Objective: To research the effect of Xinkai Kujiang method on gastric myoelectrical activity and autonomic nerve function in functional dyspepsia(functional Thirty,FD) rat,and to reveal the overall regulatory mechanism of Xinkai Kujiang method and help for the clinical trials and treatment.Methods: FD rats being the experiment subject,we observed the effects of Xinkai Kujiang method on FD rat gastrointestinal movement,including the following index,the main frequency,power,even the percentage of slow wave duality.Meanwhile we observed the effect of Xinkai Kujiang method on FD rat heart ratevariability(HRV),evaluated the effect on autonomic nerve function,and revealed FD rats overall adjustment mechanism.Results: Before treatment,the result of model group,weikangning group and the normal control group was significantly different(P0.05),but that of weikangning and the model group had significant differences(P0.05),weikangning group change trend was significantly different(P

Objective To investigate the difference in normal tissue complication probability (NTCP) of lower cranial nerves (LCNs) between target volumes recommended by Radiation Therapy Oncology Group (RTOG) and China in intensity-modulated radiotherapy (IMRT) for T1-2 nasopharyngeal carcinoma (NPC),and to provide the evidence of dose-volume effect for the protection of LCNs in IMRT for NPC.Methods A total of 20 patients with T1-2 NPC who were treated from 2013 to 2015 were enrolled,and LCNs were delineated on CT images.Target volume delineation and treatment plan designing were performed according to the method recommended by RTOG0225 (RTOG target volume delineation method) or the Chinese Working Committee for Clinical Staging of NPC in 2010 (Chinese target volume delineation method),and the differences in the dose to LCNs and NTCP were calculated.Results In the RTOG and Chinese methods for target volume delineation,Dmax to the left and right LCNs was 7 450±273 cGy/7294±309 cGy and 7 361± 160 cGy/7 190±395 cGy,respectively (P=0.018 and 0.042),Dmean was 6735±285 cGy/6 660±333 cGy and 6 446±429 cGy/6 299±467 cGy,respectively (both P=0.000),and the NTCP was 60％±10％/57％±13％ and 51％±15％/45％±17％,respectively (both P=0.000).Conclusions It is feasible to precisely delineate target volume with the LCNs as a routine OAR and predict NTCP in IMRT for T1-2 NPC.The NTCP of the LCNs is closely associated with target volume dose and irradiated volume.The dose to the LCNs and NTCP determined by the Chinese target volume delineation method are significantly lower than those determined by the RTOG method.

Objective To study three contouring approaches of the bowel and evaluate the bowel dose volume with cervical cancer patient.Methods Twelve patients were selected,prescribed dose 45 Gy/ 25f.For each patient we contoured the bowel according to three different definitions:bowel loops,bowel bag and peritoneal space.Then we generated three rival plans each considering a different bowel definition and to evaluate dose differences of the HI,CI of PTV and D D V5-V45 of bowel loops with paired t-test.Results Comparison between BL and BB plan,Dmax,HI and CI of PTV,V5-V45 of bowel loops were not significantly different (P =0.171,0.076,0.192,P =0.315-0.855),D of PTV and Dmax of bowel loops had difference (P=0.017,0.038).Comparison between BL and PS plan,Dmax,D HI and CI of PTV and Dmax of bowel loops had differences (P=0.033,0.044,0.046,0.041,0.013),V5-V45 of bowel loops were not significantly different (P=0.416-0.977).If the bowel loops V40 ≤ 15％,and bowel bag and peritoneal space V40≤20％.Conclusions All definitions provided a very similar dose volume of bowel loops.Taking into account HI and CI of PTV and max dose of bowel loops,BB seems better than PS.

Background and purpose:The pedicled pectoralis major myocutaneous lfap has been a common choice of tissue lfaps for head and neck reconstruction. Nowadays, with rapid advancement in microsurgery, free lfaps gradually replace the pedicled lfaps. However, not all patients are good candidates for reconstruction surgery using free tissue lfaps. Adjacent pedicled lfaps are safer and more reliable. This paper explores potential application of pedicled pectoralis major myocutaneous flap in reconstruction of complex surgical defects following resection of advanced head and neck malignancies through modification of their preparation and repair method.Methods:Flap design scheme and method of preparation were modiifed to improve the pectoralis major muscle lfap. Fifty-one patients with surgical defects from resection of head and neck malignancies received reconstruction surgery using modiifed pectoralis major muscle lfaps.Results:Modiifed pectoralis major muscle lfaps survived completely in 51 patients. The area of defect regained its shape and appearance after reconstruction surgery. The area of defect obtained excellent functional recovery. Postoperative functional injuries to the donor sites were minimized.Conclusion:Modiifcation in designing and preparing method of the pectoralis major muscle flap improved repair range and distance in reconstruction of complex surgical defect following resection of head and neck malignancies. It also reduced necrosis rate of skin lfaps. Postoperative donor and recipient sites regained their appearance and functions successfully. The pectoralis major muscle lfap is one of the important tissue lfaps used in reconstruction of surgical defect following resection of a head and neck malignancy.

