Objective To study the effect of labeling esophageal carcinoma with sliver clips on two sides by esophagoscopy in mapping the target for conformal radiotherapy (CRT). Methods Eighty patients with esophageal carcinoma (28 patients in early stage, 52 patients in late stage), who were eligible for CRT, were collected and the tumor volume was detected by three methods: CT (A),CT combined with X-ray (B) and CT combined with sliver clip labeling by esophagoscopy (C). The differences of the tumor length and position in head-foot site (Y-axsis) among three methods were compared. Results The comparison of average length of tumor in early stage patients showed significant difference among three methods in all types of tumor (F= 4.07 ～ 7.43, P＜0.05 ) except papillary type (F= 1. 71, P＞0. 05). There was difference (ranged from 0. 5 cm to 2. 0 cm) in detection of position in head-foot site between A and B methods and C method. Significant difference was found in determining the displacement on head-foot site among three methods (F = 34. 36 ～193.50,P ＜0.01). The comparison of average length of tumor in middle or terminal stage patients showed significant difference among three methods in all types of tumor (F=4. 07～30.10 ,P＜0.05) except mushroom type (F = 2.44, P＞ 0. 05). Significant difference was found in determining the displacement on head-foot site among three methods (F= 12.00 ～ 21.16, P ＜ 0. 01 ). Conclusion These findings indicate that C method is more sensitive and correct in mapping the target for CRT in comparison with other two methods.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Fingers ; Humans ; Male ; Middle Aged ; Neuralgia ; therapy ; Young Adult

Purpose To investigate the diagnostic value of dual energy CT spectrum curve combined with CT morphology in central lymph node metastasis of papillary thyroid carcinoma (PTC).Materials and Methods Thirty-one PTC patients who accepted dual energy CT double-phase enhanced scan before surgery were analyzed.Central lymph nodes with short diameter ＞ 5 mm were labelled using axial plus 3D positioning.Preoperative labelled lymph nodes were collected and marked during operation.The CT morphology of metastatic lymph nodes was analyzed.The spectrum curve slope (K) difference between metastatic and non-metastatic lymph nodes of arterial-phase and venous-phase primary lesion was compared.The critical K value and the diagnostic efficacy of K value combined with morphology were obtained according to receiver operating characteristic (ROC) curve.Results A total of 73 central lymph nodes were obtained from 31 patients,among which 51 were metastatic and 22 were non-metastatic.There was no significant difference in K value between metastatic and non-metastatic lymph nodes of arterial phase group (P＞0.05).While,there was a significant difference in K value between metastatic and non-metastatic lymph nodes of venous phase group (P＜0.05).For venous phase,the sensitivity and specificity of the K value in diagnosing central lymph node metastasis were 62.7％ and 59.1％,respectively,and combined with morphology,the sensitivity and specificity reached 76.5％ and 81.8％,respectively.Conclusion The K value of CT spectrum curve is of certain significance in predicting PTC central lymph node metastasis,and the K value combined with CT morphology can improve the accuracy of diagnosis.

The purpose of this study is to explore the feasibility of wheat germ agglutinin (WGA) modified liposome as a vehicle for ophthalmic administration. Liposome loaded with 5-carboxyfluorescein (FAM) was prepared by lipid film hydration method. WGA was thiolated and then conjugated to the surface of the liposome via polyethylene glycol linker to constitute the WGA-modified and FAM-loaded liposome (WGA-LS/FAM). The amount of thiol groups on each WGA molecule was determined, and the bioactivity of WGA was estimated after it was modified to the surface of liposome. The physical and chemical features of the WGA-modified liposome were characterized and the ocular bioadhesive performance was evaluated in rats. The result showed that each thiolated WGA molecule was conjugated with 1.32 thiol groups. WGA-LS/FAM had a mean size of (97.40 +/- 1.39) nm, with a polydispersity index of 0.23 +/- 0.01. The entrapment efficacy of FAM was about (2.95 +/- 0.21)%, and only 4% of FAM leaked out of the liposome in 24 h. Erythrocyte agglutination test indicated that after modification WGA preserved the binding activity to glycoprotein. The in vivo ocular elimination of WGA-LS/FAM fitted first-order kinetics, and the elimination rate was significantly slower than that of the unmodified liposome, demonstrating WGA-modified liposome is bioadhesive and suitable for ophthalmic administration.
Absorption, Physicochemical ; Adhesiveness ; Administration, Ophthalmic ; Animals ; Drug Carriers ; Eye ; metabolism ; Fluoresceins ; chemistry ; Liposomes ; administration & dosage ; chemistry ; pharmacokinetics ; Male ; Particle Size ; Polyethylene Glycols ; chemistry ; Rats ; Rats, Sprague-Dawley ; Wheat Germ Agglutinins ; administration & dosage ; chemistry ; pharmacokinetics

