Objective To analyze the 10-year survival outcome and failure patterns for patients with nasopharyngeal carcinoma (NPC) after intensity-modulated radiotherapy (IMRT),aiming to provide reference for optimized treatment for NPC.Methods Clinical data of 866 patients with NPC receiving IMRT from January 2001 to December 2008 were retrospectively analyzed.Survival analysis was performed using the Kaplan-Meier estimator.Univariate analysis was carried out by log-rank test and multivariate analysis was performed using Cox proportional hazards model.Results The median follow-up time was 132 months.The 10-year local recurrence-free survival (LRFS),distant metastasis-free survival (DMFS),progression-free survival (PFS) and disease specific survival (DSS) were 92.0％,83.4％,75.7％ and 78.6％,respectively.A total of 210 patients died including 124 patients (59.0％) from distant metastasis,which was the primary cause of death,and 47 (22.3％) from local regional recurrence.Independent negative factors of DSS included age＞50 years (P=0.00),LDH ≥ 245 IU/L (P=0.00),Hb＜ 120 g/L (P=0.01),T2-T4 staging (P=0.00),N1-N3 staging (P=0.00) and GTV-nx＞20 cm3(P=0.00).The 10-year LRFS,DMFS and DSS of stage Ⅱ NPC patients did not significantly differ after IMRT alone and chemoradiotherapy (P=0.83,0.22,0.23).For patients with stage Ⅲ NPC,the 10-year LRFS and DSS in the chemoradiotherapy arm were significantly higher than those in the IMRT alone (P=0.01,0.01),whereas no statistical significance was observed in the DMFS between two groups (P=0.14).The overall survival of stage Ⅳa+Ⅳb NPC patients is relatively poor.Conclusions IMRT can improve the long-term survival of NPC patients.Distant metastasis is the primary failure pattern.Patients with stage Ⅰ-Ⅱ NPC can obtain satisfactory survival outcomes after IMRT alone.The addition of chemotherapy can further enhance the LRFS and DSS of stage Ⅲ NPC patients.However,the optimal therapeutic strategy remains to be urgently investigated for stage a+ Ⅳb NPC patients.

Objective To establish a post?treatment prognostic score model for newly diagnosed metastatic nasopharyngeal carcinoma, and to investigate the feasibility of stratified therapy. Methods A total of 263 eligible patients with newly diagnosed metastatic nasopharyngeal carcinoma from 2002 to 2010 were enrolled as subjects. The primary tumor was treated with conventional radiotherapy, three?dimensional conformal radiotherapy, or intensity?modulated radiotherapy, and radiation areas included nasopharyngeal tumor and cervical lymphatic drainage region. The metastatic bone tumor was mainly treated with conventional external radiotherapy, while the metastatic liver or lung tumor was mainly treated with surgical resection, radiotherapy, or radiofrequency ablation. The first?line therapy for most of patients was cisplatin?based combination chemotherapy. Factors including the general characteristics, tumor status, and therapy for patients were involved in multivariate analysis, and a prognostic model was established based on the n value (HR=en ) of the prognostic factors. Results The factors influencing the overall survival (OS) in patients were a Karnofsky performance score (KPS) not higher than 70(P= 0?? 00), multiple organ metastases (P=0?? 00), combination with liver metastasis (P= 0?? 00), a number of metastases not less than 2(P= 0?? 00), a level of lactate dehydrogenase (LDH) higher than 245 IU/ L (P= 0?? 00), a number of chemotherapy cycles ranging between 1 and 3( P= 0?? 00), a poor response for metastatic tumor ( stable disease or progressive disease)(P= 0?? 00), and primary tumor not treated with radiotherapy (P= 0?? 01). Based on the prognostic score, patients were divided into low?risk group (0?1?? 5 points), intermediate?risk group (2?? 0?6?? 5 points), and high?risk group (≥7?? 0 points), and the 5?year OS rates in the three groups were 59?? 0%, 25?? 1%, and 0%, respectively. Conclusions The prognostic score model based on the KPS, serum level of LDH, multiple organ metastases, combination with liver metastasis, and number of metastases can effectively predict the survival in patients. Active treatment including at least 4 chemotherapy cycles and radiotherapy for primary tumor can prolong the survival time of patients in the low?and intermediate?risk groups. However, patients in the high?risk group were mainly treated with palliative radiotherapy due to no improvement in the survival by radiotherapy for primary tumor.

