Current studies show that postoperative adjuvant radiotherapy (PORT)may improve local control and overall survival for Ⅲ A-N2 NSCLC.With modern radiotherapy technology and techniques,the adverse effect of PORT is moderate and tolerated.Besides,modern PORT doesn′t decrease the survival.Inves-tigation concerning postoperative target volume for PORT is rare,so that definite agreement has not been reached.Available informations suggest that clinical target volume should include bronchial stump,involved lymph nodes,ipsilateral hilar nodes,subcarinal nodes and ipsilateral lower paratracheal nodes.

Objective To determine the prognostic value of standardized uptake value(SUV)of fluorodeoxyglucose(FDG)by positron emission tomography and computed tomography(PET-CT)in nonsmall cell lung cancer(NSCLC).Methods Forty-eight patients(39 male,9 female)with stage ⅢNSCLC were reviewed.All patients had at least two repeated FDG PET-CT scans either before and after therapy and the maximum standardized uptake value(SUVmax)of the primary lung lesion was calculated. Resuits Of the 45 eligible patients,after a median follow-up of 22.5 months(rang,13 to 35 months),24 patients had local and regional recurrenee or metastasis and 21 remain disease-free.The mean SUVmax of patients who had local recurrence or metastasis before and after treatment was 12.30±3.17 and 5.35±2.29,respectively.The mean SUVmax of patients who had no loeal recurrence or metastasis before and after treatment was 8.46±3.00 and 2.82±0.63,respectively.Significant differences(tbefore=4.15,Pbefore＜0.01;Pafter=4.88,Pafter＜0.01)in SUVmax were observed either before and after treatment.However,the percent change of SUVmax between pretreatment and post-treatment were not significiantly different(t=1.99,P＞0.05).Using the SUVbefore of 9.0 yielded 92% sensitivity,62% specificity,73% positive predictive value and 87%negaffve Dredictive value in predicting regional recurrence or metastasis. While using the SUVafter of 4.3 yielded 71% sensitivity,100% specificity,100% positive predictive valne and 72% negative Dredictive value. Conclusions PET-CT may have the potientials to predict response to therapy and the SUVmax is a significant predictor for recurrent or metastasis in patients of NSCLC.

Objective To discuss the value of dual-time-point 18FDG PET-CT imaging on involved field radiotherapy for hilar and mediastinal metastatic lymph nodes in patients with non-small cell lung cancer (NSCLC).Methods Fifty-four patients with NSCLC were included in this analysis,including 34 men and 20 women with mean age of 59(34-76)years.Two sequential PET-CT scans given 3-5 days before surgery were standard single-time-point imaging for the whole body and delayed imaging for the thorax.The pathologic data were used as golden standard to determine the difference between the standard single-time-point and dual-time-point FET-CT imaging in the definition of gross target volume(GTV)of involved-field radiotherapy for metastatic lymph nodes. Results For hilar metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 21 patients(39%),comparing with 31 patients(57%) by dual-time-point imaging.Using pathologic data as golden standard,GTV alteration defined by single-time-point imaging had statisticaly significant difference comparing with that defined by dual-time-point imaging(u=519.00,P=0.023).For mediastinal metastatic lymph nodes,the GTV defined by single-time-point imaging was consistent with pathologic GTV in 30 patients(56%),comparing with 36 patients(67%)by dual-time-point imaging.Using pathologic data as golden standard.GTV alteration defined by single-time-point imaging had no statisticaly significant difference comparing with that defined by dual-time-point imaging(u=397.50,P=0.616).Conclusions For patients with NSCLC receiving involved-field radiotherapy,GTV definition for hilar and mediastinal metastatic lymph nodes by dual-time-point imaging is more consistent with that by pathologic data.Dual-time-point imaging has a larger value in terms of target delineation for hilar and mediastinal metastatic lymph nodes.

etabolic response to radiotherapy may predict the prognosis of paitents with locally advanced NPC. The prognosis is poor for patients with high FDG uptake before and after radiotherapy or SUV max-NSUV max-P .

Objective:To investigate the medicinal retention of different concentrations of melatonin in the bone tissue of type 2 diabetic osteoporosis (T2DOP) rats and explore to efficacy of improvement of the bone microstructure of T2DOP rats.Methods:A total of 95 SD rats were selected, 60 of which had intraperitoneal in jection of high-fat diet combined with low-dose streptozotocin establishing a T2DOP rat model. Two months later, 45 rats' model was determined to be successful by detecting blood glucose and insulin sensitivity index. 30 successful modelling and 30 normal SD rats were randomly selected for melatonin distribution experiment, and were divided into four groups according to the injected melatonin concentration, including modeling rat high concentration group (50 mg/kg), modeling rat low concentration group (10 mg/kg), normal rat high concentration group (50 mg/kg) and normal rat low concentration (10 mg/kg), and there were15 rats in each group. Each group was divided into 5 sub-groups according to the time point of sampling (5, 15, 30, 60, 120 min), 3 animals per group. The bone tissue of each group was pretreated, and then the melatonin drug distribution in the bone tissue was detected by high performance liquid chromatography (HPLC). Another 15 rats were successfully modeled, and were divided into T2DOP group, high melatonin group (50 mg/kg) and low melatonin group (10 mg/kg), 5 rats in each group. 5 normal SD rats were taken as controls (control group), and Micro-CT was used to detect changes in bone microstructure after 8 weeks of treatment with melatonin.Results:The results of the drug distribution experiment showed that after melatonin was injected intraperitoneally, there were drugs remaining in the bone tissues of the rats in each group. The drug concentration reached the highest after 30 min of administration, and significantly decreased after 120 min. Compared with the normal rat low concentration group, there was no significant difference in the drug concentration between the two groups at 5 time points. However, the drug concentration at the four time points of 5, 15, 30, and 60 min in the modeling rat high concentration group were 7.613±2.568 ng/ml, 13.983±2.262 ng/ml, 18.816±1.291 ng/ml, 6.172±1.962 ng/ml, 1.112±0.566 ng/ml, which were significantly different compared with normal rat high group. Micro-CT results showed that after 8 weeks of melatonin treatment, the bone density of the high concentration group was (205.72±28.41 g/cm 3) significantly lower than that in the low concentration group (223.63±35.41 g/cm 3), but both groups were significantly higher than the normal rat group (158.31±31.86 g/cm 3). Conclusion:Exogenous melatonin is distributed in bone tissue, and the drug absorption rate of T2DOP rats is higher. Meanwhile, there is no difference in the distribution of melatonin in bone tissue with different concentrations, and these two concentrations of melatonincan canimprove the bone microstructure of T2DOP rats.

