AIM:To observe the therapeutic effect of aescine in the treatment of lumbar intervertebral disc prolapse(LIDP).METHODS:One hundred and seventy-six patients with LIDP were divided into 2 groups:aescine group of 80 patients［M56,F24;age(43±s17)a,course of disease(7.4±2.3) mo］ received conventional therapy plus aescine 10-15 mg in 5 % glucose or 0.9 % sodium chloride injection 250 mL,iv,drip,bid,for 7-10 d.Control group of 96 patients［M57,F39;age(42±16)a,course of disease(7±3)mo］only received conventional therapy,including towing,massage,acupuncture,anodyne.Therapeutic effects of both groups were compared after 4 wk.RESULTS:The total effective rate of aescine and control group was 95 % and 81 %,respectively(P＜0.05),while in those course of disease less than 0.5 a the effective rate was 97 % and 85 %,respectively(P＜0.05).No obvious adverse reactions occoured. CONCLUSION:Aescine is safe and effective for the treatment of LIDP.The shorter the disease course is,the better the therapeutic effects are.

Objective To observe the effects of doxazosin on the expression of type Ⅰ and type Ⅲ collagen fiber in autoantibodies against α1-adrenergic receptors (α1-AA) positive diabetic rats,and to investigate the protective mechanism of doxazosin on cardiomyopathy of diabetic rats.Methods After establishment of diabetes model with streptozocin,diabetic rats were randomly divided into diabetic group (group A,n =10),doxazosin treated group (group B,n =10),α1-AA mediated group (group C,n =8),α1-AA plus doxazosin treated group (group D,n =8).Group C and group D were injected α1-AA (100 μg/100 g) by caudal vein at 0,4,8,12,and 16 weeks.Doxazosin (0.36 mg · kg-1 · d-1) was administered by lavage for 16 weeks in group B and group D,and other groups were given the same volume of saline every day.Expressions of type Ⅰ and type Ⅲ collagen fibers in myocardium of left ventricle were detected by immunohistochemical staining.Pathological changes in the myocardium were observed by both light and electron microscopes.Changes in collagen fiber in myocardium were detected by Van Gieson staining.Results Among various groups,there was no significant difference in blood glucose levels (P ＞ 0.05).After the intervention of doxazosin,body weight in group B and group D was greater than that of group A and group C (P＜0.05 or P＜0.01).Expression of type Ⅰ and type Ⅲ collagen fibers in myocardium in group D was lower than that in group C (P＜0.05).Expression of type Ⅰ and type Ⅲ collagen fibers in group B was lower than that in group A (P＜0.05) as well.Myocardial pathological changes in group C were most serious,showing reduced mitochondrial,vacuolar degeneration,and interstitial collagen hyperplasia.Cardiomyopathy in group D and group B was less marked as compared with that in group C and group A,respectively.Myocardial collagen fiber in group C was significantly increased and showed poor alignment.Compared with group C,myocardial collagen deposition in group D was obviously reduced.Conclusions Doxazosin may suppress type Ⅰ and type Ⅲ collagen expressions in myocardium of α1-AA mediated diabetic rats,resulting in alleviation of myocardial fibrosis and protection of myocardium in diabetic rats.

BACKGROUND:Recent studies have shown that adipose-derivedmesenchymal stem cells (ADMSCs) not only have multilineage differentiation potential, but also exert an important role in blood sugar balance and hormone production.OBJECTIVE:To observe the differentiation potential of human ADMSCs (hADMSCs) into functional islet-like cells and the therapeutic effect of hADMSCs transplantation in diabetic rats.METHODS:PDX-1 gene was transfected into hADMSCs by adenovirus. Cell differentiation and insulin secretion were identified and detected by dithizone staining and ELISA, respectively. Twenty male Sprague-Dawley rats were randomly divided into control group (n=4), diabetes group (n=8) and transplantation group (n=8). Rats in the latter two groups were subjected to making diabetic models by 65 mg/kg streptozotocin injection. Afterwards, rats in the transplantation group were given PDX-1 transfected ADMSCs via the tail vein.RESULTS AND CONCLUSION:At 15 days after transfection, the number of insulin positive cells and insulin secretion were both increased significantly (P < 0.05). Fasting glucose levels in the transplantation group decreased significantly (P < 0.05), while the body weight increased significantly (P < 0.05). In the diabetic group, the fasting glucose level still maintained at a high level, and the body weight of rats was significantly decreased. These results implicated that PDX-1 gene could induce hADMSCs differentiating into functional islet-like cells. PDX-1 transfected ADMSCs transplantation is effective in treating diabetic rats, but the mechanism needs further study.

