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 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.

Objective To assess the differences in delineation of organs at risk (OAR) and dosimetry between junior and senior physicians during intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC) and to evaluate the role of specific training in reducing the differences.Methods Sixteen patients newly diagnosed with NPC were selected in the study.The OAR was delineated separately by three junior physicians and three senior physicians,and the geometric and dosimetric differences were assessed relative to the reference OAR.Delineation was performed again for the two OARs with the biggest difference after specific training in the two groups of physicians,and the differences were evaluated again.The difference was determined by paired t test.Results The maximum dose differences (Dmax) of OAR in the junior and senior physicians were (2.33 ± 12.06) ％ (-48.06％-137.82％) and (0.09 ± 4.72) ％ (-49.54％-42.96％),respectively (P =0.039),and the difference in the optic chiasm was the greatest ((5.85 ± 19.63) ％ ∶ (1.36 ± 4.64) ％,P =0.042).The mean dose differences (Dmean) of OAR in the junior and senior physicians were (3.10 ± 8.07)％ (-46.76％-59.76％) and (-0.93 ± 2.03) ％ (-45.54％-35.69％),respectively (P =0.021),and the difference in the parotid gland was the greatest ((13.23 ± 13.39) ％ ∶ (3.20 ± 6.71) ％,P =0.002).In the secondary delineation after training,the Dmax of the optic chiasm in the junior and senior physicians was (1.68 ± 3.34)％ and (1.50 ± 1.87) ％,respectively (P =0.841),and the difference in junior physicians was reduced significantly compared with before training ((1.68 ± 3.34) ％ ∶ (5.85 ± 19.63) ％,P =0.048) ; the Dmean of the parotid gland in the junior and senior physicians was (2.46 ± 3.06) ％ and (1.35 ± 3.00) ％,respectively (P =0.2 7 4),significantly reduced compared with before training ((2.46 ± 3.0 6) ％ ∶ (13.23 ± 13.39)％,P=0.002; (1.35 ± 3.00)％ ∶ (3.20 ± 6.71) ％,P =0.033).Conclusions The differences in delineation of OAR lead to dose uncertainties during IMRT for NPC,and specific training can improve the accuracy of delineation.

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

Objective To compare diagnostic performance of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum.Methods Totally 46 children suspected with Meckel's diverticulum were enrolled.Ultrasound,radionuclide imaging data were analyzed and compared with pathology.Results In 46 children suspected with Meckel's diverticulum,38 cases were confirmed by operation.Thirty-three cases of 38 were diagnosed Meckel's diverticulum by ultrasound,5 cases of 38 were false negative,there was no false positive case.Radionuclide imaging was positive in 24 cases of 46,false positive in 4 eases and false negative in 18 cases.The ultrasound diagnostic accuracy rate was 89.13％ (41/46),sensitivity was 86.84％ (33/38),specificity was 100％ (8/8).Diagnostic accuracy rate of radionuclide imaging was 52.17％ (24/46),sensitivity was 52.63 ％ (20/38) and specificity was 50.00 ％ (4/8).The sensitivity of ultrasound and radionuclide imaging in diagnosis of Meckel's diverticulum had significant difference (P＜0.01).Conclusion Ultrasound in diagnosis of Meckel's diverticulum has advantages of non-invasive,no radiation,acceptable price and high sensitivity.

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 compare the dosimetry between inversely optimised intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy using the field-in-field technique (FIF) for whole-breast radiotherapy with a boost to the tumor bed after breast-conserving surgery.Methods IMRT and FIF treatment plans were respectively performed and optimised for 9 patients with early stage leftbreast cancer after breast-concerving surgery.The prescribed dose of breast was 50.4 Gy in 28 fractions,1.8 Gy per fraction and that of tumor bed was 61.6 Gy in 28 fractions,2.2 Gy per fraction.The conformity index,the dose and volume for OAR( organs at risks),time of planning and treatment for the two plans were compared.Results The conformity index(CI) for IMRT was improved compared with the FIF in breast [(1.82±0.16) vs.(2.21±0.15)] and tumor bed [(1.19±0.04) vs.(1.59±0.11),t=2.08,3.97,P ＜ 0.05 ].There was no difference for V20 of ipsilateral lung and V30 of heart between two plans.The Dmax and Dmean of the contralateral lung of FIF were (5.41 ±2.76) and (0.51 ±0.10) Gy,lower than those of IMRT [ (25.72 ± 2.61 ) and (7.46 ± 0.39) Gy,t =-22.44,- 21.14,P ＜ 0.05 ].The Dmax and Dmean of the contralateral breast of FIF were (8.50 ± 5.61 ) and (0.47 ± 0.11 ) Gy,lower than those of IMRT [(27.73±4.30) and (6.38±0.48) Gy,t=-5.66,-14.83,P＜0.05].ForFIF,theV5of the contralateral lung and breast were (0.09 ± 0.09) ％ and (0.45 ± 0.45 ) ％,respectively,lower than those of IMRT,which were (84.66 ±3.06) ％ and (60.79 ±4.94)％ (t =-28.19,- 12.80,P＜0.05).The time of optimised plan was (61.57 ± 0.89) min for FIF and(241.28 ± 1.06) min for IMRT (t=-32.35,P＜0.05),and that of treatment were (16.14±1.42) min for FIF and (29.85 ±0.59) min for IMRT (t =- 8.82,P ＜ 0.05).Conclusions For patients with early stage breast cancer after breast-concerving surgery,IMRT could improve the conformity index of target but increase the dose of eontralateral lung and breast.However,FIF has advantage on the time of optimising plan and treatment.

