Objective To test intraoperative radiotherapy with mobile photon beam using the INTRABEAM system ( Germany) , and to analyze the dosimetric characteristics of low?energy photon beam using X?ray source and spherical applicators and explore its potential limitations in clinical application. Methods A special water phantom, a parallel?plate ionization chamber, and an electrometer were used to measure the depth dose rates and isotropy of dose distribution in x/y plane of X?ray source and different spherical applicators in the INTRABEAM system. Those data were then compared with the system data. Results For the X?ray source, the deviation of observed depth dose rate and isotropy in the x/y plane from the system data were-2.16%± 1. 36% and-1.9%~ 2. 1%, respectively. For applicators with different diameters, the deviation of observed depth dose rate, transfer coefficient, and isotropy in x/y plane from the system data were-10.0%~2. 3%,-8.9%~4. 2%, and-1.6%~2. 6%, respectively. Surface dose rate and dose gradient became larger with the decrease in the diameter of the spherical applicator. The measurement of depth dose rate and isotropy of X?ray source and spherical applicators showed good repeatability. The influencing factors for measurement accuracy included the positioning error of ionization chamber, energy response, noise current, and correction factor f ’ ( R ) . Conclusions This study reveals the dosimetric characteristics of the INTRABEAM system, verifies the accuracy of the system data, and obtains the data for clinical application and routine quality assurance. However, large dose gradient and small therapeutic range may limit its wide clinical application.

Sixteen compounds including daphnoretin (1), isofraxidin (2), scopoletin (3), kaempferol (4), quercetin (5), guaijaverin (6), astragalin (7), quercetin-3-O-β-D-glucopyranoside (8), naringenin-7-O-β-D-glucopyranoside (9), 5-O-methylapi- genin-7-O-β-D-glucopyranoside (10), methyl gallate (11), prionitiside A (12), (2S)-2,3-dihydroxypropyl-1,6,8-trihydroxy-3- methyl-9,10- dioxoanthracene-2-carboxylate (13), 3,3'-di-O-methyl ellagic acid (14), 3'-O-methyl-3,4-O,O-metheneellagic acid-4'-O-β-D- glucopyranoside (15) and 3,4-methylenedioxy-3'-O-methylellagic acid (16), were isolated from the 70% acetone extract of Euphorbia dracunculoides Lam. Among them, compounds 1-3, 6-9, 11, and 14 were isolated from E. dracunculoides for the first time, and compounds 10, 12, 13, 15, and 16 were firstly obtained from the genus Euphorbia. Their structures were elucidated by spectroscopic analysis, including 1H-NMR, 13C-NMR, and ESI-MS.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Euphorbia ; chemistry ; Molecular Structure ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Spectrometry, Mass, Electrospray Ionization

Objective At present,nasopharyngeal carcinoma (NPC) is a head and neck cancer with special geographical distribution and biological behavior.Studies have shown that 18 F-FDG PET/CT parameters have certain prognostic values in patients with NPC in high-incidence areas.The aim of this study is to investigate the prognostic values of 18 F-FDG PET/CT parameters in patients with NPC in low-incidence areas.Methods The clinical data of 83 NPC patients who were diagnosed and treated in Beth Israel Medical Center, Albert Einstein Medical College from January 2003 to December 2013 were analyzed retrospectively.Based on 18 F-FDG PET/CT images,gross tumor volume (GTV) was delineated using the gradient method to obtain 18 F-FDG PET/CT parameters:maximum standardized uptake value (SUVmax ), metabolic tumor volume ( MTV),and total lesion glycolysis ( TLG).Results The number of patients followed was 37 at 3-years time.For all patients,the 3-year failure-free survival,locoregional relapse-free survival,and metastasis-free survival rates were 74%,88%,and 85%,respectively.The univariate analysis showed that SUVmax of the primary tumor (P=0.004) and TLG (P=0.014) were prognostic factors for 3-year locoregional relapse-free survival rate,and SUVmax of the primary tumor (P=0.024) and TLG (P=0.033) were prognostic factors for 3-year failure-free survival rate.The multivariate analysis showed that SUVmax of the primary tumor was the independent prognostic factor for 3-year failure-free survival rate. Conclusion SUVmax of the primary tumor before treatment is the independent prognostic factor for failure-free survival in patients with NPC.

