Objective To measure the setup errors of patients with esophageal carcinoma during the treatment of three dimensional conformal radiotherapy (3DCRT), and to analyze the impact of setup errors on dose distribution of GTV,CTV and normal tissues around. Methods Forty-two patients with esophageal cancer treated by 3DCRT were included. The setup errors of each patient were measured once a week for 6 times by electronic portal imaging device (EPID). The setup errors were integrated into the treatment plan-ning system by moving the isocenter. Then the dose distribution of GTV, CTV and normal tissues were recal-culated. Results The systematic setup errors of the 42 patients were - 2.31 mm, - 0.55 mm and - 0.16 mm, and the random errors were 4.42 mm, 4.35 mm and 4.48 mm in the directions of lef-fight, anterior-posterior,and superior-inferior, respectively. The dose covered 95% GTV( D95 ) was reduced by 32 cGy and by 88 cGy for CTV D95. The lung V20 in the original plan and the integrated plan was 22.49% and 22.02%, respectively. The average dose of the heart in the two plans was 2077.62 cGy and 2036.23 cGy, respectively. In the original plan, no patient had maximum dose of spinal cord over 4500 cGy; While in the intergrated plan there were 18 patients had the spinal cord dose more than 4500 cGy, with a maximum dose of 5503.90 cGy. Conclusions The setup errors cause significant dose reduction of GTV and CTV, but not of the lung and heart . The maximum dose of the spinal cord may exceed 4500 cGy due to the setup errors.

Biomechanical Phenomena ; Electromyography ; Gait ; Humans ; Lower Extremity ; Muscle, Skeletal ; Walking

Objective To investigate the radiosensitivity of ESCC by signal transducer and activator of transcription 3 (STAT3) inhibitor Stattic,since the radioresistance of esophageal squamous cell carcinoma(ESCC) remains an obstacle for the effective radiotherapy of ESCC.Methods ECA109 cell line was exposed to hypoxia and treated with Stattic or radiation,alone or in combination.Cell proliferation,colony formation,apoptosis,and double-stranded DNA breaks (DSBs) were examined.The levels of STAT3,pSTAT3,hypoxiainduciblefactor1α (HIF-1α),and vascular endothelial growthfactor (VEGF) in ESCC cells were detected by Western blot.Results Stattic efficiently inhibited the proliferation of ECA109 cells in time-dependent and dose-dependent fashions with an IC50 of 5.499 μmol/ L.Clonogenic survival assay showed that stattic (1.0 μmol/L) sensitized ECA109 cells to ionizing radiation and its SERDo was 1.20 (in normoxia) or 1.28 (in hypoxia).Under hypoxic condition,stattic combined with IR disrupted the repair of DSBs and increased the apoptosis(t =7.33,P ＜ 0.05) in ESCC cells compared to that of radiation treatment alone.Moreover,Western blot assay showed that stattic inhibited STAT3 activation and downregulated the expression level of pSTAT3 and HIF-1α and VEGF.Conclusions Stattic confers radiosensitivity in ESCC cells in vitro and is a potential adjuvant for the radiotherapy of ESCC in the clinical setting.

Objective To investigate the effect of Buyang Huanwu Decoction on blood-brain barrier of focal cerebral ischemia rats, and explore the mechanism of the decoction. Methods The model of focal cerebral ischemia was made by thread embolism method. SD rats were divided randomly into sham-operated group, model group and Buyang Huanwu Decoction group. Buyang Huanwu Decoction group was given Buyang Huanwu Decoction by gavage, the sham-operated group and model group were given normal saline of the same quantity 24 h after modeling. The nervous function deficit scores was evaluated, brain tissues and serum were taken from the rats after treating for seven days, infarct volume was detected by TTC staining, and pathological changes of microvessel were observed microscopically in HE stained sections. And the protein level of MMP-9, MMP-2, VEGF in brain tissue and the serum levels of vWF in serum of every groups were measured by ELISA. Results Compared with model group, Buyang Huanwu Decoction significantly improved the neurological behavior performance, decreased the cerebral infarct volume, alleviated the pathological changes and decreased the protein level of MMP-9, MMP-2, VEGF, vWF. Conclusion Buyang Huanwu Decoction has the protective effect on blood-brain barrier in the model rats of focal cerebral ischemia. The mechanism may be related with restrainning the expression of MMP-9, MMP-2, VEGF, vWF.

