Objective To study the variation of gross tumor volume (GTV) and clinical target volume (CTV) definition for lung cancer between different doctors.Methods Ten lung cancer patients with PET-CT simulation were selected from January 2008 to December 2009.GTV and CTV of these patients were defined by four professors or associate professors of radiotherapy independently.Results The mean ratios of largest to smallest GTV and CTV were 1.66 and 1.65, respectively.The mean coefficients of variation for GTV and CTV were 0.20 and 0.17, respectively.System errors of CTV definition in three dimension were less than 5 mm, which was the largest in inferior and superior (0.48 cm,0.37 cm,0.32 cm;F=0.40,0.60,0.15,P=0.755,0.618,0.928).Conclusions The variation of GTV and CTV definition for lung cancer between different doctors exist.The mean ratios of largest to smallest GTV and CTV were less than 1.7.The variation was in hilar and mediastinum lymphanode regions.System error of CTV definition was the largest (<5 mm) in cranio-caudal direction.

Objective To investigate the causes of and prevention for cerebral complications in perioperative period in patients with carotid stenosis. Methods The causes and treatment of cerebral complications among 133 cases of carotid stenosis during perioperative period from May 2004 to Jun 2009 were analysed retrospectively. Results Among 133 cases, 94 cases underwent carotid endarterectomy (CEA) and 39 cases had carotid artery stenting(CAS). Cerebral complications developed in 16 cases including 3 cases of more than two attacks. 5 cases suffered from tansient ischemia attacks (TIA)or cerebral ischemia before operation. 5 developed TIA or cerebral hyperperfusion syndrome (CHPS) among those undergoing CEA and 4 developed TIA or CHPS among CAS cases. During postoperative period, 8 cases developed TIA, CHPS,cerebral infarction or cerebral hemorrhage. Conclusions Prevention and treatment of cerebral complications is extremely important durning surgical therapy of carotid stenosis.

Objective　 To investigate the role of calcitonin gene related peptide(CGRP) and endothelin-1(ET-1) in cirrhotic cardiomyopathy (CCM). Methods　We measured the level of CGRP and ET-1 in the samples of rat heart collected from 15 liver cirrhosis rats and 15 controls by using radio immunoassay. Results　 The data showed that the levels of CGRP (74.2130±10.3776pg/mg protein)and ET-1 level(1.4780±0.9235pg/mg protein) were significantly higher in the cirrhotic rat hearts than those in controls (P<0.05). The increase of ET-1 in the cirrhotic rat hearts was closely associated with the severity of liver cirrhosis (P=0.004); whereas no significant association was seen between the CGRP concentration and the severity of liver cirrhosis (P=0.307). Conclusion　We infer that the increasing of CGRP level in the cirrhotic rat heart may be a protective or antagonistic reaction to ET-1 or other pathogenic factors for cardiac dysfunction. The disturbance of the balance between CGRP and ET-1 in the liver cirrhosis rat hearts may contribute to the pathologic process of CCM.

Objective　The aims of this study were to determine ① the variation of blood TGFβ1 and ET-1 in patients with liver cirrhosis; ② the relationship of the blood TGFβ1 and ET-1 with Child degree of liver function and the severity of esophageal varices. Methods　Peripheral blood samples were obtained from 72 patients and 24 normal controls.The blood levels of TGFβ1 and ET-1 were measured by using a standard bioassay and the radioimmunoassay.Results　TGFβ1 level （11.77±1.32 ng/ml）and ET-1 level（78.37±17.54 pg/ml） were significantly higher in the patients than those in controls(P<0.05). The increase of the ET-1 in the patients is closely associated with Child degree of liver function (r=0.94) and the severity of esophageal varices(r=0.87). TGFβ1 concentration is not associated with Child degree of liver function (r=0.11) and the severity of esophageal varices (r=0.03) . Conclusion　TGFβ1 and ET-1 may play an important role in the pathophysiologic process of cirrhosis. ET-1 concentration may reflect portal hypertension development.

Objective To evaluate the value of non invasive examinations in the diagnosis of vascular disease of lower extremity. Methods Segmental systemic pressure (SEG), pulse volume recorder (PVR) and continuous wave (CW) were adopted to examination of 36 patients with arterosclerosis obliterans of lower limbs, and the foundings were compared with that of MRA and operation . Results In all 36 cases, non invasive examinations detected abdominal aorta and common iliac artery with femoral artery occlusion in 12 cases ,femoropoplitea artery occlusion in 28 cases, popliteal artery and the distal artery occlusion in 16 case; MRA together with operation confirmed abdominal aorta and common iliac artery with femoral artery occlusion in 11 cases, femoropopliteal artery occlusion in 32 cases and popliteal artery and the distal artery occlusion in 13 cases. The accurent diagnosis rate of non invasive examination was 85.7%. Conclusions Although PVR has not yet been used to replace the arteriography to directly observe the local situation of arterial lesions , it can preliminarily determine the obstruction sites and severe degree of the occluded arteries. PVR has convenient and reliability in the diagnosis,evaluation of the therapeutic effect and the postoperative follow up of blood vessel diseases,it is worthy to be widely applied in the clinical practice.