Many clinical studies showed that the traditional Chinese medicine (TCM) syndromes in stroke have been dynamically changing since the onset of the disease. The changing of TCM syndromes can be attributed to multiple correlative factors such as age, sex, area distribution, underlying diseases, and constitutional factor. Data-driven methods involving multivariate statistical methods and descriptive approach have been used to analyze the regularity of dynamically changed TCM syndromes of stroke. However, expressing non-linear relationship between symptom or correlative factors and syndrome patterns by data-driven models is challenging. Model-driven methods involving artificial neural networks and Bayesian networks are new methods for studying the changes in TCM syndromes in patients with stroke. In this review, the authors summarized the studies of dynamically changed patterns of stroke syndromes based on data-driven methods and some clinical trials on TCM syndromes based on model-driven methods. Further studies are needed to improve the understanding of the dynamically changing regularity of TCM syndromes for stroke by using model-driven methods so as to develop appropriate and timely TCM treatments.

Objective To evaluate multi-slice spiral computed tomography(MSCT)in the diagnosis and preoperative staging of gastrointestinal cancer.Methods (1)Three hundred and thirty-two gastric cancer patients underwent preoperative MSCT examination.The staging of gastric cancer by MSCT was compared with histological examination.(2)Seventy-three small intestinal cancer patients underwent preoperative MSCT,and 70 healthy adults were selected as normal contr01.The MSCT images of small intestinal lymphoma and small intestinal cancer were compared with those of normal small intestine.(3)Two hundred and twenty-eight colorectal cancer patients underwent preoperative MSCT,and the features of the MSCT images of colorectal cancer were analyzed by chi-square test.Results (1)The overall accuracy of MSCT in the assessment of gastric wall invasion,lymph node metastasis and distal metastasis were 78.2%(244/312),67.3%(210/312)and 93.8%(30/32),respectively.More information such as the location of lesions and the vessels around the stomach couldbe provided by MSCT image.(2)Abdominal masses,diffuse thickening of intestinal wall and intestinal obstruction were the main features of small intestinal cancer,while mesenterie and retroperitoneal lymph nodes metastases were rarely detected.The presentation of small intestinal lymphoma detected by MSCT were completely the opposite.(3)Signs such as"coarse surface"and"heterogeneous enhancement"were important to the diagnosis of colorectal cancer.The measurement of the MSCT value is helpful in the differential diagnosis of colorectal cancer and colonic inflammation.Conclusions MSCT can provide correct imaging information on the diagnosis and preoperative staging of gastrointestinal cancer.The combination of MSCT and endoscopy can improve the accuracy of diagnosis.

Objective To investigate the impact of anatomical landmarks on registration in image?guided radiotherapy (IGRT) for central and peripheral lung cancer. Methods Twenty?five patients with central or peripheral lung cancer for IGRT were enrolled in this study. Kilo?voltage cone?beam CT ( kV?CBCT) scanning was acquired before irradiotion. Tumor coverage on CBCT was assessed using gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV) contours according to tumor alignment, carina registration, and spine registration, respectively. The grading analysiswas based on visual tumor assessment as follows:grade 0, tumor within GTV;grade 1, tumor outside GTV but inside CTV;grade 2, tumor outside CTV but inside PTV;and grade 3, tumor outside PTV. Results Totally 177 sets of kV?CBCT of 25 patients was collected. According to the registration landmarks of the tumor, carina and spine for central lung cancer, the percentages were 57?55%, 53?77% and 16?04% in grade 0, 39?62%, 45?28%and 58?49% in grade 1, and 1?89%, 0?94% and 25?47% in grade 2, respectively. For peripheral lung cancer, the percentages were 47?89%, 14?08% and 2?82% in grade 0, 43?66%, 29?58% and 45?07% in grade 1, and 8?45%, 40?85% and 35?21% in grade 2, respectively. Conclusions For central lung cancer,the tumor was recommended as the best registration landmark, and the carina was recommended as well, while the spine was not recommended. For peripheral lung cancer, the tumor was recommended as the best registration landmark, while the spine and the carina were not recommended.

Objective To compare the effect of set-up errors to two different body positions that are putting arms on the side of the body (A group) or placing arms folded across the elbow on forehead (B group) in esophageal cancer' fraction radiotherapy.Methods By using case-control study,all supine patients were divided into the A group and the B group.After patients were fixed by thermoplastic membrane,they were located by spiral CT and treated by using IGRT.During treatmwnt,there were three cone-beam CT scans in the first week and then at least one scan weekly.We obtained the linear set-up errors data by using bone registration with manual proofreading in 3 directions that were left and right (x),head and feet (y),abdomen and back (z) by using CBCT.Means were compared by using independent sample t-test,and ratios were compared by chi-square test.Results Every group had 11 cases that the A group had 92 people times and the B group had 87 people times.Absolute set-up errors of two different positions:only x-axis,the mean of the A group was (2.46 ± 1.79) mm.But the mean of the B group was (1.91 ± 1.71)mm,which was significantly less than the A group (P =0.036).Relative set-up errors of two groups:only y-axis,the mean of the B group was (1.91 ± 4.12) mm.The A group was (0.09 ± 3.90) mm,which was significantly less than the B group (P =0.003).There was no significant difference of three-dimensional set-up errors (P=0.751).And there was no significant difference in absolute weekly set-up errors or weekly three-dimensional set-up errors in radiotherapy (P ＞ 0.05).Conclusions The each of two body positions in esophageal cancer' fraction radiotherapy has advantage and disadvantage for set-up errors,but they were in control and didn't affect the radiotherapy planning.We can choose appropriate treatment position according to clinical practice.

