Objective To explore the methods and effects of body fractionated stereotactic radiotherapy(X-knife) in the treatment of lung metastases.Methods There were 50 cases with lung metastases were treated by fractionated stereotactic radiotherapy using CT orientation and WiMRT model body X-knife.The diameter of the metastases was 1.0cm-5.0cm.The linear accelerator was 6Mv X-ray.The dose per fraction was 5-12Gy,and the total prescribed dose was 30-52Gy at the margin of the PTV enveloped by 90% insodose curve.Results The metastases complete regression was found 21 fo-cus(18.3%)in CT image,partial regression in 70 focus(60.9%),and the overall effective rate was 79.1%.The effective rate for the focus with diameter less than 3cm was 88.5%,and 59.4% equal or more than 3cm,there was significan differ-ence(P

The quality assurance method for the medical linear accelerator of large-scale radiotherapy equipment is introduced,whose periodic detection and adjustment are discussed.

Objective:Analysis of the clinical characteristics and genetic mutations of ten tuberous sclerosis complex(TSC) families to provide support for clinical diagnosis of TSC.Methods:Retrospective analysis of ten TSC family probands and their members were performed with detailed medical history collection and physical examination. The study consisted of 26 patients in 10 TSC families, including 12 males and 14 females, with male to female ratio of 1∶1.17, and aged 7-65 years. In terms of skin lesions, there were 24 cases of facial angiofibromas, 20 cases of hypomelanotic macules, 16 cases of ungual fibromas, and 9 cases of shagreen patch. There were 12 cases of renal angiomyolipoma, 4 cases of subependymal nodules based on craniocerebral CT, and 1 case of lymphangioleiomyomatosis. Four cases had a history of seizures. Peripheral blood was extracted for next generation DNA sequencing.Results:A total of 23 TSC patients were genetically tested, and a total of 14 patients in 6 families were TSC2 mutations(5 frameshift mutations, 5 heterozygous deletions, and 4 nonsense mutations), a total of 4 patients in 2 families were TSC1 nonsense mutations, and no mutations were seen in the 2 families.Conclusions:A total of 10 TSC families were summarized, and the patients mainly had skin manifestations and kidney lesions.There were 18/23 patients having TSC1/2 mutations, of which TSC2 mutations accounting for 14/18. In the two non-mutant families, patients mainly had facial angiofibroma and/or hypomelanotic macules.

Objective To discuss the three-dimensional conformal radiotherapy(3D-CRT) plan for pancreatic tumors.Methods The 3D-CRT plan of 30 cases of primary pancreatic cancer were designed according to the request of the doctors for PTV and the restricted receiving dose of the peripheral normal sensitive organs.The best plan was chosen referring the dose-volume histogram.Results By using ICRU dose reference point(the central point of target)as theunitary dose,95% dose line could be surrounded above 95% of the PTV.Conclusion The focus in different localization can be treated with different design in treating the pancreatic tumors.The reaction to radiotherapy is directly influenced by the volume and dosage of radiation to the normal hepatic tissues.

Objective: Tuberous sclerosis complex (TSC) is a multisystem genetic disorder caused by mutations in the TSC1 and TSC2 genes, but the molecular events contributing to TSC are not well understood.However, little is known about the role of microRNAs in TSC.To explore the microRNA differential expression profile between tuberous sclerosis complex cell line TSC2-/-MEFs and normal type cell line TSC2+/+ MEFs, and to provide new clues to study the mechanism of microRNA function in tuberous sclerosis complex.Methods: TSC2-/-MEFs and TSC2+/+ MEFs cell lines were cultured in vitro, each with three samples chosen as the experimental group and the control group respectively.Total RNA was isolated using TRizol and purified with RNeasy mini kit according to manufacturer''s instructions.RNA quality and quantity were measured by using nanodrop spectrophotometer and RNA integrity was determined by gel electrophoresis.Total RNAs were extracted by TRizol, followed by RNA quantification and quality control.MicroRNA profiles were analyzed by microarray and the threshold value used to screen up-regulated more than 2-fold change or down-regulated less than 0.5-fold change compared with controls.Real-time PCR was used to validate the reliability of microarray.Cell counting kit-8 (CCK-8) assay was performed to evaluate the proliferation.Results: Fourteen microRNAs, including miR-18a-5p, miR-376c-3p, miR-136-5p, miR-467c-5p, miR-467b-5p, miR-5104, miR-3098-3p, miR-30a-3p, miR-302b-3p, miR-18a-3p, miR-19b-1-5p, miR-19a-5p, miR-20a-5p, miR-155-5p, were up-regulated, while twenty-six microRNAs, including miR-200b-3p, miR-450a-1-3p, miR-542-5p, miR-199b-5p, miR-10a-5p, miR-466c-5p, miR-450a-5p, miR-450b-5p, miR-542-3p, miR-351-5p, miR-322-3p, miR-199a-3p, miR-335-5p, miR-10b-5p, miR-351-3p, miR-155-3p, miR-497a-5p, miR-503-5p, miR-148a-3p, miR-1843a-5p, miR-199a-5p, miR-490-5p, miR-450a-2-3p, miR-322-5p, miR-214-3p, miR-450b-3p, were down-regulated in tuberous sclerosis complex cell line TSC2-/-MEFs compared with normal type cell line TSC2+/+ MEFs (P<0.05).Real-time PCR confirmed the expressions of miR-136-5p, miR-30a-3p, miR-302b-3p, miR-10b-5p, miR-148a-3p, miR-199a-5p consistent with the microarray data (P<0.05).Furthermore, the overexpression of miR-199a-5p significantly inhibited cell proli-feration (P<0.05).Conclusion: There are differences in the expression of miRNA between the tube-rous sclerosis complex cell line TSC2-/-MEFs and normal cell line TSC2+/+ MEFs.MiRNA-199a-5p plays an important role in tuberous sclerosis complex, which may be developed as an important molecular target for the treatment of tuberous sclerosis complex.

