Purpose: To evaluate the efficacy and the side effects of 3 D-conformal radiotherapy for malignant thoracic tumor. Methods: Between September 1999 and August 2002, 36 patients with malignant thoracic tumor were treated with 3D-conformal radiotherapy. Twenty-two patients had primary lung cancer, 12 patients had metastatic lung cancer, and 2 patients had malignant mediastinal tumor. All 36 patients were pathologically confirmed. Squamous cell carcinoma 16 cases, adenocarcinoma 15 cases, small cell carcinoma 2 cases, embryonal carcinoma 1 case, malignant thymoma 1 case and sarcoma 1 case. For the primary tumor, conventional radiotherapy was first used to 50Gy/25F/5W, followed by 3D-conformal radiotherapy 16-20Gy(4Gy per fraction, 3 fractions per week) with MLC or cone from 5 ~6 non coplanar or coplanar static ports. For metastatic tumor, using arc therapy to only 28-40Gy(4Gy per fraction, 3 fractions per week, 7-10 fractions) with cone from 1 ~ 4 arcs. Tumor volumes from 1. 85 cm3 to 104. 61 cm3 with a median of 24. 96 cm3 in 3D-CRT. Results: To evaluate the effects, thoracic CT scan was taken two months after completion of 3D-conformal radiotherapy. In 34 evaluated patients, 13 cases obtained CR, 14 PR, 5 NC, and 2PD. The overall 1 and 2-year survival rates were 74. 1% and 38.4%. Toxicity consisted of grade 1 acute radiation pneumonitis in 17 patients, grade 2 in 10 patients, grade 3 in 1 patients, and 2 patients dead of radiation pneumonitis ( with non coplanar technique), late complication was radiation pulmonary fibrosis, grade 1 in 20 cases, grade 2 in 8 cases. Conclusions: 3D-conformal radiotherapy as complement of conventional external beam radiotherapy for malignant thoracic tumor can obtain better short-term effects, although the survival is yet to be investigated. But attention must be given to the irradiation technique, the irradiation volume should not be too large and beams angles appropriately adjusted to avoid excessive irradiated volume in normal lung.

Objective To analyze and discuss the causes of late dysfunction following the mismanagement of acute Lisfranc fracture- dislocations in light of the latest advancement in this field. Methods From March 2000 to February 2005, we treated 34 cases of old Lisfranc fracture- dislocation. 24 cases were treated with open reduction and internal fixation, and 10 with arthrodesis. Results According to the AOFAS for midfoot, 2 cases scored 50 to 60, 4 cases scored 60 to 70, 5 cases scored 70 to 80, 18 cases scored 80 to 90 and 5 cases scored 90 to 100. Conclusions Since the incidence of Lisfranc fracture- dislocation tends to increase, clinic orthopedists must take great care to examine the midfoot strain lest a case should be overlooked. The late complications are related to poor reduction, inadequate fixation, or inadequate postoperative immobilization. For most patients, open reduction and internal fixation within 6 weeks after injure is preferred. The cannulated screws are simple and stable for fixation of lateral and medial columns, and screw removal should be done 3 to 4 months after surgery to prevent recurrent diastasis and screw breakage.

Unilateral enlargement of the vestibular aqueduct (EVA)is a relatively rare disease. Bilateral EVA was found to be more common than unilateral EVA. There are significant differences in clinical features and molecular etiology between unilateral EVA and bilateral one. This article reviewed related researches of the unilateral EVA in clinical characteristics, molecular etiology and pathogenic mechanism.
Vestibular Aqueduct ; pathology

Objective To evaluate the clinical diagnosis,treatment and prognostic factors of kidney clear cell renal carcinoma(KIRC)in international sample database.Methods From 1998 to 2012,consecutive patients with KIRC who diagnosed and treated in TCGA organizations were enrolled.Clinical characteristics,objective response and survival time were evaluated,and correlation analysis with lncRNA urothelial cancer associated 1 (UCA1)gene was performed.Results 512 patients with KIRC were enrolled.35.4% of patients were female,59.6% of stage Ⅰ -Ⅱ, 90.0% of white and 45.1% of grade 1 -2.Comprehensive treatment was consistent with the clinical guidelines. Significant correlation was found between UCA1 expression and 4 mRNA subtype,30 genes mRNA expression, mir -101 -1 expression and PBRM1 mutation.And patients with UCA1 overexpression could achieve poor prognosis. Conclusion Diagnosis and treatment of the international TCGA -KIRC research meets clinical guidelines.UCA1 overexpression is an important poor prognostic factor.Combined with the clinical relevance of other important driver genes,UCA1 may be significantly valuable for further study.

Aim To prepare for psoriasis transgenic animals, psoriasis susceptible gene was constructed. Methods Extract gDNA from blood preparations of psoriasis patients, screen positive gDNA owns HLA-Cw*0602 gene, then copy the whole sequence and link it to pMD-19T Simple Vector. Results The identification showed the construction of psoriasis susceptible gene was sucessful. Conclusion The successful construction of HLA-Cw*0602 gene will lay the foundation for development of transgenic animal models of psoriasis.

Based on entire literature retrieval about low back pain treated with acupuncture and moxibustion, Clinical Practice Guideline for Low Back Pain Treated with Acupuncture and Moxibustion was drafted according to method of evidence quality and recommended intensity grading system(GRADE). This article specificly introduces the aim and available diseases of the guideline. The principle and recommended plans are also detailedly explained.
Acupuncture Therapy ; methods ; standards ; China ; Humans ; Low Back Pain ; therapy ; Moxibustion ; methods ; standards ; Practice Guidelines as Topic

Objective To discuss the pathomechanism of medial ankle instability after medial ligament injury. Methods The study involved 15 patients including eight males and seven females, at average age of 40 years (range 22-58 years). There were two patients with acute ankle sprain, three with chronic ankle injury, three with congenital pes planus, five with posterior tibial tendon dysfunction, one with pronation external rotation ankle fracture and one with old avulsion medial malleolus. All patients were treated surgically with deltoid ligament repair, when eight patients further received calcaneal lengthing osteotomy, five received medial cuneiform close wedge osteotomy and one received medial shift calcaneal osteotomy. All patients were followed up for 7-56 months. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was used for pre- and post-operative evaluation of the function. All data were analyzed using t test. Results The clinical data of one patient was excluded from the statistical analysis because AOFAS ankle-hindfoot scale could not be applied for evaluating the acute ankle fracture. The AOFAS ankle-hindfoot scale was 42.4 + 10.6 before surgery and 89.8 +6.2 at the final followup for 14 patients (P＜0.05). Conclusions Deltoid ligament is an important anatomical structure.More attention should be paid to its repair under following aonditions: ( 1 ) the injury of the deltoid ligament involves tibiospring and tibionavicular ligament; (2) patients have congenital pes planus and posterior tibial tendon dysfunction; (3) patients present with ankle fractures and have history of repeated ankle sprain.

Aged ; Cavernous Sinus ; Humans ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Syndrome