Structural identification of the related substances in phloroglucinol injection by two-dimensional liquid chromatography-quadrupole time-of-flight mass spectrometry / 药学学报

This study aimed to identify the related substances of phloroglucinol injection by two-dimensional liquid chromatography quadrupole time-of-flight mass spectrometry (2D-LC-Q-TOF/MS). The first-dimensional separation was carried out on an HSS T3 (250 mm × 4.6 mm, 5 μm) column by gradient elution using 1.36 g·L-1 potassium dihydrogen phosphate buffer solution (pH adjusted to 3.0 with diluted phosphoric acid) and acetonitrile as the mobile phases. The separated components were then trapped in switch valve tube lines respectively and delivered to the second-dimensional desalting gradient elution which was performed with a BDS C18 (100 mm × 4.6 mm, 2.4 μm) column using 0.1% formic acid and methanol as the mobile phases. After rapid desalting, electrospray-ionization quadrupole time-of-flight high resolution mass spectrometry was used for determining the accurate masses and elemental compositions of the parents and their product ions for both phloroglucinol and its related substance. Structures of the related substances were then figured out by mass spectrometry elucidation, organic reaction mechanism analysis, and/or comparison with reference substances. Under the established analytical conditions, phloroglucinol and its related substances were adequately separated, 17 main related substances were detected and identified in the injection and its stressed samples for the first time. The identification results can provide reference for the quality control of phloroglucinol injection.

Effect of added halide ions and pH on the solubility of nebivolol hydrochloride and the evaluation of selected, discriminating dissolution media / 药学学报

The solubility of nebivolol hydrochloride was determined in acidic aqueous media in the absence and presence of different concentration of NaCl, NaBr, or NaI at 37 ℃ in order to facilitate proper selection of dissolution media that have adequate discriminating power for enhancing the likelihood of a generic drug product to successfully pass in-vivo bioequivalence test. In the range of pH 5.0 to pH 1.0, the solubility of nebivolol hydrochloride decreased with the decrease in the pH of aqueous solution, and the solubility of nebivolol hydrochloride further decreased with the increase in the concentration of added sodium chloride. The solubility decrease of a few weakly basic drug molecules in acidic media and in higher concentration of added chloride was published previously by other researchers, and the observed decrease in the solubility in the presence of higher chloride concentration was interpreted in terms of common-ion effect. However, the results in this paper showed that the solubility of nebivolol hydrochloride also decreased when sodium chloride was replaced with sodium bromide or iodide. The approach described in this paper (i.e. substituting sodium chloride with sodium bromide or iodide) provides an effective method to verify whether common-ion effect is the true (or at least the sole) driving force behind the observed decrease in the solubility of nebivolol hydrochloride in the presence of sodium chloride. The solubility decrease reported in this paper can be interpreted in terms of salting-out effect of sodium chloride, bromide, and iodide. For hydrochloride salt of a weakly basic drug molecule like nebivolol hydrochloride, its solubility in an acidic dissolution medium can be purposely decreased to the lower end of sink condition by adding sodium chloride to make the resulting medium more discriminating. As shown in this paper, a medium at pH 1.2 with added sodium chloride is discriminating and this medium is shown to be bio-relevant to the in-vivo data collected under fasting condition (in-vivo study protocol was approved by Institutional Review Board).

Analysis of clinical characteristics, surgical strategy and prognosis for brainstem gangliogliomas / 中国医师进修杂志