BACKGROUND:At present, a large number of studies have proved that the expandable intramedul ary nail and interlocking intramedul ary nail are effective in treatment of limb fractures. However, for the treatment of tibial fractures, the advantages and disadvantages of the two kinds of fixation methods are stil inconclusive. OBJECTIVE:To systematical y review the effectiveness and safety of expandable intramedul ary nail and interlocking intramedul ary nail for treatment of tibia fracture. METHODS:We searched PubMed, Embase, The Cochrane Library (Issue 1, 2015), CBM, CNKI, VIP and WanFang Data for articles concerning randomized control ed trials on expandable intramedul ary nail versus interlocking intramedul ary nail published from inception to January 1, 2015. The key words were“tibia, fracture, tibia fracture, tibia fractures, expandable intramedul ary nail, expandable nail, intramedul ary nail, interlocking intramedul ary nail”. Meta-analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:Ten randomized control ed trials involving 574 patients were included. The results of meta-analysis showed that, compared with interlocking intramedul ary nail, expandable intramedul ary nail was shorter in operation time [MD=-23.42, 95%CI (-26.94,-19.90), P<0.000 01], less in intraoperative hemorrhage [MD=-47.64, 95%CI (-52.21,-43.09), P<0.000 01], less in fluoroscopy times [MD=-1.40, 95%CI (-1.49,-1.30), P<0.000 01], shorter in union time [MD=-30.84, 95%CI (-35.27,-26.41), P<0.000 01], and less in incidence of complications [OR=0.20, 95%CI (0.10, 0.40), P<0.000 01]. The Johner-Wruh scores showed on significant difference. These findings suggest that expandable intramedul ary nail for tibia fracture has more advantages than interlocking intramedul ary nail. That is to say, the expandable intramedul ary nail is an improved nail of interlocking intramedul ary nail, but a large sample of high quality randomized control ed trials are stil needed to confirm the conclusion.

BACKGROUND:At present, a large number of studies have proved that the discectomy and interbody fusion are effective in treatment of lumbar disc herniation. But for the treatment of lumbar disc herniation with Modic change, the advantages and disadvantages of above two kinds of surgical methods are stil inconclusive. OBJECTIVE: To systematicaly review the effectiveness of discectomy versus interbody fusion in treatment of lumbar disc herniation with Modic change. METHODS: We searched PubMed, Embase, The Cochrane Library (Issue 2, 2015), CBM, CNKI, VIP and WanFang database for randomized controled trials on discectomyversus interbody fusion for lumbar disc herniation with Modic change from inception to May 1st, 2015. Clinical outcomes were back pain Visual Analog Scale, leg pain Visual Analog Scale, Oswestry Disability Index, lumbar Japanese Orthopaedic Association score, the number of cases affecting complications, and MacNab criteria. Meta-analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION:Nine randomized controled trials were included, involving 945 patients. The results of meta-analysis showed that compared with discectomy group, back pain Visual Analog Scale was lower [MD=0.81, 95%CI (0.69, 0.92),P < 0.000 01]; Oswestry Disability Index was lower [MD=2.07, 95%CI (1.62, 2.52),P< 0.000 01]; lumbar Japanese Orthopaedic Association score was higher [MD=-2.32, 95%CI(-4.32,-0.32),P=0.02] in the interbody fusion group. No significant difference in leg pain Visual Analog Scale and MacNab criteria outcomes was detected between both groups. These findings verified that interbody fusion was safer and more effective for lumbar disc herniation with Modic change, compared with discectomy.

