Radiomics utilizes the high-throughput extraction of large amounts of quantitative features from radiographic images,giving a comprehensive quantification of tumor phenotype.Thus it can provide complementary and interchangeable information for clinical usage,such as differentiating malignant nodules from benign ones,predicting response to treatment,identifying lymph node metastasis,improving individualized treatment selection and monitoring.The advantages of radiomics give it great potential in precise treatment.But much work needs to be done before it could be used in practice.It is imperative that a standard research procedure is needed to verify its reliability and clinical value via multi-central prospective clinical trials.

Objective To investigate the effect of various concentration of inhaled oxygen during exercise on reactive oxygen species (ROS) production in chronic obstructive pulmonary disease (COPD) rats and the possible mechanism. Methods Eighty COPD Wistar rats were divided into low oxygen (LO, n=20), normal oxygen (NO, n=20) and inhaled oxygen (IO, n=20) exercising groups, which ran on tread-mill in the conditions of 13.6%, 21%, 25%oxygen, respectively, and non-exercising normal oxygen group (C, n=20), which stood on still treadmill in the condition of 21%oxygen. Their apoptosis percentage of neutrophils and ROS content were measured with flow cytometry, glutathione (GSH) in lung with immunohistochemistry and cytochrome C oxidase IV (COXIV) in skeletal muscle with Western blotting, as one and four weeks of exercising. Results For one week of exercise, the ROS was more in LO and NO groups than in C group (P<0.05), while the neutrophils apoptosis percentage was less (P<0.05);and there was no difference among C, LO, NO, IO groups in expression of GSH and COXIV (P>0.05). For four weeks of exercise, the ROS was more in LO group but less in NO and IO groups than in C group (P<0.05);while the expression of GSH and COXIV increased in NO and IO groups compared with those in C group (P<0.05). Conclusion A long term exercise in non-hypoxic state may inhibit ROS production for COPD patients, by promoting neutrophils apoptosis and antioxidant expression.

Background and purpose: The prognosis of completely resected stage ⅢA(N2) non-small cell lung cancer (NSCLC) remains a significant concern. The 5-year overall survival (OS) rates range from 10% to 30%. This study aimed to analyze the patterns of first failure in completely resected stage ⅢA(N2) NSCLC and to assess the actuarial risk of developing metastasis at different sites and to guild standard clinical practice. Methods: Patients withⅢA(N2) NSCLC who had undergone radical surgery in our hospital from Jan. 2005 to Jul. 2012 were retrospectively reviewed. The progression-free survival (PFS), the OS, patterns of first failure, the actuarial risk were analyzed. The cumulative incidence of first failure was determined using the Kaplan-Meier analysis. Results: Among 357 patients who met the eligibility criteria with completely resected stage ⅢA(N2) NSCLC, 5-year OS was 36.9%. There were 284 (77.6%) patients experiencing disease failure: 61 with local failure, 197 with local and distant failures, and 26 patients with local recurrence as the first failure. Brain, bone and lung were the main sites of distant failure as the first failure, while brain was the most common site. There were 67 patients developing brain metastases (BM) as the first site of failure. The median time of local failure as the first site of failure was 13.6 months, and the time to develop distant recurrence was 15.1 months. 92.5% BM developed in 3 years after the complete resection. Conclusion: As the first failure, the rate of distant failure was much higher than that of local failure in completely resected stage ⅢA(N2) NSCLC. Brain was the most common site of distant failure as the first failure. These results can be helpful in guiding standard clinical practice and evaluating the outcome of comprehensive treatment.

Objective To investigate the influence of ursolic acid on vascular endothelial growth factor ( VEGF) , cycloxygen-ase-2 (COX-2), and matrix metalloproteinases-2 (MMP-2) expressed in the mouse retinal ischemic model , and to explore the mecha-nisms of anti-angiogenesis.Methods Sixty 7-day clean-class C57BL/6J mice were divided randomly into 6 groups [ n =10 mice (20 eyes) per group]:blank control, model control (PBS), positive control (triamcinolone), and ursolic acid (UA) intervention (low-dose, medium-dose, and high-dose).Mice in the blank control group were raised in air , and mice in other groups in(75%±2%)O2 high-oxygen environment for 5 consecutive days .Mice in the model control group and breastfeeding mice were put back in air environ-ment (21%O2 ) on the 12th day after the new-born mice to induce the generation of retinal neovascularization .When models were suc-cessful, the drug treatments were applied immediately to the corresponding groups , with injection of 3μl of sterile PBS in model control group, 3 μl of 1.5, 3.00 and 6.0 μg UA in UA intervention group, and 3 μl of triamcinolone (1 ml∶40 mg) in positive control group, respectively.All mice were killed after overdose anesthesia on the 17th day.Their eyeballs were made into samples and retinal tissue pathological sections with H-E dying method.The positive expressions of VEGF , COX-2, and MMP-2 were detected with immu-nohistochemical method .The fresh retinal tissue homogenate was prepared to detect the protein expressions of VEGF , COX-2, and MMP-2 in retinal tissue with western blot method ,and mRNA expressions of VEGF , COX-2, and MMP-2 were detected with real-time fluorescent quantitative polymerase chain reaction ( RT-PCR) .Results According to protein and mRNA expressions of VEGF , COX-2,and MMP-2 in retinal tissue among six groups , protein expressions of VEGF , COX-2, and MMP-2 in model group were significantly higher than those in blank group ( P <0.05 ) .Each protein expression in the high UA intervention group was significantly lower than that in the model group ( P <0.05 ) .Each protein expression in the high UA intervention group was not significantly different from that in the positive group ( P >0.05 ) .Each protein expression in the high UA intervention group was significantly lower than that in the low UA intervention group( P <0.05).Conclusions UA inhibited expressions of VEGF, COX-2, and MMP-2 in retinal ischemia model .UA also played an inhibitory role in the formation of neovascularization , and this role was positively correlated with UA dose .