Objective To study the effect and mechanism of Xinkai Kujiang method(TCM treatment with the pungent and bitter herbs to regulate the gastrofunctions)on the functional dyspepsia(FD)rats.Methods Twenty-four rats were randomized into control group,model group,and Weikangning(herbal medicine for dyspepsia)group,with 8 in each.After a 7-day adaptive feed,the FD models were made with the clipping tail stimulation.Seven days after modeling,the Weikangning group was given Weikangning Capsule 0.625g/kg by gavage,twice a day,and the other two groups were given normal saline in the same dosage.The medication was appliey in succession for 12 days,and on the thirteenth day,the serum and gastric tissues were collected for detecting the lab indications:plasma motilin(MTL),plasma nitric oxide(NO),gastric tissue MTL,nitric oxide synthase(NOS),and the expression of Cajal interstitial cells(ICC)and gastrointesinal smooth muscle cells(SMC).Results Compared with the control group,the level of plasma MTL in the model group was significantly decreased,the level of NO significantly increased,and the expression of MTL,ICC and SMC positive neurons in the stomach myenteric nerve plexus was significantly weakened,but the expression of NOS positive neurons was significantly strengthened(P

Objective To investigate the role of transient hepatic parenchyma enhancement (THPE) in differentiation between hepatic abscess and hepatic metastasis.Methods Dynamic enhanced spiral CT was performed in 34 patients with hepatic abscess and 29 patients with hepatic metastasis. The images were retrospectively analyzed.Results THPE was showed in 68.1% of hepatic abscesses (32/47 ) , while only in 21.5% of hepatic metastases ( 9/52 ). When “THPE around at least one lesion” acted as the criterion for deciding that one patients suffered from hepatic abscess, the sensitivity and specificity was 70.6% and 79.3% respectively.Conclusion THPE is much more often showed around hepatic abscess than around hepatic metastasis. THPE around lesion is useful CT finding for differentiate hepatic abscess from hepatic metastasis.

Objective To study blood type B antigen elimination with α-galactosidase in human liver tissue,and discuss the feasibility of blood type conversion in human liver.Methods The liver specimens from patients with blood type B in liver transplantation were collected,and an in vitro liver perfusion model was established.The in vitro livers were perfused with UW solution +/-α-galactosidase.The effect of enzyme in B antigen of human liver were analyzed by immunofluorescence.Results With UW solution containing α-galactosidase to perfuse the in vitro livers,immunohistochemistry showed the level of blood type B antigen in liver was significantly reduced after hypothermic perfusion and preservation.The B antigen level in 1 h perfusion was reduced to approximate 58％ of this figure prior to perfusion,in 2 h was 10％,and in 4 h was 4％.Among the different intervals,the blood group antigen levels showed significant differences (P ＜ 0.05).In the control group,the blood group antigen levels showed no obvious change on statistical analysis.Conclusions α-galactosidase was effective to clear blood type B antigen in isolated liver tissue.In the experimental group,Although the B antigen did not fall to a undetectable level,liver blood type conversion from B→O remains a promising potential which has been meaningful for related researches on blood type conversion of human organs.

