Objective To evaluate the clinical efficacy and toxicities of radical intensity-modulated radiotherapy (IMRT) combined with reduction in dose of prophylactic irradiation in the treatment of stage Ⅲ small cell lung cancer (SCLC).Methods A retrospective analysis was performed on the clinical data of 40 patients with stage Ⅲ SCLC who were admitted from January 2010 to August 2012.The prescribed dose was 60 Gy in 30 fractions to the primary gross tumor volume and was 54 Gy in 30 fractions to the planning target volume.All patients received induction chemotherapy,31 patients received adjuvant chemotherapy,and 22 patients received concurrent chemoradiotherapy;the platinum-based chemotherapy combined with etoposide or teniposide was adopted.Prophylactic cranial irradiation (25 Gy in 10 fractions) was administered to 17 patients.The short-term tumor response was evaluated by RECIST 1.0,and radiation-related toxicities were assessed by CTCAE 4.0.Overall survival (OS),local recurrence-free survival (LRFS),and progression-free survival (PFS) were calculated by Kaplan-Meier method.Results The short-term tumor response rate was 98％.The follow-up rate was 100％.Twenty-two patients were followed up for at least 2 years.The 1-and 2-year OS rates were 84％ and 48％,respectively; the LRFS rates were 89％ and 85％,respectively; the PFS rates were 61％ and 41％,respectively.Grade 0-1 radiation-related pneumonia was observed in 65％(26/40) of all patients,grade 2 in 25％ (10/40),grade 3 in 5％ (2/40),and grade 5 in 5％ (2/40).Grade 0-1 radiation-related esophagitis was observed in 53％ (21/40) of all patients,grade 2 in 43％ (17/40),and grade 3 in 5 ％ (2/40).Conclusions Preliminary results from this study suggested that IMRT combined with reduction in dose of prophylactic irradiation is safe and effective in patients with stage Ⅲ SCLC and is worth further evaluation in a large,prospective,randomized study.

Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.

Objective Single nucleotide polymorphisms(SNPs) in receptor tyrosine kinaselike orphan receptor 2 (ROR2) gene were analyzed and compared between Han Chinese in Beijing(CHB) and Japanese in Tokyo(JPT) using the HapMap data,to provide basis for SNP determination.ROR2 gene related etiologic studies were conducted in the above mentioned two populations.Methods Monotonic and un-monotonic SNPs of ROR2 gene were distinguished by Haploviewprogram.Minor allele frequency (MAF),haplotype blocks and haplotype frequencies were analyzed ineligible SNPs and tag SNPs respectively with genotyping call rate ＞80％,MAF＞1％,H-Wequilibrium (P＞0.01) and no gender difference (P＞0.05).Tag SNPs were determined under thecriteria of r2≥0.8 or logarithm of the odd score (LOD) ≥3 for pairwise eligible SNPs in CHB and JPT.Common tag SNPs for CHB and JPT were directly reported by Haploview program or being identified from those which were higly related to tag SNPs reported by haploview program under SPSS 13.0 software.Results A total of 404 common SNPs were provided for both CHB and JPT samples by HapMap,where 101 common monotonic SNPs between CHB and JPT had the common minor alleles.The common SNPs between CHB and JPT were 257.In the 257 common eligible SNPs,224 (87.2％) had common minor alleles.Among the 18 and 27 haplotype blocks identified in 257common eligible SNPs between CHB and JPT,except for 2 independent haplotype blocks identified only in JPT.Other haplotype blocks between CHB and JPT were overlapped partly or completely.A number of 50 common tag SNPs between CHB and JPT were determined and the proportions in CHB and JPT were 64.9％ and 70.4％ respectively.Conclusion Analysis of HapMap data provided an opportunity to avoid monotonic SNPs that had been included in ROR2 gene related etiologic studies.SNPs in ROR2 gene had common features in alleles,MAF,haplotype blocks and haplotype frequencies between CHB and JPT populations,which were consistent with the geographic and ethnic origins of the two populations.

