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 study CT numbers correction of kilo?voltage cone?beam CT (KV?CBCT) images for dose calculation. Method Aligning the CBCT images with plan CT images, then obtain the background scatter by subtracting CT images from CBCT images. The background scatter is then processed by low?pass filter. The final CBCT images are acquired by subtracting the background scatter from the raw CBCT. KV?CBCT images of Catphan600 phantom and four patients with pelvic tumors were obtained with the linac?integrated CBCT system. The CBCT images were modified to correct the CT numbers. Finally, compare HU numbers between corrected CBCT and planning CT by paired T test. Evaluate the image quality and accuracy of dose calculation of the modified CBCT images. Results The proposed method reduces the artifacts of CBCT images significantly. The differences of CT numbers were 232 HU, 89 HU, 29 HU and 66 HU for air, fat, muscle and femoral head between CT and CBCT respectively (P= 0?? 39,0?? 66,0?? 59,1).The differences of CT numbers between CT and CBCT was reduced to within 5 HU. And the error of dose calculation with corrected CBCT images was within 2%. Conclusions The CT numbers of corrected CBCT are similar with plan CT images and dose calculations based on the modified CBCT show good agreement with plan CT.

Objective To investigate the value of dynamic contrast-enhanced(DCE)-MRI and DWI for the early assessment of curative effects in NSCLC. Methods Forty patients from September 2012 to September 2014 with NSCLC proven by pathology were examined with DCE-MRI and DWI, at one week before the first chemotherapy and one month after treatment. DCE parameters (MER, slope, WR) and ADC values of the tumors were calculated on the workstation. According to the changes of the tumor-size after treatment, all patients were divided into two groups: good response group and poor response group. Pretreatment parameters were compared between the two groups with independent-samples t test, and parameter changes before and after treatment were compared with paired-samples t Test. ROC curve of tumor response characteristic was analyzed. Pearson correlation coefficient was used to study the correlation between post-treatment parameter changes and tumor size reduction. Results Pretreatment ADC, MER and slope value were (1.15 ± 0.09) × 10-3 mm2/s, 1.13 ± 0.28, (3.76 ± 1.27)% in the good response group(15 patients), and were (1.34±0.33)×10-3mm2/s, 0.78±0.16, (2.63±0.58)%in poor response group(25 patients), respectively. There was significant difference between tumors in two groups(t=2.329, 3.152, 4.556,P=0.027, 0.032, 0.009), the lower ADC value and the higher MER/slope value was observed in the good response group. The change rates of ADC after one month treatment in the two groups were (20.43±6.40)%, (2.98±1.65)%(t=3.485,P=0.009), and slope change were (-61.80±19.21)%, (-30.80±11.16)%(t=3.280, P=0.020). Both the rising rate of ADC and decreasing rate of slope value were significant higher in good response group than the poor response group. The ROC curve was used to analyze the change rate of ADC and slope after tumors treatment, the area under the ROC curve in ADC was largest(Az=0.790), the diagnosis efficiency was highest. We found significant positive correlation between ADC, MER, slope change rate and tumor maximum diameter reduction rate after chemotherapy(r=0.637, 0.396, 0.532,P<0.05). Conclusions DCE parameters and ADC values possess important clinical value to evaluate the early effect of chemotherapy in NSCLC. ADC value is more sensitive to early lung cancer response.

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.

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.