Objective To study the efficacy and security of postoperative radiotherapy alone and post-operative radiotherapy combined with chemotherapy in patients with high-grade cerebral glioma.Methods Fifty-nine patients with high-grade cerebral glioma confirmed by pathology, including 35 with grade Ⅲ and 24 with grade Ⅳ, admitted to our hospital from June 2004 to June 2008, were chosen in our study; these patients were randomly divided into 3 groups (A, B and C). All the patients underwent three-dimensional conformal radiation therapy (3D-CRT) with a dose of 54-66Gy/27-33f/5-7w by 6/10MV-X ray; and the median total dose was 60 Gy; group A (n=21, including 13 with grade Ⅲ and 8with grade Ⅳ) received chemotherapy with termozolomide (TMZ) at a dosage of 75 mg/m2·d during radiotherapy, following by 150-200 mg/ (m2·d) for 5 d, and enjoying 28 d per cycle for a total of 3-5cycles; group B (n=26, including 14 with grade Ⅲ and 12 with grade Ⅳ) received chemotherapy with the regimen of nimustine (ACNU) with a dosage of 90 mg/m2 on the 1st d and teniposide (VM-26) at a dosage of 60 mg/m2 on the 1st, 2nd and 3rd d, enjoying 6-8 weeks per cycle for a total of 4-6 cycles; group C (n=12,including 8 with grade Ⅲ and 4 with grade Ⅳ) received radiotherapy alone. Clinical evaluations of tumor response and adverse effects were performed periodically. The primary end points were disease progression-flee survival (PFS) and overall survival (OS) Results The effective rate in the group A, B and C was 81.0％, 71.4％ and 33.3％, respectively, indicating that significant differences exited between group C and both group A and B (P＜0.05). The incidence of gastrointestinal side effects and toxic response in the group B was obviously higher than that in the group A (P＜0.05). The 1-, 3- and 5-year survival rates in group A were 66.7％, 19.0％ and 9.5％, respectively, which were the highest among the 3groups; those in group B were 53.8％, 15.4％ and 3.8％, respectively; those in group C were 25％, 8％ and 0％, respectively. The PFS in all the patients was 8 months and OS was 15 months; log-rank test indicated that significant differences of PFS and OS existed between patients received concomitant chemoradiotherapy and radiotherapy (X2=10.710, P=0.005; X2=7.185, P=0.028); the incidence of PFS and OS in group A and B was significantly higher than that in group C (P＜0.05). Conclusion To post-operative patients with high-grade cerebral glioma, concomitant chemoradiotherapy can improve the effective rate and extend the PFS and OS. TMZ is recommended as the concomitant chemotherapy regimen, having similar therapy effect with ACNU plus VM-26, but enjoying less adverse effects.

BACKGROUND: At present, studies have shown that bone marrow mesenchymal stem cells (BMSCs) have self-renewal ability, which can be used as ideal seed cells for repairing tissue and organ damages caused by aging and lesions. OBJECTIVE: To study the changes in the levels of oxidation, inflammatory factors and neurotrophic factors (BDNF) in the brain of aging rats undergoing BMSCs transplantation, and to analyze the mechanism underlying the repair of learning and memory ability in the aging rats. METHODS: A total of 30 clean Sprague-Dawley rats were randomly divided into control group, model group and BMSCs group, 10 rats in each group. Aging models were made in the rats by 3-month subcutaneous injection of D-galactose. After modeling, BMSCs treatment was performed via tail vein injection in the BMSCs group.The injection was performed once a week,for 8 continuous weeks.Morris water maze was used to detect the learning and memory abilities of the rats in each group after the final injection of BMSCs. Superoxide dismutase activity in the brain tissue of rats was detected by xanthine oxidase method. Level of malondialdehyde in the rat brain tissue was detected by thiobarbituric acid method. Total antioxidant capacity of the brain tissue was detected by Fe3+reduction method. Real-time PCR and western blot assay were used to detect the expression of brain-derived neurotrophic factor mRNA and protein in the brain tissue of the aging rat, respectively. RESULTS AND CONCLUSION: Compared with the model group, the BMSCs group exhibited significantly higher activity of superoxide dismutase, stronger total antioxidant capacity, and higher levels of brain-derived neurotrophic factor mRNA and protein (P < 0.05), but the lower malondialdehyde level in the brain (P < 0.05). Compared with the model group, there was less time and higher frequency for passing through the platform in the BMSCs group (P < 0.05). Our findings further indicate that BMSCs can improve the abilities of learning and memory in aging rats, and the underlying mechanism is likely to improve antioxidant capacity and to regulate the level of brain-derived neurotrophic factors.

OBJECTIVETo estimate the feasibility of 16-multidetector spiral computed tomography (16-MDCT) on detecting coronary plaques in comparison with intravascular ultrasound (IVUS).

METHODSSixty-eight patients suspected of coronary heart diseases were examined by 16-MDCT, quantitative coronary angiography (QCA) and IVUS. Coronary stenosis was defined as lumen diameter reduction (DS) >or= 50%. Hounsfield units (HU) were used to determine different types of plaques: soft plaque (or= 120 HU).

