Unlike conventional radiation therapy, stereotactic radiation therapy (SRT) is an emerging tumor-ablative radiation technology with a high-dose delivery to targets while dramatically sparing adjacent normal tissues. The strengths of SRT involve noninvasive and short-course treatment, high rates of tumor local control with a low risk of side effects. Although the scientific concepts of radiobiology fail to be totally understood currently, SRT has shown its potential and advantages against various tumors, especially for those adjacent to less tolerable normal organs (spinal cord, optic nerve, bowels, etc.). Nowadays, the clinical efficacy of SRT has been widely confirmed in certain patients, especially for those medically inoperable, unwilling to undergo surgery, medicine ineffective with tumor progression. Moreover, SRT could be properly used as palliative treatment aiming at relieving local symptoms and pain, and eventually achieving a potential survival benefit of several months. However, the weaknesses of SRT relate to inevitable radiation-induced toxicities as well as the inaccessibility of prophylactic irradiation. In general, one flaw cannot obscure the splendor of the jade. The emergence and development of SRT has opened the new era of precision radiation therapy, and SRT will probably step gloriously onto the remarkable stage for precision medicine.
Humans ; Neoplasms ; radiotherapy ; Precision Medicine ; Radiosurgery

Based on the realistic circumstances at home and successful experiences from abroad,this paper holds the idea to introduce medical liability insurance into medical market to relieve the currently tense physician-patient conflict and analyzes the role and function of medical liability insurance.Meanwhile,some problems and countermeasures are also explained in the functioning process of medical liability insurance.

Objective To construct the eukaryotic expression vector of pprI gene from Deinococcus radiodurans R1 and investigate its radioresistant effects in eukaryotic cells.Methods A recombinant vector pEGFP-c1-pprI was constructed by DNA recombinant technique.The empty vector pEGFP-c1 and the pEGFP-c1-pprI were transferred into human lung epithelial cells Beas-2B by LipofectamineTM 2000,respectively.Then the infected cells were screened in order to develop a cell line with stable expression of pprI gene.Cell survival rate was tested by clone-forming assay.Cell cycle distribution and apoptosis were detected by a flow cytometry.The fluorescence intensity of reactive oxygen species (ROS) was observed by a fluorescent microscope.γ-H2AX foci in the irradiated cell was detected by immunofluorescence.Results The eukaryotic expression plasmid of pprI prokaryotic gene was constructed and PprI fusion protein was expressed in human lung epithelial cells successfully,and the cell line (2BG) with a stable pprI gene expression was established.After irradiation,the cell survival fraction of 2BG cells was significantly higher than Beas-2B cells so that the value of D0 、Dq and N of the survival curve were increased.Moreover,the fluorescence intensity of ROS and the number of γ-H2AX foci in 2BG cells were also lower than those of B eas-2B cells(F =16.73,19.47,6.94,P ＜ 0.05).Between these two cell lines,the apoptosis rate and cell cycle G2 arrest also had significant difference (F =139.73,237.92,P ＜ 0.05).Conclusions The pprI gene from Deinococcus radiodurans RI can be stably expressed in the eukaryotic cells and it allows the transferred cells to have a radioresistant function.

Objective:To analyze the early changes of gene expression levels and signaling pathways in 661W cell line under hypoxic conditions and to find potential functional target genes.Methods:The cultured mouse 661W cells were divided into hypoxia treatment group and normoxia control group. Cells in the hypoxia treatment group were cultured in a three-gas incubator with volume fraction of 1% and 5% CO 2 at 37 ℃. Cells in the normoxia control group were cultured in an incubator at 37 ℃ with volume fraction of 5% CO 2. High-throughput sequencing technology was used to sequence the transcriptome of 661W cell treated with hypoxia and normoxia for 4 hours to screen for differentially expressed genes (DEG). Clustering heat map analysis, gene ontology (GO) functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and protein-protein interaction network (PPI) analysis were performed. The reverse transcription-polymerase chain reaction (RT-PCR) was used to verify the accuracy of the sequencing results. Results:A total of 506 differentially expressed genes were screened, including 459 up-regulated genes and 47 down-regulated genes. GO functional enrichment analysis showed that the main biological processes of DEG were the cell's response to hypoxia, glycolysis, negative regulation of cell proliferation and apoptosis. hypoxia inducible factor (HIF)-1α pathway, glycolysis, Forkhead box O (FoxO) pathway, Insulin signaling pathway and Adenosine 5′-monophosphate-activated protein kinase (AMPK) pathway were involved in the above process. PPI analysis results showed that hub genes related to hypoxia were Aldoa, Aldoc, Gpi1, Hk2, Hk1, Pfkl, Pfkp, Vhl, Fbxo10 and Fbxo27. The RT-PCR results showed that the relative expression levels of 15 DEG mRNA in the hypoxic treatment group were higher than that of the normoxic control group, and the difference was statistically significant ( P<0.05). The mRNA expression levels of N-myc downstream-regulated gene-1 ( Ndrg1 ), Mt1, and vascular endothelial growth factor A ( VEGFA) were time-dependent on hypoxia. Conclusions:Under hypoxia, DEG is mainly related to glucose metabolism, cell response to hypoxia, regulation of proliferation and apoptosis. HIF-1α pathway, glycolysis, FoxO pathway and AMPK pathway are involved in the early changes of 661W cells under hypoxia. Aldoa, Aldoc, Gpi1, Hk2, Hk1, Pfkl, Pfkp, Vhl, Fbxo10, Fbxo27 may play key roles in the response of 661W cells to hypoxia. Ndrg1, Mt1 and VEGFA could be potential functional target genes for the study of ischemia and hypoxia-related fundus diseases.

