Locally advanced non-small cell lung cancer (NSCLC) encompasses a heterogeneous collection of tumour and nodal stages. Despite recent advances, the overall survival for this group remains poor. Radical radiotherapy remains the mainstay of treatment. The complexities involved in the delivery of radical radiotherapy to the lung pertain to tumour volume definition, intra- and inter-fraction motion (namely tumour motion caused by respiration and GTV migration during treatment) and the proximity of organs at risk to the high-dose region. Here we discuss a selection of strategies to manage these complexities. Motion management can be addressed by 4D CT planning, radiotherapy gating and on-board imaging, including cone beam CT. Advanced planning methods such as intensity modulated radiotherapy may potentially allow dose escalation and sparing of normal tissue toxicity. Functional imaging has already improved our ability to stage tumours and more carefully select appropriate candidates for radical treatment. Better imaging also improves GTV definition. However, the complexities of image acquisition and interpretation need to be accounted for and agreed consensus protocols have yet to be defined. Novel imaging methods such as 4D PET-CT and 4D MRI may also yield improvements for the future and these are briefly discussed.

Astasia-abasia refers to the inability to stand or walk despite possessing good motor strength and conserved voluntary coordination. Although it is usually regarded as a psychogenic disorder, organic causes have been reported. Herein we describe a patient who presented with alcohol-induced episodic astasia-abasia. Interestingly, SPECT performed during an episode showed hyperperfusion in the dorsal brainstem and subthalamic region. These areas roughly coincide with the mesencephalic locomotor region and subthalamic locomotor region, respectively, and it is conceivable that abnormal neural activity in these areas is related to the symptoms in our patient.

We report a case of multiple basal cell carcinoma associated with keratoacanthoma. A 65-year-old Korean female had suffered from multiple, variable-sized papules and nodules on the face for 20 years previous to treatment. She had no history of arsenic intake, irradiation, herb medication, or hereditable or preexisting dermatoses. Histopathologically, the tumors revealed typical findings of solid and adenoid types of basal cell carcinoma and keratoacanthoma.
Aged ; Carcinoma, Basal Cell/complications/*pathology ; Case Report ; Facial Neoplasms/complications/*pathology ; Female ; Human ; Keratoacanthoma/complications/*pathology ; Skin Neoplasms/complications/*pathology

Objective To analysis risk factor and to construct a line graph prediction model for bone cement leakage after percutaneous transluminal vertebroplasty treatment in patients with osteoporotic spinal compression fractures. Methods A total of 236 patients with osteoporotic spinal compression fractures who came to our hospital from December 2019 to December 2021 were selected for the stud)', and they were divided into a leakage group (n = 58) and a non-leakage group (n = 178) according to whether bone cement leakage occurred after percutaneous transluminal vertebroplasty treatment. The clinical data were collected to analyze the factors associated with bone cement leakage; The work receiver operating characteristic^ ROC) curves of the subjects were drawn to analyze the predictive value of each relevant factor on bone cement leakage; The Logistic multiple regression model was used to analyze the risk factors affecting bone cement leakage; The R language software 4. 0 "rms" package was used to construct the prediction model of column line diagram. Results The differences in age, bone density, degree of vertebral compression, vertebral endplate/posterior wall integrity, bone cement viscosity, and bone cement injection volume between patients in the leaky and non-leaky groups were statistically significant (P< 0. 05). The area under curve(AUCs) for age, bone density, and cement injection volume to predict cement leakage were 0. 804, 0. 825, and 0. 803, respectively; The best cutoff values were 71 years, 0. 67 g/cm", and 4.4 ml, respectively. Age (>71 years), bone density (^ 0 . 67 g/cm"), vertebral compression (severe), vertebral endplate/posterior wall integrity (no), cement viscosity (low viscosity), and bone cement injection volume (> 4. 4 ml) were independent risk factors for bone cement leakage. The column line graph model predicted a C-index of 0. 802 (95% CI, 0. 689-0. 868) for cement leakage, with a threshold >0. 19, and the column line graph model provided a net clinical benefit. Conclusion Age, bone density, degree of vertebral compression, vertebral endplate/posterior wall integrity, cement viscosity, and cement injection volume are independent risk factors for cement leakage, and the column line graph prediction model constructed with these predictors is of clinical application.

