Particle radiotherapy using proton and heavier-ion beam was first proposed for clinical application by Robert Wilson in 1946. Compared to conventional photon radiation, proton and heavier-ion beam has significant physical advantage, and heavier-ion has unique biological characteristics. With the development of accelerator and radiation technique, it is being investigated for tumor treatment in many clinical centers. This article reviews the current status of clinical application of particle therapy using proton and heavier-ion beam in digestive system tumor.
Animals ; Digestive System Neoplasms ; therapy ; Heavy Ion Radiotherapy ; Heavy Ions ; therapeutic use ; Humans ; Protons ; therapeutic use

ObjectiveTo study the association between the prognosis of Ta transitional cell carcinoma (TCC) of the bladder and risk-related factors.MethodsA total of 88 cases (62 males and 26 females;mean age,61 years;age range,41-81 years)of initial T_a TCC of the bladder treated with transurethral resection of bladder tumor (TURBt) plus intravesical chemotherapy or immunotherapy were enrolled.Among them,there were 26 cases of G_1,61 cases of G_2 and 1 case of G_3.For tumor site,62 cases (16 cases of G_1,45 of G_2,1 of G_3) had single tumor and 26 cases (10 cases of G_1,16 of G_2) had multi-site tumors.The mean follow-up was 113 months (range,56-168 months).The tumor grade,original tumor number and their association with the recurrence and progression of this type of TCC were retrospectively analyzed. Results The overall recurrence rate (RR) was 60%(53/88).In single tumor group,RR of G_1 cases was 25%(4/16);RR of G_2 cases was 62%(28/45) and the total RR was 52%(32/62).In multi-site tumor group,RR of G_1 cases was 80%(8/10),RR of G_2 cases was 75%(12/16) and the total RR was 77%(20/26).The RR of multi-site tumor group was significantly higher than that of single tumor group ( P

Objective To evaluate the efficiency and safety of extraperitoneal laparoscopic radi-cal prostatectomy for the treatment of localized prostate cancer. Methods Fifteen localized prostate cancer patients were treated with extraperitoneal laparoscopic radical prostatectomy. The mean pre-op-erative PSA was 8.1 ng/ml and prostate biopsy pathological Gleason score was 5.7±1.3. The Beijing Hospital Technique characterized by cutting directly into linea alba abdominis was used to establish the extraperitoneal space. Harmonic scrapple was used in dissection and haemostasis during the proce-dure. This technique was evaluated in respects of operating time, estimated blood loss, complications during surgery, postoperative complications, post-operative pain score (NRS), catheterization time, length of hospital stay, pathological results and post-operative PSA. Results All the surgeries had been completed successfully except 1 case converted to open surgery. The average operation time was (316±74)min, the average estimated blood loss was (4084±362)m1. There were 5 cases accepted blood transfusion. No rectal or ureteral injury happened during operation. The NRS at post-operative day 1 and day 2 were 2.3 and 1.4. The average length of hospital stay was (19.5±4.9)d. The cathe-terization time was (14.1±2.9)d. There were 2 cases (13%) with positive surgical margins. No case was found having lymph node metastasis. During the 1-12 month follow up, 10 cases (67%) were continence. PSA in 12 cases was lower than 0.2 ng/ml. Conclusion Extraperitoneal laparoscopic radical prostatectomy is feasible and safe in the treatment of localized prostate cancer.

OBJECTIVETo analyze the electrical activity property changes in nucleus accumbens (NAc) of heroin-induced conditioned place preference (CPP) rats during different stages of heroin dependence and to explore NAc's roles in the formation of drug dependence.

METHODSRecording electrodes were bilaterally embedded into the NAcs of rats with the aid of stereotaxic apparatus, followed by establishment of heroin-dependent rat model. The NAc electrical activity during 3 different stages of heroin dependence, including heroin pre-exposure, immediate post-exposure and heroin withdrawal, were respectively recorded using EEG wireless telemetry techniques. The frequency distribution (ranging from 0.5 to 30 Hz) and the amplitude of NAc electrical activity were analyzed and measured.

