Objective To evaluate clinical characteristics and prognostic factors of synchronous multiple primary esophageal carcinomas (SMPEC).Methods Clinical data including sex,age,smoking history,regions,lymph node status,length of tumor,therapeutic methods and survival data of 52 patients with SMPEC were analyzed.The rates of OS depending on the different factors were calculated using the method of Kaplan-Meier analysis.Log-rank test was used for univariate survival analysis and Cox's proportional hazards regression model was used for multivariate survival analysis.Results The 1-,3-,5-year OS rates and the median survival time (MST) were 65.4 ％,17.3 ％,7.7 ％ and 15.0 months for the whole cohort,75.0 ％,33.3 ％,16.7 ％ and 19.5 months for the surgery subgroup,62.5 ％,10.0 ％,5.0 ％ and 14.5 months for the 40 non-operative patients.Multivariate analysis of prognostic factors identified that tumor length and M stage were independent prognostic factors for the whole cohort,while tumor length,M stage and chemotherapy were independent prognostic factors for the radiotherapy subgroup patients.Conclusion The tumor length and M stage are independent prognostic factors for the SMPEC patients.Combined radiotherapy with chemotherapy seems to bring survival benefit and maybe a better management choice for unresectable and non-operative SMPEC.

Objective To investigate the influence of wound treatment methods on residual ovarian reserve function after laparoscopic ovarian cystectomy.Methods A total of 120 patients with ovarian cyst who underwent laparoscopic ovarian cystec‐tomy in the hospital were randomly divided into three groups in terms of different wound treatment methods:electric coagulation group ,ultrasound group and suture group ,with 40 cases in each group.The levels of follicle stimulating hormone(FSH) ,luteini‐zing hormone(LH) ,and estradiol(E2 ) were detected in the blood before and immediately after the operation ,2 days after men‐struation at postoperative 3 and 6 months ,and the number of ovarian reserve follicles determined by transvaginal ultra‐sound.The changes of menstruation and clinical manifestations of the patients were recorded at the same time.Results The lev‐els of LH ,E2 and FSH were dramatically changed in electric coagulation group ,which was followed by the ultrasonic group.Patients in the suture group had the smallest changes of these indices and recovered quickly(P<0.05).In the electric co‐agulation group relative to the other two groups ,the number of ovarian reserve follicles was significantly decreased and the inci‐dence of adverse reactions was profoundly increased.Conclusion Electric coagulation greatly adversely affects the residual ovar‐ian reserve function after laparoscopic ovarian cystectomy ,and ultrasonic and suture hemostasis techniques can help to protect o‐varian function.

Objective To explore a desirable therapeutic regimen,which is effective,reasonable and practicable for locally advanced nasopharyngeal cancer (LA-NPC) patients in the era of IMRT,with a potential of translating into survival improvement of these patients.Methods Patients presented with stage Ⅲ-Ⅳ B,WHO type Ⅱ or Ⅲ NPC were randomly assigned to receive concurrent chemoradiotherapy (CCRT group) (45 cases) or induction chemotherapy plus radiotherapy alone (IC + RT group) (43 cases),with random number table.IMRT and rapid arc planning were generated in the same treatment planning system for all patients.These two arms received docetaxel plus cisplatin for first cycle of chemotherapy,and cisplatin only for the second cycle.Results Forty-five patients received CCRT and 43 received IC + RT.All the patients completed two cycles chemotherapy.Compared to the CCRT group,the incidence rate of grade 2-4 leukopenia was lower in IC + RT group[67.4 ％ (29/43) vs.86.7 ％ (39/45),x2 =4.628,P =0.031],while the incidence rate of dermatitis,mucositis,neutropenia and fungal infection of oral cavity had no significant differences (all P ＞ 0.05).The tumor response rate (95.3 ％ vs.100.0 ％,P =0.236),2-year overall survival rate (95.5 ％ vs.94.2 ％,P =0.627),2-year progression free survival rate (94.6 ％ vs.88.6 ％,P =0.303),2-year local recurrent free survival rate (97.3 ％ vs.95.5 ％,P =0.951),2-year regional recurrent free survival rate (94.7 ％ vs.96.2 ％,P =0.949),and 2-years distant metastasis free survival rate (93.7 ％ vs.91.5 ％,P =0.454) of the two groups were similar while comparing CCRT to IC + RT group.Conclusion Combined IMRT with TP/DDP regimen,the efficacy of IC + RT is similar to CCRT for LA-NPC.The IC + RT group has less severe leukopenia than CCRT group,which is worth further study.

