Objective The study was designed to investigate the serum levels of HE4 in patients with lung cancer,and explore its prognostic value.Methods Blood samples of 106 healthy adults and 191 patients with lung cancer before treatment were measured by means of ELISA for HE4 levels in different stages and pathological types,for analyzing prognostic effect of HE4.Results The serum levels of HE4 in patients with lung cancer (median level 91.63 pmol/L) were significantly higher than control group (median level 56.42 pmol/L) (U =3 081.00,P ＜ 0.05).AUC of serum HE4 was 0.85,with a cut-off value of 82.70 pmol/L (specificity =95.31％,sensitivity =62.32％).HE4 expression was not statistically related to clinical stage and pathological types of lung cancer.The median overall survival (mOS) was 36.87 months in the HE4-low group and 30.43 months in the HE4-high group (P ＜0.05),respectively.HE4 level was an independent prognostic factor for overall survival (HR =2.15,95％ CI 1.49-3.12,P ＜ 0.05).Conclusions The prognosis of patients with high HE4 expression is poor.Therefore,it might be necessary for patients with high level of HE4 to receive more aggressive adjuvant therapy.

Objective To test the accuracy of a three-dimensional dose verification system CompassR,which reconstructing dose distribution based on measurements and independent dose calculation,and to evaluate the feasibility of its application in clinical intensity-modulated radiotherapy (IMRT) quality assure.Methods A set of square-wave chart patterns of 2 cm,1 cm and 0.5 cm gaps was designed and 11 completed IMRT lung plans were selected for the test.EDR2 film and the ionization chamber were used for test and verifying of plane dose distribution and some special points dose of CompassR.The IMRT phantom plans were verified by CompassR with three-dimension based on anatomical information.Parameters including the volume γ pass rate and the average dose deviation were tested using dose volume histograms.Results In square-wave chart patterns test,the dose distribution reconstructed and calculated by CompassR coincided with the measurement using film.The γ pass rates (3％/3 mm,2％/2 mm) exceeded 90％.When the width of field is 0.5 cm,the γ pass rate was a little lower on account of the penumbra zone.Compared to the dose distribution profile which was measured by film,the maximum deviations of the dose distribution profile which was reconstructed and calculated by CompassR were 3.21％ and 2.70％.The absolute dose deviation of specific point in the IMRT plans was less than 3％,the maximum deviation occurred in the lung.Compared to film,the averageγpass rates on the isocenter plain in IMRT plan were (94.65 + 1.93)％ (3％/3 mm) which was reconstructed by CompassR.In three-dimensional dose verification,the volume γ pass rates of targets and risk organs were not less than 90％,and the deviation of average dose was less than 1％.Conclusions Accuracy of the tested system satisfies the demand of IMRT dose verification.CompassR could provide information of volumetric dosimetry and anatomical location of dose error,which is benefit for evaluating the clinical value of verification result.

Objective To explore the effects of HAVCR2 siRNA on apoptosis and cell cycle in the radiation-caused genomic instable liver cells.Methods RNAi was used to inhibit HAVCR2 gene transcription.Cellular apoptosis and cell cycle distribution were detected by flow cytometry (FCM).Expression of p53 gene was assayed by real time fluorescence quantitative PCR.Results HAVCR2 gene was effectively inhibited by RNAi (t =19.21,P ＜ 0.05).After siRNA transferring,cell apoptosis (t =3.65,P ＜ 0.05) and p53 gene expression (t =4.82,P ＜ 0.05) were decreased,and G2-phase arrest was induced(t =-3.41,P ＜ 0.05).Conclusion HAVCR2 siRNA can decrease the generation of apoptosis in the genomic instable liver cells and blocks the cells at G2 phase.

Objective To study the protective function of resveratrol on radiation-induced small intestine injury and lethal effect in mice.Methods Mice were randomly divided into three groups:irradiation (IR) control,IR only,and IR + resveratrol.15 mice each group were irradiated on abdomen with 7.2 Gy γ-rays for cell lethal assay and 8 mice each group were irradiated with 6.5 Gy for small intestine injury assay.For the IR + resveratrol group,the mouse was given resveratrol by intragastric administration 24 h before irradiation and then was fed with resveratrol daily for 5 days.The control and IR alone groups were fed with placebo.After 30 days of IR,mouse survival rate was detected.For small intestine injury experiments,24 h after IR,the mice were terminated and the small intestines were treated with HE and immunohistochemical staining.Results Compared with the irradiation group,resveratrol increased mouse survival by 33.3％,decreased apoptosis in intestinal crypt cells (t =17.35,P ＜ 0.05),and increased Ki67 expression (t =13.62,P ＜ 0.05).Conclusion Resveratrol could protect small intestine injury from ionizing irradiation.