OBJECTIVEThe aim of this study is to develop a simple and rapid HPLC method and investigate the effect of glycyrrhizin on pharmacokinetic fate of paeoniflorin after intravenous administration.

METHODPaeoniflorin and glycyrrhizin was administrated to rat via vena caudalis, and paeoniflorin in rat plasm was determined by RP HPLC method and internal standard method. All data were subsequently processed by the pharmacokinetic Software WinNonLin. The non-compartmental pharmacokinetic parameters of area under the plasma concentration-time curve (AUC/min x mg x L(-1)), clearance (CL/mL x min(-1) x kg(-1) ) and volume of distribution (Vd/mL x kg(-1)) were calculated based on moment methods.

RESULTThe values of AUC, V(d) and CL was 166.81 +/- 26.94, 394.33 +/- 29.52, 18.40 +/- 3.12 in control group, respectively; however, the values of AUC, V(d), CL was 235.44 +/- 46.48, 266.63 +/- 48.43 and 13.16 +/- 2.59 in experimental group.

CONCLUSIONGlycyrrhizin significantly influenced the pharmacokinetic fate of paeoniflorin, increasing the value of AUC and decreasing CL and V(d).

Animals ; Benzoates ; administration & dosage ; blood ; pharmacokinetics ; Bridged-Ring Compounds ; administration & dosage ; blood ; pharmacokinetics ; Female ; Glucosides ; administration & dosage ; blood ; pharmacokinetics ; Glycyrrhizic Acid ; administration & dosage ; Injections, Intravenous ; Male ; Monoterpenes ; Random Allocation ; Rats ; Rats, Sprague-Dawley

Three fresh lungs removed from three male adult dogs were injected with ABS. This material was injected into each lobe of the lung through the pulmonary artery and bronchus simultaneously. The pressure was maintained between 200～280 mmHg. The injected specimens were digested in 20～50％ HCl and peptic solutions for 7～10 days. A part of the cast replicas of the lungs was taken off and gilded with EIKO IB-3. Under SEM (HITACHIS～450) the specimens thus prepared were observed. The chief findings were as follows:Scanning electron micrographs of the injected vascular system presented a clear, three-dimensional picture of extensive capillary networks around the individual alveoli. In the septa between alveoli the capillary networks appeared to be a single layer. These networks looked like pentagonal or hexagonal rings; the meshes in between them were smaller than the vessels themselves.The capillaries observed here in the scanning stereopicture belonged to the category of the alvioli cappilary of the subpleura; the meshes of which were larger than those of other parts.Because the numerous alveoli and capillary networks surrounding the alveoli were filled with the ABS, the position and the shape of the capillary networks can be seen very clearly.The lumen of the alveoli were polyhedron in shape, various in sizes and smooth in contour. Many imprints of the alveolar type Ⅱ cell nuclei existed on the surface. The bridge formation between alveoli were really interalveolar pores; their number and diameter varied. The function of the interalveolar pores was briefly considered in this paper.

Hearts from eight adult dogs were perfused through both coronary arteries with methylmethacrylate. Small specimens cut out from the left ventricular wall were eroded in 50% HCL for 5-7 days. The replicas were studied under the SEM (S-450). The main results were outlined as follows: The subendocardial capillary plexus composed of varied shapes and orientation of meshes was present. The capillary network of the myocardial layers was consisted of many parallel capillaries and between them a variety of models of anastomoses, such as "H" "K" and "8" modes etc, were observed. In our findings, it was demonstrated that the arteriole and venule were distributed between the myocardial bundles and their direction was often perpendicular to the myocardial bundles. The postcapillary venules were poured into venule by the "ginger or turnip root" arrangement. The replicas of the Thebesian veins were proved in our specimens. The A-V shunting was not observed.

