Objective To establish a new automatic lung segmentation method in order to deal with the omission of pleural nodules and pulmonary vessels. Methods Lung parenchyma were extracted from chest CT images with the inversed operation of 2D region growing and connected area classification, then the contours and locating the contour points were traced with scan line searching. Finally, the parameters of lung contour points were analyzed to locate the contours distorted by nodules, and curve spline was used to correct distorted contours. Results The experimental results of many sets of CT images verified that the technique proposed was effective. The comparison with other contour correction algorithm verified that line searching contour correction was superior. Conclusion The proposed algorithm includes tumors in the segment results, and confirms the integrality, veracity, real-time quality of this auto-segmentation method.

Objective To compare the treatment effects and toxicity of late co urse accelerated hyperfractionation radiotherapy (LCAFR), LCAFR plus concurren t chemotherapy (LCAFR+C) and conventional fractionation radiotherapy(CFR) on esop hageal cancer. Methods 150 patients with squamous carcinoma of thoracic esophag us were divided randomly into three groups: 1.CFR group, patients were irradiate d 2.0?Gy/f, 5 times a week, to a total does of 60?Gy. 2. LCAFR group, patients wer e first irradiated with CFR to 30?Gy, then followed by 1.5?Gy/f bid, at more t han 6 hours' interval, to the total dose of 60?Gy. 3.LCAFR+C group: The radiotherap y technique was the same as the LCAFR group, but weekly 20 mg DDP and 500 mg 5-Fu wer e added simultaneously for 5 weeks. Results All three groups completed their tre atment course. Of CFR, LCAFR and LCAFR+C groups, the 1-,2-,3- and 4-year sur viva l rates were 54%, 30%, 18%, 18%; 76%, 56%, 44%, 42% and 82%, 62%, 50%, 44%. The 1-,2-,3- and 4-year local control rates were 40%, 32%, 26%, 24%; 72%, 60%, 5 6%, 54% and 78%, 66%, 60%, 56%, with obvious better results in the latter two groups (P0.05). The acute toxic effect was severer in the LCAFR+C g roup than in the other two, with the difference significant between the LCAFR+C and CFR group, bu t not between the LCAFR and CFR group. The tolerance of the patients to LCAFR wa s better than that of LCAFR+C group. There were no significant differences in la te complications and causes of death between the three groups. The main cause of death was local recurrence and uncontrolled primary disease, which were signifi cantly lower in the LCAFR and LCAFR+C groups than in the CFR group. Conclusions Both late course accelerated hyperfractionation radiotherapy and late course acc elera ted hyperfractionation radiotherapy plus chemotherapy can significantly improve the local control and survival of esophageal cancer, but the latter has increase d toxicity. Concurrent small dose chemotherapy can not lowered the remote metas tatic rate.

Objective To evaluate the risk of hyperuricemia in patients younger than 45 with coronary artery disease.Methods Six hundred and seventy-seven patients with coronary artery disease under 45 years old at disease onset were recruited retrospectively.The subjects were divided into hyperuricemia group (n=164) and normal uric acid group (n=513).Patients with coronary artery disease with hyperuricemia were analyzed for clinical characteristics.The risk of hyperuricemia was analyzed on the severity of coronary lesions.T-test,x2 test and Logistic regression analysis were used for statistical analysis.Results Comparing with patients with normal uric acid,patients in the hyperuricemia group were male predominant and more prevalent with hypertension [197(38.5％) and 93(56.7％) ; x2=16.85,P＜0.01],hypedipidemia [274(53.4％) and 130 (80.7％); x2=37.58,P＜0.01],and cardiac dysfunction [24 (4.7％) and 17 (10.4％); x2=7.18,P=0.01].Hyperuricemia increased the risk of coronary artery disease complicated with cardiac dysfunction [ORlcorrection=2.66,95％CI (1.28,5.53)],and it also increased the risk of coronary artery disease concurrent with cardiac arrhythmia [OR2correction=1.28,95％CI (1.00,1.65)] revealed by multivariate regression analysis.Conclusion In young patients under 45 years old with coronary artery disease,hyperuricemia is the independent risk factor for coronary artery disease complicated with cardiac dysfunction and arrhythmia.

