Objective To survey the CT radiation dose to cancer patients,and to compare it with diagnostic reference level (DRL) provided by newly issued national standard.Methods Computed tomography dose index weighted (CTDIw) of 5 CT equipments was measured by the standard phantom with typical scanning protocol and radiation dose parameters including average computed tomography dose index volume (CTDIvol),dose length product (DLP),75％ DLP with 900 adult and 300 pediatric cancer patients were collected.According to age stage,effective dose was estimated.Results The measured CTDIw for head scanning was on the same level with DRL,while lumbar vertebra and abdominal scanning were lower than DRL.To adults,DLP of cerebrovascular enhanced scanning and effective dose of abdominal enhanced scanning were the highest.To pediatric patients,there was no significant difference in DLP among different ages.Conclusion CTDI only reflects the dose contribution from a slice,but do not reflect the cumulative dose.For the patients need multiphase scanning,because they may be exposed to high dose,national standard should provide DLP value as the diagnostic reference level.Using individual scanning protocol is an effective method to reduce radiation dose of pediatric patient.

OBJECTIVE: To investigate the clinical features of chronic tracheoesophageal fistula (TEF), provided disease-related treatment experience and lessons for clinicians. METHOD: To successfully repair one case of chronic tracheoesophageal fistula with surgery, and to analyze the clinical treatment process, combined with relevant literature, the author reported the experiene of diagnosis and treatment in TEF. RESULT: After the gastrointestinal ostomy and Stent implantation, the fistula persisted, nine months later ,we took the surgery to repair the fistule, ten days postoperation, the fistule healed and esophageal iodine water examination didn't prompt obvious abnormalities, the patient was discharged without any postoperative complications 12 days postoperation. CONCLUSION If conservative treatment failed with TEF, the surgical repair should be carried timely, By double sutured with fistula in surgery, and reinforced with the approaching muscle tissue, It can achieve good results.
Humans ; Postoperative Complications ; Postoperative Period ; Tracheoesophageal Fistula ; pathology ; surgery ; Wound Healing

Objective To investigate the pathological manifestations of acute?stage radioactive myocardial damage and related mechanisms using an experimental animal model. Methods A total of 12 adult male Sprague?Dawley rats were randomly divided into control group and radiation group. In the radiation group, the model of radiation?induced myocardial damage was established by the irradiation of the anterior myocardial territory with 6?MV X?ray at a single dose of 20 Gy, and at 14 days after irradiation, HE staining was used to observe the morphological changes of cardiomyocytes and intercellular matrix, and Masson staining was used to observe the distribution of collagen fibers. The collagen volume fraction ( CVF) was used for semi?quantitative analysis. ELISA was used to measure the activity of total superoxide dismutase ( T?SOD) and the concentration of malondialdehyde ( MDA ) , and Western blot was used to measure the expression of the fibrosis marker protein collagen type I ( COL?1 ) and the endoplasmic reticulum stress?related proteins GRP78 and CHOP. The t?test, t ’?test, or nonparametric rank sum test was used for comparison between groups. Results At 14 days after local irradiation of the heart, the radiation group had disordered arrangement of cardiomyocytes, marked edema, rupture of some cardiomyocytes, mild karyopyknosis in cardiomyocytes, and infiltration of inflammatory cells in the myocardial interstitium, compared with the control group. Collagen fibers in the myocardial tissue were mainly distributed in the perivascular area and cardiomyocyte interstitium. The radiation group had a significantly higher CVF than the control group ( 11?35% vs. 5?23%, P=0?000 ) and a significant increase in the expression of COL?1 compared with the control group ( P=0?000) . The radiation group had significant increases in the activity of T?SOD and the concentration of MDA in the myocardial tissue compared with the control group ( T?SOD:156?61 U/mgprot vs. 137?06 U/mgprot, P= 0?042;MDA:2?36 nmol/mgprot vs. 1?31 U/mgprot, P=0?007) . Compared with the control group, the radiation group showed significant increases in the expression of endoplasmic reticulum stress?related proteins GRP 7 8 and CHOP ( P= 0?037 and 0?009 ) . Conclusions The pathological manifestations of acute?stage myocardial damage include degeneration of cardiomyocytes, inflammatory exudation in the interstitium, and deposition of collagen in the perivascular area and myocardial interstitium. Myocardial fibrosis can be observed in the acute stage of radiation?induced myocardial damage, and the mechanism may be related to oxidative stress and endoplasmic reticulum stress induced by radioactive rays.

