 2, 2 and 2 lesions in pancreatic body and tail, respectively. The median maximum diameter of pNET of G1, G2 and G3 was 1.5, 2.5 and 6.7 cm, respectively;For G1, G2 and G3, 13, 4 and 0 lesions demonstrated intact capsule, respectively while 2, 3, and 3 lesions cystic degeneration and necrosis, respectivel; 0, 2 and 2 lesions calcification,respectively, 0, 1 and 2 lesions dilation of pancreaticobiliary duct, respectively, 0, 1 and 4 lesions sign of malignancy, respectively. The difference of size of lesion, completeness of capsule, calcification, and dilation of pancreatic duct showed statistical significance (P< 0.05). The difference of location of lesion and cystic change or necrosis displayed no significance (P>0.05). In addition, pNET of different grades demonstrated similar density and relative density index on plain CT. Regarding CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase, the pNET of G2 showed highest value, while pNET of G3 lowest value, however, the difference about CT attenuation-related parameters among three grades showed no significant difference (P>0.05). Conclusion pNET of different histologic grades have some specific CT imaging features, which can facilitate an accurate diagnosis of pNET prior to therapy.

Objective To discuss the correlation between aortic elasticity and coronary artery calcification by CT.Methods Totally 111 patients who were diagnosed of coronary artery disease underwent coronary artery CTA.The images were qualified for aortic elasticity measurement.All patients were divided into calcification negative group (n=43) and calcification positive group (n =68).The calcification positive group was further divided into light,medium,and serious groups according to their calcification scores.The ascending aortic images were reconstructed every 5 ％ R-R intervals.The cross-sectional areas and diameters of aortic in each R-R interval were measured automatically,then diameter variation rate (％ A0),aortic distensibility (A0D),aortic compliance (A0C) and aortic stiffness (A0SI) were calculated to evaluate aortic elasticity.Correlation between aortic elasticity and coronary artery calcification were analyzed.Results ％ A0,A0 D,A0C were lower and A0SI was higher in calcification positive group than those in calcification negative group (all P＜0.05).There was no significant differences in the four reference indexes of aortic elasticity among light,medium,and serious groups in calcification positive group (all P＞0.05).Correlation analysis demonstrated negative correlations between ％ A0,A0 D,A0 C and calcification scores,and a positive correlation between A0SI and calcification scores.Conclusion Aortic elasticity is correlated with coronary artery calcification,and the combination of them will be beneficial for the early diagnosis of coronary heart disease.

This paper aimed to review the recent literature on the TCM treatment for stroke sequelae. The content summarized and discussed the definition of stroke sequelae, herbalmedicine, TCM patents, acupuncture and so on. Sequelae of stroke’s pathogenesis was mainly caused by deficiency generating stasis, so the treatment principles were to tonifying Qi and blood and promote circulation and remove stasis with the common prescriptions, such asBuyang-Huanwudecoction,Xuefu-Zhuyu decoction andDihuang-Yinzi. Meanwhile, Chinese medicine patents and acupuncture treatment canimprove the brain function and ADL.