Objective To investigate the therapeutic effects,adverse effects,and patterns of failure of elective irradiation of lymphatic drainage area (extended-field) and involved-field irradiation in three-dimensional radiotherapy (3DRT) in patients with esophageal cancer via a Meta-analysis.Methods The databases Wanfang Data,CNKI,VIP,CBM,PubMed,Embase,and Cochrane Library were searched to collect the controlled clinical trials on extended-field irradiation and involved-field irradiation in 3DRT in patients with esophageal cancer.Stata 11.0 was used for data analysis.The odds ratio (OR) with 95％ confidence interval was used to describe the differences between two groups.Results According to the inclusion and exclusion criteria,a total of 12 controlled clinical trials involving 1 095 patients with esophageal cancer were included in this meta-analysis.The results of the meta-analysis showed that compared with the involved-field irradiation group,the extended-field irradiation group had a significantly reduced rate of out-field failure in patients with esophageal cancer who received 3DRT (OR=3.727,P=0.007),but showed significantly higher rates of grade ≥ 3 acute radiation pneumonitis and radiation esophagitis (acute radiation pneumonitis:OR =0.348,P =0.001;radiation esophagitis:OR =0.385,P =0.000).The two groups had similar 1-,2-,and 3-year local control rate and overall survival rate (local control rate:OR=0.966/0.946/0.732,P=0.837/0.781/0.098;overall survival rate:OR=0.952/1.149/0.768,P=0.756/0.422/0.120),as well as a similar distant metastasis rate (OR=0.986,P=0.937).Conclusions Compared with involved-field irradiation,extended-field irradiation can reduce the rate of out-field failure in patients with esophageal cancer who receive 3DRT.However,it does not have significant advantages in local control rate and overall survival rate and has an increased incidence rate of adverse effects.

Objective To study the homology characteristics of clinicaly isolated and colonized linezolid(LZD)-resistant Enterococcus faecalis (E.faecalis) strains from a patient.Methods Ten E.faecalis strains (2 were isolated from urine specimens and 8 were from stool specimens) isolated from a patient with pulmonary infection were performed antimicrobial susceptibility testing, homology of E.faecalis was determined by pulsed-field gel electrophoresis (PFGE).Results Before and after patients received LZD therapy, 2 E.faecalis strains isolated form urine specimens were both resistant to LZD (MICs: 8 mg/mL, 16 mg/mL, respectively), among 8 strains from stool specimens (6 were isolated before therapy, and 2 were isolated after therapy), LZD susceptible, intermediate, and resistant strains were 4, 2, and 2 respectively(MICs: 0.25-12 mg/mL).10 strains of E.faecalis were homologous by PFGE typing.Conclusion In this case, the detection of E.faecalis from urinary tract and intestinal tract is homologous, which suggested that LZD-resistant Enterococcus may be colonized in vivo for a long time, and may be shift to cause bacterial infection.

