Objective To evaluate the application of three dimensional conformal radiotherapy (3D-CRT) for non-small cell lung carcinoma (NSCLC) based on CT simulation in different respiratory phases in patients gaed≥70 years. Methods A total of 51 patients gaed≥70 years (range 70-88 years, mean age 73.5 years) with NSCLC were treated by 3D-CRT alone, using CT images of different respiratory phases. The case numbers at Ⅰb, Ⅱb, Ⅲa, Ⅲb and Ⅳstage were 3, 7, 19, 17 and 5, respectively. Both gross tumor volumes (GTV) at the end of inspiration and expiration were fused to a total GTV which was close to motorial range of tumor in respiration, and the expansion of clinical target volume/ planning target volume (CTV/PTV) need not include respiratory motion moreover. Compared with plans of classic 3D-CRT, the efficacy, prognostic factors and side effect of this treatment were evaluated. Results Compared with the traditional expansion of CTV/PTV, the volumes of PTV in this scheme were averagely 19.3% lower (median, 17.5%),and the volumes of lung that received equal dose to tumor were averagely 21.8% lower (median, 19.9%). The 1-, 2-and 3-years total survival rates were 70. 6%, 54.9% and 29.4% with a overall tumor response rate of 78.4%. KPS scores and node stages were independent prognostic factors, age was not. Conclusions CT simulations in different respiratory phases can effectively reduce PTV and improve the life quality without affecting the therapeutic effect in senile patients with NSCLC, and can be well tolerated.

BACKGROUND: The repair and functional reconstruction of peripheral traumatic nerves depend, on posttraumatic operation time and operative techniques which have certain referential value.OBJECTIVE: To explore the effects of related factors on the repair and functional reconstruction of common peroneal nerve (CPN) after injuries.DESIGN: A case analysis.SETTING: Department of Orthopaedics, Fourth Hospital Affiliated to China Medical University.PARTICIPANTS: Eighteen patients diagnosed with simple CPN injury received treatment in the Department of Orthopedic Surgery of the Fourth Affiliated Hospital, Chinese Medical University, between January 1991 and January 2001. There were 15 males and 3 females aged 12-61 years old with the mean age of 26.5 years; there were 9 cases of complete transection, 3 cases of incomplete transection, 1 case of compression, 4 cases of contusion, and 1 case of irreversible injury. Posttraumatic treatment at hospital was obtained 0.5 hour to 6 months after injury.METHODS: All patients were subjected to CPN explorative operation;neuroanastomosis was performed on 12 cases, neurolysis on 2 cases, tendon graft on 1 case and conservative treatment on 3 cases. Antibiotics were administered after operation together with blood activating medicine and neurotrophic medicine. Moreover, the patients were required to do passive functional exercise in order to avoid arkylosis and myoatrophy.MAIN OUTCOME MEASURES: Functional recovery of CPN was assessed at postoperative 6 months based on the myodynamia of the same side anterior tibia muscles (excellent: above grade 4; good: grade 3; passable: grade 2; poor: grade 1 or grade 0).RESULTS: All the 18 patients entered the results analysis; their outcomes were assessed as excellent in 10 cases, good in 6 cases, and passable in 2cases, with the excellent rate being 89% (16/18).CONCLUSION: Patients diagnosed with CPN injury should be treated with primary repair of traumatic nerves as early as possible, which will benefit the functional recovery of limbs.

