Objective To investigate the associated effect of 125I implantation plus chemotherapy in local recurrent stage Ⅲ NSCLC patients.Methods From January 2006 to January 2009,34 patients documented with local recurrent stage Ⅲ NSCLC were divided into two groups by random number table.The treatment group was treated with 125I permanent implantation combined with DP regimen (docetaxel 60 mg/m2 + cisplatinum 75 mg/m2),while the control group received only DP chemotherapy.According to the TPS,the treatment group received CT-guided percutaneous implantation of 125 I seeds with a particle activity of 2.22 ×107-2.59 × 107 Bq.The prescribed dose was in the range of 90-110 Gy and the postoperatively matched peripheral dose (mPD) and D9o were verified by TPS.The control group received a DP chemotherapy regime for 4 cycles after the procedure.This study was approved by the ethics committee,and all patients signed informed consents.The follow up time was up to disease progression.Kaplan-Meier survival analysis was used to describe the local lesion control (LLC) time and progression free survival (PFS).Log-rank test was used in the comparison of the survival rates between the two groups.Fisher's exact test was used to analyze the differences of CR rate and recent efficiency between two groups.Results In the treatment group,postoperative mPD was 93.9-130.4 (M 116.7) Gy,and D90 was 103.6-148.2 (M 130.6) Gy.The LLC time was 4.7 to 24.0 months with a median of 11.6 (95％ CI:8.7-14.6) months.In two cases,there was no recurrence during the follow-up time of 24 months.PFS was 4.7 to 24.0 months with a median of 10.5 (95％ CI:7.4-13.6) months.The recent effective rate of the treatment group was 64.7％ (11/17).CR,PR,SD and PD were 41.2％ (7/17),23.5％ (4/17),23.5％ (4/17) and 11.8％ (2/17),respectively.In the control group,the LLC time was 4.5 to 11.4 months with a median of 7.5 (95 ％ CI:6.7-8.3) months,and the median of PFS was 6.5 (4.5-10.5) (95％ CI:5.7-8.3) months.The response rate,CR,PR,SD and PD were 41.2％ (7/17),5.9％ (1/17),35.3％ (6/17),35.3 ％ (6/17) and 23.5％ (4/17),respectively.There was no statistical significance of the recent effective rate between the treatment group and control group (P =0.30),but the LLC time (x2 =8.40,P ＜ 0.01),the median of PFS time (x2 =6.27,P ＜ 0.05) and CR (P =0.04) of the treatment group were all significantly higher than those of the control group.Concltusion The implantation of 125I seeds combined with chemotherapy for recurring stage Ⅲ NSCLC patients is safe and effective,and its efficacy is superior to the second line chemotherapy alone.

Recently, microRNAs (miRNAs) have been shown to be involved in multiple biological pathways that can influence tumor progression and metastasis and they can serve as prognostic biomarkers in many cancers. The present study examined the prognostic significance of miR-215 in cervical cancer. The paraffin-embedded paired cervical scrape samples and tumor tissue samples from 302 patients with stage II cervical cancer were detected for the expression of miR-215 by using qRT-PCR. A miR-215-based classifier was established by using the Cox regression model. The prognostic and predictive accuracy of this classifier was determined in both the internal testing group of 138 patients, and the external independent group of 280 patients. Moreover, cervical cancer HeLa cells overexpressing miR-215 (HeLa-miR-215) were constructed and subcutaneously injected into the nude mice to examine the effect of miR-215 on tumor growth and metastasis in vivo. The results showed that the expression level of miR-215 was significantly higher in cervical cancer tissues than in paired normal tissues (P<0.0001). When patients were classified into high- and low-risk cancer progression groups according to miR-215 level, the 5-year disease-free survival in high- and low-risk groups were 43% (95% CI: 32.1-51.6) and 67% (95% CI: 48.6-77.3) (hazard ratio [HR] 2.02, 95% CI: 1.16-3.52; P=0.013) respectively. Moreover, the expression level of miR-215 was negatively associated with survival rate in patients at TNM stage T3 (HR: 3.317; 95% CI: 1.18-5.14, P=0.017) and TNM stage T4 (HR: 3.48; 95% CI: 1.49-4.45, P=0.008). Tumor volume in nude mice injected with HeLa-miR-215 cells was significantly larger than that in mice injected with control HeLa cells. It was concluded that the expression level of miR-215 is associated with cervical tumor progression and worse survival rate, suggesting that it may serve as a potential prognostic marker to identify patients at higher risk of recurrence.

