Objective To investigate effect of combination of rosuvastatin and dual antiplatelet therapy on the serum CRP, cerebral vascular event recurrence rate and carotid artery plaque in cerebral infarction patients.Method 60 cerebral infarction patients were seleted and divided into the control group and the experiment group by different treatment(n=30).Two groups were treated by corresponding drugs.The serum levels of IMT, CRP, plaque area, plaque number and the cases of recurrent cerebral vascular events after 6 month were compared after treatment a month.Results Compared with the control group after treatment,the serum CRP were lower(P<0.05),the recurrence rate of cerebral vascular events were lower(P<0.05),the IMT value, patch area and the number of carotid plaques were lower(P<0.05).Conclusion Rosuvastatin and dual antiplatelet combination therapy has good clinical effect for cerebral infarction patients,and have the clinical guiding significance.

Objective To find a method to improve the range accuracy of moving target such as peripheral lung tumors, since a single CT snapshot may not be accurate during the treatment process.Methods A simple harmonic motion phantom, embedded with a cube and a circular ball, was used to simulate the tumor motion. Individualized moving targets were scanned 24 times with different amplitudes and frequencies. Then the images were fused from every 1, 2 or 3 sets of CT scans. The GTV volume variation of circular target and the length variation of the cube target along the z axis were contoured and analyzed. Results As motion amplitude increased, the maximum of both circular target volume and cube target length was increased, while the minimum of the factors was decreased. Motion frequency affected the target volume less than amplitude. For a cube target with the length of 3.3 cm at stationary phase, when motion frequencies was 20 and motion amplitude was 2 cm, the maximal length was 2. 4 times of the minimal length (5. 1 cm vs. 2. 1 cm). When it came to the cube target groups fused from every 1,2 and 3 sets of CT scans, the average length and standard deviation were (3.77 ± 1.20) cm, (4.18 ±0. 91)cm and (4.52 ±0. 59) cm, respectively. With the increase of fused scan number, targets became bigger, the standard deviation decreased, and the change of center positions was decreased. Conclusions The motion amplitude, frequency and the number of CT scans are the main factors affecting target definition, though, the optimized scanning phase is not certained. When 4DCT and respiration gating technique are not available,the efficient and practical method to solve this problem is to scan the target three or more times and fuse them in planning system, which will generate a larger, more reproducible GTV volume for moving targets.

Objective To investigate the experimental condition of separate purification and directed differentiation potency of pancreatic stem cells of adult rats in vitro. Methods The pancreas of adult rats were digested by collagenase V in situ perfusion. Filtration was performed by 100 mesh filter. Ficoll 400 density gradient centrifugation was used to separate pancreatic stem cells and stem cells were for cultivation. Epidermal growth factor (EGF), fibroblast growth factor (bFGF) was added to medium for in vitro cultivation.Immunofluorescence staining method was used to detect the expression of CK19, Pdx-1, nestin, insulin and glucagon, and the positive cell rate was calculated. The differentiated cell was evaluated by dithizone (DTZ)staining; insulin excretion function was determined by optical enzyme labeled ELISA staining. Results The pancreatic stem cell obtained from the study could be cultivated in vitro for 8 generations. The expression of CK19, Pdx-1 and nestin of the tem cells were all positive, and the rate of positive cells were (88.6 ± 6.2)% ,(84.6 ±8.6)% and (81.3 ±7.5)%. The differentiated cell was in brownish red color by DTZ dye. After high concentration sugar stimulation, the expression of insulin secretion was increased in the supernatant.Conclusions This method can harvest highly purified, and large amount of pancreatic duct stem cell.Artificial induction may result directed differentiate for islet-like clusters and have insulin secrete function.

As an interstitial brachytherapy,radioactive seed implantation could provide high doses in the local site and minimal doses at surrounding normal tissues.It has become one of the best choice for early stage prostate carcinoma.Radioactive seeds were implanted under the guidance by ultrasound,CT and MRI,featured with surgical and interventional treatment.Based on dosimetry for target and organs at risk,radioactive seed implantation is multiple disciplinary.In order to acquire the accurate and high quality seed implantation,it is necessary to set up a team including surgeons,radiation oncologists,interventional doctors and nuclear medicine doctors.The content of the consensus is as follows:radiation physics and dosimetry,indications,side-effects and 3 D-printing template work-follow.Despite the benefit of radioactive seed implantation for solid carcinoma,there still a compelling need for prospective randomized and stage Ⅲ clinical trials from multiple centers,so as to upgrade the evidencebased level,above all confirm the role of radioactive seed implantation in the comprehensive treatment of tumors.

