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Abstract The purpose of this work was to analyze the high-risk factors of complications in the trial of vaginal delivery of a subsequent pregnancy for scar uterus after a previous cesarean. 136 pregnant women with scar uterus with a history of cesarean who were admitted to our obstetrics department from February 2016 to March 2019 were selected and were divided into a successful group and a failed group according to the results of pregnancy and trial of labor vaginal delivery. General data of before, during, and after delivery were collected and the high-risk factors for failed vaginal delivery of scar uterine were analyzed by the logistic regression analysis. Among the 136 patients, 108 cases (79.41%) of vaginal trials were successful, and 28 cases (20.59%) of vaginal trials faired. The univariate analysis showed that the differences in gravidity, parity and the previous cesarean interval, vaginal birth history, prenatal BMI, uterine contraction, gestational age, infant weight, dilatation of the cervix, cervical Bishop score, the height of the fetal head, the thickness of the lower uterus, and whether the membranes were prematurely ruptured were statistically significant (P<0.05). Logistic regression analysis showed vaginal birth history, prenatal BMI ≥ 30 kg/m2, parity ≥ 2 times, cesarean interval <2 times, dilatation of cervix ≥ 1 cm, the height of the fetal head ≥ -3, premature rupture of the membrane and the thickness of the lower uterus of 3.0 to 3.9 cm were the high-risk factors of complications in the vaginal trial delivery of pregnancy again for scar uterus (P<0.05). It is feasible for pregnant women with scar uterus to undergo vaginal delivery, but many related factors can affect the failure of trial of labor. It is necessary to pay attention to all aspects of clinical examination and choose applications strictly according to the indications.
Resumen El propósito del presente trabajo fue analizar los factores de alto riesgo de complicaciones por cicatriz uterina en la prueba de parto vaginal del siguiente embarazo después de una cesárea previa. 136 gestantes con cicatriz uterina fueron seleccionadas con antecedente de cesárea anterior que ingresaron a nuestro servicio de obstetricia de febrero 2016 a marzo 2019, y se dividieron en un grupo exitoso y un grupo fallido según los resultados de las pruebas de embarazo y parto vaginal. Los datos generales anteriores fueron recolectados, durante y después del parto y se analizaron los factores de alto riesgo para el parto vaginal fallido de la cicatriz uterina mediante el análisis de regresión logística. Entre las 136 pacientes, 108 casos (79,41%) de las pruebas vaginales fueron exitosas y 28 casos (20,59%) de las pruebas vaginales fracasaron. El análisis univariado mostró que las diferencias en la gravidez, la paridad y el intervalo de cesárea previa, la historia de parto vaginal, el IMC prenatal, la contracción uterina, la edad gestacional, el peso del lactante, la dilatación del cuello uterino, la puntuación cervical de Bishop, la altura de la cabeza fetal, el grosor del segmento uterino inferior, y si las membranas se habían roto prematuramente fueron estadísticamente significativas (P<0,05). El análisis de regresión logística mostró antecedente del parto vaginal, el IMC prenatal ≥ 30 kg/m2, la paridad ≥ 2 veces, el intervalo entre cesáreas < 2 veces, la dilatación del cuello uterino ≥ 1 cm, la altura de la cabeza fetal ≥ -3, la ruptura prematura de la membrana y el grosor del segmento uterino inferior de 3,0 a 3,9 cm fueron los factores de alto riesgo de complicaciones por cicatriz uterina en la prueba de parto vaginal de un siguiente embarazo (P<0,05). Sería posible que las gestantes con cicatriz uterina vuelvan a someterse a parto vaginal, pero existen muchos factores relacionados que inciden en el fracaso del trabajo de parto. Es necesario prestar atención a todos los aspectos de la exploración física y elegir las aplicaciones estrictamente de acuerdo con las indicaciones.