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Objective To analyze the characteristics of published radiology original articles in China,and compare radiology research inboard and abroad.Methods According to the Contents of Chinese Science Core Periodicals in 2012,there were 15 comprehensive radiological core periodicals in China.All of them were retrospectively surveyed,and original articles published between October 2011 and October 2012were evaluated.The following information was abstracted from each article:radiologic technique used,radiologic subspeciahy,type of research,sample size and study design.At the same time,all the original articles from two top radiology journals,Radiology and European Radiology (ER) at the same period were evaluated.Chi-square test was used to compare the composition percentage inboard and abroad.Results There were 2784 original articles published in the 15 Chinese top radiological periodicals in total The most commonly used radiologic techniques were CT (1093 of 2784,39.3％),MRI (824 of 2784,29.6％) and intervention (402 of 2784,14.4％).Radiology and ER totally published 560 original articles.MRI (265 of 560,47.3％),CT (170 of 560,30.4％) and mixed techniques (63 of 560,11.3％) were most used.In China,as much as 2572 (92.4％) articles were clinical research,115 (4.1％) was basic research,9 (0.3％) was clinical and basic research,and 83 (3.2％) was non-basic non-clinical research.The sample size of less than 10,between 10 to 50,and more than 50 was 374 (13.4％),1448 (52.0％) and 847 (30.4％) respectively.339 (12.2％) Chinese articles belonged to perspective research,and 1211 (43.5％) were retrospective.For Radiology and ER,515 (92.0％) articles were clinical research,39 (7.0％) was basic research,3(0.5％) was clinical and basic research,and 3(0.5％) was non-basic non-clinical.The sample size of less than I0,between 10 to 50,and more than 50 was 30 (5.4％),225 (40.2％) and 252 (45.0％) respectively.230 (41.1％) articles belonged to perspective research,and 202 (36.1％) ones were retrospective.Radiology and ER articles used MRI more than that published in Chinese radiology journals (x2 =666.690,P ＜ 0.01).Clinical research was the most commonly used research type both inboard and abroad (x2 =0.116,P ＞0.05).Articles of sample size more than 50 abroad were more than that of China (x2 =44.895,P ＜0.01).Perspective research was used more abroad (x2 =275.667,P ＜ 0.01),and the main research type in China was retrospective.Conclusion Chinese radiology workers might need to do more perspective and larger sample size clinical researches.

BACKGROUND:Many studies concern the comparison of micro-titanium plate fixation and suture suspension fixation during cervical posterior expansive open-door laminoplasty, but the sample size of many studies has limitations. There is lack of objective evaluation on advantages and disadvantages of micro-titanium plate.
OBJECTIVE:To systemicaly evaluate the efficacy and safety of micro-titanium plate fixationversus suture suspension fixation in cervical posterior expansive open-door laminoplasty.
METHODS: English and Chinese randomized controled trials were searched by two reviewers. They retrieved the Cochrane Central Register of Controled Trials (CENTRAL), PubMed, EMbase, the ISI Web of Knowledge Database, CNKI, CMB, VIP and Wanfang database for randomized controled trials addressing micro-titanium plate fixationversus suture suspension fixation in cervical posterior expansive open-door laminoplasty published from database foundation to March 1, 2015. The references were also searched by hand. Meta-analyses were performed by using the Rev-Man 5.3 software, provided by the Cochrane Colaboration.
RESULTS AND CONCLUSION: A total of 9 studies involving 642 patients were included. The results of meta-analyses showed that: (1) safety: There were no significant differences between the two groups in operation time [SMD=-0.02, 95%CI (-0.57, 0.54),P=0.95 > 0.05], and intraoperative blood loss [SMD=0.07, 95%CI (-0.26, 0.40),P=0.69 > 0.05]. (2) Efficacy: compared with suture suspension fixation, Japanese Orthopaedic Association Scores were higher [SMD=0.26, 95%CI (0.10, 0.42),P=0.001 < 0.05], the angle of the opened laminae was bigger [SMD=0.25, 95%CI (0.02, 0.48),P=0.04 < 0.05], cervical curvature was better [SMD=0.46, 95%CI (0.27, 0.65),P < 0.000 01], and incidence of axial symptoms was lower [RR=0.40, 95%CI(0.29, 0.56),P< 0.000 01] after micro-titanium plate fixation. These findings suggest that during expansive open-door laminoplasty for treatment of cervical spondylosis, micro-titanium plate fixation and suture suspension fixation can obtain good clinical outcomes. However, Japanese Orthopaedic Association Scores were higher and the angle of the opened laminae was better in micro-titanium plate fixation than in suture suspension fixation. Micro-titanium plate fixation could effectively prevent loss of cervical curvature and reduce the incidence of axial symptoms. For the poor quality of the original studies and smal sample size, a prudent choice is suggested. More high-quality large-sample studies are needed for further verification.