[Objective]To explore the technique of arthroscopy plus radiotherapy in the treatment of pigmented villonodular synovitis of the knee and to evaluate its clinical value.[Method]A total of 14 cases of pigmented villonodular synovitis of the knee were treated from January 2000 to July 2003.Intra-articular excision under arthroscope with a combined application of routine intrusments and Bipolar radiofrequency was performed on all these 14 cases,and postoperative radiotherapy for diffused pigmented villonodular synovitis of the knee,13 patients were followed up for 10~45 months,and were evaluated for range of motion,pain,swelling effusion.[Result]Thirteen cases according to the International Knee Documentation Committee(IKDC)criteria,subjective knee score was (58.7+6.4) and (86.5 ?5.7) respectively before surgery and at the last follow-up.[Conclusion]In case of pigmented villonodular synovitis of the knee joint,arthroscopical synovectomy can make good surgical results,and postoperative radiotherapy is an effective treatment for diffused pigmented vilionoclular synovitis of the knee.

Overweight and obesity are main risk factors for chronic metabolic diseases, and are strongly associated with the increased risk of premature death. Low carbohydrate diet (LCD) has been proven to effectively control body weight and fat mass in overweight and obese patients by short-term (≤6 months) dietary intervention studies. The mechanisms include regulation of energy metabolism, anti-inflammatory, antioxidant, alteration in expression of lipid metabolic-related genes and modulation of intestinal flora. However, the conclusions are inconsistent on whether LCD can cause durable weight loss and reduce the risk of overweight and obesity. This review summarizes the current research progress on the mechanisms, epidemiological studies, intervention studies and potential risks of LCD in controlling overweight and obesity, providing a reference for the future research and clinical application.

Objective:To evaluate effect of different induction chemotherapy on the clinical efficacy of concurrent intensity-modulated radiotherapy (IMRT) and chemotherapy and identify the prognostic factors in non-endemic locally-advanced nasopharyngeal carcinoma patients.Methods:Clinical data of 210 patients with stage Ⅲ-Ⅳ B(excluding stage T 3-4N 0M 0) nasopharyngeal carcinoma treated in our hospital from 2012 to 2017 were retrospectively analyzed. According to the efficacy of different induction chemotherapy, all patients were divided into the effective group (14 cases of complete remission and 165 cases of partial remission) and ineffective group (31 cases of stability and 0 case of progression). Survival analysis was performed by Kaplan- Meier method. Multivariate analysis was conducted by using Cox′s regression model. Results:Compared with the ineffective group, the 3-year overall survival (OS)(89.2% vs. 74.2%, P=0.005), recurrence-free survival (RFS)(93.0% vs. 81.9%, P=0.010) and progression-free survival (PFS)(80.2% vs. 58.1%, P=0.005) were significantly higher in the effective group, whereas the distant metastasis-free survival did not significantly differ between two groups (84.1% vs.69.7%, P=0.070). Multivariate analysis showed that the tumor response to induction chemotherapy was an independent prognostic factor for OS, RFS and PFS. Conclusions:Tumor response to induction chemotherapy might be a prognostic factor for non-endemic locally-advanced nasopharyngeal carcinoma patients. Clinical prognosis of patients with poor response to induction chemotherapy is even worse. More intensive treatment and closer follow-up may be needed for these patients.

Objective To investigate the mechanism of the radiosensitivity effect of Cox-2 gene in esophageal cancer.Methods Cox-2 specific siRNA was constructed and transfected to EC9706 cells to downregulate intracellular Cox-2 expression.The expressions of MMP-2,Bcl-2 mRNA,AKT and phosphorylated AKT proteins were assayed after radiation.Colony formation,cell proliferation,apoptosis and cell invasion in vitro were examined as well.One-way ANOVA method was used to analyze the data.Results Affter 2 and 4 Gy irradiation,a significant increase in the mRNA expression of Bcl-2 was observed in the Cox-2 up-regulation group (F =3.36,4.32,P ＜ 0.05).In the group of Cox-2 downregulation,the expression of MMP-2 mRNA was significantly reduced(F =3.86,8.09,P ＜ 0.05).Affter irradiation,a significant decreaseof Bcl-2 mRNA (F =3.73,5.64,P ＜ 0.05) as well as an increase of Bax(F =7.03,7.42,P ＜ 0.05) was detected,and the levels of total and phosphorylated AKT proteins had the highest level in the Cox-2 upregulation group and had the lowest level in the Cox-2 downregulation group.In the Cox-2 downregulation group,the apoptosis induction obviously increased with dose (F =317.40,P ＜ 0.05),and the proportion of cells in Go-G1 phase gradually increased but the proportion of cells in S and G2-M phases decreased,concomitant with the obvious suppression of cell proliferation,in addition,cell invasion was decreased.Conclusions Downregulation of intracellular Cox-2 mRNA expression,concomitant with subsequent downregulation of MMP-2 and Bcl-2 and upregulation of Bax,resulted in reduction of the invasion and metastatic capabilities of tumor cells,and induction of Go-G1 phase arrest and apoptosis.Downregulation of AKT and phosphorylated AKT (pAKT) protein expression might also interfere with the capability of the PI3K/Akt signal transduction pathway to resist radiotherapy.