Objective To evaluate the value of gemstone spectral imaging (GSI)and multi artifact reduction system(MARs)in re-ducing metallic implants artifacts,and find the best monochromatic images.Methods Twenty-one patients with metal implants in our hospital receievd GSI examination ,MARS reconstruction and polychromatic images(140 kVp).Eleven groups of monochromatic and MARS images were obtained from 40 keV to 140 keV every interval of 10 keV by the special GSI viewer ,respetively.Subjective image quality of two methods were assessed by 3 radiologists in consensus.For every patient one group monochromatic images and blend enery images were selected two heaviest artifacts level and no artifacts level,the CT value and the standard deviations(SD)value of the region of interest(ROI)were meatured of artifacts.Contrast-to-noise ratio(CNR)and artifacts index(AI)were also caculated and were analyzed with paired-t test.Results There was significant statistical differences of CNR between energy spectral images and blend energy images in energy level of 40 to 120 keV(P <0.05),while there was no difference in energy level of 130 to 140 keV (P >0.05),and the optimal CNR was acquired at the energy level of 70 keV(CNR=8.75±3.28).The value of AI for two mehtods has no difference in energy level scope 40 to 60 keV(P >0.05),there was significant statistical differences of AI between energy spectral images and blend energy images in energy level of 70 to 140 keV(P <0.05),and the lowest of AI(AI=26.95±9.64)was ac-quired at 1 10 keV images.Conclusion The energy spectral CT possess superiority in decreasing the artifacts and will provide high image quality in the metal implants.Gemstone spectral CT has great significance for postoperative patients with metal implants in imaging diagnosis.

Objective To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with asymptomatic severe carotid artery stenosis.Methods The patients with asymptomatic severe carotid stenosis (stenosis ≥ 70％) were enrolled in the study.The cognitive function evaluation was performed before CAS,1 and 3 months after procedure respectively with mini-mental status scale (MMSE),digital span (DS),Chinese auditory learning test (CALT),judgment of line orientation test (JLOT),and verbal fluency test (VFT),including attention,memory,visual spatial function,and frontal fluency function.Results A total of 26 patients with asymptomatic severe carotid artery stenosis who performed CAS were enrolled,18 were males and 8 were females (aged 52 to 79 years,mean 64.19 ±6.76 years),and the years of education was 9.84 ± 3.29 years.Eighteen patients had left carotid artery stenosis and 8 had contralateral carotid artery stenosis.CAS was performed successfully in all patients,and no complications occurred.Compared with the CAS before procedure,all the cognitive functions were improved significantly at 1 and 3 months after procedure (all P ＜0.01),however,there was no significant difference between 1 and 3 months after procedure (all P＞ 0.05).Conclusions CAS may improve cognitive function in patients with asymptomatic severe carotid artery stenosis,and it was more obvious in the early postoperative period.

Objective To explore the mechanism of anti-tumor effects of transferring tumor-specif-ic lymphocytes obtained from pre-immunized BALB/c mice with inactive rolL-21 tumor vaccine (mIL-21-Sp2/0)to syngeneic mice, associated with mIL-21 tumor vaccine immunization, in the condition of cyclo-phosphamide (Cy)-induced lymphopenia. Methods Activated lymphocytes of spleen and lymph nodes ob-tained from pre-immunlzed syngeneic mice with irradiated mIL-21-Sp2/0 cells were infused into BALB/cmice treated with Cy 2 days before, subsequently vaccinated with mlL-21 tumor vaccine, after 7 days, chal-lenged with Sp2/0 tumor cells, observed the growth of tumor of mice. T lymphocyte subsets differentiation was measured by flow cytometry (FCM) analysis. The proliferation and cytotoxie activities of activated lym-phocytes were analyzed by FCM, respectively, staining with CFSE and 7-AAD. The number of IFN-γ-secre-ting cells was evaluated by ELISPOT. Results The lymphopenic mice were transferred with activated lym-phocytes and inoculated with raiL-21 tumor vaccine might provide superior anti-tumor immunoprotection, re-tard tumor growth of the mice. The proliferating capabilities and killing rate of transferred tumor Ag-specific lymphocytes enhanced obviously, the number of IFN-γ-secreting cells was significantly higher compared with the control groups. Conclusion Under Cy-induced lymphopenia condition, tumor Ag-specific lymphocytes sensitized by raiL-21 tumor vaccine were transferred to mice and immunized with mlL-21 tumor vaccine at the same time, benefit the proliferation of transferred effective cells and immune cells itself, assist to form and sustain special anti-tumor effects.

