Objective Study the behaviors of image registration algorithms, and analyze the elements which influence the performance of image registrations. Methods Pre-known corresponding coordinates were appointed for reference image and moving image, and then the influence of region of interest (ROI) selection, transformation function initial parameters and coupled parameter spaces on registration results were studied with a software platform developed in home. Results Region of interest selection had a manifest influence on registration performance. An improperly chosen ROI resulted in a bad registration. Transformation function initial parameters selection based on pre-known information could improve the accuracy of image registration. Coupled parameter spaces would enhance the dependence of image registration algorithm on ROI selection. Conclusions It is necessary for clinic IGRT to obtain a ROI selection strategy (depending on specific commercial software) correlated to tumor sites. Three suggestions for image registration technique developers are automatic selection of the initial parameters of transformation function based on pre-known information, developing specific image registration algorithm for specific image feature, and assembling real-time image registration algorithms according to tumor sites selected by software user.

Chemoimmunotherapy or biochemotherapy, the combination of chemotherapy with immunotherapy, is a novel compre-hensive treatment model for malignant carcinoma. In recent years, many clinical trials have shown that biochemotherapy is associated with an improved response rate. Such biological agents include tumor vaccines, monoclonal antibodies, cytokines, and immunocompe-tent cells. In this article, we review the theories, sort the clinical applications of novel treatments, and discuss some of the problems existing in this field.

Objective To explore the risk factors contributing to wound complications following operative fixation for fractured calcanea.Methods Fitly-six patients with 61 fractured calcanea who had been treated with operative fixation from March 2000 to March 2003 were enrolled in investigation.General information of the pa- tients,ages,injury causes,classification of fracture,fall heights,smoking,delayed operation time,operation time and tourniquet time were documented preoperatively and postoperatively to be analyzed statistically.Results We report an overall wound complication rate of 14.8%(9/61).Wound infection,haematoma,dehiscence,heel necrosis and osteomyelitis were noted in our series.We identified the following as risk factors of postoperative wound compli- cations:1)fall from more than 3.4 m high(P＜0.05);2)delayed operation time less than seven days(P＜0.05); 3)operating time beyond two hours(P＜0.05);4)tourniquet time beyond 1.5 hours(P＜0.05).Conclusion In order to decrease wound complications following operative fixation tor fractured calcanea,surgeons should pertorm the operation 7 to 10 days after the injury,and reduce the operation time and tourniquet time.

Objective To summarize the clinical,radiographic and genetic features of a family with metatropic dysplasia,in order to improve the level of understanding and diagnosis of this disease.Methods The proband,a one-year old boy,was diagnosed as metatropic dysplasia.His mother was 26 years old with mildly phenotype.Their clinical features and bone X-ray findings were analyzed.The DNA samples of the proband and his parents were collected.The coding exons and flanking introns regions of transient receptor potential vanilloid 4 (TRPV4) gene were amplified by polymerase chain reaction (PCR) and analyzed by DNA automatic detector.The pathology,diagnosis,treatment and prognosis were expounded.Results The symptoms of the boy were characterized by short extremities,a short trunk with progressive kyphoscoliosis,and craniofacial abnormalities that include a prominent forehead,midface hypoplasia,and a squared-off jaw.His motor development was slightly delayed.Mental development was normal.Bone X ray of the boy showed platyspondyly and severe metaphyseal enlargement with shortening of long bones and irregularities and delayed ossification of epiphysis.The patient and his mother were heterozygous for the nucleotide substitutions c.2396 ＞ T (p.P799L) in TRPV4 gene.Conclusions The patient and his mother with metatropic dysplasia were diagnosed with TRPV4 gene analysis.The patient showed typical clinical features.His mother was mild.Metatropic dysplasia had significantly clinical heterogeneity.Gene analysis is helpful for the diagnosis.

