Objective: To identify the predictive parameters and threshold values for thoracic radiationinduced pneumonitis after complete pneumonectomy for NSCLC (non-small cell lung cancer). Methods: Forty-four consecutive patients with NSCLC were enrolled prospectively in this study between April 2007 and October 2010. All patients underwent thoracic radiotherapy (three-dimension conformal radiotherapy or intensity-modulated radiotherapy) after pneumonectomy. Lung dosimetric parameters such as MLD (mean lung dose) and percentage of lung volume receiving 5 Gy or more (V5), V10, V15, V 20 and V30 were recorded. The relevance of these parameters and radiation-induced pneumonitis was assessed by ROC (receiver operating characteristic) curve to pick up the more predictive parameters and also to set up the threshold limit values. Results: Of the 44 patients, 13 patients (29.5%) developed grade 2 or greater radiation-induced pneumonitis; among the 13 patients, 4 developed grade 3 radiation-induced pneumonitis. No patients developed grade 4 or 5 pneumonitis. The median time from the end of radiotherapy to the onset of pneumonitis was 2 months. All the cases of pneumonitis were diagnosed within 9 months, and 84.6% (11/13) were confirmed within 6 months after radiotherapy. Three parameters with the largest area under the ROC curve were V5 (0.824), MLD (0.806) and V10 (0.801). The threshold values of the 3 parameters were calculated to be 21.5%, 450 cGy and 8.5%, respectively. As for the 4 patients with grade 3 pneumonitis, the MLD<800 cGy (804-887cGy), V5 < 30% (28%-42%) and V10<20% (20%-36%). Conclusion: It is safe and feasible to give radiation therapy to thorax after pneumonectomy. To avoid pneumonitis of grade 2 or more, it is recommended that the dose to the contralateral lung should be constrained as V5 < 21.5% (sensitivity 78.6%, specificity 84.6%), MLD < 450 cGy (sensitivity 79.6%, specificity 65.4%) and V10 < 8.5% (sensitivity 85.7%, specificity 61.5%). To avoid severe pneumonitis of grade 3 or more, the MLD of the contralateral lung should be limited below 800 cGy. © 2012 by Tumor.

Objective To investigate the relationship between the preterm infants after premature rupture of the membranes(PROM)brain injury and some cellular factors in the umbilical cord blood and amniotic fluid,and ana-lyze the biological markers with great predictive value,and provide a theoretical basis for early monitoring of brain injury in premature infants. Methods One hundred and thirty - nine singleton infants with PROM,their gestation less than 34 weeks,were evaluated. The umbilical cord blood and amniotic fluid of cytokines,including interleukin - 1β(IL - 1β),IL - 4,IL - 6,IL - 8,IL - 10,IL - 17A,tumor necrosis factor alpha(TNF - α),granulocyte colony - stimu-lating factor(G - CSF),monocyte chemotactic protein - 1(MCP - 1),S100B protein and soluble intercellular adhe-sion molecule - 1(sICAM - 1)levels were measured with Luminex liquid chip. All the premature infants underwent brain imaging for the diagnosis of brain damage. All cases were divided into brain injury group and non - brain injury group based on brain imaging examination. Results The concentration of IL - 10 in cord blood was significantly lower in the brain injury group than that in the non - brain injury group,and the difference was statistically significant(P ﹤0. 05). The levels of IL - 1β,IL - 6,IL - 8,TNF - α,G - CSF,MCP - 1,S100B and sICAM - 1 in the brain injury group were significantly higher than those of non - brain injury group,and the differences were statistically significant (all P ﹤ 0. 05). The levels of IL - 1β,IL - 6,IL - 8,TNF - α,G - CSF,MCP - 1 and sICAM - 1 in the amniotic fluid were significantly higher than those of non - brain injury group,and the differences were statistically significant(all P ﹤ 0. 05),but amniotic fluid S100B protein level was similar between 2 groups,which had no statistical significance (P ﹥ 0. 05). To predict the value of brain damage in premature infants,the highest sensitivity in cord blood was S100B protein,the highest specificity was IL - 6. The highest sensitivity in amniotic fluid was IL - 1β,and the highest specificity was IL - 8. The levels of IL - 4 and IL - 17A in the umbilical cord blood and amniotic fluid,IL - 10 in amniotic fluid were very low,and had no predictive value for brain damage. Conclusions Many biological markers in umbilical cord blood and amniotic fluid provide information about the risk of brain injury in premature infants. The highest sensitivity in cord blood was S100B protein,the highest specificity was IL - 6. The highest sensitivity in amniotic fluid was IL - 1β,the highest specificity was IL - 8. Changes in inflammation - related biomarkers suggest that brain damage in the preterm infants might be associated with intrauterine inflammation.