Objective To study the Effect of acute peripancreatitc fluid collection and pancreatic necrosis to the prognosis of acute pancreatitis.Methods Retrospectively analyzing the prognostic effect of acute peripancreatitc fluid collection and pancreatic necrosis according to the early Computed-Tomograghy of 323 consecutive acute pancreatitis patients from Jan 2003 to Dec 2007,the end points are systemic inflammation response syndrome ( SIRS),pancreatic infection,and mortality.Results Within 5d after onset,97 of 323 cases (30%) presented with SIRS and lasted more than 2d,12 cases (3.7%) occurred pancreatic infection during middle or late phase,14 cases died,the mortality is 4.3%.141 of 323 cases (43.7%) who had acute peripancreatic fluid collection presented with SIRS,acute peripancreatic fluid collection correlated significantly with the occurrence of SIRS,P ＜ 0.05.227 cases (277/323,85.8%) had no pancreatic necrosis,no pancreatic infection occurred,46 cases (46/323,14.2% )had pancreatic necrosis,pancreatic necrosis correlated significantly with pancreatic infection,P ＜ 0.05.Conclusions Acute poripancreafic fluid collection and pancreatic necrosis had different prognostic effect to acute pancreatitis.Acute peripancreatic fluid collection correlated well with the occurrence of SIRS during the early phase;Pancreatic necrosis may be infected during middle or late phase of acute pancreatitis,more extent of pancreatic necrosis,more possible that pancreatic infection will occur.

Objective To study the clinical features of target organ damage in children with essential hypertension.Methods From Jan.2007 to Oct.2013,86 children were enrolled who were diagnosed as essential hypertension in the Children's Hospital Affiliated to Capital Institute of Pediatrics.All children received the following examinations:fundus oculi,electrocardiogram,echocardiography,serum triglyceride,glucose,insulin,C peptide,uric acid,renal function,urine microalbumin,serum and urine β2-microglobulin.All data were collected as standard procedure and analyzed by using statistic methods.Results In all recruited children,there were 68 boys (79.1％)and 18 girls (20.9％) with the average age of (12.3 ±2.4) years old.There were 46 children(53.5％) with grade Ⅰ hypertension and 40 (46.5％) with grade Ⅱ hypertension,13.5％ (7/52 cases) of the children with retinal vessel damage,21.0％ (17/81 cases) with abnormal electrocardiogram,and 2.6％ (2/78 cases) with left ventricular hypertrophy and increased left ventricular posterior w all thickness.Thirty-seven percent (30/81 cases) of the children had a higher voltage of R wave in V5 than average values at the same ages.Renal damage mainly included increased serum creatinine and microalbuminuria,with the rates of 40.2％ (33/82 cases) and 39.7％ (23/58 cases),respectively.Metabolic disorders mainly included 87.5％ (56/64 cases) hyperuricemia,32.5％ (25/77 cases) hypertriglyceridemia,22.1％ (19/86 cases) hepatic adipose infiltration,and 36.1％ (30/83 cases) hyperinsulinemia or sugar intolerance damage.There were 58 (67.4％) children wit h obesity.Compared with normal weight children,children with obesity had a higher rate of target organ damage(98.3％ vs 82.1％,x2 =5.291,P =0.021),and hyperinsulinemia or sugar intolerance damage(45.5％ vs 17.9％,x2 =6.123,P =0.013).Children with the course longer than 6 months showed a higher rate of hyperinsulinemia or sugar intolerance damage than the children with the course less than 6 months(50.0％ vs 25.5％,x2 =5.788,P =0.021).Conclusions Target organ damage caused by adolescent essential hypertension is present at diagnosis in most of these children.Electrocardiogram and echocardiography are effective measures for early detection of cardiac damage of hypertension.Serum uric caid and urine microalbumin can be used as early warning and screening indexes.To enhance blood pressure monitoring of children with obesity will be helpful for early diagnosis of essential hypertension,which will decrease the rate of target organ damage with earlier effective interference.