Objective To evaluate the influence of epimeric glycyrrhizic acid on production of endothelin-1 (ET-1) in the lungs induced by ischemia-reperfusion(I/R) injury.Methods Twenty healthy long-ear white rabbits of both sexes, weighing 1.1-2.1kg were randomly divided into 2 groups: group I I/R alone ( n = 10) and group II I/R + epimeric glycyrrhizic acid (n = 10). The animals were anesthetized with thiopental 25 mg?kg-1 and tracheotomized and mechanically ventilated (FiO2 = 100% , VT = 10-13 ml?kg, RR = 20-30 bpm, I:E= 1: 1.2). Anesthesia was maintained with fentanyl, thiopental and vecuronium. Femoral artery was cannulated for continuous direct BP monitoring. MAP was maintained at 70-90 mm Hg during experiment. Right interval jugular vein was cannulated. Catheter was inserted into right atrium for fluid administration, blood sampling and right atrial pressure monitoring. Chest was opened and the hilum of right lung was mass-ligated to induce ischemia for 60 min and then released for reperfusion for 60 min. Epimeric glycyrrhizic acid 30 mg?kg-1 was given iv 30 min before ischemia of the right lung. Blood samples were taken from right atrium and femoral artery for determination of ET-1 concentration before ischemia of right lung (T0) and 1 and 5 min after right lung started being perfused (T1 , T2). At the end of 60 min reperfusion of the right lung, the animals were sacrificed and lungs (right and left) were removed for electron microscopic examination. Results In group 1 at T, the ET-1 levels in the blood from both femoral artery and right atrium were significantly higher than the baseline (T0) and the ET-1 concentration in the blood from femoral artery was significantly higher than that from right atrium. In group II there was no significant difference in blood ET-1 concentration between T0 and T, .Conclusion Ischemia-reperfusion induces increased production of ET-1 in the injured lung. Epimeric glycyrrhizic acid can inhibit the increase in the production of ET-1 in the induced by I/R.

Objective To investigate the effect and mechanisms of recipient-derived immature dendritic cells(imDC) transfected with IKK2dn and loaded with donor antigen on renal allografts survival in the rats.Methods DC were cultured from recipient rats'(Lewis) bone marrow,transfected with IKK2dn and loaded with donor antigen.The expression of CD86 and MHC Ⅱ was detected,and the ability of DC stimulating lymphocyte proliferation in vitro was measured.Male Brown Norwav rats and Lewis rats were used as donors and recipients respectively.Four groups were set up(DC group,empty transfection group,transfection group and control group),receiving 1×10~7 DC,Adv-0-DC,Adv-IKK2dn-DC loaded with BN antigen,and equal volume of normal saline,respectivelv 7 davs before transplantation.In the third party donor-group,Wistar rats as donors were treated the same as DC;group before transplantation.After transplantation,the T lymphocyte proliferation in reciPients was measured and the expression of serum IL-2 and IFN-γ was detected.The survival time of recipients and the acute reiection were observed.Pathological changes were examined tO identify the grade of rejection.Results DC assessment in vivo revealed that the transfected DC could still express CD86 and MHC Ⅱ in a low level as compared with those not transfected with IKK2dn. After DC were loaded with donor's antigen,the expression of CD86 and MHC Ⅱ was up-regulated.After DC were transfected with IKK2dn before loaded with donor's antigen, the expression of CD86 and MHC Ⅱ had no significant change. When DC were loaded with donor's antigen, its allostimulatory activity of T lymphocyte proliferation was enhanced (P<0. 05). When DC were transfected with IKK2dn before loaded with donor's antigen, its allostimulatory activity of T lymphocyte proliferation was not enhanced. Compared with control groups, IKK2dn-transfected DC pulsed with BN splenocyte lysate markedly prolonged the survival of renal allografts (26. 8±1.76d, P<0.01), and elicited markedly lower proliferative responses and reduced IL-2 and IFN-γ production. The pathological grade of rejection was low in the transfection group. Conclusion Recipient-derived imDC transfected with IKK2dn and loaded with donor splenocyte lysate could prolong the renal allograft survival in rats probably by down-regulating the expression of DC costimulatory molecules and inhibiting the T_H 1 cytokine production.