Objective　To investigate the effect of breast milk and some other kinds of infant foods on the adhesion of EPEC to Hela cells and intestinal mucosa so as to understand the possible protective mechanism of breast-feeding in the intestine of infants. Methods　The adhesion of EPEC to Hela cells and intestinal mucosa were examined by cell culture, bacterial adherence test, light and electron microscopy in the mediums that contain breast milk, cow's milk and formula milk or contain ecal filtrate of the infants fed by breast milk and formula milk respectively. Results　Adhesive index for EPEC to Hela cells was significantly lower in the medium containing breast milk than in control and so did in the fecal medium containing breast fed infants than artificial feeding infants. Conclusion　Breast milk may inhibit the adhesion of EPEC to infant intestine.

Objective To investigate the effect of surgical trauma on the expression of COX-2 and PGE2in the hippocampus in aged rats. Methods Forty-five 18-month-old male SD rats weighing 500-600 g were randomly divided into 3 groups (n = 15 each): group Ⅰ control (group C); group Ⅱ anesthesia (group A) and group Ⅲ surgery + anesthesia (group S). Anesthesia was induced by intraperitoneal 1% pentobarbital sodium 50 mg/kg in group A and S. The animals underwent appendectomy and splenectomy under anesthesia in group S.Cognitive function was assessed by open field test and Y-mase test on the 1st, 3rd and 7th day after anesthesia and surgery (T1-3). The animals were sacrificed after behavior tests at T1.2.3 and the hippocampi were removed for determination of the expression of COX-2 mRNA (by RT-PCR) and PGE2 content (by ELISA). Results The time the animal spent in the central square was significantly prolonged, the number of crossing grid and standing on the back legs and the number of right response were decreased, the total reaction time was prolonged and the COX-2mRNA expression at T1 and PGE2 content in the hippocampus were increased at T1,2 in group S as compared with group C and A. There was no significant difference in the variables mentioned above between group C and A. Conclusion Surgical trauma can induce early postoperative cognitive dysfunction through up-regulation of COX-2 mRNA expression and by increasing PGE2 content in the hippocampus in aged rats.

Objective:To study the improvement effect of Sophora Flavones combined with captopril on the rat diabetic cardiomyopathy,and to clarify its mechanisms of improving the myocardial fibrosis.Methods:Fifteen rats were selected randomly from 100 male Wistar rats as normal group.The other rats were fed with high fat and high sugar food and intraperitoneally injected with small dose of streptozotocin (30 mg· kg-1 )all at once to establish type 2 diabetes mellitus cardiomgopathy models.Then 72 rat models with type 2 diabetic cardiomyopathy were set up in which 60 rats were selected according to the blood glucose levels and divided into model group, captopril group,Sophora Flavones group,and Sophora Flavones combined with captopril group (combination group) (n=15).8 weeks after intragastric administration,the weights,the cardiac indexes,the activities of serum creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH ), and the contents of nitric oxide (NO), nitric oxide synthase (iNOS),collagen Ⅰ (Col Ⅰ)and collagen Ⅲ (Col Ⅲ)of the rats in various groups were detected. Results:Compared with normal group,the weight of the rats in model group was decreased and the cardiac index was increased (P <0.01),the activities of serum LDH and CK-MB were increased (P < 0.01),the contents of iNOS and NO in the myocardium tissue of the rats in model group were decreased (P <0.01),and the contents of Col Ⅰ and col Ⅲ were increased (P <0.05 or P <0.01).Compared with model group,the weights and the cardiac indexes of the rats in medication groups were decreased (P <0.05),the activities of serum LDH and CK-MB were decreased (P <0.05 or P <0.01),the contents of iNOS and NO in the myocardium tissue were increased (P <0.05),and the contents of Col Ⅰ and Col Ⅲ were decreased (P <0.05 or P <0.01).The effect of combination group was better than single medication groups (P < 0.05).Conclusion:Combination of Sophora Flavones and captopril has a improvement effect on the rat type 2 diabetic cardiomyopathy,and its mechanism may be related to reducing the myocardial injury to improve diabetic cardiomyopathy.