RESULTSHeroin-dependent rat models were successfully established and their withdrawal symptoms were evident. All rats showed a conditioned place preference (CPP) for the white box after 5-10 days of heroin-exposure, and displayed a maximum withdrawal symptoms on 2d after heroin- withdrawal. During all statges of heroin-dependence, the NAc electrical activity contained the highest proportion of delta rhythm and the lowest proportion of alpha2 rhythm. The discharge frequence band was similar across different stages. There was a significantly increased ratio of low-frequency discharges (delta rhythm) and decreased ratio of high-frequency discharges (beta rhythm) in NAc of rats during the immediate post- heroin exposure stage when compared with that during pre-exposure and heroin withdrawal stages. During the withdrawal stage, the ratio of at rhythm was significantly lower than during pre- and post-heroin exposure stages (P < 0.01). Further, the mean discharge amplitude in NAcs during immediate post-exposure and withdrawal stages was significantly increased relative to pre-exposure stage. However, the mean discharge amplitude during heroin withdrawal stage was significantly lower than during immediate post-exposure stage.

CONCLUSIONThe electrical activity properties in rat NAcs showed a significant change during different stages of heroin-dependence, which suggested that neuronal activities in NAcs might contribute to the modulation of drug-dependence.

Animals ; Conditioning, Operant ; Heroin ; pharmacology ; Heroin Dependence ; physiopathology ; Male ; Nucleus Accumbens ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Telemetry

Adult ; Antigens, CD34 ; metabolism ; Humans ; Male ; Neoplasms, Fibrous Tissue ; metabolism ; pathology ; surgery ; Prostatectomy ; Prostatic Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

ObjectiveAnalyze preoperative clinical relevanted factors of acute type A aortic dissection with hypoxemia according to a group clinical data.MethodsFrom January 2011 to June 2011,we have collected 54 preoperative cases of acute type A aortic dissection,including 42 males,12 females,aged 28-73 years old,onset to treatment time is 0.4-14.0 days.General information:age,gender,time of onset,body mass index,hypertension,diabetes mellitus,smoking,drinking,heart ejection fraction,prothrombin time,quantitative fibrinogen,fibrinogen degradation products,D-dimer,C-reactive protein,procalcitonin,ICU time,length of hospital stay.According to the blood gas analysis of quiet state case without oxygen,with PaO2 ＜ ( 100-age ×0.33 ±5) mm Hg is for the hypoxemia group,equal or higher than this is no-hypoxemia group.ResultsNo-hypoxemia group has 14 cases,11 males,3 females,average aged (51.14 ± 14.24) years old,including 12 operation patients ( no death) and 2 no-operation patients(2 cases death).Hypoxemia group has 40 cases,31 males,9 females,average aged (50.53 ± 9.73 ) years old,including 33 operation patients(2 cases death) and 7 no-operation patients(7 cases death).There is no significant difference in age,gender,time of onset,hypertension,diabetes mellitus,smoking,drinking,cardiac ejection fraction,prothrombin time and fibrinogen.There is statistically significant on body mass index,fibrinogen degradation products,D-dimer,C-reactive protein,procalcitonin,ICU time and length of hospital stay time ( P ＜ 0.05 ).ConclusionPreoperative hypoxemia with acute type A aortic dissection is associated with obesity,excessive inflammation and activation of coagulation and fibrinclytic system,and hypoxemia may prolong the time of operative patients with acute type A aortic dissection in ICU and hospital.

Objective To study serum level of prostate specific antigen (PSA) by age and its relationship with positive prostatic biopsy.Methods A total of 8818 adults who underwent PSA scanning at Health Chek-up Center of Beijing Hospital during July 2009 and July 2010 were retrospectively studied,40 of whom performed prostatic biopsy.Linear regression was used to assess the relation of PSA with age,while Chi-square test was used to compare positive prostatic biopsy in different PSA groups.Results Serum PSA of more than 4 μg/L was more commonly seen in the elderly group (40 ～ year-old group 1.4％,50 ～ yearold group 1.9％,60 ～ year-old group 9.2％,70 ～ year-old group 15.5％,80 year-old group 17％ ; P ＜0.001 ; RR =0.196).In those whose PSA was ＞ 20 μg/L,6 (83.3 ％) were found to have positive prostatic biopsy; and the figure was 10 (50.0％) or 24 (24.0％) when PSA was ＜4 μg/L or 4-10 μg/L group (P =0.048).Conclusions Age was positively correlated with PSA,although no linear correlation was confirmed.Higher serum PSA level (＞ 4 μg/L) may be more common in elderly people and those with a positive prostatic biopsy.

