Objective To investigate the clinical effect of hyper-fractionated three-dimensional conformal radiotherapy (3DCRT) combined with transcatheter arterial chemeembolization (TACE) for heating patients with inoperable primary liver cancer.Methods One hundred and two patients with inoperable advanced primary liver cancer were divided by random digits table method into control group with 49 cases treated with TACE and observation group with 53 cases treated with hyper-fractionated 3DCRT combined with TACE.The short-term efficacy,adverse reaction and survival rate of the 1st,2nd and 3rd year and serum alpha-fetoprotein (AFP) expression after treatment in two groups were observed.Results The complete remission rate,progress rate and total efficiency were 17.0％ (9/53),11.3％ (6/53),73.6％ ( 39/53 ) in observation group,2.0％( 1/49 ),28.6％ (14/49),51.0％(25/49 ) in control group.There were significant differences between two groups (P ＜ 0.05).There was no statistical significance in adverse reactions between two groups ( P ＞ 0.05 ).The survival rates of the 1 st,2nd and 3rd year in control group were 51.0％ ( 25/49 ),28.6％(14/49),14.3％(7/49),the median survival time was 15 months;while those in observation groupwere 71.7％(38/53),52.8％(28/53),39.6％(21/53) and 20 months.The survival rates of the 2nd and 3rd year in observation group were significantly higher than those in control group respectively (P ＜0.05 or ＜0.01 ).The rate of patients with no obvious serum AFP protein change between observation group [ 9.8％(4/41) ] and control group [ 31.6％(12/38) ] had statistical significance (P ＜ 0.05).Conclusion Hyper-fractionated 3DCRT combined with TACE for treating patients with inoperable primary liver cancer has good clinical efficacy,it is worthy of clinical practice.

Objective To explore the effect of three-dimensional conformal radiation dose fractionation treatment of advanced non-small cell lung cancer(NSCLC).Methods 75 NSCLC patients were treated with hypofractionated 3DCRT( observation group),while 73 cases were treated with conventional fractionated radiotherapy (control group).The efficacy and adverse reactions were observed;Survival after treatment were followed up in 1,2,3 years.Lung function was detected before and after radiotherapy treatment,including FVC,FEV1 and CLCO.Results The total effective cases of control group were 47 cases patients ( 64.4％ ),observation group's was 60 cases ( 80.0％ ),total effective rate had statistically significant difference ( x2 =4.50,P ＜ 0.05 ).Survival of control group after treatment in 1,2,3year were 50.7％,24.7％,8.2％,the median survival was 13 months,observation group's were 73.3％,45.3％,20.0％,and 19 months.The survival of these two groups was statistically different (x2 =8.07,6,94,4.22,all P ＜ 0.05 ).The patients blood system side effects of observation group were significantly lower than the control group ( x2 =4.73,P ＜0.05 ) ;acute radiation pneumonia,esophagitis of these two groups had no significant difference in the incidence( P ＞ 0.05 ).Conclusion Hypofractionated 3DCRT treatment of advanced NSCLC had good effect,and its adverse reactions was low,and it was worthy of clinical application.

OBJECTIVETo summarize the method and experience of cardiopulmonary bypass (CPB) with vacuum-assisted venous drainage technology (VAVD) in the minimally invasive cardiac surgery (MICS).

METHODS35 cases of patients undergoing MICS were achieved femoral arterial cannula and femoral venous cannula. During the course of the CPB, we used the VAVD technology. At the same time, we selected 35 cases as control group.The time of the CPB, mechanical ventilation and ICU, and the amount of the urine, blood products, and chest drainage were recorded.

RESULTSThe time of mechanical ventilation and ICU staying, the volume of the blood products and the volume drainage within 48 h postoperatively in the MICS group were significantly shorter and less than that in control group (P < 0.05).

CONCLUSIONThe use of VAVD in the MICS can increase the vena cava drainage effectively, and ensure the surgery safe and successful.

Adolescent ; Adult ; Aged ; Cardiac Surgical Procedures ; methods ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Vacuum ; Veins ; Young Adult

Objective:To investigate the factors affecting the therapeutic effects of stereotactic radiotherapy on primary liver cancer.Methods:The clinical data of 116 patients with primary liver cancer who received stereotactic radiotherapy in Binzhou Central Hospital from February 2018 to April 2020 were retrospectively analyzed. The factors that affect the therapeutic effects of stereotactic radiotherapy on primary liver cancer were analyzed.Results:Stereotactic radiotherapy was effective in 85 patients, with an overall response rate of 73.28%. There were no significant differences in maximum tumor diameter, arteriovenous fistula, portal vein tumor thrombus, distant metastasis, pseudocapsule, liver function Child-Pugh grade, Barcelona clinic liver cancer staging, and the number of stereotactic radiotherapies between different patients ( χ2 = 14.71, 12.76, 19.16, 8.54, 7.30, 7.71, 9.41, 4.08, P < 0.05 or < 0.01). Maximum tumor diameter, portal vein tumor thrombus, pseudocapsule, liver function Child-Pugh grade, Barcelona clinic liver cancer staging, and the number of stereotactic radiotherapies were the independent risk factors that affect the therapeutic effects of stereotactic radiotherapy on primary liver cancer (Wald χ2 = 3.13, 3.75, 4.16, 5.20, 3.90, 3.40, all P < 0.05). Conclusion:Many factors affect the therapeutic effects of stereotactic radiotherapy on primary liver cancer. Early identification of the high-risk factors for primary liver cancer is conducive to minimizing the risk of stereotactic radiotherapy, improving the therapeutic effects of stereotactic radiotherapy, and improving the prognosis. This study is highly innovative and scientific.

