Objective To evaluate the plan quality of volumetric modulated arc therapy (VMAT) in single brain metastasis compared with the stereotactic arc therapy (S_ARC).Methods 31 patients were replanned using VMAT and S_ARC technique.Prescription dose is 40 Gy delivered in 4 fractions covering at least 95％ of the target volume while keeping minimum doses to the volume of normal brain tissue.The plans were assessed and compared using the conformity indexes (CI),gradient indexes (GI),the mean dose of normal brain tissue,the volumes of normal brain tissue receiving 4 Gy doses,the number of monitor unit and treatment times.A paired t test or non-parametric Wilcoxon signed rank test was performed to analyze the difference between these two plans.Results VMAT plans increased dose conformity,but not dose gradient,compared with S_ARC plans.The median dose conformity index values were 0.815,0.818,and 0.779 (P =0.000,0.000),and the median dose gradient score index values were 5.865,5.706,and 3.133(P =0.000,0.000,0.000),in single arc,double arc VMAT plans and S_ARC plans,respectively.The mean dose of normal brain tissue was higher in VMAT plans.And the volume of the normal brain tissue receiving doses of 4 Gy in VMAT plans was significantly larger than the volume in S_ARC plans.The VMAT plans got higher MU number (P =0.000,0.000).And the mean treatment times were (2.7 ± 0.1) min,(2.8 ± 0.1) min,and (7.6 ± 0.2) min in single arc,double arc VMAT plans and S_ ARC plans,respectively (P =0.000,0.000).Conclusions The dosimetry of VMAT plan can meet the requirements of clinical,and is recommended in the treatment of big volume single brain metastasis or single brain metastasis in cerebellum.

A 23-year-old man in remission from acute myeloblastic leukemia after allogeneic peripheral blood stem cell transplantation developed peripheral neuropathy presenting as sciatic and peroneal nerve deficits. Electrophysiological tests localized the lesions to the left sciatic and common peroneal nerve. Magnetic resonance imaging revealed nerve thickening and enhancement, while a positron emission tomography-computed tomography scan demonstrated increased fluorodeoxyglucose uptake tracking along the nerve, suggesting peripheral nerve infiltration. This report demonstrates an unusual presentation of acute leukemia relapse presenting as focal neuropathy

Cadmium (Cd) is ubiquitous in the human environment and has toxic effect on soil microbial biomass or its activity,including microbial biomass carbon (Cmic), dehydrogenase activity (DHA) and basal respiration (BR), etc., Cmic, DHA, BR were used as bioindicators of the toxic effect of Cd in soil. This study was conducted to determine the effects of Cd on soil microbial biomass and its activity in a paddy soil. The inhibition of microbial biomass and its activity by different Cd concentrations was described by the kinetic model (M1) and the sigmoid dose-response model (M2) in order to calculate three ecological doses of Cd:ED50, ED10 and ED5. Results showed that M2 was better fit than M1 for describing the ecological toxicity dose effect of cadmium on soil microbial biomass and its activity in a paddy soil. M2 for ED values (mg/kg soil) of Cmic, DHA, BR best fitted the measured paddy soil bioindicators. M2 showed that all ED values (mg/kg) increased in turn with increased incubation time. ED50, ED10 and ED5 of Cmic with M2 were increased in turn from 403.2, 141.1,100.4 to 1000.7, 230.9, 144.8, respectively, after 10 d to 60 d of incubation. ED50, ED10 and ED5 of DHA with M2 increased in turn from 67.6, 6.2, 1.5 to 101.1, 50.9, 41.0, respectively, after 10 d to 60 d of incubation. ED50, ED10 and ED5 of BR with M2 increased in turn from 149.7, 6.5, 1.8 to 156.5, 50.8, 35.5, respectively,after 10 d to 60 d of incubation. So the ecological dose increased in turn with increased incubation time for M2 showed that toxicity of cadmium to soil microbial biomass and its activity was decreased with increased incubation time.

Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis.
Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth:the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4%articaine and 1∶100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure.
Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively;χ2=34.3, P<0.01). Both the PM and SM groups showed higher success rates than that of the FM group (v=1, χ2=16.73, P<0.01; v=1, χ2=24.5, P<0.01). No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups.
Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

Objective To investigate the correlation between ACE gene polymorphisms and stroke of Han nationality people in Fangshan district of Beijing. Methods The Insertion/Deletion(ID) polymorphisms of ACE gene were detected in 63 patients with cerebral hemorrhage,and 713 patients with cerebral infarction and 235 health control by polymerase chain reaction(PCR). We observed the frequencies of genotype of deletion homozygote(DD),insertion homozygote(II) and insertion/deletion heterozygote (ID) and the alleles of D and I. Also we analyzed the association among I/D polymorphisms of ACE gene with serum glucose(GLU),triglyceride(TG),cholesterol(TC) levels. Results There was no significant difference in the frequencies of both genotypes of DD,ID,II and alleles of D and I in three groups. The serum GLU levels in patients carrying ID,II genotype were higher than those in healthy control(P

OBJECTIVETo discuss the replantation of fingertip amputation in lack of availability of intravenous anastomosis.

METHODSFrom November 2009 to November 2010, 86 patients (104 fingers) with fingertip amputation were treated with replantatioin, including 64 males and 22 females, with an average age of 26 years ranging from 2 to 64 years. The time from injury to therapy was from 30 min to 12 h, time of broken finger ischemia was from 2.5 to 12 h. Preoperative examination showed no obvious abnormalities. Four different replantation methods were selectively applied to these 104 amputated fingertips of 86 cases: (1) replantation with anastomosis of single or bilateral proper digital artery in 37 fingers; (2) replantation with arteriovenous bypass in 27 fingers; (3) replantation with exclusive anastomosis of digital artery in 24 fingers; (4) replantation with removing the palmar pocket method in 16 fingers.

RESULTSOne hundred and two of 104 amputated fingertips were survived. Among these survived fingers,75 cases (92 fingers) were followed-up for 6 to 24 months. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 52 cases, good in 19, poor in 4.

CONCLUSIONIt benefits to expand the indications and improve the survival rate of replantation of fingertip amputation with the correct choice of different replantation methods according to the injury situation of the broken fingertip artery after debridement under the microscope.

Adolescent ; Adult ; Amputation ; Child ; Child, Preschool ; Debridement ; Female ; Fingers ; physiology ; surgery ; Humans ; Male ; Middle Aged ; Recovery of Function ; Replantation ; methods ; Young Adult

Background As the only active component in final treatment phase of Tip-Edge Plus technique,the activation of nickel-titanium orthodontic archwires is one of the factors that affect the torque expression.It is necessary to evaluate the mechanical properties of the nickel-titanium wire used in the final treatment phase in simulated oral environments to forecast the treatment outcomes.Methods The mechanical properties of 171 thermal nickel-titanium wires of 0.35 mm (0.014-in) in diameters with different deflection of 40 mm in length were investigated with three-point bending test.The samples were divided into 2 groups:as-received and bended groups.In the bended group,samples were divided into 7 subgroups according to the amounts of deflection and named by the canine angulations (-25°,-19°,-13°,-7°,-1°,+5°,+11°).The deflection of wires was made by inserting the wires into the deep tunnel of Tip-Edge Plus brackets positioned in plaster casts with different canine angulations to mimic the use of nickel-titanium wires in the final treatment phase.Immersed the bended group in artificial saliva (pH 6.8) and preserved at 37.0°C.Eight durations of incubation were tested:1 to 8 weeks.Three analogous samples of each group and subgroups were tested per week.Stiffness (YS:E) and the load-deflection characteristics of unloading plateau section were obtained.Results Significant changes in specific mechanical properties were observed in long-term immersed and large deflected wires compared with as-received groups.Both immersion time and deflection affected the mechanical properties of wires in the simulated oral environment,and the two factors had synergistic effect.In groups-25°,-19° and -13°,stiffness (YS:E) increased then decreased and average plateau force and ratio of variance decreased then increased correspondingly at specific time.Conclusions In the final treatment phase of Tip-Edge Plus technique,the mechanical properties of nickel-titanium wire are associated with the using time and amounts of deflection and it may affect treatment outcomes.As the main reason for wire deflection,canine crown angulation plays an important role in the wire performance.It may be wise to focus on the canine crown angulations and using time in clinic with Tip-Edge Plus technique and make proper adjustment to help to make sure the treatment outcomes.