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Diabetic ketoacidosis (DKA) is one of the most serious acute metabolic complications of diabetes.With the aging of population and the change of lifestyle in China, DKA is common in elderly or obese patients. The elderly patients are prone to DKA due to the poor treatment compliance, atypical symptoms and more complicated diseases; while DKA is more common in obese young men who excessively consumed sugary soft drinks before the onset of illness, their islet function can be restored after appropriate treatment. The application of some new therapeutic drugs and treatment options may induce euglycemic DKA. Through clinical data analysis, understanding the disease characteristics and following the treatment standards, the management of DKA in elderly or obese type 2 diabetic patients can be improved.
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Objective:To evaluate the effectiveness of deep learning (DL)-based radiomic features extracted from pre-treatment diffusion-weighted magnetic resonance images (DWI) for predicting neoadjuvant chemoradiation treatment (nCRT) response in patients with locally advanced rectal cancer (LARC).Methods:Forty-three patients receiving nCRT from 2016 to 2017 were included. All patients received DWI before nCRT and total mesorectal excision surgery 6-12 weeks after completion of nCRT. The patient-cohort was split into the responder group ( n=22) and the non-responder group ( n=21) based on the post-nCRT response assessed by postoperative pathology, MRI or colonoscopy. DL-based radiomic features were extracted from the apparent diffusion coefficient map of the DWI using a pre-trained convolution neural network, respectively. Least absolute shrinkage and selection operator-Logistic regression models were constructed using extracted radiomic features for predicting treatment response. The model performance was evaluated with repeated 20 times stratified 4-fold cross-validation using receiver operating characteristic (ROC) curves. Results:The model established with DL-based radiomic features achieved the mean area under the ROC curve of 0.73(SE, 0.58-0.80).Conclusion:DL-based radiomic features extracted from pre-treatment DWI achieve high accuracy for predicting nCRT response in patients with LARC.
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Objective@#To observe the clinical efficacy of Dermatix Ultra silica gel and asiaticoside cream for the treatment or repair of scar hyperplasia which was external used in internal corner incision of patients after the internal canthus correction operation.@*Methods@#A total of 90 patients were randomly chosen and divided into three groups. All patients with epicanthus were treated with the same internal canthus correction method by one doctor. There were 30 patients in each group: 30 cases in the control group were treated without any medication, and the postoperative incision healed naturally; 30 cases were treated with Dermatix Ultra silica gel; 30 cases were treated with asiaticoside cream. Patient and observer scar assessment scale (POSAS) was used as the end points to evaluate the clinical efficacy of Dermatix Ultra silica gel and asiaticoside cream 4 weeks and 12 weeks after the operation. The satisfactory degree from all the patients were collected after 6 months follow-up and we compared the scores of three groups.@*Results@#Compared with the control group, the POSAS scores in Dermatix Ultra silica gel group and asiaticoside cream group were low (P<0.05) at 4 weeks and 12 weeks after operation. At 4 weeks after operation, the POSAS score in Dermatix Ultra silica gel group was lower than that in the asiaticoside cream group (P<0.05). At 12 weeks after operation, there was no significant difference in POSAS score between Dermatix Ultra silica gel group and asiaticoside cream group (P>0.05). Follow-up for 6 months, the satisfaction degree of patients in Dermatix Ultra silica gel group and asiaticoside cream group was higher than in the control group (P<0.05); the satisfactory degree of patients in Dermatix Ultra silica gel group was higher than that in asiaticoside cream group (P<0.05).@*Conclusions@#Dermatix Ultra silica gel and asiaticoside cream have good clinical effects in repair of scar tissue after the epicanthoplasty. Dermatix Ultra silica gel is better than asiaticoside cream in scar early improvement.
