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 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 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 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.

BACKGROUND: The metacarpal fascial spaces of hand are the potential structure that is not virtual, so that difficulties are presented in diagnosis and treatment of diseases of the metacarpal fascial spaces of hand. In order to solve the difficulties,anatomical borderline and abut relationship of the metacarpal fascial spaces of hand have to be sufficiently understood. OBJECTIVE: The borderline and abut of the metacarpal fascial spaces of hand were detailedly observed and researched by fresh cadaveric dissection, thin sectional anatomy and computer image recognition technology, and the 3-D reconstruction technology was utilized to reconstructed the metacarpal fascial spaces in this paper, so the abut relationship of the metacarpal fascial spaces of hand could be displayed, and the detailed anatomical data of imaging diagnosis and surgical treatments of disease of the fascial spaces of hand could be provided. DESIGN: Repeated measuring design.SETTING: The 251 Hospital of Chinese PLA and Central Laboratory of the Third Military Medical University of Chinese PLA. MATERIALS: Twelve adult fresh cadaveric hands which involved six right hands and six left hands and wrist joint, had no organic damage by naked observation, provided by the Department of Anatomy, the Third Military Medical University of Chinese PLA, among one right hand and one left hand were waiting for being mill-cut and thin cross-section dissected and imaging reconstructed. Among ten hands were observed by fresh cadaveric anatomy. METHODS: The trial was carried out in the 251 Hospital of Chinese PLA and Central Laboratory and Department of Anatomy of the Third Military Medical University of Chinese PLA from May 2003 to February 2006. Based on the gross anatomy, thin cross-section anatomy, visible human and virtual human technology theory, the metacarpal fascial spaces of hand were three-D reconstructed in microcomputer.MAIN OUTCOME MEASURES: Anatomical borderline and about relation of the metacarpal fascial spaces of hand. RESULTS: Display of observation result of adjacent and dimension of the midpalmar space and the thenar space by fresh cadaveric anatomy combined with thin cross-section anatomy, computer image recognition technology, and the 3-D reconstruction technology: The anterior borderline of the MPS was the digital flexor tendons of middle finger, ring finger, little finger and the 2nd lumbrical muscle (LM), 3rd LM, 4th LM; the posterior borderline was the palmar interosseous fascia before 3rd palmar bone, 4th palmar bone, 5th palmar bone and corresponding interosseous muscles; the lateral borderline was the palmar intermediate septum; the medial borderline of the MPS was the medial intermuscular septum of palm. In addition, the distal section of the MPS which was separated into three little spaces by two septums of connective tissue, and 3rd 4th, 5th digital flexor tendon and 2nd, 3rd, 4th LM were respectively contained by the three little spaces. The proximal of this space opened to the posterior space of antebrachial flexor by the carpal canal; the distal of this space opened to 2nd, 3rd, 4th web space (WS) by 2nd, 3rd, compartment of 4th LM, and continuously the dorsal subcutaneous space and the subaponeurotic space. The anterior borderline of the TS was the 1st digital flexor tendon and the 1st LM; the posterior borderline was the fascia of abductor pollicis; the medial borderline was the palmar intermediate septum (PIMS); the lateral borderline was the tenden sheath of flexor pollicis longus and the lateral intermuscular septum of palm. The distal of this space opened to 1st WS by compartment of the 1st LM, and continuously to the dorsal subcutaneous space and the subaponeurotic space; the proximal of the TS was close.CONCLUSION: The proximal of the thenar space is close, the distal section of the metacarpal fascial spaces is separated into three little spaces, and the computerized three-D renconstruction of the fascial spaces of hand can provide some guidance for imaging diagnosis and surgical treatments.

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.

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 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