Stereotactic body radiation therapy ( SBRT ) for locally advanced pancreatic cancer ( LAPC) shows good signs of efficacy as measured by local control,which can also reduce toxicity. The dose fractionation in foreign countries have changed from conventional fractionation to single fraction and finally moderate hypofractionation. It is similar to that in China, with the dose fractionation changing from conventional fractionation to moderate hypofractionation. This review introduces the latest research results of dose fractionation of SBRT for LAPC.

Objective To observe the effects of constant magnetic fields (CMF) on angiotensinⅡ (AngⅡ)-stimulated proliferation of human umbilical arterial vascular smooth muscle cells (VSMC). Methods The experimental proliferation models of cultured human umbilical arterial VSMC stimulated with AngⅡ was establishea. The VSMC were cultured under 1 and 5 mT CMF for 48 hrs. Proliferation of the VSMC was detected by MTT and 3H-TdR incorporation method (A-value and cpm-value), and cell cycle was analyzed by flow cytometry. Results The CMF of 1 and 5 mT may antagonize proliferation of VSMC stimulated with AngⅡ, and hold-back VSMC from static phase (G 0/G 1)to DNA synthetic (S) and mitotic phase (G 2/M). Conclusion The study demonstrates that CMF of 1 and 5 mT can significantly inhibit the human VSMC proliferation.

OBJECTIVE:To investigate clinical efficacy and safety of Rosuvastatin calcium tablets combined with Qishen yiqi dripping pills in the treatment of chronic heart failure (CHF) and it effects on inflammatory level,oxidative stress injury and cardiac function of patients.METHODS:Ninety CHF patients in our hospital during Aug.2014-Apr.2016 were divided into observation group and control group according to random number table,with 45 cases in each group.Control group received routine anti-heart failure treatment as cardiac,diuretic,dilating vessel,and Qishen yiqi dripping pills orally 0.5 g,half an hour after meal,tid;observation group was additionally given Rosuvastatin calcium tablet orally 20 mg,at bedtime,qd,on the basis of control group.Cardiac function,serum inflammatory factor,BNP and oxidative stress levels were compared between 2 groups before and after treatment.Clinical efficacies and the occurrence of ADR were observed in 2 groups.RESULTS:Before treatment,there was no statistical significance in LVEF,LVESD,LVEDD,TNF-α,IL-6,BNP,SOD,MPO and MMP-9 levels between 2 groups (P＞0.05).After treatment,LVEF of 2 groups were increased significantly,while LVEDD,LVESD,TNF-α and IL-6,BNP levels were decreased significantly;the above indexes of observation group was significantly better than those of control group,with statistical significance (P＜0.05).MPO and MMP-9 of observation group were significantly decreased,while SOD level was significantly increased and better than that of control group,with statistical significance (P＜0.05),but there was no statistical significance in SOD and MPO,MMP-9 levels of control group before and after treatment (P＞0.05).The clinical response rate of observation group was 97.8％,which was significantly higher than 82.2％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Rosuvastatin calcium tablets combined with Qishen yiqi dripping pills show significant therapeutic efficacy for CHF,can effectively reduce inflammatory level,relieve oxidant stress injury,delay the process of ventricular remodeling,and improve cardiac function with good safety.

Aim To investigate the changes of phosphodiesterase4(PDE4,type 4 cAMP-specific PDE) activity,TNF-? and neutrophil recruitment in experimental rat lung injury(ALI).Methods ALI in the rat was induced by lipopolysacdharide(LPS).PDE4 activity was measured with HPLC,and the level of TNF-? was detected with ELISA,neutrophil infiltration in bronchoalveolar lavage fluid(BALF) and lung tissues was detected by cell count and morphological analysis.Result Lung tissue PDE4 activity significantly increased as early as 1 h,peaked 6 h,and then markedly lowered at 24 h after intratracheal administration of LPS,while there was a same time-course change of total white cell and neutrophil in the BALF(r=0.83,P