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Aim To investigate the protective effect of astragaloside IV (AS-Ⅳ) on human retinal pigment epithelium injury induced by methylglyoxal (MGO), and explore its molecular mechanism.Methods The injury of ARPE-19 cells was induced by MGO and the cell viability was measured by CCK-8 method.The morphology of cell nucleus was analyzed by Hoechst 33342 staining and the cell apoptosis was analyzed by flow cytometry to detect labbled Annexin V-FITC/PI.JC-1 staining and fluorescence probe DCFH-DA were employed to evaluate the change of mitochondrial membrane potential and reactive oxygen species (ROS).The levels of SOD, MDA, caspase-9 and caspase-3 were determined by respective kits.Western blot was used to analyse the expression of Bcl-2, Bax and PARP.Results AS-Ⅳ could significantly inhibit the decrease of cell viability induced by MGO, improve the morphology of cell nucleus, reduce the ARPE-19 cell apoptosis rate and the level of ROS and MDA, and increase the activity of SOD.Furthermore, AS-Ⅳ could enhance mitochondrial membrane potential, the ratio of Bcl-2/Bax and the expression of PARP, and inhibit the activation of caspase-9 and caspase-3.Conclusion AS-Ⅳ may protect ARPE-19 cells from the injury induced by MGO by increasing the antioxidant ability of ARPE-19 cells and inhibiting cell apoptosis.
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Objective To explore the effects of different dose rates of X-ray under the same dose on cell clonogenic formation in non-small-cell lung cancer cell line A549 in order to provide experimental basis for clinical radiotherapy plan. Methods The A549 cells were cultured at low density and irradiated with X-rays at dose of 4 Gy and selected dose rates of 1, 2, 4 and 6 Gy/min, respectively, from a linear accelerator. The 8th day after irradiation, the cells were fixed and stained with Giemsa solution, and colonies containing at least 50 cells were counted. The plating efficiency and surviving fraction were calculated. Results The clonogenic number in non-irradiated cells was 88.6±4.6. The numbers were significantly reduced in irradiated cells at dose rate 1, 2, 4 and 6 Gy/min (12.3±3.4, 9.0±0.8, 5.6±1.0, 11.5±1.7, respectively) than that in non-irradiated control cells (F=678.799, P<0.05). The plating efficiencies were decreased in irradiated cells, especially in 4 Gy/min irradiated cells, which was lower than that in any of the other three dose rate groups (P< 0.05). Conclusions Though at same radiation dose, cancer cells have different clonogenic formation efficiency when irradiation with X-ray at different dose rates. Thus, treatment with optimal dose rate may improve the radiotherapy efficacy.
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Objective To evaluate clinical effect of volume modulated arc therapy ( VMAT) for spinal metastases .Methods Twenty patients with spinal metastases who had been treated with VMAT were chosen to participate in the study .The prescribed dose varied from 45 to 60 Gy within 15 -20 fractions, 3 Gy per fraction, and one fraction per day of VMAT .Pain and quality of life were measured before VMAT and at several time points up to 6 months after treatment , by the numerical rating scale (NRS) and verbal rating scale (VRS) and the quality of life scale for bone metastases (EORTC QLQ-BM22) questionnaire.In addition, Frankel grading was used to evaluate the neurological function of spinal cord.The primary endpoint was frequency and duration of complete pain relief , and the secondary endpoint was death.Results At the end of the follow-up, the number of patients reporting no pain from spinal metastases, as measured by the NRS, increased from 0 of 20 before VMAT to 10 of 14 ( t =20.24, P0.05).After VMAT, the patients who suffered from nerve function impairment recovered to different extent . No one had radiation-induced injury , such as radiation myelitis , radiation pneumonitis , etc.Median survival time was 10 month.Conclusions VMAT is a safe and effective treatment method for spinal metastases .Significant reductions in patient-reported pain were observed , along with nerve dysfunction improved .The patients′quality of life was significantly improved .VMAT has no late spinal cord toxicities .