ObjectiveTo evaluate the biomechanical stability and the clinical efficacy of the percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures. Methods Twelve lumbar fracture models were made on fresh calf lumbar spine specimens to compare the stability of the 4 monoaxial screws and 4 muhiaxial screws transpedicular fixation by examining the range of motion(ROM) in flexion,extension, lateral bending, and torsion. Sixty cases of thoracolumbar fractures without neuro-deficiency were treated surgically, 11 of the minimally invasive group(monoaxial screw group) and 18 of the open surgery group(multiaxial screw group) were followed up more than 12 months. ResultsThe 4 monoaxial screws transpedicular fixation specimen exhibited a smaller ROM significantly in flexion, extension compared withthe 4 multiaxial screws transpedicular fixation specimen. The 4 monoaxial screws transpedicular fixationspecimen exhibited a significantly smaller ROM in flexion and extension than the intact specimens. TheROM in the 4 multiaxial screws transpedicular fixation specimen and the intact showed on significant differences. There were no significant differences between the two groups in the preoperative and postoperative anterior fractured vertebral height (AVH) and the Cobb's angle (CA), but there were significant differences in the AVH and the CA between preoperative and postoperative in the two groups. There were significant differences in the correction loss of the AVH between the two groups at final follow-up.ConclusionThe percutaneous pedicle screw fixation using Sextant system is a good minimally invasive surgical choice for patients with thoracolumbar fractures without neuro-deficiency, but which has a loss of the AVH and worse flexion-extension stiffness in follow-up compared with the open monoaxial screws fixation.

Objective To transfect EGFP gene to porcine embryonic fibroblasts ( PEFs) of Tibetan miniature pigs by Lonza Nucleofector II machine and compare the tansfection efficiency between this method and the lipofection method. Method A plasmid carrying green fluorescent protein ( GFP) was transfected into PEFs of Tibetan miniature pigs via the Lonza Nucleofector II machine ( program U020) and by Lipofectamine 2000.Results 5 hours after nucleofection, green fluorescence was observed, indicating 80%transfecting efficiency in the nucleofection group, which is significantly higher than the lipofection group. Conclusion Nucleofector II machine can efficiently transfect PEFs, provides a reliable method for efficiently generate transgenic Tibetan minipigs.

Objective To evaluate the current status of aspirin for primary prevention in hypertensive outpatients in China,and the gap between aspirin use and guidelines.Methods This was a multi-center cross-sectional study and carried out in hypertensive patients from 46 hospitals of twenty two cities in China from June to December in 2009.At least 100 essential hypertensive outpatients were consecutively recruited from each participant hospitals according to the consistent inclusion criteria.The patients underwent physical examinations and biochemical analyses,and answered questionnaires.Based on the relevant guidelines,the risk assessment of cardiovascular disease (CVD) is a prerequisite for the proper use of aspirin in primary prevention.Results A total of 5 206 hypertensive outpatients were included.Among them,1 324 (25.4％) were with a history of CVD.Among those with no history of CVD,2 705 patients (69.7％) were at high risk of CVD,and the aspirin utilization rate for primary prevention was 29.2％,with 32.2％ patients at high risk and 22.4％ patients at low-medium risk of CVD,respectively.In the application of aspirin for CVD primary prevention,the inappropriate aspirin use rate in patients at lowmedium risk was 23.3％.Conclusions The proportion of subjects at high risk for CVD is high in hypertensive outpatients suggesting a wide range of application space for aspirin.There exists underutilization for high risk and overutilization for low-medium risk patients in current aspirin primary prevention application.

