Objective To measure and calculate the dose distribution (tissue absorbed dose) of mouth floor area while using 125I to treat sublingual gland carcinoma.Methods Phantom of head and neck was used to place the 125I radioactive seeds to simulate the sublingual gland carcinoma treatment.125I radioactive seeds of 29.6 and 25.9 MBq per seed were used as two groups,with 31 seeds in each group,and prescribed dose (peripheral matched dose) was 120 Gy.Thermoluminescence dosimetry (TLD) was used to measure the absorbed dose value in the simulated target and adjacent area.Gafchromic Eriochrome Black T (EBT) film was used to draw the dose distribution curve.Results Dose absorbed in the target area,target area center and the adjacent area one centimeter away from target reached 160 Gy,390-500 Gy,and 90-170 Gy,respectively.Dose of the skin ranged from 25 to 81 Gy,dose of mandible ranged from 7.9 to 67 Gy.No radiation cold spot was found.Conclusions 125I seeds could achieve an effective therapeutic dose distribution of the target area for sublingual gland carcinoma.Dose absorbed in the adjacent tissue is under safety limit.The radiation dose at mandible is lower,reducing the possibility of radiation damage to the bone.

Objective:To investigate clinical features of distant metastases ( DM ) and analyze clinico-pathologic risk factors associated with DM from salivary gland carcinomas after being treated by surgery combined with 125 I internal brachytherapy. Methods: Between October 2001 and March 2010, 197 pa-tients with salivary gland carcinoma were treated by surgery combined with 125 I internal brachytherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate clini-copathologic risk factors that might influence the risk of distant metastases. Results:DM occurred in 28 of 197 patients (14. 2%). The commonest site of distant metastases overall was the lung 89. 3% (25/28), followed by bones 17. 9% (5/28) and liver (4/28). DM developed after an average interval of (44. 2 ± 45. 8) months from the time of initial diagnosis, and the mean interval was 64 months. The average time to death after the diagnosis of DM was only (9. 7 ± 13. 4) months, and the mean time was 12 months. The 3-year locoregional control rate and survival rate were 90. 8%, and 87. 8% respectively,and the 5-year ones 84. 0% and 81. 0%, respectively. Univariate analyses revealed that the risk of distant metasta-ses was significantly influenced by locoregional tumor failure (F=26. 997,P<0. 01) and histologic dif-ferentiation (F=1. 592,P<0. 01). Multivariate analysis of freedom from distant metastases revealed that locoregional control (F=29. 332,P<0. 01) significantly influenced this end point. Conclusion: Sali-vary gland carcinoma could achieve high local control rate after being treated by surgery combined with 125 I internal brachytherapy, and the average interval from diagnosis to DM was prolonged, DM was signifi-cantly influenced bylocoregional control.

Objective: To investigate clinical features of distant metastases from malignant salivary gland carcinomas after treated by 125I internal brachy therapy alone.Methods: Between 2002 and 2010, 43 patients with locally advanced unresectable or recurrent malignant salivary gland carcinomas were treated by 125I internal brachy therapy alone at Peking University School and Hospital of Stomatology.All of them had been follow-up at least 2 years.The primary sites of malignant salivary gland carcinomas were the parotid for 12 patients, infratemporal fossa for 9 patients, tongue for 7 patients, maxilla for 6 patients, parapharyngeal for 4 patients, floor of months for 3 patients, submandibular gland for 1 patient, and lip for 1 patient.The overall survival rate, local control rate, and distant metastases were retrospectively reviewed.Results: Distant metastases occurred in 23 of the 43 patients (53.5%).Distant metastases developed from 5 to 96 months, with an average interval of (27.0±23.7) months from the time of initial diagnosis, the mean interval was 21 months.The commonest site of distant metastases overall was the lung 69.6%(16/23).The most common pathological types of distant metastases were adenoid cystic carcinoma (14/23, 60.9%) and nonspecific adenocarcinoma (7/23, 30.4%).At the time of the last follow-up, 26 patients died, and 18 of them due to distant metastases (69.2%, 18/26).In the study, 27 patients got complete remission(CR), 12 got partial remission(PR) more than 50%, 2 less than 50%, and 2 patients were invalid.The effective rate (CR+ PR) was 90.7%.The 3 year loco-regional control rate and survival rate were 60.1%, 82.6%, respectively, and the 5 year's 53.4% and 56.0%.Conclusion: The 125I brachy therapy is a feasible and effective modality for the treatment of locally advanced unresectable or recurrent malignant salivary gland carcinomas.However, further studies are needed with larger numbers of patients and for a longer follow-up assessment.Distant metastasis was the main cause of treatment failure, and the lung was the most common site of distant metastases.

