Radiation fibrosis of human normal tissues is very common in radiotherapy. One of the main fundamental problems yet unsolved in fibrotic tissues is the origin of the chronic activation of myofibroblasts within these tissues. It has been postulated by some researchers that this chronic activation results from a continuous production of activating factors. So fibrosis could be defined as a wound where continuous signals for repair are emitted. Cytokines and growth factors probably play a vital role in this process. Among them transforming growth factor ?1(TGF ?1) is considered as a master switch for the fibrotic program. This review discusses recent evidence on the critical role played by TGF ?1 in the initiation, development, and persistence of radiation fibrosis. It summarized the results concerning this factor after irradiation of various tissues and cells. All these researches show that the TGF ?1 pathway may be a specific target for anti fibrotic agents. [

Objective To analyze the difference of the peripherally inserted central venous catheter (PICC) and central venous catheter (CVC) in cancer chemotherapy.Methods All eligible studies on PICC and CVC were searched in China National Knowledge Infrastructure,Wanfang database and VIP database.The Jadad scale was used for quality assessment of all the included studies.All analysis were conducted in Stata 12.0.Results Thirty-six studies with a total of 4920 cases of patients were included in this meta-analysis,with 2349 cases in PICC group and 2571 cases in CVC group.PICC group had advantages in puncture success rate for the first time,the average puncture time,the average catheter time than the CVC group.PICC group had fewer complication,such as the hemopneumothorax incidence,the strayed artery incidence and catheter infection incidence; however,the phlebitis incidence was higher than the CVC group.Conclusions PICC has some advantages specific in simple operation,a long retention time,fewer complications and safety.Therefore,PICC can be widely used in cancer chemotherapy.

Radiotherapy is one of the most important treatment method for head and neck cancer.The intensity-modulated radiotherapy (IMRT) has better conformal property and uniformity.IMRT is gradually replacing conventional radiation therapy and has become the mainstream radical treatment for head and neck cancer.During IMRT,the patient treatment positioning,inter-treatment,and intra-treatment variation of organ position,size,and shape impact the accuracy of radiation dose delivery.This method may cause target less and (or) additional complications.Adaptive radiotherapy (ART) is a new radiotherapy technology.Based on the patient's pre-treatment images and relative information such as dose deviation,ART can able to compensate the target coverage and clinical outcome.Under the help of ART technique,radiotherapy can be more accurate and more personalized.This paper reviews the research status of ART technology in head and neck cancerby retrospective studying the related literature at home and abroad.

BACKGROUND: Along with the emergence of porcelain-fused-to-metal (PFM) technique, Ni-Cr alloy has been shown to be the most available non-novel metal alloy used for preparation of PFM materials. The metal margin of Ni-Cr based PFM crown possibly produces some effects on periodontal tissue for it is primarily contacted with gingiva. OBJECTIVE: To investigate the influences of Ni-Cr alloy PFM crown on periodontal tissue. DESIGN, TIME AND SETTING: A retrospective case analysis was performed. All cases were from Department of Stomatology, the 476 Hospital of Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA between January 2006 and January 2007.PARTICIPANTS: Totally 23 maxillary incisors were included from 19 patients who averaged (32.5±10.8)years old and received tooth restoration using Ni-Cr based PFM crowns. Healthy contralateral corresponding teeth were used as controls. METHODS: All clinical operations were conducted by one dentist. Dental restoration principles should be strictly followed during preparation of dental prosthesis. A routine tooth preparation was performed. Specifically, gingival retraction cords were used for gingival recession, with a shoulder prepared 0.5 mm below the labial gingiva and concave shoulder thickness 0.5 mm. A temporary crown was made using silicon rubber. The normal physiological anatomical profile of complete crown should be recovered as possible while preparation. Dental axial crown overcontour should be increased within 0.2 mm. Finally, a permanent sticking was followed.MAIN OUTCOME MEASURES: At 6-9 months after wearing Ni-Cr alloy PFM crown, the gingival crevicular fluid was collected from affected and control teeth for quantitation and laboratory examinations (C reactive protein and tumor necrosis factor- a included),PARTICIPANTS: Alter placement of Ni-Cr alloy PFM crown which was clinically accepted, plaque index of affected tooth did not alter significantly, but gingival crevicular fluid volume, probing depth, sulcus bleeding index, and levels of C reactive protein and tumor necrosis factor-α were significantly greater in affected teeth than in control teeth (P < 0.05).CONCLUSION: Ni-Cr alloy PFM crown produces some harmful effects on periodontal tissue.