Objective To investigate the efficacy and safety of using stereotactic radiotherapy (SRT) technique for conducting re-therapy after thoracic tumor radiotherapy.Methods Thirty-eight patientswith SRT after receiving thoracic conventional radiotherapy (RT) in our hospital from July 2012 to November 2014 were selected.The treatment target area included the lung local primary lesion,recurrent lesions and lung metastasis tumor.Results Median dose of previous RT was 48 Gy (30-56 Gy).Median biologically equivalent effective dose (alpha/beta=10.0,BED10) of receiving SRT was 62 Gy (39-72 Gy).Median follow up time was 12.30 months;1-,2-year local progression-free survival (LPFS) was 76.32％ and 63.16 ％ respectively.Median recurrence-free (RFS) and overall survival (OS) were 13.20 months and 21.00 months respectively.Grade 2 and 3 pulmonary toxicity was 15.79 ％ and 7.89 ％ respectively.Other grade 2-4 toxicities adverse reactions included chest pain (15.79 ％),fatigue (18.42 ％) and skin lesion(2.63％).No grade 5 toxic injury occurred.Conclusion SRT can be safely and effectively used in the patients previously receiving thoracic RT.

Background and purpose:Radiotherapy (RT) is one of the most important therapeutic tools for esophageal cancer. Because tumors are heterogeneous, including for18F-FDG uptake and, most likely, for radioresistance, selective boosting of high FDG uptake zones within the tumor has been suggested. Therefore, it is critical to know whether the location of these high FDG uptake patterns within the tumor remains stable during RT.Methods:Twenty-two patients with esophageal squamous cell carcinoma treated with concurrent chemo-radiation underwent repeated18F-FDG PET-CT scans before RT and after 20 fractions of RT. On all scans, the high and low FDG uptake regions were auto-delineated using several standard uptake value (SUV) thresholds, varying from 40% to 70% of SUVmax on the pretreatment scan [gross tumor volume (GTV)40%pre, GTV50%pre, GTV60%pre, GTV70%pre] and from 70% to 90% of SUVmax on the dur-treatment scan (GTV70%dur, GTV80%dur, GTV90%dur) and ifxed thresholds of 2.5 and 5 (GTV2.5pre, GTV5pre). The volumes and overlap fractions (OF) of these delineations were calculated to demonstrate the stability of the high FDG uptake regions during RT.Results:The high uptake regions within the tumor during RT largely corresponded (OF>70%) with the 50% SUVmax high FDG uptake area (GTV50%pre) of the pretreatment scan. The hotspot within the residual area (GTV90%dur) was completely within the GTV and pre-radiotherapy high uptake regions (OF=100%). Although the location of the high FDG uptake patterns within the tumor during RT remained stable, the delineated volumes varied markedly.Conclusion:The location of the high FDG uptake areas within the tumor remained stable during RT. This knowledge may enable selective boosting of high FDG uptake areas within the tumor.

Objective To evaluate desmopressin stimulated inferior petrosal sinus sampling in diagnosing Cushing′s disease.Methods Sixteen ACTH-dependent Cushing′s disease patients underwent bilateral desmopressin stimulated inferior petrosal sinus ( IPS ) sampling because of negative or equivocal magnetic resonance imaging.Cortisol response to high-dose dexamethasone suppression test was also evaluated.ACTH sampling was taken from a peripheral vein and bilateral IPS before and both 5 and 10 min after injection of desmopressin.Diagnosis was based on the ratio of ACTH level in between IPS to peripheral vein by desmopressin test.Diagnosis was confirmed after surgery.Results High-dose dexamethasone suppression test showed suppressible in 9 of 16 patients with Cushing′s disease.An IPS gradient ＞2 was found in 14 of the 16 cases (87.5％ )with Cushing′s disease after desmopressin injection,while before injection the respective figure was 12 of 16 (75.0％).No severe adverse effects were observed during or after the procedure.Conclusion Desmopressin test during bilateral IPS sampling is a safe and effective diagnostic procedure in Cushing′s disease.

