Objective To evaluate the effect of stereotactic radiotherapy combined with conventional radiotherapy for non-small cell lung cancer(NSCLC)patients with positive stump at the resected bronchial margin. Methods From June 1996 to November 2000, 41 NSCLC patients in whom microscopic residual disease found pathologically at the resected bronchial margin were treated by: conventional radiotherapy followed by stereotactic radiotherapy ( RT+SRT group 18 patients), while the other 23 patients received routine radiotherapy alone (RT group). Results The 1-,2-and 3-year local disease-free rates were better in RT+ SRT group (92.3%,~83.1% and 83.1%) than those in RT group (80.2%,60.2% and 39.5% ). However, no significant difference was found in the complication rate or survival rate between the two groups. Conclusions Stereotactic radiotherapy is effective as a boost irradiation to patients with non-small cell lung cancer with microscopic residual disease at the resected bronchial margin by improving the local control.

Objective To investigate the prevalence of morphological abnormalities of the internal carotid artery and relationship with ischemic cerebrovascular disease and carotid atherosclerosis.Methods A total of 511 consecutive patients were enrolled in this study and carotid abnormalities were classified according to the criteria of Wain and Metz by combining high-and low-frequency ultraaonography prospectively.Relationship of carotid abnormalities to ischemic cerebrovascular disease and carotid atherosclerosis were analyzed.Results Of the 511 cases,abnormalities of the internal carotid artery were found in 256(50.1 ％),the unilateral carotid abnormalities were found in 121(23.7％),and the bilateral in 135(26.4％),respectively.There was significantly difference in prevalence of kinking and coiling between ischemic stroke and asymptomatic group(P＜0.001),and prevalence of carotid abnormalities in the plaques and arteriosclerosis groups were statistically higher than the normal group(P＜0.001).Conclusions The kinking and coiling of the internal carotid artery could be additive risk factors in the pathophysiology of an ischemic stroke,and carotid morphological abnormalities could be responsible for carotid atherosclerosis partly.

Objective To explore the expression of discoidin domain receptor 1 (DDR1) in rats with pulmonary fibrosis induced by paraquat (PQ) poisoning, and its relationship with the expression of transforming growth factor-β1 (TGF-β1). Methods 120 Sprague-Dawley (SD) rats were divided into control group and 20, 40, and 80 mg/kg PQ poisoning groups (each n = 30). Pulmonary fibrosis induced by PQ poisoning model was reproduced by one time administration of 20, 40, 80 mg/kg of 20% PQ, and the rats in control group were given 4 mL normal saline. Fifteen rats in control and different doses of PQ groups were sacrificed at 7 days and 21 days after intragastric administration, and lung tissues were collected. Pulmonary fibrosis was observed after hematoxylin-eosin (HE) staining. The immune-histochemical method was used to determine the expressions of DDR1 and TGF-β1. The relationship between the expression of TGF-β1 and DDR1 was analyzed by Pearson correlation analysis. Results The rats in control group were active, and no pathological changes in lung tissue were found. The rats in PQ groups became shortness of breath, bristles, and slow reaction etc. 0.5 hours after intragastric administration. After 7 days, the lung tissue was dark red, hard texture, appearance of yellow soil fiber nodules and obsolete hemorrhage, destruction of alveolar structure. The extent of lung injury increased gradually with the time of poisoning and the increase of PQ dose. It was shown by immune-histochemical staining that the control group had only a small amount of DDR1 and TGF-β1 positive expressions; in PQ groups, there were a large number of DDR1 and TGF-β1 positive expression particles in the alveolar wall, pulmonary interstitial and alveolar cavity. It was displayed by quantitative analysis that compared with the control group, DDR1 and TGF-β1 expressions were significantly increased in 20, 40, 80 mg/kg PQ groups with time- and dose-dependent [DDR1 (integral A value): 0.221±0.014, 0.249±0.021, 0.364±0.016 vs. 0.121±0.036 at 7 days; 0.247±0.025, 0.321±0.015, 0.432±0.027 vs. 0.139±0.021 at 21 days; TGF-β1 (integral A value): 0.230±0.016, 0.265±0.015, 0.339±0.016 vs. 0.129±0.032 at 7 days; 0.248±0.011, 0.295±0.016, 0.399±0.026 vs. 0.119±0.026 at 21 days; all P < 0.05]. It was shown by Pearson correlation analysis that DDR1 expression was positively correlated with TGF-β1 expression with the increase of PQ dose and poisoning time (DDR1 with TGF-β1: r = 0.996, P < 0.000; DDR1 with PQ dose: r = 0.985, P < 0.000; DDR1 with poisoning time: r = 0.989, P < 0.000; TGF-β1 with PQ dose: r = 0.992, P < 0.000; TGF-β1 with poisoning time: r = 0.972, P < 0.000). Conclusions The expression of DDR1 in the lung tissue in PQ poisoning rats showed a time- and dose-dependent change, and it was positively correlated with TGF-β1 expression. DDR1 may be involved in the process of pulmonary fibrosis induced by PQ poisoning.

Objective To integrate the present information systems such as HIS,EMR,LIS and UIS into an integrated medical information platform.Methods The drawbacks in point-to-point mode and mid-database mode were avoided in aspects of upgrading and maintaining,and medical data exchange technology was used to research the hot spots of hospital information construction.Results The practice has proved that the new technology in the Web Services and ZeroC ICE provides a more effective model for new generation middle ware technology and digital hospital construction.Conclusion Combined with the development of SOA technologies to analyze the development and evolution of technology,the construction direction of medical data exchange are put forward from double angle of technical and business.