OBJECTIVETo explore the function of vascular endothelial cell (VEC) in patients with coronary heart disease (CHD) of Xin-blood-stasis syndrome.

METHODSSome vasoactive substances produced by VEC were detected and analyzed in patients with CHD of or without Xin blood stasis syndrome in group A (n=112) and group B (n=108) respectively, also in patients with non-CHD but of Xin-blood-stasis syndrome in group C (n=110), and healthy persons in group D (n=100), including nitric oxide (NO), endothelin (ET), angiotensin H (Ag II), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule -1 (sVCAM-1).

RESULTSThe abnormality degree of ET, Ag II , sICAM-1 and sVCAM-1 in various groups showed such a tendency as group A> group B> group D (P < 0.01 or P < 0.05), while no significant difference in these criteria between group A and group C was shown (P > 0.05).

CONCLUSIONThe vasoactive substances secreted by VEC are closely related to the formation and progression of CHD, and are likely to be important pathological markers of blood-stasis syndrome in CHD.

Adult ; Aged ; Aged, 80 and over ; Coronary Artery Disease ; physiopathology ; Diagnosis, Differential ; Endothelial Cells ; metabolism ; physiology ; Endothelins ; metabolism ; Female ; Humans ; Intercellular Adhesion Molecule-1 ; metabolism ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Nitric Oxide ; metabolism

Objective To study the characteristics of mismatch negativity(MMN) in patients with depression.Methods MMN was recorded from 31 patients with depression and 28 age-matched controls. Results Compared with the controls, the patients with depression had prolonged latency ([189?22] ms vs [206?26] ms, P

Objective To investigate the effects of initiating oral-medication and insulin-treatment to residual islet function in adult patients with latent autoimmune diabetes in adults (LADA).Methods Fifty nice inpatients and 11 outpatients of LADA were enrolled from the Peking Union Medical College Hospital from January 1981 to October 2014,including 34 cases with initiating insulin therapy and 36 cases with initiating oral medication.Patients were followed up at least twice and with a 6-month interval.The age,body mass index (BMI),diagnosis time,fasting C peptide (FCP),2-hour postprandial C peptide (2 hCP),glycosylated hemoglobin (HbA1c) were compared between two groups.Results The age of disease onset in insulin-treatment group was significantly lower than that in oral-medication group (t =2.049,P =0.045).The proportion of patients complicated with other autoimmune diseases in oralmedication group were higher than that in insulin-treatment group [24％ (8/34) vs.47％ (17/36),x2=4.275,P=0.039].The FCP and 2 hCP in insulin-treatment group were significantly higher than those in oral-medication group [FCP:0.25 (0.00-0.80) vs.0.00 (0.00-0.60) μg/L,Z =3.498,P =0.030,2 hCP:0.42(0.02-1.20) vs.0.14(0.02-0.19) μg/L,Z =3.235,P=0.001] on 6 month after treatment;however,there were no significant differences on 6-12 months,13-36 months or 37-60 months after treatment between two groups.No antibody negative conversion was detected in 10 inpatients,who were reexamined with glutamic acid decarboxylase antibody (GADA) more than twice.The detection rate of diabetes retinopathy was 4％ (1/26) in insulin-treatment group and 28％ (8/29) in oralmedication group (x2 =6.179,P =0.013).Conclusion Initiating insulin therapy at first diagnosis of LADA can protect the residual islet function,and may reduce the rate of diabetic retinopathy.

0.05). Conclusion It seems that LTA gene polymorphism has no significant correlation with the risk of osteoporosis in patients suffering from COPD.