Unlike conventional radiation therapy, stereotactic radiation therapy (SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs (spinal cord, optic nerve, bowels, etc.). Nowadays, the clinical efficacy of SRT has been widely confirmed in certain patients, especially for those medically inoperable, unwilling to undergo surgery, medicine ineffective with tumor progression. Moreover, SRT could be properly used as palliative treatment aiming at relieving local symptoms and pain, and eventually achieving a potential survival benefit of several months. However, the weaknesses of SRT relate to inevitable radiation-induced toxicities as well as the inaccessibility of prophylactic irradiation. In general, one flaw cannot obscure the splendor of the jade. The emergence and development of SRT has opened the new era of precision radiation therapy, and SRT will probably step gloriously onto the remarkable stage for precision medicine.
Humans ; Neoplasms ; radiotherapy ; Precision Medicine ; Radiosurgery

Objective To study the efficacy and safety of reboxetine and citalopram in treating retardant depression.Methods A total of 59 patients with retardant depression were randomly divided into reboxetine group(n=29)and citalopram group(n=30)for the treatment of 6 weeks.The patients were assessed with the Hamilton depression scale(HAMD)and treatment emergent symptom scale(TESS).Results At the end of 6 weeks,the total scores of HAMD in reboxetine(18.48±6.38)group and citalopram(11.60±4.46)group both significantly decreased(P＜0.001).Between two groups,the efficacy(82.8% and 56.7%)had significant differences(P＜0.05)but side effects had no statistical significance.Conclusion Reboxetine has significant curative efficacy,milder adverse effects and higher safety for treating patients with retardant depression.

Based on the realistic circumstances at home and successful experiences from abroad,this paper holds the idea to introduce medical liability insurance into medical market to relieve the currently tense physician-patient conflict and analyzes the role and function of medical liability insurance.Meanwhile,some problems and countermeasures are also explained in the functioning process of medical liability insurance.

Objective The clinical and endoscopic characteristics of ischemic colitis (IC) were retrospectively reviewed. Methods 23 aged patients with IC were included; their symptoms,signs,laboratory findings and endoscopic appearances analysed. Results IC occurred most frequently in mid-aged and elders with predominant presentations as acute onset of lower abdominal pains and bloody stools.Endoscopic lesions located mainly in left colon with segmental distribution.Mucosal edema,erosion and submucosal bleeding were common pathological features.Most lesions (91％ ) looked to be nongangrenous, transient and reversible.Only 9 percent of cases turned into chronic stage. Conclusion IC should be suspected in all eldly patients with acute onset of lower abdominal pain and bloody stools.Early colonoscopy is of diagnostic significance.

Objective To evaluate the clinical application of transendoscopic Doppler ultrasonogra-phy in various gastrointestinal diseases. Methods Transendoscopic Doppler ultrasonography was performed in 59 patients with various gastrointestinal diseases. Results The Doppler signals were detected beneath the peptic ulcer base in 29 of 39 patients (74. 4% ) . For acute ulcer bleeding and non - bleeding, the Doppler - positive rates were 87. 5% and 65. 2% , respectively, and the measured depth of vessels were 0. 49 mm and 0. 65mm (P

OBJECTIVETo observe the effect of Zhenqing Recipe (ZQR) on non-alcoholic fatty liver (NAFL), and the expression of hepatic salt-inducible kinase 1 (SIK1) and sterol-regulatory element binding protein-ic (SREBP-lc) in type 2 diabetes rats.

METHODSA rat model of type 2 diabetes was established by high fat/sucrose diet combined with intraperitoneal injection of small dose streptozotocin (STZ) . Modeled rats were randomly divided into the model group, the ZQR group, and the metformin group, 8 in each group. Eight rats were recruited as a normal control group. ZQR at the daily dose of 12 g crude drugs/kg was administered to rats in the ZQR group by gastrogavage. Metformin suspension at the daily dose of 150 mg/kg was administered to rats in the metformin group by gastrogavage. Equal volume of distilled water was administered to rats in the normal control group and the model group. All medication lasted for 12 weeks. The levels of fasting blood glucose (FBG), free fatty acid (FFA), serum triglyceride (TG), serum total cholesterol (TC), serum alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were detected. The body weight and wet liver weight were weighed, and the liver weight index calculated. The liver TG content was measured. The pathological changes of liver and the expression of SIK1 were observed by HE staining and immunohistochemistry. The mRNA and protein expression of SIK1 and SREBP-1c were detected using RT-PCR and Western blot.