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<p><b>OBJECTIVE</b>To evaluate the prevention effect of diabetic retinopathy of Jiangtang Xiaozhi Recipe (, JXR) in streptozotocin (STZ)-induced diabetic rats.</p><p><b>METHODS</b>Sprague-Dawley rats were randomly divided into normal control group and diabetic group. Rats in the diabetic group were induced by intraperitoneal administration of STZ (50 mg/kg), and subdivided into 5 groups. Rats in the diabetic control group were given saline; four treatment groups were given metformin (300 mg/kg), JXR (2, 4 and 8 g/kg) respectively for 8 weeks, while rats in the normal control group were injected with citrate buffer and given the same volume of vehicle. Body weight and food intake were measured every week. The hypoglycaemic effects were determined by testing fasting blood glucose (FBG) every other week, and hemoglobin A1c (HbA1c), insulin, and glucagon at the end of the treatment. The preventive effects of JXR on STZ-induced diabetic rats were determined by histopathological examination with hematoxylin and eosin staining, and periodic acid-schiff staining. The effects were further evaluated by serum superoxide dismutase (SOD) activity and malondialdehyde (MDA).</p><p><b>RESULTS</b>High-dose JXR significantly reduced FBG and HbA1c level at the 8th week of administration (P<0.01, P<0.05). JXR significantly increased insulin level (P<0.05), and decreased glucagon level (P<0.05). JXR showed the antioxidant defense with increased SOD activity and decreased MDA contents in diabetic rats. Histopathological studies revealed that there were no basement membrane thickening and mild destruction in the treated groups. Morphometric measurements of retina microvascular showed that acellular capillary and capillary density decreased in treated rats while pericyte and endothelial cell increasing after the treatment.</p><p><b>CONCLUSION</b>JXR have protective effect of diabetic retinopathy and its mechanism may be associated with the obvious hypoglycemic and antioxidant effect.</p>
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OBJECTIVE:To optimize the ethanol mixed-extraction technology of Red ginseng and Salvia miltiorrhiza in Xin-likang granules. METHODS:L9(34)orthogonal test was adopted to optimize ethanol mixed-extraction technology with ethanol vol-ume fraction,amount of ethanol and extraction times as factors using weighting coefficient comprehensive score of the contents of ginsenoside Rg1,Re and Rb1 in R. ginseng and the contents of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza as index;and the verification test was detected. RESULTS:Optimal mixed-ethanol extraction technology was as follows as 6-fold 70% etha-nol,reflux extracting for 3 times,2 h each time. In verification test,average contents of ginsenosides Rg1,Re,Rb1 in R. ginseng and those of tanshinone ⅡA and salvianolic acid B in S. miltiorrhiza were 3.963 8,0.757 3,4.986 2,0.964 7,27.662 5 mg/g,re-spectively,and comprehensive score was 0.96 (RSD=1.26%,n=3). CONCLUSIONS:Ethanol extraction technology of R. gin-seng and S. miltiorrhiza in Xinlikang granules optimized by multiple indexes comprehensive score combined with orthogonal test is stable,reasonable and feasible.
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Objective:To establish a method for the determination of specnuezhenide in traditional decoction and granules of Zish-enwufa formula, and compare the content between them. Methods:HPLC was used for the determination. The samples were analyzed on a Waters Symmetry C18 column (150 mm × 3. 9 mm,5 μm) with acetonitrile-water (16 ∶84) as the mobile phase. The flow rate was 1. 0 ml·min-1 and the detection wavelength was 224nm. Results: A good linearity of specnuezhenide was within the range of 0.179 2-3.316 μg(r=0.999 9),and the average recovery of berberine hydrochloride was 101.65% with RSD of 1.49%(n=6). Conclusion:The determination method is simple, accurate and sensitive with good reproducibility,which can be used for the determi-nation of specnuezhenide in the preparation. The content of specnuezhenide in the traditional decoction and granules of Zishenwufa for-mula is similar.
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OBJECTIVE:To establish a method for the content determination of berberine hydrochloride in the Jiangtang xiao-zhi tablets. METHODS:HPLC was conducted with the Symmetry C18 column. The mobile phase was acetonitrile-0.05 mol/L sodium dihydrogen phosphate(pH adjusted to 3.0 using phosphoric acid)(24∶76,V/V)at the flow rate of 1.0 ml/min. The detection wave-length was 345 nm,the column temperature was room temperature and injection volume was 10 μl. RESULTS:The linear range of berberine hydrochloride was 0.522-4.698 μg(r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 0.72%;the average recovery was 97.79%(RSD=2.09%,n=6). CONCLUSIONS:The method is simple,accurate,sensitive and reproducible,and can be used for the content determination of berberine hydrochloride.
