Objective The objective of this study was to investigate the role of sulindac in sensitization effects of NF-κB on apoptosis induced by TNF-α in human breast cancer.Methods The human breast cancer MCF-7 cell line was added sulindal in the logarithmic growth phase and the final concentrations of sulindac were 0.5 and 1.0 mmol/L.The cells in control group was cultured without adding succinic acid.After sulindac treatment for 48 h,flow cytometry,MTT and Western blotting were used to analyze the effect and mechanism of cell growth in MCF-7 cells.Results The inhibitory rate of cell proliferation was(29.17±1.23)% and(38.15±1.51)% in MCF-7 cells treated with 0.5 and 1.0 mmol/L of Sulindac for 48 h,respectively,when compared to the control group(1.15 ± 0.02)%(P<0.05).Compared with the control group,0.5 and 1.0 mmol/L of sulindac were significantly increased the G0/G1 phase in MCF-7 cells(P<0.05).The apoptosis rate of sulindac in MCF-7 cells was significantly higher than that in the control group(P<0.05).The expression levels of TNF-α were(2.09±0.67)% and(1.18±0.09)% in the concentrations of 0.5 and 1.0mmol/L sulindac,respectively,in MCF-7 cells when compared to the control group(7.42±0.56)%.Conclusion Sulindac has a certain effect on the growth of human breast cancer cells,which can promote the prolongation of cell cycle at the G0/G1 phase and improve sensitization of apoptosis.This mechanism may be related to the inhibition of TNF-α activity.

Objective To study the effects of using jaw tracking technique with Smart LMC algorithm on the absorbing dose of planning target volume (PTV) and organs at risk (OARs) in dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods Field fluencies of 10 cases of NPC patients were optimized using DVO algorithm on Eclipse TPS (11.0),and according to the same optimal fluence,MLC operation files were calculated using jaw tracking technique and jaw fixing technique respectively,dose distribution was calculated with AAA algorithm and jaw tracking IMRT plan (JT-IMRT) and jaw fixing IMRT plan (JF-IMRT) were generated respectively.Collimators' position at the plan implementation was observed,and the total number of plans' monitor units (MU),the dose of PTV,the absorb dose of OARs,and the actual fluence verification pass rate were compared.Results The collimators' opening gap distances in 166 control points of the JT-IMRT reduced in both X and Y directions in the field,compared to that of the JF-IMRT.Total number of the JT-IMRT's MU increased by 3.59％-11.63％.There was no statistical significant difference between the doses of the PTV.Statistical significance was found in the differences between maximum dose (Dmax) of brainstem,spinal cord,crystal,optic nerve,the mean dose (Dmean) and D50％ of parotid and their decreased values after therapy (t=5.70-8.66,P＜0.05).The actual fluence verification pass rate of the JT-IMRT was higher than that of the JF-IMRT.There was a significant difference between the results (t=5.18,P＜0.05).Conclusions The JT-IMRT plan of the smart LMC algorithm is more tolerant to the radiation leakage between inter-and intra-leaf.The dose of OARs is lower,while the dose calculation precision and the verification pass rate are higher,the actual radiation dose is more accurate and reliable.Therefore it is more suitable for clinical applications.

Objective To study the probability safety assessment to analyze and evaluate radiation error risk in the external beam radiotherapy,so as to establish and strengthen the control and management of the radiotherapy process,continuous improvement of quality control and quality management.Methods To build the whole of radiotherapy flow chart and process tree,using the decision tree model to determine critical control points in the whole process,making risk assessment chart and analyzing 4 patients with potential safety hazards error.Results The whole process is divided into 22 missions in 3 functional areas,the entire cover 15 branches and 59 key and 11 key control point.The enumeration of error as risks and critical control points has certain correlation.Conclusions Probabilistic safety assessment method have strengthened manage,analyze and control to risk,and all these provide the basis for developing and improving radiotherapy process control management.Radiotherapy quality management for future multidisciplinary and high-level management personnel who take up provides a prospective study.

