Objective To conduct a computer simulation to evaluate the discrepancy between the cumulative doses calculated by four-dimensional computed tomography (4DCT) images and 4DCT scans (for real-time respiratory motions) due to the patient's irregular breathing.Methods A series of digital phantoms were generated from a patient's 4DCT images to simulate 4DCT images and 4DCT scans (for real-time respiratory motions) resulting from various irregular breathing curves.A six-field intensity-modulated radiotherapy plan was generated.Two cumulative doses in the target were calculated.The first one, named Dall, was calculated by tracking the point displacements in the target manifested on the 4DCT images;the second one, named D4D, was calculated based on the point displacements along the whole breathing motion during 4DCT scanning.Dose discrepancy between D4D and Dall was calculated to evaluate the correlation between breathing pattern and dose discrepancy in the target.Results The dose discrepancy in the target was correlated with mean motion excursion and the standard deviation of motion excursion.ΔDmin(ΔD99) in the target increased from 2.39%(2.04%) to 11.91%(5.24%) as the mean motion excursion increased from 5 mm to 15 mm, and increased from 5.93%(2.15%) to 14.65%(5.01%) as the standard deviation of motion excursion increased from 15% to 45% of the mean motion excursion.When the mean period increased from 3 s to 5 s or the standard deviation of period increased from 10% to 40% of the mean period,ΔDmin(ΔD99) in the target was greater than 6.0%(2.0%), but less than 9.0%(3.0%).When the target diameter was 2 cm, 3 cm, and 4 cm,ΔDminΔD99) in the target was 11.88%(5.50%), 6.91%(2.42%), and 7.53%(3.62%), respectively.Conclusions There is a large discrepancy between the cumulative doses calculated using 4DCT images and 4DCT scans (for real-time respiratory motions) when the patient has irregular breathing.This dose discrepancy depends on mean motion excursion and the standard deviation of motion excursion, but has little relationship with mean period, the standard deviation of period, and tumor volume.

Objective: To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods: All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results: There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95%CI:-16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95%CI:-9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95%CI:-7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95%CI:-9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95%CI: 33.5%-35.6%). Conclusion Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.

Objective To evaluate the expression of hypoxia-inducible factor (HIF)-1α and HIF-2α in cervical carcinoma.Methods To detect the HIF-1α and HIF-2α expression of 30 cases cervical carcinoma tissue (treatment group) and 30 cases cervical benign tissue (control group) by immunohistochemistry,Western blot and real time polymerase chain reaction (RT-PCR) technology,analysis the correlation of HIF-1 α and HIF-2α expression and clinical pathological.Results Expressions of HIF-1 α mRNA and HIF-2α mRNA in treatment group were (2.06 ± 0.68),(1.62 ± 0.43),had significant difference with control group (all P ＜ 0.01).Immunohistochemistry showed that the positive expression rate of HIF-1α and HIF-2α were 63.33％ and 70.00％ in treatment group,had significant difference with those in control group,which were 16.67％ and 13.33％ (all P ＜ 0.01).Western blot results showed that the HIF-1α and HIF-2α were (0.71 ± 0.01),(0.71 ± 0.03) in treatment group,had significant difference with those in control group,which were (0.53±0.03) and (0.56 ± 0.05) with significant difference (all P ＜ 0.05).HIF-1α was correlated with lymph node metastasis and anemia(all P＜0.05).HIF-2α was correlated with anemia (P ＜0.05).Conclusion The expression levels of HIF-1α,HIF-2α mRNA and protein in significant increase in treatment group,they may play a role of papillary thyroid carcinoma in tumor promotion,and they change in the same direction,suggesting that they may play the same or similar effect in cervical carcinoma through different mechanisms.

Biosimilars are biological medicinal products that are highly similar to an already licensed reference product in terms of quality, safety, and efficacy. BAT1706 is being developed by Bio-Thera Solutions, Ltd. as a proposed biosimilar candidate to bevacizumab reference product (Avastin^®). Bevacizumab acts by specifically binding to vascular endothelial growth factor A (VEGF-A), and preventing the interaction of VEGF-A with its receptors on the surface of endothelial cells, then blocking the downstream signaling pathway mediated by ligand-receptor, and inhibiting endothelial angiogenesis, thus inhibiting tumor growth. Comprehensive analytical characterization studies incorporating orthogonal analytical techniques were performed to compare the in vitro functional activities of BAT1706 and Avastin^®. BAT1706 and Avastin^® showed highly similar binding activity to multiple VEGF-A isoforms and equivalent VEGF-A neutralizing activity, as well as inhibitory activity of VEGF receptor (VEGFR)-2 tyrosine kinase autophosphorylation. Both products exhibited similar binding of the Fcγ receptors and a lack of Fc-related effector functions such as antibody-dependent cell-mediated cytotoxicity (ADCC) and complement-dependent cytotoxicity (CDC). Overall, the results demonstrate that BAT1706 and Avastin^® are highly similar in terms of in vitro functional activities.

