The research of esophageal target is a difficult spot in the precise radiotherapy and the target mobility has an important effect for the radiotherapy of esophageal cancer.By different breathing control techniques,controlling the patient's respiratory may narrow target mobility so as to improve the accuracy of radiotherapy.But the present studies of the movement range of esophageal cancer with the respiratory control technologies have not come to a consistent standard.The area shape and position change of esophageal cancer target is a key problem that needs to be solved in the esophageal precise radiotherapy.

As a transcriptional repressor,Bmi-1 is a member of polyeomb group gene family.It may play an important role in self-renewal ability and proliferation of stem cell.At present,studies show that Bmi-1 is highly expressed in a variety of solid tumors,which can be regarded as one of the markers of cancer stem cells and has a close relation to the cancer development and progression and radiation resistance.It will provide an important target gene for the treatment of malignant tumors.

BACKGROUND:Studies on high glucose exposure in human periodontal ligament cel s usual y focus on the biological behaviors, pathways and secretory factors, but whether the metabolic memory is involved is little known. OBJECTIVE:To investigate the metabolic memory of high glucose exposure in human periodontal ligament cel s. METHODS:Human periodontal ligament cel s were primarily cultured and identified. Cel s at 5-8 passages were selected and randomized into four groups. Group A (controls):DMEM containing 5.5 mmol/L glucose for 8 days;group B (5-day memory group):DMEM containing 35 mmol/L glucose for 3 days and DMEM containing 5.5 mmol/L glucose for 5 days;group C (3-day memory group):DMEM containing 35 mmol/L glucose for 5 days and DMEM containing 5.5 mmol/L glucose for 3 days;group D (8-day high glucose group):DMEM containing 35 mmol/L glucose for 8 days. The cel proliferation was detected by cel counting kit-8, the cel apoptosis was determined by flow cytometry, and the levels of total proteins and alkaline phosphatase were investigated using ELISA. RESULTS AND CONCLUSION:Compared with the control group, the cel proliferation in the other three groups was significantly reduced (P<0.05), the number of apoptotic cel s was significantly increased, while the levels of total proteins and alkaline phosphatase were significantly decreased (P<0.05). These results suggest that high glucose causes persistent changes in human periodontal ligament cel s by inhibiting cel viability, increasing the apoptosis and downregulating the levels of the total proteins and alkaline phosphatase

Objective To investigate the risk factors for castrate-resistant prostate cancer (CRPC) after prostate cancer treated with androgen deprivation therapy (ADT) within 1 year.Methods One hundred and thirty-one prostate cancer patients treated with ADT in our institute between Jan.2008 and Jan.2011 were selected for this study.Patients were followed up by telephone or in clinic,including serum testosterone,serum PSA,clinical symptoms,imaging studies,digital rectal examination (DRE),survival data,PSA nadir,time to PSA nadir and et al.We mainly studied the CRPC after prostate cancer treated with ADT within 1 year.In the 131 patients,the median age was 70 (ranged from 44-89) years.There were 13 patients (9.9％) less than 60 years,43 patients (32.8％) between 60 and 69 years,62 patients (47.3％) between 70 and 79 years,13 patients (9.9％) more than 80 years.The average body mass index (BMI) was 23.0 (ranged from 14.4-34.4) kg/m2.There were 10 patients less than 18.5 kg/m2,77 patients between 18.5 and 24.0 kg/m2,34 patients between 24.1 and 28.0 kg/m2,and 10 patients more than 28.0 kg/m2.The initial PSA was between 0.3 and 4 707.0 μg/L,there were 19 patients (14.5％) less than 20 μg/L,45 patients (34.4％) between 20 and 99 μg/L,67 patients (51.1％) more than 100 μg/L.One patient (0.7％) was in T1,39 patients (29.8％) in T2,59 patients (45.0％) in T3,32 patients (24.4％) in T4.5 patients (3.8％) were with Gleason score 4,13 patients (9.9％) were with Gleason score 5,24 patients (18.3％) were with Gleason score 6,51 patients (38.9％) were with Gleason score 7,26 patients (19.8％) were with Gleason score 8,9 patients (6.9％) were with Gleason score 9,3 patients (2.3％) were with Gleason score 10.Results There were 32 of 131 patients (24.4％) progressed to CRPC after treated with ADT within 1 year.In the CRPC group,there were 3 patients less than 60 years,15 patients between 60 and 69 years,12 patients between 70 and 79 years,2 patients more than 79 years; 3 patients were less than 18.5 kg/m2,19 patients were between 18.5 and 24.0 kg/m2,7 patients were between 24.0 and 28.0 kg/m2,3 patients were more than 28.0 kg/m2 ; 4 patients were less than 20 μg/L,6 patients were between 20 and 100 μg/L,22 patients were more than 100 μg/L; 4 patients were in T2,13 patients were in T3,15 patients were in T4; 2 patients were with Gleason score 6,11 patients were with Gleason score 7,11 patients were with Gleason score 8,6 patients were with Gleason score 9,2 patients were with Gleason score 10; 29 patients were with metastasis,3 patients without metastasis.Clinical stage (P =0.001),Gleason score (P＜0.001) and metastasis (P=0.011) were statistically significant between the CRPC within 1 year group and the rest group.Conclusions The clinical stage and Gleason score are the risk factors of CRPC treated with ADT within 1 year.The higher of the clinical stage and Gleason score,the greater risk to be the CRPC within 1 year.