Objective To compare the influences of off-pump and on-pump coronary artery bypass grafting operation on plasma thyroid hormones.Methods Forty patients undergoing coronary surgery were randomly divided into off-pump group(n=20)and on- pump group(n=20).Plasma thyroid hormones(T_3,T_4,FT_3,FT_4,rT_3)and thyroid-stimulating hormone(TSH)were studied perio- peratively.Results Before operation,the values of aU the variables were within normal range in the two groups.In off-pump group, T_3 and FT_3 concentration dropped significantly after operation,reaching the lowest value at first day postoperatively[T_3:(39.7?6.2) ng/dl vs.(78.6?2.1)ng/dl,P0.05),which were within normal range all along,rT_3 concentration rose significantly after operation,reaching the highest value at third day postoperatively[(82.1?26.8)ng/dl vs.(42.3?15.6)ng/dl, P0.05),whereas baseline,operative and postoperative variables were similar.Con- clusion Off-pump operation has some influences on plasma thyroid hormones,showing"low T_3 syndrome"postoperatively,that is similar to what on-pump operation does.

Objective To explore the potential predominance and value of percutaneous hepatocholangiostomy (PCH) in treatment of recurrence hepatobiliary stones (RHS). Methods Seventeen cases with RHS were treated by PCH from February 2001 to October 2005, which was an improved technology of percutaneous transhepatic cholangioscopy (PTCS) and made reference to the methods of percutaneous nephrostomy (PCN). Results Seventeen cases were successfully treated. The average blood loss was 40 ml (ranging from 15 to 100 ml), and stones were removed completely in 88.2% (15/17). The average hospital stay was 14 (ranging from 10 to 59) days. No one required postoperative analgesic. No postoperative bleeding and biliary leakage were found. Conclusions PCH has significant advantages of minimal invasion, little blood loss, less pain, less complications and quick recovery in the treatment of RHS.

OBJECTIVETo investigate the effects of tumor necrosis factor-alpha(TNF-alpha) on syndecan-4 protein expression and proliferation of cultured human umbilical vein endothelial-like cells (HUVECs) in vitro.

METHODSHUVECs exposed to different concentrations of TNF-alpha(100, 20, 10, and 1 ng/ml) were cultured for 24 h and 36 h to observe their proliferation in comparison with the control group. The cell proliferation rate was determined by non-radioactive MTS/PES assay. The expression of syndecan-4 protein was evaluated by immunoblotting technique using anti-syndecan-4 antibody. Results The proliferation rate of the endothelial-like cells was 1.956-/+0.214 in the control group, and 2.154-/+0.250, 2.260-/+0.151, 2.118-/+0.205 and 2.106-/+0.136 in TNF-alpha-treated groups corresponding to TNF-alpha concentrations of 100, 20, 10 and 1 ng/ml at 24 h, respectively. It was shown that TNF-alpha significantly stimulated cell proliferation at the concentration above 1 ng/ml (P<0.05) as compared with the control group (P<0.05). The proliferation rate of the endothelial-like cell was 1.915-/+0.236 in the control group, and 2.067-/+0.328, 2.207-/+0.150, 2.052-/+0.126 and 2.051-/+0.180 in TNF-alpha-treated groups corresponding to TNF-alphaconcentrations of 100, 20, 10 and 1 ng/ml at 36 h, respectively. The expression of syndecan-4 protein was significantly enhanced by TNF-alpha.