Objective: To investigate the effect of medication on left ventricular myocardial matrix remodeling in neuroendocrine hypertensive rats and the mechanism and inhibitive method thereof. Methods: A neuroendocrine hypertensive model was established with adult Wistar rat. A total of 34 rats were randomly divided into four groups: parzosin (Hα), cilazapril (Hace), pentoxifylline(Hptx) and hypertensive control group(Hc). Ten normal-tensive Wistar rats were used as normal control (Nc). The systemic blood pressure, serum procollagen type Ⅲ level, serum TNF-α level, collagen volume fraction(CVF) were detected. Results: In Hace group, systolic pressure, left ventricular weight, the levels of serum procollagen type III and TNF-α were all reduced obviously compared to those in Hc group(P < 0.05). In Hα group, the systolic pressure and left ventricular weight were reduced obviously compared to those in Hc group(P < 0.05), however, the levels of serum procollagen type III and TNF-α were higher than those of Nc group(P < 0.05). In group Hptx, the systolic pressure and left ventricular weight were not decreased, while the levels of serum procollagen typeⅢ,TNF-α and CVF were reduced to normal levels. Conclusion:The angiotensin coverting enzyme inhibitor is the effective agent to reverse myocardial fibrosis, which can be achieved mostly by the inhibition of AngⅡ. Pentoxifylline may inhibit and reverse myocardial fibrosis which correlated with inhibiting TNF-α.

Objective:To observe the resistance of hypericum japonicum Thunb.to helicobacter pylori.Methods:Liquid dilution method was used to culture mixture of hypericum japonicum Thunb.extractum and helicobacter pylori,hypericum japonicum Thunb.extraction and helicobacter pylori respectively.The minimum inhibitory concentration and minimal bactericidal concentration of hypericum japonicum Thunb.extractum and extraction were determined by comparing the growth condition of helicobacter pylori.Results:Both of hypericum japonicum Thunb.extractum and extraction had obvious resistant effect on helicobacter pylori.Conclusion:25 mg/ml hypericum japonicum Thunb.extractum and 6.25 mg crude drug/ml hypericum japonicum Thunb.extraction can suppress the growth of helicobacter pylori effectively.

BACKGROUND: It has been verified in relevant clinical and epidemiological researches in recent years that a part of stomatopathy is associated to psychological stress factors.OBJECTIVE: To analyze the relationship between the changes in salivary secretory IgA and cortisol and psychological stress states.DESIGN: cross-sectional investigation was designed.SETTING: Department of Stomatology, Zhejiang University.PARTICIPANTS: The investigated participants were 60 students in the 2nd grade of Fuzhou №.2 Senior School selected from May to November 2003. Fifty-seven of them accomplished the investigation, of male; aged varied from 17 to 19 years, of healthy, no stomatopathy and family history of disorders in immune system and without indulgence in smoke and alcohol. All of them had participated in the 3-day terminal exam.METHODS: Before the exam, evaluation with symptom checklist (there are 90 questions, including about 10 factors, such as somatization, compulsive state, sensitive interpersonal relationships, melancholy, anxiety, hostility, fear, paranoid state, psychotic state and others. The total average score results by divided total score with 90. ) was applied. Fifty-seven students that had accomplished the investigation were divided in low-symptom group (the total score of symptom checklist ＜ 2.0) and high-symptom group (the total score ≥ 2.0). 5 weeks before the exam, the students were called together to fill up investigation form of general situation. Four weeks before the exam and at 7: 30 am on the day of exam, the first and second saliva specimens were collected respectively to determine salivary secretory IgA and cortisol before and after exam stress. The students were called together again 3 days after exam to fill up questionnaire on psychological health to evaluate their psychological health state.stress.RESULTS: Intention management analysis was adopted, in which 57 stulist with Chinese norm: after exam, the scores of 4 factors, named compulsive state, anxiety, hostility and paranoid state, were higher than Chinese norm [(1.98±0.72, 1.69±0.61) scores; (1.79±0.31, 1.42±0.43) scores; (1.77±0.68,1.50±0.57)scores; (2.00±0.71, 1.52±0.60)scores, P ＜ 0.01] and there was parison of salivary secretory IgA content after stress: that before exam in low symptom group was remarkably higher than that in high symptom group [(236.6±82.29),(194.55±66.29) mg/L, P ＜ 0.05], that after exam in low symptom group was higher than that in high symptom group [(182.21±55.92,tration after stress: that after exam in low symptom group was remarkably higher than that in high symptom group [(5.96±2.46, 3.68±2.26) μg/L, P secretory IgA and cortisol in two groups: the decrease rate of secretory IgA (0.012±0.197) and increase rate of cortisol (0.199±0.654) were relevant to compulsive state and paranoid state.CONCLUSION: In evaluation with symptom checklist after exam, the scores of anxiety, compulsive state, hostility and paranoid state were higher than Chinese norm, indicating that exam stress induces increased anxiety level and variation of psychological behavior of students. The difference presented in decrease rate of salivary secretory IgA before and after exam stress between high and low symptom groups, explaining that the students with more psychological symptoms are weak to endure exam stress.

Objective To observe the curative effect of chymotrypsin and danshen mixture treatment to moist skin damage caused by radiotherapy.Methods 90 NPC patients who underwent radiotherapy plus concurrent chemotherapy were randomized into the observation group(46 cases)and the control group(44 cases).Patients in the observation group received external application of chymotrypsin and danshen mixture;while patients in the control group received laser irradiation treatment.The healing progress of skin injury of two groups was observed and compared.Results Time of detumescence,pain relieving,itching and healing of the observation group was shorter than the control group.Nursing effect for level 2 & 3 radiation-induced skin injury in the observation group was better than the control group.Conclusions Chymotrypsin and danshen mixture has a great nursing efficacy on radiation-induced skin injury.It should be used in the early stage.

