AIM: To explore the frequency of drug injection of alloxan diabetes on the established model of rabbit.METHODS: Thirty-six healthy rabbits, weighing 2-2.5kg, were randomly divided into one time drug injection group (group A, n=12), two times drug injection group (group B, n=12) and three times drug injection group (group C, n=12). Each rabbit was injected with a total amount of 150mg/kg of alloxan. Fasting blood glucose was measured. The success rate and death rate of each group were also calculated.RESULTS: The success rate of diabetic rabbit model in group B was higher than that in group A (P<0.01) and its death rate was lower than that of group A (P<0.01); the success rate of diabetic rabbit model in group C was highest and the death rate was the lowest in three groups(P<0.01). CONCLUSION: Multiple administration of alloxan can improve success rate in establishing diabetic rabbit model with decreased death rate and increased stability.

Objective To investigate the long-term survival of esophageal squamous cell carcinoma (ESCC) patients of different ages after three-dimensional conformal radiotherapy (3 DCRT).Methods From July 2003 to September 2008,769 patients with stage Ⅰ-Ⅲ ESCC were eligible for the analysis.All patients were treated with 3DCRT.The prescribed dose was 50-70 Gy (median,60 Gy),1.8-2.0 Gy per fraction,5 fractions per week.The Kaplan-Meier method was used to calculate overall survival (OS) and local control (LC) rates; the log-rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 98.3％.For all patients,the 1-,3-,and 5-year LC rates were 76.3％,52.8％,and 48.5％,respectively,and the 1-,3-,and 5-year OS rates were 70.1％,36.2％,and 23.0％,respectively.The 1-,3-,and 5-year OS rates were 71.2％,38.8％,and 24.9％,respectively,for patients aged 45-74 years,versus 69.6％,26.6％,and 15.4％ for patients aged 75-89 years (P =0.008).Multivariate prognostic analysis showed that age was also a prognostic factor in ESCC patients after 3DCRT.A total of 620 patients died.Patients aged 45-74 years had a significantly higher proportion of individuals that died of distant metastasis (23.9％ vs.14.2％,P =0.009),while patients aged 75-89 years had a significantly higher proportion of individuals that died of non-cancer diseases (14.1％ vs.4.9％,P=0.000).Conclusions Survival varies between ESCC patients of different ages after 3DCRT.The survival of elderly ESCC patients is poor,and the relatively high mortality from non-cancer diseases may be an important reason for poor survival.

OBJECTIVETo study mechanical affect of knee joint of reasonable positioning of femoral tunnel during knee posterior cruciate ligament (PCL) double-bundle reconstruction and graft fixation after reconstruction by virtual reality interactive technology and evaluate the biomechanical response of knee after reconstruction by finite element analysis.

METHODSKnee specimens from five fresh frozen cadavers were used. Computer simulations and biomechanical experiments were used in this study. Experiments on flexion and extension movements of the knee joint were performed on specimens of fresh human knee joint. Laser three dimensional scanning was used to record and calculate the indexes of movements. Three-dimensional models of knee joint bone structure were then reconstructed on computer with the experimental data. Simulations of flexion and extension movements were carried out on the models to show the spatial positions of femur and tibia and label the attachment sites of PCL. Ten test points in the anterior,posterior, proximal, distal at the femoral attachment area of anterior and lateral bundle (ALB) and postoperior medial bundle (PMB) were selected and the central points of tibial en attachment areat anchored. The distance btween each two points of two article surface was calculated and contacted by software of Geomagic. Model was import software Ansys, adopting the tetrahedron unit a finite element model of complex tibial and femoral was set up to simulat human walking in one leg,on this condition the the joint surface force of model under weight impact load were analyzed.

RESULTSThe three-dimensional models could demonstrate the spatial positions of the bone structure of the knee in different flexions and extensions. The models could be used to measure the spatial distance between 2 points on the femoral and tibial planes by software Geomagic. There was significantly difference among the length changes of anterolateral bundle and posteromedial bundle at every fixed point with different flexion angles (P<0.05), so the fixed angle with different points. The length changes of anterior lateral bundle's A2, A1 and posterior medial bundle's B3, B1 points were (1.35±0.19) mm, (5.41±1.22) mm, (1.95±0.04) mm and (5.23±2.21) mm, respectively. The A2 and B3 points' length changes were the less, and that of the Al and B1 points were the more. It had no significant difference between the length changes of anterior lanteral bundle's A2 and A3 point (P=0.913>0.05). All of the maximal length changes of anterior lateral bundle's A2, A3 and postterior medial bundle's B3 points were less than 2 mm.

