Objective To compare the dosimetric effects of systematic MLC leaf position errors on flattening filter (FF) and flattening filter-free (FFF) IMRT for nasopharyngeal carcinoma (NPC).Methods In totaly of ten patients with NPC were enrolled in the current study.FF IMRT and FFF IMRT plans were designed for each patient, and in-house software was developed to modify the corresponding MLC files.Briefly, three kinds of systematic MLC error presented with 0.5 and 1 mm magnitudes error were simulated.The modified MLC files were re-imported into IMRT plans for dose recalculation, and differences in the dosimetry trends between FF-IMRT and FFF-IMRT plans were analyzed using a dosevolume histogram.Results Upon closed MLC, the average changes in D95％ of PTV and D of parotid glands in FFF-IMRT plans were more sensitive than in FF-IMRT plans (t =3.298-4.793, P ＜ 0.05).Otherwise, when MLC are shifted in the same direction, changes in D95％of PTV, D of PGTV, PTV as well as D of left parotid gland in FFF-IMRT plans were also more sensitive (t =2.372-6.844, P ＜ 0.05), whereas average changes in D of right parotid gland presented with less sensitivity (t =-4.049,-3.378, P ＜ 0.05).Conclusions For out-of-field or large organs, FFF-IMRT plans are more sensitive to leaf position error than FF-IMRT plans.

Objective To evaluate effects of glucocorticoids on maxillary bone mineral density in rats with acute adriamycin-induced nephrotoxicity (ADR). Methods Forty rats were randomly divided into four groups, control group, glucocorticoids- treated group, ADR group and ADR + glucocorticoids- treated group. ADR group and ADR +glucocorticoids-treated group were given 4 mg/kg adriamycin injection via tail vein to establish ADR model. Control group and glucocorticoids-treated group were given 4 mg/kg saline injection via tail vein. After establishment of ADR model, glucocorticoids-treated group and ADR + glucocorticoids-treated group were intragastric administration of 30 mg/(kg · d) methylprednisolone for 10 weeks, and control group and ADR group were given the same volumes of normal saline. Values of bone calcium pigment (BGP), type Ⅰ collagen, N-terminal pro-peptide (PINP), β-Ⅰ type collagen C-terminal cross-linked telopeptide (CTX) were detected by ELISA. The micro-CT scan was used to measure Tb.Th, Tb.Sp, Tb.N, BVF and bone mineral density (BMD). Results Compared with other three groups, the levels of BGP and PINP were significantly decreased, and CTX were significantly increased in ADR + glucocorticoids-treated group (P<0.05). Micro-CT analysis showed that there was significant maxillae osteoporosis, including changes of porous micro architecture, lower BMD, decreased BVF, lower Tb.Th and widening Tb.Sp in ADR + glucocorticoids-treated group (P<0.05). There was no significant difference in Tb.N between four groups. Conclusion There is imbalanced bone metabolism in rat model of ADR. High-dose hormone therapy can accelerate the occurrence of osteoporosis, decrease bone metabolism, and affect bone structure.

Objective To investigate the local or systemic effects of initial periodontal therapy on peritoneal dialysis in patients with chronic kidney disease and periodontitis. Methods Sixty-one patients with both periodontitis and regular peritoneal dialysis were selected in this study and were randomly divided into observation group (n=31) and control group (n=30). Patients in observation group were given periodontal initial therapy (ultrasonic supragingival scaling and ultrasonic subgingival irrigation, drug, root planing, oral health education) and peritoneal dialysis treatment. Patients in control group were given only peritoneal dialysis treatment. Clinical parameters including plaque index (PLI), gingival index (GI) and probing depth (PD) were detected before and one month after treatment in two groups. The concentrations of high-sensitivity C-reactive protein (hs-CRP) in gingival sulcus fluid and serum samples were measured by immune transmission turbidity method in two groups. Results There were no significant differences in PLI, GI, PD, hs-CRP of gingival sulcus fluid, and serum hs-CRP before treatment between the two groups. After one-month initial therapy, all the indexes were decreased in observation group, which were significantly different compared with those before treatment (P<0.05). And all the indexes were significantly lower in observation group than those of control group. There were no significant differences in PLI, PD, GI, hs-CRP of gingival sulcus fluid, and serum hs-CRP between control group and observation group before treatment. Conclusion Periodontal initial treatment can improve the periodontal inflammation in patients with chronic kidney disease, and reduce the concentration of systemic inflammatory factor hs-CRP, decreasing the risk of infection.

