Objective To evaluate the dosimetric errors of organs-at-risk (OARs) induced by the optimal auto-segmentation using Mim Maestro based on dose calculation and measurement.Methods The Mim atlas library composed of 240 nasopharyngeal carcinoma,breast cancer,and rectal cancer patients that were retrospectively selected was used for the auto-segmentation of OARs on the CT images of corresponding regions in 76 patients.Relative to the manual contouring,one optimal case was selected from each site based on conformity index (CI),mean distance to conformity (MDC),relative volume difference (Dv％),DICE,sensitivity index (Se.Idx),and inclusion index (Inc.Idx).Treatment plans were made to satisfy the DVH constraints of OARs based on auto-contours,and then the dose errors to the actual organs were evaluated in terms of calculation and measurement.The paired t-test (normal distribution) or rank sum test (non-normal distribution).Results Significant differences were observed in the 76 patients between the manual and automated segmentation (P＜0.05).For the optimal cases,the DICE index of various OARs ranged from 0.43 to O.98,and 73％(16/22) of DICE values were higher than 0.70.The calculated dose errors to various OARs were (-1.15±15.94)％(95％ CI:-8.21％ to 5.92％) (mean dose) and (-6.53±21.13)％ (95％ CI:-15.90％ to 2.84％) (maximum dose).The measured dose errors were (-2.43± 24.52)％ (95％ CI:-13.30％ to 8.44％)(mean dose) and (-3.38±20.87)％(95％ CI:-12.63％ to 5.87％)(maximum dose).Conclusion Without human interference,even the optimal auto-segmentation results are not clinically acceptable for treatment planning.

BACKGROUND:Crowe type-IV developmental dysplasia of the hip presented complete dislocation of the femoral head, significantly shortening lower limb, serious adverse development of upper segment of acetabulum and femur, and even deformity. At present, there are no reports concerning its therapeutic strategy.
OBJECTIVE:To explore the therapeutic strategy of adult bilateral Crowe type-IV developmental dysplasia of the hip.
METHODA total of 12 cases of adult bilateral Crowe type-IV developmental dysplasia of the hip, who were treated in the Department of Orthopedics, The First People’s Hospital of Changzhou from January 2000 to January 2013, were col ected. There were 5 males and 7 females, at the age of 19-47 years old, averagely 33.5 years old. After two or three weeks of skeletal traction, they received bilateral total hip arthroplasty. Hip rotation center was reconstituted at the level of the“true”acetabulum. The subtrochanteric osteotomy was performed for patients with reduction difficulty. For patients with femoral neck anteversion>40°, subtrochanteric rotary osteotomy was performed.
RESULTS AND CONCLUSION:Disappearance of hip pain, satisfied move function and normal gait were gained after operation. Lower limbs recovered to be isometric. The average leg lengthening was 3.1 cm (range, 2.5 to 4.8 cm). One patient affected sciatic nerve irritation. The average fol owed-up time was 3.5 years. No fracture, dislocation or loosening of the prosthesis appeared. The post-operative Harris Hip Score averaged 86.3. By reconstruction of the hip rotation center in the“true”acetabular level, correction of femoral neck anteversion, reconstruction of function of the abduction muscle and proper selection of prosthesis, total hip arthroplasty for adult bilateral Crowe type-IV developmental dysplasia of the hip could obtain good curative effects.

AIMTo compare the effects of the non-mitogenetic human acidic fibroblast growth factor (nmhaFGF) and the human acidic fibroblast growth factor (haFGF) on the proliferation and MAPK signal transduction pathway of the malignant tumor cell and to study the clinical safety of nmhaFGF.

METHODSThe mammary tumor cells (MCF-7) were treated with haFGF and nmhaFGF separately. The mitogenic activities of both haFGF and nmhaFGF were detected by MTT method and the cell cycle was analyzed by flow cytometer (FCM). The expression levels of the signal proteins, Grb2 (growth factor receptor bound 2) and ERK1/2 (extracellular signal-regulated kinase 1/2), were detected by semi-quantitative Western blotting method.

RESULTSThe mitogenic activity of nmhaFGF was obviously lower than that of haFGF. The activity of nmhaFGF was weaker than that of the haFGF. The ratio of G1/G0, G2/M of haFGF was markedly lower than that of nmhaFGF and control group, and was reverse in S phase. The expression levels of both Grb2 and ERK1/2 of the nmhaFGF treated group were lower than that of the haFGF treated group and approaching the control group.

CONCLUSIONThe mitogenic activity of the nmhaFGF decreased remarkably. Its mechanism probably via down-regulation of the expression of the signal moleculars, MAPK-ERK1/2 and Grb2.