Background The filtering surgery is the main method of treating glaucoma.Fibrosis of filtering bleb is a key cause of failure of operation.The study about application of anti-scaring drug in filtering surgery is a hotspot.Objective Present study was to investigate the anti-scaring effect of paclitaxel aher trabeculectomy.Methods Thirty-two adult clean domestic rabbits underwent standardized trabeculectomy and randomly divided into 4 groups.Normal saline solution was used beneath the scleral flap during trabeculectomy for 3 minutes in 16 eyes of 8 rabbits as controls.0.3 g/L mitomycin C,0.2 g/L paclitaxel or 0.3 g/L paclitaxel was administered at the same way respectively in other 3 groups.Intraocular pressure (IOP) was measured,and eye numbers with function blebs were compared among 4 groups at the 4th,7th,14th and 28th day after surgery.The opening of filtration tunnel and the number of inflammatory cells were observed by hematoxylin and eosin staining,and proliferation of new collagen fibers was evaluated by Masson trichrome method.This study complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission(version 1988). Results No significant differences were found in the change of lOP among 4 groups before operation(F=0.54,P=0.83)and the 4th day aher operation(F=0.57,P=0.87).The IOP value was statistically lower in 0.3 g/L mitomycin C group,0.2 g/L paclitaxel group and 0.3 s/L paelitaxel group than the normal saline solution group(P＜0.05)with the lowest value in 0.3 s/L paclitaxel group in 7,14,28 days after operation(P＜0.05).Functional filtering bleb was seen in all the rabbit eyes in the 4th day after operation.In 7,14,28 days after operation,the number of eyes with functional bleb wag evidently more in 0.3 g/L mitomycin C group,0.2 g/L paclitaxel group and 0.3 g/L paclitaxel group compared with normal saline group(P＜0.05).The histological examination showed that the infiltration of inflammatory cells in filtering tunnel was much more obvious in normal saline solution group than the other groups with the most mild response in 0.3 g/L paclitaxel group.Masson trichrome revealed that proliferation of new collagen fibers in 0.3 g/L paclitaxel group was significantly decreased in comparison with those in other three groups at the 4th,7th,14th and 28th day after surgery(all P＜0.05). Conclusion Paclitaxel can inhibit the inflammatory response and collagen fibrosis and therefore open the filtering tunnel after it be used topically during the glaucoma trabeculectomy.

The antisense transcript long non-coding RNA (1ncRNA) (antisense non-coding RNA in the INK4 locus,ANRIL) is an antisense of the cyclin-dependent kinase inhibitor 2B (CDKN2B) gene on chromosome 9p21 that contains an overlapping 299-bp region and shares a bidirectional promoter with alternate open reading frame (ARF).In the context of gene regulation,ANRIL is responsible for directly recruiting polycomb group (PcG) proteins,including polycomb repressive complex-1 (PRC-1) and polycomb repressive complex-2 (PRC-2),to modify the epigenetic chrornatin state and subsequently inhibit gene expression in cis-regulation.On the other hand,previous reports have indicated that ANRIL is capable of binding to a specific site or sequence,including the Alu element,E2F transcription factor 1 (E2F1),and CCCTC-binding factor (CTCF),to achieve trans-regulation functions.In addition to its function in cell proliferation,adhesion and apoptosis,ANRIL is very closely associated with atherosclerosis-related diseases.The different transcripts and the SNPs that are related to atherosclerotic vascular diseases (ASVD-SNPs) are inextricably linked to the development and progression of atherosclerosis.Linear transcripts have been shown to be a risk factor for atherosclerosis,whereas circular transcripts are protective against atherosclerosis.Furthermore,ANRIL also acts as a component of the inflammatory pathway involved in the regulation of inflammation,which is considered to be one of the causes of atherosclerosis.Collectively,ANRIL plays an important role in the formation of atherosclerosis,and the artificial modification of ANRIL transcripts should be considered following the development of this disease.

OBJECTIVETo evaluate speech outcomes in patients of maxillary reconstruction with free fibula composite flap.

METHODSSpeech measurements of 20 patients of maxillary reconstruction with free fibula composite flap were collected. Palatopharyngeal valve, the symmetry and movement of soft palate, hypernasality and nasal emission were examined by nasoendoscopy. At the same time the speech intelligibility was measured.

RESULTSNo palatopharyngeal valve insufficiency was found and all the soft palates had good symmetry and movement. The average speech intelligibility was 98.4%.

CONCLUSIONSFree fibula composite flap can reconstruct the phonatory structure and support the function of soft palate, which can restorate speech function well. It is a good choice for maxillary reconstruction.

Adult ; Female ; Fibula ; Humans ; Male ; Maxilla ; surgery ; Middle Aged ; Speech Intelligibility ; Surgical Flaps

Objective To isolate and study the phenotype and biological characteristics of chronic myelogenous leukemia-derived mesenchymal stem cells. Methods Cultivate the mesenchymal stem cells from chronic myelogenous leukemia in vitro, identify the immunophenotype by fluorescence-activated cell sorter (FACS), and detect the bcr-abl fusion gene by RT-PCR and FISH. Results The mesenchymal stem cells from chronic myelogenous leukemia can express the bcr-abl fusion gene. Conclusion These findings provide the evidence that the rearrangement of bcr-abl gene might happen at least more primitive than CD+34 CD-38 cells.