The study is to report the establishment of a method of screening the antitumor compounds based on the dynamic bio-response profile of cells to make up for the shortages of conventional end-point tests such as tedious operation and low sensitivity. Based on the principle of electric impedance of cells, the real-time cell electronic sensing (RT-CES) system was used to monitor the effect of epirubicin (EPI), cisplatinum (DDP) and carboplatin (CBP) on the growth of HepG2 cells, with the cell index (CI), half maximal inhibitory concentration (IC50) and detachment curve as evaluation indexes. Meanwhile, cell counting kit-8 (CCK-8) and microscopy were applied for verification. The results showed that CI curve could sensitively real-time profile the inhibitory effect of model drugs on HepG2 cells. The IC50 of EPI, DDP and CBP were 0.53 +/- 0.04, 9.79 +/- 0.26 and 597.00 +/- 3.79 microg x mL(-1), respectively. What's more, the significant differences of detachment curves of the three drugs indicated that their functional mechanisms might be different, this is consistent with the literature. The RT-CES system with non-invasive, label-free and real-time characteristics could be used to monitor the bio-response profile of the three drugs to HepG2 cells, allowing to qualitatively and quantitatively distinguish the antitumor activities of the three drugs, and could be a complementary method for the present screening of antitumor compounds.

This study aims at trying to establish a novel method of sterility test for injections based on biothermodynamics, in order to overcome the deficiencies of routine sterility tests such as long detecting cycle, low sensitivity and prone to misjudgments. A biothermodynamics method was adopted to rapidly detect the microorganism contamination of injections by monitoring the heat metabolism during the growth of microbe. The growth rate equal to or greater than zero and the heat power difference of P(i) and P(0) with three folds higher than the noise of baseline were chosen as indexes to study the heat change rule of microbe. In this way, the effectiveness of the new method to detect strains required by conventional sterility test or in injection samples was also investigated. Results showed that the Gram-positive bacteria, Gram-negative bacteria and fungi demanded by sterility testing methodology could be detected by biothermodynamics method within 10 hours, with the sensitivity lower than 100 CFU x mL(-1). Meanwhile, this method was successfully applied to the sterility test of Compound Yinchen injection (FFYC), Shuanghuanglian powder injection (SHL) and Compound Triamcinolone injection (TAND) which were sterilized with different degrees. Therefore, the biothermodynamics method, with advantages of fast detection and high sensitivity, could be a complementary solution for conventional sterility tests.

Objective To systematically evaluate the psychological intervention effect of music therapy on the patients during the digestive endoscopic process.Methods The databases of EMbase,PubMed,Cochrane Library,CNKI,VIP,Wanfang and CSCD were retrieved by computer,the retrieval time was from their establishment to March 2016.The randomized controlled trials (RCTs) on the music therapy application in the digestive endoscopic process were included.The data were independently extracted by 2 researchers for conducting the literature quality assessment.After extracting and checking the data,the meta analysis was performed by using the RevMan 5.3 software.Results Twenty-six RCTs conforming to the standard were included,involving 4593 patients.The meta analysis results showed that the music therapy could alleviate the anxiety status(SMD=-0.82,95％ CI:-1.14--0.49,P＜0.01),relieve the pain perception(WMD=-1.27,95％CI:-1.87--0.66,P＜0.01),remit the vital signs fluctuations of blood pressure,heart rate and respiratory rate(P＜0.01),meanwhile shorten the duration of examination procedure (WMD=-4.64,95％CI:-6.75--2.52,P＜0.01).Conclusion The current evidences indicate that the music application during the digestive endoscopic process can obviously decrease the anxiety status and pain perception.

