The postoperative pathological status of head and neck cancer is the determining factor for the use of radiotherapy. It is still unknown whether the interval between operation and postoperative radiotherapy has any impact on local control of the disease.However, from the radiobiological point of view, early postoperative radiotherapy is preferred, especially for patients with high-risk factors. Research has shown that concurrent chemoradiotherapy could improve the local control rate、overall survival rate and disease-free survival rate for head and cancer without surgery. Concurrent chemoradiotherapy was also recommended to the postoperative patients even though the acute toxicities might be increased significantly, but no evidence showed that it would aggravate late injuries including second primary neoplasm. The role of modern radiation technology and targeted therapy in adjuvant treatment of head and neck cancer needs to be further clarified.

Objective To explore the ability of intestinal bacteria making use of creatinine in the patients with uremia and healthy subjects. Methods Creatinine, which was energy source only,and tetrazolium violet as indicator were added into intestinal bacteria of the patients with uremia and healthy subjects(n=10). It was positive that solution showed violet. Intestinal bacteria were added in Nutrient Broth medium with creatinine. The concentration of creatinine was measured before and after incubation. Results The solution of intestinal bacteria of the patients with uremia showed violet. The solution of intestinal bacteria of healthy subjects showed bright violet.The concentration of creatinine decreased after incubation in both groups. Conclusions The intestinal bacteria of uremic patients and healthy subjects had the ability to make use of creatinine. The former was stronger than the latter.

BACKGROUND: Mesenchymal stem cells (MSCs) are capable of differentiating into a variety of lineages, including bone, cartilage, or fat, depending on the inducing stimuli, specific growth and differentiation factors.Recombinant human bone morphogenetic protein 2 (rhBMP-2) produced by gene engineering has an obvious osteoinductive activity and can induce undifferentiated mesenchymal cells into cartilage and bone irreversibly, resulting in new bone formation. Basic fibroblast growth factor (bFGF) modulates chondrogenic and osteogenic differentiation of MSCs.OBJECTIVE: To investigate the effect of bFGF and rhBMP-2 on the differentiation and proliferation of cultured rabbit mesenchymal stem cell in order to find out an optimal way of osteogenesis instead of conventional osteogenic supplements (OS).DESIGN: A randomized and controlled trial.SETTING: General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA.MATERIALS: The subjects were rabbit mesenchymal stem cells cultured by the author.METHODS: This experiment was conducted at the Center of Orthopaedic Surgery, General Institute of Orthopaedic Oncology, Tangdu Hospital,Fourth Military Medical University of Chinese PLA from June 2004 to December 2004. ①Rabbit MSCs cultured in vitro were treated with different growth factor (100 μg/L rhBMP-2, 100 μg/L bFGF, 10 μg/L rhBMP-2and 100 μg/L bFGF and OS; ②The proliferation and differentiation of MSCs were observed through activity of MTT, expression of alkaline phosphatase(ALP), and von Kossa staining.MAIN OUTCOME MEASURES: the rate of proliferation and the activity of ALP.RESULTS: ①rhBMP-2 could promote the proliferation and differentiation of MSCs, especially the cell differentiation; ②bFGF could stimulate the proliferation , the cellular proliferation rate increased 100% as compared with control group, and has no effect on differentiation of MSCs , but it could enhance effect on the cell proliferation of rhBMP-2.CONCLUSION: bFGF and rhBMP-2 are effective induction factors for MSCs. Both of them can stimulate the proliferation and differentiation of MSCs in vitro. bFGF and rhBMP-2 exerted a synergetic action in speeding up the pace of osteoinduction and osteogenesis and can be used to differentiate seed cells for tissue engineering bone.