Objective To analyze the clinical and imaging features, surgical strategy and prognosis in patients with brainstem gangliogliomas (GG). Methods The clinical data of 46 patients with brainstem GG from February 2010 to August 2017 were retrospectively analyzed. The clinical and imaging features, surgical methods and prognosis were reviewed. Results The age of 46 brainstem GG patients was (22.5 ± 4.6) years, the duration was (38.1 ± 8.9) months, and the most common symptoms were dizziness and headache, accounting for 47.8％(22/46). The MRI results showed that endogeny type was in 5 cases, exogenesis type in 10 cases, and endogeny-exogenesis type in 31 cases. The exogenesis type was enrolled as non-infiltrate brainstem group (10 cases), and the endogeny type and endogeny-exogenesis type were enrolled as infiltrate brainstem group (36 cases). The axial T1WI showed that the crescent sign was in 20 cases (43.5％, 20/46), and the sagittal T1WI showed that the patching sign was in 31 cases (67.4％, 31/46). Among all patients, total resection was achieved in 13 cases, near total resection in 9 cases, subtotal resection in 16 cases, partial resection in 7 cases and biopsy in 1 case. No operative death occurred. The patients were followed up for 3 to 87 (40.6 ± 12.8) months, and 5 patients died (all in infiltrate brainstem group). The progression- free survival in non- infiltrate brainstem group was significantly longer than that in infiltrate brainstem group:(46.0 ± 13.1) months vs. (19.5 ± 8.9) months, and there was statistical difference (P<0.05). Conclusions Most brainstem GG has some unique MRI characteristics. Microsurgical resection might be preferred. Tumors that locate outside the brainstem can be fully removed. The long-term prognosis of brainstem GG is better.

Identification of the related substances of vortioxetine hydrobromide by LC-MS techniques / 药学学报

The study was aimed to identify the related substances of vortioxetine hydrobromide by hyphenated techniques. The separation of the six related substances was performed on a Phenomenex Luna Phenyl- Hexyl column (150 mm×4.6 mm, 3 μm) by linear gradient elution of acetonitrile and ammonium formate solution. Electrospray and atmospheric pressure chemical ionization were interfaced respectively with high resolution Q-TOF/MS for the determination of the accurate mass and elemental composition of the parent ions of the related substances, and triple quadrupole tandem mass was employed for the product mass spectra determination. The structures of the related substances were identified through elucidation of the fragment ions. Vortioxetine hydrobromide and its related substances were adequately separated under the established HPLC conditions. Six major related substances were detected and identified for the first time. The data provides a reference for optimization of the synthetic process and quality assurance of vortioxetine hydrobromide.

Pharmacokinetics of mercury after oral administration of cinnabaris and Fufang Niuhuang Xiaoyan capsule in rats / 中国中药杂志

Fufang Niuhuang Xiaoyan capsule was a classical compound prescription with the efficacy of heat-clearing, detoxification, sedation and anti-inflammation, with cinnabaris as one of its active ingredients. The study focuses on the pharmacokinetics of mercury in rats after oral administration of cinnabaris and Fufang Niuhuang Xiaoyan capsule, in order to explore the effect of combined traditional Chinese medicines on mercury metabolism. In this study, the method of nitric-perchloric acid digestion system coupled with cold atomic-atomic fluorescence spectroscopy (CV-AFS) was adopted to accurately determine mercury in whole blood of rats. Fufang Niuhueng Xiaoyan capsule had three dose schemes of oral administration, namely equivalent clinical dose, 3 times of equivalent clinical dose and 10 times of equivalent clinical dose; And the doses of oral administration of cinnabaris was calculated according to that of Fufang Niuhuang Xiaoyan capsule. SPF grade healthy SD rats were fasted overnight before the oral administration with cinnabaris suspension (or Fufang Niuhuang Xiaoyan capsule suspension). After oral administration of different doses of cinnabaris, no obvious changes in tmax and MRT were observed, while Cmax/dose, AUC0-48 h/dose and AUC0-∞/dose decreased with the increase in dose, indicating that total mercury absorption in body was declining. As the dose increased, Ke, CL/F decreased, and t1/2 increased, indicating that the elimination slowed down, and mercury metabolism showed non-linear dynamic characteristics within a certain range of dose (22-220 mg•kg⁻¹). The total mercury metabolism in the whole blood of rats after oral administration with different doses of Fufang Niuhuang Xiaoyan capsule also showed non-linear dynamic characteristics. The results were correlated with the low solubility of cinnabaris in the body. Compared with cinnabaris, Fufang Niuhuang Xiaoyan capsule showed no obvious changes in V/F and MRT, while Ke, CL/F, tmax decreased, and t1/2, Cmax/dose, AUC0-48 h/dose, AUC0-∞/dose increased significantly. The results showed that Fufang Niuhuang Xiaoyan capsule accelerated absorption, slowed down elimination and improved the total absorption of mercury in the whole blood, indicating that Fufang Niuhuang Xiaoyan capsule may contain components for promoting absorption and alleviating elimination of mercury. Fufang Niuhuang Xiaoyan capsule had an impact on the pharmacokinetics of cinnabaris, and long-term administration of cinnabaris (Fufang Niuhuang Xiaoyan capsule) was possible to cause accumulation of mercury in the body. This study could explain changes in efficacy of Fufang Niuhuang Xiaoyan capsule, evaluate the rationality of compound medicines containing toxic elements and provide scientific basis for the rational and safe use of Fufang Niuhuang Xiaoyan capsule.

