Objective To retrospectively analyze clinical outcomes of brain metastases treated with Cyberknffe. Methods From Aug. 2006 to Aug. 2007, 40 patients with brain metastases treated with Cy-berknife in Tianjin Cancer Hospital were included. Totally 68 brain metastatic lesions were treated. The maximal diameter was 0.4 -7.5 cm (average 1.9 cm). The primary tumor of 35 patients was partial re-ponse or stable to the previous treatment at the diagnosis of brain metastasis. The geometric center of target volume was set as the isocenter and the nominal standard dose point. More than 95% target volume was cov-ered by 80% isodose surface. Hypofractionated radiation was 18 -36 Gy given in 1 -5 fractions of 5 -25 Gy. Results The Follow-up rate was 95%. The clinical symptom remission rate (including complete and partial remission) at one week after Cyberknife treatment was 90% (36/40). The therapeutic effective rate (CR + PR + SD) was 94% (64/68) after three months follow-up, which was evaluated by contrast-en-hanced CT or MRI. The 3-month local control and 1-year survival rates were 78% (53/68) and 68% (27/40). New brain metastatic lesions outside the radiation field occurred in 14 patients within 3 months, which was independent of age, whole brain irradiation, number or maximal diameter of original lesions, frac-tion dose, frequency or total dose of Cyberknife treatment. Conclusions Cyberknife, used as the primary treatment of brain metastases, can achieve good clinical outcomes.

An investigation of the dietary conditions and the growth of children was made from February to May 1982 in 14 nurseries and kindergartens in G districts of Tianjin.The results showed: the calorie intake was lower than 80% of the daily allowance of normal children in 11 of 14 nurseries and kindergartens while the protein intake was lower than 70% of the daily allowance in 12. The levels of other nutrients were also lower. The heights and body weights of children in these institutions belonged to B class of 6 grades by Zhou Qi-yuan.The causes of calorie and protein insufficiency and some suggestions were discussed.

Objective To assay the early quality of life and posttraumatic stress disorder (PTSD) and relating influential factors in patients with severe blunt chest trauma (sBCT).Methods Demographic and clinical data of sBCT patients treated between January 2011 and December 2011 were collected.Early quality of life and PTSD symptom level at posttraumatic months 1,3,and 6 were analyzed by using short form 36 health survey (SF-36) and impact of event scale-revised (IES-R) respectively.Furthermore,logistic regression analysis was performed to identify the risk factors associated with quality of life of the patients.Results A total of 107 patients were included in the study.Ultimately,83 patients were available to the 6-month follow-up.A low score for SF-36 remained at posttraumatic 6 months and one-third of the 83 patients sustained mild or severe PTSD symptoms.Major influential factors to posttraumatic quality of life included age,ISS ≥ 20,combined craniocerebral injury,combined spinal and pelvic injuries,posttraumatic complications,and PTSD.Conclusions Early quality of life in sBCT patients is poor.Therefore,the early intervention with identification of specific risk factors is contributive to better quality of life.

Objective To study the effects of PIAS3 knocking down on the proliferation,cell cycle and apoptosis of human prostate cancer cell line DU145 in vitro.Methods PIAS3 specific short hairpin RNA(shRNA) expressing plasmid was constructed and named pSilencer4.1/PIAS3.DU145 cells were transfected with pSilencer4.1/PIAS3.The proliferation of DU145 cells was analyzed by MTT assay.Cell cycle and apoptosis of DU145 cells were analyzed by flowcytometry.Results PIAS3 shRNA expressing plasmid was succefully constructed and then confirmed by sequencing.Expression of PIAS3 in DU145 was significantly reduced after pSilencer4.1/PIAS3 transfection.MTT assay showned accelerated proliferation after PIAS3 knocking down,and showned dose-effect curve.Flowcytometry showed cells in S phase increased,cells in G0/G1 decreased and percentage of apoptotic cells decreased after PIAS3 knocking down.Conclusion Knocking down of PIAS3 expression accelerates DU145 cell proliferation and inhibit cell apoptosis in vitro.