For understanding the effect of MDG-1, a water-soluble β-D-fructan polysaccharide from Ophiopogon japonicas, on intestinal microecological balance, especially on the changes of lactobacillus, sixty 8-week-old male C57BL/6J mice were given a high-fat diet for six weeks and were also gavaged with saline once a day simultaneously. Then the mice which is below 30 grams or dropped more than 10% through lavage were eliminated and the rest were randomly divided into four groups: diet-induced obese (DIO) model group (n = 12, gavaged with saline), low-dose MDG-1 group (n = 12, gavaged with MDG-1, 75 mg · kg(-1)) , medial-dose MDG- 1 group (n = 12, gavaged with 150 mg · kg(-1)), and high-dose MDG-1 group (n = 12, gavaged with 300 mg · kg(-1)) according to the weight and blood glucose; the model group and MDG-1 group were placed on a high-fat diet while the normal control group (n = 12, gavaged with saline) were kept on a low-fat diet through the experiment. After 12-weeks of treatment, feces samples were collected and cultured for intestinal microecological balance analysis. Then the intestinal probiotics were cultured through traditional methods combined with modified gradient gel electrophoresis (DGGE) method. The changes of lactobacillus in each treatment group were also detected by a statistical analysis of the total number of the intestinal flora. We have established the phylogenetic tree by 16S rDNA sequencing and use some molecular identification methods such as PCR-DGGE to analyse the changes of the dominant bacteria floras, and also get the pure culture. In conclusion, different concentrations of MDG-1 can increase the number of the intestinal probiotics, especially Taiwan lactobacillus and Lactobacillus murinus, and improve their diversity and promote proliferation in a dose-dependent way.
Animals ; Biodiversity ; Diet, High-Fat ; adverse effects ; Dietary Carbohydrates ; administration & dosage ; analysis ; Humans ; Intestines ; drug effects ; metabolism ; microbiology ; Lactobacillus ; classification ; drug effects ; genetics ; growth & development ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Obese ; Molecular Structure ; Obesity ; drug therapy ; metabolism ; microbiology ; Ophiopogon ; chemistry ; Phylogeny ; Plant Extracts ; administration & dosage ; chemistry ; Polysaccharides ; administration & dosage ; chemistry

To compare the measurements of axial length by A-scan ultrasound and IOLMaster.For a total of 138 eyes,axial length was measured with IOLMaster followed by contact A-scan ultrasound.Though a great correlation existed between two measurements,the axial length was a little longer with IOLMaster than with A-scan ultrasound.And the difference was statistically significant (P ＜ 0.01).The mean difference of two methods was (-0.198 ± 0.146) mm.With the elongation of axial length,the difference of two methods also increased.For cataract patients with axial length ＞ 28 mm,the control range of crror from IOLMaster for axial length was much lower than that from A-scan.Thus IOLMaster is a simple,fast,reliable and non-contact measurement method of axial length.

Objective To explore the reason for remedy radical operation after endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinical data of 26 early gastric cancer cases who received remedy radical gastrectomy after ESD between January 2012 to March 2015 in Nanjing Drum Tower Hospital were analyzed retrospectively.Results All cases were followed up and mid follow-up was 25 months.There was no death nor tumor reccurence cases during the follow-up.Three cases suffered from complications in radical surgery for gastric cancer including afferent jejunal loop obstruction,adhesive intestinal obstruction,stomach paralysis respectively,all were cured by conservative therapy.Postoperative pathology found lymph node metastasis in 3 cases.Conclusions En bloc resection and negative resection margin,as well as free lymphatic metastasis are two important factors determing the survival of early gastric cancer patients undergoing ESD treatment.

Objective To investigate the value of functional MRI in the diagnosis and differential diagnosis of breast diseases.Methods Sixty-five patients with 68 lesions were enrolled in this study. Conventional T_1 WI and T_2 WI scan,dynamic contrast enhanced MRI,diffusion weighted imaging and ~1H single voxel MR spectroscopy were performed consequently.All lesions were verified by pathology,including 4 cases of breast adenosis,22 fibroadenomas,2 chronic inflammations,3 cysts,33 infitrating ductal carcinomas,1 intraductal carcinoma and 3 cystosarcoma phyllodes tumors.Morphological features,maximum enhancement ratio,time-intensity curve,apparent diffusion coefficient and Choline peak were analyzed. Results The detection rates of T_1 WI and T_2 WI were 14.7%(n=10)and 51.5%(n=35).The sensitivity,specificity,accuracy of dynamic contrast.enhanced MRI for the malignant tumor were 94.6%, 71.4% and 76.5% respectively.Retrospective study showed that diffusion weighted imaging,with the b value from 800 s/mm~2 to 1000 s/mm~2,could be used to differentiate various types of breast lesions.~1H signal voxel spectroscopy had a sensitivity of 51.4%,specificity of 82.6%,and accuracy of 67.6% for the malignent.The sensitivity,specificity and accuracy could reach 97.3%,90.0% and 92.6% respectively by combining conventional scan,dynamic contrast enhanced MRI and MR spectroscopy.Conclusion Functional MRI,with high sensitivity,specificity and accuracy,can be used widely in the diagnosis of malignant breast lesions.

Adult medical education has its own particularity.Its quality is affected by students' work units,families,schools,their own and other factors.Changing concepts,optimizing management,promoting personal quality education,setting up early warning mechanism,and doing full co-ordination are effective ways to improve the quality of adult medical education.