Objective To comparatively analyze the immunological characteristics of patients with mild and severe influenza A (H1N1), and to provide the evidence for condition monitoring and treatment . Methods 52 cases with mild influenza A ( H1N1), 152 cases with severe influenza A ( H1N1) and 26 healthy subjects from July 1, 2009 to December 31, 2009 were enrolled in the study.Lymphocyte subsets in peripheral blood were analyzed by flow cytometry and the serum concentrations of interferon -γ( IFN-γ) and interleukin-4 (IL-4) were detected by enzyme-linked immune-sorbent assay (ELISA).Results The total lymphocyte counts were decreased obviously in patients with severe influenza A ( H1N1) than in mild pa-tients and in healthy subjects (P<0.01).The T lymphocyte, NK cells, CD4+T lymphocyte and CD8+T lym-phocyte were also decreased obviously in severe patients than in mild patients (P<0.01).The B lymphocyte and CD4+/CD8+were also decreased in severe patients than in mild patients but had no significant statistical difference (P=0.11, 0.175).The serum IFN-γlevels in patients with mild and severe influenza A (H1N1) were lower than those in control group, especially in patients with severe influenza A (H1N1) (compared with control group and mild group , P<0.01).And the changes of serum IL-4 levels were the same with the former, but there were no statistically significant differences in three groups (P>0.05).Con-clusion Immune dysfunction in patients with influenza A (H1N1) infection is associated with the severity of disease, especially cellular immunity .Therefore, monitoring of the immune system is valuable for the diag-nosis of influenza A(H1N1) infection.

Objective To investigate the inhibiting effect of CGP77675 (CGP),a Src inhibitor,on epithelial-mesenchymal transition (EMT) of human retinal pigment epithelial (RPE) cells induced by transformation growth factor-β1 (TGF-β1).Methods Human RPE cell line (ARPE19 cells) was cultured in vitro and divided into control group,TGF-β1 group and TGF-β1 +CGP group.Corresponding agent was added into culture medium based on grouping.The morphology of the cells were examined under the optical microscope 3 days after culture.The expressions of EMT-related genes and proteins in the cells were detected by real-time quantitative PCR and Western blot,respectively,including fibronectin 1 (FN 1),and plasminogen activation inhibitor 1 (PAI1),and the expressions of zonula occludens protein 1 (ZO1) and cytoskeleton protein filamentous actin (F-actin) were detected by immunofluorescence staining.MTT assay was employed to evaluate the cell proliferation rate.The migration distance of the cells was measured by scratch test.Results The ARPE19 cells in the control group showed an epithelial-like morphology and F-actin and ZO-1 were expressed along cell membrane.In the TGF-β1 group,the cells appeared to be fibrous-like,and the fluorescence staining of F-actin was disordered and ZO-1 was discontinuous on the cell membrane.The cells in the TGF-β1 +CGP group remained to be an epithelial-like in shape with clear and complete expressions of F-actin and ZO-1.The relative expressions of FN1 mRNA and PAI1 mRNA in the cells were 0.211 ± 0.080 and 0.116±0.073,1.000±0.001 and 1.000±0.001,0.368±0.097 and 0.362±0.048 in the control group,TGF-β1 group and TGF-β1 +CGP groups,showing significant differences among the groups (F=33.14,82.92;both at P＜0.01),with the highest expressions ofFN1 mRNA and PAI1 mRNA in the TGF-β1 group (all at P＜0.05).The relative expressions of FN1 and PAI1 proteins were 0.166±0.055 and 0.327±0.066,1.000±0.001 and 1.000± 0.001,0.143 ± 0.030 and 0.260 ± 0.077 in the control group,TGF-β1 group and TGF-β1 + CGP group,with significant differences among three groups (F=181.90,48.85;both at P＜0.01),and the expressions FN1 and PAI1 proteins were significantly higher in the TGF-β1 than those in the control group and TGF-β1 +CGP group (all at P＜0.05).The cell proliferative rate in the TGF-β1+CGP group was (79.30±3.44) ％ and (54.80±7.39) ％ at the third day and seventh day after culture,which were significantly reduced in comparison with (99.50 ± 1.00)％ and (99.10±0.50)％ in the control group as well as (95.10±4.20)％ and (92.10±4.50)％ in the TGF-β1 group (all at P＜0.05).The migration distance was disappeared in the TGF-β1 group,and the scratch width was not obviously changed in the TGF-β1 +CGP group.Conclusions Src inhibitor can inhibit EMT process of ARPE19 cells induced by TGF-β1,indicating that Src signaling pathway may play a critical role in EMT of RPE cells.