Objective To investigate the risk factors of cerebral palsy(CP)in children.Methods 1∶2 matched case-control study was carried out in 100 CP children and 200 controls individually matched for sex and age were selected for each case.The data were analyzed with Logistic regression.Results 9 risk factors were suggested from univariate analysis,namely hospital level,educational level of mother and father,premature birth,neonatal asphyxia,ABO hemolysis,lower birth weight,hypoxic-ischemic encephalopathy(HIE)and kernicterus.The risk factors confirmed by multivariate analysis were hospital level,educational level of father,premature birth,neonatal asphyxia,ABO hemolysis,lower birth weight and HIE.Conclusion Relevant risk factors of CP are various.

Objective To evaluate the dose distribution of target volume and normal tissues in forward intensity modulated radiotherapy (fIMRT) and inverse intensity modulated radiotherapy (iIMRT) modes for breast cancer after radical mastectomy.Methods Both fIMRT and iIMRT plans were developed for 10 patients with breast cancer after radical mastectomy.On each patient's CT images the supraclavicular area, chest wall, and internal mammary area were delineated.The prescription dose was 50 Gyin 25fractions.In the fIMRT plan X-ray irradiation at the dose of 6 MV was adopted for the supraclavicular and the chest wall areas and electron irradiation at the dose of 9 - 12 MeV was adopted for the internal mammary area, and the doses of cold and hot spots were adjusted according to the fitting doses of these 3 regions.In the iIMRT plan the supraclavicular area, chest wall, and internal mammary area were taken asa whole target, 6 MV X-rays was used, and inverse optimal design was performed.The dose distribution oftarget volume and normal tissues, conformal index (CI) , and heterogeneous index (HI) , and acceleratormonitor unit (MU) were analyzed using dose-volume histogram (DVH)for the two intensity modulated modes.Results The maximum dose of PTV of the iIMRT plan was significantly lower than that of the fIMRT plan(t = -3.23,P ＜0.05), the minimum dose and V95% of PTV of the iIMRT were significantly higher than those of the fIMRT plan(t = 4.08, -2.69, both P ＜0.05).The CI level of the iIMRT plan was significantly higher than that of the fIMRT plan and the HI level of the iIMRT plan was significantly lower than that of the fIMRT plan (t = -3.13, 2.74, both P ＜0.05).There were not significant differences in V10, V20, V25, V30, and Dmean of the ipsilateral lung between these 2 groups.However, the V15 of ipsilateral lung of the iIMRT group was significantly lower by 4.2% than that of the fIMRT group (t= 3.2, P ＜ 0.05).There were not significant differences in the mean dose (Dmean) and V30 of heart, and Dmean of contralateral lung and contralateral breast between these 2 groups.Conclusions Compared with fIMRT, the iIMRT plan results in more PTV coverage, higher conformity index, and more homogeneous dose distribution, with lower dose upon the lung at the affected side, and better protection of the contralateral lung, heart, and breast.

Objective To analyze the setup errors of external?beam and intracavitary radiotherapy for cervical cancer based on the data of cone?beam computed tomography ( CBCT) , and to provide a basis for clinical practice. Methods Sixty patients with stage ⅡA?ⅢB cervical cancer who were admitted to our hospital and underwent external?beam and intracavitary radiotherapy from March to June, 2015 were enrolled as subjects. Sixty patients with stage ⅡA?ⅢB cervical cancer undergoing conventional external?beam radiotherapy within the same period were also enrolled. The CBCT?based setup errors, containing setup errors in x, y, and z directions and three?dimensional vector deviation, in the initial treatment were obtained from each patient. Comparison of errors between the two treatment approaches was made by independent?samples t test. Results Fitting the data to a linear model revealed that the setup errors in x, y, and z directions increased with the increase in the distance between the position reference point and the center point of the target volume. External?beam radiation combined with intracavitary radiation had significantly reduced setup errors in x, y, and z directions than the conventional external?beam radiation ( 0.13± 0?12 vs. 0.31± 0?24, P=0?000;0.23±0?18 vs. 0.47±0?36, P=0?001;0.18±0?11 vs. 0.27±0?18, P=0?001). Conclusions In order to reduce the setup errors, CT scan needs not only a reference marker as close as possible to the center of the tumor, but also a reliable and accurate approach for postural fixation.

