Unlike conventional radiation therapy, stereotactic radiation therapy (SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs (spinal cord, optic nerve, bowels, etc.). Nowadays, the clinical efficacy of SRT has been widely confirmed in certain patients, especially for those medically inoperable, unwilling to undergo surgery, medicine ineffective with tumor progression. Moreover, SRT could be properly used as palliative treatment aiming at relieving local symptoms and pain, and eventually achieving a potential survival benefit of several months. However, the weaknesses of SRT relate to inevitable radiation-induced toxicities as well as the inaccessibility of prophylactic irradiation. In general, one flaw cannot obscure the splendor of the jade. The emergence and development of SRT has opened the new era of precision radiation therapy, and SRT will probably step gloriously onto the remarkable stage for precision medicine.
Humans ; Neoplasms ; radiotherapy ; Precision Medicine ; Radiosurgery

significant for the precaution of gastric cancer risk population. Aims:To explore gastric cancer susceptibility gene profiling in an area in Shanghai,and to assess the risk of gastric cancer susceptibility. Methods:A total of 152 patients with primary gastric cancer at Shanghai Pudong Hospital were enrolled,and 152 demographic characteristics matched patients with non-gastrointestinal diseases,non-tumor were served as controls. Gene polymorphism was determined by allele specific polymerase chain reaction. Susceptibility gene of gastric cancer was screened. Multiple genes interactions were analyzed and multiple genes risk was evaluated by DEMCHUK model. Results:Univariate analysis showed that CYP2E1,NAT2M1,NAT2M2,NAT2,XRCC1194,MTHFRA1298C,VDR TaqⅠ were susceptibility genes of gastric cancer. Multivariate analysis showed that CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2(A/ A),XRCC1194( T/ T)and MTHFRA1298C(A/ C)were susceptibility genotypes. Synergistic effect was found between genes except MTHFRA1298C (A/ C)with NAT2M1(T/ T)and NAT2M2(A/ A)(P ﹤0. 05). Multiple genes risk analysis showed that combination OR of multiple genes was highly correlated with gene frequency,and the risk of gastric cancer was increased with the increasing number of susceptibility genes. Conclusions:CYP2E1(C1/ C1),NAT2M1(T/ T),NAT2M2( A/ A),XRCC1194( T/ T) and MTHFRA1298C( A/ C) are susceptibility genotypes of gastric cancer. Carrying multiple susceptibility genes can significantly increase the risk of gastric cancer.

Objective To explore the differences and development of executive function(EF) between cerebral palsy(CP) children and normal children. Methods Forty-eight 4 ～6 years old CP children and fiftyeight normal children were tested by "cool" and "hot" EFs. Results There were significant differences between "cool" EF of CP children(18.34±14.31) and normal children(6.94 ±3. 18) ( t = 3. 83, P<0.01 ) ;and there were significant differences between "hot" EF of CP children(279.67 ±330. 18) and normal children(709.31 ± 304. 13)( t = -4.93, P< 0.01). There were significant age differences on the "cool" EF ( F=8.689, P< 0.01) and "hot" EF ( F=3. 833, P<0.05) of CP children. There were significant age differences on the "cool" EF ( F= 15.469, P<0.01) and on the "hot" EF ( F=8.470, P<0.01) of normal children. There was negative correlation between "cool" EFs and "hot" EFs( r= -0.440, P<0.01). Conclusion "Cool" and "hot" EFs of CP children are lower than those of normal children. "Cool" and "hot" EFs can develop from 4 to 6 years old,but the development of EFs are not absolutely consistent between CP children and normal children. There is correlation between "cool" and "hot" EFs in patients with CP,but not dissociation.