Analysis on clinical features and prognosis of patients with neurofibromatosis type 2 after operation / 中国综合临床

Objective To investigate the correlation between clinical features and prognosis of patients with neurofibromatosis type 2(NF2)after operation.Methods The clinical features and prognosis of sixty patients with neurofibromatosis type 2(NF2)from 2000 to 2013 in Xi′an No.1 Hospital were analyzed.Cox proportional hazards regression model was used for variable analysis.Results The patients were followed up for 1-188 months,53 patients survived(88.3%,53/60),and 7 patients died(11.7%,7/60).Single factor analysis showed that the first symptom age,age of diagnosis,intracranial meningioma and spinal cord tumor were related to the prognosis of the patients(P<0.05).However,gender,genetic factors,skin lesions,eye diseases, postoperative hearing improvement and relief of dizziness after surgery were not correlated with the prognosis of patients(P>0.05).Spinal cord tumors or intracranial meningiomas were the independent risk factors for the prognosis of NF2 patients(P=0.042,0.037,95%CI=0.021-2.069,0.587-2.543,RR=2.475,3.663).The first symptoms age,age of diagnosis,ocular lesions were the risk factors for the occurrence of spinal cord tumors and intracranial meningiomas(P<0.05).Conclusion NF2 has many clinical symptoms,accompanied by spinal cord tumor and intracranial meningioma,which are the important prognostic factors in patients with poor prognosis.

Comparison of routine shunting and selective shunting in patients with moderate and severe carotid artery stenosis undergoing carotid endarterectomy / 中国医师进修杂志

Objective To compare the therapeutic effect between routine shunting and selective shunting in patients with moderate and severe carotid artery stenosis undergoing carotid endarterectomy (CEA). Methods One hundred and ninety-two patients with moderate and severe carotid artery stenosis undergoing CEA were selected, and the patients were divided into control group (routine shunting) and observation group (selective shunting) according to the random digits table method with 96 cases each. The intraoperative carotid artery occlusion time and incidences of stroke event 30 d after operation were recorded. Results In the observation group, the rate of carotid artery shunting was 35.4％ (34/96), among which the rate of carotid artery shunting in patients with contralateral severe carotid artery stenosis or occlusion was 8/13, the rate of carotid artery shunting in patients with unilateral carotid stenosis was 31.3％ (26/83), and there was statistical difference (χ2 = 13.006, P0.05). In the observation group, the intraoperative carotid artery occlusion time in patients with carotid artery shunting was significantly shorter than that in patients without carotid artery shunting:(4.36 ± 0.48) min vs. (10.15 ± 0.91) min, and there was statistical difference (t=7.884, P0.05). Conclusions The selective shunting during CEA can reduce the incidence of postoperative stroke event in patients with carotid artery stenosis, and especially it can give a good clinical effect in the patients with contralateral severe carotid artery stenosis or occlusion.