Objective To evaluate the therapeutic effects of noninvasive bi-level positive airway pressure (BiPAP) ventilation after extubation in chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.Methods Forty-one intubated COPD eases with severe respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study.At the time of pulmonary infection control (PIC) window,the extubation was conducted and followed by BiPAP ventilation in 21 cases (the experimental group),while the other 20 COPD cases with similar clinical characteristics,as the control group,who continuously received invasive mechanical ventilation after PIC window.Outcomes including the duration of invasive ventilation,the total duration of ventilation support,success rate,the incidence of ventilator associated pneumonia (VAP) and mortality rate were observed and compared between the two groups.Results The two groups had similar clinical characteristics and gas exchange at the time of PIC window (P ＞ 0.05 ).Compared with the control group,the experimental group had shorter duration of invasive mechanical ventilation (6.9±3.0) d vs.(13.1 ±4.3) d,t=5.38,P＜0.001),lower rate of VAP (1/20 vs.8/20,x2 =5.51,P=0.02) andhigher extubation rate (20/21 vs.13/20,x2 =4.19,P =0.04).Conclusion In COPD patients with intubation and mechanical ventilation for respiratory failure,BiPAP ventilation after extubation at the point of PIC window may improve patients' prognosis.

Background and purpose:Metabolism change is one of the main characteristics of the tumor de-velopment. Many studies have conifrmed that cytosolic acetyl-CoA synthetase 2 (ACSS2) plays a critical role in hydro-carbon metabolism of cancer cells. This study aimed to explore the effect of ACSS2 on cellular proliferation, apoptosis and migration of A549 cells by RNA interference.Methods:The ACSS2 interference fragment ACSS2-siRNA and neg-ative control were designed and synthesized for RNA interference followed by the transient transfection in non-small cell lung cancer (NSCLC) cell line A549. Real-time lfuorescence quantitative polymerase chain reaction (RTFQ-PCR) was used to detect ACSS2 mRNA expression. Methyl thiazolyl tetrazolium (MTT), lfow cytometry and wound healing assay were used to detect cell proliferation, apoptosis rate and migration.Results:The expression of ACSS2 mRNA was signiifcantly decreased after transfection with the interference fragment ACSS2-siRNA in NSCLC cell line A549. The proliferation and migration activity of ACSS2-siRNA treated cells were decreased significantly compared with the control group. The apoptosis rate, especially the early apoptosis, was increased..Conclusion:Knockdown of the ACSS2 expression in NSCLC cell line A549 can signiifcantly inhibit the cell proliferation, migration ability and pro-mote the apoptosis rate, especially early apoptosis. This study indicates that ACSS2 may contribute to the progression of human lung adenocarcinoma and may have the potential to serve as a novel therapeutic target.