Objective To synthesize novel gold nanoparticles of GAL-PEG-GNPs,study its radiation effect on hepatocellular carcinoma cells HepG2 cells in vitro,and investigate the underlying mechanisms.Methods GAL-PEG-GNPs were synthesized and characterized successfully.HepG2 cells were divided into three groups of control,GNPs and GAL-PEG-GNPs.The cytotoxicities of these compounds were tested by the CCK-8 assay and their IC50 values of HepG2 cells were calculated.Cell uptake of nanoparticles was detected by TEM and ICP-MS.The radiosensitization effect of nanoparticles was tested by the colony formation assay.Cell cycle distribution was detected by FCM.The expressions of CAT,SOD,and total GSH were detected with a microplate reader,and the expressions of apoptosis-related proteins were tested by Western blot.Results The GNPs and GAL-PEG-GNPs had absorption peaks at 520 and 530 nm,respectively,and their diameters were (22.6-±2.12) and (32.0 ± 1.41) nm detected by ICP-MS.The GAL-PEG-GNPs and GNPs had similar cytotoxicity profiles (P ＞ 0.05),while GAL-PEG-GNPs could be more effectively uptaken by HepG2 cells than GNPs.The sensitive enhancement ratio (SER) of GNPs and GAL-PEG-GNPs to HepG2 cells were 1.46 和 1.95,respectively.The percentage of cells at phase of G2/M in HepG2 population treated with GNP was higher than that of untreated cells (t =14.20,P ＜0.05).The protein expressions of Cytochrome C,Bax,Caspase-3,and Caspase-9 were upregulated while Bcl-2 expression was down-regulated in the cells treated with GNPs/radiation or GAL-PEGGNPs/radiation.The expressions of CAT,SOD and total GSH in the GNP treated groups were significantly decreased compared with the control group(t =12.34,29.39,12.85,P ＜ 0.05).Conclusions GALPEG-GNPs has obvious radiosensitization effect on HepG2 cells,which is related to the induction of cell apoptosis and the generation of free radicals.

Objective To study the impact of setup error caused by computed tomography ( CT) images with different resolutions in the Sentinel system on clinical treatment. Methods A phantom was scanned by large?aperture positioning CT with two different resolutions ( CT1:0. 5 mm × 0. 5 mm × 1. 0 mm, FOV 256 mm, Matrix 512, thickness 1 mm;CT3:1. 0 mm×1. 0 mm×3. 0 mm, FOV 500 mm, Matrix 512, thickness 3 mm) . The CT images were transferred to the planning system. The radiation fields were designed and transferred to MOSAIQ and Sentinel systems. Ten fixed setup errors were applied to a six degree of freedom couch. The Sentinel system was used to position the two groups of CT images and generate the setup errors. The comparison of two datasets was made by paired t?test. Cone?beam CT was used for independent verification. Results The setup errors in x?, y?, and z?directions were significantly smaller on CT1 than on CT3(0.19±0. 11 vs. 0.33±0. 16 mm, P=0. 061;0.59±0. 79 vs. 1.07±1. 09 mm, P=0. 008;0.67±0. 75 vs. 1.16±1. 30 mm, P=0. 043). There were no significant differences in rotational errors in x?, y?, or z?directions between the two datasets ( P=0. 494;P=0. 182;P=0. 298) . Conclusions The Sentinel system has a higher setup accuracy in the 0. 5 mm×0. 5 mm×1. 0 mm mode than in the 1. 0 mm×1. 0 mm×3. 0 mm mode. However, the later mode is still an acceptable choice in clinical treatment.