Objective To evaluate the clinical value of color Doppler ultrasound (CDUS) and computed tomography angiography (CTA) in diagnosis of Budd-Chiari syndrome(BCS).Methods The CDUS and CTA data about 33 BCS patients diagnosed by digital subtraction angiography(DSA) and treated by interventional therapy were retrospectively analyzed.All of 33 patients with BCS were examined with CDUS,26 cases of then received CTA.The diagnostic value of BCS between two methods were compared.Results The diagnostic accordance rate of CDUS and CTA for BCS were 90.9％ and 96.2％ respectively,which had no significant statistical difference(P ＞ 0.05).The two methods could not only comprehensively systematically reflect the morphologic changes of liver and spleen,the stenosis and blood flow state of the lesion regions,but also clearly display the intrahepatic/extrahepatic collateral vessels trend in the abdomen.One week after interventional therapy,the CUDS results showed blood vessels pristine and stable hemodynamics.Conclusion CDUS is the preferred imaging in the diagnosis and postoperative re-examination of BCS.While,CTA can provide many important parameters for preoperative assessment and operation way.

ObjectiveTo investigate the modification method of Cervical Spine Injury Severity Score System and discuss diagnosis and treatment strategy of lower cervical spine injuries.Methods Treatments of lower cervical spine injuries were selected according to the injury severity graded by the modified Moore' s classification system.Conservative therapy could be adopted for the patients with stability quantification rating ＜ 3 points or for the those with stability quantification rating =3 points but without spinal cord or nerve root compression.Surgical treatment was recommendable for the patients with stability quantification rating =3 points and with spinal cord or nerve root compression.Surgical therapy could be required for the patients with stability quantification rating ≥4 points and with risk of lower cervical instability.The higher the stability quantification score implied the stronger the surgical indications.Lower cervical spine injury combined with spine cord or nerve root compression had absolute surgical indications.At the same time,therapies were selected based on patients' other factors.ResultsBased on basic principles of the modified Moore' s classification system together with opinions of the patients and their relatives,14 patients were managed with surgical treatment and 16 with conservative treatment.Among the patients with complete spinal cord injury (Grade A),two patients treated surgically showed no obvious signs of spinal function recovery,but their nerve root irritation symptoms disappeared; the other one patient who needed surgery but received conservative treatment had no change of the spinal cord function and nerve root irritation.The patients with incomplete spinal cord injury (Grades B,C and D) treated surgically obtained certain degree of spine cord function recovery,with their American Spinal Injury Association (ASIA) score raised by 0.5 grade on average.However,the patients who needed surgery but received conservative treatment gained average increase of ASIA score for 0.5 grade.Imaging examination showed that patients without combined spinal injuries obtained interbody fusion after surgery,with normal alignment and height of the cervical vertebra but without presence of vertebral shift or instability. ConclusionsThe modified Moore' s classification system takes patients' spiaal injury condition and other factors into consideration in selection of conservative or surgical treatment,which improves the Cervical Spine Injury Severity Score System to some extent and has prospect of clinical application.

Objective To study the role of preoperative CA19-9 level in predicting resectability of pancreatic cancer.Methods Preoperative CA19-9 levels were determined by radioimmunoassay.The receiver operating characteristic curve was used to determine the cut-off point.The clinical value of the level of CA19-9 as a predictive marker of resectability was evaluated by the area under curve.Results The preoperative CA19-9 levels in the resectahle group was (313.6±515.5) kU/L,which was significantly lower than (852.1± 865.1)kU/L in the unresectable group (P＜0.001).The cut-off point of CA19-9 for predicting pancreatic cancer resectability was 312.1 kU/L,which had a sensitivity of 56.6％ and a specificity of 73.3％.The area under curve was 0.67.Conclusions The preoperative CA19-9 level may be used to predict resectability of pancreatic cancer.