Objective To investigate the type of plasmid map of Y. pestis in the R. opimas natural plague loci in Junggar Basin. Methods A total of 39 plasmid DNA of Y. pestis which were isolated from the natural plague loci of Junggar Basin, Tianshan Mountain, Kunlun Mountain, Qinghai-Tibet Plateau and In-ner Mongolia were extracted by the methods of Kado and Liu. The plasmid map was analyzed by the methods of agarose gel eleetrophoretogram. Results Two types of plasmid map were found in 26 Y. pestis which were isolated from Junggar Basin. Of them 23 were 6 × 106, 45 × 106 and 65 × 106 type of plasmid map, and 3 were 6 × 106, 45 × 106 and 72 × 106 type. Conclusion There are two types of plasmid map in the R. opi-mus natural plague loci in Junggar Basin. One type, which is the dominant type in this area, is 6 × 106, 45 × 106 and 65 × 106 type. This type is also similar to the dominant plasmid map type of the nature plague loci of Tianshan Mountain, Kunlun Mountain, Qinghai-Tibet Plateau and Inner Mongolia. The other type is 6 × 106, 45 × 106 and 72 × 106 type, and this type is new plasmid map type of Y. pestis in our country.

Objective To analyze the characteristics and risk factors of preoperative deep vein thrombosis in patients with hip fracture,and provide a theoretical basis for clinical treatment and intervention.Methods 470 patients with hip fracture were chosen as the objects of study.The clinical data of the patients were retrospectively analyzed,including age,gender,injury,combined with other systemic diseases,fracture type (whether old fractures),two D-dimer level.All the patients with deep venous thrombosis of lower extremity were divided into DVT group and nonDVT group.There were 83 cases in DVT group,387 cases in non-DVT group.The factors like aboves as independent variables,presence of deep vein thrombosis as dependent variable,,preoperative deep venous thrombosis of the characteristics and risk factors were analyzed.Results 83 patients had DVT,the incidence rate was 17.7％.There were significant difference in age (40/83 vs 268/387),combined with other system diseases (57/83 vs 283/387),prevention measures (58/83 vs 196/387),D-thrombosis two dimer level (16/83 vs 122/387) of the two groups (x2 =13.712,14.836,9.876,5.313,all P ＜ 0.05).3 age ≥ 40 years,with other system diseases and injury,did not take to prevent the formation of thrombus measures were independent risk factors influencing the occurrence of DVT.Conclusion Age ≥40 years,combined with other system diseases and injury,don't take to prevent the formation of thrombus measures are independent risk factors influencing the occurrence of DVT.

Retrospectively from February, 2006 to June, 2009 the clinical characteristics of 14 misdiagnosed cases of insulinoma in the First Affiliated Hospital of Zhengzhou University were analysed. The rate of misdiagnosis was 38% ( 14/37). The rate of IRI/G≤0. 3 was 33%. Insulinoma has often been misdiagnosised when IRI/G≤0. 3. Hence a diagnosis of insulinoma can not be excluded with this IRI/G rate.

Objective:To evaluate the efficacy and safety of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) therapy in the primary prevention of concurrent chemoradiotherapy-induced neutropenia.Methods:In this single-center, open-label, single-arm clinical observation, the efficacy of PEG-rhG-CSF in the primary prevention of neutropenia after concurrent chemoradiotherapy in 58 patients admitted to Tianjin Medical University Cancer Institute and Hospital from June 2018 to June 2019 was evaluated.Results:During the whole concurrent chemoradiotherapy, chemotherapy delay occurred in 6 patients (10%). Three patients (5%) had delayed concurrent chemotherapy due to leukopenia or neutropenia. The completion rate of chemotherapy cycle was 94.6%(106/112). Radiotherapy delay occurred in 10 patients (17%) including 2 patients (3%) of delayed radiotherapy due to leukopenia or neutropenia. No patient developed febrile neutropenia (FN). Subgroup analysis found that after completing 1 cycle of concurrent chemoradiotherapy, the incidence rates of grade 4 leukopenia and neutropenia were both 0. After completing 2 cycles of concurrent chemoradiotherapy, the incidence rates of grade 4 leukopenia and neutropenia were 0 and 2%.Conclusion:During the chemoradiotherapy, application of PEG-rhG-CSF in the primary preventation can significantly reduce the incidence of FN, grade 4 leukopenia and neutropenia, which is beneficial to ensure the smooth progress of concurrent chemoradiotherapy.

