OBJECTIVE:To observe clinical effect and safety of temozolomide (TMZ) combined with radiotherapy in the treatment of malignant glioma. METHODS:58 patients with malignant glioma were randomly divided into TMZ-RT group(32 cas-es)and RT group(26 cases). RT group were given the therapy of 3D-CRT 1.8-3 Gy/d,and some patients received the hyperfrac-tion radiotherapy with total dose of 60-75 Gy. TMZ-RT group were given TMZ chemotherapy 75 mg/(m2·d)combined with radio-therapy for 6 weeks and TMZ sequential therapy 150-200 mg/(m2·d)for 4 weeks. Therapeutic efficacy and ADR were observed in 2 groups. RESULTS:After treatment,in TMZ-RT group,9 cases had complete remission,11 cases had partial remission,10 cas-es were stable and 2 cases were progressive;in RT group,6 cases had complete remission,8 cases had partial remission,8 cases were stable and 4 cases were progressive. There was no statistical significance in short-term efficacy between 2 groups(P>0.05). The 1,2,3-year survival rates of TMZ-RT group were 81.3%(26/32),78.1%(25/32) and 62.5%(20/32),while those of RT group were 84.6%(22/26),34.6%(9/26)and 15.4%(4/26). There were statistical significance in 2,3-year survival rates between 2 groups (P<0.05). Median recurrent time of TMZ-RT group was (23.2 ± 8.6) months,while that of RT group was (15.6 ± 8.7) months,with statistical significance(P<0.05). According to the KPS,TMZ-RT group was(89.6±9.6)and RT group(65.1±10.1), with statistical significance (P<0.01). The side effect of 2 groups were slight. CONCLUSIONS:Radiotherapy combined with TMZ can significantly improve the survival rates of 2 and 3-year and delay the tumor recurrent time,and lighter adverse reaction. It can be used as new therapy method for malignant glioma. But it needs further study for treating the malignant glioma patients with osteomyelitis or low immune function.

Objective To investigate the therapeutic effects of endovascular management for oculomotor nerve palsy caused by unruptured aneurysm of posterior communicating artery.Methods Endovascular treatment was carried out in 11 patients with oculomotor nerve palsy due to unruptured aneurysm of posterior communicating artery.The choice of the therapeutic opportune moment and the treatment way were retrospectively evaluated.The relationship between the therapeutic results and the treatment time and way was analyzed.Results Of the 11 patients,complete recovery of oculomotor nerve palsy was obtained in 10(90.91%) and partial recovery in one(9.09%).Conclusion Oculomotor nerve palsy cause by unruptured aneurysm of posterior communicating artery can be effectively treated by endovascular management,and the recovery of oculomotor nerve function depends on the time to take treatment and the degree of nerve palsy.

Objective A group of patients who had undergone total hip arthroplasty were followed up radiologically to explore the effects of abduction angle, the anteversion angle and the height of the femoral head center on dislocation, because these measurements could be used as a basis to evaluate current practice and to seek improvements. Methods A series of 326 hip joints (318 patients) were followed up routinely. The average follow up period was 2.7 years. 10 was found to have dislocation. The abduction angle, the anteversion angle and the height of the femoral head center were measured. The results were statistically analyzed, with a P value less than 0.05 indicating significant difference. Results The abduction angle of 55?or larger was found to be associated with greater risk of dislocation, compared with the abduction angle of less than 55?. Meanwhile, cups with the femoral head center superior placement greater than 30 mm resulted in more dislocation, compared with those less than 30 mm. As an independent variable, the anteversion angle had no significant association with dislocation. Conclusions Based on the results of the current study, the abduction angle and the height of the femoral head center should be considered as prerequisites for maintaining hip stability and decreasing the risk of dislocation. We believe that hips with the abduction angle of less than 55?and the height of the femoral head center less than 30 mm can decrease the risk of dislocation.

0.05). The median diameter of the nodules in survival group was smaller (4.3?2.2cm)than that in death group(7.3?2.7cm, P0.05). Ten of 14 survived patients remained clinical free of tumor. In conclusion, RFA could extend survival time for patients with unresectable PHC.

Much attention has been paid to photocatalytic oxidation in the field of air and water purification. Photocatalytic oxidation employs semiconductors such as TiO2, ZnO as a photocatalyst in ultraviolet radiation. Several factors which affect photocatalytic decomposition were discussed in the present paper. Photocatalytic oxidation technique is applicable for the elimination of gas-phase contamination in air.

Objective To explore the way and the clinical value of chest coronal CT scan in children.Methods There were 16 patients with airway or pulmonary diseases proved by clinic underwent chest coronal scan,the ages ranged from 3 months to 5 years.Picker Ultra-Z spiral CT unit was applied,the aperture of the gantry was 70 cm,gantry's maximum tilted angle was 30?.The scanning parameter were :120 kV,200 mA,0.9 s,spiral pitch 1.5,thickness 2 mm,space 1.5 mm.Results The chest coronal images acquired in all cases were good.Tracheobronchial tree up to lobar bronchi were all displayed.Bronchial foreign body in 12 cases,bronchia tumor in 1 cases,lung hypogenesis in 1 case,lung inflammation in 8 cases,atelectasis in 5 cases and the local emphysema in 10 cases were demonstrated on CT images.Conclusion Children's chest coronal CT scan can show the whole tracheobronchial structure.It has high clinical applied values.