Objective To estimate the impact of the image quality of conebeam CT on the accelerator for the Bowtie filter. Methods This study used the system of conebeam CT on the accelerator,and scaned the phantom of Catphan 500 in the multiplicate scanning conditions with and without the Bowtie filter. The scanning conditions were : voltage :120 kV, 100 kV, 80 kV, electricity:25 mA, 40 mA, 64 mA,time of exposure :40 MHz, collimator: M20, L20, scanning angle :358°. We transmitted the scanning data in the treatment planning systems of Philips Pinnacle 8. 0, and estimated the influence of the image quality.Results With and without the Bowtie filter, all of the images had high geometric precision, and the maximum difference of the nominal and actual distance at the horizontal, vertical and arrowy directions in the transection were 0. 50% and 0. 56% ( t = 0. 44, P ＞ 0. 05 ), 0. 44% and 0. 48% ( t = 1.01, P ＞ 0. 05 ),0. 50% and 0. 56% (t = 1.06,P ＞0. 05 ), respectively. The spatial resolution was 0. 167 cm, immutably.The ununiformity with the Bowtie filter was decreased of 28.0% -76.0% (t=2.53,P＜0. 05)、2.8%-50.0% (t= 3.02,P＜0.01 ) than those without the Bowtie filter, and the contrast-to-noise ratio was increased of 4.0% -41.6% (t=2.70,P＜0.05)、4.0% -50.0% (t=2.14,P＜0.05), using the collimators of M20 and L20, respectively. The Bowtie filter could display clearly the edge of scanning phantom, and improve the CT number of the image edge of phantom. And the linearity of CT number was also improved. Couclusions With the Bowtie filter, the image uniformity, the precision and linearity of CT number and the contrast-to-noise ratio were improved obviously, the edge artifacts were decreased, and the geometric precision and the spacial resolution did not change.

Objective To investigate the expressions and the clinical significance of nectin-4 in pancreatic carcinoma and the relationship with clinicopathological features. Methods Immunohistocbemical techniques were used to detect nectin-4 expression in pancreatic carcinoma tissues (n = 40) and normal pancreatic tissues (n = 12 ), and the relationship between the expressions and clinicopathological parameters was analyzed. Results The IOD and area of nectin-4 were 2. 43 ± 0.75 and 9. 73 ± 1.86 in pancreatic carcinoma tissues, which were significantly higher than those in the normal pancreatic tissues( P ＜ 0.01 ).The expression of nectin-4 was not correlated with patients demographics ( P ＞ 0.05 ), and the protein expression was correlated with histopathologic grade ( P ＜ 0.01 ) and lymph metastasis ( P ＜ 0.05 ).Conclusions The high expression of nectin-4 in pancreatic carcinoma tissues suggests that its high expression may be correlated with the malignant degree of the carcinoma. nectin-4 can be considered as a reference index of differentiation, metastasis and prognosis in pancreatic carcinoma.

Objective To investigate the potential of pancreatic stem cells (PSCs) directed differentiation in vitro, and to evaluate the effects of differentiated PSCs allograft on the treatment of diabetes.Methods The PSCs of adult Wistar rats were separated and purified in vitro. The surface of PSCs was determined by immunofluorescence staining, and then it was stimulated by hepatocyte growth factor (HGF) and nicotinamide to induce directed differentiation. Dithizone dyeing was used to determine the islet-like cells after induction, and ELISA staining method was used to detect the insulin levels. Streptozotocin peritoneal injection was used to induce the diabetic rat mode. 40 rats were randomly allocated into pancreatic islet cells allograft group (experiment group) and placebo group. The serum insulin and glucose levels 1 d before transplantation and 1, 2, 3, 4 week after transplantation were measured. Results PSCs of adult Wistar rats were successfully obtained, and the expression of CK19, Pdx-1 and Nestin on cell surface was positive. Dithizone dyeing for directed differentiation cells showed brownish red color. The cells could express and secrete insulin after hyperglycaemia stimulation. The serum insulin and glucose levels 4 week after transplantation were (11.41 ±1.52) mU/L and (8.22 ± 2.7) mmol/L, which were (9.30 ± 1.56) mU/L and (12.23 ± 3.8) mmol/L in the placebo group, and difference was statistically significant (P＜0.05). Conclusions PSCs can be induced and directed differentiated in vitro into islet-like clusters with insulin secretion function. And its allograft has the potential for the treatment of diabetes.

