At present,reports at home and abroad suggest a low probability of successful preservation of ovarian endocrine function after ovarian shift radiotherapy.After radiotherapy for cervical carcinoma,the ovarian function is associated with various factors,such as radiotherapy dose and method,patient's age,shift position,and concurrent chemotherapy drugs.Therefore,as for each patient,the dose to the ovarian tissue should be controlled within the individual dose limit to effectively preserve the ovarian function.

Objective To evaluate right ventricular function of chronic thromboembolic pulmonary hypertension (CTEPH) patients by echocardiography and cardiac magnetic resonance (CMR),and to evaluate the value of clinical application of those right heart function indexes.Methods 32 patients with CTEPH who underwent CMR and echocardiography were involved in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (FAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.Right ventricular end-diastolic volume (RVEDV) and end-systolic volume (RVESV) were measured by cardiac magnetic resonance and right ventricular ejection fraction (RVEF) was calculated.Results A positive correlation was found between FAC and RVEF (r =0.423,P =0.022),there was a negative correlation between RIMP and RVEF (r =-0.387,P =0.048),there was no correlation between TAPSE and RVEF (r =0.451,P =0.22),a positive correlation was found between S' and RVEF (r =0.689,P =0.000).Conclusions The echocardiographic parameters FAC,RIMP and S' can reflect right ventricular function in patients with CTEPH and can be used as a routine clinical parameters.

Objective To evaluate right ventricular systolic function in patients with pulmonary hypertension (PH) by real-time three-dimensional echocardiography (RT-3DE),and compared with cardiac magnetic resonance.Methods A total of 23 patients with PH who underwent MRI and echocardiography in the study.Right ventricular index of myocardial performance (RIMP),fractional area change (RVFAC),tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler-derived tricuspid lateral annular systolic velocity (S') were measured by echocardiography.RV end-diastolic volume (RVEDV) and endsystolic volume (RVESV) were measured by RT-3DE and cardiac magnetic resonance and RV ejection fraction (RVEF) was calculated.Results A positive correlation was found between RVFAC and RVEF (r =0.595,P =0.003),there was a negative correlation between RIMP and RVEF (r =-0.745,P =0.000),has no correlation between TAPSE and RVEF (r =-0.029,P =0.896),a positive correlation was found between S' and RVEF (r =0.489,P =0.018).There were close correlation between RVEDV,RVESV and RVEF measured by RT-3DE and MRI (P ＜0.001,respectively);Bland-Altman analyses showed good agreement between them.Conclusions RT-3DE can noninvasive,accurate assessment right ventricular systolic function in patients with PH,and provide prognosis and treatment choice for clinical demands.

Objective To study the pro-invasive effect of irradiation on human glioblastoma cell line U87 and its possible mechanism.Methods Cultured U87 cells received different doses of irradiation (0,2,and 4 Gy).The change in cellular invasiveness was measured using the real-time cell analyzer system.The activities of matrix metalloproteinase-2 (MMP2) and matrix metalloproteinase-9 (MMP9) in U87 ceils were measured by gelatin zymography before and after irradiation.The content and distribution of intracellular β-catenin after irradiation were determined by immunohistochemistry.The mRNA levels of Wnt/β-catenin target genes were measured by real-time quantitative PCR.Results After irradiation,the invasiveness of U87 cells increased significantly (P ＜ 0.01),which was dose-dependent within a certain dose range; the activities of MMP2 and MMP9 in U87 cells increased significantly (P =0.031 for MMP2 ; P =0.004 for MMP9) ;the content of β-catenin in U87 cells increased significantly (P ＜ 0.01),with translocation from the cell membrane and adherens junctions to the nucleus; the mRNA levels of Wnt/β-catenin-related genes (FZD7 and TCF1) increased significantly (P ＜ 0.01),and the transcription of Wnt/β-catenin target genes,especially those related to migration and invasion such as MMP2,MMP7,MMP9,and CD44,was significantly enhanced (P ＜ 0.05).Conclusions Irradiation can promote the invasion of glioblastoma U87 cells,possibly by activating the Wnt/β-catenin pathway and enhancing the transcription of migration-and invasion-related genes.