CONCLUSIONThe models of knee joint were builded through computer technology and it can be measure the lenth of cruciate ligament with software Geomagic exactly. The femoral tunnel for the PCL double-bundle reconstruction should be located as follows: ALB at the middle point of upper edge of femoral attachment site (proximal point),while PMB at the middle point of femoral attachment site (proximal point). This model provides a satisfactory method for the evaluation of the biomechanical response of knee after cruciate ligament reconstruction.

Adult ; Aged ; Biomechanical Phenomena ; Computer-Aided Design ; Female ; Femur ; surgery ; Humans ; Knee Joint ; physiology ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; methods

ObjectiveTo explore the application of diffusion-weighted magnetic resonance imaging (DWMRI) in precise radiotherapy of esophageal carcinoma.MethodsThirty-seven patients with biopsy proven esophageal cancer from March 2010 to January 2011 were included.To delineate the gross tumor volume (GTV) using CT and DWMRI images,each patient was examined by DWMRI and CT scan using the same position before radiotherapy.To compare the maximum diameters and volumes of tumor between CT and DWMRI. The tumor lengths measured by esophagogram,esophagoscope,CT and DWMRI were compared.ResultsTumor lengths under esophagogram,esophagoscope,CT and DWMRI were 5.70 cm,6.06 cm,7.97 cm and 5.79 cm respectively. The lengths between CT and esophagogram,CT and esophagoscope,CT and DWMRI had statistical significance respectively (F=4.88,P=0.003).The maximum diameters of tumor shown on CT and DWMRI were 3.79 cm and 3.81 cm respectively ( t =-0.32,P=0.751 ).The GTV were 45.75 cm3 and 38.05 cm3 in CT and DWMRI respectively (t=5.30,P =0.001 ).53 lymph nodes were assessed positive on both CT and DWMRI.DWMRI excluded 25 positive lymph nodes assesed by CT; also confirmed 15 negative lymph nodes excluded by CT,6 of which were paraesophageal lymph nodes.The addition of DWMRI information altered the clinical stage in 6 patients.ConclusionsTumor lengths measured on DWMRI and esophagogram had the optimal approximation.It was easy to find paraesophageal lymph nodes via DWMRI.With the addition of DWMRI information,the target range and clinical stage were alerted in some patients.

ObjectiveTo analyze the prognosis of 784 patients according with clinical staging of esophageal carcinoma treated with non-surgical methods,investigate the predictive value and deficiency of the clinical staging.MethodsFrom July 2003 to January 2009,784 patients with esophageal carcinoma received 3DCRT treatment.The prescribed doses ranged from 50 Gy-70 Gy with median dose of 60 Gy,1.8-2.0 Gy/fraction,1 fraction/day,5 fractions/week.65 patients received prescription dose of＜60 Gy and all the others'≥60 Gy.All the patients were divided into subgroups according to different T,N and TNM stages.Therapeutic effect was evaluated.ResultsThe follow up rate was 97.1％,503 patients were followed up for more than 3 years and 122 were followed up for more than 5 years.The 1-,3-,5-year local control rates and overall survival rates were 77.2％,54.2％,46.5％ and 69.5％,34.9％,23.9％,respectively,with median survival time of 21 months.There were significant differences of survival curves for different T stages,N stages and TNM stages.For the groups of stage Ⅰ,Ⅱ and Ⅲ,the 1-,3-,5-year survival rates were 86.4％,47.6％,45.1％ ;84.7％,46.3％,36.4％ and 64.0％,30.9％,19.1％,respectively ( x2 =29.34,P =0.000).There were 752 patients with squamous cell carcinoma ( 95.9％ )and 32 patients with non-squamous cell carcinoma (4.1％ ),the median survival time were 21 and 16 months,respectively ( x2 =4.44,P =0.035 ).There were significant difference of survival rates for the subgroups whose GTV volume ≤20 cm3,20 -40 cm3,40 -60 cm3 and ＞60 cm3 (54 months,29 months,21months and 14months,x2 =68.71,P =0.000).ConclusionsThe clinical staging of esophageal carcinoma treated with non-surgical methods could predict the prognosis accurately,for patients with different pathology and GTV volumes,there were variance in the prognosis,so we advised the complement of the two factors in the draft of clinical stages.