Objective To investigate the level Ⅰb contouring,dose analysis and regional recurrence in level Ⅰb lymph node-negative (Ⅰb-negative) nasopharyngeal carcinoma (NPC) patients treated by intensity-modulated radiotherapy (IMRT).Methods One hundred ninety newly-diagnosed,Ⅰb-negative NPC patients treated by IMRT were enrolled.Level Ⅰb contouring and dose prescribing in this cohort were classified into planned prophylactic irradiation (PPI) group (56 cases) and non-planned prophylactic irradiation (non-PPI) group (134 cases).The mean dose (Dmean) of the level Ⅰb bilaterally and submandibular glands (SMGs) was recorded for comparison.Results After a median follow-up of 47 months,there was no level Ⅰb regional recurrences noted in the entire group.The mean doses of level Ⅰb and the submandibular glands were significantly lower in the non-PPI group than those in the PPI group as follows:(50.81±5.37) Gy vs (59.68±3.32) Gy for the left level Ⅰb,(51.55±5.02) Gy vs (59.66±3.85) Gy for the left submandibular gland,(51.55±5.02) Gy vs (59.66±3.85) Gy for the right level Ⅰb and (57.25±4.69) Gy vs (63.41±2.88) Gy for the right submandibular gland (all P =0.000).Conclusion In this retrospective analysis of non-randomized single institute data,it seems unlikely that PPI to level Ⅰb is necessary in Ⅰb-negative NPC patients treated by IMRT.

ObjectiveTo assess the feasibility and efficacy of a docetaxel plus cisplatin regimen for patients of locally advanced nasopharyngeal carcinoma(NPC)treated concurrently with definitive IMRT in a short-term observation.MethodsRadiation consisted of 7000 cGy given to the planning target volume (PTV) of primary tumor, 6600 cGy given to the PTV of metastatic lymph nodes and 6000 cGy to the PTV of subclinical disease in 220-228 cGy/fraction were delivered over 31-32 treatment days. Thirty-two patients with newly diagnosed NPC received definitive intensity-modulated radiation therapy(IMRT)concurrent with docetaxel 75 mg/m2 on day 1 and DDP 75 mg/m2 on day 1(or DDP 25 mg/m2 on day 1-day 3), repeating every 21 to 28 days for 2 cycles.ResultsAll patients received the full dose of radiotherapy and completed 2 cycles of chemotherapy with a median follow-up of 13 months (2-28 months).No treatment-related death was observed. Major toxicities included hematologic toxicity and mucositis. The incidence rates of grade 3-4 leucopenia,grade 3-4 neutropenia and grade 3 acute mucositis were 46.9 ％ (15/32),59.4 ％ (19/32) and 40.6 ％ (13/32) respectively.The complete remission (CR) rate was 96.9 ％ (31/32).During treatment,90.6 ％ (29/32)patients acquired granulocyte colony stimulating factor (G-CSF)for leucopenia. The 1-year overall survival, local recurrence-free survival, regional recurrence-free survival and distant metastasis-free survival were 100 ％ (31/32),96.9 ％ (31/32),96.9 ％ (31/32),96.9 ％ (31/32),respectively,for the whole cohort.Conclusions2 cycles of the docetaxel plus cisplatin regimen with concurrent IMRT are demonstrated being feasible and effective in treating locally advanced NPC with promising results.The major toxicities are leucopenia and neutropenia, but they are tolerable with the use of G-CSF. Further investigation of long-term efficacy of the regimen is required.

Objective To observe the influence of wind-dispelling therapy on therapeutic effect of blood-cooling and kidney-tonifying herbs for chronic idiopathic thrombocytopenic purpura(CITP),and to investigate its immunoregulatory effect.Methods Forty-two CITP patients were randomized into 2 groups:the treatment group(N=22) received therapy of dispelling wind,cooling blood and tonifying kidney,and the control group(N=20) received therapy of cooling blood and tonifying kidney.Six weeks constituted one treatment course,and the treatment lasted 3 courses.Serum interleukin 2(IL-2),soluble IL-2 receptor(sIL-2R),Fas protein,Fas-L protein,and platelet-associated immunoglobulin G(PAIgG) levels and lymphocyte subtypes were compared before and after treatment.Results In the treatment group,14 patients were clinically cured,5 markedly effective,2 effective,1 ineffective and the total effective rate was 95.5%;in the control group,8 patients were clinically cured,4 markedly effective,3 effective,5 ineffective and the total effective rate was 75.0%.The therapeutic effect in the treatment group was superior to that in the control group(P