Objective To explore the clinical features, diagnosis, and treatment of Kawasaki disease in neonates. Methods The diagnosis and treatment of incomplete Kawasaki disease in one case were retrospectively analyzed. The related literatures were reviewed. Results Male infant had persistent fever with rash at 26 days after birth. The anti-infective treatment was ineffective. No abnormality was found in the first coronary artery ultrasonography. However, coronary artery dilatation was confirmed by ultrasonography after skin peeling at fingertips. After the treatment of gamma globulin and aspirin, the symptoms of fever and rash were improved. The left dilated coronary artery returned to normal after 3 month. The size of coronary artery and the corresponding indexes were normal in 6-months, 1-year and 3 year follow-ups. Conclusion Neonatal Kawasaki disease is rare and atypical.

Objective To investigate the changes of serum cytokines and explore their role in infants with cytomegalovirus (CMV) infection. Methods We recruited 41 positive CMV-IgM plus normal ALT infants (other disease group), 30 positive CMV-IgM plus abnormal ALT infants (hepatitis group) and 30 healthy infants (control group) in the study. The levels of tumor necrosis factor-?(TNF-?), interferon-?(IFN-?) and interleukin-4 (IL-4) in serum were measured with ELISA. The association between TNF-? and ALT was analyzed. Results The levels of TNF-?, IFN-?, IL-4 were higher, and IFN-?/IL-4 was significantly lower in the two CMV infection groups than the control group. Compared with other disease group, the changes of TNF-?, IL-4, and IFN-?/IL-4 showed significance in hepatitis group. The level of TNF-? showed a positive association with ALT in hepatitis group(r=0.76,P

Purpose To evaluate the value of imaging on the diagnosis and treatment of human-infected H10N8 virus. Materials and Methods The chest X-ray and CT features of one case of human infected H10N8 virus were retrospectively studied. Results A 73-year-old female patient was admitted to the third affiliated hospital of Nanchang University on November 30, 2013 due to cough, sputum for 3 days and fever for 1 day. The patient was diagnosed with severe pulmonary infection and underwent chest CT on December 1, which showed large opacities with air bronchograms were in the lower lobe of her right lung and ground-glass exudative lesions in the lower lobe of the left lung;the next 24 h, 48 h and 72 h review tracking chest X-ray showed the chest lesions developed rapidly which involved more lobes with more areas, integration of lesions and plenty of pleural effusion in a very short time. This was a typical white lung sign of acute respiratory distress syndrome. The patient died later on December 6, which was reported as the case of human-infected avian influenza (H10N8 virus) by Chinese Center for Disease Control and Prevention. Conclusion The chest imaging features found in human infected H10N8 virus present as progressive opacities and exudative lesions.

Objective To discuss the etiology, clinical features and prognosis of non benign neonatal arrhythmias. Method Clinical data of 27 cases of non benign neonatal arrhythmias diagnosed from January 2005 to January 2010 were retrospectively analyzed. Results Among 27 neonats, there were 15 male and 12 female. Fourteen cases were early neonatal and 13 were late neonatal. Gestational age was less than 32 weeks in 6 cases, and more than 32 weeks in 21 cases. In 19 cases with tachyarrhythmia, 14 cases were induced by respiratory infection. The causes of 8 newborns with bradycardia arrhythmia were congenital heart disease (3 cases), electrolyte disturbance (2 cases), severe asphyxia with sepsis (2 cases), and severe asphyxia (1 case). The onset age and gestational age were lower in cases with bradycardia arrhythma that those in cases with tachyarrhythmia (P<0.005). The cure rate and effective rate of tachyarrhythmia was 89.5%and 100%, of bradycardia arrhythmia was 0%and 12.5%, respectively, and the differences were signiifcant (P<0.005). Conclusion Clinical characteristics, pathogenesis and prognosis were different between tachyarrhythmia and bradycardia arrhythmia in neonates.

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

Objective To investigate color Doppler flow imaging features of the ophthalmic artery,external carotid artery,which is known the secondary compensatory collateral circle,in patients with unilateral internal carotid artery occlusion.Methods A total of 42 patients with unilateral internal carotid artery occlusion were enrolled,and ipsilateral and contralateral ophthalmic artery,external carotid artery were examined by color Doppler flow imaging,prospectively,peak systolic velocity,pulsatility index and resistance index were analyzed and compared with findings of control group.Results In the 42 cases with internal carotid artery occlusion,the compensatory collateral circle was observed by the external carotid artery and ophthalmic branches,through their communicating arteries in 40 (95.2％) cases of chronic occlusion.Compared with the contralateral side,the ophthalmic arteries were characterized by retrograde blood flow,peak backward shifting,increase of diameter [(1.91 ± 0.53) mm vs (1.69 ± 0.34) mm,P =0.009] and peak systolic velocity [(43.41 ± 27.28) cm/s vs (29.91 ± 14.16) cm/s,P =0.003],reduced pulsatility index (1.18 ± 0.49 vs 1.69 ± 0.73,P =0.000) and resistance index (0.65 ± 0.26 vs 0.75 ±0.12,P =0.000),and prolonged acceleration time [(147.71 ± 56.16)ms vs (51.80 ± 7.81)ms,P =0.000].Ophthalmic arteries had antegrade blood flow with a decrease of peak systolic velocity and resistance in another two cases of acute thrombosis of ICA.Conclusions External-ophthalmic-internal carotid artery passway is another compensatory collateral circle for the chronic occlusion,but only by ipsilateral and contralateral internal carotid artery circle,for acute thrombosis.