Objective To research the influence of docetaxel on radiosensitivity in papillary thyroid carcinoma TPC-1 cells.Methods 6 MV X-ray irradiation and deocetaxel were incubated separately or jointly with TPC-1 cells.Proliferation inhibition of docetaxel on TPC-1 cells was detected by CCK-8 method.Radiosensitization of docetaxel was measured by clone formation assay.Flow cytometry (FCM) was employed to analyze cell apoptosis and cycle progression.Western blot assay was applied to examine the expressions of Bax and Bcl-2 proteins.Results The proliferation inhibition effect depended on the concentration and treatment time of docetaxel with IC50 value of 6.06 (24 h),1.39 (48 h),and 0.09 μg/ml (72 h),respectively.The value of SF2,D0,Dq in the radiation treatment group combined with docetaxel were obviously lower than those in the radiation alone group.The SER of docetaxel was 1.53.Following treatment with 0.05 μg/ml docetaxel combined with radiation for 24,48,72 h,the ratios of apoptosis in TPC-1 cells were 31.67％,44.57％,70.20％,which were higher than that of radiation alone group(t =-146.56,-15.13,-19.15,P ＜ 0.05).FCM measurement showed that cell cycle arrest in G2/M phase in the cells treated with docetaxel and radiation was much more obvious than the group of radiation alone (t =-79.17,P ＜ 0.05).In addition,in the combination treatment group,the expression of Bax increased (t =93.56,P ＜ 0.05) while the expression of Bcl-2 decreased (t =41.02,P ＜ 0.05).Conclusions Docetaxel can enhance the radiosensitivity of TPC-1 cells by promoting cell cycle arrest,induction of apoptosis and formation of associated proteins Bax/Bcl-2.

Objective To investigate the value of computed tomography (CT)-magnetic resonance imaging (MRI) image fusion in target volume delineation of postoperative precise radiotherapy for gliomas.Methods Thirty-six patients newly diagnosed with gliomas were enrolled and received postoperative intensity-modulated radiotherapy.Landmark (L) combined with manual fusion (M) and maximization of mutual information (MI) was used for image fusion.Target volume and organs at risk were delineated based on CT images and fused images,respectively.Comparison of the volume was made by pairwise t test.The distance from a landmark on CT image to the corresponding one on MRI image was calculated.The volume method and geometric center method were used to calculate the degree of volume overlap and changes in central positions after image fusion.Results The L+M+MI method achieved a high registration accuracy in image fusion,with a registration error less than 2 mm.In patients with grade Ⅲ-V gliomas,the CT images yielded significantly smaller gross tumor volume (GTV) and clinical target volume (CTV) than the MRI images (74.62±46.91 vs.105.99±58.86 cm3,P=O.042;304.03± 130.05 vs.387.94± 150.12 cm3,P=0.040).After image fusion,the smallest change in central position occurred in the chiasma (1.32± 1.42 mm),and the largest change occurred in CTV (7.99± 11.06 mm),followed by GTV and the brain stem.Conclusions CT-MRI image fusion helps to reduce the uncertainty of target volume delineation in patients with gliomas,especially in those with edema and residual tumor after surgery.

Objective To establish a simple ,low cost and stable method to detect right ventricular pressure in mice .Methods A PE-50 duct length 15 cm(outside diameter :0 .9 mm ,inner diameter :0 .5 mm) was bent on one terminal and the other terminal was inserted into a 7# syringe needle to connect to a pressure transducer .This duct was intubated into right ventricle via right external jugular vein to detect right ventricular pressure in 80 SPF grade male C57BL/6 mice .Successful cases and operation time were re-corded .Besides ,40 SPF grade male C57BL/6 mice were randomized into the control group (n=20) and chronic hyperbaric hypoxia group(n= 20) .Mice in chronic hyperbaric group were raised in a hyperbaric chamber of simulated 5 000 m high altitude for 4 weeks .The control group was raised outside the chamber simultaneously .Right ventricular systolic pressure was detected with the PE duct .Left and right ventricles were detached and weighed ,and Hermann-Willson index was calculated .Results With this PE duct ,right ventricular intubation success rate was 90% (72/80) ,the operation cost approximately 3 to 5 min each mouse from the separation of blood vessels to detect the time needed for the right ventricle waveform .right ventricular systolic pressure[(39 .52 ± 4 .34 )mm Hg] and Hermann-Willson index(0 .356 ± 0 .039)of chronic hyperbaric hypoxia group were significantly higher than that of control group [(21 .24 ± 2 .7)mm Hg and (0 .256 ± 0 .020)] ,which has significant positive correlation (P<0 .01) .Conclusion It is simple ,fast ,stable ,costing low and of high success ratio to detect right ventricular pressure with this method .

