Objective To prospectively assess the influence of intensity-modulated radiotherapy (IMRT) and conventional radiotherapy on quality of life (QOL) in patients with head and neck cancer (HNC) for clinical guidance. Methods From May 2007 to May 2008, 102 HNC patients were enrolled in this study. Fifty-two patients were treated with IMRT and 50 with conventional radiotherapy. In patients with IMRT, at least one parotid gland was spared, and the contralateral submandibular gland was spared in 24 patients. The parotid and submandibular gland were not spared in patient with conventional radiotherapy.QOL was assessed using EORTC QLQ C30 and HN35 questionnaires at 4 time points (before radiotherapy,end of radiotherapy, 2 months and 6 months after radiotherapy). A change of 10% in scores of the instru-ment range had been previously demonstrated to be clinically significant. Results In the study, 94% (31/33) of the QOL domains were worse after IMRT or conventional radiotherapy, including 49% (16/33) with significant difference (U=2.72-5.98, all values of P<0.01) and 33% (11/33) with clinical signifi-cance. At 2 months after radiotherapy, 12% (4/33) of the domains showed clinically significant improve-ment, however, 15% (5/33) of the domains did not show any improvement (U=3.10-5.93,all value of P < 0.01). Continuous improvement in most domains of QOL was shown at 6 months after radiotherapy. Clini-cally and statistically significant improvement were shown in 21% (7/33) of the domains, and some were even better than pretreatment except in dry mouth and sticky saliva scales (U=4.49 , P<0.01 and U=4.87 ,P <0.01). Compared with conventional radiotherapy, the dry mouth and sticky saliva caused by IM-RT were milder (U=4.57,P <0.01 and U=5.57, P < 0.01) and continuous improvement were shown over time after radiotherapy (U=7.23, P <0.01 and U = 7.57, P < 0.01). Similar improvement weren't shown in patients with conventional radiotherapy. Conclusions QOL in HNC patients is significant worse after ra-diotherapy. QOL can be improved continuously over time after treatment except dry mouth and sticky saliva which are the main factors affecting QOL. IMBT, causing less dry mouth and sticky saliva when compared with conventional radiotherapy, has benefits for the preservation of QOL.

Objective To evaluate Western blot analysis in diagnosing limb-girdle muscular dystrophy type 2A (LGMD2A). Methods The clinical records including their pathological and biochemical results of 4 patients with LGMD type 2 were reviewed. Histochemical and immunohistochemical staining were performed on muscle biopsy specimens from the four patients. The expressions of dysferlin and calpain-3 in muscles were analyzed by Western biol. Results All 4 LGMD patients shared some common clinical features, such as dorsal muscular atrophy of lower limbs and remarkably elevated CK. The immunohistochemical results showed partial or complete deficiency of dysferlin staining in all 4 LGMD patients. However, Western blot revealed that the calpain-3 protein in the muscle of patient 1 was completely absent, who was later diagnosed with LGMD2A. The other 3 patients had complete dysferlin deficiency with reduced calpain-3 expression and they were confirmed to be LGMD2B. Conclusions Western blot analysis of calpain-3 and dysfcrlin can be used to differentiate LGMD2A which shows absence of calpain-3 from other LGMD types which show dysferlin deficiency. Western blot is an invaluable method in clinical diagnosis of LGMD2A.

Objective To evaluate the effect of the dimethicone powder in bowel preparation before capsule endoscopy (CE) and to observe its possible adverse effects. Methods A total of 60 patients receiv-ing CE were prospectively randomized into 2 groups according to bowel preparation method. In dimethicone powder group, patients were arranged to take dimethicone powder 30 rain before the examination on basis of macrogol electrolytes powder and in control group, patients had macrogol electrolytes powder only. Images of small intestine were equally divided into segments A, B and C according to intestinal transit time, and re-viewed by 2 experienced physicians independently. Intraluminal gas bubbles were graded and any possible adverse effects were monitored. Results Interobserver agreement was excellent (P < 0.05). In segments A and C, images from dimethicone powder group were less interfered by gas bubble than those from control group (P < 0. 05), but in segment B there was no difference between 2 groups (P > O. 05). No adverse effects were observed. Conclusion The dimethicone powder administration before capsule endoscopy im-proves the visualization of the intestinal mucosa.