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Abstract?AlM: To study the number of myogenin - positive activated satellite cells in the inferior oblique muscles and the medial muscles of V- pattern exotropia with inferior oblique overaction, to further explore the possible etiological factors of V-pattern exotropia with inferior oblique overaction.? METHODS: The inferior oblique muscles and the medial muscles were cut from V - pattern exotropia patients with inferior oblique overaction during strabismus operation treated as the strabismus group. Cross sections were stained immunohistochemically for the presence of activated satellite cells, as identified by myogenin immunoreactivity. The inferior oblique muscles and the medial muscles were obtained from the corneal transplant donors ( six eyes of six cases) , which treated as the control group.? RESULTS: The frequency of myogenin - positive satellite cells of the inferior oblique muscles was (22. 7± 7.03)% and (4. 2±0. 75)% in the strabismus group and the control group. Significant differences existed in the expression of myogenin in two groups (P<0. 05). Again, the frequency of myogenin-positive satellite cells of the medial muscles was (2. 2±0. 75)% and (4. 5±1. 05)% in the strabismus group and the control group. Significant differences also existed in the expression of myogenin in two groups (P<0. 05).?CONCLUSlON: lt is first report that myogenin-positive satellite cells presents in extraocular muscles of V -pattern exotropia with inferior oblique overaction. The current results suggest that myogenin is one of possible etiological factors of V-pattern exotropia with inferior oblique overaction.
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Aim To investigate the optimum trypsin digestion time and the optimum trypsin concentration of the long-term formalin-fixed retina in rats.Methods Male SD rats were sacrificed by cervical dislocation. The removed eyes were fixed in 4% formaldehyde fixa-tive for 2 days,2 weeks,4 weeks,3 months,5 months and 7 months respectively.Fixed retinas at dif-ferent time were separated and put in 3%,6% and 9% trypsin at 37℃ in incubator.The time required was recorded for complete digestion of retinas,which fixed for different time and digested in different con-centrations of trypsin.The retinal blood vessels were recorded under a microscope after PAS staining of stretched retinal blood vessel.Results After conven-tionally fixed for 48 hours,retinas were digested com-pletely in 3% trypsin at 37℃ for 3.5 hours.The di-gestion time extended to 9 hours and 1 4 hours for the 2 weeks and 1 month fixed eyes,using 3% trypsin, which achieved the same result as conventional fixed eyes.For the 3 months fixed eyes,a complete retinal blood vessel could also be attained by using conven-tional concentrations of trypsin,and only by extending digestion time to 22 hours.It is also indicated that the increased concentration of trypsin did not shorten the time of digestion.In addition,for the fixed eye from 5 months to 7 months,6% and 9% trypsin could short-en,to some extent,the time to 22 hours and 28 hours respectively,which was conductive to obtaining rela-tively complete retinal blood vessels.Conclusions Retinal tissues which fixed time shorter than 3 months can completely be digested using 3% trypsin.Howev-er,for retinal tissue,which fixed from 5 months to 7 months,both the extending time of digestion and the increasing concentration of trypsin to 6% are necessary to get optimum retinal vascular digestion.