Objective To study the positive pressure intravenous catheter in HIV patients' infusion.Methods 4000 HIV out-patients from Feb 2010 to Mar 2012 were studied and divided into experimental group and control group depending on patients' intention for positive pressure venous catheter.2000 cases in the experimental group were applied with positive-pressure intravenous catheter infusion.Traditional needle was used for the infusion in 2000 cases of the control group.Fluid fluency,skin lesions,phlebitis,needle injuries,and incidence of occupational exposure of the patients were observed by the responsible nurses.Results In the experimental group,1 870 cases(93.5％ ) of infusion were fluent; 180 cases (9.0％) had red and swollen at the puncture site; 189 cases (9.5％) had vascular damage.No phlebitis,needle injuries and occupational exposure were observed.On the contrary,fluency,red and swollen at puncture site and vascular damage were found 1 729 (86.5％),250( 12.5％ ) and 235 ( 11.8％ ) cases respectively in the control group.4 cases of needle injuries and occupational exposure were found in the control group.The difference between two groups was statistically significant ( x2 =55.103,12.768,5.582,4.004,4.004,respectively; P ＜ 0.01 or P ＜ 0.05 ).Conclusions Positive-pressure intravenous catheter provides a safe and effective infusion for AIDS patients.It avoids the pain caused by repeated puncture to patients,effectively protects blood vessels,reduces the risk of needle injuries and occupational exposure due to repeated puncture.The positive pressure intravenous catheter plays an important role in promoting the treatment of AIDS natients.

BACKGROUND:Icariin can promote bone formation and inhibit bone resorption,but it is difficult to dissolve in water,and its bioavailability is very low in vivo.Therefore,a suitable carrier is essential to fully utilize the biological activity of icariin.OBJECTIVE:To prepare an icariin/β-tricalcium phosphate (β-TCP) composite scaffold and to characterize its biological characteristics.METHODS:Three-dimensional printing technology was utilized to prepare porous β-TCP scaffolds carrying nano zinc oxide,and the compressive strength of porous β-TCP scaffolds was detected before and after addition of nano zinc oxide.Water absorption and porosity of the porous β-TCP scaffolds were also measured.Ultrasonic emulsification solvent dialysis was performed to prepare icariin/poly(lactic-co-glycolic acid) (PLGA) microspheres,followed by the detection of water absorption and porosity.The porous β-TCP scaffolds and icariin/PLGA microsphere suspension were mixed to prepare icariin/β-TCP composite scaffolds.Microstructure observation of the composite scaffolds was done by scanning electron microscope,and meanwhile,water absorption and porosity were detected.The composite scaffold was then immersed into PBS,and icariin concentration in the supematant was measured at corresponding time points,based on which Icariin cumulative release curve was drawn.RESULTS AND CONCLUSION:(1) The porous microstructure of the porous β-TCP scaffold was regular,well distributed,and the connectivity was good.The pore spacing was about 600 μm.After addition of nano zinc oxide particles,the surface structure of the scaffold was more compact and the crystallinity was higher.(2) PLGA microspheres were spherical with a diameter of 1-4 μm,and the microspheres were uniform in size.(3) The maximum compressive strength of the porous beta tricalcium phosphate scaffold was (2.98±0.78) MPa,and increased to (8.95±0.29) MPa after addition of nano zinc oxide.(4) The water absorption rate and porosity were (25.09±0.96)％ and (66.93±2.84)％ for the porous β-TCP scaffold,(28.46±1.85)％ and (32.65±3.32)％ for the icariin/β-TCP composite scaffold,respectively.(5)The average encapsulation efficiency of the PLGA microspheres was (78.87±2.31)％,and the drug loading was (6.04±1)％.(6) The release amount of icariin could reach 52％ of the total amount at 16 days and 60％ of the total amount at 32 days.These findings indicate that the icariin/β-TCP composite scaffold has good mechanical properties and sustained-release performance.

OBJECTIVETo determine the expression status of survivin gene in pancreatic carcinoma.

METHODSExpression of survivin gene was evaluated by immunohistochemistry, Western Blot and RT-PCR in 59 cases of pancreatic carcinoma along with their corresponding adjacent benign tissues, 11 cases of chronic pancreatitis, and 7 pancreatic carcinoma cell lines.

RESULTSThe positive expression rate of survivin in pancreatic carcinoma was 72.8% (43/59). There was no relationship between the expression of survivin and tumor stage and differentiation. No expression of survivin was detected in benign tissue adjacent to the tumors as well as in samples of chronic pancreatitis. All 7 pancreatic carcinoma cell lines showed a positive expression of survivin mRNA and protein.