Aging ; physiology ; Animals ; Female ; Male ; Mitochondria, Heart ; enzymology ; Mitochondrial Membrane Transport Proteins ; physiology ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; Ventricular Function, Left ; physiology

The "pre-disease" theory of traditional Chinese medicine focuses on the dynamic and continuous evolution from health to disease, and emphasizes early identification and intervention in the complex and gradual process of evolution from health to disease. The "pre-disease" theory and complexity science share the same perspective on health and disease from the standpoint of features of the dynamic evolution and holism, i. e., life is considered as a complex system with ongoing dynamic changes, which exhibit the nonlinear features of " homeostasis-destabilization-phase transition-another homeostasis". In this paper, from the perspective of nonlinear dynamics in complexity science, we explain the scientific connotation of the evolution law of "pre-disease"-disease based on the theory of critical slowing down in traditional Chinese medicine. Based on the theory of critical slowing down and the dynamic network biomarker method generated by its development, combined with the macro signs of comprehensive analysis of data gained by four diagnostic method and the micro features including transcriptomics and the microbiomics, this paper proposes to integrate macro and micro multi-hierarchy information to construct a "pre-disease" critical slowing down identification model with the characteristics of traditional Chinese medicine diagnosis and treatment, which provides a new perspective and method for the early warning of complex diseases.

OBJECTIVETo explore the effect of fixation of Kirschner needle and thread cancellous bone screw through the sinus tarsi interstice for the treatment of calcaneal fractures.

METHODSFrom January 2009 to December 2012,20 patients with calcaneal fracture were treated by minimally invasive Kirschner wire and threaded cancellous bone screw fixation and bone graft,including 12 males and 8 females with an average age of 39 years old ranging from 21 to 65. Among them, 8 cases were left foot, 12 were right foot. According to Sanders's classification, 8 cases were type II, 10 cases were type III, 2 cases were type IV.

RESULTSAll patients were followed up from 6 to 16 months with an average of 12 months. The incision were healed. Böhler angle were increased from preoperative (17.75 +/- 4.22) degrees to postoperative (26.85 +/- 7.37) degrees (t = 4.308, P = 0.000). Gissane angle were reduced from preoperative (137.05 +/- 24.91) degrees to postoperative (113.75 +/- 13.17) degrees (t = 7.083, P = 0.000). At 3 months after operation, the scores of AOFAS were 85.50 +/- 7.99; the results were excellent in 5 feet and good in 11 feet, fair in 3 feet, and poor in 1 foot.

CONCLUSIONMinimally invasive fixation of Kirschner needle and thread cancellous bone screw fixation is a simple operation, it can get reliable fixation, easy to remove, low cost, less postoperative complications, and it is a good treatment of calcaneal fracture.

Adult ; Aged ; Bone Screws ; Bone Wires ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged

AIMTo investigate the level of immune response and the immune mechanism of the single-dose hepatitis B surface antigen (HBsAg)-poly (d, l)-lactide-co-glicolide acid (PLGA) microspheres in BALB/c mice.

METHODSThree kind of HBsAg-PLGA microspheres, HBsAg-PLGA50/50-COOH microspheres, HBsAg-PLGA75/25 microspheres and HBsAg-PLGA50/50 microspheres, were prepared by double emulsion microencapsulation technique used three kinds of PLGA with different L/G ratio. The single-dose of HBsAg-PLGA microspheres was subcutaneously injected into BALB/c mice at the dose of 7.5 microg HBsAg per mouse. The conventional aluminum-adjuvant vaccine was subcutaneously injected at 0, 1 and 2 month as positive control. In certain time interval, the induced immune level of total antibody was detected by enzyme linked immunosorbent assay (ELISA). For subclass of IgG antibody and cytokines studies, the dose of HBsAg was 2.5 microg per mouse.

RESULTSThe HBsAg-PLGA microspheres could successfully induce a humoral immune response in BALB/c mice. Compared with the conventional aluminum-adjuvant vaccine, the antibody response of the HBsAg-PLGA50/50-COOH microspheres was significantly lower than the group received three injections of aluminum-adjuvant vaccine (P < 0.01) except for a higher priming response during the early 6 weeks. The results were ascribed to the relatively rapid degradation charactics of PLGA50/50-COOH polymer. The immune response for the HBsAg-PLGA50/50 microspheres and HBsAg-PLGA75/25 microspheres were comparable to the group administered with aluminum-adjuvant vaccine (P > 0.05) which was due to the sustained degradation of PLGA50/50 and PLGA75/25 polymer.

CONCLUSIONThe HBsAg-PLGA microsphere is a promising candidate for the controlled delivery of a vaccine which does not require multiple injections.

Animals ; Delayed-Action Preparations ; Dose-Response Relationship, Immunologic ; Drug Carriers ; Female ; Hepatitis B Antibodies ; blood ; Hepatitis B Surface Antigens ; administration & dosage ; chemistry ; immunology ; Hepatitis B Vaccines ; administration & dosage ; immunology ; Immunization ; Immunoglobulin G ; blood ; Interferon-gamma ; metabolism ; Interleukin-2 ; metabolism ; Interleukin-5 ; metabolism ; Lactic Acid ; Mice ; Mice, Inbred BALB C ; Microspheres ; Polyglycolic Acid ; Polymers ; Random Allocation ; Rats ; Rats, Wistar