Objective To compared intensity modulated radiation therapy (IMRT) with conventional radiotherapy(CR) for the left side breast cancer after breast-conserving surgery in regard to the homogeneity of dose in the target area, cardiac dose and irradiation volume in the target area. Methods Thirty-eight patients received inverse planning of IMRT with dynamic multi-leaf collimation (dMLC). Prescription dose was 46Gy in breast volume with X-ray, and added electron boost dose was 14Gy in the tumor bed, with a total dose of 60Gy. Clinical target volume(CTV) and heart were evaluated with dose-volume histograms(DVH) in the two plans, with the t test taken with SPSS 11.0. Results Average received dose of 95% breast volume(D 95) was (4541?34),(4517?62)cGy, volume of 105% of dose prescription(V 105%) was 17.5%?17.6%,29.4%?26.3%, while V 110% was 0.3%?0.8%,3.7%?8.2% with IMRT and CR, respectively. Received 30Gy by the heart(V 30) was 4.6%?4.3%,18.8%?12.2%(P

AIM: To investigate the effects of psychological stress on ulcerative colitis rats and to explore the mechanisms of this;meanwhile to investigate the effects of anxiolytic drug on symptoms of ulcerative colitis rats under psychological stress and the mechanisms of it.METHODS: eighty male Wistar rats were randomly divided into four groups(n=20): UC control group;UC stress group;UC+clonazepam group;UC stess+clonazepam group.After UC model was established with immunization,these rats were fightened by cat to set up psychological stress model.During establishing stress model,each groups were respectively received physiologic saline or clonazepam by intragastric administration.After 15d treatment,all rats were sacrified simultaneously.Colon mucosal inflammationand damage were assessed by measuring colon mass,morphologic damage score,colonic MPO and NO activity levels.Morphologic damage score was examined under microscope.Colonic MPO and NO was measured by spectrophotometric method.Serum hydrocortisone was determined by radioimmunoassay(RIA).RESULTS: Morphologic damage score,colonic MPO and NO,serum hydrocortisone of UC stress group were significantly increased compared with those of UC control group;morphologic damage score,colonic MPO and NO,serum hydrocortisone of UC+clonazepam group were decreased markedly vs UC stress group;Little difference was observed between UC+clonazepam group and UC control group.CONCLUSION: Psychological stress can aggravate symptoms of UC.Although benzodiazepine have no anti-inflammatory action,it relieve effects on internal organs of psychological stress and aggravation of symptoms of UC by to effect limbic system and formatio reticularis.

Objective To assess the feasibility of applying intensity-modulated radiotherapy(IMRT)simultaneous integrated boost(SIB)to replace conventional radiotherapy(CR)plus brachytherapy of whole pelvis in locally advanced cervical eaneer(LACC).Methods Five LACC patients based difference position of uterus were chosen and worked out CR and IMRT SIB plans respectively.Dose distributions were compared between IMRT SIB and CR.Results When uterus was in ante-,neutral-,retro-pnsition and deviation respectively,IMRT SIB could provide enough and homogeneous dose distribution for target volume and reduce irradiated volumes and doses for organs at risk(recta,bladder and small intestine)than CR.The doses of the A,B,and fundus of uterus were higher in IMRT SIB than CR.However,in ease of small intestine was close to or encircled the uterus,the targets volume dose would be inadequacy.Conclusions LACC IMRT SIB's dose distribution is better than CR(except excess ante-position)and may help to treat those patients who couldn't be suitable with brachytherapy.

Objective To compare the dosimetric difference of RapidArc and fixed gantry angle dynamic IMRT (dIMRT) for loco-regionally advanced nasopharyngeal carcinoma.Methods Ten previously treated patients with loco-regionally advanced nasopharyngeal carcinoma were replanned with RapidArc and dIMRT, respectively.The prescription dose was GTV 70 Gy/33 f and PTV 60 Gy/33 f.All plans met the requirement:95% of PTV was covered by 60 Gy.Dose-volume histogram data, isodose distribution, monitor units,and treatment time were compared.Results Dose distribution has no significant difference between the two techniques.RapidArc reduced the dose of the brainstem, mandible, and other normal tissues compared with dIMRT.Mean monitor units were 589.5 and 1381.0 for RapidArc and dIMRT (reduced by 57% relatively).Mean treatment time was 2.33 min and 7.82 min for RapidArc and dIMRT (reduced by 70% relatively).Conclusions Compared with dIMRT, RapidArc achieves equal target coverage and OAR sparing while using fewer monitor units and less time during radiotherapy for patient with loco-regionally advanced nasopharyngeal carcinoma.

