Objective To analyze the efficacy,complications and prognostic factors of three-dimensional conformal radiotherapy(3 DCRT)for locally advanced non-small cell lung cancer(NSCLC).Methods 56 patients who were treated either by radiotherapy alone(14 patients)or radiotherapy plus chemotherapy(42 patients)from Jan.2005 to Feb.2008 were enrolled.The patient cohort consisted of 36 men and 20 women,median age 62,median total dose 60 Gy.Results The following-up rate was 96%.The number of patients completed follow-up were 14 and 10,respectively at 3-year and 5-year.The response rate of 3DCRT was 70%.with complete mmission 9%and partial remission 61%.The 1-、3-、and 5-.year survival rates were 62%、25% and 17%,respectively,and the median survival time(MST)was 20 months.By logrank test,clinical stage,KPS perfomance,tumor volume,radiation dose,treatment regimen and response to treatment showed statistically dramatic impact on overall survival.By Cox muhivariable regression,the independent adverse prognostic factors by both univariate analysis and multivariate analysis were clinical stage,treatment type,and response to treatment.Grade 2 acute radiation pneumonitis was observed in 1 patient and grade 3 in 1 patient.Late grade 2 lung injury developed in 1 patient,and grade 3 in 1 patient.Acute grade 1 radiation esophagitis were observed in 20 patients.and above Grade 2 in 5patients.Acute grade 1+2 hematologic toxicity developed in 15 patients,and above Grade 2 developed in 4 patients.Conclusions 3 DCRT was feasible in the treatment of locally advanced NSCLC with acceptable normal tissue toxicity.Relative early stage.radio-chemotherapy with total radiation dosage≥60 Gy and good immediate tumor response are favorable prognostic factors for overall survival.

ObjectiveTo determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC)treated with radical intent.MethodsWe searched The Cochrane Library,MEDLINE,EMbase,CBM,CNKI and VIP.The quality of the includedstudieswascriticallyevaluated.Dataanalyseswereperformed usingtheCochrane Collaboration's RevMan 5.1 software.ResultsFour randomized controlled trials involving 905 patients met the inclusion criteria.The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group ( x2 =1.98,P =0.000 ) ; but there is no evidence of 1-year overall survival (OS) benefit ( x2 =1.12,P =0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P =0.600) or ADL ( P =0.880) after PCI,but there was a significant decline in immediate recall (P=0.030) and delayed recall (P =0.008 ) at 1 year,At 1 year,there was no significant differences in QOL after PCI ( P =0.050).Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation.There is insufficient evidence to support the use of PCI in clinical practice.Where possible,patients should be offered entry into a clinical trial.

ObjectiveTo explore the optimal method of protecting bone marrow in postoperative concurrent chemoradiotherapy of stage Ⅱ - Ⅲ rectal cancer by comparing two techniques of intensitymodulated radiotherapy (IMRT). MethodsFifteen patients with stage Ⅱ - Ⅲ rectal cancer after surgery had CT simulation. Clinical target volume, small bowel, bladder and bone marrow were contoured. Two IMRT treatment plannings with and without bone marrow-sparing (BMS-IMRT and IMRT) were separately designed. The dose distribution was compared based on that 95％ of the planning target volume received the prescribed dose. ResultsBMS-IMRT had an advantage over IMRT in terms of conformity indices ( 1. 06∶1. 04, t =- 2. 61, P =0. 023 ), but inferior to I M RT for homogeneity indices ( 0. 81 : 0. 75, t =- 2. 34, P =0.037)).Compared with IMRT, BMS-IMRT reduced the V5, V10, V20, V30, V40 of bone marrow (97.09％∶98.72％, t=-2.34, P=0.037;92.38％∶96.46％, t=-2.41, P=0.033;83.36％∶91.70％, t=-3. 18, P=0.008;51.47％∶69.65％, t=-4.92, P=0.000;36.34％∶49.57％, t=-2.66, P =0. 021 ). The doses received by small bowel and bladder were similar between BMS-IMRT and IMRT, except that the V20 of bladder was lower in BMS-IMRT (77. 32％∶92. 39％, t =-3.52, P=0. 004). Conclusions BMS-IMRT reduces low dose volume of bone marrow without increasing dose to other risk organs.BMS-IMRT might reduce acute hematologic toxicity and increase the feasibility of postoperative concurrent chemoradiotherapy in stage Ⅱ -Ⅲ rectal cancer.