Objective To observe the effects of pioglitazone on secretion of E2 and expressions of P450 aromatase (P450arom), insulin-receptor substrate-1 (IRS-1), and insulin-receptor substrate-2 (IRS-2) mRNA in polycystic ovary syndrome (PCOS) ovarian granulosa cells.Methods In this study, granulosa cells that were fertilization-embryo transferred from 27 PCOS patients were primary cultured in vitro with different concentrations of pioglitazone (0, 10, 102, 103 and 104nmol/L) (Group A), different concentrations of pioglitazone+FSH (50ng/L, Group B) and different concentrations of pioglitazone+insulin-like growth factor I (IGF-I, 50ng/L, Group C).Estradiol concentrations in the culture supernatant were detected by radioimmunoassay;P450arom, IRS-1 and IRS-2 mRNA expressions on granulosa cells were detected by Real-time PCR.Results The levels of E2 secreted by granulosa cells and the expression of P450arom mRNA on granulosa cells of PCOS for 48 hours were different among Groups A, B and C (P<0.05).With increase in pioglitazone concentration, the level of E2 and the expression of P450arom mRNA declined, some of which correlated negatively with the concentration of pioglitazone.Among these groups, the level of E2 secretion and the expression of P450arom mRNA were higher in Group C than in Group B (P<0.01) and Group A (P<0.01) at the same concentration of pioglitazone.The level of E2 secretion and the expression of P450arom mRNA were higher in Group B than in Group A (P<0.05) at the same concentration of pioglitazone.The expressions of IRS-1 and IRS-2 mRNA on granulosa cells of PCOS under pioglitazone stimulation for 48 hour were different among the groups of different pioglitazone concentrations (P<0.05).With increase inpioglitazone concentration, the expression of IRS-1 mRNA on granulosa cells of PCOS was decreased, but the expression of IRS-2 mRNA on granulosa cells of PCOS was increased.Conclusion Pioglitazone may decrease estrogen production by inhibiting p450 aromatase and adjusting the expressions of IRS-1 and IRS-2 on granulosa cells of PCOS to play a role in ovulation induction and ameliorate insulin resistance in ovary of PCOS.Pioglitazone can inhibit IGF-I and FSH in inducing E2 secretion by ovarian granulosa cells.

75 years old) with calculous acute cholangitis were endoscopically treated from May 1998 to June 2005.The endoscopic nasobiliary drainage(ENBD) was firstly performed.After patient's conditions had relieved,basket stone removal,endoscopic common bile duct exploration,or endoscopic retrograde biliary drainage(ERBD) were carried out respectively according to patient's individualized conditions.Results The ENBD was performed successfully in all the 273 patients.Three patients died before further treatment.Out of the remaining 270 patients,complete removal of common bile duct stones was achieved by single-session of emergent endoscopy in 36 patients,and by secondary duodenoscopy in 178 patients.ERBD was carried out in 31 patients.Common bile duct exploration with the combination use of duodenoscopy,laparoscopy,and choledochoscopy was conducted in 25 patients,including a conversion to open surgery in 1 patient.No serious complications were found in all the patients.Conclusions For senile patients with calculous acute cholangitis,emergent ENBD combined with duodenoscopic stone removal is safe and effective.

[Objective]To evaluate the surgical results and value of posterior lumbar decompression and intervertebral bone fusion with pedicle screw interval fixation in degenerative sympotomatic lumbar scoliosis.[Method]From Jan.1999 to Apr.2006,37 cases with degenerative sympotomatic lumbar scoliosis underwent posterior lumbar decompression and intervertebral bone fusion with pedicle screw interval fixation,including 21 male and 16 female patients,aged 62.6 years old averagely.All the patients were assessed by routine X-ray and Bending X-ray.CT and MRI were performed necessarily.According to patients ' symptom,total or semi-laminectomy,intervertebral bone fusion with pedicle screw interval fixation were performed.[Result]The fellow-up period varied from 1 year to 6 years(averaged,2 years and 7 months),clinical symptoms were effectively relieved after operation in all cases.Neurological functions were evaluated using JOA system,the clinical success rate in all 37 patients was 91.9%.The corrective rate was 54.8%.The average solid arthrodsis time was 11.6 weeks.The height of intervertebral disc and corrective rate had no loss.All patients X-ray of the third month and the first year didn 't show the interplantation 's clinch and breakage.[Conclusion]In the treatment of the elderly patients with degenerative sympotomatic lumbar scoliosis,first of all,the particular principle of surgical operation should be applied,the old age and long course of disease are not absolute contraindication.In addition,The technique of posterior lumbar decompression and intervertebral bone fusion with pedicle screw interval fixation can be safely performed in the elderly patients with degenerative sympotomatic lumbar scoliosis.