RESULTSCompared to QCA, the sensitivity and the specificity for patients with DS >or= 50% were 91.8% (112/122) and 97.8% (556/568) respectively, the positive and negative predictive value were 90.3% (112/124) and 98.2% (556/566) respectively. In 96 plaques evaluated both by 16-MDCT and IVUS, 20 and 21 soft plaques, 37 and 36 fibrous plaques, 39 and 38 calcified plaques were identified by 16-MDCT and IVUS respectively. HU value of soft (11 +/- 36), fibrous (83 +/- 20), and calcified (292 +/- 80) plaques were significantly different (P < 0.05).

CONCLUSIONSNoninvasive 16-MDCT could correctly estimate coronary stenosis and coronary plaques compositions.

Aged ; Atherosclerosis ; diagnostic imaging ; Coronary Angiography ; Female ; Humans ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods ; Ultrasonography, Interventional

Objective To investigate effects of different times and procedures of postoperative radiation and chemotherapy on treatment efficacy of high-grade gliomas.Methods A prospective clinical trial was conducted in 71 patients with high-grade gliomas (HGG); they were separated randomly into two groups:one group including 39 patients received chemo-radiotherapy and adjuvant chemotherapy sequentially (RC+C) and the other group including 32 patients received neo-adjuvant chemotherapy and chemo-radiotherapy and adjuvant chemotherapy sequentially (C+RC+C).The clinical benefit rate (CBP),progression free survival (PFS) and overall survival (OS) were followed up after the treatment.Results No significant difference on CBP 5 months after treatment was noted between the two groups (P＞0.05),but the CBP in the C+RC+C group (87.5％) was significantly higher than that in the RC+C group (66.7％)8 months after treatment (P＜0.05).No significant difference on OS was noted between the two groups.The median PFS of patients in C+RC+C group was 11.5 months while that in the RC+C group was 8.6 months; the PFS of patients in C+RC+C group was significantly longer that in the RC+C group (P＜0.05).Conclusion Procedure of C+RC+C can prolong the PFS of patients with HGG.

OBJECTIVETo investigate the effect of coronary microemboliation (CME) on coronary microvascular injury and myocardial endothelin-1 (ET-1) level.

METHODSCME was induced in 10 miniswines by selective infusion of microspheres (45 microm) into left anterior descending artery (LAD). The ET-1 level in coronary sinus was measured with radioimmunoassay. The microvascular integrity indicator CFR was measured by Doppler flow wire in LAD at baseline and after infusion of microspheres.

RESULTCompared to the baseline, CFR decreased significantly with different doses of microspheres. ET-1 level increased significantly with doses of 5 x 10(4) and peaked with 10 x 10(4), and progressively decreased from doses of 12 x 10(4) to 15 x 10(4) microspheres. There was negative correlation between ET-1 and CFR (r=-0.31, P=0.02).

CONCLUSIONThe extent of microvascular injury is not linearly related to the extent of microembolization, but it is closely associated with myocardial ET-1 level.

Animals ; Coronary Vessels ; pathology ; Disease Models, Animal ; Embolism ; Endothelin-1 ; blood ; Female ; Male ; Myocardial Infarction ; blood ; pathology ; Swine ; Swine, Miniature

OBJECTIVETo evaluate the feasibility and clinical effect of transperitoneal laparoscopic enucleation of renal angiomyolipoma (RAML) without obstruction of renal pedicle.

METHODSTen patients with renal angioleiomyoma (tumor diameter < 4 cm) were operated by transperitoneal laparoscopy without obstruction of renal pedicle. The operating time, blood loss, hospital stay after operation, intraoperative and postoperative complications and the operative effect were observed.

RESULTSAll the 10 patients underwent the operation successfully. The average operating time was 90 min, average blood loss was 80 ml, the average hospital stay after operation was 7 d. No intraoperative or postoperative complications occurred. Follow-up period was 3-19 months and no tumor metastasized or occurred again.

CONCLUSIONThis mininvasive procedure is a more precise and complete method than before, which can minimize the blood loss and make patients recover quickly, so it is well worth clinical applying.

Adult ; Angiomyolipoma ; surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; surgery ; Laparoscopy ; Male ; Middle Aged ; Nephrectomy ; methods ; Treatment Outcome

BACKGROUNDInvasive intravascular ultrasound (IVUS) is current diagnostic standard for myocardial bridging (MB). Non-invasive multislice computerized tomography coronary angiography (MSCT) technique has provided a good anatomical view of the tunnel artery now.

METHODSA total of 51 consecutive patients with atypical or typical angina scheduled for IVUS were enrolled in this study and MSCT was performed 7 days before IVUS. Coronary imaging was quantified using IVUS and MSCT. Four main vessels (left main artery (LMA), left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA)) were examined.