Objective To investigate the safety and efficacy of three column osteotomy (3-CO) procedures through previous spinal fusion site for the revision surgical treatment in severe spinal deformity patients.Methods From Oct.2010 to May 2014 in our hospital,a total of 12 severe spinal deformity patients underwent 3-CO for the revision surgical treatment.There were 7 males and 5 females with the average age of (21.8±3.8) years,ranging from 18 to 30 years.The mean time from the initial operation to the revision surgery was (10.2±4.8) years (ranging from 3 to 17 years).The reasons for revision were:curve progression in 7 patients,neurologic deficit in 2 cases,implant failure in 1 patient and pseudarthrosis in 2 patients.The coronal parameters including major Cobb angle and distance between C7 plumb line and center sacral vertical line (C7PL-CSVL),and the sagittal parameters including global kyphosis curve and sagittal vertical axis (SVA) were measured pre-operatively,post-operatively and at last followup,respectively.The operation time,intraoperative blood loss and complications were recorded.The paired t test was used to evaluate the difference among pre-revision,post-revision and last follow-up.Results The average operation time was (451.7±83.1) min (range,320-600 min) and the average blood loss was (4 016.7± 1 080.0) ml (range,2 700-6 000 ml).The average follow-up time after revision operation was (35.4±9.8) months (range,24-49 months).The coronal Cobb angles of pre-revision and post-revision were 83.8°±23.3°and 34.6°± 13.7°.The average correction rate was 60.1％ ±8.8％.At last follow-up,the average coronal Cobb angle was 34.9°±13.8°,there was no significant loss of correction.The pre-revision and post-revision values of global kyphosis were 99.1°±13.3°and 38.7°±7.8° with a mean correction rate of 60.8％ ±6.7％.At the last follow-up,the average global kyphosis was 39.3°±7.5°and no loss of correction was found.For the C7PL-CSVL and SVA,pre-revision (30.3± 17.1) mm and (40.1±31.1) mm were corrected to (14.3 ±7.6) mm and (19.1± 12.3) mm immediately after revision operation,respectively.At final follow-up,the average C7PL-CSVL and SVA were(14.1 ± 7.6) mm and (19.6± 12.1) mm,the correction was well maintained.Obviously,two patient's neurological status improved from Frankel C before revision surgery to Frankel E.Complications were encountered in five patients (41.7％),including SEP signal changed in 1 patient (8.3％),transient neurologic deficit after revision surgery in 1 patient (8.3％),cerebrospinal fluid leak in 1 patient (8.3％),and pleural effusion in 2 patients (16.7％).During the follow-up time,there was no patient experienced pseudarthrosis,implant failure,infection or significant loss of correction.Conclusion Based on results of this study,it was concluded that 3-CO procedures through previous spinal fusion sites could obtain satisfactory and safety results in severe spinal deformity revision surgery.However,it is a technique-demanding procedure with more blood loss,longer operative time and higher risk of perioperative complications.

Objective To construct a chimeric infectious clone of the fatal virulent strain SDLY 107, containing the gene fragments encoding 2A and 3B proteins of the mild virulent strain SDLY 1, and to establish a reverse genetic system platform for further investigation on virulence of enterovirus 71 strains. Methods The overlap PCR analysis was performed to obtain the gene fragments encoding 2A and 3B pro-teins of the mild virulent strain SDLY 1.The obtained gene fragments were digested and then cloned into a plasmid pMD19-T containing the full-length gene of SDLY 107 strain by using gene replacement strategy. The recombinant RNA was transfected into Vero cells for the preparation of recombinant virus particles.Sev-eral assays including the PCR, indirect immunofluorescence ( IFA) , Western blot and sequencing were per-formed for virus identification.Virus titers were measured by 50%cell culture infective dose ( CCID50 ) and plaque assay.Results The infectious clones of SDLY 107-2A-1 and SDLY 107-3B-1 chimeric virus strains were constructed successfully.Typical cytopathic effect was observed in Vero cells after viral transfection. Identification of the rescued viruses by PCR, IFA, Western blot and sequencing further confirmed the suc-cessful construction of infectious virus strains.The virus titers of SDLY 107-2A-1 and SDLY 107-3B-1 strains detected by CCID50 and plaque assay were 1.25 ×105 PFU/ml and 0.7 ×105 PFU/ml, respectively. Conclusion The chimeric viruses SDLY 107-2A-1 and SDLY 107-3B-1 were rescued successfully, causing cytopathic effects similar to those by using the parental virus strain SDLY 107.This study might pave the way for further investigation on in vitro and in vivo virulence of enterovirus 71 strains.

