Stereotactic radiotherapy is a rapidly growing treatment strategy for tumor due to the advances in target definition,radiation dose delivery,and image guidance of radiation.We reviewed the clinical application of stereotactic radiotherapy in the management of early stage non-small cell lung cancer including the technique,the workflow of the technique established,the outcome and relative radiation toxicity.

Objective: To summarize surgery experience and efficiency of laparoscopic excision of choledochal cyst and reconstruction of biliary tract and to analyze the treatments administered during intra and post-operation of the biliary reconstruction. Methods: We enrolled 48 cases of video-guided laparoscopic intraoperative cholangiography, cholecystectomy, choledochocele resection, Roux-en-Y hepaticojejunostomy with an anti-reflux valve from August, 2001 to October, 2003.Their operative procedures and aims were retrospectively analyzed. Results: Forty-four out of 48 patients successfully underwent laparoscopy and recovered soon. Only 4 cases were transformed to open operation. The post-operation complications were found in 4 cases. Conclusion: Video-guided laparoscopic excision of choledochal cyst, biliary tract reconstruction and Roux-en-Y hepaticojejunostomy are an effective method of treatment with advantages of minimal injury, less bleeding, and sooner recovery.

This study evaluated the change in regional left ventricular myocardial function in rats following acute occlusion of the left anterior descending coronary artery (LAD) by using two-dimensional speckle tracking imaging (2D-STI). Sixty Wistar rats were randomly divided into two groups, a myocardial infarction (MI) group, in which 50 rats were subjected to LAD occlusion for 30-45 min, and a sham-operated (SHAM) group that contained 10 rats serving as control. Echocardiography was performed at baseline and 1, 4 and 8 week(s) after the operation. High frequency two-dimensional images of left ventricular short axis at papillary muscle level were recorded. Peak systolic radial strain (PRS) and circumferential strain (PCS) were measured in the mid-ventricle in short-axis view by using EchoPAC workstation. Left ventricular internal diameter at diastole (LVIDd) and systole (LVIDs), fractional shortening (FS), ejection fraction (EF) and left ventricular mass (LVM) were measured by anatomical M-model echocardiography. Infarct size was measured using triphenyl tetrazolium chloride (TTC) staining 1 week and 8 weeks after the operation. Fibrosis of left ventricular myocardium was displayed using Van Gieson staining 1 week after the infarction. In terms of the TTC staining results, the left ventricle fell into three categories: infarcted, peri-infarcted and remote myocardial regions. Compared with those at baseline and in the SHAM group, (1) PRS and PCS in the infarcted, peri-infarcted and remote myocardial regions were significantly decreased in the MI group within 1 week after the operation (P<0.05) and the low levels lasted 8 weeks; (2) Compared with those at baseline, LVIDd, LVIDs, FS, EF and LVM in the MI group showed no significant difference 1 week after the operation (P>0.05). However, LVIDd, LVIDs and LVM were increased significantly 4 and 8 weeks after the operation (P<0.05), and FS and EF were decreased substantially (P<0.05). Van Gieson staining showed that fibrosis developed in all the three myocardial regions to varying degrees. It is concluded that 2D-STI is non-invasive and can be used to assess regional function of myocardium with different blood supply in rats following acute occlusion of the LAD, and can be used as a sensitive and reliable means to follow up the process of left ventricular remodeling.

Objective To explore the value of two-dimensional strain echocardiography for quantitative assessing the change of regional left ventricular myocardial function in rats following acute myocardial infarction. Methods Sixty Wistar rats were randomly divided into two groups. The study group consisted of 50 rats with occlusion of LAD for 30-45 minutes and the sham-operated group consisted of 10 rats without occlusion of LAD. Echocardiography were performed before operation, which was defined as baseline, and 1 week, 4 weeks and 8 weeks after operation. Left ventricular internal diameter at diastole ( LVIDd) and systole < LVIDs), fractional shortening( FS), ejection fraction (EF) and left ventricular mass(LVM) were measured by anatomical M-model echocardiography. High frame rate two-dimensional images were recorded in the left ventricular short-axis views at the papillary muscle level. Peak systolic radial strain(PRS) and circumferential strain(PCS) of each segment were measured using 2-dimensional strain software. The rats were sacrificed and the infarcted size of each segment was measured using triphenyl tetrazolium chloride (TTC) after echocardiography was performed. Fibrosis of left ventricular myocardium was displayed using Van Gieson stain in 1 weeks after infarction. Results Based on the TTC findings,the left ventricle of the study group was divided into three regions:infarcted,peri-infarct and remote myocardial regions. Van Gieson stain showed fibrosis existed in all the three regions. Compared with baseline and sham-operated group, PRS and PCS of infarcted, peri-infarct and remote myocardial regions of the study group significantly decreased within 1 week after operation ( P <0. 01) and persisted for 8 weeks. PCS and PRS of infarcted, peri-infarct and remote myocardial regions of the study group in 4 weeks and 8 weeks after operation showed no significant difference when compared with those in 1 week after operation ( P >0. 01). Compared with baseline and sham-operated group,LVIDd,LVIDs and LVM of study group all increased significantly ( P <0. 05) in 4 weeks and 8 weeks after operation,and FS and EF reduced significantly ( P <0. 05). Two-dimensional strain obtained in interobserver and intraobserver both showed high agreement. Conclusions Two-dimensional strain echocardiography can assess regional function of myocardium with different perfusion in rats following acute myocardial infarction, and provides a sensitive and reliable method to follow up the process of left ventricular remodeling after myocardial infarction.