Analysis on clinical features and prognosis of patients with neurofibromatosis type 2 after operation / 中国综合临床

Objective To investigate the correlation between clinical features and prognosis of patients with neurofibromatosis type 2(NF2)after operation.Methods The clinical features and prognosis of sixty patients with neurofibromatosis type 2(NF2)from 2000 to 2013 in Xi′an No.1 Hospital were analyzed.Cox proportional hazards regression model was used for variable analysis.Results The patients were followed up for 1-188 months,53 patients survived(88.3%,53/60),and 7 patients died(11.7%,7/60).Single factor analysis showed that the first symptom age,age of diagnosis,intracranial meningioma and spinal cord tumor were related to the prognosis of the patients(P<0.05).However,gender,genetic factors,skin lesions,eye diseases, postoperative hearing improvement and relief of dizziness after surgery were not correlated with the prognosis of patients(P>0.05).Spinal cord tumors or intracranial meningiomas were the independent risk factors for the prognosis of NF2 patients(P=0.042,0.037,95%CI=0.021-2.069,0.587-2.543,RR=2.475,3.663).The first symptoms age,age of diagnosis,ocular lesions were the risk factors for the occurrence of spinal cord tumors and intracranial meningiomas(P<0.05).Conclusion NF2 has many clinical symptoms,accompanied by spinal cord tumor and intracranial meningioma,which are the important prognostic factors in patients with poor prognosis.

Arsenic speciation in rat plasma after oral administration of realgar and Niu Huang Jie Du Pian / 药学学报

The arsenic species in rat plasma were studied after oral administration of realgar and Niu Huang Jie Du Pian (NHJDP) and the possible compatible effects of realgar was evaluated by comparing the pharmacokinetics of arsenic species after administration of realgar and NHJDP. The separation of the arsenicals was performed by a high performance liquid chromatography-hydride generation-atomic fluorescence spectrometry (HPLC-HG-AFS) technique. Dimethylarsinic acid (DMA) was found to be the main species in rats' plasma after dosing. No traces of arsenite[As(Ⅲ)], monomethylarsonic acid (MMA) or arsenate[As(V)] were detected at any sampling time points. Compared with realgar administration alone, dose-normalized peak concentration (Cmax) and AUC0-t of DMA were significantly decreased by NHJDP administration, while the tmax was significantly delayed with the clearance and apparent volume of distribution significantly increased, indicating that the pharmacokinetics of As from realgar was affected by other ingredients in the compound prescription of NHJDP.

Study on the dynamic changes of peripheral endothelial progenitor cells in hypertensive cerebral hemorrhage patients / 中国医师杂志

Objective To investigate the dynamic changes of endothelial progenitor cells (EPCs) in peripheral blood of patients with hypertensive cerebral hemorrhage.Methods Flow cytometry was used to detect the dynamic changes of EPCs in 79 cases of hypertensive cerebral hemorrhages as the experimental group and 70 cases of normal healthy people as the control group.Results In the acute phase after hemorrhage (3 days),EPCs in experimental group [(51.3 ±9.3) × 103/ml,(52.0 ±6.3) × 103/ml,(53.1 ±9.3) × 103/ml] were significantly lower than the control group [(75.4 ± 15.6) × 103/ml] (P ＜0.05).However,after that the level of EPCs in experimental group [(110.9 ± 12.0) × 103/ml,(132.8 ± 11.8)× 103/ml,(115.3 ±9.9) × 103/ml] increased rapidly and was significantly higher than the control group (P ＜0.05),and approximately two weeks later it reduced to normal levels [(83.1 ±7.9) × 103/ml].Conclusions In patients with hypertensive cerebral hemorrhage,the levels of EPCs in peripheral blood were closely related with the disease and might become a prognostic marker.

