Objective To investigate the accuracy of CTVision image-guided stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC).Methods 10 lung SBRT patients were imaged with CTVision before and after irradiation for acquiring and analyzing the three-dimensional set-up error data sets in our department from October 2010 to May 2012.Gross tumor volumes (GTVs) were contoured on pre-and post-SBRT CT sets and combined for generating internal gross tumor volumes (IGTVs).Planning target volume (PTV) margin was calculated,and IGTVs and PTVs were compared for off-line verification of accuracy of SBRT.A paired t-test statistical analysis was conducted with the datasets using SPSS 17.0.Results 80 CT image sets were totally obtained.Setup errors was significant difference before and after radiotherapy in the left-right,superior-inferior and anterior-posterior directions,that were (-0.10±1.30) mmand (-0.15±1.31) mm (P=0.720),(0.18±1.32) mm and (0.18±1.43) mm (P =1.000) and (-0.08 ± 1.19) mm and (-0.13 ± 1.18) mm (P =0.750),respectively.IGTVs of ten patients were smaller than corresponding PTVs (13.53 cm3 and 37.84 cm3,P =0.000).Conclusion Accuracy and safety of SBRT could be verified by imaging with CTVision before and after delivery for non-small cell lung cancer.

0.999 9.The recovery was between 60%-120%.CONCLUSION:The method is simple,accurate and can be used to determine aflatoxin G2、G1、B2、B1 in Naoliqing Pill,Renshen Yangrong Pill,Rensen Jiapi Pill,Sanqi Tablet,Jinshuibao Capsule and Bailine Capsule.

AIM:To bring forward a method of determining aflatoxin G_2、G_1、B_2、B_1 in six kinds of traditional Chinese drugs by HPLC.METHODS:After being extracted by 70% methanol,purified by immunoaffinity column,aflatoxins were analysed by HPLC with fluorescence detection.RESULTS:Aflatoxin G_2、B_2 showed a good linear relationship at a range of 1.5-60pg,and Aflatoxin G_1、B_1 at a range of 5-200 pg,r＞0.999 9.The recovery was between 60%-120%.CONCLUSION:The method is simple,accurate and can be used to determine aflatoxin G_2、G_1、B_2、B_1 in Naoliqing Pill,Renshen Yangrong Pill,Rensen Jiapi Pill,Sanqi Tablet,Jinshuibao Capsule and Bailine Capsule.

OBJECTIVETo investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation.

METHODSFrom January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI).

RESULTSAll patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000).

CONCLUSIONRecurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the advantage including less invasion and quickly recovery.

Adult ; Aged ; Bone Screws ; Feasibility Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Spinal Fusion

Objective To investigate the curative effect of acute severe brain injury complicated ARDS, Methods 31 patients who had acute severe brain injury complicated ARDS were divided into two groups:A group was early discovery of ARDS and given treatment.B group was late discovery of ARDS and treated late.Then the curative effects were compared.Results A group was significantly higher than B group in blood gas analysis(P

OBJECTIVETo investigate the feasibility and safety of unilateral incision hybrid fixation using pedicle screws and a translaminar screw in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).

METHODSFrom January to June 2010, 18 patients with single-level lumbar disc disease were treated with MIS-TLIF under METRx(TM) X-tube. After decompression and fixation using unilateral pedicle screws, a translaminar screw was inserted from the same incision to the other side. The results of perioperative parameters, radiographic images and clinical outcomes were assessed.

RESULTSAll patients underwent MIS-TLIF were accomplished unilateral hybrid fixation without any neural complication. The average operative time was (107 ± 19) min, the average operative blood loss was (62 ± 21) ml, and the average postoperative ambulation time was (21 ± 5) h. The average length of translaminar facets screw was (52 ± 2) mm, and the postoperative images showed all screws penetrate through facets joint. During the follow-up the visual analogue scale and Oswestry disability index scores were significant improved compared with preoperative (F = 42.221 - 259.833, P < 0.01).

CONCLUSIONSBilateral hybrid fixation could be completed through unilateral incision by pedicle screws and a translaminar screw in MIS-TLIF, and the advantage including less invasion, quickly recovery, short operative time, and saving fixation cost.

Adult ; Bone Screws ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Spinal Fusion ; methods ; Treatment Outcome ; Visual Analog Scale ; Young Adult

Background & Objective: Radiotherapy and temozolomide are the standard therapy for newly diagnosed glioblastoma multiforme (GBM). However, it is unclear whether adding another agent to the commonly used radiotherapy-temozolomide (RT + TMZ) benefits newly diagnosed GBM patients. The present network meta-analysis aimed to assess the efficacy of combining other agents with RT + TMZ for GBM treatment. Methods: A comprehensive literature search was conducted on PubMed, EMBASE.com, Web of Science, and the Cochrane Central Register of Controlled Trials from inception to September 23, 2014, to include all randomized controlled trials of RT + TMZ-based therapy in GBM patients. Pairwise and network meta-analyses were performed to compare the therapeutic regimens. Results: Seventeen studies involving 4,148 patients were identified. The results of pairwise meta-analysis indicated no significant differences among most comparison groups, except for bevacizumab + RT + TMZ versus RT + TMZ for progression-free survival (hazard ratio [HR] = 0.71, 95% confidence interval [CI]: 0.59–0.86; P = 0.000) and RT + TMZ versus RT alone for overall survival (HR = 0.71, 95% CI: 0.58–0.88; P = 0.001). The results of network meta-analysis also showed no significant differences in most comparisons; however, adverse events were more common among patients receiving additional therapeutic agents other than RT + TMZ. The ranking probability analysis indicated that bevacizumab + RT + TMZ and nimustine + cisplatin + RT + TMZ were associated with the best progression-free and overall survival, but they also caused the most adverse events in GBM patients. RT + bevacizumab + irinotecan had the highest probability of being the best regimen for minimizing adverse events. Conclusions: The addition of other targeted agents, particularly bevacizumab and nimustine, to RT + TMZ could be slightly effective for the treatment of newly diagnosed GBM patients; however, adverse events remained common.
Glioblastoma