Objective: To achieve quantitative analysis of image quality parameters and establish warning and action thresholds for the on-board imaging (OBI) system of linear accelerator. Methods: The Catphan604 phantom was repeatedly scanned in the Full-Fan and Half-Fan CBCT scanning modes on a Varian EDGE linear accelerator, and the software based on Python language development in-house was utilized to analyze image quality parameters, such as CT number linearity, geometric consistency, slice thickness, spatial resolution, uniformity and low-contrast resolution. The quantitative analysis results of each image quality parameter obtained from 16 times of scanning within 16 months were normalized to the mean and the standard deviations were recorded. A run chart analysis was created to determine the warnings and action thresholds. Results: The software built in-house can quantitatively analyze the image parameters of the two scanning modes of OBI system. The low-contrast resolution of Half-Fan was better than that of Full-Fan, whereas the spatial resolution of Full-Fan was superior to that of Half-Fan. One standard deviation (1σ) was set as the warning threshold and 2 standard deviations (2σ) as the action threshold, respectively. The tolerance level of Half-Fan was smaller than that of Full-Fan. Conclusion Self-developed software enables quantitative analysis of accelerator image quality parameters, establishes warning and action tolerance of quality assurance and provides guidance for image quality assurance under image-guided radiotherapy specification.

OBJECTIVETo study the effects of tunicamycin (a glycosylation inhibitor) combined with cisplatin on the proliferation and apoptosis of human nasopharyngeal carcinoma cells and explore the molecular mechanism.

METHODSNasopharyngeal carcinoma CNE-1 and CNE-2 cells cultured in vitro were treated with different concentrations of tunicamycin with or without cisplatin. The inhibition of cell proliferation was examined using MTT assay and colony formation assay, and the cell apoptosis was analyzed using flow cytometry with propidium iodide staining. The expressions of Bax, Bcl-2, and GRP78 in cells treated with 3 µmol/L tunicamycin with or without 6.00 µmol/L cisplatin were measured with Western blotting.

RESULTSTreatment with tunicamycin or cisplatin obviously inhibited the proliferation of CNE-1 and CNE-2 cells. Treatment with 3 µmol/L tunicamycin for 24, 36 and 48 h resulted in a viability of 72.13%, 51.97%, and 37.56% in CNE-1 cells and 85.61%, 56.95%, and 43.66% in CNE-2 cells, respectively, and the combined treatment with 6 µmol/L cisplatin lowered the cell viability to 67.97%, 47.76%, and 34.68% in CNE-1 cells and 56.89%, 37.05%, and 29.30% in CNE-2 cells, respectively. Tunicamycin at 0.3 µmol/L combined with 0.6 µmol/L cisplatin showed an obviously enhanced inhibitory effect on colony formation of CNE-1 and CNE-2 cells. Tunicamycin treatment (3 µmol/L) of CNE-1 and CNE-2 cells for 48 h induced an apoptosis rate of only 8.89% and 8.67%, but when combined with 6 µmol/L cisplatin, the cell apoptosis rate increased to 37.02% and 32.25%, significantly higher than that in cells with cisplatin treatment alone (7.25% and 6.36%, respectively). Compared with tunicamycin and cisplatin alone, the combined treatment significantly increased Bax expression and decreased Bcl-2 expression in the cells; tunicamycin up-regulated the expression of GRP-78 and enhanced the activity of caspase-3.

CONCLUSIONTunicamycin can inhibit the proliferation of CNE-1 and CNE-2 cells and enhance cisplatin-induced cell death, the mechanism of which may involve excessive endoplasmic reticulum stress response and increased activity of caspase-3.

Apoptosis ; drug effects ; Carcinoma ; Caspase 3 ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cisplatin ; pharmacology ; Endoplasmic Reticulum Stress ; drug effects ; Heat-Shock Proteins ; metabolism ; Humans ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Tunicamycin ; pharmacology ; bcl-2-Associated X Protein ; metabolism