RESULTSForty-one out of 51 (80%) patients received metaprolol (25 mg) before the MSCT scan and 25 of them were current beta-blocker users. The mean heart rate was (64 +/- 3) beats per minute. A total of 51 patients underwent IVUS examination (30 with MB and 21 without MB) were chosen for this study. Twenty-eight out of 30 MB cases were correctly diagnosed by MSCT and 2 patients with MB were not detected. Comparison with IVUS, the sensitivity of detection by MSCT was 93%, specificity was 100%. The lumen diameter of the tunnel artery derived from MSCT and IVUS significantly decreased from (2.9 +/- 0.3) mm to (2.4 +/- 0.4) mm (P < 0.001) and from (3.3 +/- 0.3) mm to (2.6 +/- 0.5) mm (P < 0.001), respectively. Minimal and maximal diameters of MB derived from MSCT were significantly smaller than those from IVUS ((2.4 +/- 0.4) mm vs (2.6 +/- 0.5) mm, P < 0.05 and (2.9 +/- 0.3) mm vs (3.3 +/- 0.3) mm, P < 0.05), respectively.

CONCLUSIONSMSCT offers a reliable non-invasive method for MB in LAD and atherosclerosis diagnosis with diagnostic accuracy comparable with invasive IVUS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Myocardial Bridging ; diagnostic imaging ; Tomography, Spiral Computed ; methods ; Ultrasonography, Interventional ; methods

OBJECTIVETo explore the incidence and angiographic features of exercise-induced ST-segment elevation in patients without prior myocardial infarction.

METHODSExercise-induced ST-segment elevation occurred in 15 out of 4601 consecutive patients without prior myocardial infarction underwent treadmill exercise testing during a 2-year period. The coronary angiographic features of the 15 patients (13 males, aged between 40 - 75 years) were analyzed.

RESULTSCoronary angiography revealed one hemodynamically relevant stenotic vessel in 6 patients, two hemodynamically relevant stenotic vessels in 6 patients, three hemodynamically relevant stenotic vessels in 3 patients. Left anterior descending (LAD) coronary artery was affected in 12 patients. Left main coronary artery (LMCA) stenosis was evidenced in 1 patient and right coronary artery stenosis in 7 patients. Severe (90% - 100%) occlusions were visualized in 8 out of 13 patients with LAD or LMCA lesions. Elevated ST-segment leads were consistent with the ischemic area where the blood supply of myocardium was affected by diseased vessels.

CONCLUSIONSThe incidence of exercise induced ST-segment elevation in patients without prior myocardial infarction is very low and mostly due to severe fixed coronary artery stenosis, especially in LAD. The location of ischemic myocardium can be suggested by ST-segment elevation leads during exercise.

Adult ; Aged ; Coronary Angiography ; Coronary Artery Disease ; diagnosis ; physiopathology ; Electrocardiography ; Exercise Test ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo assess the efficacy and safety of Saw Palmetto Extract Capsules in the treatment of benign prostatic hyperplasia (BPH).

METHODSWe conducted a multi-centered open clinical study on 165 BPH patients treated with Saw Palmetto Extract Capsules at a dose of 160 mg qd for 12 weeks. At the baseline and after 6 and 12 weeks of medication, we compared the International Prostate Symptom Scores (IPSS), prostate volume, postvoid residual urine volume, urinary flow rate, quality of life scores (QOL), and adverse events between the two groups of patients.

RESULTSCompared with the baseline, both IPSS and QOL were improved after 6 weeks of medication, and at 12 weeks, significant improvement was found in IPSS, QOL, urinary flow rate, and postvoid residual urine. Mild stomachache occurred in 1 case, which necessitated no treatment.

CONCLUSIONSaw Palmetto Extract Capsules were safe and effective for the treatment of BPH.

Capsules ; Humans ; Male ; Plant Extracts ; adverse effects ; therapeutic use ; Prostatic Hyperplasia ; drug therapy ; Quality of Life

OBJECTIVETo investigate the relationship between endothelin-1 (ET-1) and tumor necrosis factor-alpha and myocardial microcircular dysfunction during coronary microembolization (CME).

METHODSCME was induced in 10 miniswine by selective infusion of microspheres (45 microm) into left anterior descending artery (LAD). We measured (1) coronary sinus level of ET-1, TNF-alpha using radioimmunoassay; (2) CFR, a measure of microvascular integrity, using Doppler flow wire in LAD at baseline and different doses of microspheres.

RESULTSCFR decrease significantly with different doses of microspheres (vs. baseline, P < 0.05). Level of ET-1, TNF-alpha increased significantly with doses of 5 x 10(4) and peaked with 10 x 10(4). Interestingly, ET-1 progressively decrease while TNF-alpha persistently elevated from doses of 12 x 10(4) to 15 x 10(4). There are reverse correlations between ET-1 and CFR (r = -0.31, P < 0.05).

CONCLUSIONSThe extent of microvascular injury wasn't linearly related to the extent of ME, where, it closely associated with myocardial ET-1.

Animals ; Coronary Thrombosis ; physiopathology ; Disease Models, Animal ; Endothelin-1 ; blood ; Microcirculation ; physiopathology ; Swine ; Swine, Miniature ; Tumor Necrosis Factor-alpha ; blood