Objective To investigate the influence of fixation of both lower limbs with negative pressure vacuum cushion and fixation of both ankles with self-made foam mat on setup errors in radiotherapy for rectal cancer.Methods A total of 12 patients with rectal cancer were enrolled in 2014 and randomly divided into group A (using negative pressure vacuum cushion) and group B (using self-made foam mat).An offline registration analysis was performed for the images of 108 times (A,B group of 54 times) of kilovoltage cone-beam CT (CBCT) before and after treatment.Grey scale translation error registration was used,and the results of registration were analyzed.The setup errors in x-axis (left-right direction),y-axis (cranial-caudal direction),and z-axis (anterior-posterior direction) were compared between the two groups.Results There was no significant difference in the absolute setup error in the y-axis between the two groups (2.13±0.64 mm vs.2.61±1.17 mm,P=0.399),while group A showed significantly lower absolute setup errors in the x-axis and z-axis than group B (x-axis:1.51±0.28 mm vs.2.70±1.05 mm,P=0.039;with an error rate of 7.41％ vs.42.59％;z-axis:1.10±0.29 mm vs.2.37±0.71 mm,P=0.002;with an error rate of 1.85％ vs.35.19％).Conclusions In the radiotherapy positioning for rectal cancer,fixation of both lower limbs with negative pressure vacuum cushion effectively avoids the translation and rotation of both lower limbs,reduces absolute setup errors,and has higher accuracy than fixation of both ankles with self-made foam mat.

Adolescent ; Adult ; Barium ; poisoning ; Chronic Disease ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; diagnosis ; therapy ; Retrospective Studies ; Young Adult

Objective To explore the impact of metabolic syndrome (MS)in bone mineral density (BMD) in elderly male type 2 diabetics (T2DM). Methods One hundred and fourty cases were divided into MS group and non-MS(NMS)group according to with or without MS. Height,weight were measured, body mass index(BMI) were calculated and the total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c)were tested. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). The differences among these groups were compared and the risk factors for MS were analyzed. Results The MD, BMI, TC,TG in MS group was higher than that in NMS group (P < 0.05 vs. P < 0.01),and HDL-C was lower than NMS group (P < 0.05). Correlation analysis showed that BMD was negatively correlated with age , TG , HDL-C , and was positively correlated with BMI.The results of multiple stepwise regression analysis showed that age ,HDL-C,BMI were independent risk factors for BMD. Conclusion The BMD significantly increases in T2DM with MS.Obesity and low HDL-C have positive effects in bone mass.

Objective:To analyze risk factors of breast ductal carcinoma in situ (DCIS) with microinvasion (DCIS-MI) and explore suitable axillary lymph node surgery treatment for patients with DCIS-MI. Methods:The clinical characteristics, such as age, menopausal status at diagnosis, size of breast mass, and pathology reports of 45 patients with breast DCIS or DCIS-MI treated at Jinling Hospital, Medical School of Nanjing University from February 2013 to February 2016, were retrospectively collected and analyzed statistically to deter-mine the risk factors associated with microinvasion. Results:Premenopause (P=0.006), tumor size≥3.15 cm (P=0.006), and family his-tory of malignant tumor (P=0.002) were proven risk factors of DCIS-MI. Conclusion:Patients with clinical palpable axillary mass, pre-menopause, large breast mass, and family history of malignant tumor demonstrated high possibility of DCIS-MI. Hence, sentinel lymph node biopsy should be performed. Axillary lymph node dissection is highly recommended to patients whose main symptom is palpable axillary mass.

OBJECTIVETo investigate and clarify the key surgical techniques and evaluate clinical effectiveness of modular cementless femoral stems(LINK MP modular stem) in complex revision hip arthroplasty.

METHODSFrom January 2002 to December 2013, 470 patients in Chinese PLA General Hospital received revision hip arthroplasties using MP stems. Among them, 246 patients were followed for an average of 5.7 years (ranged, 0.5 to 11 years). There were 148 males and 98 females, with an average age of 62.5 years old (ranged from 26 to 83 years old). The most common reason for revision was aseptic loosening of femoral stems (107 cases, 43.5%), followed by prosthetic joint infection (104 cases, 42.3%). Other reasons included unexplained hip or thigh pain, periprosthetic femoral fracture, prosthesis wear and dislocation. According to Paprosky classification of femoral deficiency, there were 171 cases of type IIIA (69.5%), 14 cases of type I, 39 cases of type II, and 22 cases of type IIIB. The average preoperative Harris hip score (HHS) was 37.4 ± 7.5. In addition, radiographic presentation, degree of patients' subjective satisfaction, and clinical effectiveness were assessed as well.

RESULTSThe average Harris score was im- proved to 87.8 ± 4.2 after operation,with significant statistical difference when compared to preoperative score (t = 92.13,P = 0.00). Analysis of patients' subjective satisfaction for leg length discrepancy, stability and overall degree of satisfaction showed that the number of patients with great satisfaction were 27, 60, 61 respectively. The most common complication was the periprosthetic fracture (intraoperatively 21 cases and postoperatively 8 cases). Other complications included infection (7 cases), dislocation (5 cases), numbness possibly caused by incomplete sciatic nerve injury (6 cases) and thigh swelling (3 cases). The X-ray taken at the final follow-up revealed that prosthesis subsidence occurred in 4 cases, 2 of which needed a second revision.