Objective:To investigate the relationship between cancer-related fatigue and cortisol in cancer patients and elucidate the underlying mechanism. Methods:A total of 80 cancer cases were divided into two groups:fatigue group (50 cases with cancer-related fatigue) and non-fatigue group (30 cases without fatigue). The scores were evaluated through the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) and the Fatigue Symptom Inventory (FSI) report. Serum specimens were examined through electrochemiluminesence immunoassay and enzyme-linked immunosorbent assay. Serum cholesterol was examined through the CHOD-PAP method, and serum total protein and albumin were determined via the Biuret method. Agarose gel electrophoresis was conducted to determine alpha 2 globulin ratio and to calculate serum alpha 2 globulin concentration. Results: The cortisol level in the fatigue group was significantly lower than that in the non-fatigue group[(119.68±5.34) nmol/L vs. (163.45± 31.49) nmol/L, P<0.05], and the adrenocorticotropic hormone (ACTH) level in the fatigue group was significantly higher than that in the non-fatigue group [(104.50 ± 17.15) ng/L vs. (51.43±13.24) ng/L, P<0.05]. Cortisol negatively correlated with MFSI-SF (r=-0.867, P<0.001) but positively correlated with ACTH (r=0.809, P<0.001). Furthermore, cortisol negatively correlated with FSI (r=-0.747, P<0.001) but positively correlated with ACTH (r=0.70, P<0.001). The levels of serum cholesterol [(1.25±0.70) mmol/L vs. (3.28±0.73) mmol/L, P<0.05], albumin[(18.24 ± 7.03) g/L vs. (37.40 ± 8.05) g/L, P<0.05], and alpha-2 globulin [(2.25±1.07) g/L vs. (5.36±1.09) g/L, P<0.05]were significantly lower in the fatigue group than in the non-fatigue group. Conclusion:The patients with cancer-related fatigue exhibited increased MFSI-SF score, decreased serum cortisol level, and enhanced ACTH level. The low serum cortisol levels caused a disorder in the serum ACTH and cancer-related fatigue of malignant tumor patients. The mechanism underlying the reduction in serum cortisol level correlated with the insufficient amounts of serum cholesterol, the composite material of cortisols, and of serum albumin, particularly alpha-2 globulin, the carrier protein of serum cholesterol.

Objective To evaluate the diagnostic value of triptorelin stimulation test in disorders due to delayed puberty.Methods Triptorelin stimulation test was carried out in 128 teenagers with delayed puberty,due to idiopathic hypogonadotropic hypogonadism(IHH) in 77 cases and constitutional delayed puberty(CDP) in 51.Blood samples were obtained 15 min before and 0,30,60,and 120 min after tripotorelin administration,and the levels of LH and FSH were determined.An extended GnRH stimulation test was carried out in 3 patients with IHH.Results Peak LH,peak FSH,and LH increment were parameters with high diagnostic value.A cut-off point at 8.2 IU/L of peak LH showed a sensitivity of 87％ and a specificity of 80.4％ in the differential diagnosis of IHH and CDP.Conclusion Peak LH cut-off point at 8.2 IU/L of triptorelin stimulation test seems to be sufficient to confirm diagnosis of IHH and CDP.An extended GnRH stimulation test may distinguish hypothalamic from the pituitary hypogonadotropic hypogonadism.