Pericellular matrix (PCM) is a narrow tissue region surrounding chondrocytes, which "chondron" with its enclosed cells. A number of studies suggested that PCM is rich in proteoglycans, collagen and fibronectin, and plays an important role in regulating microenvironment of chondrocytes. Direct measures of PCM properties through micropipette aspiration technique showed that PCM was different from mechanical property of chondrocytes and nature extracellular matrix. However, the function of PCM is not clear, and need further study.
Animals ; Biomechanical Phenomena ; Chondrocytes ; chemistry ; cytology ; metabolism ; Extracellular Matrix ; chemistry ; metabolism ; Humans

Adult ; Atropine ; therapeutic use ; Bronchodilator Agents ; therapeutic use ; Combined Modality Therapy ; Female ; Hemofiltration ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organophosphorus Compounds ; Poisoning ; therapy ; Treatment Outcome

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.

Objective To evaluate the effects of regular follow-up and systematic management in premature infants on early discovering of cerebral palsy and intervention efficacy in early phase. Methods Fifty premature infants with cerebral palsy recruited from early children development outpatient service, were classified as treatment group; 40 premature infants with cerebral palsy recruited from general outpatient service, were classified as control group. The infants of treatment group received systematic follow-up and intervention. while the infants of control group received no systematic management. Age and therapeutic efficacy were compared between the two groups. ResultsThe average age in the treatment group ( [4. 0 ± 1.2] months) was significantly younger than that of the control group ( [7.0 ± 1.4] months) ( P ＜ 0. 05 ). The mental development index ( MDI )and physical development index (PDI) in the treatment group was 91.8 ± 10. 2 and 90. 2 ± 11.2,respectively,which were significantly higher than that of the control group(80. 2 ± 11.7 for MDI and 79. 3 ± 10. 2 for PDI)( P ＜ 0. 05 ) . Conclusion Systematic management could help discover cerebral palsy in premature infants in time and could improve physical and mental development of these infants.

Objective To discuss the optimal radiation dose in the treatment of the late course accelerated hyperfractionation(LCAH) radiotherapy for esophageal carcinoma by using two different treatment doses,focusing on the difference of the short term results,local control rates,treatment tolerance and long term survival rates between the two groups.Methods One hundred patients with esophageal carcinoma were randomly divided by the envelope method into two groups:the 60Gy group and the 75Gy group.Patients in 60Gy group received conventional fraction radiation for the first 3 weeks,and then hyperfractionation radiation(1.5Gy per fraction,two fractions a day with 6 hour interval,10 fractions per week) to the total dose of 60Gy/35 fractions/5 weeks.The radiation schedule of the 75Gy group was the same as the 60Gy group: conventional fractionation of radiation for the first 3 weeks and then hyperfractionation radiation for the rest 3 weeks to the total dose of 75Gy/45 fractions/6 weeks.Results There was no significant difference between the two groups in short term results.The 1-,3-,5-year local control rates were 86%,42%,32% in 60Gy group and 88%,52%,48% in 75Gy group,respectively.The 1-,3-,5-year survival rates were 86%,40%, 28% in 60Gy group and 72%,34%,16% in 75Gy group,with no significant difference(P= 0.283).The median survival time was 25 months for the 60Gy group and 19 months for the 75Gy group.Patients suffered from heavy radiation-induced esophagitis in the 75Gy group were significantly more than those in the 60Gy group(28% vs 10%,P= 0.022).But it was similar for patients who died of side effects in the two groups.Conclusions It is not suitable to pursue high dose in treating esophageal carcinoma with late course accelerated hyperfractionation radiotherapy as high incidence of side effects are unadvoidable if the dose is increased without changing the radiation fields and techniques.When escalating the dose to the esophagus,the radiated lung volume as well as the other normal tissues should be first subjected to meticulous and careful consideration.

OBJECTIVETo investigate the expression of Tenascin-C mRNA in keloids and hypertrophic Total RNA was isolated from normal adult skin. A cDNA fragment (base 5941-6481bp) of the scars.

