Objective To evaluate the association of prognostic factors and the interval between surgery and radiotherapy in postoperative radiotherapy for non small cell lung cancer (NSCLC). Methods Between December 1982 and December 1992, 132 patients with NSCLC were retrospectively analyzed. The time interval between surgery and radiotherapy ranged from 12 to 90 days, with a median of 36 days. All patients received D T 40～72 Gy. Results Cox proportional analysis showed that stage, Karnofsky performance status, and the interval between treatments were important prognostic factors. Patients with a long interval of 37～90 days had a better survival than those with a short interval of 12～36 days (P

0.05). Anastomotic leak was found in a intraoperative radiotherapy patient on the 9th day after surgery as slipping of the residual stomach into the field had been observed after completon of the intraoperative radiation.The patients recovered unevertfully after surgical repair. No radiation induced mediastinnitis,myelopathy or pneumonitis developed in patients who survived over 2 years.Conclusion IORT,as one of the methods of combination treatment for esophageal carcinoma, is benefitial in local control. Its efficacy,being closely related to the sige of the dose and radiation field, warrants further investigation.

0.05). In the xenogeneic fresh nerve graft group, the xenogeneic nerve segment was rejected and absorbed by the recipient. CONCLUSION Xenogeneic acellular nerve could sustain facial nerve regeneration, and may be a substitute to autograft for repairing facial nerve defects.

Objective To investigate the diagnostic significance of the difference values between Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)in elderly patients with dementia.Methods 331 elderly patients with dementia were collected from outpatients in our hospital.There were 148 people with Alzheimer's disease (AD),87 cases with vascular dementia (VaD),44 cases with mixed dementia (MD),41 cases with frontotemporal dementia (FTD) and 11 cases with dementia with Lewy bodies (DLB).MMSE and MoCA were applied to test the cognitive impairment separately.Results The difference values between MMSE and MoCA was (3.3±1.7) points,(6.6±2.1) points,(6.6±2.1) points,(5.4±2.3) points,(6.1 ± 1.9) points in AD,VaD,MD,FTD and DLB group respectively,and there were statistical differences among the five groups (F=46.420,P=0.000).Statistical differences were found in the difference values between MMSE and MoCA between dementia patients with AD and non-AD (t=-13.429,P=0.000).According to receiver operating characteristic curve (ROC curve),the optimal cut off point of the difference values between MMSE and MoCA for differential diagnosis between AD and non-AD dementia was 5 points,with 79.8％ sensitivity and 78.4％ specificity,and area under the curve was 0.848 (95％CI:0.807-0.890).Conclusions The difference values between MMSE and MoCA may be one of parameters for differential diagnosis between AD and non-AD dementia.

Objective To evaluate the role of spinal sigma-1 receptors in the maintenance of bone cancer pain (BCP) in rats and the relationship with extracellular signal-regulated kinase (ERK).Methods Part Ⅰ Twenty-four female Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups using a random number table:sham operation group (S group,n =4) and BCP group (n =20).BCP was induced by inoculating Walker 256 mammary gland carcinoma cells into the medullary cavity of the right tibia.Four rats were sacrificed on day 10 after inoculation in S group or on day 3,5,7,10 and 14 after inoculation in BCP group,and the L4-6 segments of the spinal cord were removed to measure the expression of sigma-1 receptors by Western blot.Part Ⅱ Forty female Sprague-Dawley rats,weighing 180-220 g,were randomized into 4 groups (n =10 each) using a random number table:sham operation group (S group),sigma-1 receptor inhibitor BD1047 group (BD group),BCP group,and BCP + BD1047 group (BCP + BD group).On day 10 to 14 after inoculation,normal saline 20 μl was injected intrathecally once a day in S and BCP groups,or BD1047 120 nmol/20μl was injected intrathecally once a day in BD and BCP + BD groups.Mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured one day before inoculation,on day 3,5 and 7 after inoculation,and on day 10,12 and 14 after administration.After measurement of MWT on day 14 after inoculation,the rats were sacrificed and the L4-6 segments of the spinal cord were removed to determine the expression of phosphorylated ERK (p-ERK) by Western blot.Results Part Ⅰ Compared with group S,the expression of sigma-1 was significantly up-regulated and peaked on day 10 after operation in group BCP.Part Ⅱ Compared with S group,no significant changes were found in MWT and p-ERK expression at each time point in BD group,and MWT was decreased and p-ERK expression was up-regulated in BCP and BCP + BD groups.Compared with group BCP,after intrathecal injection of BD1047,MWT was significantly increased and the expression of p-ERK was down-regulated in BCP + BD group.Conclusion Spinal sigma-1 receptors are involved in the maintenance of BCP in rats possibly through promoting phosphorylation of ERK.