Objective To establish an high performance liquid chromatography method for determination of 2-indole ketone derivative and its related substances. Methods Agilent Eclipse XDB-C18(250 mm×4.6 mm,5 μm) column was adopted.The mobile phase was acetonitrile-water with gradient elution mode at a flow rate of 1. 0 mL?min-1; the column temperature was 35 ℃;the injection volume was 20 μL and the detection wavelength was set at 257 nm. Results 2-indole ketone derivative ID and related substances could be well separated. The 2-indole ketone derivative had good linear correlation ( r=0.999 4) within the range of 40-300 μg?mL-1 . It had a good precision ( RSD<1%) . The limit of detection was 8 ng. Conclusion The method is accurate,simple,sensitive and selective,which can be used for the quality control of 2-indole ketone derivative and related substances.

Objective To evaluate prognostic value of pentraxin3 (PTX3) content combining with extravascular lung water index (EVLWI) in patients with sepsis.Methods A retrospective analysis of complete clinical data of septic patients admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Zhengzhou University from February 2013 to February 2014 was conducted.These patients were divided into two groups,survival group and death group,according to the outcome on the 28th day.Pulse index continuous cardiac output (PiCCO) was used to record the levels of EVLWI on the 1st,2nd and 3rd day of intensive care unit (ICU) admission.The plasma level of PTX3 was measured simultaneously by enzyme-linked immunosorbent assay (ELISA).At the same time,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and sequential organ failure assessment (SOFA) were calculated.Correlation analysis between plasma PTX3 and EVLWI values was performed,receiver operating characteristic curve (ROC) was drawn,and the prognostic value of each parameter was assessed finally.Results A total of 74 septic patients were enrolled,with 41 cases in the survival group and 33 cases in the non-survival group.Blood lactate,APACHE Ⅱ,SOFA scores in the non-survival group were significantly higher than those of the survival group at ICU admission,and the length of ICU stay was significantly shorter than that of the survival group,while differences of the other clinical characteristics between two groups were not statistically significant.The plasma PTX3 level gradually declined with time in both groups,and plasma PTX3 at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [PTX3 (μg/L) at 1 day:46.3± 10.5 vs.19.4±6.5,t =-13.486,P =0.000; 2 days:34.8± 10.7 vs.17.7±8.4,t =-8.284,P =0.000; 3 days:23.9± 11.2 vs.15.6 ± 7.9,t =-5.036,P =0.000].EVLWI gradually declined in survival group,but increased in death group.EVLWI at 1,2,3 days after ICU admission in non-survival group were significantly higher than those in survival group [EVLWI (mL/kg) at 1 day:12.12 ± 4.31 vs.10.02 ± 2.87,t =-2.502,P =0.023; 2 days:13.67 ± 4.95 vs.9.08 ± 2.89,t =-5.188,P =0.000; 3 days:14.51±5.06 vs.8.09±2.50,t =-7.126,P =0.000].PTX3 at 1,2,3 days after ICU admission showed a significant positive correlation with EVLWI (r1 =0.747,r2 =0.719,r3 =0.705,all P =0.000).ROC curve analysis showed that the area under the ROC (AUC) of PTX3 at 1 day was 0.845 ± 0.045,at the cut-off point of 23.0 μg/L,PTX3 showed a sensitivity of 84.8％,a specificity of 74.1％,a negative predictive value of 85.81％,and a positive predictive value of 72.42％.AUC of EVLWI at 3 days was 0.838 ± 0.048,at the cut-off point of 10.5 mL/kg,EVLWI showed a sensitivity of 83.9％,a specificity of 82.9％,a negative predictive value of 86.45％,and a positive predictive value of 79.79％.Their sensitivities and specificities were found to be better than APACHE Ⅱ,SOFA score.AUC of PTX3 combined with EVLWI at 1 day was 0.886 ± 0.038.On the 1st day after ICU admission,with combination of the two indicators,cut-off point was found to be 0.312,a sensitivity of 86.8％,a specificity of 85.4％,a negative predictive value of 88.93％,and a positive predictive value of 82.72％.On the 3rd day after ICU admission,AUC of PTX3 combined with EVLWI was 0.856 ± 0.046,and showed a cut-off of 0.471 for the prognosis of sepsis,a sensitivity of 85.8％,a specificity of 85.4％,a negative predictive value of 87.97％,and a positive predictive value of 82.50％.Compared with other single index,a combination of above mentioned two indexes showed a better sensitivity and specificity.Conclusions PTX3 can serve as a novel prognostic indicator at early stage in septic patients.Combined with EVLWI,it shows important value in predicting prognosis of septic patients,and it also provides guidance in treatment of high-risk patients.