Objective To evaluate the efficacy of salvage radiotherapy for supraclavicular lymph node metastasis ( SLNM) after initial treatment in patients with esophageal cancer. Methods A total of 117 patients with SLNM after radical resection for esophageal cancer were enrolled as subjects from 2006 to 2012. All patients received three?dimensional radiotherapy with 1. 8?2. 0 Gy per cycle, 5 cycles a week. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. The Cox model was used for multivariate analysis. Results The follow?up rate was 100%. In all the patients, the 1?and 3?year overall survival (OS) rates were 38. 5% and 14. 1%, respectively. The 1?and 3?year OS rates were significantly higher in patients treated with salvage radiotherapy or radiochemotherapy ( n=100) than in patients without any salvage treatment (n=17)(42% vs. 18%,P=0. 008;17% vs. 0%, P=0. 008). The patients treated with radiochemotherapy ( n=32) had significantly higher 1?and 3?year OS rates than those treated with radiotherapy alone (n=68)(59% vs. 34%, 36% vs. 11%, P=0. 002) or without any salvage treatment (n=17)(59% vs. 18%, 36% vs. 0%, P=0. 002). Patients without visceral metastasis (n=80) had significantly higher 1?and 3?year OS rates than those with visceral metastasis ( n=37) ( 44% vs. 27%, P=0. 002;22% vs. 0%,P=0. 002) . Patients with supraclavicular doses of ≥60 Gy in salvage radiotherapy ( n=75) had significantly higher 1?and 3?year OS rates than those with supraclavicular doses of<60 Gy in salvage radiotherapy ( n=25) ( 75% vs. 25%,P=0. 000;24% vs. 8%,P=0. 000) . The multivariate analysis using the Cox model showed that supraclavicular doses of ≥60 Gy, mediastinal metastasis, visceral metastasis, and salvage treatment method were independent factors for survival ( P=0. 001,0. 015,0. 009, 0. 025) . Conclusions Salvage radiotherapy can improve the survival of patients with SLNM in esophageal cancer. Salvage radiotherapy or radiochemotherapy is highly recommended for patients with SLNM alone. A radiation dose of ≥60 Gy in salvage radiotherapy improves survival in patients.

To investigate the cell-killing effect and its possible mechanism of rClone30-hDR5 in combination with TRAIL on human hepatic carcinoma (HCC) cell line, first of all, recombinant plasmid pee12.4-hDR5 was introduced into HepG2 cells by liposome transfection. After five rounds of screening by flow cytometry, HepG2 cells expressing high levels of DR5 on cell surface were isolated. The cytotoxicity of TRAIL to selected cells was higher than that of TRAIL to HepG2 cells by MTT method (P < 0.01). The result suggested that the cloned hDR5 gene had biological activity. MTT assay showed that, rClone30- hDR5 in combination with TRAIL more efficiently inhibited the tumor growth of HepG2 cells compared to rClone30-hDR5 or TRAIL in vitro. The results of Annexin V-FITC/PI staining and Quantitative Real-time PCR indicated that rClone30-hDR5 in combination with TRAIL significantly increased the mRNA levels of caspase 3 and caspase 8, and induced the apoptosis of tumor cells. HepG2 cells were infected with rClone30-hDR5 or rClone30 at MOI of 1. The expression of hDR5 on tumor surface increased significantly by rClone30-hDR5 compared to that by rClone30, which contributed to the sensitivity to TRAIL. In conclusion, rClone30-hDR5 in combination with TRAIL has potential application value in cancer treatment.

Objective To investigate PET/CT and PET/MR characteristics of head and neck squamous cell carcinoma (HNSCC).Methods Totally 40 patients with HNSCC underwent whole body 18F-FDG PET/CT and MR scans of head and neck before anti-tumor treatment.PET positive lesions of HNSCC,including primary lesions and lymph nodes were evaluated by 2 radiologists independently.Then the imaging quality,fusion quality,lesion conspicuity and lesion characteristics were assessed based on PET/CT,PET/MR T1WI and PET/MR T2WI.Results Ninety PET positive lesions in all 40patients were evaluated,including 40 primary lesions and 50 lymph nodes.Similar imaging quality and fusion quality of PET/CT,PET/MR T1WI and PET/MR T2WI were obtained without statistical difference (both P＞0.05).For the lesion conspicuity,PET/MR T1WI and PET/MR T2WI demonstrated significantly better than PET/CT in positive primary lesions and lymph nodes (all P＜0.05).For the characteristics of positive primary lesions,PET/MR T2WI provided more information than PET/CT in 29 lesions,equal to PET/CT in 4 lesions,and less than PET/CT in 7 lesions.Conclusion The application of PET/MR in HNSCC is feasible,being superior to PET/CT in indication of lesions in head and neck area.