As an efficient health care system ,the hierarchical medical system is characteristic of its continuation of the division of work at different levels of medical services in the diagnosis and treatment functions .Two major roadblocks hinder the building of such a system ,namely a serious shortage of primary service capabilities ,and lack of incentives in the referral from superior institutions .Success of such a system lies in enhancement of the service capabilities of primary medical institutions by all means , and smooth functioning of a dual referral system .

Objective To investigate the result of colonoscopic positioning in laparoscopic treatment of colon tumors . Methods A retrospective analysis was made in 16 cases of colon tumors treated with laparoscopic colon resection from January 2014 to November 2015.During the operation, the lesion could not be locatized and the resection range could not be determinated because the serous layer was not involved or the lesion was located in the lateral abdominal wall .Transanal colonoscopic positioning of the lesion with light transmission method was carried out . Results The pathological changes were found under colonoscopy in all the 16 cases and the laparoscopic resection was successfully completed without conversion to open operation .No missed resection or incorrect resection occurred.The operation time was (112.5 ±31.0) min and the blood loss was (22.8 ±11.2) ml.Among 9 cases of preoperative pathological diagnosis of benign tumors , there were 6 cases of malignant tumors after surgery , including 4 cases of moderately differentiated adenocarcinoma , 1 case of moderate to severe atypical hyperplasia with cancerous lesions , and 1 case of moderately differentiated adenocarcinoma with mucous adenocarcinoma .A total of 15 patients were discharged from hospital at 12-24 days after the operation , whereas 1 patient was dismissed 1 month after the operation due to anastomotic fistula .The 16 patients were followed up for 3 months with no recurrence under colonoscopic examiantion . Conclusions During laparoscopic colon resection , if the tumor can not be locolized , colonoscopic positioning can help prevent missed resection or incorrect resection , which increases the indication and safety of laparoscopic and colonoscopic minimally invasive treatment .It has good clinical application value and deserves further promotion .

Objective To explore mechanisms of sustained and transient effects in encoding processes of emotional memory by examining activation of amygdala via functional MRI and to provide evidence for understanding the underlying neural mechanism related to emotional memory disorders further. Methods Twenty two subjects (aged from 20 to 24 years old) participated in the study and mixed blocked/event-related design was adopted. Sixty negatively emotional pictures and sixty neutral scene pictures were used. Functional MRI scanning was performed while subjects were doing encoding tasks. Behavioral data were acquired during retrieval. Correlation analyses of functional MRI data and simples paired t -test of behavioral performance were performed with SPM2 and SPSS13.0 statistical software,respectively. Results Significant differences of behavioral performance ( t= 2.791,P= 0.01 ) was found between emotional (3.15 ± 0.14) and neutral (2.25 ± 0.08 ) pictures. A whole-brain voxelwise correlation analysis between functional MRI and emotional enhancement effect indicated that the transient effect of emotional enhancement of memory involved the left amygdala, left hippocampus and left lateral orbitofrontal cortex, while the sustained effect involved the right amygdala, right hippocampus, right inferior frontal gyrus, right medial and lateral orbitofrontal cortex. Region of interest analysis demonstrated that the sustained effect was related to the right amygdala (r= 0.50, P = 0.019 ), which was different from transient effect ( Z = 1.655, P = 0.049 ),while the transient effect was correlated with the left amygdala (r=0.65, P=0.001 ) ,which was different from sustained effect( Z= 2.512, P=0.006). Conclusion Different neural mechanisms are involved in sustained and transient effects of emotional memory encoding. The right amygdala is responsible for sustained effect and the left amygdala is responsible for transient effect ,respectively. The results confirm and extend the model of the left-transient/right-sustained effect.

Objective To explore the efficacy and prognostic factors of postoperative intensity?modulated radiotherapy ( IMRT) with or without chemotherapy in rectal cancer. Methods A retrospective analysis was performed on the clinical data of 218 patients with rectal cancer, who underwent postoperative IMRT in our hospital from January 2009 to December 2013. The Kaplan?Meier method was used to calculate survival rate;the log?rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow?up rate was 97. 7%. The 1?and 3?year overall survival rates were 90. 8% and 75. 2%, respectively, the 1?and 3?year disease?free survival rates were 85. 3% and 70. 5%, respectively, and the 1?and 3?year locoregional recurrence?free survival rates were 96. 7% and 88. 1%, respectively. The incidence of grade 3?4 acute adverse reactions was 28. 4%, mainly manifested as leukopenia ( 13. 8%) and diarrhea ( 11. 0%) . Univariate prognostic analysis showed that preoperative carcinoembryonic antigen ( CEA) and CA199 levels, maximum tumor diameter, tumor location, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM stage, perineural invasion, surgical procedure, total mesorectal excision, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 006, 0. 000, 0. 000, 0. 017, 0. 000, 0. 016, 0. 000,0. 011,0. 001,0. 006,0. 037 and 0. 010) . Multivariate prognostic analysis showed that preoperative CEA level, tumor location, TNM stage, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 000,0. 000,0. 000,0. 001 and 0. 001) . Conclusions Postoperative IMRT with or without chemotherapy is an effective method for rectal cancer with mild adverse reactions and high compliance. Preoperative CEA level, tumor position, TNM stage, preoperative bowel obstruction, and preoperative anemia are independent prognostic factors for the overall survival.