Objective To explore the relation of newly genome-wide association study (GWAS) identified lipid-associated genes by euramerican white and coronary heart disease ( CHD ) susceptibility in Chinese Han population. Methods One thousand patients with CHD were enrolled according to WHO criteria. 1000 age-and sex-matched controls were included. Single-nucleotide polymorphisms (SNPs) were detected by Taqman technique. Results Two novel SNPs (rs599839 in SORT1 region and rs16996148 in NCAN region) were significantly associated with CHD risk in Chinese Han population. Compared to AA genotype of rs599839, subjects with AG genotype of rs599839 (OR=0.64, 95%CI=0.48~0.85, P=0.002 and OR=0.67, 95%CI=0.52~0.91, P=0.008, respectively). Compared to GG genotype of rs16996148, subjects with GT genotype were associated with significantly decreased risk of CHD(OR=0.67, 95%CI=0.52~0.91, P=0.008). Two another SNPs (rs12695382 in B4GALT4 region and rs2254287 in B3GALT4 region) were not significantly associated with CHD in Chinese Han population. Conclusions Two novel SNPs (rs599839 and rs16996148) at newly identified lipid-associated loci were significantly associated with CHD susceptibility in Chinese Han population.

Objective To compare the effects of biphasic square waveform (BSW) with low or high energy on external defibrillation.Method Adult swine model of closed chest ventricular fibrillation induced by electricity was established.Eighteen swine,weighing (30?3.3) kg were randomly divided into three groups:50-50-50 J group (n=6),30-50-75 J group (n=6),120-150-200 J (n=6).After three minutes of ventricular fibrillation without treatment,the pigs in the three groups were defibrillated accordance to the above sequences. Results 30 J BSW didn't succed to external defibrillate.The first defibrillation successful rate of 50 J and 120 J BSW was 5/6.The total defibrillation successful rate of every group was 100%.All pigs quickly had spontaneous circulation after defibrillation and survived more than 24 hours.ST-T change of low-energy was less than that of high-energy.After resuscitation,myocardial function decreased,but there had not significant differences between groups.Conclusions In the study,30J BSW could not reach successful defibrillation,and 50 J and 120 J BSW had similar defibrillation efficacy.The ideal energy of BSW external defibrillation was 50 J.

Objective To investigate the correlation between CT perfusion parameters of pulmonary carcinoma and standardized uptake values(SUV)derived from ~(18)F-fluoro-deoxyglucose positron emission tomography(~8F-FDG PET)and tumor microvessel density(MVD),and to determine the validity of CT perfusion in assessing tumor angiagenic activity of pulmonary carcinoma.Methods Fifty patients(mean age 57.5,17 females)with pulmonary carcinoma underwent CT perfusion using 16-slice helical CT.Blood flow(BF,ml?100g~(-1)?min~(-1)),blood volume(BV,ml?100g~(-1)),mean transmit time(MTF,s)and permeability surface area product(PS,ml?100g~(-1)?min~(-1))were analyzed.SUV of PET was calculated in 14 patients.The CD34 immunohistochemical staining was used for tumor microvessel counting.CT perfusion parameters of pulmonary carcinoma were correlatively studied with SUV and tumor MVD.Pearson's correlation analysis was performed to evaluate the association between CT perfusion parameters and SUV and MVD.Results The average values of BF,BV,MTT and PS were 97.30 ml?100g~(-1)?min~(-1), 8.86 ml?100g~(-1),6.75 s and 34.52 ml?100g~(-1)?min~(-1),respectively.The average value of MVD was 61.82/FOV.The mean value of SUV was 5.96.There was positive correlation between BF and SUV(r= 0.727,P

Trichinella spiralis infection in rodents is a well-known model of intestinal inflammation associated with hypermotility. The aim of the study was to use this experimental model to elucidate if Th17 cells are involved in the development of gastrointestinal hypermotility. Colonic smooth muscle contractility was investigated in response to acetylcholine. The levels of IL-17, IL-23 and TGF-beta1 in colon were measured by Western blotting. Flow cytometric detection of intracellular IFN-gamma/IL-4/IL-17 cytokine production was used to analyze the proportions of CD4+ T cells subsets in colon. Our results showed that colonic muscle contractility was increased 2 weeks post infection (PI) and stayed high 12 weeks PI when no discernible inflammation was present in the gut. The proportion of Th17 cells and the expression of IL-17 were up-regulated in colon 2 weeks PI and returned to normal 8 weeks PI. The content of IL-17 was correlated with the colonic smooth muscle hypercontracility 2 weeks PI. Meanwhile, TGF-beta1 was increased 2 weeks PI, while IL-23 was normal. Our results suggest that Th17 cells affect the colonic muscle contractility in mice infected with Trichinella spiralis at intestine stage but not at muscle stage and the effect of Th17 cells on muscle contractility might be induced by TGF-beta1. Other cytokines might be involved in the hypercontracility of colonic smooth muscle at muscle stage.