Objective To analyze the outcome of applying venous flow-through flap in replantation of complex severed finger.Methods From March,2011 to August,2012,15 cases of complex severed fingers were repaired by flow-through flap with two sets of venous system of forearm vein and one stage repair of wound.The time from injury to operation was 1.5-5.5 h (mean 2.5 h).Vascular defect length ranged from 1.5 to 11.0 cm (mean 3.6 cm);and soft tissue defect of 1.5 cm × 3.0 cm to 11.0 cm × 11.0 cm.All digits had severe soft tissue defect and segmental defect of blood vessels.All the finger blood circulation was disorder.Results All flaps and replanted fingers survived completely,except 1 case of postoperative venous crisis occurred which was remission after the vascular transplantation,and 1 case of skin flap necrosis at the distal part which was healed after skin grafting; Fourteen cases were followed-up from 7 to 20 months.At the final followed-up the flaps were of good consistency and appearance.Function of the finger was graded excellent in 7 cases,good in 5 cases,and poor in 2 cases.All flaps and replanted fingers survived completely over a period of 12 to 30 months follow-up.The flaps were of good consistency and appearance.Function of the finger was graded excellent in 7 cases and good in 5 cases.Conclusion With less injury at donor site,and good repair results,venous flow-through flap is well indicated in complex finger replantation with soft tissue defect and vascule defect.

AIM: To examine the effects of hydrogen peroxide on intracellular free calcium concentration([Ca~(2+)]i) in cardiomyocytes and its antagonism by taurine. METHODS: A cell culture model of neonatal rat cardiac myocytes was used. There were four groups, control group, hydrogen peroxide (H_2O_2) group, H_2O_2+taurine (simultaneously) group,and H_2O_2+taurine (in sequence) group. Confocal microscope was used with Fluo-3/AM as calcium indicator to detect changes of [Ca~(2+)]i immediately and 15 minutes after H_2O_2 intervention, respectively. RESULTS:The intracellular fluoresence intensity of singular cardiomyocyte in H_2O_2 group was significantly higher than the control group 15 minutes after intervention (P

Objective To evaluate the safety and efficacy of the CT-guided percutaneous cryoablation of osteoid osteoma in children.Methods Nine children with osteoid osteoma proved by histopathology were treated with CT-guided cryoablation from January 2007 to January 2010.There were 6 boys and 3 girls.Their mean age was ( 13.0 + 1.6 ) years ( ranging from 10.0-15.0 years ).The procedures were performed under local anesthesia.Eight G bone biopsy needles for biopsy and 17 G freezing needles were used in the procedure.CT guidance was used for procedural planning,instrument guidance,and monitoring.Each cryoablation included two freezing-thawing cycles.Follow-up was performed to assess technical and clinical outcome.A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure,and mean VAS for the group was compared pre- and post-procedure with Kruskal-Wallis rank sum test.Results Biopsy and cryoablation were successfully performed in all children.No major immediate or postponed complications were observed.Significant pain relief ( P ＜ 0.01 ) was observed in all patients after procedure.The VAS of preoperation(8 points 1 case,7 points 3 cases,6 points 4 cases,5 points 1 case) compared with that of one month after operation ( 1 point 4 cases,0 point 5 cases),the difference was statistically significant( H =32.838,P ＜ 0.01 ).These patients were allowed to fully weight-bear and function without limitation 3 days after the procedure.Pain was obviously released.Pain recurrence was not observed in all patients.Moderate fever (37.8 ℃ ) was observed in a patient one day after operation and fully recovered 2 days later.Conclusion CT-guided percutaneous cryoablation is a safe and effective minimally invasive method for the treatment of osteoid osteoma in children.

ObjectiveTo investigate the technique,safety and clinical value of CT-guided percutaneous interstitial brachytherapy for metastatic carcinoma of lymph nodes in mediastinum.Methods Eight patients with metastatic carcinoma of lymph nodes in mediastinum were treated by CT-guided interstitial implant of radioactive seeds in our department.Anterior approach were performed on all cases,125I radioactive seeds were implanted by setting CT Gantry at an oblique angle,three-dimensional reconstruction with SCT and separation the narrow gap between aortic arch and superior vena cava with fiatscalp core.Dose distributions were checked by TPS after operation.The improvement in clinical symptoms and lymph node sizes were documented in order to investigate the therapeutic effects.ResultsThe particle coverage rate was 93.5％ ± 1.5％.According to the CT scans two months later,3 patients ( 37.5％ ) had complete ablation,4 (50％) partial ablation,and 1 ( 12.5％ ) stable disease.Overall response rate (CR + PR) for this group of patients was 87.5％.The symptoms of all patients including shortness of breath (5 patients),cough (4 patients),dysphagia (4 patients) showed varying degree of improvement.No edema of head-and-neck and upper extremity was observed.There was no major vascular,tracheal and esophageal injury.A small amount of pneumothorax was observed in one patient.ConclusionsCT-guided percutaneous interstitial brachytherapy,a minimally invasive procedure associated with favorable therapeutic results,is a promising technique for treatment of metastatic carcinoma of lymph nodes with local pressure symptoms which may not respond to conventional therapy.