Objective To evaluate the efficacy and safety of wuling capsule compared with deanxit in treatment of patients with depression or anxiety status. Methods A total of 139 patients with depression or anxiety status were enrolled in a multi-center double blind clinical trial. All patients were randomized into two groups, 67 patients in wuling capsule group and 73 patients in deanxit group. Efficacy and adverse effects were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD),Pittsburgh Sleep Quality Index (PSQI) and Treatment Emergent Symptoms Scale (TESS) before treatment and 1, 2, 4, 6 weeks after treatment to verify the noninferiority of wuling capsule. Results There was no significant difference in score decline of HAMA and HAMD between the two groups (HAMA: wuling vs deanxit group: 9.0 ± 5.4 vs 10.3 ± 5.4, F = 2.11, P =0.148 ; HAMD: wuling vs deanxit: 9.1±5.6 vs 10.5±5.7, F = 1.61, P=0.207). There was no significant difference in response rate and remission rate between the two groups. No significant difference was found in score decline of PSQI between the two groups (wuling vs deanxit group: 4.1±4.5 vs 5.0 ± 4.2, F = 0.72, P=0.192). The incidence of adverse events was 41% in the wuling group and 55% in the deanxit group respectively. The main adverse effects were symptoms of gastrointestinal and neurology system. Conclusion Safe and well tolerated, wuling capsule improves the anxiety, depression and insomnia symptoms of patients with depression or anxiety status.

BACKGROUND:Transplantation of autologous stem cells for treatment of liver cirrhosis has been widely reported.But up to now,there exist some concerns for clinical physicians,including relationship between stem cells and post-transplantation prognosis/turnover of liver cirrhosis,directed differentiation of stem cells in the impaired liver,and malignant phenotype.OBJECTIVE:To dynamically monitor the serum levels of alpha-fetoprotein(AFP)and AFP variants(AFP-L3)in decompensated cirrhosis patients following intrahepatic transplantation of peripheral blood stem calls via portal vein and evaluate the safety of this treatment method.METHODS:A total of 44 decompensated cirrhosis patients who underwent intrahepatic transplantation of peripheral blood stem cells via portal vein in the 309 Hospital of Chinese PLA in April 2007 were included in this study.Prior to and after surgery,serum levels of AFP and AFP-L3 were detected by chemiluminescence.Through the use of a positive criterion for liver cirrhosis,i.e.,the proportion of AFP-L3 in AFP[AFP-L3(%)]≥10%,and the relationship between decompensated cirrhosis treatment using stem cells transplantation and the malignant phenotype of liver cancer were analyzed.RESULTS AND CONCLUSION:At 2 months after surgery,serum level of AFP showed a transient increase.There was no significant difference in AFP-L3(%)between prior to and after surgery(P>0.05).No significant difference in AFP-L3-positve rate,as well as AFP-L3(%),existed among patients with different serum level of AFP.These findings indicate that clinical symptoms and liver function of decompensated cirrhosis patients recovered to some extent after transplantation of peripheral blood stem cells via portal vein.Results regarding serum level of AFP-L3,a serological marker of liver cancer,did not demonstrate the appearance of malignant biological phenotype.

OBJECTIVETo investigate the pathogenic infection and its drug resistance in expressed prostatic secretion (EPS) and its correlation with serum PSA, and provide some evidence for the systematic and normalized diagnosis and treatment of prostatitis.

METHODSThree EPS swabs were collected from each of the 320 prostatis patients following measurement of the serum PSA level, 1 for bacterial culture and identification, 1 for detection of Mycoplasma and drug sensitivity, and the other for examination of Chlamydia trachomatis antigen by colloidal gold immunoblot.

RESULTSTotally 244 strains were isolated from the 320 EPS samples, including 188 bacterial strains (dominated by Staphylococcus and sensitive to vancomycin or linezolid) and 44 Mycoplasma and Chlamydia strains (mainly Ureaplasma urealyticum and susceptible to josamycin or doxycycline). The serum PSA level was significantly higher in the pathogen-positive than in the pathogen-negative group ([6.98 +/- 0.56] microg/L vs [2.32 +/- 0.12] microg/L, P < 0.05).

CONCLUSIONProstatitis may lead to the elevation of the serum PSA level and the pathogens involved vary in their resistance to different antibacterial spectrums. Therefore, appropriate and individualized antibiotic therapy should be selected according to etiological diagnosis and the results of drug sensitivity test.