0.05), CGI and HAMA. Safety analysis suggested that no significant differences were found in symptoms and frequency of side effects between the two groups.Conclusion Bupropion hydrochloride tablet is an effective and safe antidepressant. It has similar effect and safety compared with fluoxetine in the treatment of depression.

Objective To investigate the effect of paroxetine in the adjuvant treatment of maintenance hemodialysis(MHD)com-plicating depression.Methods 60 patients with MHD complicating depression were randomly divided into the control group and the observation group,30 cases in each group.The control group received the routine therapeutical scheme(hemodialysis,complication treatment and correcting the renal anemia,etc).On the basis of the routine therapy the observation group was given oral paroxetine 10 mg/d,once daily for continuous 8 weeks.The depression level was assessed by the Hamilton depression scale(HAMD).The clinical symptoms,levels of Hb,ALB,Kt/V,iPTH,SF and HAMD scores were statistically analyzed and compared between the two groups.Results The clinical symptoms,levels of Hb,ALB,Kt/V after 8-week treatment in the two groups were significantly im-proved compared with pretherapy(P<0.05);the level of iPTH,SF and the HAMD scores in the two groups were decreased com-pared with pretherapy(P<0.05).The effective rate of depression was 86.67% in the observation group and 23.33% in the control group,the difference between the two groups had statistical significance(P<0.05).Conclusion Paroxetine in the assisted treat-ment of MHD complicating depression symptom can improve the quality of life in MHD patients.

ObjectiveTo investigate the role of CD4+ CD25+ regulatory T cells(Treg) in peripheral blood and intestinal endotoxin (ET) in liver injury of rat severe acute pancreatitis (SAP).MethodsSixty male Wistar rats were randomly allocated into sham operation group(SO group) and severe acute pancreatitis group(SAP group).The rats in SAP group recevied the injection of Sodium Taurocholate(NaTc) into their far-end of bile-pancreatic duct and were sacrificed in 3-,6-and 12-hour,serum amylase(AMY) and alanine aminotransferase(ALT) determined by full-automatic biochemistry instrument,limulus reagent method is used to determine ET content in plasma,the proportion of Treg among peripheral lymphocytes was determined by Flow Cytometry(FCM),HE stain is used to observe pathological changes in liver and pancreas,the protein of Foxp3 activity was evaluated by immunohistochemistry staining,and the relationships between these indicators were analyzed using Pearson correlation analysis test.ResultsHistopathologic examination and the level of ALT revealed the occurrence of pancreatic inflammation and pathological changes of liver in SAP group.The percentage of Treg in SAP groups significantly increased at 3 h(2.26％ ±0.32％),6 h(2.36 ％ ±0.48％)and 12 h(2.80％ ±0.35％) comparing to the SO groups(P＜0.01) ; plasma ET levels compared with the SO group was statistically significant (P＜ 0,01 ),and 12 h (0.85 ± 0.11) compared to,3 h (0.74±0.11) and 6 h (0.78-±-0.07) was no significant difference (P＞0.05).The expression of Foxp3 protein on the livers were upregulated markedly.Pearson correlation analysis teat showed that quantities of Treg were positively proportional to the levels of ET(r=0.89,P＜0.01) after liver injury of SAP.ConclusionsSAP may lead to liver injury and the high plasma levels of ET and Treg in peripheral blood may play an important role in liver injury of SAP.