Objective To evaluate the tolerance and safety of sorafenib for elderly patients with advanced renal cell carcinoma.Methods Forty cases with advanced renal cell carcinoma were enrolled,26 were males and 14 were females,the average age was 70 years.Recurrence or metastasis was found in 32 patients who had received nephrectomy,22 of the 32 cases had received cytokine therapy before recurrence or metastasis.Primary renal lesions of 8 cases could not be resected,so patients get renal tumor biopsy.Pathological type of all patients was clear cell carcinoma.KPS of all the patients were ≥70 points.Sorafenib was used as first-line treatment,with 400 mg twice per day,until intolerance or disease progression occurred.Results The average treatment time was 7.5 months (3-18 months),CR 0 case,PR 6 cases,SD 29 cases,PD 5 cases.The overall objective response rate and disease control rate were 15.0% (6/40)and 87.5%(35/40),respectively.The median follow-up period was 11 months.The adverse reaction included hand-foot skin reaction(70.0%),alopecia (62.5%),rash(52.5%),diarrhea(37.5%),loss of appetite(32.5%),fatigue(27.5%).Most adverse reactions occurred around the second week after drug therapy initiation,their duration did not equal.And most of these adverse reactions could be released by symptomatic treatment,they did not affect the treatment.Conclusions The types of adverse reactions of sorafenib for elderly patients with advanced renal cell carcinoma are similar to those reported in the literature.Generally the degree of adverse reactions is minor,with good tolerance and safety.

Objective To investigate the effects of pulsed electromagnetic fields(PEMFs)on proliferation and differentiation of endothelial progenitor cells(EPCs).Methods EPCs were isolated from rat bone marrow by density gradient centrifugation.EPCs were exposed to PEMFs from the 5th day to the end of culture.MTT was used to measure the proliferation of EPCs.The expression ofⅧ-related antigen and NOS_3 was evaluated by flow cytometry. Results Compared with the control,the proliferating ability of EPCs exposed to PEMFs was stronger;the number ofⅧ-related antigen and NOS_3 positive cells increased significantly in EPCs exposed in PEMFs.Conclusion PEMFs promotes the proliferation and differentiation of rat bone marrow EPCs.

17 strains of bacterium that produced a large amount of ?-PGA when it was grown aerobically in a culture medium containing ammonium salt and sugar as sources of nitrogen and carbon respectively,were isolated from bean products.With the following identifications of colony morphology,physiological and biochemistry experiments,and genetics,the strain PGA-O-7 was classified as a Bacillus subtilis.The PGA production 2.8 (mg/mL) was obtained when it was grown in a medium containing 3% ammonium sulfate and 4% glucose at 30℃ for 72h with sharking.

Arginine Deiminase(ADI) was purified to homogeneity using ammonium sulfate precipitation,Q-Sepharose Fast Flow anion exchange chromatography and SephadexG-75 gel filtration chromatography. This purification protocol resulted in a 34.5-fold purification of ADI with 31.4% final yield. A molecular weight of about 190 kD determined by native gradient polyacrylamide gel electrophoresis. The enzyme has only one kind of 46 kD subunit determined by SDS-PAGE. Combining the results from the two kinds of electrophoresis,the authors deduce that the enzyme may be a tetramer. The optimum pH and temperature for lipolytic activity of ADI was pH 6.5 and 50℃,respectively. It was extremely stable at 45℃ and retained 97.9% of its original activity for 30 min. The stability declined rapidly as soon as the temperature rose over 50℃. ADI was highly stable in the pH range from pH 5-8. ADI acted on L-arginine but not on D-arginine. ADI catabolism was dependent on metal ions. At their adequate concentration,Mn2+,Mg2+ and Co2+ were the effective promoter,while superfluous Zn2+and Co2+ inhibited ADI activity. L-citrulline did not act on ADI,but L-ornithine inhibited ADI activity. The degradation of L-arginine with ADI catalysis was according to simple Michaelis-Menten equation. The Michaelis constant was 3.2686 mmol/L and the maxi-mum velocity was 2.44 ?mol/min.