METHODSfull-length human Tenascin-C cDNA was synthesized by polymerase chain reaction and subcloned in pGEM-T-easy. Dioxygen-labeled anti-sense and sense probes were synthesized by using a Sp6/T7 RNA synthesis kit in the present of Dig-UTP in vitro. The samples were taken from keloids in 10, hypertrophic scars in 10 and normal adult skin in 5. The hybridization was performed with 4% paraformaldehyde-fixed and wax-embedded sections to detect the Tenascin-C mRNA.

RESULTSThe Tenascin-C mRNA was negative in the normal adult epidermis and weakly located in the fibroblasts of the papillary dermis and the epidermal adnexa. In all of the 10 keloid specimens, the Tenascin-C mRNA was positive throughout the epidermis and widely distributed in the dermis included in the fibroblasts, endothelial cells and epidermal adnexa. In the specimens of the 3 hypertrophic scars,the Tenascin-C mRNA was also positive in the epidermis, but in the other 7 cases, it became negative. In the dermis of the hypertrophic scar,the Tenascin-C mRNA was weaker than that in the keloid, but stronger than that in the normal skin.

CONCLUSIONSThe expression of Tenascin-C mRNA is markedly enhanced in the keloids.

Cicatrix, Hypertrophic ; genetics ; metabolism ; pathology ; Female ; Humans ; Keloid ; genetics ; metabolism ; pathology ; Male ; RNA, Messenger ; metabolism ; Tenascin ; genetics ; metabolism

Objective To study the pattern of lymphatic metastasis in patients with thoracic esopha-geal carcinoma, and to determine the indication and the target volume for post-operative radiotherapy. Meth-ods 229 patients with thoracic esophageal carcinoma who had undergone radical esophagectomy and two-field lymph node dissection were included in this study. The pattern and ratio of lymph node metastasis were analyzed. The effect of the tumor length and pathology stage on lymph node metastasis was studied. Then the indication and target of post-operative radiotherapy for the thoracic esophageal carcinoma was determined. Results Regional lymph node metastasis was found in 57.1% patients with upper thoracic esophageal car-cinoma. For the middle thoracic esophageal carcinoma, the ratio of regional metastasis, skip, upward, down-ward and two-way spread were 39.0%, 19.5% ,5.2% ,28.6% and 7.8% ,respectively. For lower thoracic esophageal carcinoma,downward spread was found in 77.2% patients. For upper thoracie esophageal carci-noma,the proportions of patients with lymph node metastasis were 19.0% ,6.7% ,9.8% and 14.3% in the superior mediastinum, middle mediastinum, inferior mediastinum and abdominal cavity ( x2 = 2.75, P = 0.433). The corresponding figures were 26.1% ,7.4% ,11.8% and 11.9% (x2 = 17.98,P =0.000) for middle thoracic esophageal carcinoma,and 0%, 1.6% ,5.3% and 10.0% (x2= 5.96 ,P = 0. 051 ) for low-er thoracic esophageal carcinoma. The lymph node metastasis ratios were 9.1%, 11.6% and 11.7% in pa-tients with tumor ≤3 cm,3-5 cm and ≥5 cm,respectively (x2 =3.93,P=0. 140), and were much higher in stage Ⅲ disease than those in stage 0 to Ⅱ (19.3% vs4.8% ;x2 =131.06,P=0.000). Conclusions he pattern of lymph node metastasis is complex and extensive in patients with thoracic esophageal carcinoma. For upper and middle thoracic esophageal carcinoma, the extended prophylactic portal is suggested and the superior mediastinum is an important target area. For the lower thoracic esophageal carcinoma,it seems that regional fields could be applied. Post-operative radiotherapy should be performed in stage Ⅲ disease because of the high lymph node metastasis ratio.