Objective To study the variation of gross tumor volume (GTV) and clinical target volume (CTV) definition for lung cancer between different doctors.Methods Ten lung cancer patients with PET-CT simulation were selected from January 2008 to December 2009.GTV and CTV of these patients were defined by four professors or associate professors of radiotherapy independently.Results The mean ratios of largest to smallest GTV and CTV were 1.66 and 1.65, respectively.The mean coefficients of variation for GTV and CTV were 0.20 and 0.17, respectively.System errors of CTV definition in three dimension were less than 5 mm, which was the largest in inferior and superior (0.48 cm,0.37 cm,0.32 cm;F=0.40,0.60,0.15,P=0.755,0.618,0.928).Conclusions The variation of GTV and CTV definition for lung cancer between different doctors exist.The mean ratios of largest to smallest GTV and CTV were less than 1.7.The variation was in hilar and mediastinum lymphanode regions.System error of CTV definition was the largest (<5 mm) in cranio-caudal direction.

Objective To analyze the acute and late toxicities in patients with prostate cancer trea-ted with hypofractionated intensity-modulated radiotherapy (IMRT). Methods Between June 2006 and June 2008, 37 patients with prostate cancer were treated with hypofractionated IMRT. The clinical target vol-ume (CTV) was the prostate, seminal vesicles and pelvic lymph nodes in 24 patients, the prostate and semi-hal vesicles in 12, and only the tumor bed in 1. The dose per fraction was 2.3 - 2.8 Gy, with 2.7 Gy in 26 patients. The minimal dose was 62.5-75.0 Gy to the prostate and seminal vesicles, and 50 Gy to the pelvic lymph nodes. Results The median follow-up was 14 months. None of the patients experienced grade 4 a-cute gastro-intestinal (GI) toxicity. Grade 1, 2 and 3 acute GI toxicity occurred in 24.3%, 35.1% and 2.7% of the patients, respectively. The rectal V50>27% and V55>20% were highly significantly associat-ed with grade ≥1 acute GI toxicity. Grade 1,2 and 3 acute genitourinary (GU) toxicity occurred in 68%, 0% and 3% of the patients, respectively. The bladder V50> 10% was significantly associated with grade ≥1 acute GU toxicity. The incidence of late GI toxicity was low. No grade ≥3 late GI toxicity was observed. The incidence of late grade 1 and 2 GI toxicity was 24% and 5%, respectively. The rectal V65> 10% was highly significantly associated with grade ≥1 late GI toxicity. No late grade 4 GU toxicity was observed. The incidence of grade 1, 2 and 3 late GU toxicity was 49%, 11% and 3%, respectively. Grade ≥2 late GU toxicity was correlated with V40, V50 and mean dose of the bladder. Conclusions Acute and late toxicity of hypofractionated IMRT is acceptable in patients with prostate cancer.

OBJECTIVETo study the effect of Badu Shengji San (BDSJS) and its decomposed recipes on morphological changes of injured skin in rats.

METHODSD rats with injured skin were treated with BDSJS and its different decomposed recipes for consecutively 14 days. Morphological changes in the injured skin were observed by H&E staining.

RESULTMercury and lead-containing ingredients significantly decreased epidermal thickness and caused vascular hemorrhage, hyperemia and inflammatory cell infiltration in reticular layer of dermis. The compatible herbs alleviated epidermal thickness and reduced dermal lesions.

CONCLUSIONBDSJS' mercury and lead-containing ingredients can accelerate the healing of skin wound and its compatible herbs can relieve the dermis injury induced by mercury and lead.