Objective To analyze the clinical epidemiology of primary hepatocellular carcinoma (PHC) in the Xinjiang region. Methods Clinical data of the patients with PHC were collected at First Affiliated Hospital of Xinjiang Medical University from 5 577 cases from January 2002 to December 2014, their gender, race, age, household distribution, hepatitis virus-positive rate were analyzed retrospectively. Results Among the 5 577 eases, the men/women gender ratio was 3.45∶1;the proportion of Han, Uighur, Kazakh, and other ethnic groups (Hui, Mongolian, Manchu, Xibo) was 79.67%, 9.86%, 4.55%, 3.31%and 2.61%, respectively. The Constituent ratio difference between Uighur and Han was significant (P<0.05);4 232 patients had hepatitis B surface antigen (HBsAg) detection, and 3 833 patients had HCV antibody (HCV-Ab) detection. HBsAg was positive in 2 560 cases (60.49%), HCV-Ab was positive in 490 cases (12.78%). Hepatitis B virus detection positive rate in Uygur was 35.52%, in Kazak was 40.00%, which was lower than the Han's (65.68%, P<0.05). Urban and rural population had 3589 cases (64.35%) and 1988 cases (35.65%). Conclusion An increased risk for PHC was found in hepatitis virus-positive patients, the Xinjiang Uygur and Kazak people had significantly lower prevalence of HBV infection than the Han's. Appropriate measures should be taken for clinical diagnosis, treatment and prevention of PHC.

Objective To investigate the relationship of PI3K/Akt signaling pathway with the activation of hepatic stellate cells (HSC) and its role in radiation-induced hepatic fibrosis.Methods HSC was treated with 6 MV X-ray irradiation (IR) together with the inhibitor of PI3K/Akt signaling pathway.The cells were divided into inhibitor group,10 Gy IR group,10 Gy + inhibitor group,20 Gy IR group,an 20 Gy + inhibitor group and blank control group.Then cell apoptosis rate was detected,the expression of transforming growth factor β1 (TGF-β1) in cell supernatant and the mRNA expressions of α-smooth muscle actin (α-SMA) and phosphorylation protein kinase B (p-Akt) were measured.Results Compared with the control group,the apoptosis rate of 10 and 20 Gy IR group increased with irradiation dose (t =8.43,11.63,P ＜0.05) but they were reduced by the inhibitor of PI3K/Akt (t =8.09,4.88,P ＜0.05).The expressions of TGF-β1,α-SMA,and p-Akt also increased with irradiation dose (t =6.91,7.80,9.28,P＜0.05) but they were declined by this inhibitor for both 10 Gy IR (t =6.17,15.11,10.34,P＜0.05) and 20 Gy IR (t =10.04,6.85,23.84,P＜0.05).Conclusions X-ray irradiation could activate HSC through PI3K/Akt signaling pathway,which may further result in hepatic fibrosis.

Objective To study the recogniting patients identity for the safety and reliability of radiotherapy. Methods Through PDCA 4 footwork, namely, plan, do, check, action the technicians in the hospital to improve patients' identity verification.Results After 4 months of PDCA cycle,the patient identity verification qualified rate increase gradually,from 88.17% up to 99.07%,the privacy of patients satisfaction rate rose from 52. 69% to 98. 15%. The patients identification accuracy rate of 100%, technicians working efficiency has been greatly improved. Conclusions The measure of patient identification can improve the working process of radiotherapy for safety and efficiency and can get better privacy protection.