Objective To observe the function of recombinant human tissue factor pathway inhibitor1(rTFPI-1)in acute myocardial infarction in rabbit. Method Forty New Zealand White rabbits were subjected to coronary artery occlusion for 120 min and followed by reperfusion for 60 min,then they were ranlow dose rTFPI-1 group(n=10/group).The extent of ischemic area and the extent of myocardial infarction area were measured by Evan's blue stain and TTC stain,respectively.The degrees of infarction severity and ischemic severity were expressed as the ratios of the total left ventrieular wall area.The degrees of infarction severity and ischemic severity in different groups were compared by using one-way ANOVA and then followed by LSD procedure.Results The degree of infarction severity in the larger dose rTFPI-1 group was significantly lessened than that in low dose RTFPI-1 group and control group(P<0.001),and than that in modcrate dose rTFPI-1 group as well(P<0.05).The degree of infarction severity in the moderate dose rTFPI1 group was significantly lessened than that in low dose rTFPI-1 group and control group(P<0.001).There was no significant difference in degree of infarction severity between low dose rTFPI-1 group and control group(P>0.05).Conclusions Human rTFPI-1 might decrease myocardial infarction severity and save the survival myocardial tissue.

Objective To study the probability of transferring the regulatory T cells induced by TGF-β1 to prolong the allograft survival and the mechanisms involved.Methods According to the different culture conditions.three experimental groups were established:control group(T cells from C57 BL/6 mice cultured with II-2),MLR group(T cells from C57BL/6 mice activated by alloantigen)and TGF-βgroup(T cells from C57BL/6 mice activated by alloantigen and cultured with 5.0 ng/ml TGF-β1).After the culture,the ratio of CI4+CD25+T and the Foxq3 expression were measured by FACS and RT-PCR,respectively.On 9th day,the pathologic analysis was performed and the ratios of TH1,TH2 and Treg and the proliferation of lymphocytes were measured.Results The ratio of CD4+CD25+T in TGF-β group was higher than that in control group and MLR group(P<0.05),and Foxp3 was expressed in CD4+CD25+T cell from TGF-βgroup.After transferring ofthe cells,the allografi survival time in TGF-β group was prolonged and its mean survival time(MST)was(22.8±1.9)d,which was longer than that in MLR group and control group (P0.05),lower than that of control group(P<0.05). And the ratio of CD4+CD25+T in TGF-β group was higher than that in control and MLR group obviously(P

BACKGROUND:Vascular smooth muscle is the main cell component of constructing vascular wall tissue structure and maintaining vascular tension.Studies have shown that smooth muscle progenitor cells obtained from peripheral blood can differentiate into vascular smooth muscle cells.OBJECTIVE:To compare smooth muscle progenitor cells dedved from human peripheral blood with mature vessel wall smooth muscle cells in cell morphology and proliferation potential.DESIGN,TIME AND SETTING:Cell culture and observation trials were performed at the Key Laboratory of Molecular Medicine in Jiangxi province from October 2008 to April 2009.MATERIALS:Peripheral blood 20mL were adopted from 6 healthy volunteers,and great saphenous vein were sourced from 6 patients with varicose vein.METHODS:Mononuclear cells were isolated from human peripheral blood and cultured in fibronectin,platelet derived growth factor-BB and EGM-2 medium.At the same time,the smooth muscle cells were obtained from great saphenous vein with the collagenase digestion method.High-glucose DMEM medium was used for the culture.MAIN OUTCOME MEASURES:Cellular morphology;Cellular immumofluorescence method and RT-PCR method were used to detect the expression of α-SMA and calponinl.MTT method was used to analyze the proliferation activity.RESULTS:The smooth muscle progenitor cells denved from human peripheral blood exhibited biological characteristics of vascular smooth musc Je cells.they were found to express α-SMA and calponin1.The proliferation activity of smooth muscle progenitor cells was also greater than vascular smooth muscle cells.CONCLUSlON:Peripheral blood mononuclear cells in the stimulus of platelet-derived growth factor can differentiate into smooth muscle progenitor cells.Compared to smooth muscle cells,smooth muscle progenitor cells proliferate better,and are not easy to age in a long time of cultivation.Smooth muscle progenitor cells are a ideal ceil source of tissue engineered vessel.