ObjectiveTo evaluate the outcomes and toxicities of elderly nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy alone.MethodsFrom January 1995 to December 1998,95 newly diagnosed nasopharyngeai carcinoma with age ≥65 years treated in our hospital.The clinical data were analyzed retrospectively.Kaplan-Meier method was used for analysis of local-regional control survival and distant metastasis-free survival. The Logrank test was used for univariate prognostic analysis and Cox regression was used for multivariable prognostic analysis.ResultsThe follow-up rate was 98％.The 3-,5- and 8-year local-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 89％,87％,84％ and 85％,79％,79％,respectively. The most common acute toxicities were grade1-2 leukopenia (36％),skin reaction (64％) and mucositis (66％).The most frequent late toxicities were hearing impairment (8％),trismus ( 10％ ) and radiation-induced cranial neuropathy (5％).In univariate analysis,interruption of radiotherapy ( χ2 =7.45,P =0.006 ) and regional neck lymph nodes response (χ2 =4.17,P=0.041 ) was the prognostic factors for LRC,T stage (χ2 =4.16,P=0.032),N stage ( χ2 =4.66,P =0.031 ) and interruption of radiotherapy ( χ2 =9.42,P =0.002 ) was the prognostic factors for DMFS. In multivariable analysis,interruption of radiotherapy and the regional neck lymph nodes response were the prognostic factors for LRC (χ2=6.19,P=0.013 and χ2=12.16,P=0.002;respectively),N stage and radiotherapy interruption were prognostic factors for DMFS.(χ2=15.06,P =0.000 and χ2 =21.62,P =0.000 ; respectively ).ConclusionsConventional radiotherapy alone for elder NPC can produce satisfactory results with acceptable treatment-relative toxicities.Our experience showed that the early N stage,without radiotherapy interruption and good regional lymph nodes response had a good longterm prognosis.

ObjectiveTo analyze the correlation between primary tumor volume (PTV) and prognosis of nasopharyngeal carcinoma ( NPC ) treated by intensity-modulated radiotherapy ( IMRT ).Methods330 NPC patients treated by IMRT were included.Pretreatment computerized tomography image were input into tree-dimensional treatment-planning system,in which the primary tumor volume were calculated automatically.The receiver operating characteristic curve was used to determine the best cut-off point of PTV.Within the framework of UICC 2002 T stage,The PTV was divided into four groups:V1 ＜ 10cm3,V2 10-25 cm3,V3 ＞ 25-50 cm3 and V4 ＞ 50 cm3.Kaplan-Meier and Logrank test was used to analyze the survival,Cox proportion risk regression model were used to analysis the correlation between PTV and prognosis.ResultsThe mean PTV for all NPC patients was ( 34.2 ± 27.1 ) cm3 with the range of 0.4- 153.7 cm3.The 3-year overall survival for V1,V2,V3 and V4 stage were 88.6％,90.0％,91.2％ and 74.2％,respectively (x2 =12.83,P =0.005 ).There was no significant difference among V1,V2 and V3in terms of overall survival ( x2 =1.96,P =0.376).The 3-year distant metastasis-free survival and diseasesfree survival or overall survival were decrease in PTV ＞50 cm3 and PTV≤50 cm3 (77.4％:89.9％,x2 =7.24,P=0.007and 64.5％:85.1％,x2 =13.95,P=0.000 or 74.2％:90.3％,x2 =11.76,P=0.001).Multivariate analysis revealed that PTV was a adverse prognostic factors for overall survival (x2 =0.00,P =2.580).ConclusionOur data showed that the primary tumor volume had significantly impacted on the prognosis of NPC patients treated by intensity modulated radiotherapy.