Objective To evaluate the clinical efficacy and analyze relevant prognostic factors of simultaneous integrated boost intensity-modulated radiation therapy ( SIB-IMRT ) for esophageal squamous cell carcinoma. Methods A total of 101 patients diagnosed with esophageal squamous cell carcinoma received SIB-IMRT from 2009 to 2015. The prescribed dose of PTV was 5040 cGy/28 times ( 180 cGy/time) and the dose for planning gross tumor volume (PGTV) was 6020 cGy/28 times (215 cGy/time) or 6160 cGy/28 times ( 220 cGy/time) simultaneously. The total treatment time was 5. 5 weeks ( once a day, 5 times a week).The adverse events, mode of treatment failure,l-,3-and 5-year local control (LC) and overall survival ( OS) rates were observed. Results The quantity of patients who completed the 1-,3-and 5-year follow-up was 101, 84 and 45, respectively. The 1-,3-and 5-year LC rates were 81. 6％,70. 4％ and 68. 4％, respectively. The 1-, 3-and 5-year OS rates were 72. 3％, 49. 4％ and 45. 2％, respectively. The median survival time was 36 months. Univariate and multivariate analyses showed that clinical staging ( stageⅠ/Ⅱ/Ⅲ) and tumor response ( complete remission/ partial remission/no remission ) were the prognostic factors of OS (P=0. 016,0. 000,0. 005,0. 000).There were no significant differences in the LC and OS between the two groups of 215 cGy and 220 cGy (P=0. 283,0. 951).The incidence rates of grade 1,2,3 acute pneumonitis were 10. 9％(11/101),2. 0％(2/101) and 2. 0％(2/101), respectively. The incidence rates of grade 1, 2, 3 acute esophagitis were 63. 4％( 64/101 ) , 10. 9％( 11/101 ) and 4. 0％( 4/101 ) , respectively. No acute esophageal perforation or hemorrhage occurred. Five patients experienced late pneumonitis ( two died) . One case developed late lemostenosis, two cases developed esophageal perforation and hemorrhage, and two patients experienced esophageal hemorrhage. The patients treated with a fractionated dose of 220 cGy had a higher incidence rate of acute pneumonitis and upper gastrointestinal adverse reactions than those receiving 215 cGy ( P= 0. 062, 0. 024 ) . The local failure and recurrence accounted for 62. 5％ of all treatment-related failures. Conclusions SIB-IMRT yields high long-term clinical efficacy and tolerable adverse events in the treatment of esophageal squamous cell carcinoma. Compared with the dose of 215 cGy, the fractionated dose of 220 cGy fails to improve LC and OS rates, whereas enhances the risk of adverse events. The clinical staging and short-term clinical efficacy are the prognostic factors of survival rate.

Objective:To evaluate the dosimetric properties of intensity-modulated proton therapy (IMPT) plans for simulated treatment planning in patients with ventricular tachycardia (VT) using stereotactic ablative body radiotherapy (SABR), in comparison with the volumetric-modulated arc therapy (VMAT).Methods:A total of 25 gross target volume (GTV) of the apical, anterior, septal, inferior and lateral wall of the left ventricle (LV) were delineated on the CT simulation images of 5 patients with complete data. An additional 5 mm GTV margin was added to the internal target volume (ITV), and an additional 3 mm ITV margin was added to the planning target volume (PTV). VMAT and IMPT plans were designed in each target area. Dose prescription was 25 Gy (RBE) in a single fraction. The dosimetric differences of ITV and organ at risk (OAR) were compared between VMAT and IMPT.Results:The median volume of ITV was 45.40 cm 3(26.72-67.59 cm 3). All plans had adequate target coverage(V 95%Rx≥99%). Compared with the VMAT plans, IMPT reduced the D mean of whole heart, pericardium and non-target cardiac tissues (relative difference) by 44.52%, 44.91% and 60.16%, respectively, which also reduced D 0.03 cm 3 of the left anterior descending artery by 17.58%( P<0.05). After stratified analysis according to the lesion sites, IMPT could still reduce the dose of most OAR. However, the D 0.03 cm 3 of LAD and LCX for the lesions in the anterior wall of LV, the D 0.03 cm 3 of LCX in the inferior wall and D 0.03 cm 3 of LAD in the apical wall did not significantly differ (both P>0.05). Conclusions:Both VMAT and IMPT plans can meet the clinical dosimetric requirements when SABR is simulated in patients with VT. However, IMPT can lower the dose of normal heart tissues, which has the potential benefit of reducing the risk of complications, such as ischemic heart disease, pericarditis/pericardial effusion, etc.