Objective To compare the accuracy and feasibility among CT, MR, and CT-MR image fusion technology in the delineation of gross target volume (GTV) for nasopharyngeal carcinoma (NPC). Methods Thirty-six consecutive patients with newly diagnosed or recurrent NPC were enrolled. Each pa-tient underwent both CT and MR scanning in the same treatment position. Several lead marks were made at the exactly same locations of the body surface before CT and MR scanning. The two sets of images were then transferred to the Tomcon workstation for image fusion. CT-MR image registration was performed using Land-Mark methods. GTV of each patient was contoured on CT (GTV_(CT)), MR (GTV_(MR)) and CT-MR (GTV_(CT-MR)) images. Results The mean GTV_(CT), GTV_(MR) and GTV_(CT-MR) were 27.60 cm~3, 30.99 cm~3 and 31.71 cm~3, respectively (F = 7.48, P = 0.001). Significant difference was found between GTV_(CT) and GTV_(MR) (q =2.54,P=0.016), GTV_(CT) and GTV_(CT-MR) (q =3.10,P =0.004), but not GTV_(MR) and GTV_(CT-MR) (q = 1.31 ,P = 0. 199). Significant difference among GTV_(CT), GTV_(MR) and GTV_(CT-MR) was found in patients with skull base invasion (35.65, 42.70 and 44.22 cm~3 ; F = 14. 13, P = 0. 000), but not in those without skull base invasion (20.79 cm~3, 20.46 cm~3 and 21.18 cm~3 ; F = 0.18, P = 0.832). Significant difference between GTV_(CT) and GTV_(CT-MR) was found in patients with T_3 and T_4 tumor (t = -2.17,P =0. 036), but not in those with T_1 and T_2 (t = -0.66 ,P = 0.514). Conclusions CT-MR image fusion is helpful in GTV de-lineation for NPC, particularly for patients with skull base invasion.

Objective To investigate the risk factors for childhood acute leukemia complicated with streptococcus mitis bacteriaemia and to explore a better therapeutic regimen of antibiotics.Methods Seventy-eight cases of childhood acute leukemia complicated with bacteriaemia hospitalized in Zhujiang Hospital of Southern Medical University from January 2012 to December 2016 were collected,among them there were 8 cases (10.26％) caused by streptococcus mitis.The susceptible factors,clinical manifestations,drug susceptibility,treatments and outcomes of 8 cases of streptococcus mitis bacteriaemia were summarized and analyzed.Results All of 8 cases were attacked during the agranulocytosis phase lasting for more than 1 week after chemotherapy for acute leukemia.Four cases of them had been exposed to the third-generation cephalosporins for more than 7 days,and 5 cases exposed to proton pump inhibitor (PPI) for more than 10 days.The incidence of remittent fever,shiver,stomatitis and pneumonia was 100.0％ (8/8 cases),62.5％ (5/8 cases),62.5％ (5/8 cases) and 62.5％ (5/8 cases),respectively.And severe pneumonia occurred at a rate of 37.5％ (3/8 cases).The sensitivity to Linezolid,Vancomycin,Penicillin and Cefotaxime was 100.0％,100.0％,37.5％ and 25.0％,respectively.Five of the 7 cases treated with Meropenem had a fever 3 days later and then they took Linezolid as a replacement according to the drug sensitivity.One case was treated with Cefoperazone-Sulbactam.The duration time of fever,positive blood culture,agranulocytosis and course of antibiotics therapy was 1-19 d(10.4 d on average),4-22 d(13.4 d on average),10-30 d (21.6 d on average),9-26 d (18.3 d on average),respectively.Among 3 patients with severe pneumonia,1 patient received the respirator assisted ventilation for 1 week.Conclusions Streptococcus mitis is one of the major causes of severe infection among children with acute leukemia.Agranulocytosis after chemotherapy,stomatitis,exposure to PPI and antibiotics may be the risk factors for streptococcus mitis infection.Fever,stomatitis,respiratory and digestive symptoms are the common clinical manifestations.Streptococcus mitis is resistant to Penicillin and Cefotaxime,but sensitive to Linezolid,which can shorten the course of infection and improve the outcomes.Thus,Linezolid may serve as an optional therapy for streptococcemia mitis bacteriaemia.