A serious leaf disease caused by Colletotrichum dematium was found during the cultivationof Sarcandra glabra in Jingxi, Rong’an, and Donglan Counties in Guangxi Province, whichinflicted huge losses to plant productivity. Biological control gradually became an effectivecontrol method for plant pathogens. Many studies showed that the application of actinomycetesin biological control has been effective. Therefore, it may be of great significance tostudy the application of actinomycetes on controlling the diseases caused by S. glabra.Strains of antifungal actinomycetes capable of inhibiting C. dematium were identified, isolatedand screened from healthy plants tissues and the rhizospheres in soils containing S.glabra. In this study, 15 actinomycetes strains were isolated and among these, strains JT-2F,DT-3F, and JJ-3F, appeared to show antagonistic effects against anthracnose of S. glabra.The strains JT-2F and DT-3F were isolated from soil, while JJ-3F was isolated from plantstems. The antagonism rate of strain JT-2F was 86.75%, which was the highest value amongthe three strains. Additionally, the JT-2F strain also had the strongest antagonistic activitywhen the antagonistic activities were tested against seven plant pathogens. Strain JT-2F isable to produce proteases and cellulase to degrade the protein and cellulose componentsof cell walls of C. dematium, respectively. This results in mycelia damage which leads toinhibition of the growth of C. dematium. Strain JT-2F was identified as Streptomyces tsukiyonensisbased on morphological traits and 16S rDNA sequence analysis.

A serious leaf disease caused by Colletotrichum dematium was found during the cultivationof Sarcandra glabra in Jingxi, Rong’an, and Donglan Counties in Guangxi Province, whichinflicted huge losses to plant productivity. Biological control gradually became an effectivecontrol method for plant pathogens. Many studies showed that the application of actinomycetesin biological control has been effective. Therefore, it may be of great significance tostudy the application of actinomycetes on controlling the diseases caused by S. glabra.Strains of antifungal actinomycetes capable of inhibiting C. dematium were identified, isolatedand screened from healthy plants tissues and the rhizospheres in soils containing S.glabra. In this study, 15 actinomycetes strains were isolated and among these, strains JT-2F,DT-3F, and JJ-3F, appeared to show antagonistic effects against anthracnose of S. glabra.The strains JT-2F and DT-3F were isolated from soil, while JJ-3F was isolated from plantstems. The antagonism rate of strain JT-2F was 86.75%, which was the highest value amongthe three strains. Additionally, the JT-2F strain also had the strongest antagonistic activitywhen the antagonistic activities were tested against seven plant pathogens. Strain JT-2F isable to produce proteases and cellulase to degrade the protein and cellulose componentsof cell walls of C. dematium, respectively. This results in mycelia damage which leads toinhibition of the growth of C. dematium. Strain JT-2F was identified as Streptomyces tsukiyonensisbased on morphological traits and 16S rDNA sequence analysis.

ObjectiveTo study the effect of menbranous milkvetch root parenteral solution on insulin resistance of gerontism cerebral infarction in recovery stage.Methods66 patients with gerontism cerebral infarction were randomly divided into therapy group(33 cases) which received membranous milkvetch root parenteral solution and control group(33 cases).Both groups adopted routine treatment at the same time, the period was 20 days. Insulin(Ins), free blood sugar(FBS), total cholesterol(CH), triglyceride(TG), hemorheology and insulin resistance(indicating by index of insulin sensitive) of blood on empty stomach were evalutated before and after treatment. ResultsAfter treatment there was decrease in CH, FBS, FINS in therapy group than in control group(P<0.01 or P<0.05); the clinical effect in therapy group was better than in control group(P<0.01).ConclusionMembranous milkvetch root parenteral solution can significantly decrease insulin resistance, blood lipin, blood viscosity in recovery stage of gerontism cerebral infarction, and improve clinical efficiency.

