OBJECTIVE: The purpose of this study is to investigate the effective of alternating Chemo-radiotherapy for locally Advanced Nasopharyngeal Carcinoma. METHOD: Retrospective analysis 106 cases of patients with locally advanced nasopharyngeal carcinoma between November 2005 and March 2007. All patients received cisplatin-based chemotherapy but 15 patients received radiotherapy(RT) alone. Inducing chemotherapy (IC) + RT + adju-vant chemotherapy (AC) regimen in 36 patients, IC+RT regimen was delivered in 25 patients and AC + RT regimen in 30 patients. 61 patients received 1 to 2 cycles of inducing chemotherapy and 66 patients received 3 to 6 cycles of adjuvant chemotherapy after radiotherapy. Chemotherapy started on the first day after the end of the induction chemotherapy, adjuvant chemotherapy begun after radiotherapy for a week. All patients were treated by radiotherapy using 60 Co r-ray, the nasophyarynx primary site was given a total does of 68 -74 Gy. The lymph nodes of the neck was given 60 to 70 Gy. The prophylactic irradiation does of the neck was 48-50 Gy. RESCULT: The median follow up time was 51 months. A total of 58 patients died, the overall survival rate was 45% in whole groups. The 5-year overall survival rates were 33%, 63%, 60% and 50% in RT, IC + RT + AC, IC + RT and RT+AC group, respectively. The 5-year disease-free survival rates were 13%, 56%, 48% and 40% in RT, IC + RT + AC, IC + RT and RT + AC group, respectively. The 5-year relapse-free survival rates were 13%, 53%, 48% and 50% in RT, IC + RT + AC, IC + RT and RT + AC group, respectively. The 5-year metastasis-free survival rates were 6%, 50%, 44% and 47% in RT, IC + RT + AC, IC+ RT and RT + AC group, respectively. There was significant difference in all groups (P < 0.05). The median time to relapses were 22 months, 29 months, 28 months and 25 months in RT, IC + RT + AC, IC + RT and RT + AC group, respectively. The median time to first distant metastasis were 10 months, 19 months, 15 months and 12 months in RT, IC + RT + AC, IC + RT and RT + AC group, respectively. There was no significant difference in all groups (P > 0.05). IC + RT + AC group had heavier acute toxicity effects than other groups, but it did not affect the treatment process, all patients could be tolerated. CONCLUSION This retrospective study has demonstrated that alternating Chemo-radiotherapy and early radiotherapy not only can improve the survival rate for locally Advanced Nasopharyngeal Carcinoma, but also have slight toxicities and side reaction, all patients may tolerated.
Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma ; Chemotherapy, Adjuvant ; adverse effects ; Cisplatin ; administration & dosage ; Disease-Free Survival ; Female ; Humans ; Induction Chemotherapy ; adverse effects ; Male ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; mortality ; pathology ; radiotherapy ; Neoplasm Staging ; Radiotherapy Dosage ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Carcinoma ; Cytological Techniques ; Humans ; Nasopharyngeal Neoplasms ; pathology ; Neoplastic Stem Cells ; cytology ; Oncogenes

Chronic Periodontitis ; diagnosis ; diagnostic imaging ; therapy ; Dental Scaling ; Follow-Up Studies ; Furcation Defects ; diagnosis ; diagnostic imaging ; therapy ; Gingival Hyperplasia ; diagnosis ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Periodontal Index ; Radiography, Panoramic ; Root Canal Therapy ; Tooth Loss ; diagnosis ; diagnostic imaging ; therapy ; Tooth, Artificial

ObjectiveTo explore the clinical role of island flap nourished by sural nerve nutrition blood vessel for repairing of the deep burn wounds of the lower extremities.MethodsIsland flap nourished by sural nerve nutrition blood vessel were performed to repair the deep burn wounds of the lower extremities below the knee in 22 cases,aged 10 ～58 years old,average aged 34 years old,including flame burns in 6 cases,electrical burns in 10 cases,chemical burns in 4 cases,scalding hot water in 2 cases.All were deep skin damage,The island flaps,including anterograde and retrograde flaps,was from 5cm ×4cm to 13cm × 10cm in size,The defect at the donor site was sutured primarily or repaired by a skin graft.ResultsAll the flaps survived well,18 patients were follow-up postoperatively for 4 ～24 months.The color,texture,shape of the flaps were satisfactory,but the sensory recovery was unsatisfactory.ConclusionSural neurovascular flap had a constant anatomy and reliable blood supply without the sacrificeof the major blood vessels.The procedure was simple and easy,and an effective method of repairing the skin and soft tissue defects below the knee.