Angiogenesis, i.e. neovascularization from preexisting vasculature, is involved in a variety of physiological and pathological processes of the body, including the initiation, maintenance and progression of tumors. The process of angiogenesis depends on the dynamic balance between the activities of proangiogenic and anti-angiogenic factors. Angiogenesis inhibitors specifically prevent endothelial cells from proliferation, migration and tube formation. One of the inhibitors is endostatin, which is of wide spectrum and possesses profound angiogenesis inhibition and therapeutic effects on tumors with rich vasculature. This paper aims to explain the mechanism of the action, structure and biological function of endostatin, and to discuss its application in anti-neoplastic therapies and the issues in the field of interventional radiology. The authors point out emphatically that the application scheme must be designed strictly and scientifically. Only when combination use of endostatin with other therapeutics which can effectively destroy tumor tissues is carried out to gain synergistic and intensified effect, can marked objective efficacy be obtained.

Objective To investigate the expression of suppressor of cytokine signaling-3 (SOCS-3) gene in placenta,its role in the pathogenesis of pre-eclampsia and its effect on proliferation and migration of HTR-8/SVneo cells.Methods Fifteen women with severe pre-eclampsia hospitalized in the First Affiliated Hospital of Nanjing Medical University from October 2010 to March 2011 and t 5 normal pregnant women during the same time period were investigated.Cultured HTR-8/SVneo cells were transfected with SOCS-3 specific small interfering RNA (siRNA) or negative siRNA as the controls.The expression of SOCS-3 mRNA and protein in placenta and these cells was detected by real-time quantitative reverse transcription-polymerase chain reaction and Western blot.Cell proliferation was detected by methyl thiazolyl tetrazolium,cell cycle by flow cytometry and migration by the Transwell test.Two independent t tests were used for statistical analysis.Results The SOCS-3 mRNA and protein levels in the severe pre-eclampsia group were lower than those in the normal group (0.25±0.03 vs 0.71±0.08 and 0.21±0.05 vs 0.75±0.12,t=15.94 and 14.29,respectively,both P＜0.05).SOCS-3 mRNA and protein levels in the transfection group at 24 hours were lower than those in the negative control group (0.39±0.02 vs 1.00±0.04 and 0.003 7±0.001 4 vs 1.514 9±0.035 7,t=27.58 and 73.35,respectively,both P＜0.05).The integral absorbance values of cell proliferation in the transfection group at 48,72 and 96 hours after transfection were 0.23 ± 0.01,0.32±0.02 and 0.37± 0.02,respectively,which were lower than those in the negative control group (0.39± 0.02,0.55 ± 0.04 and 0.86± 0.04,t=2.60,6.64 and 42.44,respectively,all P＜0.05).The cell clonal formation was lower in the transfection group compared with the negative group (116± 15 vs 312±24,t=9.96,P＜0.05).The ratios of G1/G0 and S phase cells in the transfection group were (55.75±2.21) ％ and (31.59±0.83) ％,respectively,and were significantly different from those in the negative control group [(47.88± 1.87) ％ and (37.38± 1.34) ％,t=45.43 and 20.06,respectively,P＜0.05].After 48 hours,cell migration in the transfection group was lower than that in the negative control group (93 ± 11 vs 167± 17,t=21.36,P＜O.05).Conclusion SOCS-3 expression is probably involved in the pathogenesis of pre-eclampsia by being down-regulated and therefore impeding proliferation and migration of the trophoblast.