Objective To explore the emergency PCI symptom-onset-to-balloon time (SOTBT) influence on the local cardial function in patients with acute ST-segment elevation myocardial infarction (STEMI) by two-dimensional speckle tracking imaging (2D-STI) technology.Methods Sixty cases were ifrst diagnosed with ST-elevation myocardial infarction (STEMI) and undergone emergency PCI surgery in Huangshi central hospital from June 2014 to June 2016. According to SOTBT, patients were divided into two groups: SOTBT≤6h myocardial infarction group, 6 h

Objective To investigate the changes of pathogens and antimicrobial susceptibility in patients with biliary tract infection during the past 30 years.Methods During the periods of 1981-1984,1988-1998 and 2003-2013,each 100 patients treated with common bile duct exploratoration were selected from every period.Biopsied bile specimens were performed with bacteria culture and antimicrobial susceptibility tests.This study reviewed the changes in bilary pathogens and antimicrobial susceptibility test.Results From 1981 to 1984,the most common pathogens were Escherichia coli (59.2％) and Klebsiella pneumonia (28.9％).Mixed infection of these pathogens accounted for 16.9％.From 1988 to 1998,the types of pathogens significandy increased.Escherichia coli (33.1％) and Klebsiella pneumonia (16.5％) accounted for less than 50％.Mixed infection with Escherichia coli and Pseudomonas aeruginosa was the most common type.From 2003 to 2013,gram-negative bacteria were still the main pathogens,accounting for 61.8％.Escherichia coli and Pseudomonas aeruginosa accounted for 20.1％ and 10.4％,respectively.Gram-positive bacteria increased sigrnificantly.Enterococcusfaecium (22.2％) ranked the first.Mixed infection increased (36％),of which more than 50％ was mixed pathogens of Escherichia coli and Enterococcusfaecium.The incidence of fungi infection also increased (5.6％).Conclusions There was a remarkable change of pathogen category in the biliary infections over the past years.With an increase of gram-positive bacteria and fungi infection in clinical practice,antimicrobial susceptability results could be considered in choosing appropriate drug to avoid bacterial resistance.

Stereotactic body radiation therapy(SBRT) is a new technology developed in recent years.The advantage of the technique resides in its ability to provide a high dose to tumor but spare normal tissues to an extent.The use of SBRT in gynecological cancers mainly concentrated in local treatment of pelvic recurrence,para-aortic lymph node metastasis and oligometastatic disease.SBRT boosts to macroscopic recurrences and oligometastatic disease can provide local control and a possibility of long-term disease-free survival in carefully selected patients.However,patients who received SBRT following prior irradiation,despite its tight conformality,were still confronted with significant morbidity.SBRT can be used as an alternative treatment for locally advanced cervical cancer after external-beam radiation therapy in patients who are unsuitable for brachytherapy.

Abstract: Objective　To prepare a microparticle delivery system that regulates the release rate of extracellular vesicles (EVs), and to exert long-term enhancement of liver cell proliferation after only one intervention. Methods EVs was extracted by differential centrifugation. The structure of the EVs was observed by transmission electron microscopy and the membrane marker protein of EVs was detected by Western blotting. EVs-PLA microspheres with "core-shell" structure were prepared by emulsion-solvent evaporation method. Scanning and transmission electron microscopy were used to detect the morphology of EVs-PLA microspheres and EVs. The release test detected the release behavior of EVs in EVs-PLA microspheres. Scanning electron microscopy was used to detect the morphological changes of EVs-PLA microspheres at 8 weeks of release. EVs-PLA microspheres were co-cultured with hepatocytes, and Phalloidin/DAPI staining was used to observe the cell morphology and evaluate the cytotoxicity of the microspheres. CCK8-test was used to evaluate the cell proliferation activity. Western blot analysis was used to detect extracellular vesicles membrane marker protein expression. Results Comparing the ability of hepatocyte proliferation in the group treated with EVs-PLA microspheres and the control group, it was found that EVs-PLA microspheres did not cause cell apoptosis and mutation in cell structure, had biocompatibility and no cytotoxicity. The EVs-PLA microspheres with "core-shell" structure regulated the release behavior of EVs, which can continuously release EVs, exerting a continuous biological role in promoting hepatocyte proliferation after a single intervention. Conclusions The EVs-PLA microspheres can control-release EVs and promote hepatocyte proliferation continuously after a single intervention, providing a reference for further exploration of EVs-loaded delivery systems in promoting liver regeneration.