The pathogenic effects of crops from Keshan disease area were studied by rat-feeding. As double controls, another two groups were fed with crops from non-endemic area and synthetic diet. Those from disease area caused necrosis of heart muscle vascular changes of myocardial mitochondria and fatty degeneration of liver. Compared with the controls, the free radical and lipid peroxide content in heart and liver were significantly higher, while the ATP and AN contents in these organs were apparently lower. The multielement contents and its constituent patterns in the feeds, whole blood, heart, liver, kidney and brown adipose tissue of rats in experimetal group were apparently different from those in the control groups. The statistic analysis of multiple factors showed that eight elements Se, Mo, Cu, Mn, Cr, Fe, Zn and Pr might be the perilous factors, that is, under the condition of low selenium, the constituent pattern of selenium and the eight elements might be the complicated factors of endemic crops.

Objective To detect cytokeratin in routine pathology negative regional lymph nodes postoperatively in non-small cell lung carcinoma (NSCLC). To investigate the relationship of lymph node micrometastasis in P-TNM stages NSCLC and survival rates. Methods From Jan. 1996 to Dec. 2003, 107 paraffin-embedded specimens of T1-T4N0-N1M0 NSCLC patients were collected. Anti-cytokeratin(CK) an- tibody AE1/AE3 was applied to detect cytokeratin with Envision~(TM) method in routine pathological negative re- gion lymph nodes in NSCLC, and selected negative control, positive control and blank control. The pulmo- nary hilar lymph node micrometastasis was upward regulated with stage pCK-N1, mediastinal lymph node mi- crometastatsis was upward regulated with stage pCK-N2. The result applied to SPSS11.0 software to process. Results The CK positive rate was 29.9% in all the patients. The CK positive rate was 27% (21/78), 30% (7/23), 67% (4/6)in stage p-Ⅰ, p-Ⅱand p-Ⅲ, respectively. All these data showed the tendency by which detectable rate increased and was accompanied by disease progress. Comparing the annual survival rate and median survival time of the non-micrometastasis group with the mierometastasis group in two groups, the survival rate difference was statistically significant. Comparing the annual survival rate and median sur- vival time in pCK-ⅢA stage with p-Ⅰ-Ⅱstage, pCK-ⅢA stage annual survival rate and median survival time was significantly different (P=0.020). Similarly, comparing the survival rate in pCK-ⅡB stage with p-ⅠB stage, pCK-ⅡB stage survival rate was significantly different(P=0.059). Comparing the survival time of pCK-ⅢA stage with p-Ⅲstage, pCK-ⅡB stage, with p-ⅡB stage, euther survival time difference was statistically significant (P=0.838, 0.518). Conclusions The rate of positive cytokeratin increase is ac- companied by the disease progress in NSCLC. Positive cytokeratin has disadvantagious prognosis. It is showed that pCK-N1 may be equal to p-N1 and pCK-N2 which also may be equal to p-N2. Micrometastasis may affect the UICC staging currently in use.

The Sertoli cell-rich or Sertoli-germ cell aggregates of 15-21 day immature rat testis were cultured in serum-free Ham F-12 medium for observation of the reorganization of the seminiferous tubules in vitro. The results showed that after first week of culture, the cell aggregates were spreaded on the bottom of culture dish as a monolayer consisted of Sertoli cells as well as spermatogenic cells. While after second week these monolayer cell cultures rearranged and transformed into cellular cords which connected each other to form a cellular rete. During this time, there were many small cells with long cytoplasmic processes appeared in the cultures. They looked like immature spermatozoon-like cells which were released from the cellular cords and floated in the medium, however no movement was detected. After third week, the cellular cords developed into a solid or tubule-like structures consisted of Sertoli cells and spermatogenie cells in different stages of spermatogenesis.These cultures have been studied by phase-microscopy in vitro, light and electron microscopy on semithin and ultrathin sections. These studies revealed that the Sertoli cells and Sertoli-germ cell aggregates of immature rat testis, in vitro, not only developed into monolayer cell culture as mentioned, but were also able to be further reconstructed, or reorganized, in some extent, to solid and tubule-like structures. The possible significance and mechanism were discussed.