Objective To investigate the better radiation modalities for single and multiple brain metastases.Methods Between July 2005 and July 2008,50 patients with single or multiple brain metastases were retrospectively analyzed.The primary cancer of all patients were controlled.Thirty patients with whole brain radiotherapy and stereotactic radiosurgery were included in the combination group,and 20 patients with stereotactic radiosurgery were included in another group.Stereotactic radiosurgery prescription doses of 45％-75％ isodose line were used to wrap around the planning target,which was 15-20 Gy in edge and 30-45 Gy in center.Stereotactic radiosurgery was performed once.Whole brain radiotherapy total dose was 40 Gy,which was given to patients by 2 Gy in 1 fraction,1 fraction every day,5 times every week.Results The efficient rate of combination group was 90％ (27/30),and single group was 60％ (12/20).It was obviously higher in combination group (x2 =6.294,P =0.012).For combination group,the 1-year survival rate was 50％ (15/30) and the 2-year survival rate was 30％ (9/30).However,for another group,the 1-year survival rate was 35％ (7/20) and the 2-year survival rate was 15％ (3/20).The survival rates of two groups were no difference (x2 =1.096,P =0.295 ; x2 =1.480,P =0.224).There were no patients survived more than 3 years in both groups.Stratified analyses showed that the l-year survival rates of the patients with single brain metastasis were no difference in two groups (100.0％ vs 66.7％,x2 =1.556,P =0.212).Whereas the 1-year survival rate in combination group of the patients with multiple brain metastases was higher than that in single group (42.3％ vs 29.4％,x2 =11.023,P =0.001).There were no statistically significant differences in 2-year survival rates in both groups with single and multiple brain metastases (75.0％ vs 66.7％,x2 =1.200,P =0.273 ; 23.1％ vs 5.9％,x2 =3.782,P =0.052).Conclusion Whole brain radiotherapy and stereotactic radiosurgery are important treatment modalities for single or multiple brain metastases.The optimal treatment modality for single brain metastasis is stereotactic radiosurgery,while it is a good choice to make whole brain radiotherapy and stereotactic radiosurgery for multiple brain metastases.

Objective:To assess the quality of life (QOL) and cognition function in patients with severe obstructive sleep apnea (OSAHS), and to study the relationship between the QOL and severity of OSAHS, excessive daytime sleepiness (EDS),cognition disorders. Methods:Sixty-two patients with OSAHS and 32 non-OSAHS patients (control group) which all diagnosed by polysomnography (PSG) were chosen from The First Hospital of Lanzhou University, and they were assessed by QOL using the Short-Form 36 Health Survey questionnaire (SF-36), by EDS using the Epworth sleepiness scale (ESS), and for cognition disorders by mini-mental state examination (MMSE).The associations between the total score on the SF-36 and the baseline characteristics, PSG parameters, such as ESS score, and MMSE score were examined by simple regression analysis and stepwise multiple regression analysis.Results:The scores of SF-36 and MMSE in OSAHS group were significantly lower than the control group (63.9?14.7/78.8?4.5, 24.6?2.0/27.1?1.3,P

Objective To evaluate the effect of catheterization on the serum prostate specific antigen (PSA) in acute urinary retention (AUR) patients due to benign prostate hyperplasia (BPH). Methods The data of 35 patients with AUR due to BPH were analyzed, and the changes in serum PSA values were compared before and after catheterization. The effect of AUR on serum PSA in BPH patients was discussed. Results It has been found that serum PSA declined from 9.93?8.85ng/ml to 6.46?5.75ng/ml after catheterization for the patients of AUR with BPH, and the values showed a significant difference (P0.05) in the patients in whom the serum PSA ≤4ng/ml, while a significant difference existed in both the group of patients in whom the serum PSA was 4~10ng/ml (from 5.95?1.43ng/ml to 4.09?2.00ng/ml, P10ng/ml (from 18.93?8.49ng/ml to 11.49?6.37ng/ml, P4ng/ml.