Human tissue kallikrein-binding protein (Kallistatin, KAL), a secretory protein that participates in the regulation of multiple signaling pathways by binding to the extracellular receptor, however, at present has not been reported about the intracellular activity, and whether it has the similar biological activity with extracellular activity. Here we constructed no signal peptide KAL (NSK) into the adeno-associated virus vector to explore the intracellular activity of KAL. Both the endothelial cell and lung cancer cells could express KAL, but not secreted after rAAV2-NSK transfection. The proliferation and migration of human umbilical vein endothelial cells (HUVECs) were inhibited, but the apoptosis rate was not affected. The proliferation rates, mobility and tubule formation of all the three tested lung cancer cells, such as NCI-H446, NCI-H460 and A549, were inhibited to different extents. This cellular study not only confirmed the intracellular activity, but also suggested it may serve as a kind of "balance factor" in multi-targeted controlling, which may provide a new train of thoughts to explain the regulatory contradiction in PI3K-Akt signaling pathways by KAL.
Apoptosis ; Cell Proliferation ; Dependovirus ; Genetic Vectors ; Human Umbilical Vein Endothelial Cells ; metabolism ; Humans ; Lung Neoplasms ; metabolism ; Serpins ; metabolism ; Signal Transduction ; Transfection

Objective To evaluate the effect of TGF-β1 and IL-1β expression in serum on acute radiation-induced heart disease (RIHD) in patients with thoracic tumors.Methods Three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiotherapy (IMRT) was delivered at 1.8-2.0 Gy,5 times per week to a total dose of 50-66 Gy to 44 patients with lung cancer and 10 patients with esophagus cancer.The target and organs at risk dose distribution were analyzed by 3-dimensiond treatment planning system.The expressions of TGF-β1 and IL-1β in serum were detected by enzyme linked immunosorbent assay before and at the end of the irradiation.The cardiac injury was evaluated by detecting the cmyocardium creatase,cardiac troponin I (cTnI),electrocardiogram and cardiac function before and at the end of the irradiation within 90 d.The acute RIHD was evaluated by the Common Terminology Criteria V 3.0 (NCI-CTCAE 3.0).The expressions of TGF-β1 and IL-1β in the serum of RIHD patients with thoracic tumors were analyzed.Results The expression of TGF-β1 in serum was (888.4 ± 41.1) μg/L before the irradiation and approached to (926.1 ± 23.1) μg/L at the end of the radiotherapy.The expression level of TGF-β1 in the serum of acute RIDH group was (900.6 ± 34.5) μg/L,higher than that of normal group [(865.7 ±47.0) μg/L,t =-2.646,P ＜0.05)].The acute RIDH was correlated with the expression level of TGF-β1 before irradiation and the difference before and at the end of irradiation (r =0.378,0.311,P ＜0.05).The IL-1β expression had no significant difference before and after irradiation.The expression of TGF-β1 in serum before and at the end of irradiation had positive correlation with the expression of IL-1β at the end of the irradiation (r =0.416,0.389,P ＜ 0.05).Conclusions The expression of TGF-β1 in the serum of patients with thoracic tumor increases after irradiation and correlated with the acute RIHD,but the expression of IL-1β in serum has no relationship with RIHD.TGF-β1 could induce the expression of IL-1β at the end of the irradiation.

Objective To investigate the role of a subunit of N-methyl-D-aspartate (NMDAR), a receptor-channel complex, in the neurotoxicity secondary to brain injury and explore its mechanism of action. Methods The animal model of brain injury was established in rats by free-fall metal and the treatment model was induced by injecting AP5 into the lateral ventricle. NMDAR1 mRNA expression levels after brain injury were determined by in situ hybridization. Result NMDAR1 mRNA expression increased significantly at 15 min, utmostly lowered at 72 h and returned to the normal level at 168 h after brain injury. In response to AP5 treatment, NMDAR1 mRNA expression in the treatment group was lower than that in the injured group at 15 min and recovered the normal level at 72 h after brain injury. Conclusion Excessive expression of NMDAR1 mRNA might be involved in the secondary cerebral impairerment after brain injury and the treatment with AP5, a competitive antagonist of NMDAR1, functions to offer neuroprotection.