Objective To compare the outcome of proximal femoral nail anti-rotation (PFNA)versus anatomical locking plate (ALP) in treatment of unstable intertrochanteric fracture.Methods The study included 89 patients who had received PFNA fixation (PFNA group,n =45) or ALP fixation (ALP group,n =44) for unstable intertrochanteric fracture between February 2008 and September 2009.Operation time,amount of bleeding,drainage volume,postoperative complications,fracture healing time and hip joint score after fracture healing were compared between two groups.Results Mean operation time in PFNA group was obviously shorter than that in ALP group (61.4 minutes vs 114.8 minutes,P ＜0.01).Mean amount of bleeding and drainage volume were significantly lower in PFNA group than in ALPgroup (119.3 mlvs 136.8ml,P＜0.01; 74.9mlvs80.3 ml,P＜0.01).While,PFNA group was not significantly different from ALP group with regard to average fracture healing time and Harris hip joint score after fracture healing (4 months vs 4.1 months,P ＞ 0.05; 91.2 points vs 89.8 points,P ＞0.05).Two patients had poor fracture reduction in PFNA group,but all patients had good fracture reduction in ALP group.No obvious adverse postoperative complications occurred in PFNA group,but one patient had fracture nonunion in ALP group.Conclusions PFNA and ALP fixation of unstable intertrochanteric fracture present insignificant differences in fracture healing time,postoperative complications and hip joint function after fracture healing.Whereas,PFNA is more suitable for the elder patients on account of shorter operation time and less intraoperative bleeding.

OBJECTIVETo compare the difference in the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication.

METHODSOne hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency electric-pulsing apparatus was used at Dazhui (GV 14) and Shenshu (BL 23), once a day; the treatment of 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time. In the placebo group, starch capsules were taken orally, 1 capsule each time. All the drugs were taken before sleep every night, continuously for 15 days as one session, and 2 sessions were required. PSQI changes and clinical efficacy were observed before and after treatment in each group.

RESULTSPitlsburgh sleep quality index (PSQI) score was reduced in every group after treatment (all P < 0.01). In the low-frequency electric stimulation group and medication group, the score was reduced much more significantly as compared with the placebo group (both P < 0.01). In the placebo group, 1 case was rejected. The total effective rates were 95.0% (38/40), 92.5% (37/40) and 17.9% (7/39) in the low-frequency electric stimulation group, medication group and placebo group separately. The efficacy in the low-frequency electric stimulation group and medication group was better apparently than that in the placebo group (both P < 0.01).

CONCLUSIONThe low-frequency electric stimulation at the acupoints effectively and safely treats post-stroke insomnia and the efficacy of it is similar to that of estazolam.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electric Stimulation ; Female ; Humans ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; etiology ; therapy ; Stroke ; complications ; Treatment Outcome

Objective To investigate the medium-term efficacy of total hip replacement with CFP handle prosthesis.Methods Thirty-two patients (34 hips) undergoing total hip replacement with CFP handle prosthesis were selected.The preoperative diagnosis was:femoral neck fracture in 6 cases,femoral head necrosis in 12 cases,osteoarthritis in 10 cases,ankylosing spondylitis in 3 cases,and pigmentation villi nodular synovitis in 1 case.Ten days,1 month,6 months,and 1 year (a year later) after surgery,the hip joint function and X ray film performance were followed up.Results There was no complication such as infect and injury of blood vessel and nerve.Postoperative X ray film showed the femoral handle prosthesis position was good.The average Harris hip score was 32.6 (20-53) scores before surgery,and back to 95.3(90-100) scores after surgery,no patients needed revision surgery.Postoperative Engh score was above 10 scores after half a year.Conclusion The medium-term efficacy of total hip replacement with CFP handle prosthesis is good,and can be used as one of the choice of primary total hip replacement.