Objective To compare the dose volume and normal tissue complication probability (NTCP) of small intestine between intensity-modulated radiotherapy (IMRT) with dose constraints to the peritoneal space (PS) and the bowel loop (BL) in the treatment of rectal cancer,and to investigate the feasibility of placing a dose constraint to the PS instead of the BL in protection of the small intestine.Methods A total of 24 patients with rectal cancer undergoing postoperative adjuvant radiotherapy were enrolled as subjects.In the 24 patients,12 were treated in supine position an.d 12 in prone position.The weekly computed tomography (CT) scans from pre-treatment to weeks 1-4 of treatment were defined as Plan,1 W,2 W,3 W,and 4 W.Contours of PS and BL were delineated on all CT images.Based on the Plan CT images,two IMRT plans,PPS and PBL,were designed with dose constraints to the PS and BL,respectively.The method was applied to 1-4 W CT images.For each CT scan,the dose volume and NTCP of the small intestine were evaluated in PPs and PBL.Results A total of 109 sets of CT images were acquired from 24 patients,and 218 plans were designed and copied.The median volume of the PS and BL was 1339.28 and 250.27 cm3,respectively.For the Plan CT scans,V15 values of the PS in PPs plan and the BL in PBL plan were 918.96 and 199.57 em3,respectively.For all CT scans,the dose volume of the small intestine in PPs,in most cases,was lower than that in PBL,while V15 values in Ps and PBL were 170.07 and 178.58 cm3 (P=0.000).The dose volume of the small intestine was correlated with V15 (P=0.000).PPs had significantly lower NTCP of chronic and acute adverse reactions than PBL(2.80％ vs.3.00％,P=0.018;57.32％ vs.58.64％,P=0.000).In patients with prone and supine treatment positions,most of the dose volume and NTCP of the small intestine in Ps were significantly lower than those in PBL(P＜0.05 for V10,V15,V30,and NTCP of acute adverse reactions).Conclusions It is feasible to place a dose constraint to the PS instead of the BL for protection of the small intestine during IMRT for rectal cancer.V15＜830 cm3 can be referred to as the objective function of dose restraint.

Objective To construct the eukaryotic plasmid expression vector mediated short hairpin RNA(shRNA) interference targeting TLR4 gene,and transfect it into pancreatic adenocarcinoma cell line PANC1,then screen stably transfected clonal cell line.Methods Three shRNA interference expression plasmid vectors targeting the TLR4 gene were constructed,named TLR4-1,TLR4-2,TLR4-3.The shRNA plasmid with highest inhibitory efficiency was selected and transfected into PANC1 cells with liposome.The silencing efficiency and transfection efficiency of TLR4-shRNA was assayed with real-time quantitative PCR and flow cytometry analysis.Monoclonal cell with stable transfection of TLR4-shRNA were selected by geneticin 418 (C418) and limiting dilution analysis.Results Transient transfection efficiency of PANC1 was (46.72 ±5.06) ％.TLR4 mRNA expressions were 0.025 ± 0.004,0.027 ± 0.003,0.019 ± 0.006in cells transfected with TLR4-1,TLR4-2,TLR4-3,respectively,which were significantly lower than that in untransfected group (0.061 ±0.018) and negative control group (0.057 ±0.015,P ＜0.05).The transfection efficiency of TLR4-3 vector in stably transfected clones [(82.79 ±8.16)％] was significantly higher than that of transient transfection (P =0.001 ).The expression of TLR4 mRNA was decreased to 0.010 ± 0.002,which was significantly lower than that of transient transfection ( P =0.001 ).The expression of TLR4 protein was (0.54±0.32) ％,which was significantly lower than that of untransfected cells [( 87.42 ± 5.00 ) ％] and that of negative control [(82.9±5.00)％,P =0.000].Conclusions Stable transfection PANC1 cell lines with TLR4 gene silencing are successfully identified.

Objective To investigate the dosimetric difference of organ at risk (OAR) for planning and actual estimated during intensity-modulated radiotherapy (IMRT) for patients with nasopharyngeal carcinoma.Methods Thirteen patients were enrolled to accept full course of IMRT.CT scans were acquired in the 10th,20th,and 30th fractions during radiotherapy,respectively.OAR,including brain stem,spinal cord,parotid gland and submandibular gland,were delineated on repeated CT scans.The volume change of OAR were investigated.After that,the plans were copied to the new CT image to calculate the escalated average dose of OAR during radiotherapy (Actual estimated receiving dose minus planning dose).Results The change trend of volume was decreasing gradually for parotid gland and submandibular gland during the 10th,20th,and 30th times radiotherapy (all P =0.000).The maximum dose (Dmax) of brain stem and spinal cord and the 50％ volume receiving dose (D50) of parotid gland increased significantly in the 10th,20th,and 30th times during radiotherapy,respectively.The escalated average dose were 3.76 and 3.68 Gy for Dmax of brain stem and spinal cord (P =0.000,0.000),5.11 and 3.54 Gy for D50 of left and right parotid (P =0.001,0.023),and 0.49 and 0.75 Gy for D50 of left and right submandibular gland (P =0.220,0.230),respectively.Conclusions The volume of parotid gland and submandibular gland significantly decreased after radiotherapy The actual receiving dose of brain stem,spinal cord,and parotid gland increased significantly during radiotherapy.However,there was no significant change for the actual receiving dose of submandibular gland.