OBJECTIVETo describe the early experiences with rFVIIa in the management of bleeding after cardiovascular surgery.

METHODSFrom May 2006 through December 2007, 16 patients received rFVIIa during or after surgery despite conventional medical therapy and transfusion of blood products. There were 15 male patients and 1 female patients, aged from 36 to 77 years old with a mean of 52 years old. The surgical procedures include aortic procedures for 8 cases, valve replacement for 6 cases, pulmonary thromboendarterectomy for 1 case and atrial septal defect repair for 1 case. The data of these patients were reviewed and the safety and efficacy of rFVIIa after cardiovascular surgery were evaluated.

RESULTSrFVIIa was administered as a first dose of 27.6 to 54.5 microg/kg with a mean of 40.2 microg/kg. Six patients achieved hemostasis after the first dose. Nine patients received a second administration within 30 min, with a cumulative dose of 59.3 to 90.9 microg/kg, a mean of 80.3 microg/kg. Eight patients achieved hemostasis and 1 patient went to exploration. One patient received four doses of rFVIIa with a cumulative dose of 203.4 microg/kg and the bleeding stopped. Mean amount of chest drain loss and the amount of red blood cell, fresh frozen plasma, cryoprecipitate, and platelet transfusions decreased significantly after rFVIIa administration. The total amount of chest drain losses, transfusions of red blood cell and cryoprecipitate within 12 h postoperatively was positively correlated with the time from the end of bypass to administration of rFVIIa. No thromboembolic complications and other adverse reactions were noted.

CONCLUSIONSThe use of rFVIIa is associated with reduced blood loss, rapid improvement of coagulation variables, and decreased need for blood products. rFVIIa is safe and efficacious in the management of refractory postcardiotomy bleeding.

Adult ; Aged ; Cardiovascular Surgical Procedures ; Coagulants ; administration & dosage ; therapeutic use ; Factor VIIa ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage ; drug therapy ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Retrospective Studies

OBJECTIVETo explore the prognostic factors for very severe aplastic anemia (VSAA) patients treated mainly with Chinese Kidney (Shen)-invigorating drugs (CKID) combined with anti-lymphocyte globulin (ALG) or anti-thymocyte globulin (ATG).

METHODSTwenty-seven VSAA patients were treated with CSID+ALG/ATG therapy in conjunction with cyclosporine A, androgen, hemopoietic growth factor, etc. The relationship of the effectiveness and some factors (age of patients, course of illness, blood and bone marrow figures, etc.) were analyzed.

RESULTSIn the 25 evaluated VSAA patients who had been followed up for over 1 year, 9 patients (36.0%) were basically cured, 5 (20.0%) remitted, 6 (24.0%) were markedly improved, and 5 (20.0%) were treated in vain, with the total effective rate of treatment being 80.0% (20/25). Better clinical therapeutic effects were shown in patients newly diagnosed with VSAA, of male sex (P=0.037), >20 years old (P=0.045), with an illness course [Symbol: see text] month (P=0.048), with peripheral neutrophil count >0.1 × 10(9)/L (P=0.023), and with reticulocyte count >10 × 10(9)/L (P=0.002). Platelet count (P=0.620) and bone marrow lymphocyte percentage (P=0.736) showed no correlation with the therapeutic effectiveness. Multi-factor analysis by the Kaplan-Meier procedure on the factors influencing survival showed that rather longer survival times occurred in patients > 20 years old, with peripheral neutrophil count [Symbol: see text] 0.1 × 10(9)/L, reticulocyte count [Symbol: see text]10 × 10(9)/L, and platelet count > 10 × 10(9)/L (all P=0.0001). Bone marrow lymphocyte percentage and the initiation time of ALG/ATG application (from onset of the illness) showed no significant influence on patients' survival time (P=0.085 and P=0.935, respectively).

CONCLUSIONSCSKD+ALG/ATG therapy for treatment of VSAA could enhance the current clinical therapeutic effects and elevate patients' survival rate. Conditions including male sex, age >20 years, illness course [Symbol: see text]1 month, neutrophil count >0.1 × 10(9)/L, and reticulocyte count >10 × 10(9)/L are the likely effective indices for predicting favorable therapeutic effectiveness in newly diagnosed VSAA patients.

Adolescent ; Adult ; Anemia, Aplastic ; diagnosis ; drug therapy ; pathology ; Animals ; Antilymphocyte Serum ; pharmacology ; therapeutic use ; Child ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Horses ; Humans ; Kidney ; drug effects ; Male ; Middle Aged ; Prognosis ; Survival Analysis ; Sus scrofa ; Time Factors ; Treatment Outcome ; Young Adult