Objective To evaluate T2WI sequence and liver acquisition with volume acceleration (LAVA) technique in the diagnosis of early endometrial carcinoma on 3.0 T MR scanner. Methods Twenty-seven patients with endometrial carcinoma confirmed by pathology were retrospectively analyzed. MRI sequences included axial T1WI and sagittal T2WI with fat saturation, axial and sagittal LAVA scanning including four phases: early arterial phase, late arteral phase, parenchymal phase and delayed phase. The tumor location, signal features, and myometrial infiltration by tumor were recorded and preoperative staging was compared with pathologic results. The sensitivity, specificity, accuracy of T2WI and LAVA in diagnosing endometrial carcinoma was assessed. The accuracy of the evaluation of the deep myometrium infiltration was compared between the two sequences using Fisher's exact test. Results According to Federation International of Gynecologie and Obstetrigue (FIGO) standard, 27 patients with endometrial carcinoma were classified as: stage Ⅰ in 22 cases, stage Ⅱ in 5 cases. The sensitivity, specificity, positive and negative predictive values in assessing deep myometrium infiltration were 70.0% (7/10), 94. 1% (16/17), 87. 5% (7/8), 84. 2% (16/19) respectively for T2WI sequence. Its accuracy in assessing myometrium invasion was 85.2% (23/27). The sensitivity, specificity, positive and negative predictive values were 80. 0% (8/10), 94. 1% ( 16/17 ), 88. 9% (8/9), 88. 9% ( 16/18 ) respectively for LAVA sequence, and the accuracy was 88.9% (24/27). There was no statistical difference of accuracy between two techniques( P = 1.00). Conclusion 3.0 T MR T2WI sequence has important role in diagnosing early endometrial carcinoma, and LAVA technique is highly valued in preoperative diagnosis and staging in early endometrial carcinoma for myometrium infiltration.

Objective To compare and evaluate the defect-repaired capabilities of human bone morphogenetic protein-2(hBMP-2) gene modified tissue engineered bone in the segmental bone defect model of rabbit's radius.Methods Rabbit's bone mesenchymal stem cells (BMSCs)were transferred with hBMP-2 gene through Adeno-XTM adenoviral expression systems,then seeded onto the compound scaffold of calcium phosphate cemept(CPC)and fibrin glue(FG)to construct a new kind of gene modified tissue engineered bone after proliferation in vitro for three weeks(Group A).Meanwhile,the compound scaffold of calcium phosphate cement(CPC)and fibrin glue(FG),which were seeded by rabbit's bone knesenchyrmal stem cells(BMSCs) after proliferation in vitro for three weeks(group B)and the compound scaffold without cells(Group C)acted as control groups.Then,three kinds of reconstructive modalities were implanted into segmental bone defect of donator rabbit's radius.Besides these three groups,bone defect model of rabbit's radius without treatment(Group D)represented blank group.The defect-repaired capabilities were assessed by gross observation,radiograph,Single Photo Emission Computed Topography (SPECT)and histological analysis in the 4th week,8th week and 12th week after operation.The rates of bone healing in the different groups were compared each other.Results All defects that had been treated with implants(Group A,B,C)exhibited new bone formation and could attain osseous tissue healing 12 weeks after operation,but defects in blank group(Group D)were repaired only by fibrous tissue.The defects in the Group A regenerated more new bone,bridged earlier and stronger than those in the Group B and Group C.The quantity and rate of new bone formation in the Group B and Group C had no significant difference and the rates of bone healing in different groups showed the same results.Conclusion hBMP-2 gene modified tissue engineerod bone have better potential to form new bone and the rate of bone healing in repairing bone defects is higher,so this way is an optimal kind of material for artificial bone graft.

BACKGROUND:Studies have shown that selection of implant crowns that directly impact the service life of implants and patient’s periodontal health is very important.
OBJECTIVE:To compare the clinical effects of Lava zirconia crowns, goal-platinum al oy ceramic crowns and silver-pal adium al oy crowns supplemented by dental implants used in the single missing posterior tooth.
METHODS:Sixty patients with first molar missing (120 teeth) were divided into three groups and treated with Lava zirconia, goal-platinum al oy ceramic and silver-pal adium al oy crowns applied to the dental implants for posterior column defects. The clinical restorative effects of three prostheses were compared.
RESULTS AND CONCLUSION:During 6-48 months of fol ow-up, the gingival edge coloring, gingival margin microleakage, the color of prosthesis of Lava zirconia al oy ceramic crowns and gold-platinum al oy ceramic crowns were better than those of silver-pal adium al oy crowns, and the gingival edge coloring and the color of prosthesis of Lava zirconia al oy ceramic crowns were better than those of gold-platinum al oy ceramic crowns, while the gingival margin microleakage of gold-platinum al oy ceramic crowns was better than that of Lava zirconia al oy ceramic crowns. Silver-pal adium al oy crowns were lower than Lava zirconia ceramic crowns and gold-platinum al oy ceramic crowns in the fracture extent. But silver-pal adium al oy crowns had the highest gingival index, the worst gingival health and rapidest and most severe plaque formation. Therefore, Lava zirconia al-ceramic crowns and gold platinum al oy-porcelain crown are ideal prostheses for implant restorations. The former has better biocompatibility, and the latter shows better marginal adaptation.