Objective To measure 5Fu concentration after intraoperative regional arterial perfusion chemotherapy in gastric antrum cancer patients.Method In this study,32 gastric antrum cancer patients intraoperatively received through right gastroepiploic artery intraarterial perfusion of 5-Fu (1000 mg/m2),and drug conentrations were measured in portal venous blood,peripheral venous blood,peritoneal fluid and in removed cancer tissues 2,5,10,20,30,60 minutes after infusion started by high performance liquid chromatography method.Result 5-Fu in portal vein blood and peritoneal fluid reached peak concentration after 2 minutes at (48.8 ±6.8) μg1/ml and (75.3 ±30.7) μg/ml,respectively.The drug concentration in portal venous blood was (19.2 ± 2.0) μg/ml at 30 minutes and that in peritoneal fluid was (17.3 ±7.4) μg/ml at 60 minutes,both were higher than that of the effective experimental tumor suppressing concentration (15 μg/ml).Peripheral venous blood concentration reached peak concentration of (5.4 ± 2.0) μg/ml at 5 minute.The drug concentration in removed cancer tissues was (80.5 ± 20.1) μg,/ml.Conclusions Regional intraarterial perfusion chemotherapeutics in gastric antrum cancer patients during operation immediately makes the concentration of chemotherapy rise in the portal vein blood and peritoneal fluid and in cancer tissues to a much higher level than that in peripheral blood.This helps kill cancer cells that fell out during the surgery.

Objective To evaluate salmeterol/fluficasone combined with N-acetylcysteine in treatment of stable chronic obstructive pulmonary disease (COPD). Methods Sixty patients with stable COPD were randomized into treatment group(n = 30) and control group(n = 30). Patients in control group were given salmeterol/fluticasone twice per day ; while patients in treatment group in addition to salmeterol/ fluticasone, also took N-acetylcysteine 0.6 g three times per day. The course of treatment lasted for four weeks. Pulmonary function was measured in all patients; interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), superoxide dismntase (SOD) and malondialdehyde (MDA) in blood serum and induced sputum were determined. The white cell count and classification in sputum smear was examined and the quality of life (QOL) of patients was evaluated. Results FEV1, FEV1 %, QOL evaluation, IL-8, TNF-α, white cell count and the percentage of neutrophil granulocytes in induced sputum after treatment were significantly improved compared with those before treatment in control group (P <0.05 or P <0.01). FEV1, FEV1%, QOL evaluation, SOD and MDA in blood serum, IL-8, TNF-α, SOD and MDA, total white cell count, the percentage of neutrophil granulocytes and macrophage in induced sputum after treatment were significantly improved in treatment group (P <0. 05 or P <0.01). The differences in SOD and MDA in blood serum and the percentage of neutrophil granulocytes in induced sputum smear between treatment group and control group were staffsticaUy significant (93 ± 8) × 10-6 U/L, (4. 0 ± 1.0) × 10-3 mmol/L and 0. 5 ± 0. 3 vs (85 ± 10) ×10-6U/L,(4.2±1.1) ×10-3mmol/Land0.6±0.2; allP<0.05. Conclusion Combination of salmeterol/fluticasone and N-acetylcysteine has better therapeutic results in treatment of airway inflammation of stable COPD.

Objective To analyze the clinical features of patients with cholelithiasis treated in our hospital in the recent 10 years to explore the changing tendency of the spectrum of cholelithiasis in the Jiaodong region. Methods The clinical data of 2899 patients receiving operation for cholelithiasis in this hospital between January 1998 and January 2008 were retrospectively analyzed. The clinical parameters of sex, age and the lesion sites were reviewed. Compared with the clinical data of cholelithiasis patients in 1991, the data of the 2899 patients were statistically analyzed by SPSS 12.0 package.Results Significant differences existed in sex, e peak morbidity, and lesion sites. The ratio of male patients and female patients with cholelithiasis in differents site had obvious diversity. The constituent ratio of the female was manifestly higher than that of the male. The peak morbidity age range of cholecystolithiasis was 40 to 69. The peak age of gallbladder stones combined with common bile duct stones was 70 to 79, which was the same as that of common bile duct stones. The peak age of intrahepatic bile duct stones was 40 to 59. The constituent ratio of cholecystolithiasis was obviously higher than cholelithiasis in other sites. The incidence of cholecystolithiasis increased with age. Conclusion In the recent 10 years, female's ratio of gallbladder stones and intrahepatic stones was higher than male's.The morbidity of cholelithiasis significantly increased in aged patients. The spectrum of cholelithiasis has changed significantly.