Objective To explore the success rate and the risk of establishment of the acute myocardial infarction model between the beagle dogs and the mini-pigs by interventional technique ,further to provid theoretical basis for choose a more suitable animal model .Methods 6 dogs and 6 mini-pigs were anaesthetized ,then underwent the coronary arteriography via femoral artery .After is-chemic preconditioning the coronary balloon was inflated to occlude the middle left anterior descending coronary for 180 minutes . The electrocardiogram was examined throughout the operation and the pathological sections were examined until the animals were executed one week later .Results All beagle dogs survived ,while 1 case of mini-pigs dead(1/6) .There was 1 cases(1/6) of beagle dogs had acute myocardial infarction ,while 5(5/6)cases in mini-pigs .All mini-pigs had malignant arrhythmia(6/6) but never seen in beagle dogs .The time needed for building a model was similar between the two groups ,the difference had no statistical signifi-cance(P>0 .05) .Conclusion The risk of establish myocardial infarction model in mini-pigs is higher than beagle dogs ,but the suc-cess rate is still high ,it might be the better choice .

Objective To explore the appropriate treatment according to the grading system of adolescent idiopathic cervical kyphosis.Methods A retrospective study was performed in 115 adolescent patients with idiopathic cervical kyphosis.The patients were divided into 4 groups according to the magnitude of kyphosis.The initial Cobb angle of 4 groups were 12.7°±1.4° 25.4°±4.8°,47.2°±4.4° and 62.6°±5.7° respectively.The patients in group I were treated with the collar support for 4-8 weeks.The patients in group Ⅱ were treated with skull traction (3-5 kg) and then fixed by cranio-cervical-thoracic plaster.According to the angles between the tangents of posterior vertebral body at each level on lateral cervical radiograph in extension,the anterior fusion levels of the group Ⅲ and angles and range of osteotomy in the group Ⅳ were decided.In group Ⅳ,the patients were treated by two steps.The anterior release and posterior osteotomy were performed firstly.Then skull traction (1/10 body weight) was maintained in order to correct the deformity for 7-10 days,fusion and anterior fusion with autologous bone graft and internal fixation was completed.Results Post-operative radiograph showed that Cobb angle were -5.5°±2.0°,-8.2°±6.1°,-4.5°±6.6° and -2.9°±7.9° in Ⅰ-Ⅳ group after treatment.The deformed appearance of the patients improved significantly.A improvement neck pain and neurologic function were found in all patients.Post-operative MRI showed that physiological curve of the cervical spine was restored,and the cerebrospinal fluid line was clear in the previous kyphosis area.Conclusion Adolescent idiopathic cervical kyphosis has specific characteristics.Surgical strategy is determined by the severity of deformity.

This article was aimed to investigate the effect of theXin-Jiang-Tang(XJT) Granules on activity of hepatic glycometabolic key enzymes and liver function in streptozotocin (STZ)-induced type 2 diabetes mellitus (T2DM) rats. Fifty male SD rats were randomly divided into the normal control group with 8 rats fed with normal diet, and other rats in the model group fed with high-fat diet for 4 weeks. And then, STZ (40 mg·kg-1) was peritoneally injected once to induce T2DM rat model. The model rats were randomly divided into the T2DM model group, metformin (0.15 g·kg-1) group, and high-dose (12.64 g·kg-1) and low-dose (6.32 g·kg-1) XJT Granules group. The intragastric administration was given once a day for 8 weeks. After 8-week intervention, fasting blood glucose (FBG), fasting serum insulin (FINS), glycosylated hemoglobin (HbA1c), hepatic glycogen, serum ALT, AST, ALP,γ-GT and the activity of HK, PFK, PK, and G6PDH were detected. The results showed that comparing with the model group, XJT Granules group can obvious reduce FBG, FINS, HOME-IR, HbA1c and liver function indexes such as ALT, AST, ALP,γ-GT levels (P < 0.05,P < 0.01), increase the content of hepatic glycogen (P < 0.01), and the activity of HK, PFK, PK and G6PDH (P < 0.05,P < 0.01). It was conclude that XJT Granules can remarkably regulate glycometabolism of diabetic model rats and the regulatory mechanism may be associated with the increasing of HK, PFK, PK and G6PDH activity, promoting the synthesis of hepatic glycogen, improving liver function, downregulating FINS level, improving insulin resistance and eventually decreasing the level of FBG and HbA1c of T2DM rats.