Objective:To investigate the efficacy of stereotactic body radiotherapy (SBRT) combined with modified FOLFOXIRI (mFOLFOXIRI, irinotecan, oxaliplatin, leucovorin and fluorouracil) and cetuximab in the treatment of postoperative liver metastases in patients with KRAS, BRAF and NRAS gene wild-type colorectal cancer, and to evaluate treatment-related adverse reactions.Methods:A total of 86 patients with postoperative liver metastases from colorectal cancer diagnosed in Shandong Daizhuang Hospital from January 2018 to January 2021 were selected, all of whom were KRAS, BRAF and NRAS gene wild-type. All patients were divided into control group and study group according to the random number table method, with 43 cases in each group. The patients in the control group were treated with mFOLFOXIRI and cetuximab, 14 days a cycle, for a total of 12 cycles. The patients in the study group were treated with SBRT for liver metastases on the basis of the control group. Two patients in the control group were withdrawn from the study due to intolerance of myelosuppression (grade 4), and patients in the study group were withdrawn from the study due to intolerance of 1 case of myelosuppression, 1 case of gastrointestinal reaction and 1 case of abnormal liver function (all grade 4). The efficacy, median progression-free survival (PFS), median overall survival (OS) and adverse reactions were compared between the two groups after treatment.Results:After 12 cycles of treatment, the objective response rate (ORR) and disease control rate (DCR) of the study group were 55.00% (22/40) and 80.00% (32/40) respectively, which were higher than 31.71% (13/41) and 58.54% (24/41) of the control group, with statistically significant differences ( χ2=4.48, P=0.034; χ2=4.37, P=0.037). After treatment, 14 patients (35.00%) in the study group were resectable, which was higher than 6 patients (14.63%) in the control group, with a statistically significant difference ( χ2=4.52, P=0.034). The median PFS and median OS of the study group were 9.2 months and 19.5 months respectively, which were longer than 6.5 months and 15.2 months of the control group, with statistically significant differences ( χ2=8.83, P=0.015; χ2=7.52, P=0.027). There were no significant differences in incidences of leukopenia [55.00% (22/40) vs. 46.34% (19/41), χ2=0.61, P=0.436], anemia [45.00% (18/40) vs. 39.02% (16/41), χ2=0.30, P=0.585], thrombocytopenia [37.50% (15/40) vs. 31.71% (13/41), χ2=0.30, P=0.584], nausea and vomiting [55.00% (22/40) vs. 48.78% (20/41), χ2=0.31, P=0.575], constipation and diarrhea [20.00% (8/40) vs. 17.07% (7/41), χ2=0.12, P=0.734], liver function damage [35.00% (14/40) vs. 29.27% (12/41), χ2=0.31, P=0.581], peripheral sensory neuropathy [30.00% (12/40) vs. 26.83% (11/41) ), χ2=0.10, P=0.752], acute cholinergic syndrome [12.50% (5/40) vs. 14.63% (6/41), χ2=0.08, P=0.779] and fatigue [52.50% (21/40) vs. 43.90% (18/41), χ2=0.60, P=0.439]. Conclusion:SBRT combined with mFOLFOXIRI and cetuximab is more effective than drug therapy alone in patients with liver metastases after colorectal cancer surgery, which can effectively prolong the survival period, and the adverse reactions are tolerable.

Objective To investigate the therapeutic effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on motor function and affective disorder in patients with Parkinson's disease (PD). Methods Twenty PD patients were performed by 1 Hz rTMS therapy for 15 days and 10 matched patients were performed sham stimulation. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Unified Parkinson' s Disease Rating Scale (UPDRS) were assessed before and 15 days after rTMS treatment. Results After treatment with rTMS, the motor function was improved, and UPDRS total score and UPDRS-Ⅰ , UPDRS-Ⅱ, UPDRS-Ⅲ scores were decreased. UPDRS score was decreased from (38.45±17.33) to (30.95± 17.00) (t=6.780,P<0.01). At the same time, HAMD score was decreased from (12.15±7.62) to (8.75±7.31 ) (t = 5.101, P<0.01 ). The scores of somatization, blockage and sleep disorders were lowered after treatment, but the HAMA score had no significant change(t=1.757, P>0.05). The rigidity of PD patients was improved obviously. All indexes had no improvement in sham stimulation group. Conclusions Low frequency rTMS may improve motor dysfunction and affective disorder in PD patients .

Objective To study the possible effects of transcranial magnetic stimulation (TMS)on the sleep structure of the patients with Parkinson's disease.Methods Fifteen PD patients attending an outpatient Movement Disorders Unit at Department of Neurology,Cerrahpasa Faculty of Medicine,between September 2006 and December 2007 were included in the study.All patients had received TMS treatment.The stimuli were delivered through a circular coil with a 12 cm diameter and a 2.0 T peak magnetic field.They underwent clinical evaluation and polys omnographic (PSG) evaluation before and after a minimum treatment period of 10 days with TMS.Results The mean UPDRS score was significantly decreased after TMS(before treatment,38.83?16.72;after treatment,25.09?11.10).PSG revealed that administration of TMS resulted in significant decrease in mean Sleep latency[before treatment,(53.50?46.40)min;after treatment,(30.43?23.91)min].Slow wave (stage 3+4) was found in somes patients after treatment.But here was a trend towards an decrease in Percentage of stage 1,REM latency and REM sleep without significance.Conclusion This study demonstrates that motor symptom of PD was improved and Sleep latency was decreased by TMS.Sleep structure was not changed before and after TMS treatment.