Objective To investigate the dynamic expressions and clinical significance of CD141, CD31 and CD95 on circulating endothelial cells (CEC) in febrile and polyuria phases of patients with hemorrhagic fever with renal syndrome (HFRS). Methods Expressions of CD141, CD31 and CD95 in the peripheral blood of patients with HFRS in febrile and polyuria phases were detected by flow cytometry. Comparisons among groups were done by one-factor analysis of variance. Results The percentages of CD141+ CD31+ cells in the peripheral blood cells from patients with HFRS in febrile and polyuria phases were 9.47% ±1.98 % and 8. 26% ±1.55 %, respectively, which were both higher than that (7.05%±1.45%) in healthy controls (F=8. 42; P=0. 000 and P=0. 029, respectively), and that in febrile phase was higher than that in polyuria phase (P = 0. 048). The mean fluorescent intensity (MFI) of CD95 on CEC of HFRS patients in febrile and polyuria phases were both significantly higher than that in healthy controls (F=19. 93; P=0. 000 and P=0. 000 respectively), and that in febrile phase was higher than that in polyuria phase (P=0. 049). In the febrile phase of HFRS,the MFI of CD95+ on CEC in patients with all clinical types were all higher than that in healthy controls (F= 17. 36; all P=0. 000), and that in severe (critical) type was the highest and higher than those in mild type and moderate type (P=0. 002 and P=0. 009, respectively). Conclusion The proportion of CEC and expression of CD95 on CEC are possibly related with the phase and severity of HFRS.

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.

Objective To evaluate the uncertainty of the small bowel dose?volume and the normal tissue complication probability (NTCP) during intensity?modulated radiotherapy (IMRT) for rectal cancer, and to provide a reference for the dose limit and protection of the small bowel during IMRT for rectal cancer. Methods A total of 20 patients with rectal cancer who received postoperative adjuvant radiotherapy from March 2014 to August 2015 were enrolled in this study, including 10 patients receiving CT scan in the supine position and 10 patients in the prone position. All patients received computed tomography ( CT) scan before the treatment and at weeks 1, 2, 3, and 4 of treatment, and they were defined as Plan, 1W, 2W, 3W, and 4W CT groups, respectively. The small bowel loop ( BL ) and peritoneal space ( PS ) were delineated on the images. The IMRT plan based on the Plan CT was copied to the 1W, 2W, 3W, and 4W CT groups, and then the small bowel dose?volume and NTCP were assessed for all CT groups. The paired t?test was used for comparison between groups. The Pearson method was used to analyze the correlation between NTCPC(chronic NTCP) and dose?volume. Results A total of 89 CT images of 20 patients were obtained. In all the patients, the volumes of BL and PS were 25121 cm3 and 132416 cm3 , respectively, and the shift% was 2315% and 1134%, respectively. The V15 of BL and PS was 18486 cm3 and 79245 cm3 , respectively, and the shift% was 3169% and 370%, respectively. The V30 of BL and PS was 8801 cm3 and 64573 cm3 , respectively, and the shift% was 3766% and 1049%, respectively. The V15 of BL in 35% of patients and V15 of PS in 20% of patients, the Dmax of BL in 50% of patients, and the NTCP of 15% of patients in the course of treatment exceeded the safety limits. The 1?4W CT groups had a significantly higher NTCPC than the Plan CT group (402% vs. 320%, P=0104), and their SD% was 4168%. There was a significant correlation between NTCPC and V30?V50 of BL (R>0400, P=0000). The NTCPA ( acute NTCP ) and NTCP C in the supine position were significantly higher than those in the prone position ( 6230% vs. 5674%, P=0061;488% vs. 322%, P=0145 ) . Conclusions Small bowel motility leads to an uncertainty of the adverse event assessment during IMRT for rectal cancer. The change in BL is significantly larger than that in PS and the change in BL and PS in the supine position is significantly larger than that in the prone position. Using the prone position and minimizing V15 and V30 when designing the treatment plan can reduce the NTCP A and NTCP C in the small bowel.