ObjectiveTo investigate the long term clinical result of three-dimensional radiotherapy for esophageal carcinoma,discuss the effect of correlative factors to survival and local control.Methods From July 2003 to December 2008,792 patients with esophageal cancer were eligible.Patients were treated with three-dimensional radiotherapy (672 patients) or intensity-modulated (120 patients) radiotherapy.The radiotherapy was delivered in 1.8-2.0 Gy per fraction,5 fractions per week,total dose of 50-70 Gy,(median,60 Gy).142 patients were treated by concurrent radiochemotherapy,and the other 650 patients radiotherapy alone.The local control rate and survival rate were calculated by Kaplan-Meier method.Logrank method was used for univariate analyses.Cox regression model was used for multivariate analyses.ResultsThe follow-up rate was 95.8％.The number of patients with 5 years time followed-up was 133.The 1-year,3-year and 5-year local control rates were 76.6％,53.2％,48.6％,and the 1-year,3-year and 5-year overall survival rates were 70.1％,36.7％ and 28.0％,respectively.There were significant influence on the prognosis of T stage,N stage,TNM stage,tumor volume ( x2 =20.58-55.60,all P =0.000).The Cox multivariate model showed that N stage and tumor volume were independent prognostic factors (x2 =6.35,29.23,P =0.012,0.000).For the two groups of concurrent chemo-radiotherapy and radiotherapy alone,5-year local control rates were 57.0％ and 46.8％ ( x2 =7.34,P =0.007 ),the 5-year overall survival rate 32.8％ and 27.6％ ( x2 =3.42,P =0.064.ConclusionsThree-dimensional radiotherapy is effective for esophageal carcinoma.It might improve the local control rate and overall survival rate to some extent.T staging,N staging,TNM staging and tumor volume were important prognostic factors for long-term survival.The addition of concurrent radiochemotherapy could improve local control rates.

Objective To investigate the regional left ventricular function after mitral valve replacement with and without chordal preservation by strain rate imaging. Methods A total of 55 patients undergoing mitral valve replacement were enrolled. Twenty underwent complete excision of the subvalvular apparatus (group A), 20 preserved the posterior chordopapillary apparatus only (group B) and the other 15 underwent total chordal preservation (group C). Systolic peak strain rate (SRs) were measured preoperatively, at 7-10 days and 3 months after operation. Results Before operation, SRs had no differences between different segments of the left ventricular in each group (F=0.37, 0.74, 0.90, all P>0.05). At 7-10 days after operation, SRs in the most segments of left ventricular were signiifcantly lower than those of before operation (F=3.91, 8.12, 7.57, all P<0.05). At 3 months after operation, SRs in some segments of left ventricular were signiifcantly higher than those of preoperation in each group (t=2.12, 3.19, 3.25, 2.08, 2.78, 4.79, 2.81, 2.58, 2.87, 1.60, 0.34, 1.04, 0.73, 0.70, 1.68, all P<0.05). SRs had no signiifcant differences between each segment of left ventricular in group C (F=1.76, P>0.05). By contrast, SRs in some segments of left ventricular were different from those of other segments in group A and group B (F=17.8, 8.52, both P<0.05). Conclusion Comparing to conventional mitral valve replacement and mitral valve replacement with preservation of posterior subvalvular apparatus, mitral valve replacement with preservation of total subvalvular apparatus makes the papiltary function preserved completely, which are beneifcial for the motor coordination of left ventricular wall and the recovery of regional left ventricular function.

OBJECTIVETo investigate the expression of tenascin-C (Tn-C) in keloid and hyperplastic scar (HS).

METHODSTissue samples were harvested from 10 patients with keloid and 10 with HS (6 - 10 months) and from the skin of 5 adult healthy volunteers. The expression of Tn-C in these samples was determined with immunohistochemistry method.

RESULTSThere was scarce expression of Tn-C in the skin tissue in adult healthy volunteers, and it was only present in the dermal papillae at the dermis epidermis conjunctions and partly in the blood vessels and skin appendages adjacent to the basement membrane. There was enhanced expression of Tn-C in the dermal scar tissue and skin appendages in both keloid and HS, especially in keloid, which exhibited a diffused pattern in the tissue. When compared with that in normal skin, the Tn-C expression in the normal skin adjacent to the keloid was enhanced markedly, but not in the normal skin near HS tissue.

CONCLUSIONThere was increased Tn-C expression in keloid and HS (6 - 10 months).

Cicatrix, Hypertrophic ; metabolism ; Female ; Humans ; Immunohistochemistry ; Keloid ; metabolism ; Male ; Skin ; chemistry ; Tenascin ; analysis