Objective To establish a model of homogenous bladder transplantation without blood vessel anastomosis in rat,and to investigate the outcome of the transplanted grafts.Methods 20 newborn SD rats were used as donors,and a total of 20 Wistar rats of 5-week-old were used as the reeipiemts for transplantation of homogenous bladder.The grafts were harvested from the SD rats,and they were wrapped with the greater omentum of the recipients without blood vessel anastomosis.Immunosuppressive agent was given postoperatively.10 rats were sacrificed on the 7th day and the remainings rats were sacrificed on the 14th day after bladder transplantation.The transplanted bladder grafts were observed grossly and microscupicully.Results Of 20 rats undergone homogenous bladder transplantation,19 rats were alive and the grafts were in good condition microscopically.There was no obvious rejection reaction in the transplanted bladders.The bladder mucosa,blood vessels and muscle layers of the grafts appeared to be normal microscopically.Conclusions The homogenous bladder transplantation into the omentum without blood vessel anastomosis in rats is considered to be a kind of stable animal model,with a higher survival rate of the tramsplanted bladder.

Objective To evaluate the long-term complications of continent ileocolic reservoir with in situ appendix conduit through umbilicus and their management.Methods We reviewed 37 patients with bladder diseases who underwent the surgery of continent ileocolic diversion with in situ appendix conduit through umbilicus and followed up for 85 to 136 months(mean 109 months).Long-term postoperative complications were documented.Results Complications occurred in 15 cases(40.5%),including stone formation in urinary pouch in 2 cases,efferent limb stricture and difficulty in catheterization in 3 cases,ureter stricture and hydronephrosis in 7 cases,foreign matter in urinary pouch in 2 cases,efferent limb mucosa exstrophy in 1 case.These complications were correctly treated and good results were achieved.Conclusion Long-term complications of continent ileocolic diversion with in situ appendix conduit through umbilicus were related to nursing in daily life after operation and unsuited design in operation.Nursing in daily life is considered very important in preventing postoperative complications.

OBJECTIVE: To examine and determine the contents of endothelin (ET) and nitric oxide (NO) in plasma, and to observe the effects of gastrodin injection on blood pressure, ET and NO levels in old patients with refractory hypertension. METHODS: A total of 63 old patients with refractory hypertension, 30 patients with common hypertension and 30 healthy people were included. The contents of ET and NO in plasma of patients in different groups and healthy people were examined and analyzed. The old patients with refractory hypertension were randomly divided into two groups: gastrodin-treated and routine treatment groups. Besides conventional hypotensive drugs, intravenous drip infusion of 1 000 mg gastrodin was administered to the patients in gastrodin-treated group for two courses (4 weeks), while the patients in routine treatment group were treated only with conventional hypotensive drugs. The changes of blood pressure, ET and NO levels before and after treatment in different groups were measured. RESULTS: The plasma level of ET in refractory hypertension group was higher than that in common hypertension group (t=3.27, P=0.008), while the level of NO was lower (t=-3.81, P=0.002). The systolic pressure and pulse pressure difference in gastrodin-treated group were decreased significantly after one course of treatment (t=1.85, P=0.03; t=1.74, P=0.04). The level of ET in gastrodin-treated group decreased gradually after treatment, but there were no significant difference between before treatment and two courses of treatment, while the level of NO in gastrodin-treated group was increased after treatment (t=-2.70; P=0.04). CONCLUSION: Gastrodin injection is beneficial to old patients with refractory hypertension, and can improve the balance of ET and NO levels in plasma.

3:00~4:00 time slot.The older the patients are,the more severe the OSAHS is,the more significant this correlation is.