Objective To evaluate the application of “expert-guided network tracking system” in training community general practitioner for hypertension management.Methods Total 855 general practitioners (GPs) from 20 community health service centers in Hangzhou,Jiaxing and Shaoxing of Zhejiang province were divided into two groups: 430 GPs from 10 community health centers received training for hypertension management using “ expert-guided networking tracking system” (intervention group) in December 2008 and 425 GPs from another 10 health centers received conventional training (control group).Questionnaire surveys about the knowledge and skill of hypertension management were conducted before and 3 y after training.Results The awareness rates of knowledge about hypertension prevention and control,non-drug therapy and drug therapy increased from 37.0％ (159/430),45.6％ (196/430),42.8％ (184/430) to 66.8％ (284/425),81.4％ (346/425),77.6％ (330/425),respectively and the accuracy of case analysis increased from 38.4％ (490/1290) to 73.3％ (946/1290) (P ＜0.01) after training in intervention group.Meanwhile the knowledge and case management abilities in control group were also improved after conventional training,but the degree was significantly lower than that in the intervention group.Conclusions “Expert-guided networking tracking system” can significantly improve the knowledge and skills for hypertension management in community general practitioners.

Objective To analyze and determine the efficient T- and B-combined (T/B) antigenic epitopes in Helicobacter pylori adhesin A. Methods Recombinant HpaA (rHpaA) was expressed for immunizing rabbit to generate antiserum. T- and B-cell epitopes in HpaA molecule were predicted by using bioinformatic technique. The segments to encode T/B combined epitope peptides were amplified by PCR and the phage display systems of T/B combined epitopes were subsequently constructed. PEG/NaCl precipitation method was applied to extract the recombinant phage PⅢ (rPⅢ) that displayed T/B combined epitopes. By using either commercial IgG against whole-cell of Helicobacter pylori or rHpaA antiserum as the primary antibody, the T/B combined epitopes displayed in rP Ⅲ s were screened and identified by Western blot and ELISA. MTT was applied to determine the proliferation of rHpaA-immunized mouse splenocytes after stimulation of the different recombinant rPⅢ proteins. Results In the HpaA molecule there were five T/B combined epitopes: HpaA10, HpaA37, HpaA79, HpaA116 and HpaA143. All the T/B combined epitopes were successfully displayed on the surface of PⅢ protein of phage M13. The results of Western blot, ELISA and MTT confirmed that HpaA116 was the predominant antigenic epitope, both HpaA37 and HpaA79 were the efficient antigenic epitopes. However, HpaA10 and HpaA143 were identified as ineffective antigenic epitopes. Conclusion The phage display systems of T/B combined epitope peptides of H. pylori adhesin A have been successfully generated in this study. HpaA37 and HpaA79, especially HpaA116 are the efficient T/B combined antigenic epitopes in HpaA of H. pylori.

OBJECTIVETo establish the steriod-induced osteoporosis model with the type of Kidney-Yin deficiency.

METHODSTotally 45 female Kunming mice were randomly divided into normal group,model group and Liuwei Dihuang pills(Chinese character: see text)group. The model was established by intramuscular injecting of Dexamethasone. Liuwei Dihuang pills (Chinese character: see text) group was administered orally with Liuwei Dihuang pills (Chinese character: see text). The signs and symptoms of mice were observed dynamically. All the animals were sacrificed at the end of the 6th weeks. The level of ACTH, cAMP, cGMP, TSH and E2 in serum were detected to evaluate deficiency of Kidney-Yin. Morphological changes and bone density were observed to evaluate osteoporosis.