Breast Neoplasms ; metabolism ; pathology ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Down-Regulation ; Female ; Fibroblast Growth Factor 1 ; genetics ; pharmacology ; GRB2 Adaptor Protein ; metabolism ; Humans ; Mitogen-Activated Protein Kinase 1 ; metabolism ; Mitogen-Activated Protein Kinase 3 ; metabolism ; Mitosis ; drug effects ; Mutation

Objective Toinvestigatethethrombusclinicalcurativeeffectandpracticalvalueintreatmentofdeepveinthrombosis (DVT)byusingmodifiedaspirationcatheter.Methods Atotalof35patientswhometthediagnosticcriteriaofDVTwererandomly assignedintoexperimentalandcontrolgroups.Afterasufficientpreoperativepreparation,thepatientsweredividedintotheexperimentalgroup (n=18,usingmodifiedaspirationcatheterwithsubsequenturokinasethrombolysisandconventionalanticoagulationtherapy)andthe controlgroup [n=17,usingthe8Fvascularsheaths (COOK,USA)duringtheprocedure,subsequenturokinasethrombolysisand conventionalanticoagulationtherapy].Thepatencyofvessels,theperimeterdifferenceandthecomplicationweredocumented.Theresultswere comparedbetweenthetwogroups.Results Inexperimentalgroup,thrombusremovalofgradeⅣ (removalratelessthan0%)was 0%in0case,gradeⅢ (removalratelessthan50%)was5.56%in1case,gradeⅡ (removalrategreaterthan50%)was94.44%in ncontrolgroup,thrombusremovalofgradeⅣwas23.53%in4cases,gradeⅢwas52.94%in9cases,gradeⅡwas23.53%in4cases. Thedifferencesofthelegcircumferenceoftheaffectedextremitiesat15cmaboveandbelowthekneejointattimeofdischargewere alllessthanthoseatadmission.Thedifferencesinbothpreoperativeandpostoperativedatabetweenthetwogroupswerestatistically significant(bothP<0.05).Noseriouscomplicationswerefoundintwogroups.Conclusion UsingmodifiedaspirationcathetertreatingDVTisa safeandeffectivemethod,whichhashighsuctionefficiencyandfewcomplications.Therefore,itisworthytoberecommended. 17casesI.

Objective To report the microsurgical outeome of the meningiomas located in the eranio- cervical junction.Methods Seven eases of meningiomas arising from the craniocervical junction operated with microsurgical technique by use of the posterior approaehes including the suboccipital approach,the lower lateral suhoecipital approach and for lateral approach.Reviewed the related ariieales and were analysed relative to their approach selection and outcomes were analysed.Results The tumors ranged in size from 0.8 to 4.8 cm and the tumors location with 2 cases posterior,3 cases anterior and 2 cases lateral to the brain stem.3 in 7 cases were operated by use of the suboccipital approach,2 in 7 cases with the lower lateral suboccipital ap- proach and 2 in 7 cases with farlateral approach.Total excisions were got in 6 of 7 cases,4 in 6 cases with Simpson gradeⅠand 2 in 6 cases withⅡ.The subtotal excision was got in 1 of 7 cass.Follow-up with 6 ca- ses between 6 to 36 months,the occupied symptoms in 6 cases improved good.No remnant tumor and recur- rent were found in the MRI follow-up.Conclusion By using of the proper posterior approaches,the micro- surgical outonmes of the meningiomas arising from craniocervical junction are good.

OBJECTIVETo characterize DNA-PKcs and Ku70 expressions in hepato- and cholangio-neoplastic tissues and the association with the degree of malignancy and invasiveness of the tumors.

METHODSThe expression of DNA-PKcs and Ku70 was examined in 47 cases of hepato- or cholangio-neoplasm by immunohistochemistry.

RESULTSKu70 was expressed in all of the neoplastic tissues examined and with a little variation in levels. The highest expression was observed in adenocarcinomas and adenomas. There was no statistically significant association between Ku70 expression level and the degree of their malignancy extent or invasiveness. In contrast to Ku 70, a wide variation in expression levels of DNA-Pkcs was observed among different types of neoplastic tissues. The highest ratio of positive expressing cells was detected in hepatocellular carcinomas (92.1%), which was significantly higher than that in cholangioadeno carcinomas (65.3%) and biliary cystadenocarcinomas (51.9%). Low or no expression level was detected in papillary adenoma cases. DNA-PKcs expression of invasive adenomas and adeno-carcinomas (61.2%) was significantly higher than that of non-invasive adenomas and adeno-carcinomas (30.4%). There was no expression observed in the normal tissues adjacent to the tumors.

CONCLUSIONDNA-PKcs is expressed in hepato- and cholangio-neoplasms and its variable level of expression is associated with the types of the tumor and their degree of malignancy and invasiveness. DNA-PKcs could be recognized as a new biomarker for liver neoplasm.

