Objective To investigate the better radiation modalities for single and multiple brain metastases.Methods Between July 2005 and July 2008,50 patients with single or multiple brain metastases were retrospectively analyzed.The primary cancer of all patients were controlled.Thirty patients with whole brain radiotherapy and stereotactic radiosurgery were included in the combination group,and 20 patients with stereotactic radiosurgery were included in another group.Stereotactic radiosurgery prescription doses of 45％-75％ isodose line were used to wrap around the planning target,which was 15-20 Gy in edge and 30-45 Gy in center.Stereotactic radiosurgery was performed once.Whole brain radiotherapy total dose was 40 Gy,which was given to patients by 2 Gy in 1 fraction,1 fraction every day,5 times every week.Results The efficient rate of combination group was 90％ (27/30),and single group was 60％ (12/20).It was obviously higher in combination group (x2 =6.294,P =0.012).For combination group,the 1-year survival rate was 50％ (15/30) and the 2-year survival rate was 30％ (9/30).However,for another group,the 1-year survival rate was 35％ (7/20) and the 2-year survival rate was 15％ (3/20).The survival rates of two groups were no difference (x2 =1.096,P =0.295 ; x2 =1.480,P =0.224).There were no patients survived more than 3 years in both groups.Stratified analyses showed that the l-year survival rates of the patients with single brain metastasis were no difference in two groups (100.0％ vs 66.7％,x2 =1.556,P =0.212).Whereas the 1-year survival rate in combination group of the patients with multiple brain metastases was higher than that in single group (42.3％ vs 29.4％,x2 =11.023,P =0.001).There were no statistically significant differences in 2-year survival rates in both groups with single and multiple brain metastases (75.0％ vs 66.7％,x2 =1.200,P =0.273 ; 23.1％ vs 5.9％,x2 =3.782,P =0.052).Conclusion Whole brain radiotherapy and stereotactic radiosurgery are important treatment modalities for single or multiple brain metastases.The optimal treatment modality for single brain metastasis is stereotactic radiosurgery,while it is a good choice to make whole brain radiotherapy and stereotactic radiosurgery for multiple brain metastases.

Liver three-dimensional simulation technology is a cross-field study of hepatic surgery,anatomy,computer image technology and virtual three-dimensional technology.Compared to the two-dimensional images,the three-dimensional technology applied to the planning of liver surgery has obvious advantages and unique features.This technology not only can three-dimensional clarity of presentation and precise positioning of the important structures of the liver inside and outside,but also allow the surgeon independent dividing a interest region of liver inside and outside.Visualization of the liver and liver volume measurement preoperative planning,can effectively reduce the risk of postoperative liver failure,the remnant liver necrosis and postoperative bile leakage.

Objective To evaluate the effect of aldosterone (Ald) on glomerular mesangial cells apoptosis and to explore the possible mechanisms.Methods Twenty-four Sprngue-Dawley rats were subcutaneously embedded with osmotic mini-pumps and randomly divided into 3 groups.Aldosterone (1.5 μg/h) was administrated subcutaneouly by osmotic mini-pumps in Ald group,eplerenone (Epl,100 mg·kg-1·d-1) and Ald (1.5 μg/h) was given to Epl group.And normal saline was used in control group (Con group).Systolic blood pressure and urinary albumin excretion rate (UAER) were detected on day 0,7,14,21,28.Blood and kidney samples were harvested on day 28.Plasma creatinine,potassium and aldosterone were measured.Renal paraffin sections were stained by PAS and the morphological changes were evaluated by light microscopy.Apoptosis index of mesangial cells were detected by TUNEL assay.The glomerular mesangial cells (MCs) were cultured in a DMEM-F12 media.MCs apoptosis was evaluated by staining cells with Annexin V and propidium iodide (PI) using flow cytometer.Expression of Bcl-2 and Bax mRNA was examined by RT-PCR.The protein level of Bad or phospho-Bad was measured by Western blotting.Results Ald-infused rats developed hyperaldosteronemia and hypokalemia.Rats in Ald group exhibited significant hypertension and marked albuminuria.Ald group rats showed increased number of TUNEL-positive mesangial cells when compared with control rats (P＜0.05).Aldosterone induced mesangial cells apoptosis in a time-dependent manner.Expression of Bcl-2 mRNA was decreased but Bax mRNA was increased in aldosterone treated MCs compared to that in Con group (P＜0.05).Aldosterone promoted dephosphorylation of cytosolic phospho-Bad compared with vehicle treated cells (P＜ 0.05).However,eplerenone attenuated these effects of aldosterone.Conclusion Aldosterone directly promotes mesangial cells apoptosis,and eplerenone can attenuate this effect of aldosterone.Dephosphorylation of cytosolic phospho-Bad may be the key role in the progression of mesangial cells apoptosis induced by aldosterone.