BACKGROUND:With the wide application of bone repair scaffold in the field of medicine, nano-hydroxyapatite (nHA) and silk fibroin (SF) both of which have good biological properties have become research hotspots in recent years.OBJECTIVE:To study the feasibility of nHA/SF composite materials loaded with recombinant human bone morphogenetic protein 2 (rhBMP-2) to restore the initial stability of the spinal segment in rabbits.METHODS: Thirty-six male health New Zealand rabbits were randomly divided into three groups, followed by preparation of spinal instability models. Autogenous iliac bone, nHA/SF composite, and rhBMP-2/nHA/SF composite were implanted into the L4/5 spinal segment in autologous bone group, nHA/SF group and rhBMP-2/nHA/SF group, respectively. X-ray exmaination was performed at 12 weeks postoperatively, and then the animals were killed for gross observation. The stability of the fusion segments was tested through a tensile machine. Histologically, bone graft fusion at the surgical site was observed.RESULTS AND CONCLUSION:(1) Findings from the gross specimen observation showed that the specimens at the fusion site presented with a hard texture. Obvious signs of fusion were visible in the autologous bone group, followed by the rhBMP-2/nHA/SF group, while no signs of fusion were detected in the nHA/SF group. (2) At 12 weeks postoperatively, a large number of trabecular bones grew into the boundary between the vertebral body and the iliac crest graft block in the autologous bone group. A little trabecular bone was found in the boundary in the nHA/SF group, while a lot of trabecular bone tissues were found in the boundary in the rhBMP-2/nHA/SF group. In accordance with the standard of fusion, there were 10, 3, and 9 rats in the autologous bone, nHA/SF and rhBMP-2/nHA/SF groups, respectively. (3) The range of motion of the spine in the rhBMP-2/nHA/SF showed no statistical difference from that in the autologous bone group, but was significantly higher than that in the nHA/SF group (P < 0.05). (4) Osseous connection was found around the bone graft in the autologous bone and nHA/SF groups, but no mature bone tissue was visible in the latter group. In the rhBMP-2/nHA/SF group, a large number of new capillaries was found and permeated into the spinal tissues. In summary, nHA/SF composite materials loaded with rhBMP-2 possess good biocompatibility, mechanical properties and bone induction ability, which can rebuild the initial stability of the spine in a short time.

To clarify the effect of the sympathetic nerves on the body's physiopathological changes and acupuncture effect by the alphal-AR mediation in the past 30 years.The paper has referred to the database of CNKI and Pubmed,and systematically reviewed the publications in the past 30 years about the research of the alphal-AR mediation of the sympathetic nerves to the body's physiological andpathological changes and acupuncture effect.Alphal-AR not only mediated the sympathetic nerves on the inotropic change of the heart,and the contraction of the vascular smooth muscles,bladder sphincter,and uterine smooth muscles and other physiological effect,but also mediated cardiac arrhythmia,myocardial hypertrophy and other pathological process.In addition,Alphal-AR also mediated the acupuncture signal transmission,and acupuncture was able to adjust the sympathetic nervous tension.The body's physiopathological changes are closely related to alpha1-AR and subtype alteration.The in-depth study of alphal-AR helps to explain physiopathological mechanism of the body,as well as provide theoretical basis and the corresponding pharmacological models for better selective drugs.Studying Alpha1-AR on meridians contributes to the discovery of meridian essence and the substantial basis of acupuncture effects.