Adult ; Humans ; Male ; Middle Aged ; Prostate ; microbiology ; secretion ; Prostate-Specific Antigen ; blood ; Prostatitis ; blood ; microbiology ; Young Adult

Background How to control progression of myopia is a central issue in clinical optometry.Some clinical trials showed that wearing base-in (BI) prism can slow down progression of myopia to certain degree.However,whether BI prism or base-out (BO) prism should be used is worth discussing.Objective This study was to investigate the influences of different prisms on accommodative response and microfluctuation in emmetropias.Methods This clinical trail was approved by Ethic Committee of Peking University People's Hospital.During July in 2014,twenty-two emmetropias of 22 normal volunteers aged 21-27 years were recruited from Peking University People's Hospital under the written informed consent.An open-field infrared refractometer was used to monitor and record pupil diameter and accommodative response under three conditions including non-prism,3△ BI prism,and 3△ BO prism.The accommodative response value was calculated as the difference between reading value and-3.0 D,and root mean square (RMS) of accommodative response value served as amplitude of accommodative microfluctuation.Spectrum of accommodative response was analyzed by one dimension discrete Fourier transformation.The differences of accommodative response value,amplitude of accommodative microfluctuation and pupil diameter among three conditions were compared using repeated one-way ANOVA.Results The accommodative response values were (+0.31±0.78),(+0.51±0.75) and (+0.18±0.72) D under the non-prism,3△BI prism and 3△BO prismconditions,respectively,with a significant difference among them (F =28.078,P =0.000),and compared with the non-prism condition,the accommodative lag of 3△BI prism condition was increased and that of 3△BO prism condition was reduced (P =0.000,0.012).No significant difference was found in the amplitude of accommodative microfluctuation among the three conditions (F=0.062,P =0.879).The percentages of low frequency signal power (0-0.5 Hz)/total power (0-2.5 Hz) was 97.5％,98.3％ and 91.4％ under the non-prism,3△BI prism and 3△BO prism condition,respectively.The pupil diameter was (5.37-±0.69) mm under the 3 △ BI prism condition,which was larger than (5.07±0.66) mm under the non-prism condition and (5.01 ±0.69) mm under the 3△ BO prism condition (both at P =0.000).Conclusions Compared with wearing 3△ BI prism,wearing 3△ BO prism lessens the accommodative lag,decreases the pupil diameter and reduces the power of low frequency component in accommodative response.

Objective:To explore the efficiency of a new scoring system of gastric cancer screening for early gastric cancer in health examination population.Methods:The risk score of gastric cancer was assessed based on the new scoring system in health examination population. A notice for further gastroscopy was sent to the medium-risk and high-risk people. Gastroscopy was performed on those who agreed to undergo the examination.Results:From January to April 2019, a total of 5 357 people in health system visited the Physical Examination Center of Shanghai Songjiang Clinical Medical College of Nanjing Medical University for health examination. Seven hundred and forty people were classified as medium- and high-risk groups by the new screening system, 576 in medium-risk group, and 164 in high-risk group. Among them, 131 cases (17.70%) came for further gastroscopy, of whom 91 (69.47%) were in the medium-risk group and 40 (30.53%) in the high-risk group. After gastroscopy, 4 cases of gastric cancer and 1 case of esophageal cancer were detected, and both were early cancer. In the medium-risk group, 2 cases (2/91, 2.20%) of early gastric cancer and 1 case (1/91, 1.10%) of early esophageal cancer were found. In the high-risk group, 2 cases (2/40, 5.00%)of early gastric cancer were found. The tumor detection rate of high-risk group (5.00%) was higher than that of medium-risk group (3.30%), but there was no significant difference ( P>0.05). Conclusion:Risk stratification with the new scoring system of gastric cancer screening can improve the detection rate of early gastric cancer.

Objective To explore the expressions of Survivin and VEGF and relationship between them in hepatocellular carcinoma(HCC).Methods The expressions of Survivin protein and VEGF protein in 50 HCC.30 cirrhosis and 10 normal tissues were assessed by immunohistochemical method.The expressions of Survivin mRNA and VEGF mRNA in 50 HCC,30 cirrhosis and 10 normal tissues were assessed by in situ hybridization.Results The expressions of Survivin and VEGF in cancer tissues,cirrhosis tissues,normal tissues weresignificantly different. The expression of Survivin in HCC tissues was stronger than that in cirrhosis,but the expreesion of VEGF in cirrho- sis was stronger than that in HCC tissues.Conclusion The expression of survivin.is closely associated with the ex- pression of VEGF in HCC and they take positive correlation.The abnormal expressions of Survivin and VEGF are closely associated with the development of HCC.They may play important roles in the development of HCC.