Objective To evaluate set-up errors by megavoltage cone-beam CT in head and neck cancers treated with precision radiotherapy. Methods From April 2007 to March 2008, 22 patients with nasopharyngeal carcinoma (15 patients) ,parotid carcinoma (4 patients) and brain glioma (3 patients) were enrolled, among whom 7 patients underwent three-dimensional conformal radiotherapy (3DCRT) and 15 received intensity modulated radiotherapy (IMRT). The radiation dose was 56. 0 -70.4 Gy in 28 -32 fractions within 6 -7 weeks. Megavoltage cone-beam scan was performed weekly before treatment. The isocenter displacement was calculated by comparing megavoltage cone-beam CT and planning CT in left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions. Results Totally 129 sets of megavoltage cone-beam CT images were obtained for 22 patients. The frequency of isocenter shift more than 0. 3 cm,0. 4 cm and 0. 5 cm were 28,15 and 9, respectively. The maximum mean set-up error was found in CC, which was about 0. 1 cm more than that in LR and AP. The frequency of isocenter shift direction was almost identical in LR and CC, which was more frequent (about 75%) in the posterior direction. Conclusions During the course of radiation of brain tumor and head and neck cancer, the enlarging tendency of set-up errors has been found in all the three directions. The isocenter shift in AP was more frequent to the posterior direction.

Objective To investigate the possible risk factors of functional dyspepsia(FD)in Beijing university students.Methods 490764 random samples were selected.A self-reported questionnaire containing ROME III questionnaire and other questions regarding food habit,studying style,past history,etc was delivered to all students.The factors related to FD were compared between the two groups.Results To distribute questionnaire 9800,call in 8608.The response rate is 87.8%,the qualification rate is 80.8%.A total of 602 youth were divided into FD group(110 cases)and control group(492 cases without any symptoms related to FD).The differences between the two groups were found as follows:① Indexes in height,weight and body mass in FD group were significantly lower than those in the control group(P

Objective To analyse the routes and MRI characteristics of disseminated intracranial gliomas after operation. Methods 10 patients of intracranial gliomas confirmed by pathology and intracranial dissemination after operation underwent MRI examina-tions including T_1 WI, FSE T_2 WI, FLAIR and fat-suppressed T_1 WI after intravenous injection of Gd-DTPA. In addition, 4 cases were also examinated with DWI, 1 case with SWI and DTI. Results In 10 cases,there were glioblastoma in 7 cases,grade Ⅱ astro-cytoma in 2 and grade Ⅲ astrocytoma in one. The disseminated tumors were found by MRI in 4 to 56 months after operation. The le-sions in all patients were confirmed with the comparison of contrast-enhanced MRI positive signs between preoperation and post-operation. Plain MR scanning showed line-like thicking with isointensity in 1/7 case/time (C/T)and multiple noduli in 5/7 (C/T) on T_1 WI respectively;shallowed cortical sulci and cistern in 2/7(C/T) and nodular in 5/7(C/T) on T_2 WI;shaUowed cortical aulci and cistern in 2/7 (C/T) and nodular in 6/7(C/T) on FLAIR. The signal intensity of noduli of disseminated tumors in 7 cases were in complete consistency with that of primary neoplasm , however, in 3 cases, it was inconsistent. Enhanced scanning showed 7 ca-ses with the signs of line-like thicking, 7 cases with noduli , 6 cases with :cast-like shape" sign and 6 cases with different extent of hydrocephalus. Conclusion Enhanced MRI can be used as a most useful and reliable monitoring tools for detecting dissemination of brain glioma.

OBJECTIVE To explore the expression of Maspin in invasive fungal rhinosinusitis (IFRS) and the value of Maspin in the diagnosis of IFRS. METHODS Forty two cases of fungal rhinosinusitis (FRS) were set as the experimental group, which included 12 cases of IFRS and 30 cases of noninvasive fungal rhino-sinusitis (NIFRS). At the same time, 30 cases of chronic rhino-sinusitis were set as control group. Immunohistochemistry (IHC) was used to detect the expression of Maspin. RESULTS Compared with the control group, the expression of Maspin in FRS group decreased statistically (t=-3.367, P<0.05). The IFRS group, compared with other two groups, had the lowest expression of Maspin (t=-3.390, P<0.05; t=-4.143, P<0.05). By using Maspin score of 5.70 as the cut-off point, the sensitivity and specificity for the diagnosis of IFRS was 91.7% and 88.3% respectively. CONCLUSION The expression of Maspin is very low in IFRS group. Down-regulation of Maspin expression may be a potential indicator for diagnosis of IFRS.