OBJECTIVETo observe the impact of mesenchymal stem cells (BMSCs) transplantation on myocardial myocardin-related transcription factor-A (MRTF-A) and bcl-2 expression in rats with experimental myocardial infarction (MI).

METHODSThirty rats were randomly divided into sham, MI and MI + BMSCs (1 × 10(6) injected into 4 infarct points immediately post coronary artery ligation) groups (n = 10 each).One week later, TUNEL was used to detect cardiomyocyte apoptosis, the myocardial expression of MRTF-A and bcl-2 was detected by laser scanning confocal microscope and Western blot. In vitro plasmid of MRTF-A and co-transfection with plasmids of MRTF-A and bcl-2 or mutated bcl-2 transfection into cardiomyocyte was applied to evaluate the relationship between MRTF-A and bcl-2.

RESULTSThe number of apoptotic cardiomyocytes in the sham group, MI group and MI + BMSCs group were (4.05 ± 1.56)%, (62.38 ± 8.41)% and (22.36 ± 6.17)%, respectively (P < 0.05). The protein expression of MRTF-A and bcl-2 in the MI group were significantly lower than those in sham group, while significantly upregulated in MI + BMSCs group (P < 0.05 vs. MI). In cultured neonatal rat cardiomyocyte, the expression of bcl-2 protein was significantly upregulated after transfection with MRTF-A plasmid, and bcl-2-luciferase activity significantly increased after co-transfection with plasmids of MRTF-A and bcl-2-luciferase, however, the positive regulatory effect of MRTF-A was abolished after transfection with mutated bcl-2.

CONCLUSIONMesenchymal stem cells transplantation can effectively reduce cardiomyocyte apoptosis in this rat MI model, and upregulate the expression of MRTF-A. Consequent up-regulated bcl-2 expression might be involved in the beneficial effects of BMSCs transplantation in this model.

Animals ; Apoptosis ; Heart ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; Myocardial Infarction ; Myocardium ; Myocytes, Cardiac ; Nuclear Proteins ; Proto-Oncogene Proteins c-bcl-2 ; Rats ; Rats, Sprague-Dawley ; Trans-Activators ; Transcription Factors ; Transfection

Objective: To determine the association between anthropometric parameters and 20 meter shuttle run test (20 m SRT) score among children and adolescents. Methods: The convenient sampling method was conducted to select 3 192 primary and secondary school students in Baoan District, Shenzhen, based on the street school types school from April to May 2019. Height, weight, 20 m SRT score and general demographic indicators were assessed and collected. Individuals were divided into two groups based on the dose response correlation between different anthropometric parameters (the Z score of height, weight and BMI) and 20 m SRT score analyzed with the restricted cubic spline. The association between the Z score of height and 20 m SRT score was further analyzed using the Spearman correlation analysis. Logistic regression analysis was used to analyze separately the relationship different anthropometric parameters and 20 m SRT score. Results: The Z value of weight and 20 m SRT score showed a non linear dose response association ( P <0.01), the significant but weak linear correlation between the Z value of height and 20 m SRT score ( r=0.06, P <0.05). The prevalence rate on the low level of the Z value of 20 m SRT score in 3 192 children and adolescents was 44.7%, and the gender ( χ 2=14.02, P <0.01) and grade difference ( χ 2=93.28, P <0.01) were both statistically significant. There was no significant relationship between the Z value of height and 20 m SRT score grade among total population, different genders and different grades ( P > 0.05). Compared with the reference group on the Z value of weight ≤-0.23, individuals with the Z value of weight >-0.23 had the low level of 20 m SRT score ( OR =0.61, P <0.05). Compared with the reference group on the Z value of BMI ≤ 0.25, individuals with the Z value of weight >0.25 had the low level of 20 m SRT score ( OR =0.45, P <0.05). Stratified for gender and grade, the above significant relationship on the Z value of weight, Z value of BMI and 20 m SRT score were still observed ( P <0.01). Conclusions The higher height Z value shows on correlations with 20 m SRT score, but the positive association is found between weight and BMI Z value and the 20 m SRT score. The cardiopulmonary fitness improvement may be more effective among children and adolescents when tuking weight and BMI Z scores into consideration.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.