ObjectiveTo explore the clinical value of ultrasound and MRI in diagnosis of simple fetal indirect hernia.MethodsA total of 671 558 fetuses were examined in maternal and child healthcare hospital of Hubei from February 2003 to February 2015. Once inguinal hernia or testicular tumors was suspected, MRI examination was performed after prenatal ultrasound. Final diagnosis was confirmed by postnatal follow-up. The ultrasonographic characteristics of fetal indirect hernia were compared with prenatal MR image characteristics and postnatal follow-up results.ResultsThree cases were conifrmed after birth. The simple fetal indirect hernia was uncommon clinical entity which occurred during 3rd trimester. The ultrasonic characteristics in prenatal period were: (1) Right enlarged scrotum was iflled with heterogeneous lesion; intestinal peristalsis within the scrotum was found in real-time ultrasonography. (2) The contralateral testis in left scrotum and penis could be found. MRI could display the characteristicsof indirecthernia contents and its extension from abdominal cavity intoinguinalregion, which may help diagnose fetal simple indirect hernia. One case of fetal indirect hernia was misdiagnosed as testicular tumors, which was correctly diagnosed by MRI.ConclusionsThe simple fetal indirect hernia can be prenatally diagnosed by characteristic ultrasonic features, which can present with abnormal mass ininguinalregion. Prenatal ultrasound is the primary screening method of fetal indirect hernia. MRI can serve as a supplement approach. The combination of US and MRI can further improve the diagnostic accuracy of fetal indirect hernia.

Objective To study the polysomnography(PSG) indexes which can reflex the severity of anoxia in obstructive sleep apnea-hypopnea syndrome(OSAHS) more comprehensively. Methods Sixtythree OSAHS patients' PSG indexes, including the apnea-hypopnea index (AHI), apnea time/total sleeping time (AM), hypoventilation time/total sleeping time (HM), mean oxygen saturation (MSaO2),the lowest oxygen saturation (LSaO2) and the longest apnea time (LAT) were analyzed retrospectively. Results In patients with OSAHS,the AHI was positively correlated with AM, HM and LAT(P ＜ 0.01 or ＜ 0.05 ), and was negatively correlated with MSaO2 and LSaO2(P ＜ 0.01 ). The AHI had linear regression relationship with AM,HM and LSaO2 (F =202.264,P ＜0.01). Conclusions Among the PSG indexes,AM is intimately associated with AHI. Therefore,compared with LSaO2,AM and HM can reflex the severity of anoxia in patients with OSAHS more accurately.

Objective To analyze the causes of early death in elderly patients undergoing maintenance hemodialysis ( MHD) and major risk factors.Methods A retrospective study was conducted.Fourty-three patients who had undergone MHD between January 2005 and December 2015 and died within 3 -12 months after hemodialysis in the Hemodialysis Center of China Aerospace Center Hospital were included in Group A while 106 patients who had undergone hemodialysis in the same period but survived for over 12 months were selected as control group(Group B).Results The main causes of early death of 43 elderly patients with MHD were cardiovascular ( 46.5%) and cerebrovascular diseases ( 25.6%) (CCVD), and infections(14.0%).The age,proportion of patients with diabetes and CVD,and the proportion of patients using the central venous catheter( CVC) as vascular access were higher in Group A,but the level of hemoglobin and serum albumin was lower.Indicators of cardiac structure and function showed that the left ventricular end-diastolic diameter (LVDd),left ventricular posterior wall thickness(LVPWT),and left ventricular myocardial quality index(LVMI)in Group A were well above those in Group B, but EF and E/A ratio were significantly lower(P<0.05 and P<0.01).COX regression analysis indicated that the comorbidity with CVD, a lower level of serum albumin and EF were the main risk factors for early mortality in elderly patients under MHD.Conclusion The main cause of early death in elderly MHD patients is CCVD.The comorbidity of CVD, malnutrition and decreased left ventricular systolic function might be the main risk factors for early mortality in elderly MHD patients.Early and adequate dialysis,active treatment of underlying diseases, and the correction of hypoalbuminemia can decrease complications,prolong life and improve the quality of life.