Objective To investigate the clinical values of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET-CT) and magnetic resonance imaging (MRI) in precise radiotherapy after surgery in patients with oropharyngeal squamous cell carcinoma.Methods A total of 53 patients with oropharyngeal squamous cell carcinoma were enrolled and underwent PET-CT and MRI imaging within two weeks after surgery.The detection rates of residual lesions and lymph node metastases after surgery by PET-CT and MRI were compared on the basis of the pathological results of biopsy.The gross tumor volume (GTV) and clinical target volume (CTV) determined by PET-CT and MRI were compared;the normally distributed data were analyzed using the t test, and the skewed distribution data by the Wilcoxon rank sum test.The sensitivity, specificity, accuracy, positive predictive value and negative predictive value in predicting precise radiotherapy after surgery, as determined by PET-CT and MRI, were compared with the chi-square test.Results Fourteen patients had residual lesions after surgery.The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET-CT in detecting residual lesions after surgery were significantly higher than those of MRI (92.86%, 94.87%, 86.67%, 97.37%, and 94.34% vs.57.14%, 76.92%, 47.06%, 83.34%, and 71.70%, all P<0.05);the specificity, positive predictive value, and accuracy of PET-CT in detecting lymph node metastases were also significantly higher than those of MRI (all P<0.05), except for the sensitivity and negative predictive value (P>0.05).For the 14 patients with residual lesions, GTVPET/CT was significantly smaller than GTVMRI(45.62±22.13 cm3 vs.60.61±23.12 cm3, P=0.034), so did CTV (125.54±17.53 cm3 vs.142.18±21.22 cm3, P=0.011).There was no significant difference between CTVPET-CT and CTVMRI in 39 patients without residual lesions after surgery (117.87±17.66 cm3 vs.128.05±20.65, P=0.099).Conclusions PET-CT is superior to MRI in detecting the residual lesions and lymph node metastases after surgery in patients with oropharyngeal squamous cell carcinoma, which provides valuable information for radiotherapy planning.

Objective:To observe the effect of herbal-partitioned moxibustion (HPM) on pain-related behavior and emotion in a rat model of chronic inflammatory visceral pain, and to investigate the mechanism.
Methods:Twenty-four male Sprague-Dawley (SD) rats were randomly divided into three groups:a normal group, a model group and an HPM group. Except for the normal group, rats in the other two groups were clystered with mixed liquor of Trinitrobenzene Sulfonic Acid (TNBS) and 50%ethanol to induce the chronic inflammatory visceral pain model. After the models were established successfully, rats in the HPM group were treated with HPM at bilateral Tianshu (ST 25) and Qihai (CV 6). Rats in the normal group and the model group were only fixed as those in the HPM group without treatment. Abdominal withdrawal reflex (AWR) score, mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were adopted to detect the visceral and somatic pain;meanwhile, open field test (OFT) and elevated plus maze test (EPMT) were employed to evaluate pain emotions such as depression and anxiety.
Results:Compared with the normal group, AWR scores of the model group were significantly increased under different stimulus expansion pressure level (P<0.01), MWT and TWL were significantly decreased (P<0.05);in OFT, the values of horizontal activities and vertical activities were significantly decreased (P<0.01);in EPMT, the proportion of the number of entry into the open arms (OE%) and that of residence time in the open arms (OT%) significantly decreased (P<0.01), indicating that the model was successful. Compared with the model group, the AWR score of the HPM group was decreased significantly (P<0.05), MWT and TWL were significantly increased (P<0.05), the values of horizontal activities and vertical activities in the model group were significantly increased (P<0.01);in OFT and EPMT, OE%and OT%were significantly increased (P<0.01).
Conclusion:HPM has analgesic effect on chronic inflammatory visceral pain. It can reduce the visceral and somatic pain in rats and markedly improve the emotions such as anxiety and depression induced by chronic visceral pain.

Endoplasmic reticulum plays a key role in both basic structure formation and function performance of microenviron-ment. Endoplasmic reticulum homeostasis unbalance caused by endoplasmic reticulum stress has become a hot research topic in recent years. This paper focuses on the role of endoplasmic retic-ulum stress in ischemic stroke. Research progress of related sig-naling pathways were reviewed, especially mechanisms through which endoplasmic reticulum stress trigger the inflammatory reac-tion, so as to provide a new research method for prevention of is-chemic stroke.