Objective:To compare the clinical efficacy and toxicity of intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in radical radiotherapy for cervical cancer.Methods:Clinical data of 1002 patients with cervical cancer treated with radical radiotherapy at Zhejiang Cancer Hospital from September 2013 to December 2016 were retrospectively analyzed. All patients were divided into the IMRT group and 3D-CRT group according to the technology of external beam radiation therapy (EBRT). After 1∶1 propensity score matching (PSM), clinical prognosis of patients receiving IMRT or 3D-CRT was compared. Continuous data were expressed as Mean ± SD or median . Categorical data were described by case number (percentage). Quantitative data were compared by t-test. Qualitative data were compared by chi-square test or Fisher's exact test. Survival rates in two groups were calculated by Kaplan-Meier method and log-rank test. Results:The percentage of patients who received pelvic and para-aortic radiotherapy in the IMRT group was significantly higher than that in the 3D-CRT group (14.9% vs. 1.2%, P<0.001). The percentage of patients whose positive lymph nodes dose reached 55 Gy or more in the IMRT group was significantly higher than that in the 3D-CRT group (26.6% vs. 15.5%, P=0.002). In the IMRT group, the 5-year disease-free survival (DFS) rate (74.6% vs. 68.9%, P=0.084) and overall survival (OS) rate (79.4% vs. 74.9%, P=0.270) were slightly higher than those in the 3D-CRT group, but there were no significant differences between two groups. In the IMRT group, the local recurrence (3.0% vs. 6.9%, P=0.020) and distant lymph node metastasis rates (4.2% vs. 9.0%, P=0.013) were significantly lower compared with those in the 3D-CRT group. In terms of acute radiotherapy toxicities, grade 3-4 leukopenia (46.3% vs. 37.9%, P=0.028) and anemia (18.8% vs. 14.0%, P<0.001) occurred significantly more frequently in the IMRT group than in the 3D-CRT group. Conclusions:Both IMRT and 3D-CRT could achieve good therapeutic outcomes in radical radiotherapy of cervical cancer. IMRT can boost the radiation dose of metastatic lymph nodes and has significant advantages in reducing local recurrence and distant lymph node metastasis.

Objective To investigate the effects of cell suspension including Matrigel, normal culture medium and phosphate buffer saline (PBS) on the xenograft model establishment of human osteosarcoma. The function of Matrigel on regulating human osteosarcoma cell differentiation and proliferation was analyzed. Methods Twenty-four BALB/c-nu/nu nude mice were randomly divided into three groups with 8 animals in every group: Matrigel and RPMI 1640 suspension (group M), RPMI 1640 culture medium (group R), PBS (group P). Human osteosarcoma cell-SaOS-2 was suspended in the three groups respectively. 1×106/ml equivalent cell counts were injected into the back of each anesthetized nude mouse (400 μl per mouse). Xenograft tumors were measured at regular intervals and the tumor volume was calculated. After 5 weeks of inoculation, the tumor parts were dissected. Paraffin-embedded sections from xenograft tumor tissues were fixed in 4 % paraformaldehyde and pathological study was made after paraffin embedding and cutting under microscope by HE stains. Results Eight nude mice formed tumor lumps at 0 day in group M and were gradually increased over time. Xenograft tumors of group R and group P disappeared in 2-4 days and some appeared again after 1 week with an increase of tumor size. After 5 weeks, the tumor volume in the group M was significantly larger than that in the group P and group R [(3 185 ± 488), (598 ± 189), (512 ± 109) mm3 respectively,F=85.7,P<0.001].After 5 weeks,tumor body was dissected.The tumor weight in the group M was significantly larger than that in the group P and group R[tumor weight:(2.22 ± 0.18),(1.48 ± 0.13),(1.47 ± 0.17) g respectively, F= 37.07, P< 0.001]. There was no difference between group R and group P in tumor volume and weight(P>0.05).Histopathological analysis showed that cells in the group M could keep original degrees of pathological differentiation in osteosarcoma cells. Besides, cells suspension of culture medium or PBS in the group P and group R were poorly differentiated. Conclusions Matrigel can promote high tumor growth rate and good uniformity of human osteosarcoma cells in experimental animals. The histological state is similar to original structure,which conforms to the occurrence and development of human osteosarcoma.