Objective To study the role of using PSA in prostate cancer screening in the male physical examination population over 50yrs in Beijing.Methods From January 2010 to December 2010,in Physical Examination Center of Beijing Hospital and Beijing MeiZhao Health Screening Center,men over 50years with PSA records in the past three years (from 2007 to 2009) were selected.The exclusion criteria included history of prostate cancer,severe diseases of the heart,brain,lung,liver and kidney,and mental or neurological disorders.People who couldn't cooperate with the investigation due to any reasons were excluded as well.The number of recruited cases was 2862.Among the cases,males with PSA over 4 μμg/L received prostate biopsy after singing the informed consent form.The average age was 67.2 ± 9.3 years.Results In the 2862 males,2621 cases (91.5％) had normal PSA levels and 241 cases (8.5％) had abnormal PSA levels.With the age increasing from 50 to 89 years,the proportion of abnormal PSA levels increased significantly from 2.7％ to 10.9％,P ＜ O.001.86 patients (33.2％) received prostate biopsy in the group of abnormal PSA levels; The positive prostate biopsy rate was 41.4％ (39/86).In PSA ＜4 μg/Lgroup,the positive rate was 25.0％ ; in 4 μg/L≤PSA ＜ 10 μg/L group,the positive rate was 29.8％ ; in PSA ≥ 10 μg/L group,the positive rate was 68.9％,P ＜ 0.001.With the PSA level increasing,the proportion of the localized cancer decreased from 100％ to 70％,and the ratio of locally advanced and distant metastatic tumor increased from 0 to 30％ ; the proportion of Gleason≤6 fell from 100％ to 30％,the proportion of Gleason ≥ 8 increased from 0 to 50％.The differences above did not show statistical significance.Conclusions Use of PSA in prostate cancer screening for men over 50 years could increase the detection rate of prostate cancer.

Objective To investigate the age distribution of serum prostate-specific antigen (PSA) in middle-aged and aged people in Beijing. Methods From November 2006 to November 2008, the data of men, who visited Beijing Hospital for routine health examination and received a measurement of serum PSA level, were collected and analyzed retrospectively. The eligible men were classified into various age groups over 10-years interval, and the PSA distributions were analyzed in the groups. Results A total of 11557 men were enrolled in this study. Within the entire cohort, the median PSA level was 0. 89 μg/L. The median PSA levels in each age group were as follows: 0. 79 μg/L in 40-49 yrs age group, 0.85 μg/L in 50-59 yrs age group, 1.20 μg/L in 60-69 yrs age group,1.44 μg/L in 70-79 yrs age group and 1.52 μg/L in more than 80 yrs age group. The serum PSA level gradually increased along with age. A rapid increase of PSA level began from 60 yrs age. The percentile of men with PSA ＞4 μg/L were 1.3%, 2.6%, 8.8%, 15.4% and 14.4% according to age category. Conclusions The PSA level is positively correlated with age in middle-aged and aged people in Beijing. Especially from 60 years of age, the percentile of men with abnormal PSA increases dramatically. Our results can guide clinicians to understand the population-based distribution of serum PSA and to screen prostate cancer.

As the incidence of prostate cancer keeps rising in China, urological surgeons are more and more concerned about the early diagnosis and treatment of the disease. Despite the evidence that the prostate cancer screening program can help to decrease the mortality relevant to the disease, it is still controversial whether to start this program in China. Digital rectal examination (DRE), prostate specific antigen (PSA) and ultrasound guided transrectal prostate biopsy remain to be the main approaches to the diagnosis of early prostate cancer. As for the treatment of the disease, emphasis has been laid on curative approaches, such as radical prostatectomy and radiotherapy. And close follow-up has been stressed, as this might facilitate the early finding of possible relapse and hence the prompt initiation of the second line therapy.
Biopsy, Needle ; Follow-Up Studies ; Humans ; Male ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; therapy