The canonical transient receptor potential channels (TRPCs) constitute a series of nonselective cation channels with variable degrees of Ca2+ selectivity. TRPCs consist of seven mammalian members, TRPC1, TRPC2, TRPC3, TRPC4, TRPC5, TRPC6, and TRPC7, which are further divided into four subtypes, TRPC1, TRPC2, TRPC4/5, and TRPC3/6/7. These channels take charge of various essential cell functions such as contraction, relaxation, proliferation, and dysfunction. This review, organized into seven main sections, will provide an overview of current knowledge about the underlying pathogenesis of TRPCs in cardio/cerebrovascular diseases, including hypertension, pulmonary arterial hypertension, cardiac hypertrophy, atherosclerosis, arrhythmia, and cerebrovascular ischemia reperfusion injury. Collectively, TRPCs could become a group of drug targets with important physiological functions for the therapy of human cardio/cerebro-vascular diseases.
Arrhythmias, Cardiac ; Atherosclerosis ; Cardiomegaly ; Cardiovascular Diseases ; Cerebrovascular Disorders ; Humans ; Hypertension ; Hypertension, Pulmonary ; Relaxation ; Reperfusion Injury ; Transient Receptor Potential Channels*

Nanotechnology has shown obvious advantages in the field of medical treatment and diagnosis. Through the encapsulation of nano carriers, drugs not only enhance the therapeutic effect and reduce toxic and side effects, but also become intelligent responsive targeted drug systems through the modification on the surface of nano carriers. However, due to the obstacles in relevant basic research, production conditions, cost, clinical trials, and the lack of pharmacokinetic research on various drug loading systems, few nano systems have been used in therapy. In order to solve the above problems, this paper reviewed and analyzed the research progress of nano carriers in drug delivery, including their auxiliary role and characteristics, types and functions, pharmacokinetics, application prospects and challenges.

Cadmium (Cd) is ubiquitous in the human environment and has toxic effect on soil microbial biomass or its activity, including microbial biomass carbon (C(mic)), dehydrogenase activity (DHA) and basal respiration (BR), etc., C(mic), DHA, BR were used as bioindicators of the toxic effect of Cd in soil. This study was conducted to determine the effects of Cd on soil microbial biomass and its activity in a paddy soil. The inhibition of microbial biomass and its activity by different Cd concentrations was described by the kinetic model (M1) and the sigmoid dose-response model (M2) in order to calculate three ecological doses of Cd: ED(50), ED(10) and ED(5). Results showed that M2 was better fit than M1 for describing the ecological toxicity dose effect of cadmium on soil microbial biomass and its activity in a paddy soil. M2 for ED values (mg/kg soil) of C(mic), DHA, BR best fitted the measured paddy soil bioindicators. M2 showed that all ED values (mg/kg) increased in turn with increased incubation time. ED(50), ED(10) and ED(5) of C(mic) with M2 were increased in turn from 403.2, 141.1, 100.4 to 1000.7, 230.9, 144.8, respectively, after 10 d to 60 d of incubation. ED(50), ED(10) and ED(5) of DHA with M2 increased in turn from 67.6, 6.2, 1.5 to 101.1, 50.9, 41.0, respectively, after 10 d to 60 d of incubation. ED(50), ED(10) and ED(5) of BR with M2 increased in turn from 149.7, 6.5, 1.8 to 156.5, 50.8, 35.5, respectively, after 10 d to 60 d of incubation. So the ecological dose increased in turn with increased incubation time for M2 showed that toxicity of cadmium to soil microbial biomass and its activity was decreased with increased incubation time.
Biomass ; Cadmium ; toxicity ; Soil ; Soil Microbiology ; Soil Pollutants ; toxicity ; Time Factors