Objective To analyze the distribution of multiple risk factors for hospitalized patients with acute coronary syndromes (ACS) and explore the status and determinants of drug usage recommended by the guideline.Methods This was a multi-center cross-sectional study in 34 hospitals from 22 provinces in China.About ninety ACS patients were consecutively enrolled from each hospital since April 15,2012 according to a standard protocol.Totally,3 253 patients with complete data were analyzed in this study.Results (1) The average age of male patients with ACS was lower than that of female patients (60.4 years vs 66.2 years,P ＜0.01).Nearly 60％ of ACS patients were under the age of 65 years.Early onset of ACS accounted for one-third of male (＜ 55 years of age) and two-fifthes of female patients (＜ 65 years old).(2) Among the four ACS major risk factors (hypertension,hyperlipidemia,smoking and diabetes),hypertension was with the highest prevalence (68.4％).More than 90％ of ACS patients had at least one risk factor and about two-thirds of them had at least two.(3) As for the application of evidence-based drugs,the top one was aspirin with 95.3％ of ACS patients reseiving it.The second was statins (90.1％).Angiotensin converting enzyme inhibitors (ACEI) or angiotension Ⅱ receptor blocker(ARB) was the lowest (53.6％).Multivariable analysis indicated that,in contrast to that in ACS patients without percutaneous coronary intervention(PCI),the drug usage rates were increased by more than 30％ for ACEI or ARB and β receptor blockers,by more than 50％ for statins,and by 4-7 times for antiplatelet agents among ACS patients with PCI.Conclusions In China,more than 90％ of hospitalized patients with ACS carried at least one major risk factor.There is still room for improving in the application of drugs recommended by the guidelines,especially for ACS patients without PCI.

AIM:To study the influence of stimulation by LPS and CD40 ligandization in vitro on the TLR4-MD2 expression and IL-12 production in dendritic cells (DCs) modified by sCD40 gene and provide the experimental clues of inducing dornor-specific immune tolerance.METHODS: Plasmid pEGFP-N1/sCD40 and pEGFP-N1 was transfected into DC2.4 cell line with lipofectamine. After 6 h of treatment with LPS and anti-CD40mAb, the expression of TLR4-MD2 on DCs was determined with flow cytometry (FCM) and RT-PCR. IL-12p70 protein was detected by ELISA.RESULTS: LPS treatment of DCs down-regulated surface expression of TLR4-MD2, LPS treatment along with anti-CD40mAb significantly up-regulated TLR4-MD2 surface expression. CD40 ligandization did not affect TLR4-MD2 mRNA expression in DCs but partly increased its low level induced by LPS and markly enhanced IL-12p70 secretion after LPS stimulation. DCs modified by sCD40 gene inhibited the above effect.CONCLUSION: After treatment with LPS and anti-CD40mAb, DCs modified by sCD40 gene down-regulate surface expression of TLR4-MD2 and IL-12p70 secretion decreases significantly, which might be linked with the interruption of TLR4-MD2 transportation from cytoplasm.

Objective To explore the 15-years change in fasting TG level and the accumulative incidence of type 2 diabetes mellitus (T2DM) from 1992 to 2007,and to assess the association between the change in TG level and the accumulative onset risk of T2DM.Methods A total of 11 387 subjects aged 35-64 years were recruited from 6 provinces in China in the baseline survey in 1992,and were followed-up for cardiovascular disease till 2007.In 2007,9184 subjects were successfully followed-up and 5966 subjects entered into the second examination.Totally 5408 participants,who were free of diabetes at baseline and had complete information for both check ups,were included in this analysis.Fasting TG levels were categorized into three groups:＜ 1.70 mmol/L,1.70-2.25 mmol/L and ≥2.26 mmol/L.The association between 15-years change in TG level and the accumulative onset risk of T2DM was assessed by logistic regression analysis.Results In 1992,the mean level of TG was 1.49 mmol/L in male and 1.26 mmol/L in female.During the 15 years,TG levels increased by 0.25 mmol/L and 0.53 mmol/L in male and female,respectively.The prevalence of elevated TG ( ＜ 1.70 mmol/L) increased from 23.4％ in 1992 to 39.0％ in 2007.The 15-year accumulative incidence of diabetes was 13.9％ in male and 11.8％ in female.The incidence rates were 10.5％,16.2％ and 26.6％ for TG levels of ＜ 1.70 mmol/L,1.70-2.25 mmol/L and ≥2.26 mmol/L,respectively.Multivariate logistic regression analysis showed that the baseline TG level was significantly associated with the onset risk of diabetes after adjustment for other cardiovascular risk factors.At any given baseline TG level,the onset risk of diabetes increased with the TG levels in the second examination in 2007.After adjusting other risk factors,participants with the highest categories of both baseline and follow-up TG levels had 2.1 folds higher accumulative onset risk of diabetes ( RR =3.39,95％CI 2.49-4.61 ) than those with the lowest categories of both baseline and follow-up TG levels.Conclusion Baseline TG level is independently associated with diabetes onset risk,and the change of TG level in a 15-year interval predicts the onset risk of diabetes beyond the baseline TG level.