Objective To evaluate the treatment of malignant submandibular gland tumors with surgery combined with 125I radioactive implantation.Methods Thirty-two patients with malignant submandibular gland tumors were treated with surgery combined with 125I seed implantation from December 2005 to December 2012.All of the 32 patients with primary disease were treated by excision of the submandibular gland and neoplasm.None of the patients received wide excision or neck dissection without the evidence of the neck metastases.The planning targets was based on computerized tomography (CT)images,tumors site,extent and pathologic type.The matched peripheral dose (mPD) was 90-110 Gy.Recurrence-free survival (RFS),overall survival (OS) rates and side effects were retrospectively reviewed.Results Totally 32 patients received 1394 radioactive seeds implantation,radioactive seeds and dose distributed were well in all patients.All patients were followed for 15-126 months (mean of 64 months),with 5 recurrence,5 distant metastases,and 4 patients who died of disease.The 3-and 5-year RFS were 93.1％ and 87.9％,and OS rates were 93.3％ and 84.5％,respectively.No severe complications were observed during follow-up.Conclusions The excision of the neoplasm and the submandibular gland,combined with 125I seed implantation brachytherapy was an effective modality for the treatment of malignant submandibular gland tumors.

Objective: To evaluate the value of clinical application of Heart of the City type TJH-03A remote electrocardiogram recorder (remote ECG). Methods: A total of 1 014 community residents from Wuhan received ECG examination by Heart of the City type TJH-03A remote ECG recorder. Clinical and ECG data of all subjects were collected and analyzed. Results: There were 359 (35.40%) cases with normal ECG and 655 (64.60%) cases with abnormal ECG, after remote ECG examination . There were 581 cases had a variety of arrhythmia in 655 cases with abnormal ECG, so there were 828 cases times with abnormal ECG, in which there were （1）320 cases times (38.65%) with repolarization abnormality,（2）98 cases times(11.84%) with sinus bradycardia, （3）98 cases times (11.84%)with myocardial ischemia,（4）78 cases times (9.42%)with conduction block,（5）56 cases times(6.76%) with ventricular hypertrophy and high voltage,（6）43 cases times(5.19%) with atrial premature beats（7）37 cases times (4.47%)with atrial fibrillation,（8）35 cases times (4.23%)with sinus tachycardia,（9）24 cases times (2.90%)with ventricular premature beats, （10）19 cases times (2.29%)with suspected myocardial infarction according to ECG abnormality rate order. In addition, there were 5 cases times with QT interval prolongation, and abnormal ECG with abnormality rate ≤3 cases times: atrial tachycardia, atrial flutter, supraventricular tachycardia, ventricular tachycardia, Brugada wave, dextrocardia. Conclusion: Heart of the City type TJH-03A remote electrocardiogram recorder is convenient to use, it can perform remote electrocardiogram record, and find a variety of arrhythmias. It’s important for ECG diagnosis, especially for diagnosis of arrhythmias.

Objective To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD). Methods Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss,diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniquks were compared. The proportions of patients with positive findings using each examination were compared. Results Of the 57 patients, 50 underwent ileocolonoscopy, terminal ileum lesion was found in 33 patients (66. 00% ), the remaining 17 (34.0%)were normal; among 34 patients who had CTE, 29 of small bowel lesion were found (85. 29% ); CE were performed in 27 patients, due to prolonged gastric transit one time, the capsule did not reach the cecum in one patient during battery lifetime. CE showed small bowel lesion in 26 patients (96.30% ); SBF was performed in 39 patients and 26 of small bowel lesion were detected (66. 67% ). CE had the highest diagnostic yield for CD and ileocolonoscopy had the lowest, and there were statistically significant difference among the 4 examinations (P = 0. 006 ). The combinded positive rates of two methods were: CE + CTE 92. 86% (13/14), SBFT + CTE 90. 91% (20/22), CE + ileocolonoscopy 95. 65% (22/23), CE + SBFT100% (17/17), ileocolonoscopy + CTE 89. 66% ( 26/29 ), ileocolonoscopy + SBFT 77.78% ( 28/36 ), but there were no significant differences between each two examinations. Conclusion CE, CTE have a higher yield in depicting mild to moderate finding of CD than SBFT. CE is better for assessing early mucosal disease,whereas CTE is better for detecting transmural and extraluminal abnormalities. Most important, CE plus CTE may depict nonobstructive CD of the small bowel when conventional techniques such as ileocolonoscopy or SBFF have negative or inconclusive finding. CE provides us explanations for the symptoms of patients, decision to follow up or therapy.