CONCLUSIONThe application of modular cementless femoral stems (LINK MP modular stem) in complex revision hip arthroplasty (especially in cases with the serious defect of proximal femoral bone) shows good results at both the short-term and long-term follow-up, especially in the revision for prosthetic infection with the high success rate. In order to avoid complications and improve clinical outcomes,the surgeons should carefully select proper surgery candidates,perform the procedure with care, and master the key surgical techniques.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications ; therapy

Alveolar Epithelial Cells ; pathology ; Diagnosis, Differential ; Humans ; Hyperplasia ; diagnostic imaging ; etiology ; metabolism ; pathology ; Lung Diseases ; diagnostic imaging ; etiology ; metabolism ; pathology ; Mucin-1 ; metabolism ; Nuclear Proteins ; metabolism ; Radiography ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism ; Tuberous Sclerosis ; complications ; diagnostic imaging ; metabolism ; pathology

Objective To detect the variation of vascular endothelial growth factor (VEGF) in the splanchnic vessels under portal hypertension (PHT) and explore its mechanism and influence on the process of hyperdynamic circulation.Methods In humans,the level of VEGF pathway related proteins were detected in the splenic artery of PHT patients in clinical trials.In animal experiments,the following parameters were observed for rats in the control group (group N,n =7) and the CCl4 induced portal hypertension group (group PHT,n=7):portal vein diameter,portal vein blood flow velocity (PBV),portal vein blood flow (PBF),portal vein pressure (PP),norepinephrine (NE) reactivity in the isolated mesenteric artery microcirculation,contractile reactivity and degree of endothelial ni tric oxide synthase (eNOS) activation in the mesenteric artery by selectively inhibiting the VEGF signal pathway with SU5416.In cell experiments,primary culturing of arterial endothelial cells in vitro were used to verify the effects of VEGF on eNOS activation.Results The results showed that VEGF expression levels in the splenic artery of PHT patients significantly increased.In animal experiments,there was not a significant difference in portal vein diameter between group N and group PHT.How ever,the PBV and PBF of group PHT were lower than those of group N,and SU5416 had no clear effect on PBV and PBF in group PHT.PP of group PHT was much higher than that of group N,and SU5416 had little influence on reducing PP in group PHT.The contractile response of mesenteric artery microcirculation to NE in group PHT decreased significantly,EC50 increased a lot,and SU5416 improved this hypoergia partially.The protein levels of VEGF,VEGFR-2,eNOS,and p-eNOS in the mesentery artery of group PHT raised quite a lot compared to group N,and SU5416 decreased the protein level of VEGFR-2 and activation of eNOS significantly.Experiments in vitro confirmed that VEGF could promote the activation of eNOS.Conclusion The excessive VEGF produced in visceral arteries under PHT may participate in the process of hyperdynamic circulation partially through promoting the synthesis and activation of eNOS and then reducing visceral arteries' response to NE.

Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Intrahepatic ; pathology ; Cholangiocarcinoma ; diagnosis ; Humans ; In Situ Hybridization, Fluorescence

A canine distemper virus strain was isolated from the lung of dog coming from Aksu in Xing Jiang using lung primary M cell during the CDV molecular epidemiological study. It was demonstrated to be a virulent strain of CDV by a series of systematic identification such as morphology , serology neutralization test, canine infection test, and molecular virology test.

AIMTo study the preparation conditions and its oral pharmacokinetic characteristics of cyclosporine A (CyA) pH sensitive nanoparticles.

METHODSThe CyA pH sensitive nanoparticles were prepared by the quasi-emulsion solvent diffusion technique (QESD). Male Sprague-Dawley (SD) rats weighing (250 +/- 20) g were selected and randomly divided into five groups. The bioavailability of CyA from nanoparticles and Neoral microemulsion were assessed at a dose of 15 mg x kg(-1) by gavage. The concentration of CyA in whole blood samples was detected by HPLC to evaluate the relative bioavailability of CyA pH sensitive nanoparticles.

RESULTSThe blood concentration profiles of CyA pH sensitive nanoparticles in rats fitted to two compartment models using 3P87 pharmacokinetic calculation program. Compared with the Neoral microemulsion, the relative bioavailability of CyA was 94.8%, 115.2%, 113.6% and 132.5% for CyA-E100, CyA-L100, CyA-L100-55 and CyA-S100 nanoparticles respectively.

CONCLUSIONCyA-S100 nanoparticles was shown to significantly improve the oral bioavailability of CyA compared with Neoral microemulsion (P < 0.05). While there were no significant differences between Neoral microemulsion and other CyA pH sensitive nanoparticles. With these results, the potential of pH-sensitive nanoparticles for the oral delivery of CyA was confirmed. Furthermore, this formulation approach can be used to improve the oral bioavailability of other poorly soluble and poorly absorbable drugs.

Administration, Oral ; Animals ; Area Under Curve ; Biological Availability ; Cyclosporine ; administration & dosage ; pharmacokinetics ; Hydrogen-Ion Concentration ; Male ; Nanostructures ; Random Allocation ; Rats ; Rats, Sprague-Dawley