RESULTSCompared with the normal control group, FBG, FFA, TG, TC, ALT, AST, liver weight index, and liver TG contents significantly increased (P < 0.01); liver steatosis was severe, the mRNA and protein expression of SIK1 obviously decreased (P < 0.01); mRNA and protein expression of SREBP-1c increased (P < 0.01). After drug therapy, compared with the model group, FBG, FFA, TG, TC, ALT, AST, and liver weight index significantly decreased, liver TG contents significantly decreased, the mRNA and protein expression of SIK1 obviously increased, while mRNA and protein expression of SREBP-1c obviously decreased (P < 0.05, P < 0.01) in the ZQR group and the metformin group (P < 0.05, P < 0.01); and the pathological changes were also improved. All the indices were improved more in the ZQR group (all P < 0.05).

CONCLUSIONIn this experiment, we found that the expression of SIK1 decreased in NAFL rats with type 2 diabetes. ZQR could alleviate lesion of NAFL type 2 diabetes rats possibly by up-regulating hepatic SIK1 expression at mRNA and protein levels.

Animals ; Diabetes Mellitus, Type 2 ; complications ; drug therapy ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; complications ; drug therapy ; metabolism ; Liver ; metabolism ; Male ; Protein-Serine-Threonine Kinases ; metabolism ; Rats ; Rats, Wistar ; Sterol Regulatory Element Binding Protein 1 ; metabolism

Objective To evaluate the effects of dexmedetomidine on the expression of Toll-like receptor 2 (TLR2) and TLR4 in monocytes of blood during the perioperative period in the patients undergoing pulmonary lobectomy.Methods Fifty patients of both sexes, aged 40-64 yr, with body mass index of 20-24 kg/m2 , of ASA physical status Ⅰ or Ⅱ , scheduled for elective pulmonary lobectomy under general anesthesia, were randomized into 2 groups (n =25 each) using a random number table: control group (group C) and dexmedetomidine group (group D).In group D, dexmedetomidine was infused intravenously at dose of 1.0 μg/kg over 10 min before induction of anesthesia, followed by continuous infusion at a rate of 0.3 μg · kg-1 · h-1 until 30 min before the end of operation, while the equal volume of normal saline was given in group C.After admission to the operating room, at 1.5 h after beginning of operation, at the end of operation, and at 12 and 24 h after operation, blood samples were taken for blood gas analysis, and for determination of the expression of TLR2 and TLR4 in monocytes.Oxygenation index was calculated.The consumption of propofol and remifentanil and pulmonary complications within 48 h after operation were recorded.Results Compared with group C, the expression of TLR2 and TLR4 in monocytes of venous blood was significantly down-regulated, oxygenation index was increased, and the incidence of pulmonary complications after operation was decreased in group D (P＜0.05).Conclusion The mechanism by which dexmedetomidine attenuates acute lung injury is associated with down-regulation of TLR2 and TLR4 expression in monocytes of blood in the patients undergoing pulmonary lobectomy.