No abstract available.

Bezoars ; complications ; Fruit ; adverse effects ; Gallstones ; diagnosis ; pathology ; Humans ; Ileus ; diagnosis ; etiology ; Male ; Middle Aged ; Seeds ; adverse effects ; Tomography, X-Ray Computed

No abstract available.
Animals ; Dogs* ; Nephrectomy*

One of the most important prognostic factors in LCP disease is the extent of epiphyseal involvement. Magnetic resonance imaging is considered to be the technique of choice for early diagnosis of Legg-Calve-Perthes disease. Gadolinium-enhanced spin-echo MR images were obtained after nonenhanced Tl-weighted(spin-echo) and T2-weighted(gradient-echo) images. Four different areas were identified in the femoral epiphysis(necrosis, regenerative, cartilaginous and normal fatty bone tissue). The histological evolution of LCP is well described by Catterall and others. Comparing their description with our MRI finding, we suggest classification of LCP into three phases: (I) necrosis, (II) regeneration(IIa-early and IIb-late) and (III) reossification and sequale. T2 weighted image was useful in the early stage and Tl weighted image was useful in the later stage for evaluation of involved extent of the disease. With MRI, we think that we can find out the stage of LCP more early and rationally, pathological factors more easily and appropriate time for operation exactly. we believe that MRI is more adequate method to decide the stage of LCP disease.
Classification ; Early Diagnosis ; Legg-Calve-Perthes Disease ; Magnetic Resonance Imaging* ; Necrosis

Objective: To explore the mechanism of shRNA Twist gene on proliferation and invasion of lung adenocarcinoma NCI-H1299 cells. Methods: Twist siRNA interference expression vector was constructed and NCI-H1299 cells were divided into three groups: blank control group, negative control group and experimental group. The blank control group was the untreated cell group, while the negative control group was the lentivirus transfected cell group by the blank vector. The experimental group was the lentivirus transfected cell group constructed by the lentivirus interference vector of shRNA Twist. The siRNA interference expression vector of Twist was constructed by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot to detect the expression of Twist. Transwell kit was used to detect cell invasion. Cell counting kit-8 (CCK-8) kit was used to detect cell proliferation. Results: ⑴ The titer of lentivirus was detected. The transfection titer of lentivirus vector: shRNA-Twist vector was 3×10⁸ TU/ml. ⑵ The results of qRT-PCR test showed that compared with the negative control group, the mRNA expression of Twist in the experimental group was decreased (q=3.177, P=0.0234). ⑶ The results of Western blot showed that compared with the negative control group, the protein expression of Twist in the experimental group was decreased (q=4.071, P=0.0304). ⑷ The results of Transwell test showed that there was significant statistical difference among the three groups (F=19.472, P=0.000). Compared with the negative control group, the number of cell imigration in the experimental group was decreased (q=3.567, P=0.0318). ⑸ The results of CCK-8 showed that there was significant statistical difference among the three groups (F=20.983, P=0.000). Compared with the negative control group, the proliferation rate in the experimental group was decreased (q=5.272, P=0.0157). Conclusions ShRNA Twist gene can significantly inhibit the proliferation and invasion of lung adenocarcinoma NCI-H1299 cells.

In order to deepen the connotation of nursing service, accelerate the construction of nursing discipline and promote the industrialization of nursing service, nursing alliances are mushrooming rapidly. However, the construction of nursing alliances deserves rational consideration, while policy guidance should be strengthened, functions and positioning be clarified, and personnel training be standardized. These efforts ought to promote the healthy and orderly development of nursing alliances along the initial purpose of its establishment. in the end, the alliance should give full play to its unique role in safeguarding people′s health and meeting the needs of primary medical care.