Objective To evaluate the role of autophagy in hydrogen-induced inhibition of apoptosis in hippocampal neurons in a rat model of orthotopic liver transplantation (OLT).Methods Fifty-six pathogen-free healthy adult male Sprague-Dawley rats,aged 8-10 weeks,weighing 220-250 g,were used in the study.Thirty-two rats were selected and assigned into 4 groups (n =8 each) using a random number table:sham operation group (group S),OLT group,hydrogen-rich saline group (group HS) and chloroquine group (group CQ).The other 24 rats severed as the donors.In group S,laparotomy was performed,and the related blood vessels were isolated.The model of OLT was established in OLT,HS and CQ groups.In group OLT,normal saline 6 ml/kg was slowly injected via the inferior vena cava at 5 min before anhepatic phase.In group HS,hydrogen-rich saline 6 ml/kg was slowly injected via the inferior vena cava at 5 min before anhepatic phase.In group CQ,autophagy inhibitor chloroquine 60 mg/kg was injected intraperitoneally at 1 h before establishment of the model,and the other treatments were similar to those previously described in group HS.At 6 h of reperfusion,the rats were sacrificed and hippocampi were isolated for determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity,for pathological examination (with light microscope),and for detection of cell apoptosis (by TUNEL staining) and expression of autophagy-and apoptosis-related proteins caspase-3,cytochrome c (Cyt c),microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p53 in hippocampal tissues (by Western blot analysis).Apoptosis index (AI) was calculated.Results Compared with group S,the MDA content and AI were significantly increased,the SOD activity was decreased,and the expression of caspase-3,Cyt c,LC3 Ⅱ,Beclin-1 and p53 was up-regulated in OLT,HS and CQ groups (P＜0.05).Compared with group OLT,the MDA content and AI were significantly decreased,the SOD activity was increased,the expression of caspase-3 and Cyt c was down-regulated,and the expression of LC3 Ⅱ,Beclin-1 and p53 was up-regulated in group HS (P＜0.05).Compared with group HS,the MDA content and AI were significantly increased,the SOD activity was decreased,and the expression of caspase-3 and Cyt c was up-regulated,and the expression of LC3 Ⅱ,Beclin-1 and p53 was down-regulated in group CQ (P＜0.05).Conclusion The mechanism by which hydrogen inhibits apoptosis in hippocampal neurons is related to promotion of autophagy in a rat model of OLT.