Objective To observe the changes of mechanical pain thresholds and autophagy related proteins microtubule-associated protein 1 light chain 3 (LC3) and sequestosome 1 (SQSTM1 also known as p62) expression levels in the C57BL/6 mouse models of chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS),and provide animal experimental evidence for CP/CPPS pain and autophagy study.Methods 36 male C57BL/6 mice were randomly divided into three groups: the model group,control group and na(i)ve group.The CP/CPPS model was established by subcutaneous injection in the lower abdomen region with suspension liquid,containing protein extract of male SD rat prostate gland and complete Freund adjuvant.At 1month and 6 months after modeling,the mice were sacrificed and prostate tissues were harvested for histological examination using HE staining.Mechanical tactile hyperalgesia was measured with von Frey filaments.The autophagy-related proteins LC3 and p62 expression levels were detected by immunohistochemistry,respectively.The average IOD was measured by Image Pro Plus 6.0,and the statistical analysis was performed with GraphPad Prism 5 software.Results The histopathology showed the appearance of chronic prostatitis in the model group,representing hyperplasia and lymphocytic infiltration to a different degree and lasted for 6 months after modeling.Moreover,prostate intraepithelial neoplasia (PIN) appeared in the model group at 6 months after modeling,characterized by the disappearence of basement membrane and obvious nuclear abnormality,while the control and na(i)ve groups showed normal histology during the 1-6 months.Compared with the control and na(i)ve groups,the mechanical pain threshold in the model group was significantly decreased along with the time from (0.353±0.154) g at 0 week to (0.008±0.00) g at 22 weeks (P<0.05).The average IOD of LC3 and p62 expression in the model group was significantly increased with timing from [(2.767±0.464)%,(2.872±1.642)%] at 1month to [(13.501±1.900)%,(9.07±0.49)%] at 6 month,P<0.05.Conclusions A CP/CPPS model is successfully established in C57BL/6 mice.For the model group,the mechanical pain threshold is decreased and autophagy levels are increased gradually with time.These phenomena show that chronic inflammation microenvironment may promote pain and autophagy activity in the prostate,which is closely related with the occurrence and development of prostatic intraepithelial neoplasia.

Objective To study the dosimetry and safety of the non-coplanar IMRT plan for advanced lung cancer.Methods The two groups IMRT plans were designed with coplanar (5,7F) and non-coplanar field (5,7F-n) for patients.To compare the dosimetry of two groups and perform 4 patients F7-n IMRT plan.Results With the increase of the fields in each group PTV's CI were improved (all P =0.000),especially the 7F-n plan PTV's Dmean,Dmax,V95％ and HI also were improved (P=0.001,0.001,0.009,0.000) ; in the coplanar group each lung' s V5 increased (P =0.000,0.002,0.000) and whole lung's Dmean increased (P =0.000),but non-coplanar group whole lung's and contralateral lung's V5 reduce (P =0.001,0.005).Between the groups,7F-n plan PTV's indicators were all improved to compared with 5F plan (all P =0.000),and each lung's V20 reduced (all P =0.000),and whole lung's Dmean,V30,contralateral lung' s V5 reduced (P =0.000,0.001,0.000),and spinal cord' s Dmax also reduced (P =0.033),but ipsilateral lung's V5 and heart's Dmean increased (P =0.000,0.003);with compared to 7F plan,the 7F-n's ipsilateral lung's V5 and heart's Dmean also increased (P =0.000,0.048),but whole lung' s and contralateral lung's V5 decreased (all P =0.000).Four patients were performed successfully non-coplanar IMRT treatment,no collision occurred.Conclusions 7 fields non-coplanar IMRT plan not only improve the dose distribution of PTV,but also effectively control the volume of low dose lung increase,lung V20 and Dmean reduce too.Thus recommended to use this design in patients with advanced lung cancer for radiotherapy

Objective To evaluate the setup errors for lower neck with cone beam CT (CBCT) in breast cancer patients immobilized by breast bracket,and to probe the margins from supraclavicular clinical target volume (CTV) in 3 directions.Methods A total of 14 breast cancer patients with supraclavicular lymph node radiation were enrolled.All patients were immobilized by breast bracket,and each patient would undergo CBCT at the first,tenth and twentieth treatment after positioning,respectively.Then these CBCT images were registered to the planning CT to determine setup errors in translational and rotational direction,and evaluated correlation between them.At last,CTV margins were calculated from the systenatic and random errors.Results The setup errors on x (left-ring),y (superior-inferior),z (anterior-posterior) translational directions were (2.89 ±.2.52),(3.96 ±2.97),(4.21 ±2.24) mm and on θ (pitch degree),φ (roll degree),Ψ (yaw degree) rotational direction were (2.38 ± 1.97)°,(1.60±1.63) °,(1.91 ±1.54)°,respectively.The margins from CTV were 8.08,8.13,6.30mminx,y and z direction.On y and z directions translational errors were correlated significantly with φ and Ψ degree rotational errors(Pearson =-0.515,-0.509,P ＜ 0.05).In inter-fraction only on z direction the setup changes were considered as correlative with Ψ degree (Pearson =-0.583,P ＜ 0.05).Conclusions For supraclavicular region irradiation breast cancer patients immobilized with breast bracket,the margins from CTV were recommended as not less than 8.08,8.13,6.30 mm in x,y,z directions,respectively.The position immobilized method and the positioning workflow should be further improved in order to reduce the influence of the neck rotational on setup errors.