Objective To evaluate the curative effect between conventional fraction radiotherapy (CFRT) and intensity modulated radiation therapy (IMRT) combined with concurrent chemotherapy for unresectable esophageal carcinoma.Methods 144 patients were enrolled into this study.They were divided into CFRT group and IMRT group.CFRT group (60 cases):irradiation field encompassed primary lesion and mediastinal lymph drainage regin.Neck and thoracic upper segment cases were made front thorax T field irradiation first,DT 36 Gy/18 f,followed by two front oblique field made Iso-central irradiation,field width was 4.5-5.0 cm,gantry angle 50°-60°,wedge filter 30°,DT added to 66 Gy.For thorax middle or lower segment patients,field width was 6.0-6.5 cm,field length was that the tumor upper and lower each extended 3.0-5.0 cm,vertically irradiated in thoracic front and at the back,after DT 36 Gy/18 f,changed to two back ablique field,made Iso-central irradiation,DT added to 66 Gy.IMRT group (84 cases):GTV was esophageal primary lesion and metastasis lymph node (GTVnd);CTV included GTV,GTVnd and mediastinal lymph drainage region,at GTV around all was widened 0.8-1.0 cm,its upper and lower each extended 3.0-5.0 cm;PTV were in the basis of CTV,all were widened 0.5 cm again.With ≥95 ％ isodose curve covering the PTV and the target dose was prescribed to PTV 60-64 Gy/30-32 f.Organ at risk (OAR):both lungs V20≤30 ％,spinal cord ≤45 Gy/6 weeks,heart V30≤40 ％.Chemotherapy of two groups was same,DDP 25-30 mg/m2 × 3-5 days,5-Fu 450-500 mg/m2 × 5 days civ,28 days were one period,total 2 period,after 1-3 months,strengthen chemotherapy 3-4 period.Results Leucopenia and radiation-induced esophagitis as shown by the WHO staging system were the most common acute toxicities,but were mainly grade 1 or 2.The incidence rate of leucopenia and radiation-induced esophagitis in CFRT group were 78.3 ％ (47/60) and 83.3 ％ (50/60),IMRT group were 82.1％ (69/84) and 79.8 ％ (67/84).After symptomatic treatment,all patients completed the planner treatment.During radiotherapy and after treatment,the patients showed grade 1-2 radiation-induced pneumonitis,CFRT group were 36.7 ％ (22/60),but IMRT group were only 9.5 ％ (8/84) (x2 =9.99,P ＜ 0.01).In CFRT group and IMRT group,the 1-,3-,5-year survival rates were 75.0 ％ (45/60),36.7 ％ (22/60),20.0 ％ (17/84) and 79.8 ％ (67/84),35.7 ％ (30/84),21.4 ％ (18/84),respectively.Conclusion The overall response and 5-year survival rates of CFRT and IMRT combined with concurrent chemotherapy are similar,however,the incidence of grade 1-2 radiation-induced pneumonitis of IMRT is low,which indicates that IMRT can reduce the lungs irradiational volume and dose.

Objective To investigate the effect of down-regulated Blimp1 gene expression on differenetiation of bone marrow cells into dendritic cells (DCs).Methods Blimp1-shRNA was constructed and then loaded into lentivirus vector as lenti-blimp1-shRNA.Bone marrow cells from Balb/c mice were induced differentiation to DCs in an 8-day cell culture system with GM-CSF/IL-4 incubation and LPS stimulation at day 7.The cells were divided into groups as empty control (no treatment),lenti-control (transfected by lentivirus empty vector at day 1),and lenti-Blimp (transfected by lenti-blimp1-shRNA at day 1).The transfection efficiency was evaluated by GFP fluorescence for one week.The morphology and growth curve were analyzed.Real-time PT-PCR and Western blotting were used to evaluate mRNA and protein expression of Blimp1.At day 8,CD11 c and CD86/MHC-Ⅱ were quatitified using flow cytometry.Results GFP fluorescence emerged 3 days after transfection and was continuously expressed.Classic DC morphology was shown in no treatment cells,while damaged morphology presented in the cells with lentivirus transfection.The empty control cells proliferated from day 3,peaked as (2.45 ± 0.26) 106/well at day 4,and kept at (2.27 ± 0.19) 106/ well at day 8,The cells receiving lentivirus presented (1.69 ± 0.39) 106/well.The expression of Blimp1 mRNA and protein in the lenti-Blimp1 group was 76％/1％ and 1.0％/74.0％ of the empty control group.At day 8,CD11c,CD86 and MHC-Ⅱ expression in the empty control group was (69.2 ±5.0)％,(51.1± 4.9) ％ and (56.3 ± 7.3) ％,while (68.6±5.9)％,(49.5±4.3)％ and (69.4±4.5)％ in the lenti-control group,and (72.8 ± 5.5)％,(50.2 ± 6.0)％ and (46.5 ± 5.7)％ in the lenti Blimp1 group.Conclusion Lentivirus-mediated Blimp1-shRNA gene therapy modulates blimp1 expression of DC precursors.Down-regulation of Blimp1 fails to interrupt the differentiation of DCs but inhibits the maturation.