More than 85% of all cancers express telomeras e activity. Human telome rase has been proposed as a novel and potentially highly selective target for ca ncer therapy. Inducers of differentiation are involved in regulation of telomera se activity. In the present review, the effects of retinoids, vitamin D3 compo unds, tea catechins and matrine on telomerase activity in malignant cells were r eviewed.

More than 85% of all cancers express telomerase activity. Human telomerase has been proposed as a novel and potentially highly selective target for canon therapy. Inducers of differentiation are involved in regulation of telomerase activity. In the present review, the effects of retinoids, vitamin D3 compounds, tea catechins and matrine on telomerase activity in malignant cells were reviewed.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) on the expression of C-terminal Src kinase (Csk) in Ang Ⅱ-infused rat model and cultured podocytes,and to explore the role of Csk in Ang Ⅱ-induced cytoskeletal rearrangement of podocytes.Methods Twenty-four Wista rats were randomly subjected to normal saline infusion,or Ang Ⅱ infusion at 400 ng · kg1 · min-1 (via subcutaneous osmotic minipumps) for 2 or 4 weeks.Renal histomorphology was evaluated through electron microscopy.The expression of glomerular Csk was analyzed by immunofluorescence and Western blotting.In vitro,conditionally immortalized mouse podocytes were cultured and treated with Ang Ⅱ doses ranging from 10-9 mol/L to 10-5 mol/L and for different hours.The expression of podocytes Csk was assessed by Western blotting.After transfection to podocytes with Csk siRNA,FITC-conjugated phalloidin was used to stain F-actin,to investigate the role of Csk in Ang Ⅱ-induced or cytochalasin D-induced cytoskeletal rearrangement.Results (1) Examination of Ang Ⅱ infusion rats glomerular and podocyte ultrastructure by electron microscopy revealed foot process effacement and fusion; (2) In Ang Ⅱ infusion rats,the expression of glomerular Csk was increased (P ＜ 0.05); (3) In vitro,Ang Ⅱ-stimuli up-regulated the expression of Csk (P ＜ 0.05),and the effects of Ang Ⅱ were on dose-dependent and time-dependent manner; (4) Ang Ⅱ-induced disruption of F-actin was alleviated by Csk siRNA transfection in cultured podocytes; furthermore,cytochalasin D depolymerized the F-actin cytoskeleton,while Csk siRNA stabilized the actin filaments.Conclusion The enhanced expression of Csk may be involved in Ang II-induced podocytes cytoskeletal rearrangement and foot process fusion.