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Objective To evaluate the efficacy of stereotactic body radiation therapy (SBRT) for hepatic metastases from colorectal cancer,and to collect data for the application of this technique.Methods A total of 28 patients from No.306 Hospital of PLA,including 17 male and 11 female with median age of 63.8 (range from 31 to 86),were treated with SBRT for colorectal cancer with liver metastases with 54 lesions in total.The GTV,CTV and PTV were delineated above the enhanced CT scans acquired during normal quiet respiration.CTV was obtained by adding 5 mm isotropic margin from GTV,and PTV was obtained by adding 5 to 10 mm isotropic margin from CTV.Prescription dose line covered 50％-60％ of isodose curve at 3-6 Gy/fraction.The total dose was 39-45 Gy and the biologically equivalent doses(BED)was 50.7-65.3 Gy.The patients were followed-up beginning at 3 months after SBRT.The change in size of the lesion based on enhanced CT or MR scans was evaluated.Toxicity was evaluated and scored according to the RTOG criteria.Local control rate and survival rate were analysed.Results All patients completed the treatment.With median follow-up of 15.1 months (range frome 3 to 30 months),7 patients survived at the end of follow-up.The local control rate (LC) was 79.2％,and 1-and 2-year overall survival rate(OS) were 82.7％ and 48.6％,respectively.There was a close corelation between the size of lesion and the LC.The LC (PR + CR) was much better at the size of lesion less than 14 cm3 than that at the size more than 65 cm3(x2 =4.17,P＜0.05).When the size was more than 180 cm3,the LC was zero.Toxicity included fatigue (60.7％),grade 1 and 2 digestive system toxicity (28.6％),a transient grade 1 and 2 bone marrow suppression (46.4％) and a transient increase in transaminase(17.8％).No grade 3 toxicity and above and late toxicity were observed.Conclusions Stereotactic body radiation therapy could be suggested as the first choice for the selected patients who suffer form colorectal liver metastases,especially for those who cannot undergo surgery.
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Objective To evaluate the therapeutic efficacy of stereotactic body radiotherapy (SBRT) with gamma knife on stage Ⅰ-Ⅱ non-small-cell lung cancer(NSCLC)and the quality of life of the patients undergoing this therapy.Methods Twenty NSCLC patients with the median age of 76,10 at stage Ⅰ and 10 at stage Ⅱ who were unable or unwilling to undergo surgery were given SBRT with gamma knife at the doses of 3-6 Gy in 8-15 fractions,finished within 2 to 3 weeks.The prescription isodose line was 50％,the marginal dose was 39-56 Gy,the central dose was 78-112 Gy,and the total biologically effective dose was 51-83 Gy.The patients were observed after admission and followed up by chest CT 1,3,6,and 12 months after treatment until progressive disease or death.EORTC QLQ-LC43 questionnaire was used to investigate the changes in quality of life.Results The 20 patients were followed up for 24 (12-46) months.At six months after the treatment,the overall response rate was 80％,and the complete response rate was 35％.The 1,2 and 3-year local control rates were 100％,95％ and 95％,respectively.The 1,2 and 3-year overall survival rates were 95％,80％ and 50％ respectively; The 1,2,and 3-year progression free survival rates were 85％,64％ and 33％,respectively.The failure rate was 20％ and the rate of progress within the planning target volume was 5％.No acute toxicity at grade 3 and over occurred in any patient during the treatment.15％ of the patients developed grade 1-2 radiation pneumonia.Age,gender,pathologic index or not were weakly correlated with the overall survival.The emotional function was improved significantly after treatment (P ＜ 0.05),dyspnea and cough were improved at different degrees,however,not significantly.There were no significant changes in the physical function and symptoms,such as fatigue,lack of appetite,insomnia,etc.Conclusions Significantly improving the motional function and maintaining the quality of life,SBRT with gamma knife is effective for elderly NSCLC patients with high local control rate fair overall survival rate and few side effects.