RESULTS(1) Compared with control group, mice in model group appeared obvious Kidney-Yin deficiency symptoms, including hair dry, restlessness, excitability, hard stool, and yellow. (2) Compared with control group,the weight of mice in model group gained slower (P<0.01); the index of adrenal gland,liver and spleen decreased (P<0.01, P<0.01 ,P<0.01); the level of ACTH and TSH increased (P<0.01 ,P<0.01), the level of E2 decreased (P<0.01) and the ratio of cAMP/cGMP increased (P< 0.05). (3)Compared with control group,the bone density of lumbar vertebra and femur in model group were significantly decreased (P<0.01, P<0.05); HE staining revealed osteoporosis in model group mice. (4)However, the Liuwei Dihuang pills (Chinese character: see text) group can partly antagonize the inhibition of the HPA axis, alter the disordered sex hormone and the ratio of cAMP/cGMP, and reverse the osteoporosis partly.

CONCLUSIONthe model of osteoporosis with type of Kidney-Yin deficiency could be established by Dexamethasone intramuscular injection. With less interference, it wight be a stable and reliable modeling method for integration of disease and syndrome in TCM.

Animals ; Bone Density ; Dexamethasone ; toxicity ; Disease Models, Animal ; Female ; Kidney Diseases ; etiology ; Medicine, Chinese Traditional ; Mice ; Osteoporosis ; chemically induced ; Yin Deficiency ; complications

OBJECTIVETo evaluate the effect of the platelet-derived growth factor-BB (PDGF-BB) on the phenotypic transformation of corpus cavernosum smooth muscle cells (CCSMC) in SD rats.

METHODSCCSMCs were primarily cultured in the modified tissue sticking medium and subjected to immunofluorescence assay. The cells were divided into a blank control and four PDGF-BB groups, the latter exposed to 5, 10, 20, and 40 ng/ml of PDGF-BB, respectively, for 24 hours, and the cells in the 20 ng/ml PDGF-BB group treated for 24, 48, and 72 hours. The the relative expressions of α-SMA, SMMHC, calponin, and OPN mRNA were determined by real-time fluorescence quantitative RT-PCR (qRT-PCR).

RESULTSThe α-SMA positive rate of the CCSMCs was over 95%. Compared with the blank control group, the expression levels of α-SMA, SMMHC, and calponin mRNA were significantly decreased (P < 0.05) while that of OPN mRNA remarkably increased (P < 0.05) in the PDGF-BB groups. The 20 ng/ml PDGF-BB group also showed significantly downregulated expressions of α-SMA, SMMHC, and calponin mRNA (P < 0.05) and upregulated expression of OPN mRNA (P < 0.05) at 24, 48, and 72 hours.

CONCLUSIONPDGF-BB can induce the transformation of the phenotype of CCSMCs in SD rats from the contractile to the synthetic type.

Actins ; metabolism ; Animals ; Calcium-Binding Proteins ; metabolism ; Cell Culture Techniques ; Cells, Cultured ; Male ; Microfilament Proteins ; metabolism ; Muscle Contraction ; Myocytes, Smooth Muscle ; cytology ; drug effects ; metabolism ; Myosin Heavy Chains ; metabolism ; Penis ; cytology ; drug effects ; metabolism ; Phenotype ; Proto-Oncogene Proteins c-sis ; administration & dosage ; pharmacology ; RNA, Messenger ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors

Objective To explore the current status of radiation protection in interventional procedure and to analyze the existent problems.Methods Using the random sampling,70 interventional radiology workplaces were selected from Hangzhou,Ningbo,Wenzhou,Shaoxing and Jinhua.Information on personal radiation protective products and equipment was collected by filling out the form by hospital and the radiation dose was monitored at various body parts of the workers and at the outside of the operating room.Results All hospitals have been equipped with personal radiation protective products and equipment,22 of which were not with these products and equipment as required.Chest,abdomen and lower limb of interventional radiology workers are easy to receive higher radiation dose than in head (F =4.85,4.92,P ＜ 0.05).The acceptance rates among different body parts of the workers were difference significantly (x2 =35.14,14.92,P ＜ 0.05).Using protective curtain can reduce the radiation dose significantly (t =11.61-68.28,P ＜ 0.05).Meanwhile,it also can improve the acceptance rates significantly (x2 =6.09-28.45,P ＜ 0.05).Conclusions It is necessary to strengthen the use of radiation protection equipment among interventional radiology workers to reduce the levels of the individual doses to them.Hospitals must enhance the routine monitoring for improved radiaton protection.