Animals ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; toxicity ; Epidermis ; drug effects ; injuries ; pathology ; Hemorrhage ; chemically induced ; Hyperemia ; chemically induced ; Lead ; toxicity ; Male ; Mercury ; toxicity ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Skin ; drug effects ; injuries ; pathology ; Skin Diseases ; drug therapy ; pathology ; Wound Healing ; drug effects

Objective To compare target dosimetric distribution and normal tissue radiation between different static intensity?modulated radiation therapy ( IMRT) plans and volumetric modulated arc therapy ( VMAT) and to identify the best IMRT plan for patients with primary mediastinal B?cell lymphoma ( PMBCL) . Methods A total of 16 patients ( 8 males and 8 females) with early?stage ( Ann?Arbor stageⅠ) PMBCL were enrolled in this study,with doses of 45 Gy for primary gross tumor volume ( PGTV) and 40 Gy for planning target volume (PTV).Four plans were designed for each patient,consisting of static IMRT (5F?IMRT,7F?IMRT,9F?IMRT) and VMAT,and the target dosimetric distribution,normal tissue radiation dose,and efficiency of each plan were evaluated. The difference of dose was analyzed by analysis of variance. Results The mean conformity index ( CI) and homogeneity index ( HI) for PGTV in 5F?,7F?,9F?IMRT and VMAT were 1. 01 and 1. 10, 1. 01 and 1. 10, 1. 01 and 1. 10, and 1. 01 and 1. 11 ( P= 0. 963 and 0. 843) ,respectively,while these two indices for PTV were 1. 04 and 1. 22,1. 03 and 1. 19,1. 03 and 1. 17, and 1. 08 and 1. 14( P=0. 964 and 0. 969) ,respectively. The parameters of volume and dose were similar on normal tissue ( P= 0. 192?1. 000 ) . The treatment time and number of monitor units in 9F?IMRT were significantly higher than those in other static IMRT plans and VMAT ( P=0. 000,0. 000) ,and among these plans,VMAT had the lowest number of monitor units ( 13 345. 0 MU) and the shortest treatment time ( 5. 9 min) . Conclusions The target volume coverage of 7F?and 9F?IMRT is better than that of 5F?IMRT and VMAT.For early?stage PMBCL,VMAT is not superior to IMRT in terms of dosimetry,especially with a larger area of low?dose radiation to the breast,but it is highly efficient in practice.

Objective To prospectively evaluate the efficacy and toxicity of hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer.MethodsFifty-two consecutive patients with localized prostate cancer were enrolled in this study between Feb.2009 and Mar.2011.All patients received hypofractionated IMRT (2.7 Gy/fx,25 fractions,total 67.5 Gy) to the prostate and seminal vesicles.32 high risk patients also received prophylactic irradiation to the pelvic lymph nodes concurrently (2 Gy/fx,25 fractions).Imaging-guided radiotherapy was employed in 35 patients.Androgen deprivation therapy was adopted in 48 of 52 patients.ResultsAfter a median follow-up of 13 months,the mean prostate specific antigen (PSA) was reduced from (40.3 ± 36.6) ng/ml before treatment to (0.5 ± 1.7)ng/ml at the last follow-up.By the time of last follow-up,2 patients (4％) failed.One had PSA failure and the other had both PSA failure and pelvic lymph node relapse.25％ of the patients experienced grade 2 acute gastrointestinal (GI) toxicity and 4％ experienced grade 3 GI toxicity.Acute grade 2 and grade 3genitourinary ( GU ) toxicity occurred in 15％ and 2％,respectively.The incidence of late grade 2 and grade 3 GI toxicity was 17％ and 0％,respectively.Late grade 2 and 3 GU toxicity was 8％ and 2％.The potency was unable to evaluate because most of the patients received androgen deprivation therapy.Conclusions The short-term PSA-free survival after 2.7 Gy/fx,25 fractions' hypofractionated IMRT for localized prostate cancer is favorable,and the acute and late GI and GU toxicity are acceptable.A longer time follow-up is warranted to ascertain the long term efficacy and safety of this regimen.

Curdlan is a water insoluble exopolysaccharide produced by Alcaligenes faecalis under nitrogen-limiting conditions. After excretion, the polysaccharide is attached the cell wall. Thus enhancement of biomass production during the cell growth phase is important to curdlan production. A strategy of increasing nitrogen source to improve biomass production was adopted for curdlan production by Alcaligenes faecalis (ATCC 31749). In the batch fermentation of curdlan, a relatively higher NH4Cl level of 3.6 g/L with continuous glucose feeding increased the cell density leading to improvement of curdlan production. However, excessive NH4Cl would inhibit curdlan production and biomass production was not improved significantly. In addition, feeding of ammonia water at the initial phase replaced NaOH solution to control pH at 7.0. Subsequently, feeding of NaOH solution was resumed to control pH at 5.6 for curdlan production after ammonia was consumed. As a result, biomass production and curdlan yield were both enhanced remarkably. Feeding of ammonia water during the first 24 h led to biomass production of 18.8 g/L. However, higher cell density did not lead to increase in curdlan production. The maximum curdlan production (72 g/L) was obtained by feeding ammonia water for the first 14 h, during which the cell density was about 11.9 g/L.
Alcaligenes faecalis ; cytology ; metabolism ; Ammonium Chloride ; pharmacology ; Cell Culture Techniques ; methods ; Cell Proliferation ; Fermentation ; beta-Glucans ; metabolism