Objective To compare the dosimetric difference between RapidArc and fixed gantry angle dynamic intensity modulated radiotherapy (dIMRT) in developing the pre-operative radiotherapy for rectal cancer patients.Methods Two techniques,RapidArc and dIMRT,were used respectively to develop the synchronous intensity modulated plans for 10 stage Ⅱ and Ⅲ rectal cancer patients at the dose of gross tumor volume (GTV) of 50.6 Gy divided into 22 fractions and planning target volume (PTV) of 41.8 Gy divided into 22 fractions.Both plans satisfied the condition of 95% of PTV covered by 41.8 Gy.The dose-volume histogram data,isodose distribution,monitor units,and treatment time were compared.Results The two kinds of dose volume histogram (DVH) developed by these two techniques were almost the same.The conformal indexes of GTV and PTV by RapidArc were better than those by dIMRT (t =7.643,8.226 ,P < 0.05),while the homogeneity of target volume by dIMRT was better (t =-10.065,-4.235 ,P <0.05).The dose of rectum and small bowel planned by RapidArc was significantly lower than that by dIMRT (t =2.781 ,P <0.05).There were no significant differences in the mean doses of bladder and femoral head between these two techniques.The mean monitor units of RapidArc was 475.5,fewer by 48.5% in comparison with that by the dIMRT (924.6).The treatment mean time by RapidArc was 1.2min,shorter by 79.5% in comparison with that by dIMRT (5.58 min).Conclusions There is no significant dosimetric difference between the two plans of RapidArc and dIMRT.Compared with dIMRT,RapidArc achieves equal target coverage and organs at risk(OAR) sparing while using fewer monitor units and less time during radiotherapy for patient with rectal cancer.

Objective: Investigation on the quality control method of bacterial endotoxin in betahistine hydrochloride injection.
Methods: The method of bacterial endotoxin gel test of 23 batches of betahistine hydrochloride injection from 5 manufacturers was studied.
Results: The limit value of endotoxin in this product was 3 EU·mg^-1, which was suitable for the bacterial endotoxin test of China Pharmacopoeia 2020.
Conclusion: The quality of betahistine hydrochloride injection can be controlled by bacterial endotoxin test, and the limit of bacterial endotoxin can be set as follows: the content of endotoxin in every 1mg of betahistine hydrochloride should not exceed 3 EU.

OBJECTIVETo demonstrate the expression of proteolysis induce factor(PIF) in the gastrointestinal(GI) cancer cachexia patients and evaluate its role in cancer cachexia.

METHODSExamination of PIF was performed in urine samples from 28 GI cancer cachexia patients, 13 GI cancer patients without cachexia, and 12 weight loss patients with benign disease. PIF was added to the mice cultured C2C12 muscle cells, then the protein kinase B(Akt) phosphorylation and morphological change were measured.

RESULTSThe positive rate of PIF in urine of 28 cancer cachexia patients was 53.6%(15/28). In the other two groups, no positive result was detected. PIF could successfully induce Akt phosphorylation, cell atrophy, metamorphosis, and death. The peak of this phosphorylation could be detected after half an hour of the initiation of PIF at a concentration of 4 nmol/L.

CONCLUSIONSPIF is specifically and highly expressed in GI cancer cachexia patients' urine. PIF can induce cancer cachexia possibly by activating Akt phosphorylation and inducing downstream proteolysis.

Animals ; Cachexia ; etiology ; metabolism ; Cell Line ; Gastrointestinal Neoplasms ; complications ; Humans ; Mice ; Proteoglycans ; Proteolysis

