BACKGROUND:A large number of clinical trials have found that the number of bone marrow stem cels at the femoral neck and proximal femur in patients with osteonecrosis of the femoral head is significantly reduced, accompanied by decreased activity, which causes a significant decrease in osteogenic capacity that the necrotic bone cannot be effectively repaired after absorption, leading to the colapse of the femoral head. OBJECTIVE:To probe into the early clinical efficacy of autologous peripheral blood mononuclear cel transplantation with porous core decompression for treatment of avascular necrosis of the femoral head. METHODS:Forty-five patients with avascular necrosis of the femoral head (49 hips) were enroled in this study, and underwent autologous peripheral blood mononuclear cel transplantation with porous core decompression. After treatment, pain scores, Harris hip score, scores on the satisfaction of patients were evaluated, as wel as X-ray, CT and MRI examinations. RESULTS AND CONCLUSION:Al the patients received a folow-up visit of 11-14 months, averagely (12.5±0.6) months. During the folow-up, there were no complications and serious adverse reactions. Postoperative pain scores and Harris scores were both improved significantly compared with preoperative ones (P < 0.05). At 12 months after treatment, the excelent satisfaction rate was up to 92%. Patient’s MRI low signal region accounting for a percentage of the volume of the femoral head was decreased from (40.1±7.34)% preoperatively to (20.23±5.4)% at 6 months postoperatively, and there was a significant difference (P < 0.05). These findings indicate that autologous peripheral blood mononuclear cel transplantation with porous core decompression for treatment of avascular necrosis of the femoral head has significantly clinical effects at early stage, which can obviously reduce joint pain, improve and restore hip joint function, and delay progression of disease.

OBJECTIVETo discuss the influence of setup errors on the accuracy of pelvic cancer in IGRT, analysis setup errors and determine the CTV-to-PTV margins.

METHODS60 pelvic cancer patients treated with Varian 23IX, all of them were performed by CBCT before and after-correction three times in the first week and after that once a week. Then, to measure the setup errors at X(left-right), Y(superior-inferior), Z(anterior-posterior) axis and E(coronal), F(sagittal), G(axial) rotation directions.

RESULTS530 scans obtained in all, the setup errors in X, Y, Z, E, F, G were (-0.52 ± 4.18) mm, (0.73 ± 4.86) mm, (-0.36 ± 3.62) mm, (0.14 ± 1.20)degrees, (0.13 ± 1.34)degrees, (0.21 ± 1.73)degrees respectively and were much lower after correction at X, Y, Z axis, besides, CTV-to-PTV margins decrease a lot.

CONCLUSIONThe accuracy of radiotherapy can be highly increased with the use of IGRT in pelvic cancer.

Humans ; Pelvic Neoplasms ; radiotherapy ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Image-Guided

Objective To study clinical characteristics in patients of systemic lupus erythematosus (SLE)with cardiac involvement and to assess relevant risk factors contributed to it.Methods Totally,239 patients of SLE were evaluated by cardiogram,echocardiogram and serologic examinations,and those with cardiac involvement were compared to those without it by clinical and laboratory data.Results There were 114 of 239(47.7%)SEE patients with cardiac abnormalities,of whom only 31(27.2%)had cardiac symptoms,including 44 cases(38.6%)with hydropericardium,32(28.1%)with myocardial damage,14 (12.3%)with cardiac valvular lesions,19(16.7%)with cardiac block,and 13 with other cardiac damages.No significant difference in age,gender,course of disease,SLE activity index(SEEDAI)scores,serum levels of auto-antibodies and complement(C3),and so on,were found between 114 SLE patients with cardiac abnormalities and 64 without it,who were:randomly selected from 125 patients of SEE without cardiac damage.But,patients of SLE complicated with pericarditis or myocardial lesions had higher SLEDAI scores and lower serum level of C3 than those without cardiac lesions(both P＜0.05),and relatively longer course of disease was found in those with valvular heart disease.Conclusions Cardiac damage was common in patients with SLE,but most of whom were asymptomatic,and only those with severe and active illness tended to develop pericarditis and myocardial damage and those with longer course were liable to have valvular heart disease.