Compensatory sweating after restricting or lowering the level of sympathectomy: a systematic review and meta-analysis

OBJECTIVE: To compare compensatory sweating after lowering or restricting the level of sympathectomy. METHOD: A systematic review and meta-analysis were conducted of all randomized controlled trials published in English that compared compensatory sweating after lowering or restricting the level of sympathectomy. The Cochrane collaboration tool was used to assess the risk of bias, and the Mantel-Haenszel odds ratio method was used for the meta-analysis. RESULTS: A total of 11 randomized controlled trials were included, including a total of 1079 patients. Five of the randomized controlled trials studied restricting the level of sympathectomy, and the remaining six studied lowering the level of sympathectomy. CONCLUSIONS: The compiled randomized controlled trial results published so far in the literature do not support the claims that lowering or restricting the level of sympathetic ablation results in less compensatory sweating. .

Identification of related substances in nicergoline by HPLC-MS / 药学学报

To study the related substances in nicergoline, electrospray positive ionization high resolution TOF/MS was used for the determination of the accurate mass and elemental composition of the related substances. Triple quadrupoles tandem MS/MS was employed for the determination of the fragmentations of the parent ions. 16 related substances were detected and identified to be eight synthetic by-products and eight degradation products, by using impurity references matching, product mass spectra fragmentations elucidation, and verified further according to synthetic processes and stress testing results. The results obtained are valuable for nicergoline manufacturing process control and quality assurance.

Identification of the related substances in fasudil hydrochloride with hyphenated techniques / 药学学报

The study aims to identify the related substances in fasudil hydrochloride by hyphenated techniques. A WondaSil C18 (250 mm x 4.6 mm, 5 microm) column was used for the separation of the related substances with a mixture of methanol and ammonium acetate buffer solution as the mobile phase by gradient elution. The structures of the related substances were speculated by electrospray positive ionization LC-TOF/MS accurate ion mass and MS/MS determination and elucidation, and verified further through synthesis and spectroscopic analysis. Fasudil hydrochloride and the related substances were separated under the established HPLC condition. Three related substances in fasudil hydrochloride were characterized by hyphenated techniques. The hyphenated LC-MS method is useful for the identification of related substances in fasudil hydrochloride and the results obtained are valuable for its manufacturing process and quality control.

Complications of radical nephrectomy for renal cell carcinoma: a retrospective study comparing transperitoneal and retroperitoneal approaches using a standardized reporting methodology in two Chinese centers / 癌症

The reporting of complications following transperitoneal and retroperitoneal open radical nephrectomy (RN) is nonstandardized. This study aimed to compare early complications between the two approaches using a standardized reporting methodology in a large contemporary cohort. Between 1996 and 2009, 558 patients underwent open RN for renal cell carcinoma (RCC) in our two centers (424 from Sun Yat-sen University Cancer Center and 134 from the First Affiliated Hospital of Sun Yat-sen University). Records were reviewed for clinicopathologic features and complications. Complications were graded using the Clavien system based on the severity of impact. One hundred and five patients (18.8%) had one or more early complications (168 complications overall). The overall rates of grades I to V complications were 5.6%, 10.8%, 2.2%, 0.4%, and 0.2%, respectively. Patients who underwent transperitoneal RN did not experience more overall or procedure-related complications than those who underwent retroperitoneal RN (P = 0.911 and P = 0.851, respectively). On subgroup analysis, neither grade I/II nor grades III-V complications were significantly different between the transperitonal RN and retroperitoneal RN groups. Multivariate analysis showed that for any grade of complication, age (P = 0.016) and estimated blood loss (P = 0.001) were significant predictors. We concluded that open RN is a safe procedure associated with low rates of serious morbidity and mortality. Compared with retroperitoneal RN, transperitoneal RN was not associated with more complications. Older patient and more blood loss at surgery were independent predictors for higher early postoperative complication rates.