Objective To explore the effectiveness and safety of deep brain magnetic stimulation technique (dTMS) for treatment of Alzheimer's disease (AD).Methods Totally 116 patients with AD were randomly divided into 4 groups:(1) dTMS:given dTMS really stimulation therapy,(2)medication group:treatment with donepezil 5 mg/d,(3) combination treatment group:given dTMS and donepezil therapy,(4) blank control group:given pseudorandom stimulation treatment.33 healthy control cases were given dTMS's stimulation treatment.The treatment course was 6 months.Application of mini mental state examination scale (MMSE),the Montreal cognitive assessment scale (MoCA),Hamilton Depression Scale (HAMD),ischemic scale (HIS),Boston naming test,activity of daily living(ADL) and neuropsychological questionnaire (NPI) were used to evaluate the cognitive function.All the participants received blood tests and ECG in order to evaluate the safety of dTMS.Results After 6 months treatment,compair with the blank control group,all scale scoresof dTMS group,medication group and combined treatment group were improved significantly in MMSE (t=2.49,2.46,2.20),MoCA(t=2.59,2.39,2.87),ADL(t=2.35,2.17,2.83),NPI(t=3.05,2.40,2.65) and sub-cognitive scale score (all P＜0.05).All scale scores of combination treatment group were better than dTMS group and medication group (P＜0.05).There's no significant difference between drug treatment groups and dTMS group (P＞0.05).After 6 months treatment,compared with healthy control group,the scale scores were aggravated in 4 groups of AD (P＜0.05)Conclusions dTMS can be effective and safe in the treatment of AD patients with cognitive and noncognitive symptoms.

OBJECTIVETo assess the feasibility and safety of robot-assisted laparoscopic radical prostatectomy (RLRP) in the treatment of prostate cancer.

METHODSUsing the da Vinci robot surgical system, we performed RLRP for 34 patients with localized prostate cancer and analyzed the intraoperative and follow-up data.

RESULTSThe procedures were performed successfully in all the patients, with the mean operation time of 198 min (range 135-340 min), average blood loss of 257 ml (range 50-700 ml), and 1 case of blood transfusion, but no postoperative complications. Three cases had positive surgical margins. Postoperative examination at 4 weeks showed PSA > 0.2 microg/L in 2 cases, suggestive of residual tumor, for which maximal androgen block therapy was administered. The other 32 patients were followed up for 3-10 (mean 7.5) months, during which the average level of serum tPSA remained < 0.2 microg/L. Urinary continence was found in 94% (32/34) and 97% (33/34) of the patients at 3 and 6 months, respectively, of whom 77% (26/34) and 88% (30/34) had no urinary leakage (0 pad per day).

CONCLUSIONRLRP, with its advantages of less perioperative blood loss, low rate of positive margin, and good urinary continence, is a safe and effective surgical option for the treatment of prostate cancer.

Aged ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Prostatectomy ; methods ; Prostatic Neoplasms ; surgery ; Retrospective Studies ; Robotics

Objective To study the clinicopathologic characteristics and differential diagnosis of T-cell immunophenotype in intestinal non-Hodgkin's lymphoma(NHL).Methods The clinicopathologic characteristics of 13 cases with intestinal T-cell lymphoma were analyzed by light microscopy and immunohistochemistry(Envision detection method).Results The lesions of 8 cases with T-cell lymphoma were found on the small intestine and 5 on the colon.Grossly,8 cases showed ulcer pattern,3 polypoid pattern and 2 presented as a regional thickening of intestinal wall.The tumor cells were medium to large size with pleomorphic nuclei and inflammatory background.The neoplastic lesions expressed the immunophenotype of peripheral T cells.The neoplastic cells of 13 cases(100%)expressed leukocyte common antigen(LCA);10(76.9%)cases expressed CD3;9(69.2%)CD45RO;5(38.5%)EB virus(EBV);3(23.1%)CD56 and 2(15.4%)vimentin(VIM).All the cases were negative for CD20,CD79a,CK,CDX2,NSE,CgA and CD117.ConclusionIntestinal T-cell lymphoma is a rare,aggressive neoplasm with poor prognosis and should be distinguished from other malignant tumors of intestine.