Mechanical ventilation is not only an important treatment method of acute respiratory distress syndrome (ARDS),but also one of the basic treatments in the intensive care unit (ICU).However,mechanical ventilation itself can cause or aggravate acute lung injury,which is called ventilator-induced lung injury (VILI).Currently,clinical pathogenesis of VILI includes four categories such as barotrauma,volutrauma,atelectrauma and hiotrauma.The pathogenesis of mechanical injury has been widely accepted,but the biological injury pathogenesis is unclear.With further research,we found that in the late stage VILI patients occured proliferation of puhnonary fibrosis,which may be formed by partial epithelial-mesenchymal transdifferentiation (EMT).Further study of specific pathogenesis of biotrauma and ARDS pulmonary fibrosis proliferation could provide new ideas for the clinical treatment of VILI.

Objective To discuss specific CT signs of primary trachea,bronchus mucoepidermoid carcinoma.Methods A retro-spective analysis was made on CT features,clinical manifestations and relevant pathology materials of 10 cases of trachea,bronchus mucoepidermoid carcinoma that had been proved by pathological examinations.Results (1)Sites:1 case was in the trachea,1 case in the bronchus,3 cases in lobar bronchus,5 cases in segmental bronchus and they were all central types.(2)Form and size:2 cases were lobular,7 cases were oval or round,1 case was irregular.The maximum diameters of the tumor were 10-39 mm (averagely 25 mm).(3)Edge:8 cases had smooth edge,2 cases had rough edge with infiltration of adjacent pulmonary parenchyma.(4)Densi-ty:6 cases with uneven density,3 cases with even density.The density of 4 cases were higher than that of chest wall muscle,4 cases were similar to chest wall muscle and 1 case lower than chest wall muscle.Calcification can be seen in 4 tumors.(5 )Enhancement features:9 cases underwent CT enhancement scanning,8 cases had mild enhancement and 1 case with light enhancement.(6)Pe-ripheral conditions:all cases showed trachea or bronchus stenosis and blocking,5 cases with obstructive pneumonia,2 cases with obstructive atelectasis,3 cases with far-end bronchus obstructive mucous embolism,1 case with obstructive emphysema,there was no evident swelling in mediastinum or hilar lymph nodes,1 case with multiple pulmonary bulla and pneumothorax in the left lung. Conclusion Primary mucoepidermoid carcinoma of trachea and bronchus is mostly central type,low potential malignancy.CT mani-festations are as follows,occurred in the trachea or bronchus,oval or lobulated masses with smooth edge,slight enhancement,gen-erally with calcification,but few showed invasive growth .

Objective To investgate the effect of Tiao qi xing shui decoction combined with peritoneal injection DDP and IL-2 on Bax,Caspase-3, TGF-β1 gene expression in mouse with ascetes hepatoma,and explore its mechanism from molecular biology.Methods 72 pure lines of Kunming mice were randomly divided into control group,Chinese medicine group,combination of traditional Chinese and Western medicine,in high,middle,low dose group and Western medicine group,each had 12.All mices were killed after treatment,and the expression of Bax,Caspase-3,GF-β1 protein in mouse liver tumor tissues were detected by Immunohistochemical. Results Immunohistochemical results showed that,the positive expression of apoptosis gene Bax protein in high dose group of TCMand Western Medicine was higher than that of control group(P<0.01),and the positive expression of apoptosis gene Caspase-3,TGF-β1 protein in high and middle dose group of TCMand Western Medicine were higher than that of control group(P<0.01).Conclusion The high dose group of TCM and Western Medicine can significantly increase the expression of Bax protein,the high and middle dose guoup of TCMand Western Mdicine can significantly increase the expression of Caspase-3,TGF-β1 protein,induction apoptosis.