CONCLUSIONSThe expression of survivin appears to be tumor specific to some extent in our pancreatic carcinoma samples. Survivin may be an ideal target for therapy against pancreatic carcinoma.

Adenocarcinoma, Mucinous ; metabolism ; pathology ; Biomarkers, Tumor ; Carcinoma, Pancreatic Ductal ; metabolism ; pathology ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Inhibitor of Apoptosis Proteins ; Male ; Microtubule-Associated Proteins ; biosynthesis ; genetics ; Neoplasm Proteins ; biosynthesis ; genetics ; Neoplasm Staging ; Pancreatic Neoplasms ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics

OBJECTIVETo investigate the value of using protective new intracolonic drainage in decreasing low colorectal anastomotic leakage.

METHODSOne hundred and nineteen cases of rectal cancer accepted low anterior resection were randomly assigned to study group (n=55) and control group (n=64). The study group was added with a new intracolonic drainage composed of biofragmentable anastomosis ring and condom during operation. The control group was added with protective ileostomy during operation. The results of surgery were compared between the two groups.

RESULTSAll the cases were followed up over three months and there were no perioperative death. There were no significant differences in physiopathological factors such as age, sex, body type, site of tumor, size of tumor, differentiation of tumor, site of anastomosis, condition of nutrition, concomitant disease between the two groups. In the study group, anastomotic leakage occurred in 4 cases (7.3%), the drainage devices were ablated 18.3 days after operations and there were no drainage-related complications; light anastomotic stenosis occurred in 3 cases (5.5%) three months after operations. Among the cases with leakage, no severe abdominal infection was found, the time of abdominal drainage was 4.8 days, and the amount of abdominal drainage was 12.8 ml/d in primary three days after leakage. In the control group, anastomotic leakage occurred in 7 cases (10.9%), ostomy-related complications occurred in 29 cases (45.3%), anastomotic stenosis occurred in 18 cases (28.1%) and severe anastomotic stenosis occurred in 4 cases (6.3%) after three months. Among the cases with leakage, severe infection occurred in two cases, anastomotic spoiled occurred in one case, the amount of abdominal drainage was 35.4 ml/d in primary three days after leakage, and the time of abdominal drainage was 17.1 days. There was no significant difference in the rate of anastomotic leakage between the two groups (P>0.05). But there were significant differences in the amount of abdominal drainage, the time of abdominal drainage and abdominal infection in the cases of anastomotic leakage (P<0.01). There was significant difference in anastomotic stenosis after three months between the two groups (P<0.01).

CONCLUSIONSThe intracolonic drainage is a simple, safe and effective method in protecting low colorectal anastomotic leakage, and avoiding harmful results caused by anastomotic leakage. Compared with protective ileostomy, intracolonic drainage can avoid stomy-related physical mental suffering and complications, the rate of later anastomotic stenosis is less, and the time of abdominal drainage is shorter in the cases with leakage.

Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; adverse effects ; Drainage ; methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Rectal Neoplasms ; surgery ; Rectum ; surgery

[Objective]To investigate the character of expression of NK cells and its receptors in peripheral blood of pa-tients with HBV-related acute-on-chronic liver failure(HBV-ACLF)in different phase.[Methods]There are thirteen pa-tients with HBV-ACLF in advanced phase group and thirty-three patients in plateau phase group,with thirteen healthy per-son in control group.The frequency of NK cells and expression of NK cell activating receptors(NKAR)including NKG2D, NKp30 and NKp46,NK cell inhibitory receptors(NKIR))cludingsd ate the character of including NKG2A,KIR2DL1, KIR2DL3 and KIR3DL1,NK cell killing function related factors including Perforin,GranzymeB and FasL in peripheral blood of all patients were detected by flow cytometry.[Results]The percentage of NK cells in advanced group was lower than plateau group and healthy control group(H=7.771,P=0.021).The expression of KIR3DL1 in healthy control group was high-er than advanced group and plateau group(Z=6.639,P=0.036)while the expression of FasL was significantly lower than ad-vanced group and plateau group(Z=22.5,P<0.001).[Conclusion]Patients in advanced group had lower frequency of NK cells,lower expression of inhibitory receptor KIR3DL1 and higher expression of FasL than patients in plateau group and healthy control group,which is associated with immune status of patients in different phase of liver failure.

The industry of germ-free animals has been a hot spot in research along with the rapid development of studies on the relationship between microbiota and host diseases. Because it is pathogen?free, and the high degree of simi?larity in anatomy, physiology, pathogenesis to humans, germ?free pig is considered a clinical relevant model to be widely used in life science research. Based on the current state of research of germ?free pig cultivation at home and abroad and the experimental studies carried out in our laboratory as well, this article gives a simple discussion on germ?free technique of domestic pigs.