Transrectal ultrasonography in the etiological diagnosis of male obstructive azoospermia: analysis of 695 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the role of transrectal ultrasonography (TRUS) in the etiological diagnosis of male obstructive azoospermia.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data and TRUS findings of 695 patients with obstructive azoospermia from January 2007 to May 2009.</p><p><b>RESULTS</b>Concerning the etiology of obstructive azoospermia, the main TRUS findings included ejaculatory duct abnormality (29.2%), seminal vesicle abnormality (25.4%) and prostate midline cyst (18.5%). TRUS revealed 203 cases of ejaculatory duct dilation, 177 cases of seminal vesicle abnormality (including 108 with absence or agenesis and 51 with dilation of the seminal vesicle), and 128 cases of prostate midline cyst (including 75 with ejaculatory duct cyst and 39 with Müllerian cyst). Calcification of the verumontanum or ejaculatory duct was suspected to be the causes of obstructive azoospermia in 34 cases. However, no significant etiological abnormality was found in 153 cases. Obvious etiology was shown by TRUS in 78.0% of the patients.</p><p><b>CONCLUSION</b>TRUS can clearly display the structural abnormality of the ejaculatory duct and seminal vesicle, and provide important information on the etiology of male obstructive azoospermia.</p>

Stage T1N0M0 renal cell carcinoma: the prognosis in Asian patients / 癌症

The prognostic features of T1N0M0 renal cell carcinoma (RCC) in Asian patients have not been well explored in large sample studies. In this study, we retrospectively analyzed the records of 713 patients undergoing nephrectomy for T1N0M0 RCC between 1991 and 2009 in three Asian hospitals. Univariate and multivariate analysis were performed to identify the independent predictive factors for T1N0M0 RCC prognosis among a series of clinicopathological parameters, including age, gender, tumor size, Fuhrman grade, and histological classification. Our results showed that 388 of 713 patients had tumors 4.0 cm or smaller (stage T1a) and 325 of 713 patients had tumors 4.0-7.0 cm in size (stage T1b). Five-year cancer-specific survival (CSS) and recurrence-free survival (RFS) rates for this group of patients were 96.0% and 93.5%, respectively. The patients with T1b RCC had a significantly lower 5-year CSS and RFS rates than did those with T1a RCC (CSS, 93.1% vs. 98.6%, P = 0.026; RFS, 90.0% vs. 96.5%, P < 0.001). Patients with low grade (grades I-II) tumors had a higher 5-year CSS (97.8% vs. 91.2%, P = 0.001) and RFS (95.5% vs. 85.5%, P < 0.001) rate than did those with high grade (grades I-II) tumors. More interestingly, when stratifying patients to T1a and T1b groups, the role of grade in distinguishing prognosis could be only observed in patients with T1b disease. Cox regression showed tumor size and Fuhrman grade were significant in predicting CSS and RFS. Our study suggests that the prognosis of patients with T1N0M0 RCC is excellent, and these results are comparable to previously reported studies in Western patients. Furthermore, our data indicates that patients with T1b disease and high Fuhrman grade have high risk of tumor recurrence and death, thus requiring more frequent follow-up.

Serum uric acid and prehypertension among Chinese adults / 中华内科杂志

Objective The aim of this article is to discuss the relation between serum uric acid and prehypertension, and to evaluate the influence of age, obesity, fasting plasma glucose (FPG) and lipids in Chinese adults. Methods All the 14 451 non-hypertensive samples were analyzed for blood pressure, body mass index (BMI), FPG, lipids and serum uric acid. Results The serum uric acid levels were stratified by quintiles, after adjustment for relevant factors, OR values of prehypertcnsion increased with the elevated uric acid levels. Serum uric acid level was 200-380 μmol/L, it had a linear relationship with the risk of prehypertension, 200 μmol/L as a turning point for this linear relationship, FPG could affect their correlation (P ＜ 0.0001 ). Conclusions Serum uric acid was associated with prehypertension, independent of metabolic risk factors. The associations were not significant in old individuals. FPG may modify the associations.