[Objective] To explore the effect of wind-expelling and blood-cooling therapy in treating chronic idiopathic thrombocytopenia purpura (ITP) . [Methods] Thirteen cases of chronic ITP differentiated in TCM as heat-induced blood extravasation (group A) were treated with wind-expelling and blood-cooling therapy. The changes of peripheral T-lymphocyte subsets and natural killer (NK) cells before and after treatment were observed and compared with the normal volunteers (group B). [Results] Before treatment, peripheral T-lymphocyte subsets of CD3 and CD4 levels, CD4/CD8 ratio and NK cells count were lower in group A than those in group B while CD8 level was higher ( P

ObjectiveTo observe the effect of bubble bath coordinating with functional training on the children with spastic cerebral palsy.Methods210 children with spastic cerebral palsy were randomly divided into the treatment group (n=118) and control group (n=92). All children were treated with functional training, acupuncture and other physical therapies. Children in the treatment group were added with bubble bath one time every day, twenty days as one course. Muscular tension was evaluated with modified Ashworth Scale and range of motion was measured before and after treatment.ResultsIn the treatment group, 55 cases were significant, 53 cases were effective, 10 cases were invalid, the total effective rate was 91.5%; in the control group, 26 cases were significant, 46 cases were effective, 20 cases were invalid, the total effective was 78.2%. There was a significant difference between the total effective rates of two groups (P<0.05).ConclusionBubble bath can significantly decrease the muscular tension of children with spastic cerebral palsy.

Objective To analyze the prognostic factors in patients with initially diagnosed bone-only metastatic nasopharyngeal carcinoma (NPC). Methods We collected the data of 68 patients with initially diagnosed bone-only metastatic NPC admitted to The Affiliated Tumor Hospital of Shantou University Medical College from 1997 to 2015. Forty-nine patients received chemoradiotherapy. The Kaplan-Meier method was used to calculate the overall survival rate;the log-rank test was used for univariate prognostic analysis;the Cox model was used for multivariate prognostic analysis. Results The median follow-up was 953 months. The 1-, 2-, 3-, and 5-year overall survival ( OS) rates were 53%, 38%, 21%, and 15%, respectively. The median OS time was 134 months. The univariate prognostic analysis showed that spinal metastases, the number of bone metastases, lactic dehydrogenase level before treatment, the radiotherapy technology and dose for primary tumor, and the short-term outcome of primary tumor were associated with OS ( P=002, 001, 000, 002, 002, 001 ) . The multivariate prognostic analysis showed that ≤3 bone metastases, dose to primary tumor>65 Gy, and intensity-modulated radiotherapy ( IMRT) were favorable prognostic factors for OS ( P=003,002,004) . Conclusions For patients with initially diagnosed bone-only metastatic NPC, active treatment ( IMRT, dose to primary tumor>65 Gy) should be considered for those with ≤3 bone metastases to achieve a complete response of primary tumor.

Objective To investigate the operation strategy of pediatric intracranial arachnoid cysts (IACs).Methods Surgical intervention was performed in 76 patients with pediatric IACs,admitted to our hospital from January 2003 to October 2013; cyst-peritoneal shunt was chosen in 40 patients and fistulation in 36 (including microscopic fistulation in 31 and endoscopic fistulation in 5).According to the changes of cyst volume and the relief of symptoms,the efficacy was evaluated,and the complications after operation,including the recent complications (within 2 months of operation) and long-term complications (longer than 2 months of surgery),were observed.Results The efficiency of cysts-peritoneal shunt was 80％ (32/40); the rate of recent complication for patients performed cysts-peritoneal shunt was approximately 17.5％ (7/40),including 3 of CSF leakage,3 of intracranial infection and 1 of wound infection; the rate of long-term complications was approximately 22.5％ (9/40),including 3 of shunt-dependency,2 of intracranial infection,2 of obstruction of the catheter,1 of off the catheter and 1 of skin channel infections.Meanwhile,the efficiency of fistulation was approximately 91.67％ (33/36); the rate of recent complication was approximately 8.33％ (3/36),including 1 of intracranial infection,2 of subdural hematoma; the rate of long-term complications was 0.Significant difference was noted in the surgical efficiency (x2=1.126,P=0.289) and the rate of recent complication (x2=0.707,P=0.401) between cyst-peritoneal shunt and fistulation; however,the rate of long-term complications in patients after cyst-peritoneal shunt insertion was significantly higher than that in patients after fistulation (x2=7.159,P=0.008).Conclusion Fistulation might be the preferred method for pediatric IACs,and shunt should be avoided.