Objective To observe the acute side effects, local control rate and survival rate of concurrent chemoradiotherapy (CC) and radiotherapy alone (R) for patients with esophageal carcinoma.Methods From June 2006 to February 2009, 209 patients with esophageal carcinoma were observed, 105 of them were treated with CC.Of all the patients, 117 received three-dimensional conformal radiotherapy, 92 received intensity modulated radiotherapy, the median prescription dose was 60 Gy.The regimen of LFP (5-FU, cisplatin and calcium folinate) was selected for this study, side effects, local control rate and survival rate were observed and subsets analysis were performed.Results The overall follow-up rate was 99.0%,there were 99 and 44 patients whose follow-up time was more than 2 and 3 years, respectively;for the CC group, the data were 45 and 14, respectively;and for the R group, 54 and 30, respectively.The 1-,2-,3-year local control rates of CC group and R group were 88.1%,69.2%,66.2% and 81.0%,64.0%,54.9%(χ2=2.31,P=0.128), respectively.The 1-,2-,3-year overall survival rates of CC group and R group were 84.4%,52.9%,45.6% and 75.2%,50.7%,37.0%(χ2=1.57,P=0.210),respectively.Subset analysis indicated that for the patients of N0 group and whose length of GTV>7 cm, the local control rate of CC was significantly higher than that of radiotherapy alone (χ2=5.11,7.66;P=0.024, 0.006).For N0 group, the survival rate of CC was higher than that of R alone.(χ2=5.07,P=0.024).The incidence of WBC, PLT and HGB reduction for the two groups were 81.9% and 49.0%(χ2=36.45,P=0.000),14.3% and 1.9%(χ2=10.54,P=0.006),and 24.8% and 2.9%(χ2=22.95,P=0.000),respectively.The incidence of nausea, vomiting and constipation for the two groups were 63.8% and 7.7%(χ2=71.52,P=0.000), respectively.The incidence of ≥2 grade esophagitis of CC group and R group were 48.57% and 38.46%(χ2=2.17,P=0.141), respectively.The incidence of ≥2 grade radiation pneumonitis of CC group and R group were 15.24% and 7.69%(8/104)(χ2=2.93,P=0.087),respectively.ConclusionsCompared to radiotherapy alone, the local control rate and overall survival rate of concurrent chemoradiotherapy were not improved significantly, the patients with N0 may be the conspicuous beneficiary.About side effects, only marrow depression and gastrointestinal tract reaction were significantly different between the two groups,the value of addition of concurrent chemoradiotherapy for esophageal carcinoma needs further investigation.