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Matrix metalloproteinase-2 (MMP-2) level and the ERK1/2 signal pathway are dependent factors for the growth and metastasis of cancer. However, the impact of MMP-2 in combination with ERK1/2 in tumor patients with drug resistance is unknown. To determine the relationship between MMP-2 and the ERK1/2 signal pathway, we established an adriamycin (ADM)-induced MG-63 (ADM-MG-63) cell line. With the increase of the ERK1/2 pathway blocker PD98059, we detected the expression levels of MMP-2 and p-ERK1/2 by Western blot in ADM-MG-63 cells. In ADM-MG-63 cells transfected with MMP-2-siRNA, the expression of ERK1/2 was detected for understanding the function of the ERK1/2 signal pathway. Three siRNAs for MMP-2 (MMP-2-siRNA) were designed, and the optimal one was selected and tested at different time points of 24, 48 and 72 h. Under an ADM-induced condition, ADM-MG-63 cells were finally stable living in the medium of ADM (200 ng/mL). PD98059 could effectively suppress the expression levels of p-ERK1/2 and MMP-2. When the MMP-2 was silenced by using MMP-2-siRNA, the expression of p-ERK1/2 was enhanced. It is concluded that MMP-2 may be involved in ADM resistance dependent on ERK1/2 signal pathway, suggesting interference in ERK1/2 may be a new method of targeted therapy for tumor resistance.
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Objective To analyze the efficacy and prognosis of stereotactic radiotherapy (SRT) and whole-brain radiotherapy (WBRT) in treatment of brain metastases,and to observe the influence of temozolomide (TMZ) on survival rate during the period of radiotherapy.Methods A total of 52 patients with brain metastases were divided into two groups according to treatment methods,including 35 patients treated with WBRT plus SRT and 17 patients treated with SRT alone.WBRT dose was 1.8 - 3.0 Gy per fraction,one fraction a day,five fractions per week,with total dose of 30 - 40 Gy.After WBRT,gamma knife was performed with prescription isodose line of 45％ -70％ surrounding the planned target volume in WBRT + SRT group.The marginal dose was 12 - 15 Gy and the center dose was 20-30 Gy.In SRT group,the prescription isodosc line was 45％ - 70％ and the marginal dose was 36 - 40 Gy while the center up to 70 - 80 Gy.The follow up time was 1 - 2 years.Besides 20 patients in this study took temozolomide capsule during and after radiotherapy.The schedule of concomitant chemotherapy was temozolomide of 75 mg/m2 by oral administration every day until radiotherapy was over,and then temozolomide of 150 mg/m2 was taken for 3 -6 months after radiotherapy.Results The efficiency during 1 -3 months after treatment was 84.62％ in this study.In the WBRT + SRT group,the efficiency was 88.57％ and declined to 76.47％ in the SRT group.The six month-and one year-local control rate were 92.10％ and 85.20％,respectively.The average survival time of WBRT + SRT was 13.2 months and median survival time was 11 months.Six month-,one year-and eighteen months-survival rate were 71.40％,54.30％ and 14.30％,respectively.In the SRT group,the average survival time was 10.2 months and median survival time was 9 months.Six month-,one year- and eighteen month-survival rate were 41.20％,23.50％ and 5.88％,respectively,while those for RT + TMZ group were 80.00％,60.00％ and 10.00％.In comparison,those in RT group were 56.30％,37.50％ and 12.50％,respectively.Conclusions Effect of gamma knife stereotactic radiotherapy combined with WBRT is better than GK stereotactic radiotherapy alone in treatment of brain metastases.Compared with radiotherapy alone,concomitant temozolomide chemotherapy could improve the survival rate of the patients with brain metastases without increasirg adverse reactions significantly.
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Objective To evaluate the clinical effectiveness of combined use of traditional Chinese and Western medicine for chronic pelvic inflammatory diseases.Methods By searching in the major databases of CNKI,ISI Web of Knowledge,VIP Information and Pubmed,we collected data of randomized controlled trials pertaining to combined use of traditional Chinese and Western medicine in the treatment of chronic pelvic inflammatory diseases.Results Twenty-five randomized controlled trials involving totally 3081 patients were collected according to the inclusion criteria,and meta-analysis of the data indicated that combined use of traditional Chinese and Western medicine can be of great value in the management of chronic pelvic inflammatory diseases in comparison with exclusive use of Western medicine [combined odds ratio(OR)was 3.20 with 95% confidence interval(CI)(2.74,3.73),Z=14.85,P＜0.01].Conclusion The clinical evidence derived from the analysis suggests that the combination of traditional Chinese and Western medicine for chronic pelvic inflammatory diseases can be effective with good security.