Objective To observe the clinical efficacy and adverse reactions of intensity modulated radiotherapy (IMRT) combined with cisplatin for patients with carcinoma of cervix.Methods One hundred patients with carcinoma of cervix were randomly divided into 2 equal groups to undergo IMRT only (IMRT group)and IMRT combined group (IMRT with cisplatin chemotherapy group),with 50 cases in each.Both groups were treated with external intensity modulated radiotherapy,with the total dose of 50 Gy,2 Gy/fraetion,25 fractions in total,and 5 times/week.Two weeks later,internal radiotherapy followed,with the total dose of 42-48 Gy,1 time/week with 6-8 times and 6-7 Gy/fraction.When the internal radiotherapy began,the external radiotherapy stopped immediately.The combination group was treated concurrently with cisplatin given by intravenous drip once a week,at the dose of 30-40 mg/m2 body surface area for 4-5 weeks,and with total cisplatin dosage of 50-65 mg.Follow-up was conducted for 18 months(3-60 months).The 1-,3-,and 5-year survival rates,local control rate,distant metastasis rate,and disease-free survival rate,blood test,rectum,and bladder were observed.Results The 1-year survival rate,local control rate,distant metastasis rate,and disease-free survival rate did not differ significantly between these 2 groups,however,the 3-and 5-year survival rates,local control rates,distant metastasis rates and disease-free survival rates of the combination group were all significantly better than those of the IMRT group (x2 =3.843,4.336,4.336,4.960,P ＜ 0.05 ; x2 =3.934,4.454,4.000,4.244,P ＜0.05).The incidence rates of radiation proctitis and leukopenia of the combination group were significantly higher than those of the IMRT only group (x2 =4.110,4.320,P ＜ 0.05),whereas the incidence rates of cystitis,anemia,and thrombocytopenia were not significantly different between these 2 groups.No serious grade 3-4 proctitis and cystitis were observed in these 2 groups.Conclusions The IMRT combined with cisplatin chemotherapy shows higher 3-year and 5-year long-term efficacy in the patients with carcinoma of cervix than IMRT only group.

Objective To compare the event-related potential(ERP) difference waveforms between attention deficit hyperactivity disorder (ADHD) children and normal children in the conflict task,and to investigate the neural mechanism of conflict monitoring of ADHD. Methods ERPs elicited by performing the spatial SimonStroop task were recorded in 32 children with ADHD and 32 normal children. The differences of ERP and behavior dren with ADHD(0.80±0. 11 ,0.87 ±0.08) were less than normal children (0.88 ±0.07,0.93 ±0. 04)in Sireaction time of ADHD group( (773.03 ±99.34)ms) in the Siin were longer than the control group( (737.21 ±81.40)ms) ,the differences had statistic significance (P＜0. 05). 2. ERP results:the amplitude of N2 of the children with ADHD in the four conditions were smaller than the control group, the difference in Siin had statistic sigof prefrontal and anterior cingulate cortex of ADHD were weaker than the control group. Conclusions The results suggest that, due to the inadequate allocation of attention resources of the children with ADHD, they have conflict monitoring function defects compare with normal children. The function defects of conflict information processing related brain areas may be the main neural mechanism. The result of the behavior and ERP can become the reference indicator for the early diagnosis and treatment of ADHD.

Objective The present study aimed to trace the behavior results and event-related potential (ERP) of conflict monitoring from 7 ～ 12 years old to explore the development features of the conflict monitoring.Methods In six groups of 144 children aged from 7 to 12,behavior and non-target N2 amplitude were analyzed in continuous performance test (CPT) task. Results 1. Behavior results:the reaction time of target stimulus decreased ( ( 533.33 ± 66.65 ) ms, (523.91 ± 92.96 ) ms, (468.37 ± 64. 13 ) ms, ( 46 1.48 ± 98.31 ) ms, (457.57 ±84.05 ) ms, (405.02 ± 67.90) ms) and the hitting number increased ( ( 34.87 ± 4.84 ), ( 37.64 ± 3.54 ), ( 37.95± 2.92 ), (38.67 ± 1.23 ), (39.31 ± 1.08 ), ( 39.45 ± 1.00 ) ) as age increased, and the difference was statistically significant ( P＜0.01 ). 2. ERP: ①The non-target N2 amplitude was significantly higher than the target,and the difference was statistically significant (F= 98.57, P＜ 0.01 ). ②The amplitude of non-target N2 amplitude decreased with age, and the difference was statistically significant (F= 5.54, P＜ 0. 01 ). Conclusion The non-target N2 was closely related to the monitoring conflict, and the behavior and ERP results in this study showed the development trend. 8 ～ l0 and 12 years old are the critical development period of information processing speed, attention and conflict monitoring function for children.