Adenocarcinoma ; enzymology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, Nuclear ; biosynthesis ; genetics ; Bile Duct Neoplasms ; enzymology ; Bile Ducts, Intrahepatic ; enzymology ; Biomarkers, Tumor ; biosynthesis ; genetics ; Carcinoma, Hepatocellular ; enzymology ; DNA-Activated Protein Kinase ; biosynthesis ; genetics ; DNA-Binding Proteins ; biosynthesis ; genetics ; Female ; Humans ; Ku Autoantigen ; Liver Neoplasms ; enzymology ; Male ; Middle Aged

[Introduction] To design a workable compensatory scheme of new cooperative medical system (NCMS) in rural China, 'Monte Carlo Simulation Techniques' is developed based on the data of a multistage random sampling survey. The total compensation rate, the decreased percentages of poverty caused by diseases and the deficit ratio of fund a 0.3782, 0.6540 and -0.0794 respectively, when the main strategy of inpatient reimbursement is recognized as 'serious illness'. The deficit ratios of funding appeared to be 0.4840, 0.4091 and -0.3789 when the main strategy of outpatient reimbursement is recognized on minor diseases. Compensation for minor diseases is more important than that of serious diseases. Considering the further impact of minor diseases on peasants, we should incorporate compensation for minor diseases into the compensatory scheme of NCMS.

In order to decrease the potential side-effects of human basic fibroblast growth factor (hbFGF) caused by its broadspectrum mitogenic activity, a single residue of hbFGF, the residue serine 108, was replaced with neutral alanine residue to construct a mutant of hbFGF (mhbFGF) with reduced mitogenic activity. The mutant was overexpressed in Escherichia coli BL21(DE3) by IPTG induction. The expression level of mhbFGF was about 30% of the total cellular protein. The expressed mhbFGF was purified by ionic exchange and heparin affinity chromatography from the supernatant of bacteria lysate. Measured by MTT method, the effect of mhbFGF on Balb/c 3T3 cell proliferation was much lower than that of wild-type hbFGF. The purified recombinant mhbFGF was prepared and sufficient for the following pharmacological and safety studies.

OBJECTIVETo investigate the expression of RKIP, p65 and pERK in hepatocellular carcinoma (HCC) and theIr correlation with invasion and metastasis of HCC.

METHODSReverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of RKIP mRNA. The expression levels of RKIP, p65 and pERK proteins in HCC tumor and peritumoral tissues were determined by immunohistochemistry and Western blot analysis. Statistical analysis was performed to determine the relationship between their expression and clinicopathological parameters.

RESULTSRKIP protein expression level (RKIP/actin) was 0.579 ± 0.380 in HCCs, 1.178 ± 0.659 in peritumoral tissues and 1.115 ± 0.442 in normal liver tissues. The pERK protein level was 1.023 ± 0.478, 0.605 ± 0.367 and 0.461 ± 0.293, p65 protein level was 0.83 ± 0.376, 0.63 ± 0.337 and 0.466 ± 0.345, respectively. Immunohistochemistry analysis showed that the RKIP positive rates in HCCs, peritumoral tissues and normal liver tissues, were 22.2%, 86.0%, and 93.8%, positive rates of p65 were 73.6%, 56.0% and 37.5%, positive rates of pERK were 65.3%, 38.0% and 31.3%, respectively. Statistical analysis revealed that there was a significant difference in RKIP protein expression levels (P < 0.05), but no significant difference in RKIP mRNA expression levels (P > 0.05) among HCC tumors, peritumoral tissues and normal liver tissues. The p65-positive and pERK-positive rates were higher in tumor tissues than that in peritumoral tissues and in normal liver tissues (P < 0.05), but RKIP-positive rates were lower in tumor tissues than that in paritumoral tissues and normal liver tissues (P < 0.05). RKIP protein expression levels were significantly lower in HCCs with intrahepatic or lymphatic metastasis than that in without. The RKIP positive rates in moderately and well differentiated HCCs were significantly higher than that in poorly differentiated HCCs. There was a relationship between RKIP and pERK expressions (P = 0.04), but RKIP expression was not correlated with p65 expression in HCCs (P = 0.143).

CONCLUSIONSOur findings indicate that the down-regulation of RKIP expression may serve as a predictive marker for HCC development, progression and metastasis, which may contribute to the elevated ERK activity. The inhibiting effect of RKIP on invasion and metastasis of liver cancer cells may be due to the down-regulation of pERK expression rather than p65 expression.

Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Down-Regulation ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Liver ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Phosphatidylethanolamine Binding Protein ; genetics ; metabolism ; Phosphorylation ; RNA, Messenger ; metabolism ; Transcription Factor RelA ; metabolism

In order to study the tumor suppression effect of p53 with CMV enhancer and hTERT promoter mediated by human-derived vector pHrn in liver cancer cell Bel-7402, report plasmid pchEGFP, tumor suppressor plasmids pchp53Arg and pchp53Pro were constructed by inserting expression cassette CMVe+hTERTp+EGFP, CMVe+hTERTp+p53Arg and CMVe+hTERTp+p53Pro into pHrn respectively. 24 h after cell transfection by lipofectamine 2000, GFP expression pattern was analyzed through fluorescence microscope and flow cytometry; RT-PCR and Western blot were taken to study the p53 expression pattern. The cell apoptosis by Hoechst 33258 and Annexin V-FITC/PI staining was also studied. Results show that the expression of GFP and p53 protein in Bel-7402were detected, but apparent cell apoptosis could not be found. The recombinant p53 mediated by human-derived vector could express in Bel-7402, but no significant tumor suppression effect was detected, which might result from the down regulation effect of the wild type p53 on hTERT promoter.