To investigate the effect of dietary fiber on blood glucose and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). One hundred and twelve patients with GDM in the second trimester of pregnancy were recruited from Women's Hospital, Zhejiang University School of Medicine. Patients were randomized into two groups with 56 in each group: the control group received basic nutrition support; while the dietary fiber group were given additional dietary fiber ( total dietary fiber per day) before meals in addition to basic nutrition support. Intervention for all cases lasted for 8 weeks. Fasting blood glucose and postprandial blood glucose (2 h BG) were measured every week, and oral glucose tolerance test (OGTT) was performed at 42 d postpartum to evaluate the glycemic outcomes. Perinatal outcomes were recorded. The dietary fiber intervention markedly improved 2 h BG in patients with GDM and significantly elevated the glucose compliance rate from the 3rd to 8th week compared to the control group ( <0.05 or <0.01). OGTT 2 h glucose and the incidence of impaired glucose tolerance in the dietary fiber group were significantly lower than those in the control group, while the glucose compliance rate was significantly higher than that in the control group (all <0.01). Moreover, the rates of adverse perinatal outcomes, such as premature rupture of membranes and neonatal hyperbilirubinemia were declined in the dietary fiber group (<0.05 or <0.01). Dietary fiber intervention can ameliorate hyperglycemia in GDM patients, improve perinatal outcomes and reduce the incidence of postpartum impaired glucose tolerance.
Blood Glucose ; Diabetes, Gestational ; Dietary Fiber ; Female ; Glucose Tolerance Test ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome

China's healthcare payment reform seeks to combine a medical insurance point-system with a global budget.The focus and difficulty in implementing the payment reform is how to make effectively link.On the basis of theoretical analysis,it selects the regions that have implemented the payment by disease under regional total budget and the payment by disease under institutional total budget,and summarizes the synergistic mechanism of total budget and payment by disease,including the strict control of total budget at the regional level,the reasonable setup of the budget or the standard of expected service volume at the institutional level,and the rate fluctuation and discount mechanism for the settlement of excess service;and further sort out the additional incentive mechanism to support innovation and quality enhancement under the background of the total budget and the payment by disease.Lessons can be drawn from the experiences of typical regions to strengthen the synergy between regional budgets,institutional budgets and payment by type of disease,and cautiously deal with the risks of excessive competition and"punching points"that may arise from the regional point method.

China's healthcare payment reform seeks to combine a medical insurance point-system with a global budget.The focus and difficulty in implementing the payment reform is how to make effectively link.On the basis of theoretical analysis,it selects the regions that have implemented the payment by disease under regional total budget and the payment by disease under institutional total budget,and summarizes the synergistic mechanism of total budget and payment by disease,including the strict control of total budget at the regional level,the reasonable setup of the budget or the standard of expected service volume at the institutional level,and the rate fluctuation and discount mechanism for the settlement of excess service;and further sort out the additional incentive mechanism to support innovation and quality enhancement under the background of the total budget and the payment by disease.Lessons can be drawn from the experiences of typical regions to strengthen the synergy between regional budgets,institutional budgets and payment by type of disease,and cautiously deal with the risks of excessive competition and"punching points"that may arise from the regional point method.

China's healthcare payment reform seeks to combine a medical insurance point-system with a global budget.The focus and difficulty in implementing the payment reform is how to make effectively link.On the basis of theoretical analysis,it selects the regions that have implemented the payment by disease under regional total budget and the payment by disease under institutional total budget,and summarizes the synergistic mechanism of total budget and payment by disease,including the strict control of total budget at the regional level,the reasonable setup of the budget or the standard of expected service volume at the institutional level,and the rate fluctuation and discount mechanism for the settlement of excess service;and further sort out the additional incentive mechanism to support innovation and quality enhancement under the background of the total budget and the payment by disease.Lessons can be drawn from the experiences of typical regions to strengthen the synergy between regional budgets,institutional budgets and payment by type of disease,and cautiously deal with the risks of excessive competition and"punching points"that may arise from the regional point method.