BACKGROUNDRheumatoid arthritis (RA) is a chronic, systemic autoimmune inflammatory disorder. Many methods have been used to observe the progress of RA. The purpose of this study was to observe the progress of RA in rats with 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), magnetic resonance (MR) imaging and arthritis score, and analyze the relationships among different methods in evaluation of RA.

METHODSSixteen healthy Sprague Dawley (SD) rats about 8-week old were randomly assigned to a RA group and a control group. Bovine type II emulsified incomplete Freud's adjuvant was used to induce arthritis in the RA group. Arthritis score of the rats in two groups were recorded, and (18)F-FDG PET/CT, MR imaging were performed both on the corresponding rats every 3 days. All the rats were sacrificed at week 5, and histopathological examination was performed on rat knees stained with haematoxylin and eosin.

RESULTSThe arthritis score and the standard uptake value (SUV) of knee joints in RA rats increased with the progression of arthritis gradually. Both peaks of arthritis score and SUV appeared at 21 days after the first immune injection, then the arthritis score and SUV of knee joints decreased slowly. The arthritis scores of knee joints in RA rats were positively correlated with their SUV changes. The MR images were confirmed by the histopathological studies.

CONCLUSIONPET/CT can detect the earliest molecular metabolism changes of RA, and MR imaging can follow up the dynamical anatomical changes of RA, all of which indicated that PET/CT and MR imaging may be applied as useful tools to monitor the progress of RA.

Animals ; Arthritis, Rheumatoid ; diagnosis ; pathology ; Fluorodeoxyglucose F18 ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Radiopharmaceuticals ; Rats ; Rats, Sprague-Dawley ; Tomography, X-Ray Computed

OBJECTIVETo investigate the effects of total flavonoid extract of Epimedium sagittatum (TFE) on the proliferation and differentiation of newborn rat calvarial osteoblasts (ROB).

METHODTFE was supplemented into the culture medium of ROB at 0. 1, 1, 10 and 100 microg x mL(-1) respectively. The serum of rats administered TFES (SRAT) was also added into the medium in a parallel treatment at 2.5%, 5% and 10% respectively. Their effects on cell proliferation and differentiation was studied by MTT and the analysis of osteogenic differentiation marks.

RESULTTFE had no appreciable and on cell proliferation and differentiation at any concentration. However, 2.5% and 5% SRAT stimulated cell proliferation strongly and, 5% SRAT significantly promoted the maturation and function of osteoblast by improving the alkaline phosphatase activity, osteocalcin secretion, calcium deposition and the number of mineralized nodular structures.

CONCLUSIONThe metabolites of TFE should be the anti-osteoporosis constitutes of Epimedium sagittatum.

Animals ; Calcification, Physiologic ; drug effects ; Calcium ; metabolism ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Epimedium ; chemistry ; Flavonoids ; blood ; pharmacology ; Osteoblasts ; cytology ; drug effects ; metabolism ; Rats ; Rats, Wistar

OBJECTIVEto evaluate the clinical outcomes of transpedicular lumbar wedge resection osteotomy in treating adult idiopathic scoliosis.

METHODStwenty-five adult idiopathic scoliosis patients treated with transpedicular lumbar wedge resection osteotomy from July 2001 to November 2007 were included, among whom 18 were female and 7 were male. Nine of 25 were with double major curve in thoracic and thoracolumbar/lumbar spine, and 16 were with single curve in thoracolumbar/lumbar spine. The average age was 35 years (29 - 48 years) at operation. Osteotomy were performed at T(11), T(12), L(1) or L(2). The motion evoked potential monitoring system and awaking test were used during surgery. The preoperative, postoperative immediately and latest standing posteroanterior and lateral radiographs were reviewed.

RESULTSall patients were operated successfully. The average operation time was 274 min (range, 220 - 380 min) and the average blood loss were 2328 ml (range, 1500 - 5000 ml). The average coronal Cobb angle of all patients in thoracolumbar/lumbar curves was 88° (range, 70° - 121°) before operation, which was corrected to 43° (range, 35° - 70°). The coronal correction rate was 44%. The average kyphosis angle of all in thoracolumbar/lumbar curves was 63° (range, 50° - 90°) before operation, which was corrected to 10° (range, -40° - 21°). The sagittal correction rate was 86%. Nerve root injury occurred in 3 of all patients who complained about postoperative radicular pain. No spine cord injury, delayed paralysis, infection and instrumentation failure were found. With a follow-up of 2 - 4 years, no correction loss or decompensation happened. The back pain existing before operation was relieved in large measure. The cosmetic appearance were all promoted significantly.

CONCLUSIONSthe transpedicular thoracolumbar/lumbar wedge osteotomy is efficient and safe in the correction of adult idiopathic scoliosis. The correction is much better on the sagittal plane than that on the coronal plane.

Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Osteotomy ; methods ; Retrospective Studies ; Scoliosis ; surgery ; Treatment Outcome