Objective To evaluate the expression of peroxisome proliferator-activated receptor γ(PPARγ)and retinoid x receptorα(RXRα)in cholangiocarcinoma to explore its relation to clinicopathological factors and investigate its impact on prognosis.Methods Expression of PPARγ and RXRα was detected by immunohistochemistry in 69 cases of cholangiocarcinoma and 12 non-tumor cases.The relation of PPARγ and RXRα expression to clinicopathological parameters and prognosis was determined.Results The expression rates of PPARγ in 69 cases of cholangiocarcinoma and 12 non-tumor cases were 59.4% and 0, respectively(P＜0.05).The expression rates of RXRα in 69 cases of cholangiocarcinoma and 12 non-tumor cases were 78.3% and 20%, respectively.There were significant differences between the 2 groups in PPARγ and RXRα expression.PPARγ expression was associated with TNM clinical stages and lymph node metastasis.According to univariate survival analysis,PPARγ expression was correlated with poor prognosis(P＜0.05).There was positive correlation between PPARγ and RXRα.Conclusion The expression of PPARγis significantly correlated with the clinicopathological characteristics and biological behaviors of cholangiocarcinoma.PPARγ and RXRα expression may play an important role during tumorigenesis.

Objective To study the relationship and clinical significance of the serum level of Pro-gastrinreleasing peptide31-98 (ProGRP)and bronchoalveolar lavage fluid for small cell lung cancer of different TNM staging.Methods 96 cases of SCLC with definite pathohistological typing were divided into stage Ⅰ～Ⅱ SCLC group (n=30),stage ⅢSCLC group (n=31),stage IVSCLC group (n=35),and the benign cases (n=90)were taken as control.Using enzyme-linked immunoserbent assay ( ELISA),the serum levels of ProGRP and bronchoalveolar layage fluid of all patients were detected,meanwhile the neuronspecific enolase were served as controls.The relation between serum and bronchoalveolar lavage fluid ProGRP level and small cell lung cancer of different TNM staging was analyzed.Results The serum level of ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (295.33±118.56),(421.13±196.66),(758.76±326.19)and (29.68±16.32)μg/mol,respectively (P＜0.01 ).The level in bronchoalveolar lavage fluid ProGRP were ( 516.67 ±208.45),( 1170.55±414.65 ),( 1739.12±696.08 )and (49.23±22.50)μg/mol,respectively (P＜0.01 ).The serum level of NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were (10.36±6.76),(24.19±10.88 ),(35.76±17.30)and (9.70 ±5.28)mg/mol.The level in bronchoalveolar lavage fluid NSE were (16.66±11.62),(45.47±20.74),(65.18±29.87)and (9.70±5.28)mg/mol,respectively (P＜0.01).The positive rate of serum ProGRP in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group,stage Ⅳ SCLC group,and the benign group were 0.6000,0.7097,0.8286 and 0.0667 ,respectively(P＜0.01).The positive rate in bronchoalveolar lavage fluid ProGRP were 0.6333,0.7419,0.8571 and 0.0444,respectively (P＜0.01).The positive rate of serum NSE in stage Ⅰ～Ⅱ SCLC group,stage Ⅲ SCLC group ,stage Ⅳ SCLC group,and the benign group were 0.2333,0.6774,0.8000 and 0.2222.The positive rate in bronchoalveolar lavage fluid NSE were 0.2667,0.7097,0.8286 and 0.2667 ,respectively(P＜0.01 ).Both the ProGRP level and positive rate in serum and bronchoalveolar lavage fluid were obviously higher in stage Ⅰ～Ⅱ,Ⅲ,and Ⅳ SCLC group than in benign group (P＜0.01 ),both the ProGRP and NSE level and positive rate in bronchoalveolar lavage fluid were obviously higher than that in the serum.The positive rate in serum and bronchoalveolar lavage fluid ProGRP in stage Ⅰ～Ⅱ SCLC group were obviously higher than that in the NSE (P＜0.01),but there was no significant difference in stage Ⅲ and Ⅳ SCLC group.Conclusion ProGRP level in serum and bronchoalveolar lavage fluid have great value to the diagnosis and clinical stages of SCLC,especially the early diagnosis,ProGRP is better than NSE;As to the diagnosis of small cell lung cancer of different TNM staging,ProGRP detection in bronchoalveolar lavage fluid is better than in serum.

Objective To study the methods of matching kilovolt CBCT image with planning CT scan. Methods A total of 121 CBCT scans were matched with planning CT scan using a manual and four automatic match methods by four observers in the offline. In the manual match, the live contour was used as a surrogate for image registration. Four automatic match methods, including routine soft?tissue match, routine bone match, automatic liver match and vertebral body match, were performed using image registration sofeware. First, the stability of the sofeware was tested. Then, the reproducibility of the same automatic match method was evaluated by comparing different observers’ match results. After the manual match by four observers, the mean of the match results was used as a standard to compare with others. The differerces was test by McNemar method. Results In the uniform match factors, automatic match result would not change. The reproducibility of routine soft?tissue and bone match are best, automatic vertebral body match is better than automatic liver match. Howerver, the automatic liver match result is the most similar to manual match, the percentages of match result have an absolute error no more than 3 mm in left?right, superior?inferior and anterior?posterior directions are 84?? 3%, 77?? 7% and 92?? 6%. Conclusions Automatic liver match can be used in image?guided radiotherapy for liver cancer, however, it should be performed by experienced oncologist and technologist together in each fraction, after that, the matching result should be adjusted carefully according to live contour.

Objective:To observe the clinical therapeutic effect of needling the acupoints of Governor Vessel and Bladder Meridian plus cupping on chronic fatigue syndrome. Methods: Fifty cases of chronic fatigue syndrome were divided into the treatment group(n= 25) and the control group(n=25). The patients in the treatment group were treated by needling Dazhui (GV 14), Zhiyang (GV 9),Xinshu (BL 15), Geshu (BL 17), Mingmen (GV 4), Shenshu (BL 23) and Changqiang (GV 1). Even reinforcing and reducing manipulation was used. Every time after the needles were withdrawn, the glass jar with thick and smooth mouth was selected to go on the back. The patients in the control group were treated by taking Chinese medicinal herbs, Caili composition, orally. Results: After 3durations of treatment, the therapeutic effects of the two groups were 92. 0% and 64. 0%respectively. There was significant difference in the therapeutic effect between the two groups(x2 =7.29,P ＜ 0.05).Conclusion: Acupuncture plus cupping is an effective method in treating chronic fatigue syndrome.