Objective To investigate the effect of high glucose on renal tubular epithelial-mesenchymal transition,and to analyze the relationship between high glucose and transforming growth factor β1(TGF-β1)and the mechanism of renal interstitial fibrosis. Methods HKC and Smad7-overexpression HKC cells were grown in DMEM/F12 medium containing 5%～10%newborn calf serum.They were cultured for 16 h in free serum medium after 80%cells were adhered onto the surface of the flask.Afterwards,they were stimulated by high glucose(glucose concentration:25 mmol/L and 50 mmol/L).The expression of α-SMA,E-cadherin and fibronectin was detected by Western blot while the supernatant level of TGF-β1 was detected by ELISA.Cell motility and migration was evaluated using Boyden chamber motogenicity assay. Results In HKC induced by high glucose,the expression of α-SMA and fibronectin protein was highly upregulated while the expression of E-cadhefin protein was down-regulated.The expression of TGF-β1was up-regulated in a dose-dependent manner.These above-mentioned effects could be obviously inhibited by anti-TGF-β1 antibody.The protein expression of α-SMA,fibronectin and E-cadherin had no obvious change in Smad7-overexpression HKC induced by high glucose.HKC exhibited enhanced motility and invasive capacity in high glucose groups,compared to that in control group.Migrated cell counting was(12.4±3.7)and(18.6±4.4)cell/HP in 25 and 50 mmol/L glucose groups respectively. Conclusion High glucose may induce renal tubular epithelialmesenchymal transition through TGF-β1 pathway,which can be inhibited by blocking the Smad signal pathway.

Objective To assess the feasibility and clinical results of video-assisted high anterior transcervical approach (Smith-Robinson) in treatment of spinal lesions of the craniovertebral junction. Methods Between April 2007 to October 2009, nineteen consecutive patients with spinal lesions of the craniovertebral junction were included in the study. There were 9 males and 10 females aged from 16 to 62 years old with a mean of 32 years. The primary pathologies included 4 cases with chronic odontiod fracture, 2 cases with purely irreducible atlantoaxial dislocation, 6 cases with os odonteideum, 1 case with Marfan synd rome, 1 case with primary basilar invagination from Kippel-Feil syndrome, 3 case with axis tumor and 1 case with irreducible rheumatoid atlantoaxial dislocation. All of the patients underwent combined video-assisted high anterior transcervical procedure and posterior fixation at one-stage. The anterior procedure included atlantoaxil release and reduction (8 cases), odontoidectomy (8 cases), and intralesional extracapsular excision and reconstruction (3 tumor cases). The posterior technique were C1-C2 pedicle screw fixation (13 cases), C1-C3 pedicle screw fixation (2 cases), and occipitalcervical fusion (4 cases). Results Anatomical reduction was achieved in eight cases with anterior release and reduction. Tumors were completely removed in three cases with axial tumor. The mean follow-up was 14 months (6-36 months). All of them achieved solid bone fusion. In the 14 patients with symptoms of spinal cord dysfunction, the average Japanese Orthopaedic Association (JOA)score had improved from 9.1±3.3 preoperatively to 14.1±2.9 postperatively. The improvement rate was excellent for 7 cases, good for 5 cases, fair for lcase and poor for 1 case. One patient experienced leakage of cerebrospinal fluid which was resolved by bioprotein gelatin blocking and lumbar subarachnoid continuous drainage within 1 week. Dysphagia which occurred in 3 cases responded well to dexamethason and mannitol.No infection and hardware failure were observed. Conclusion Video-assisted high anterior transcervical procedure is a safe and effective alternative for treating spinal lesions in the craniovertebral junction.

Objective To explore the effect of mesenteric lymphatic ligation on liver injury induced by severe acute pancreatitis. Methods 54 SD rats are randomly divided into sham-operation group (A), severe acute pancreatitis group (B) and severe acute pancreatitis and ligation group (C). Liver tissues were collected from each rat in 6, 12, and 24 h after ligation. Pathological changes in liver tissues were observed by haematoxylin and eosin staining. Levels of serum glutamic-pyruvic transaminase and glutamic oxalacetic transaminase were detected. Levels of TNF-α and IL-1 in liver homogenate were examined by enzyme linked immunosorbent assay. Results Under light microscopic examination, neutrophils and inflammatory exudate in hepatic lobule was increased as time prolonged in group B. Inflammation was reduced in group C as compared with group B.Levels of serum glutamic-pyruvic transaminase and glutamic oxalacetic transaminase were more significantly increased in groups B and C than in group A (P<0.05);while they were more significantly decreased in group C than in group B. Levels of TNF-αand IL-1 in liver homogenate were significantly increased in group B as compared with group A (P < 0.05); whereas they were more significantly decreased in group C than in group B at 24 h (P < 0.05). Conclusions Mesenteric lymphatic ligation can reduce liver injury in severe acute pancreatitis. Mesenteric lymphatic fluids may play an important role in severe acute pancreatitis.