Objective To evaluate the value of Multi-slice spiral CT angiography for spinal cord vessels.Methods 11 adult subjects with suspected of myelopathy were performed with Multi-slice spiral CT angiography,An iodine contrast agent was injected at 3.5 ml/s,for total 100 ml.The parameters were axial 16 slice mode,0.625 mm slice thickness,0.8 s rotation,delay time depending on smartprep (15—25 s), multi-phase scan.The coronal and sagittal MPR and SSD were generated on a workstation compared with spinal digital subtraction angiography (DSA) to analyze normal or abnormal spinal cord vessels.Results Normal findings at spinal CTA and digital subtraction angiography in six adult normal subjects and spinal cord vascular malformations( 1 intradural extramedullary AVF,4 dural AVFs) in five cases,Recognizable intradural vessels corresponding to anterior median (midline) veins and/or anterior spinal arteries were show in six adult normal subjects.Abnormal intradural vessels were detected in all five spinal cord vascular malformation with CT angiography ,in comparison with digital subtraction angiography these vessels were primarily enlarged veins of the coronal venous plexus on the cord surface,radiculomedullary-dural arteries could not be clearly shown in four dural AVF,only one anterior spinal artery was detected in one patient with intradural medullary AVF,which direct shunt between anterior spinal artery and perimedullary vein with tortuous draining vessel.Conclusion Multi-slice CT angiography is able to visualize the normal or abnormal spinal cord vessels.It could be used as a noninvasive method to screen the spinal cord vascular disease.

Objective To investigate the characteristic MRI features of sporadic inclusion?body myositis(sIBM). Methods Clinical and MR imaging data of 6 patients with sIBM diagnosed by muscle biopsy from May 2013 to November 2014 were retrospectively analyzed. All patients showed insidious onset of lower limb muscle weakness and diagnosed as sIBM by muscle biopsies. All patients were evaluated by the score of the severity of fatty infiltration, inflammation and atrophy in MRI. Results All patients were observed fatty infiltration with different degrees. The fatty infiltration in thighs was characterized in a decreasing order of frequency:gluteus maximus (6 cases), vastuslateralis (6 cases), vastusintermedius (6 cases), vastusmedialis (6 cases), sartorius (5 cases), adductor magnus (5 cases), rectus femoris (4 cases), semi?membranosus (4 cases), semi?tendinosus (4 cases), biceps femoris (4 cases), gracilis (3 cases), adductor longus(2 cases).The fatty infiltration in thighs was characterized in a decreasing order of severity:vastuslateralis (3.2 points), vastusintermedius (3.2 points), vastusmedialis (3.0 points), adductor magnus (3.0 points), gluteus maximus (2.7 points), bicepsfemoris (2.2 points), semi?membranosus (2.1 points), semi?tendinosus (2.1 points), rectus femoris (1.5 points), sartorius (1.3 points), gracilis (0.8 points), adductor longus (0.7 points). All patients showed the features of distal distribution andsymmetry. Inflammation was observed in 3 patients. 1 patient only involved the vastuslateralis, the other 2 patients were observed muscle inflammation with different degrees in 12 muscles. Atrophy was observed in 5 patients. The atrophy in thighs was characterized in a decreasing order of frequency:vastuslateralis (5 cases), vastusintermedius (5 cases), vastusmedialis (4 cases), adductor magnus (4 cases), semi?membranosus (2 cases), rectus femoris (1 cases), sartorius (1 cases) and gluteus maximus;there was no atrophy in adductor longus, gracilis,semi?tendinosus, biceps femoris. Conclusion The MRI characteristic manifestations of sIBM is fatty infiltration and atrophy in the distal portion, particularly involving the vastuslateralis, vastusintermedius, vastusmedialis and adductor magnus.