Objective To compare radiation doses to patients between rotational angiography and standard angiography.Methods According to different modes,our experiment was divided into RA (Dual-axis Rotational Angiography) group and SA (Standard Angiography) group.The latter was divided into 3 subgroups (SA1,SA2 and SA3) in terms of different time of cine.The procedure time and the position were controlled by the order preset into the machine.Each group consisted of 10 repeated operations with a unique phantom to simulate the true patients.The radiation doses were measured by using dose meter provided by the machine and TLD system; the means of the data were compared.Results The mean of total accumulated DAP and AK in group RA were 3 061.6 mGy·cm2 and 64.2 mGy,respectively,compared with group SA1 (4 213.9 mGy·cm2 and 85.5 mGy),SA2 (6 436.0 mGy·cm2 and 112.2 mGy),SA3 (12 810.4 mGy·cm2 and 243.7 mGy).The mean of accumulated dose in group RA was 37.70 mGy,higher than group SA1 (26.56 mGy) but lower than group SA2 (46.86 mGy) and SA3 (77.79 mGy).The gap between highest dose and lowest dose in RA group was insignificant whereas significant in the subgroups of SA.Conclusions In comparison with conventional angiography,the dual-axis rotational angiography has the potential to reduce radiation exposure of patients significantly so as to prevent skin radiation injures.

Objective To determine the biological effectiveness of 125I radioactive seeds with continuous low dose rate radiation on the human esophageal cancer cell line KYSE150 in vitro and explore the underlying cellular mechanisms.Methods The cells were divided into three cell groups:control group,single dose radiation group (SDR) and 125I radioactive seeds with continuous low dose rate radiation group (125 I-CLDR).The KYSE150 cells were exposed to radiation of X-ray at a high dose rate of 1.052 Gy/min or 125I radioactive seeds at a low dose rate of 2.77 cGy/h.The responses of KYSE150 cells to two modes of irradiation were evaluated by the colony-forming assay,cell apoptosis as well as cell cycle analysis.Furthermore,the expression levels of γ-H2AX and Bax were detected by Western blot.Results KYSE150 cells were more radiosensitive to 125I-CLDR than SDR.The relative biological effectiveness (RBE) for 125I-CLDR related to SDR was 1.56.Compared with SDR,125I-CLDR yielded more proportions of the early and late apoptosis rate (t =4.07,11.08,P ＜0.05) as well as cells at G2/M phase (t =11.25,P ＜0.05).Moreover,γ-H2AX and Bax expression levels in 125I-CLDR significantly increased compared with SDR.Conclusions Compared with the high dose rate X-ray radiation,the continuous low dose rate radiation of 125I radioactive seeds had stronger inhibition effect on KYSE150 esophageal cancer cells by impairing clonogenic capacity,inducing apoptosis and G2/M cell cycle arrest,and increasing radiosensitivity.

Objective To investigate the radioprotective function of lianhuaqingwen (LHQW) in rat acute radiation-induced lung injury.Methods Totally 36 female Wistar rats were randomized into 3 groups as administered group (treated by LHQW plus radiation),radiation group irradiated with a single of 20 Gy in 6 MV X-ray by Elekta Synergy VMAT,and blank control group without radiation.Performance status (PS) was estimated during 31 d of LHQW instragastric administration.After rats being sacrificed at 1,14,28 d of LHQW adminstration,the pathomorphological changes were observed in trauma lung tissue,the cell number in BALF (Bronchoalveolar lavage fluid) was counted,the levels of TNF-α and IL-6 in serum were measured by ELISA,and TNF-α and IL-6 mRNA expressions in lung tissue were assayed by RT-PCR.Results After LHQW treatment,the PS of rat was significantly elevated with less inflammation in morphous,and the cell number in BALF was markedly decreased in compare with radiation alone group.Furthermore,the serum levels of TNF-α and IL-6 were obviously reduced (tTNF-α =7.372,2.891,tIL-6 =6.335,3.257,P ＜ 0.05) and the TNF-α and IL-6 mRNA levels in lung tissue were also decreased (tTNF-αmRNA =3.714,2.144,tIL-6mRNA =3.589,2.883,P＜0.05).Conclusions LHQW plays a protective role against acute radiation-induced lung injury in rats and the down-expressions of TNF-α and IL-6 may be involved.