Objective To explore the identification of the hypoxia regions within the primary foci and imaging time selection in 18F-fluoromisonidazole (FMISO) imaging on patients with nasopharyngeal carcinoma (NPC).Methods From July 2013 to July 2014,44 NPC patients (33 males,11 females,age range:18-74(53.45± 12.88) years) underwent 18 F-FMISO PET/CT imaging,including 3 cases with twice imaging (totally 47 case times).Inaging data were acquired and reconstructed 2 and 4 h after the injection of 18 F-FMISO.1s F-FMISO PET/CT images were merged with MRI images obtained 1 week before to construct fusion images.The boundary of primary tumor was determined based on MRI.Visual analysis was performed and SUVmax of posterior cervical muscles,NPC primary foci was measured by 2 observers respectively.The uptake ratio of primary tumor to muscle (TMR) was calculated.The identify consistency of hypoxic region between two observers were evaluated by Kappa test and intraclass correlation coefficient (ICC).The image contrast was evaluated by Wilcoxon paired rank sum test of TMR.Results PET images and MRI images of NPC primary foci were successfully fused.Positive non-NPC tissues were identified by MRI.The visual recognition of hypoxic regions of the two observers for 2 and 4 h imaging were highly consistent (Kappa =0.931 and 0.965,both P＜0.001).There was a high degree of consistency between the SUVmax of posterior cervicalmuscles and that of primary tumors.ICCs of posterior cervical muscles in 2 and 4 h were 0.896 (95％ CI:0.814-0.942) and 0.924 (95％ CI:0.865-0.958),respectively.ICCs of primary tumors in 2 and 4 h were 0.991 (95％ CI:0.985-0.995) and 0.998 (95％ CI:0.996-0.999),respectively.TMRs (M(P25,P75))in 2 and 4 h were 1.560 (1.341,3.015) and 1.675 (1.387,3.001) respectively in 24 positive case times,and the difference was statistically significant (z=-2.557,P＜0.05).Conclusions Using fusion images of 18F-FMISO PET and MRI,hypoxic tissues within NPC primary foci can be accurately identified.There is a high degree of consistency within the visual and quantitative analysis of two observers.The image contrast of 18F-FMISO PET at 4 h is superior to that at 2 h.

Objective To synthesize 18F-FMISO and analyze the quality of the product.Methods 1-(2'-nitro-l'-imidazolyl)-2-O-tetrahydropyranyl-O-trluendulfonylpropanediol (NITIT) was taken as the precursor and simple one pot method was used.CFN-MPS-100 fluorine multifunction radiopharmaceutical chemical synthesis module was adopted to complete the radioactive fluorination reaction in a closed flat flask,and the crude product was purified by semi-preparative HPLC,the solvent was removed by rotary evaporation.Then 15 ml saline was added into the product to get 18F-FMISO injection.Radio-HPLC and radio-TLC were applied for quality control.Results 18F-FMISO was obtained in 60 min with the radiochemical yield of (32±5.0)％ (no decay corrected,n=25).The radiochemical purity was above 99.0％ and still above 98.5％ after 6 h.The radioactive concentration was above 1.11 × 1012 Bq/L.The product was colorless solution,with pH value of 7.0.The radioactive nuclear purity was more than 99％.The K222 was less than 25 μg/ml.Conclusion 18 F-FMISO could be synthesized with automatic synthesis method based on the CFN-MPS-100 fluorine multifunction module.The labeling rate,stability and chemical purity are high.