To investigate the protective effect of preconditioning with hyperoside ( Hyp) against myocardial ischemia-reperfusion injury (MIRI) in rats and the role of PI3K/Akt signaling pathway. MIRI was established by ligation of left anterior descending coronary artery for 30 min followed by reperfusion for 120 min in rats. Male SD rats were randomly divided into five groups: sham group,model group (MIRI),Hyp preconditioning group(Hyp), Hyp preconditioning + LY294002 (a PI3K/Akt signaling pathway inhibitor) group (Hyp + LY), and LY294002 group (LY). At the end of reperfusion, hemodynamic parameters were recorded as left ventricular systolic pressure (LVSP) , left ventricular end-diastolic pressure ( LVEDP) and maximal rate of increase and decrease of left ventricular pressure (± dP/dt(max)). Myocardial infaret size, the oxidative stress markers, myocardial enzymes indicators and inflammatory factors were also analyzed. The expressions of Akt, p-Akt, Bax and Bcl-2 proteins was detected by using Western blot method. The results showed that Hyp preconditioning remarkably improved cardiac constriction and relaxation function, reduced myocardial infarct size and enhanced the activities of oxidative stress markers about correlated to MIRI, such as superoxide dismutase (SOD), catalase (CAT) and glutathione-peroxidase (GSH-Px) and decreased the contents of malondialdehyde (MDA) as compared with MIRI group. Simultaneouly, the levels of myocardial enzymes, i. e. creatine kinase ( CK) and creatine kinase MB isoenzyme (CK-MB), and inflammatory factors, for instance tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were decreased. Hyp pretreatment apparently restrained myocardial apoptosis as evidenced by decreasing the level of Bax expression, increasing the levels of phosphorylation of Akt and Bcl-2 expression. These effects were inhibited by LY294002, a blocker of PI3K/Akt signaling pathway. These findings indicated that the cardioprotection of Hyp preconditioning against MIRI may be related to activating PI3K/Akt signaling pathway, upregulating the expression of BCL-2 protein and down-regulating the expression of Bax protein.
Animals ; Creatine Kinase ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Heart ; drug effects ; Humans ; Interleukin-6 ; genetics ; metabolism ; Ischemic Preconditioning, Myocardial ; Male ; Malondialdehyde ; metabolism ; Myocardial Reperfusion Injury ; drug therapy ; enzymology ; genetics ; prevention & control ; Phosphatidylinositol 3-Kinases ; genetics ; metabolism ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Quercetin ; administration & dosage ; analogs & derivatives ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; genetics ; metabolism

ObjectiveTo systematically review the efficacy and safety of endoscopic papillary large balloon dilation (EPLBD) versus endoscopic sphincterotomy combined with large balloon dilation (ESBD) in the treatment of large common bile duct stones (≥10 mm). MethodsPubmed, Embase, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for related articles published up to March 2020. Two reviewers independently performed article screening, data extraction, and quality assessment, and RevMan 5.3 software was used for statistical analysis. ResultsA total of 11 studies (6 randomized controlled trials and 5 non-randomized controlled trials) were included, with 1282 patients in total. The meta-analysis showed that in the 6 randomized controlled trials, there were no significant differences between the EPLBD group and the ESBD group in initial stone clearance rate (odds ratio ［OR］=0.71, 95% confidence interval ［CI］: 0.45-1.12, P=0.14), overall stone clearance rate (OR=1.39, 95%CI: 0.65-2.96, P=0.39), rate of use of mechanical lithotripsy (OR=1.19, 95%CI: 0.75-1.89, P=0.46), and incidence rate of early complications (OR=1.10, 95%CI: 0.60-2.03, P=075); in the 5 non-randomized controlled trials, there were no significant differences between the EPLBD group and the ESBD group in initial stone clearance rate (OR=0.64, 95%CI: 0.35-1.15, P=0.13), overall stone clearance rate (OR=0.46, 95%CI: 0.19-112, P=009), and incidence rate of early complications (OR=1.20, 95%CI: 0.65-2.21, P=0.56), but the EPLBD group had a significantly higher rate of use of mechanical lithotripsy than the ESBD group (OR=1.96, 95%CI: 1.26-3.05, P=0.003). ConclusionEPLBD and ESBD have similar efficacy and safety in the treatment of large common bile duct stones, while EPLBD may increase the risk of the use of mechanical lithotripsy. More high-quality randomized controlled trials are needed to confirm this conclusion.

Objective To study the diagnostic value of contrast-enhanced CT scan with split bolus for the ureleropelvic junction obstruction(UPJO) caused by aberrant vessel of kidney.Methods 52 patients with UPJO underwent contrast-enhanced CT scan with split bolus.The aberrant vessels and its origin as well as the relationship between aberrant vessels and UPJO were observed comparatively with the results of surgery.Results In 52 cases,CT showed UPJO caused by aberrant vessl of kidney in 14 cases,including accessory renal arteries in 10,ovarian artery originated from left renal artery in one,right accessory renal artery in one and gonad veins in 2.CT findings were corresponded to operations in all these 14 cases.The sensitivity and specificity of CT in evaluating UPJO were 100% respectively.Conclusion The UPJO caused by aberrant vessel of kidney can be diagnosed accurately by contrast-enhanced CT scan with split bolus,which can be offered for surgical treatment for UPJO.The patient's CT dose can be decreased with split bolus.