Objective To determine the level of monocyte chemoattractant protein-1 (MCP-1) in patients with systemic lupus erythematosus (SLE) and to assess its relationship with disease activity and organ damage. Methods The plasma levels of MCP-I were measured by enzyme linked immunosorbent assay (ELISA) in 95 patients with SLE and 21 healthy controls. Disease activity in SLE patients was assessed using the SLE Disease Activity Index (SLEDAI). Results Plasma level of MCP-1 was significantly elevated in SLE patients than in healthy controls [(849±289) pg/ml vs (426±266) pg/ml, P<0.01]. Moreover, level of MCP-1 was significantly higher in SLE patients with lupus nephritis (LN) than in patients without LN (P<0.01), andin SLE patients with neuropsychiatric symptoms than in patients without neuropsychiatric involvement (P< 0.01). In addition, significant correlation between plasma MCP-I levels and the SLEDAI was observed (r= 0.3699, P<0.01), and this relationship was not influenced by the treatment with glucocorticoid and cyclophosphamide. Conclusion MCP-I may play an important role in the pathogenesis of SLE, including renal and neuropsychiatric involvement. MCP-I is also a serologic marker of disease activity in patients with SLE, and its measurement in SLE patients may be useful for the evaluation of disease activity.

Objective To study the imaging distribution feature and diagnostic value of high resolution computed tomography(HRCT)in peripheral lung cancer(PLC).Methods The feature of imaging distribution was analysed in 37 patients with PLC by pathological proved,which compared with those in 23 cases with lung benign nodules by selected randomly.A double blind method was taken on the manifestations of HRCT about lung nodules tumor-lung interface in near heart side and far heart side.①cloudy or/and shaggy②spiculate③smooth.To search and define the correlation between its distributing feature;manifestations of 3 kinds HRCT;alteration of segment level bronchus and lung benign malignancy nodules.Results Cloudy,or shaggy,spiculalte departing from heart side in lung-tumor interface by HRCT were observed in peripheral lung cancer(79%) and benign nodules(22%);smooth was observed in peripheral lung cancer(14%) and benign nodules(74%).Some cases possed simultaneously two or more than two kinds HRCT's signs.Incidence rate of emphraxis and stenosis signs of segment level bronchus in PLC was higher than that in benign nodules.Conclusion Asymmetry apo-tip dominant position distribution of cloudy or shaggy,and spiculate change of tumor-lung interface by HRCT played an important role in qualitative diagnosis of peripheral lung cancer(≤3.5 cm).The appearance reason relates with the bronchial ventilation that the lesion results in occlusion.

Objective To determine plasma soluble HLA-G (sHLA-G) levels in patients with systemic lupus erythematosus (SLE),and to analyze its association with the possibility of organs or systems involvement in lupus patients.Methods Plasma samples were collected from 96 SLE patients and 74 healthy controls,and sHLA-G levels were determined by enzyme-linked immunosorbent assay.The sHLA-G levels in SLE patients and healthy controls were compared with students't-test.The difiefence of clinical and seroimmunological data among the SLE patients was assessed by chi-square test or students't-test.A value of P<0.05 was considered to be significant.Results Plasma concentration of sHLA-G was significanto higher in SLE patients than that in healthy controls[(230±192)U/ml vs(118±38)U/ml,P=0.0001].No relationship between plasma sHLA-G levels and SLE disease activity index(SLEDAI)was found(r=0.157,P=0.141).However,the patients with increased levels of sHLA-G had more severe disease activity (11±5 vs 8±5,P=0.027) and more central nervous system (CNS) involvement (24.2% vs 4.8%,P=0.007) in comparison with patients with normal plasma levels of sHLA-G.Conclusion The increased production sHLA-G,paralleled with more severe disease activity and higher CNS involvement,indicates that sHLA-G may play an important role in the pathogenesis of SLE.

Objective To characterize the effects of TPP1 knockdown on Pot1a and Pot1b localization at telomeres and on the telomere end protection.Methods Knockdown of endogenous TPP1 in mouse embryonic fibroblasts(MEFs) with the retrovirus vector encoding shRNA targeting TPP1,IF/PNA-FISH was performed to determine the localization of Pot1a and Pot1b at telomeres,and TdT-FITC was applied to characterize the effects on the function of telomere end protection,cellular senescence was analyzed by SA-beta gal staining,and phosphorylated p53ser18 and p21 were examined by Western blotting.Results Pot1a and Pot1b were unable to localize at telomeres in about 65% of MEFs with TPP1 knockdown,while that was found in less than 5% of MEFs without TPP1 knockdown(t=10.96,P