Objective To construct the eukaryotic expression vector of pprI gene from Deinococcus radiodurans R1 and investigate its radioresistant effects in eukaryotic cells.Methods A recombinant vector pEGFP-c1-pprI was constructed by DNA recombinant technique.The empty vector pEGFP-c1 and the pEGFP-c1-pprI were transferred into human lung epithelial cells Beas-2B by LipofectamineTM 2000,respectively.Then the infected cells were screened in order to develop a cell line with stable expression of pprI gene.Cell survival rate was tested by clone-forming assay.Cell cycle distribution and apoptosis were detected by a flow cytometry.The fluorescence intensity of reactive oxygen species (ROS) was observed by a fluorescent microscope.γ-H2AX foci in the irradiated cell was detected by immunofluorescence.Results The eukaryotic expression plasmid of pprI prokaryotic gene was constructed and PprI fusion protein was expressed in human lung epithelial cells successfully,and the cell line (2BG) with a stable pprI gene expression was established.After irradiation,the cell survival fraction of 2BG cells was significantly higher than Beas-2B cells so that the value of D0 、Dq and N of the survival curve were increased.Moreover,the fluorescence intensity of ROS and the number of γ-H2AX foci in 2BG cells were also lower than those of B eas-2B cells(F =16.73,19.47,6.94,P ＜ 0.05).Between these two cell lines,the apoptosis rate and cell cycle G2 arrest also had significant difference (F =139.73,237.92,P ＜ 0.05).Conclusions The pprI gene from Deinococcus radiodurans RI can be stably expressed in the eukaryotic cells and it allows the transferred cells to have a radioresistant function.

Objective To approach the design and clinical application of large anterolateral thigh flap and its effect in wound repair.Methods The flaps were designed according to the anatomical features of perforating branches in the anterolateral thigh flaps.When a flap was chipped,a thick branch or a terminal branch of original vessel was reserved,another suitable perforating branch was selected in the proximal or distal end of the flap,and then the two vessels were anastomosed to enlarge the range of blood supply.If the vessel pedicle of a flap was a musculocutaneous perforating branch,the perforating branch of anastomosis was cut at out-point of muscle.If the vessel pedicle of a flap was a intermusclar branch or a direct skin artery,the perforating branch of anastomosis was cut widely.From May 2006 to May 2012,the technique was applied in 28 patients with large skin defect of limbs.The diameters of perforating branches obtained at out-point of muscles were measured during surgery.The survival of flaps was observed after surgery and complications in donor sites were checked during follow-ups.Results There were 18 flaps whose vessel pedicle were musculocutaneous perforating branches.The branches were cut at outpoint of muscles.The diameters of these vessels were measured during surgery.They ranged from 1.3 mm to 1.8 mm with an average of 1.45 mm.All of the vessels could be anastomosed.All 28 flaps survived.All flaps survived.The areas of the flaps ranged from 22 cm × 15 cm to 42 cm × 14 cm.Artery crisis happened in 2 flaps whose vessel pedicle were musculocutaneous perforating branches.The second look operation found that the areas of artery anastomosis of perforating branches and vessel pedicles were compressed by hematoma and thrombus formed.The 2 flaps survived after the hematoma was cleared away and the vessels were reanastomosed.There were no infections.Both the donor and recipient site healed by first intention with no necrosis of flap margin.All 28 patients were followed up by 4-13 months with an average of 8 months.There were no apparent collapse deformities,muscle necrosis,declines of muscle strength and muscle hernia in the donor sites.The appearance of flaps was flat,the color was close to normal and the quality was fine.Conclusion It is a safe and effective method to repair wound surface by large anaterolateral thigh flap obtained by the modus operandi of perforating branch anastomosis.

The nucleocapsid protein VP15 of white spot syndrome virus (WSSV) is a basic DNA-binding protein. Three canonical bipartite nuclear localization signals (NLSs), called NLS1 (aa 11-27), NLS2 (aa 33-49) and NLS3 (44-60), have been detected in this protein, using the ScanProsite computer program. To determine the nuclear localization sequence of VP15, the full-length open reading frame, or the sequence of one of the three NLSs, was fused to the green fluorescent protein (GFP) gene, and transiently expressed in insect Sf9 cells. Transfection with full-length VP15 resulted in GFP fluorescence being distributed exclusively in the nucleus. NLS 1 alone could also direct GFP to the nucleus, but less efficiently. Neither of the other two NLSs (NLS2 and 3) was functional when expressed alone, but exhibited similar activity to NLS1 when they were expressed as a fusion peptide. Furthermore, a mutated VP15, in which the two basic amino acids (11RR12) of NLSI were changed to two alanines (11AA12), caused GFP to be localized only in the cytoplasm of Sf9 cells. These results demonstrated that VP15, as a nuclear localization protein, needs cooperation between its three NLSs, and that the two residues (11RR12) of NLS1 play a key role in transporting the protein to the nucleus.