Objective To evaluate the clinical significance of serum levels of ProGRP, TPS and NSE in diagnosis and therapy monitoring in small cell lung cancer patients. Methods The levels of serum ProGRP, TPS and NSE in 51 SCLC patients (SCLC group), 60 benign pulmonary disease patients (benign disease group ) and 60 healthy people (healthy group ) were determined using chemiluminescent immunoassay, ELISA and electrochemiluminescent immunoassay respectively. Blood samples were collected and detected prior to therapy, before the second course of chemotherapy and the third course of chemotherapy consecutively in all the 51 SCLC patients. Results The serum ProGRP, TPS and NSE concentrations prior to chemotherapy in limited stage SCLC (LSCLC) were 136. 9(22.8-631.7)ng/L, 78. 2(56.4-114.6) U/L and 28.1(20.9-46.1)μg/L, respectively; And in extensive stage SCLC patients (ESCLC) were 1 106.6(41.2-2161.1) ng/L, 230. 9( 143.5-259.0) U/L and 81.1 (34.3-140.0)μg/L, respectively. The serum concentrations of the 3 markers in benign disease group were 19. 7 ( 9. 5-29. 1 )ng/L, 48. 7 ( 17.9-95.4) U/L and 12. 1(1.2-13.9) μg/L; and in healthy group were 20.3(10.7-30.6) ng/L, 50.3(19.5-70.7) U/L and 11.7 (1.1-13.4)μg/L, respectively. The Kruskal-Wallis test showed significantly statistical difference in different groups of the 3 tumor markers, Chi-Square were 51. 368,36. 532 and 81. 645( P ＜0. 01 ). Significant statistically differences showed when the concentrations of the 3 marks of the 2 control group were compared with that of the LSCLC group ( U =491, 827, 609 and 476, 831, 585,respectively, P ＜ 0. 05 ). Differences were also statistically significant when the 2 control group compared with that of the ESCLC group ( U = 314,532,456 and 302,553,430, respectively, P ＜ 0. 01 ). The AUC of ProGRP was 0.832 +0.029(95% CI:0.774-0.890). When cutoff value of ProGRP set as 37.7 ng/L, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and Youden's index were 71% (36/51), 97% (116/120), 90% (36/40), 89% ( 116/131 ) and 67%, respectively; show good detection performance. The sensitivity increased to 92%, 86%, 92% and 88%, when combination detection of ProGRP + TPS + NSE, ProGRP + TPS, ProGRP + NSE and TPS + NSE were used, and the specificities were 77%, 77% , 92% and 77% accordingly. The Fridman test showed significantly statistical difference in the 3 tumor markers at different stages of treatment, x2 were 49. 120, 10. 614 and 44. 392, P ＜0. 01. After the first chemotherapy course, all the tumor marker levels except TPS decreased significantly in comparison with the pretreatment concentrations. However, only ProGRP levels showed a progressive drop during the two consecutive courses of therapy, and the median concentrations were 68.0 ( 18. 6-158.4 ) and 21.0( 14. 9-63.5) ng/L (compared to the level before therapy,Z=-4. 889 and -5. 594, P ＜0. 01 ). The median of serum TPS increased slightly to 105.2 (54. 1-181.2 ) U/L after the first chemotherapy course (Z=-1.248, P＞0.05), and decreased significantly to 79.0(48.7-155.3) U/L after the second chemotherapy course (Z=-2.484, P＜0. 05 ). As to the NSE, the median concentration decreased to 11.8(8.0-16.0)μg/L after the first chemotherapy course ( Z= - 5. 568, P ＜ 0. 01 ). However, the median was 10. 6(9.0-12.7)μg/L, which showed no significant decrease after the second chemotherapy course (Z=-1.851, P＞0.05).Forty-six SCLC patients evaluated as clinical remission ( 3 CR and 43 PR) after the second chemotherapy course, among them there were 38 patients (83%) with normal serum ProGRP, TPS and NSE level ( 19 patients) or with only 1 abnormal tumor level ( 19 patients). There were only 2 patients with all abnormal serum ProGRP, TPS and NSE level, and both patients were evaluated as clinical PD. Two patients with 2 abnormal tumors results were classified as SD, the only 1 patient without therapy evaluation also had 2 abnormal tumor marker results. Conclusions The serum ProGRP, TPS and NSE are valuable tumor markers for diagnosis and treat monitoring of SCLC, particularly the ProGRP + NSE shows the highest clinical value. Combing detection of the 3 tumor markers are valuable for therapy monitoring and prognosis in SCLC patients.

Objective To investigate the radiation-induced esophageal toxicities in Ⅲ stage non-small cell lung cancer (NSCLC) treated by three-dimensional conformal radiotherapy (3DCRT) combined with concurrent chemotherapy, and to find the relevant predictive factors. Methods From September 2006 to October 2007, 37 patients with stage Ⅲ NSCLC were treated by 3 DCRT (60 Gy in 30-34 fractions) con-currently with navelbine and cisplatin (NP). Chemotherapy was given in the first and fifth week. Univariate and multivariate analyses and receiver operating characteristic curves (ROC) were used to assess the associ-ation of radiation-induced esophagitis and correlated factors. Results Of all the patients, 91.89% (34/37) developed radiation-induced esophagitis, including grade 1 in 11 patients, grade 2 in 9, grade 3 in 14 and grade 4 in none. According to Spearman correlative analysis, the correlative factors included mean esophagus dose (MED), the LETT_(40)、LETT_(45)、LETT_(50)、LETT_(55)、LETT_60)of esophagus.All the 11 factors had good correlation with esophagitis in univariate analysis, while only V_55 was independ-ently associated with esophagitis in multivariate analysis. The ROC analysis indicated that the cut-off point of the curve was 30% with the area under ROC curve of 0.906, (P=0.000). Grade 2 or 3 radiation esophagi-tis occurred in all the patients with esophageal V_55 > 30%, while only in 36% ( 8/22 ) of those with V_55<30%. Conclusions 3DCRT combined with concurrent chemotherapy in patients with stage Ⅲ NSCLC could develop severe esophagitis. Dosimetric parameters (MED, LETT_(40),LETT_(45),LETT_(50),LETT_(55),LETT_(60),V_(40),V_(45),V_50,V_55,V_(60))are related with esophagitis,V_55 with V_55 > 30% being the most valuable predictor.

ant metastases. For patients with nearby tissue and organ invasion, the risk of perforation, bleeding or metastasis after radiotherapy is significantly higher than those with early T-stage disease.

Air Pollutants, Occupational ; analysis ; Coke ; Fatty Liver ; epidemiology ; Humans ; Logistic Models ; Male ; Occupational Exposure ; adverse effects ; Risk Factors