Objective To investigate the role of nuclear factor erythroid 2-related factor 2 (Nrf2) / heme oxygenase-1 (HO-1) signaling pathway in reduction of acute kidney injury following orthotopic liver transplantation (OLT) by hydrogen-rich saline in rats.Methods Thirty-two healthy adult male SpragueDawley rats,weighing 220-250 g,were randomly assigned into 4 groups (n =8 each) using a random number table:sham operation group (S group),OLT group,hydrogen-rich saline group (HS group),and all-trans retinoic acid (ATRA) group.Laparotomy was performed,and the related blood vessels were isolated in group S.The model of orthotopic autologous liver transplantation was established in OLT,HS and ATRA groups.Normal saline and hydrogen-rich saline 6 ml/kg were injected through the inferior vena cava at 5 min before the portal vein was clamped in OLT and HS groups,respectively.In group ATRA,Nrf2 inhibitor ATRA 7 mg/kg was injected intraperitoneally once a day for 2 consecutive days,the model of orthotopic autologous liver transplantation was established at 16 h after the last injection of ATRA,and the other treatments were similar to those previously described in group HS.At 6 h of reperfusion,blood samples were collected for determination of serum blood urea nitrogen (BUN),creatinine (Cr),interleukin10 (1L-10) and tumor necrosis factor-alpha (TNF-α) concentrations.After blood sampling,the lungs were removed for determination of malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,expression of HO-1,Bcl-2 and Bax mRNA (by using real-time reverse transcriptase polymerase chain reaction),and HO-1 protein expression in lung tissues (by Western blot) and for microscopic examination.The damage to the renal tubules was scored.Results Compared with group S,the serum BUN,Cr and TNF-α concentrations were significantly increased,the serum IL-10 concentrations were decreased,the MDA content and renal tubular damage score were increased,the SOD activity was decreased,and the expression of HO-1 protein and mRNA,and Bcl-2 and Bax mRNA was up-regulated in group OLT (P＜ 0.05).Compared with group OLT,the serum BUN,Cr and TNF-α concentrations were significantly decreased,the serum IL-10 concentrations were increased,the MDA content and renal tubular damage score were decreased,the SOD activity was increased,the expression of HO-1 protein and mRNA and Bcl-2 mR-NA was up-regulated,and the expression of Bax mRNA was down-regulated in group HS (P＜0.05).Compared with group HS,the serum BUN,Cr and TNF-α concentrations were significantly increased,the serum IL-10 concentrations were decreased,the MDA content and renal tubular damage score were increased,the SOD activity was decreased,the expression of HO-1 protein and mRNA and Bcl-2 mRNA was down-regulated,and the expression of Bax mRNA was up-regulated in group ATRA (P＜0.05).Conclusion The mechanism by which hydrogen-rich saline reduces acute kidney injury following OLT is probably associated with activation of Nrf2/HO-1 signaling pathway in rats.

Objective To investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) on motor function and excitability of motor cortex in Parkinson's disease (PD) patients and to study the mechanism of PD from the electrophysiology. Methods Twenty-eight patients with PD received 1 Hz rTMS therapy for 15 d. Thirty normal volunteers were enrolled as controls. Unified Parkinson's Disease Rating Scale (UPDRS) and motor evoked potential (MEP) were adopted as assessment indicators. The excitability of motor cortex was assessed by rest motor threshold (RMT), central motor conduction time (CMCT) and the amplitude of MEP. Results The initial RMTs and CMCTs of PD patients were significantly lower than those of the controls, but MEP amplitudes were not significantly different. After rTMS treatment, motor function of PD patients improved, RMTs increased and CMCTs prolonged. Conclusion In PD patients, motor function disorder and increased motor cortical excitability were observed. Low frequency rTMS may inhibit these changes to some extent.

Objective To study the diagnostic value of magnetic resonance imaging (MRI) and spiral CT in thyroid microcarcinoma (TMC), in order to improve the diagnostic accuracy of TMC. Methods The preoperative imaging manifestations of MRI and spiral CT in 68 TMC patients who were confirmed by surgical pathology were retrospectively analyzed, and the diagnostic accordance rates were compared between the independent and the combined diagnosis. Results The diagnostic accordance rates of MRI and spiral CT in TMC were 73.53%(50/68) and 66.18%(45/68). The diagnostic accordance of combined MRI and spiral CT in TMC was 88.24%(60/68). The diagnostic accordance rate of combined MRI and spiral CT was significantly higher than that of independent examine, and there was statistical difference (P<0.05). The lesion detection rate of MRI was significantly higher than that of spiral CT:95.59% (65/68) vs. 83.82% (57/68), but the calcification lesion detection rate of spiral CT was significantly higher than that of MRI: 85.42% (41/48) vs. 4.17% (2/48), and there were statistical differences (P<0.05 or <0.01). There were no statistical differences in the detection rates of irregular shape lesions, boundary indistinct/coarse lesion, signal/uneven density lesions and cervical lymph node metastasis between MRI and spiral CT (P>0.05). Conclusions Spiral CT is superior to MRI in the micro-calcification detection, and MRI, with a high resolution of soft tissue, can display the lesions of surrounding tissue organs and neck lymph node metastasis better. The combined examine can increase the diagnostic accuracy of TMC.