0.05).However,the patients with increased levels of sHLA-G had higher incidence of central nervous system involvement(P=0.007) and more severe disease activity(P=0.027) in comparison with patients with normal plasma sHLA-G levels.Finally,the expression of plasma sHLA-G was not influenced by the treatment with glucocorticoids,immunosuppressive agents or antimalarials.Conclusion The increased production of sHLA-G indicates that sHLA-G may play an important role in the pathogenesis of SLE.The expression of sHLA-G may be associated with disease activity and severity of lupus patients,but be independence of HLA-G 14bp ins/del polymorphism and drug treatment.

OBJECTIVETo observe the ultrastructures of rat alveolar type II cells and change of composition of phospholipid(PL) and content of protein in pulmonary surfactant(PS), to investigate the relation between change in composition of PL and activity of alveolar type II cells.

METHODSThe rats lung injury models were made by intratracheally instilling bleomycin(BLM) (4 mg/ml, 5 mg/kg). 28 rats were divided into four groups: 3-day group, 7-day group, 14-day group and 28-day group. Preparations of each group were stained histochemically and examined by electron microscope, content of PL in BALF, composition of PL and content of protein of each group were determined respectively.

RESULTS(1) Rats lungs in experimental groups were found that PS lost continuously, appeared homogenous and chorionic, dropped in the pulmonary alveolies. 3-day group was more apparent. Ruthenium red attaching on pulmonary surfactant was thicker in 3-day group, and the colour deeper, no difference in 7-day group and 14-day group, thinner in 28-day group. Content of PL in PS of BALF was increasing. Content of phosphatidylglycerol(PG) increased in 3-day group, decreased in 7-day, 14-day and 28-day group. The change of content of phosphatidylinositol(PI) was reversed. (2) Alveolar type II cells degenerated, necrotized, even disintegrated in 3-day group and 7-day group. 3-day group was more apparent. Proliferations of alveolar type II cells were found in each group, 7-day group was more apparent. We found that type II cells transformed to type I cells in 14-day group, extended and attached on bare basement membrane. Content of protein in PS was the highest in 3-day group, almost equal to the content of the control group in 28-day group.

CONCLUSIONMorphologic change and alternation of quality and quantity of PS after bleomycin-induced pulmonary injures specifically reflect the activity of alveolar type II cells. Measuring content of PL in BALF is one of simple and feasible method judging activity of alveolar type II cells when lungs of the rats are injured early by bleomycin.

Animals ; Antibiotics, Antineoplastic ; toxicity ; Bleomycin ; toxicity ; Bronchoalveolar Lavage Fluid ; chemistry ; Lung ; drug effects ; pathology ; ultrastructure ; Pulmonary Alveoli ; chemistry ; Pulmonary Surfactants ; analysis ; Rats

Objective To investigate the demographic characteristics, clinical features, diagnosis and treatment of patients with gout in China.Methods Clinical data of 6 814 patients with gout from 100 hospitals in 27 provinces, municipalities or autonomous regions in China were collected and analyzed. Results (1)The ratio of male to female in patients with gout was 14.7:1.The mean age of onset was(48.8 ± 15.1)years old.Mean serum urate level was(526.7 ± 132.3)μmol/L.Patients'education background was of U-shaped distribution; (2) Hypertension was the most common comorbidity [15.8%(1 079/6 814)], then overweight or obesity[51.9%(3 536/6 814)];(3)Alcohol and high-purine food intake were dominant triggering factors in men. The diagnosis of gout was made after onset in majority of patients with cardinal symptom arthralgia.Most patients had the disease less than 5 years,and the longer the course,the more flares in the previous year of entry;(4)Febuxostat was the mostly used urate-lowering medication.20.7%(1 412/6 814), 10.8%(739/6 814) and 3.9%(265/6 814) of patients were followed up in 4 weeks, 12 weeks and 24 weeks after registration,and 18.9%(267/1 412),29.1%(215/739)and 38.1%(101/265)of them reached the control target of serum urate levels,respectively.After treatment,patients'liver function was not affected,but serum creatinine levels decreased significantly. Conclusions The proportion of gout patients who reach target serum urate level is very low.Further steps including education and survey need to be carried on.