Objective To verify the reliability of radiotherapy dosimetric parameters in reference and non-reference conditions using thermoluminescent dosimeters (TLDs).Methods Using the established TLD method,the dose variations with different radiation field sizes and 45 ° wedge plate were verified for 10 photon beams of 6 MV,together with dosimetric parameters at the point of maximum axial dose for 4 electron beams of 9 MeV under reference and non-reference conditions.Comparisons were made between TLD results and finger ionization chamber results.Results The average relative deviation,for 6 MV photon beams,between TLD results and finger ionization chamber measurements was 4.7％,within ± 7％ as required by the IAEA.The average relative deviation,for 9 MeV electron beam,between TLD results and plane parallel ionization chamber measurements was 2.4 ％,not beyond ± 5％ permitted by IAEA.Conclusions Using TLD method to verify the radiotherapy dosimetric parameters in reference and non-reference conditions was reliable,simple and feasible.

Objective To verify the reliability of TLD-based quality audit for radiotherapy dosimetry of medical electron accelerator in non-reference condition by monitoring the dose variations from electron beams with different field sizes and 45° wedge and the dose variations from photon beams with different field sizes and source-skin distance.Methods Both TLDs and finger ionization chambers were placed at a depth of 10 cm in water to measure the absorbed dose from photon beams,and also placed at the depth of maximum dose from electron beams under non-reference condition.TLDs were then mailed to National Institute for Radiological Protection,China CDC for further measurement.Results Among the 70 measuring points for photon beams,58 points showed the results with a relative error less than ± 7.0％ (IAEA's acceptable deviation:± 7.0％) between TLDs and finger ionization chambers measurements,and the percentage of qualified point numbers was 82.8％.After corrected by P,value,62 points were qualified and the percentage was up to 88.6％.All of the measuring points for electron beams,with the total number of 24,presented a relative error within ± 5.0％ (IAEA's acceptable deviation:± 5.0％) between TLDs and finger ioization cylindrical chambers measurements.Conclusions TLD-based quality audit is convenient for determining radiotherapy dosimetric parameters of electron beams in non-reference condition and can improve the accuracy of the measuring parameters in connection with finger chambers.For electron beams of 5 MeV ＜ E0 ＜ 10 MeV,the absorbed dose parameters measured by finger ionization chambers,combined with TLD audit,can help obtain the precise and reliable results.

Objective To reduce the radiation dose to children from CT scanning through proper adjustment to milliamps (mAs) and scan lengths with a view to learning the relationship between scanning condition and radiation dose.Methods To compare the differences in main scanning parameters used for head,chest and abdomen at multi-detector CT examination of paediatric patients (＜ 1 year old,1-5 years old,6-10 years old,11-15 years old) at seven hospitals in Jiangsu province.CT dose index (CTDI) and dose-length-product (DLP) were gained by using standard children dose model (diameter 16 cm) under the same scanning conditions.Effective doses (E) at different parts of the body from children CT scanning were estimated after modification by empirical weighting factor.Statistical analyses of mAs,scan lengths and DLP were performed with SPSS 16.0 software.The differences in radiation dose due to the choice of condition of scanning were compared between two typical hospitals.Results The mean values of effective doses to paediatric patients during head,chest and abdomen CT scanning were 2.46,5.69,11.86 mSv,respectively.DLP was correlated positively with mAs and scan length (head,chest and abdomen examination,r =0.81,0.81,0.92,P ＜0.05).Due to higher mAs used,the effective dose from chest and abdomen CT examination among all age groups was higher than that in Germany Galanski research.Due to larger scanning length in abdominal examination among all age groups,effective doses in hospital were the highest.Conclusions Reasonablely reducing the scan length and mAs during CT scanning could lower children's CT radiation risk,while clinical diagnosis is not affected.