Objective To prepare the survival motor neuron(SMN)polyclonal antibody and explore the localization of SMN protein in transfected cells and its expression in skeletal muscles of patients with spinal muscular atrophy(SMA).Methods A prokaryotic expressional plasmid named pET-28? (+)/SMN was constructed and SMN-His fusion protein was induced.The fusion protein was used to immunize New Zealadd rabbits to prepare SMN polyclonal antibody.A eukaryotic expressional plasmid named pcDNA3.1/myc-HisB-SMN was constructed and used to transfect CHO cells.Skeletal muscles were collected from 3 patients with bone fracture who were regarded as normal controls, and 3 SMA patients of type Ⅰ, 3 of type Ⅱ and 3 of type Ⅲ who were ascertained by genetic analysis.Western-blotting and immunofluorescence stain were applied to study the expression of SMN in transfected CHO cells and skeletal muscles of normal individuals and SMA patients.Results Correct pET-28a(+)/SMN prokaryotic expressive plasmid was constructed and SMN-His fusion protein was obtained from E coli BL21 transformed with pET-28a(+)/SMN.Then, rabbit anti-human full-length SMN polyclonal antibody of high specificity and sensitivity was obtained from rabbits immunized by SMN-His fusion protein.SMN proteins were shown diffusedly locating in the cytoplasm and nucleus of CHO cells transfected with pcDNA3.1/myc-HisB-SMN plasmid and mainly accumulating around the nucleus.The results of Western-blotting were as follows:the average ratio of SMN band density to glyceraldehyde phosphate dehydrogenase(GAPDH)band density (SMN/GAPDH)is 0.619 in skeletal muscles from normal controls, the average values of SMN/GAPDH in skeletal muscle from SMA patients of type Ⅲ and Ⅱ were 0.347 and 0.340 respectively, which were lower than that of normal controls.However, the average values of SMN/GAPDH in skeletal muscle from SMA patients of type I was only 0.079, which was quite lower than that of normal controls.Conclusions The rabbit anti-human full-length SMN polyclonal antibody is of high specificity and sensitivity, which makes the basis for the research of SMN function and SMA pathogenesis.There may be a correlation between the SMN level in skeletal muscle and the severity of disease.

Objective To study whether the presence of gastric pepsin in the sputum might be used as a reliable criteria of laryngopharyngeal reflux. Methods Fifty-six patients with the symptoms of laryngopharyngitis and fifteen healthy people were recruited. Fifty-six patients were divided into laryngopharyngeal reflux group and chronic laryngitis group by the reflux symptom index (RSI), by the reflux finding score (RFS) and by their treating experiment taking omeprazole 20 mg bid for 2 weeks. Sputum in all three groups was obtained in the morning. Pepsin in the sputum was measured by enzyme-linked immunoadsorbent assay. Results The positive rate of pepsin in sputum among LPR group, chronic laryngopharyngitis group and normal group were 93.8% (30/32), 75.0% (18/24), 20.0% (3/15) respectively, and the median concentration of pepsin were 5. 3 [1.3;53.4] ng/ml, 0.8 [0.1;17.2] ng/ml, 0.0 [0.0;0.0] ng/ml (H=23.29, P=0.000). Compared with co-diagnosis as gold standard, the sensitivity of RSI, RFS treating experiment and the pepsin immunoassay was 59.4%, 84.4%, 81.3% and 93.8%, and the specificity of those was 87.2%, 61.5%, 95. 8% and 46.2% respectively. Conclusions Detection of pepsin in sputum by immunoassay might provide a high sensitive, noninvasive method for laryngopharyngeal reflux.