BACKGROUND: Mild cognitive impairment (MCI) in elderly people is becoming increasingly a new hot spot for the clinical study of Alzheimer disease at present, and it is still unknown how many cases of MCI will convert into Alzheimer disease. OBJECTIVE: To analyze the incidence rate of mild cognitive impairment and the conversion rates into dementia and Alzheimer disease among elderly people.DESIGN: A prospective cohort study based on diagnosis. SETTING: Second Department of Cadre's Ward, Bethune International Peace Hospital of Chinese PLA.PARTICIPANTS: The subjects were 216 MCI patients and 2 302 subjects with normal cognition selected in the baseline investigation to the retired cadres aged 60 years and above, in 26 military cadres' sanatoriums of Shijiazhuang city between August and September 2001.METHODS: The MCI diagnosis was according to the MCI diagnostic standard in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-Ⅳ), and the diagnosis of dementia was according to the standard in DSM-Ⅳ revised by American Psychiatric Association. Alzheimer disease was diagnosed according to the standards of National Institute of Neurological and Communicative Disorders and Stroke/the Alzheimer Disease and Related Disorders Association (NINCDS-ADRDA). All the 216 MCIpatients and 2 302 subjects with normal cognition were enrolled in the 3-year cohort study. MAIN OUTCOME MEASURES: The incidences of MCI among subjects with normal cognition; the annual conversion rates into Alzheimer disease in MCI patients and subjects with normal cognition; the relative risks (RR) and 95% confidence interval (95% CI) of MCI and normal cognition developing into Alzheimer disease. RESULTS: The MCI group and normal cognition group were followed up once every year for 3 years. Of the 216 MCI patients, 7 died, and 209 were followed up actually, and the follow-up rate was 96.8%. Of the 2 302 subjects with normal cognition, 36 died, and 2 266 were followed up actually,and the follow-up rate was 98.4%. ① In the elderly subjects with normal cognition, the annual incidence of MCI was 4.8%, and those of dementia and Alzheimer disease were 1.3% and 0.8 respectively. ② The annual in cidence rates of dementia and Alzheimer disease in MCI patients were 8.1% and 5.6% respectively, which were insignificantly different between males and females (P ＞ 0.05). ③ The incidence rates of dementia and Alzheimer disease showed a descending trend with the elevation of educational level in both the MCI patients (trend x2 =5.57, P=0.02; trend x2 =4.92, P=0.03) and the subjects with normal cognition (trend x2 =23.1, P＜ 0.001; trend x2 =18.0, P ＜ 0.001). ④ The annual incidence rates of dementia and Alzheimer disease showed an ascending trend with aging in both the MCI patients (trend x2 =14.6, P ＜ 0.01; trend x2 =13.9, P ＜ 0.01) and the subjects with normal cognition (trend x2 =32.3, P ＜ 0.01; trend x2=23.8, P ＜ 0.01). ⑤ The relative risks of the conversion into dementia and Alz heimer disease in MCI patients were 6.4 and 7.4 times as many as those in the subjects with normal cognition.CONCLUSION: The risks of conversion into dementia and Alzheimer disease in elderly MCI patients are far higher than those in elderly people with normal cognition. It should be reinforced to monitor elderly MCI patients, who are the of high risk group of dementia.

Objective To investigate the optimal condition for the detection of anti-non-galactose (Gal) xenoantigen and antibody in human serum.Mehtods Peripheral blood mononuclear cell (PBMC) obtained from Wuzhishan miniature pig models with α-1,3-galactosyltransferase gene knockout (GTKO) were used as target cells,mixed and incubated with healthy human serum of different concentrations (4.8％,16.7％ and 100％) for 0.5,1.0,2.0,3.0 and 6.0 h,respectively.The abilities of PBMC to bind with IgM and IgG were detected by flow cytometry.Results At the serum concentration of 16.7％,the ability ofnon-Gal IgM to bind with PBMC was significantly enhanced from 0.5 h to 3.0 h incubation (P＜0.01),whereas no statistical significance was noted in terms of IgG (P＞0.05).Increasing serum concentration could also enhance the ability of non-Gal IgM to bind with PBMC.At the serum concentration of 100％ and incubation for 3 h,the ability of IgM to bind with PBMC was the highest among all groups (P＜0.01).At the serum concentration of 100％ and incubation for 6 h,the ability of IgG to bind with PBMC was significantly enhanced (P＜0.05).Prolonging incubation time and increasing serum concentration did not affect the activity of PBMC.Conclusions The optimal condition for detection of anti-non-Gal xenoantigen and antibody is determined.A quantity of 1×105 PBMC from pig should be incubated with 100％ human serum for 3 h for detection of IgM level,or incubated with 100％ human serum for 6 h for measurement of IgG level.This optimized condition contributes to screening the donor pigs which lowly express non-Gal antigen.