Objective To investigate the effect of different additional filtration thickness of DSA on image quality and radiation dose with cerebral angiography. Methods Prospective collected 90 patients with DSA examination of the whole cerebral artery, patients were divided into A, B and C group according to the time of the examination, each group included 30 cases. Patients underwent conventional DSA, the additional filtration of group A, B and C were (1.0 mmAl+0.1 mmCu), (1.0 mmAl+0.4 mmCu) and (1.0 mmAl+0.9 mmCu), respectively. Dose area product (DAP), air kerma (AK), tube current and tube voltage of anteroposterior and lateral radiography of the whole brain were recorded, and scored the image quality. Eye lens organ dose values were obtained by using simulation phantom and LiF dosemeter under A, B and C groups with three different additional filtrations for cerebral angiography. The image quality scores and the radiation dosewere analyzed by one-way ANOVA tests or Kruskal-Wallis tests. Results The image quality comprehensive score of three groups showed significant difference (F=40.07,P<0. 01), which were (3.8±0.4), (3.6 ± 0.5) and (3.0 ± 0.6), respectively. The DAP and AK value of anteroposterior and lateral radiography of three groups also showed significant difference (P<0.05), B and C group were lower than the A group. Left and right eye lens organ dose were decreased along with the increase of the additional filtration thickness, and the difference between the 3 groups also had significant difference (P<0.01). Conclusion Both the image quality and radiation dose can acquire when conducted the whole brain DSA with 1.0 mmAl+0.4 mmCu additional filtration.

Objective To observe the effect of pentylenetetrazole(PTZ)-kindled epliepsy on rat's learning and memory and the expression of calmodulin dependent protein kinaseⅡ(CaMKⅡ)in hippocampal neurons.Methods The rats were injected intraperitoneally with PTZ to establish the kindled models.The changes of behavior were evaluated through Morris water maze and the expression of ?-CaMKⅡ in hippocampal neurons was observed by immunohistochemistry technique.Results The Morris water maze test showed that the escape latency and the swimming distance in PTZ-kindled rats increased significantly(P

Objective To evaluate the performace of fixed field Intensity modulated radiation therapy (IMRT) and RapidArc in the radiotherapy for multiple intracranial metastases.Methods The clinical data of 10 patients with multiple intracranial metastases,8 male and 2 female,aged 65-73,were used to design 3 plans:fixed field IMRT,RapidArc with single Arc (RA1),and RapidArc with double Arc (Arc 2).Dose-volume-histogram analysis was used to compare dose results,monitor unit,and delivery time.Results All 3 plans met the clinical requirements.The best target conformity and homogeneity were observed in the RA2 plan (Z = -2.803,- 2.904,P ＜ 0.05) and there were no statistical differences between the IMRT plan and RA1 plan.The maximum doses to the lens,eyes,and brainstem of the two RapidArc plans were all significantly lower than those of the IMRT plan(Z = -2.803--2.191 ,P ＜0.05),and the maximum dose to the optic nerves of the RA2 plan was significantly lower than that of the IMRT plan (Z = -2.293,-2.701 ,P ＜0.05).Compared with the IMRT plan,the average monitor units of the RA1 and RA2 plans were reduced by 29% and 24%,respectively,and the delivery time of these plans were significantly shorter by 84% and 69%,respectively.Conclusions Compared to the IMRT plan,RapidArc plans with single or double Arcs show similar or better effects in the target dose distribution,reduction of irradiation doses on organs at risk and,moreover,significant decrease of the monitor units and delivery time.