Objective To systematically evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for resectable stage Ⅰ non-small cell lung cancer (NSCLC).Methods Clinical trials of SBRT or surgery for resectable stage Ⅰ NSCLC were collected by computerized search of Cochrane Library,MEDLINE,EMbase,CBM,CNKI,and VIP.Literature selection,quality evaluation,and data extraction were performed by two inspectors based on the inclusion and exclusion criteria.A meta-analysis was performed on the enrolled studies using RevMan 5.3 software.Results A total of four clinical trials involving 410 patients were included.The results of meta-analysis showed that there was no significant difference in 3-year overall survival rate between SBRT and surgery (RR=1.13,95％ CI=0.66-1.94,P=0.66);there was no significant difference in local control rate between SBRT and surgery (RR=0.71,95％ CI=0.26-1.93,P=0.50);patients treated with SBRT had significantly lower incidence rates of grade 3-4 adverse reactions than those treated with surgery (RR=0.29,95％ CI=0.16-0.53,P=0.000).Conclusions SBRT shows equivalent efficacy to surgery in the treatment of resectable stage Ⅰ NSCLC.However,due to the limitations in this systematic evaluation,the conclusion needs to be further confirmed by large randomized controlled trials.

Objective To evaluate the treatment outcome and prognostic factors in patients with grade Ⅲ/Ⅳ glioma following postoperative chemoradiotherapy.Methods A retrospective analysis was performed on the medical records of 119 patients with grade Ⅲ/Ⅳ glioma who received treatment in our hospital from January 2007 to April 2012.Of the 119 patients,49 received radiotherapy alone,21 received radiotherapy combined with nitrosoureas,and 49 received radiotherapy combined with temozolomide.The Kaplan-Meier method was used to calculate overall survival (OS) rates and recurrence rates.The Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 94.1％.Fifty-three patients were followed up for at least 1 year,and 10 for at least 2 years.The overall recurrence rate was 69.7％.The 1-and 2-year OS rates were 44.5％ and 8.4％,respectively.The multivariate analysis showed that age,presence or absence of seizures before surgery,extent of tumor resection,and radiotherapy plus concurrent and adjuvant temozolomide were the main prognostic factors for tumor recurrence (P =0.002,0.005,0.000,and 0.000).The above factors and the pathological grade of tumor were the independent prognostic factors for patients' survival (P =0.006,0.010,0.000,0.000,and 0.001).Conclusions Postoperative radiotherapy plus concurrent and adjuvant temozolomide produce a good clinical effect in patients with grade Ⅲ/Ⅳ glioma.Age of ＜ 60 years,no seizures before surgery,total tumor resection,and pathological grade Ⅲ of tumor are the favorable prognostic factors for the long-term survival in patients with malignant glioma.

Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.

Objective: To observe the efficacy and safety of 308 nm excimer light combined with compound triamcinolone acetoniazole cream in the treatment of chronic hand eczema. Methods: From February 2016 to August 2017, 62 patients with chronic hand eczema admitted to the First People's Hospital of Taicang were divided into two groups using random digital tables, with 31 cases in each group.The treatment group was given 308nm excimer light combined with compound triamcinolone acetoniazole cream.The control group was treated only with compound triamcinolone acetoniazole cream.The effect after 4 and 8 weeks of treatment were determined in both two groups. Results: After 4 and 8 weeks of treatment, the effective rates in the treatment group were 35.48% and 87.10%, respectively, which in the control group were 29.03% and 61.29%, respectively.After 8 weeks of treatment, the difference between the treatment group and the control group was statistically significant(χ²=5.39, P<0.05). Conclusion 308 nm excimer light combined with triamcinolone acetoniazole cream in the treatment of chronic hand eczema has good clinical effect and less adverse reactions, and the recurrence rate is low.