Effects of combination of Salvia miltiorrhiza and Panax notoginseng on the pharmacokinetics of their major bioactive components in Beagle dog / 药学学报

After oral administration of Salvia miltiorrhiza (Danshen in Chinese), Panax notoginseng (Sanqi in Chinese) and Danshen Sanqi combination suspensions to Beagle dogs, the plasma concentration-time profiles of danshensu, tanshinone II(A), cryptotanshinone, notoginsenoside R1, ginsenoside Rg1 and Rb1 were analyzed by LC-MS/MS. Pharmacokinetic parameters were calculated and analyzed with BAPP 2.0 software. The results showed that the Cmax and AUC of danshensu, notoginsenoside R1, ginsenoside Rg1 and Rb1 in Danshen Sanqi combination group all decreased in comparison with those of Danshen or Sanqi given alone, while the CLz/F and Vz/F increased to some extent. No significant differences of the pharmacokinetics of tanshinone II(A) and cryptotanshinone were observed between groups.

HPLC tandem-mass spectrometric analysis of the chemical components and decomposition products of allicin extract of garlic / 药学学报

To analyze the chemical components and decomposition products in allicin extract of garlic, the chemical components screening and identification were made with HPLC-MS/MS method by full scan TIC MS, HPLC retention time, product MS spectra and chemical reference standards. The stability of the extract in water and alcoholic solutions was also investigated. There were five major components in allicin extract which were all identified as thiosulfinates. The extract was stable for at least 3 months when stored at -20 degrees C as water solution, but obvious decomposition was observed with the increase of alcoholic concentration. The decomposition products were also identified by HPLC-MS/MS.

Risk factors for radiation pneumonitis in patients with non-small-cell lung cancer treated with postoperative three-dimensional conformal radiotherapy / 中华放射肿瘤学杂志

Objective To evaluate the relation between lung dosimetric parameters and the risk of symptomatic radiation pneumonitis (RP) in patients with non-small cell lung cancer (NSCLC) who had re-ceived postoperative radiotherapy. Methods From November 2002 to March 2006, 90 patients with NSCLC who had received postoperative 3-dimentinal conformal radiotherapy (3DCRT) were retrospectively analyzed, including 53 with stage ⅢA disease, 25 with stafe ⅢB disease and 12 with stage Ⅰ-Ⅱ disease but positive margins. Seventy (78%) patients underwent lobectomy, 20 ( 22% ) underwent pneumonectomy, and 38 ( 46% ) received adjuvant chemotherapy. The median radiation dose was 60 Gy given in 30 fractions of 2 Gy using 6 MV X-ray. The percentage of the whole lung volume ( Vx ) and the ipsilateral absolute lung volume ( Vipsi-dosewhich received more than a certain dose were calculated. The endpoint was grade 2 and above RP based on CTC AE 3.0. The relation between the dosimetric factors and RP was also analyzed with receiver operating characteristic (ROC) curves. Results Nine patients ( 10% ) developed symptomatic RP ( grade 2 in 7 and grade 3 in 2), and all of them were in the lobectomy group. No RP was observed in patients who received pneumonectomy. Both V30 and V35 were higher in patients with RP than those without ( 19% vs 14% ,U= -2.16,P=0.030, and 15% vs 11%,U= -2.65,P =0.007, respectively). The area under curve in receiver operating characteristic curves based on the relation between incidence of RP and the value of Vipsi-dose was 0. 757. Using Vipsi-30 of 340 cm3 as a cut-off to predict RP, the sensitivity and specificity were 88% and 70%, respectively. The incidence of RP was 3% in patients with Vipsi-30< 340 cm3 compared with 29% in those with Vipsi-30>340cm3 ( X2 = 9.75 , P = 0.003 ) . Conclusions More than340 cm3 of the ipsilateral lung receiving 30 Gy is significantly related to the risk of RP in patients undergoing lobectomy. It is safe for patients who undergo pneumonectomy to receive postoperative 3DCRT if lung V20 is less than 10%.