China ; Digestive System Surgical Procedures ; Humans ; Physicians ; Science

Combined Modality Therapy ; Head and Neck Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Humans ; Hypopharyngeal Neoplasms ; radiotherapy ; surgery ; Medical Oncology ; education ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Neoplasm Staging ; Otorhinolaryngologic Surgical Procedures ; education

Combined Modality Therapy ; Consensus ; Head and Neck Neoplasms ; therapy ; Humans

Health Knowledge, Attitudes, Practice ; Humans ; Neoplasm Staging ; Risk Assessment ; methods ; Thyroid Diseases ; surgery ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; adverse effects ; methods

Carcinoma, Squamous Cell ; pathology ; surgery ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Minimally Invasive Surgical Procedures ; methods ; Neck ; Neck Dissection ; methods ; Neoplasm Staging

Objective The present study aims to determine the correlation between liver function dam-age and hepatitis B virus ( HBV ) reactivation caused by chemotherapy , and the preventive effect of entecavir on HBV reactivation in lung cancer with HBV carriers .Methods A total of 160 lung cancer patients with HBV car-riers in the affiliated tumor hospital of Harbin Medical University from January 2011 to December 2012 was inves-tigated and the clinical data were studied retrospectively .The patients were divided into prophylactic group ( n=80)and control group(n=80).In prophylactic group,0.5 mg of daily oral entecavir was administered before the chemotherapy until 6 months after the completion of chemotherapy .Control group received no entecavir .The inci-dence of HBV reactivation ,functional damage of liver ,toxicities and disruption of chemotherapy were measured . Results The comparison between the control group (25%) and prevent group (5%) showed a statistically signifi-cant difference in the incidence of HBV reactivation (P<0.01).Moreover,HBV-DNA level(HBV-DNA≥104 copies/mL)was risk factors of HBV reactivation (P<0.05).Histology and stage of lung cancer,the chemother-aphy scheme containing platinum , positive HBeAg were not significantly correlated with HBV reactivation ( P>0.05).There were significant differences in grade III and IV hepatic toxicity (P<0.05)between control group (30%)and prevent group(5%),but was not in grade I and II hepatic toxicity (P>0.05).Disruption of chemo-therapy showed significant difference between control group (20%)and prevent group(5%)(P<0.05).The ma-jor grade 1 ~2 toxicities were myelosuppression,nausea,vomiting,skin rash,diarrhoea,neurotoxicity,fatigue, headache,insomnia,etc.All adverse reactions were cured after treatment .Conclusion The prophylactic adminis-tration of oral entecavir could reduce the risk of HBV reactivation in lung cancer with HBV carriers .

Objective Neuropsychiatric systemic lupus erythematosus ( SLE) is a common complication of SLE, whose path-ogenesis is not yet clear but associated with the alteration of cerebral blood flow ( CBF) in some studies.This study was to investigate the CBF alteration in SLE patients without overt neuropsychiatric symptoms by arterial spin labeling ( ASL) MRI. Methods Twenty-eight SLE patients without overt neuropsychiatric symptoms and 30 age-and sex-matched healthy controls underwent conventional MRI and ASL examinations, and all received such neuropsychologic tests as number connecting test-A ( NCT-A ) , digit symbol test ( DST ) , self-rating anxiety scale ( SAS ) , and self-rating depression scale ( SDS) .Independent sample-t test was used to detect the mean CBF in the whole brain, gray matter, and white matter of the SLE patients and healthy controls.The voxel-wise CBF maps of the two groups of subjects were further analyzed with the SPM8 software to compare the regional CBF between the two groups, followed by evaluation of the correlation between the regional CBF values and clinical markers. Results In comparison with the healthy controls, the SLE pa-tients showed significantly reduced CBF in the gray matter (40.5 ±3.7 vs 37.3 ±6.5, P=0.028) and the whole brain (38.0 ±3.5 vs 35.1 ±6.1, P=0.032), especially in the supplementary motor area and the adjacent middle cingulate, anterior cingulate, left medial frontal gyrus, left inferior frontal gyrus, and left insula (P<0.05, FWE corrected).The NCT-A score was negatively correlated with the CBF values of the left medial frontal gyrus (r=-0.402, P=0.032) and left inferior frontal gyrus (r=-0.382, P=0.045) of the SLE patients. Conclusion ASL and MRI showed significantly reduced cerebral blood flow in the SLE patient without overt neu-ropsychiatric manifestations, which was correlated with the change of the patient's cognitive function.

Objective To investigate the distribution of pelvic recurrence in rectal cancer after radical resection and analyze the outcome and prognostic factors of pelvic recurrent rectal cancer treated with radiotherapy. Methods Ninety-three patients with pelvic recurrent rectal cancer who received radiotherapy from August 2000 to August 2006 were retrospectively analyzed. Of them, 21 patients received pelvic radiation alone;56 received pelvic radiation plus chemotherapy and 16 received pelvic radiation plus surgery and/or chemotherapy. Radiotherapy was delivered with 60Coγor 6/15 MV X ray to a median dose of 59. 4Gy (range,20-74 Gy). Conventional fractionation was used in 90 patients. Chemotherapy was given to 68patients with a median number of 3 cycles ( range, 1 - 8 cycles). Concurrent chemo-radiation with 5-FU based regimen was given to 42 patients. After radiotherapy, 16 patients underwent surgical resection, with 7R0 resection and 9 palliative resection. Results The entire cohort included 132 recurrent sites. The most common recurrent sites were peri-rectal region ( 31.8% ), pre-sacral region ( 30. 3% ) and internal iliac nodal region (20. 2% ). The follow-up rate was 92% for the entire cohort, 39 and 4 patients had minimum follow-up time of 2 and 5 years respectively. Overall clinical response ( complete and partial symptomatic relief) was achieved in 83% of the patients after radiation therapy. The 2-and 5-year local progression-free survival rates were 49% and 22% respectively, and the 2-and 5-year overall survival rates were 46% and 14% respectively. Multivariate analysis showed that treatment modality was the independent prognostic factor for local progression-free survival. Patients treated with radiation plus surgery and/or chemotherapy had better local progression-free survival than those treated with radiation plus chemotherapy or radiation alone.Recurrent tumors larger than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were independent unfavorable prognostic factors for overall survival. Conclusions Perirectal region, pre-sacral region and internal iliac nodal region were the most common pelvic recurrent sites in rectal cancer. Radiotherapy is an effective palliative approach for patients with pelvic recurrent rectal cancer.Radiotherapy plus surgery and/or chemotherapy was associated with better local progression-free survival,and recurrent tumors lager than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were unfavorable prognostic factors for overall survival of pelvic recurrent rectal caner.

Objective To study the clinical application of the peak expiratory flow rate( PEFR) in children with asthma.Methods The PEFRs of 43 cases of asthma at the acute stage were measured to guide the clinical grading and therapy by the optimum individual PEFR of the patients at the remission stage, and the descending rate and warning value of individual PEFR were determined to investigate the relationship between the individual PEFR descending rate and the asthma attack conditions in the standard and nonstandard monitoring groups.Results At the asthma attack stage, the clinical symptoms became severe with PEFR declining; at the remission stage, the preventive application of drugs was based on the changes of the individual PEEF descending rate . The case number and frequency of asthma attack and the cases subjected to moderate or severe attacks in the standard group were 15 %,23.5 % and 25 % respectively; while those in the nonstandard group were 43.5 %, 75.5 % and 76.9 % respectively, which showed a significant difference( P

Contraindications ; Humans ; Thyroidectomy ; methods