The innervation of sino-atrial node in 5 dogs demonstrated by Faworsky's silver impregnation technique was studied and the results were summarized as follows: 1.On the basis of observation under microscope,two-third of the area adjacent to the suleus terminalis was found to be occupied by the main part of the sino-atrial node in the dog. 2.The nerve ganglia in the sino-atrial node and its peripheral zone were distingu- ished in two groups. 1)The Subepicardial group,i.e,the nerve ganglia of the peripheral zone around the node:It consists of the superficial and profund groups.Most of the nerve ganglia are present close to the sulcus terminalis and become less in number as approaching the cava- auricular angle.The largest nerve ganglion comprising of 30 cells could be seen with naked eye on the section,and the smaller ones are those with individnd cells. 2)Peripheral group around the artery,i,e the nerve ganglia within the node:They were situated around the sino-atrial artereis adjacent to the sulcus terminalis.Occasionally two ganglia may appear in one visual field.They were scattered among the nodal cells and also among myocardial fibers between the sino-atrial node and the endocardium. The characteristics of the structure of the nerve ganglia in both groups were described. 3)The relation of the nerve bundles and the nerve ganglia was studied in detail. The authors presumed that both the parasympathetic postganglionic fibers and parasympa- thetic preganglionic fibers existed in the sino-atrial node.

The coronary arteries of 80 rabbit hearts were studied.Suspension of red lead oxide (Pb_3O_4)in turpentine was injected into the coronary artery.With clearing method and angiographic technique,we studied the branches of the left and right coronary artery, the angle between the anterior descending branch and the left circumflex branch of the left coronary artery,the relationship between the anterior descending artery and the great cardiac vein,the origin of the sinoatrial nodal artery and the atrioventricular nodal artery as well as the type of branch in coronary artery.The results were outlined as follows: 1.The angle between the anterior descending branch and the left circumflex branch is 35～45?in more than one half of the cases(54.5%). 2.The anterior descending branch is often small and short and accompanies the great cardiac vein.It may exist in four forms:1)Both branches run closely to each other. 2)Both run along with each other but leaving a distance in between.3)Both are over- lapping each other.4)Both are crossing each other between the inferior margin of the left auricle and pulmonary artery cone.Ligation of the anterior descending branch in animal experiments should be appropriately made between the right inferior margin of the auricle and the pulmonary artery cone. 3.The left ventricular branch is a direct continuation of the circumflex branch and gives off branches to anterior and posterior wall of the left ventricle. 4.There is an independent ventricular septal artery in the rabbit heart. 5.The sinoatrial nodal artery of the rabbit heart arises frequently from the right coronary artery(86.6%)and the atrioventricular nodal artery from the left coronary artery(72.5%). 6.Commonly the distribution of the coronary blood supply from the left and right coronary arteries to rabbit heart is nearly a balanced circultion(67.5%).Next frequent is the preponderance of the left coronary artery(28.8%),and the preponderance of the right coronary artery occurs only in 3.7%.

The architecture of the alveolus and its capillaries of human lung injected withsolution of ABS in methyl ethyl ketone was studied under the SEM.The results wereoutlined as follows:1.The alveolar casts were observed from the subpleural and intralobular septu-lar surfaces.The human alveolus is irregular polygon in appearance.The size ofthe alveolus is variable,its surface is smooth,there are many depressions of the topof type Ⅱ cells.The bridge-like structure between two adjacent alveoli are thecasts of the alveolar pores.They are variable both in size and number,and ofround or oval shapes with smooth surface.2.Capillaries of the subpleural space and interlobular septulum are transitional,and identical in appearance.Meshes of the capillary network are larger than thoseof other parts,but more closer in density compared with those in dog.Each capil-lary is branched from the metaarteriole.3.Capillaries in the alveolar septum is a single layer of dense network,theirdiameter are larger than those of the mesh hole.They originate mainly from thecapillaries of subpleural space and interlobular septulum.

The vascular architecture of the adult man testis was examined by using thevascular casting method combined with scanning electron microscopy.The circuitousmain branches of testicular artery ran radially from testicular porta towards testicu-lar free border in tunica vasculosa.The test(?)cular surface veins were accompaniedby the main branches of testicular artery and they converged from testicular circum-ference circuitously towards testicular porta.There were centripetal artery andvein as well as centrifugal artery and vein in the septula testis.The intertubularblood vessels and the peritubular capillary plexus were contained in the testicularlobules.The latter was made up of two capillary layers.The outer layer was capil-lary network interwined in fine capillaries.The inner layer was coarse capillarycircles.The interstitial capillary plexus was situated in interstitial tissue between theseminiferous tubules and compose of capillaries arising from the origin of someperitubular capillaries.