CONCLUSIONSTNF-alpha can stimulate HUVEC proliferation, and expression of syndean-4 may represent an additional component of the pro-inflammatory, growth-stimulating pathways that are activated in response to changes in the vascular wall.

Cell Proliferation ; Cells, Cultured ; Endothelial Cells ; metabolism ; Humans ; Syndecan-4 ; metabolism ; Tumor Necrosis Factor-alpha ; pharmacology ; Umbilical Veins ; cytology

OBJECTIVEIt is necessary to compensate the system latencies in real-time tumor-tracking radiotherapy by prediction. However, due to the irregularities of respiratory motions, the results obtained with traditional methods were not acceptable. The purpose of this study is to evaluate the value of nonparametric regression model in respiratory motion prediction.

METHODSThe data of respiratory trajectory of 11 volunteers were obtained and predicted based on nonparametric regression method. The results were compared with those of autoregressive model and back propagation neural network. An improved method was proposed to deal with the abnormal state in respiration. We combined the prediction method with the tracking system to test its performance in practical application.

RESULTSThe results indicated that the proposed method could predict the motion accurately in real-time for different latencies. This method decreased the error of the abnormal state substantially and also allowed effective prediction of respiration motion when combined with the tracking system.

CONCLUSIONThe nonparametric regression model can predict the respiratory motion accurately in real-time and therefore meets the requirement of real-time tumor-tracking radiotherapy.

Forecasting ; Humans ; Models, Theoretical ; Movement ; Neoplasms ; radiotherapy ; Radiotherapy, Computer-Assisted ; methods ; Regression Analysis ; Respiration

Objective:To evaluate the accuracy of measurement of the output factor of high-energy photon small field (Scp) using commercial semi-diodes and ionization chambers in small fields in accordance with the IAEA-483 report, which has been proposed that all kinds of detectors should be revised for small field Scp measurement in clinical practice.Methods:EGSnrc of Monte Carlo (MC) software was utilized to simulate the treatment head of Varian Novalis Tx linear accelerator, and the profile curve and relative dose value were generated by simulation in DOSXYZnrc based on derived phase space file. Measurement of PDD and Profiles was used to adjust and validate the simulation mode. Detectors including ionization chambers A16, A14 sL, CC01, CC13, PFD and EFD and semi-diodes PFD, EFD and Razor under different radiation field settings (0.5 cm to 10.0 cm) were employed to measure the profile curves and Scp of FWHM equivalent rectangular fields, which were compared with data of Monte-Carlo simulation. The measurement of Scp was revised by data given in the IAEA-483 report. The data with or without correction were compared with the data of MC simulation.Results:A curve deviation o F<2.0% between MC simulation and PFD measurement was accepted. MC simulated Profiles were consistent with PFD, EFD and Razor measurements, when the field was<3.0 cm. Razor response in the out-field region was 2.3% higher than those of MC and PFD, and it increased with the increment of field and was 3.0% at 10.0 cm. The maximum 20.0%-80.0% penumbra width was detected as 3.0 mm for CC13 at 10.0 cm rectangular field. With the decrease of the radiation field, the deviation relative to MC simulation was increased as for Scp mean values of 7 detectors before correction. The standard deviation (SD) of the measured value was increased rapidly when it was close to 1.0 cm, ranging from 0.009-0.014 for the field of 5.0 cm-1.5 cm to 0.030-0.089 for the field of 1.0 cm-0.5 cm. The mean value of SD for the whole measurement before correction was 0.030. The mean SD of Scp measured by the six probes was 0.008, 0.013 at 0.8 cm and 0.021 at 0.6 cm after correction. When the equivalent field was ≥1.0 cm, the corrected Scp and MC simulation deviation was ranged from -3.6% to -0.5%. The error was between -6.9% and -1.3% when the radiation field was<1.0 cm. Conclusion:The SD of Scp measured by different detectors after correction in accordance to the IAEA-483 report is small, which is in good agreement with the data of MC simulation, suggesting that it could be applied in clinical dosimetry.