Objective To investigate the expression of nuclear factor-κB (NF-κB) and p53 up-regulated modulator of apoptosis (PUMA) in acute lung injury (ALI) induced by severe acute pancreatitis (SAP), and the therapeutic role of proline dithiocarbamate (PDTC). Method SD rats weighed 200～ 250 g were randomly(random number) divided into sham operation group (A group, n = 18), ALI group (B group, n = 18) and PDTC treatment group (C group, n = 18). The model of SAP was eastablished by injecting 1 mL/kg of sodium tauarocholate into the pancreatic capsule of the rats in B group and C group. The model rats in C group were treated with PDTC one hour after modeling. Six rats of each group were sacrificed 6 h,12 h, and 24 hours after modeling. The histopathological changes in lung and pancreas were observed. The levels of NF-κB p65 and PUMA in lung were detected by using Western blotting, and the expressions of bcl-2, bax and caspase-3 mRNA in the lung were detected by using RT-PCR. The lung tissue was taken for examination under transmission electron microscope. TUNEL was used for detection of apoptotic alveolar epithelial cells. Results Six to 24 hours after modeling, the pathological scores in lung of ALI group were significantly higher than those of control group and PDTC group after sodium taurocholate injection ( P ＜ 0.05). The levels of NF-κB p65 and PUMA, and the expressions of bax and caspase3 mRNA in ALI group at different intervals were higher than those in control group and PDTC group ( P ＜ 0.05),whereas the expression of bcl-2 mRNA in ALI group was lower than that in control group and PDTC group ( P ＜0.05). The NF-κB p65 was correlated closely and positively with PUMA ( r= 0.987, P ＜ 0.01). Higher activity of caspase-3 acrtive units was seen in ALI group than that in control group and PDTC group ( P ＜ 0.05). The microvilli disappeared in ALI group 24 hours later. The apoptosis index in ALI group was higher than that in control group and PDTC group ( P ＜ 0.05). Conclusions The apoptosis of alveolar epithelial cells of rats in ALI group is caused by PUMA activated by NF-κB. PDTC treatment can inhibit apoptosis of alveolar epithelial cells of rats in ALI group by inhibiting the activation of NF-κB.

Objective To investigate expression of slug and E-cadherin in pancreatic cancer tissues and determine the inhibitory effects of anti-Slug, an anti-sense plasmid, on the invasion of pancreatic cancer cell lines in vitro. Methods Slug and E-cadherin protein and mRNA was analyzed by IHP and RT-PCR in 36 cases of pancreatic cancer. Then anti-Slug plasmid was transfected into herin and Slug expression. The inhibitory effects of anti-sense Slug were also detected by Transwell motility assay and Matrigel invasion assay. Results The expression of Slug and mRNA in metastatic pancreatic cancer tissue was higher than that in non-metastatic tissue. E-cadherin and mRNA was lower in metastasis tissues(P＜0.05). The inverse relationships were further observed by transient transfection of anti-Slug into SW1990H4 cells. The downregulated expression of Slug and re-expression of E-cadherin were found. The Slug mRNA levels were 0.985±0.016,0.973±0.014, 0. 554±0. 011 after 0, 48 h of transfection of anti-sense Slug, and that of E-cadherin were 0.120±0.001, 0.360±0.002, 0. 727±0. 006, respectively. The diference was significant between different time points (P＜0.05). The Slug mRNA levels were 0. 206±0.017, 0.968±0.015, and that of E-cadherin were 0. 18±0.002,0.727±0.006 after stable transfection of anti-sense Slug, and control plasmid, respectively. The diference was significant (P＜0.05). The motility activity(393±28, 352±24, 96 ±13 )and the invasion activity (223 ± 69, 202 ± 64, 65 ±19) of1 antisense Slug transfectant cells were significantly decreased as compared with those of control cells (P＜0.05). Conclusions Higher expression of slug and lower expression of E-cadherin is related to the invasion and metastasis in pancreatic cancer. A reverse corelation of E-cadherin and Slug expression exists in pancreatic cancer. Slug is possibly a potential target for cancer gene therapy blocking invasion and metastasis in human pancreatic cancer.