objective To evaluate the diagnostic efficiency of magnetic resonance imaging(MRI)for rheumatoid arthritis(RA).Methods The major international databases was searched by computer and Other methods to collect control studies about MRI for the diagnosis of RA,the searching deadline was December 2009.Data were screened and extracted by inclusion criteria.Meta-disc software Was used for statistics,including sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio(OR)and heterogeneity analysis.Results Twelve random control tests were included.Meta-analysis indicated that sensitivities of vities of synovitis,bone-erosion and tendenosynovitis were 81%~100%,48%～100%and 67%～96%while specificities of them were 64%～89%,16%~100%and 21%-74%respectively for RA patients(≤2vears).Sensitivities of synovitis and bone-erosion were 91%and 84%while specificities of them were 70%and 81%for RA Datients (>2 years).Conclusion Synovitis shown by MRI is helpful for the diagnosis of earlv and med-to-late RA.Diagnostic values of bone-erosion and tendonosynovitis demonstrated by MRI for earlv RA were not clear.The sample size of the included studies is small and some studies lack of control groupsput the conclusion of this meta-analysis liable for bias.We suggest that better designed and larger sample clinical studies are necessary.

Objective As SELDI-TOF-MS (Surface Enhanced Laser Desorption/Ionization Time of Flight Mass Spectrometry) has been broadly used to screen biomarkers for a variety of diseases, the identification and validation of the revealed biomarkers requires more focused attention.Method In this paper, the serum samples from 60 cholangiocarcinoma, 146 lung cancer, 65 LGC and 58 LPC, 49 benign diseases of hepatobiliary and 53 normal individuals were analyzed by SELDI-TOF-MS. Results Among a set of proteins automatically selected as specific biomarkers by Biomarker Wizard software, three protein peaks, with molecular weights of 13. 71 × 103 , 13.83 × 103 and 13. 99 ×103 , were found significantly decreased in cholangiocarcinoma samples. The candidate biomarkers obtained from Tricine-SDS-PAGE gel bands by matching the molecular weight with peaks on CM10 chips were identified by Mass spectrometry as the native transthyretin(native TTR),cysTTR and glutTTR.These preliminary results were further proven by immunoprecipitation using commercial TTR antibodies. This allowed us to re-measure the TTR levels in all the groups more simply by ELISA assay. It showed a firm consistency between ELISA and SELDI analysis. In addition, while TTR levels in cholangiocarcinoma were found to be lower than those in normal healthy controls, TTR levels in benign diseases of the hepatobiliary system were found to be higher than those in healthy controls.Conclusion TTR could be a biomarker that better discriminates cholangiocarcinoma patients from the benign diseases compared to other biomarkers presently available.

OBJECTIVE: To screen and analyze items of the second-generation sub-health questionnaire through various item analysis methods, so as to provide basic data for the further study of sub-health measuring scale. METHODS: The investigation and analysis was completed in Southem Medical University between November 2006 and May 2008. A total of 6 000 college students were selected as the investigation targets with cluster sampling method from a medical university in Guangzhou. 6 000 questionnaires were assigned to them in which the answerer was asked about their somatic symptoms, psychological symptoms and social symptoms, with 5 599 valid ones obtained. Eighty three items were analyzed through five methods based on dispersion, correlation coefficient, factor analysis, t-test and Cronbach's g. RESULTS: At last, 63 items were selected to constitute the item pool of the sub-health scale, which were nominated over 4 times according to the nomination summary of the 5 methods.CONCLUSION: All the 63 items kept in the second-generation sub-health questionnaire feature satisfactory sensibility, representation, independence, significance and intemal consistency, which can accordingly lay a good foundation for the further study of the sub-health measuring scale.