Objective To investigate the effect of human CD47 (hCD47) in inducing the immune tolerance of human macrophages to porcine endothelial cells. Methods The porcine iliac endothelial cell (PIEC) transfected with pCDH-hCD47-FLAG plasmid was assigned into the pCDH-hCD47 group, PIEC transfected with pCDH-FLAG empty vector plasmid was assigned into the pCDH group, PIEC transfected with hCD47-dN was assigned into the pCDH-hCD47-dN group and human umbilical vein endothelial cell (HUVEC) was assigned into the positive control group. The cells were co-cultured with human macrophages to detect and analyze the phosphorylation of signal regulatory protein α (SIRPα) and the killing effect of human macrophages on PIEC. Furthermore, porcine arteriae endothelial cell (PAEC) was isolated from GT^－/－ and GT^－/－/ hCD 47 gene editing pigs to analyze the phosphorylation of SIRPα and the killing effect of human macrophages on PAEC. Results The pCDH group cells could not induce the phosphorylation of SIRPα, whereas the pCDH-hCD47 group cells could activate the phosphorylation of SIRPα after 10 min co-culture with human macrophages, and the degree of phosphorylation of SIRPα was increased with the prolongation of the co-culture time. The pCDH-hCD47-dN group cells failed to activate the phosphorylation of SIRPα. Human macrophages exerted significant effect on killing the pCDH group cells. The pCDH-hCD47 group cells could evidently inhibit the killing effect of human macrophages (P < 0.05), whereas the pCDH-hCD47-dN cells failed to suppress the killing effect of human macrophages. GT^－/－-PAEC could not activate the phosphorylation of SIRPα after co-culture with human macrophages. However, GT^－/－/hCD47-PAEC significantly activated the phosphorylation of SIRPα after co-culture with human macrophages. Human macrophages exerted significant killing effect on GT^－/－-PAEC, and GT^－/－/hCD47-PAEC could obviously inhibit the killing effect of human macrophages (P < 0.05). Conclusions The expression of hCD47 in the porcine endothelial cells can inhibit the killing effect of human macrophages on endothelial cells by activating the phosphorylation of SIRPα.

Objective:To develop a geriatric nursing core literacy evaluation scale and to test its validity and reliability.Methods:The scale item pool was constructed by referring to relevant literatures and expert consultation method was used to form initial scale. A preliminary investigation was conducted among 40 nurses to form the formal scale, and then 252 nurses were selected to test the validity and reliability of the formal scale.Results:The formal scale consisted of four dimensions and 37 items. The Cronbach α coefficient of the formal scale was 0.980, the content validity index was 0.912, exploratory factor analysis identified 4 principal factors (knowledge geriatric nursing core literacy, skill geriatric nursing core literacy, cognitive geriatric nursing core literacy, belief geriatric nursing core literacy) and explained 73.135% of the total variance.Conclusion:The geriatric nursing core literacy evaluation scale has good reliability and validity, which can be used to evaluate the geriatric nursing core literacy of nursing staffs.

Objective To investigate the isolation and culture of porcine bone marrow mesenchymal stem cell (BMSC) with α-1, 3-galactosyltransferase (GGTA1) gene knockout (GTKO), GTKO/ human CD46 (hCD46) insertion and cytidine monopho-N-acetylneuraminic acid hydroxylase (CMAH)/GGTA1 gene knockout (Neu5GC/Gal), and the protective effect of co-culture with porcine islets on islet cells. Methods Bone marrow was extracted from different transgenic pigs modified with GTKO, GTKO/hCD46 and Neu5GC/Gal. Porcine BMSC were isolated by the whole bone marrow adherent method and then cultured. The morphology of BMSC was observed and the surface markers of BMSC were identified by flow cytometry. Meantime, the multi-directional differentiation induced by BMSC was observed, and the labeling and tracing of BMSC were realized by green fluorescent protein (GFP) transfection. The porcine BMSC transfected with GFP were co-cultured with porcine islet cells. Morphological changes of porcine islet cells were observed, and compared with those in the porcine islet cell alone culture group. Results BMSC derived from pigs were spindle-shaped in vitro, expressing biomarkers of CD29, CD44, CD73, CD90, CD105 and CD166 rather than CD34 and CD45. These cells were able to differentiate into adipocytes, osteoblasts and chondrocytes. Porcine BMSC with GFP transfection could be labeled and traced, which could be stably expressed in the daughter cells after cell division. Porcine BMSC exerted certain protective effect on islet cells. Conclusions GFP-labeled porcine BMSC modified with GTKO, GTKO/hCD46 and Neu5GC/Gal are successfully established, which exert certain protective effect upon islet cells.