[Objective]The clinical efficacy of endometriosis pelvic pain using traditional Chinese medicine in cycle treatment is discussed in the paper.[Methods] Forty patients of endometriosis diagnosed by chromatic colour type-B ultrasound or 1aparoscopy with typical dysmenorrhea were treated for three months in cycle therapy with traditional Chinese medicine based on dispersing liver,clearing away heat and activating blood circulation.The pain symptoms are evaluated before and after therapy per month.[Results]After three months treatment of traditional Chinese medicine,the diversified bellyache was significantly relieved and dysmenorrhea score was alleviated from 4.83?1.6 to 2.85?2.23(P

Purpose:To study bcl-2 and MDR expressions in renal cell carcinoma and to evaluate its clinical significance.Methods:blc-2 and MDR expression were studied by immunohistochemical technique in 48 specimens of renal cell carcinoma tissues and in 10 normal renal tissues and their clinical significance was analyzed.Results:The positive rate of expression of bcl-2 in the renal cell carcinoma tissue was 77.1%, while it was 40.0% in the normal renal tissue(P＜0.05). However, it was not related to the tumor grade and tumor stage(P＞0.05). On the other hand, There was a positive expression of MDR1 in renal cell carcinoma and normal renal tissue. MDR1 was positively related to tumor cell type(P＜0.05). Compared with the other types of renal cell carcinoma. The granular existed higher expression. Both have no relationship with prognosis.Conclusions: bcl-2 Protein is overexpressed in the majority of renal cell carcinomas. The overexpression of bcl-2 may have a role in tumorigenesis. MDR1, an established predictor for chemo-resistance, however, has no significant correlation with bcl-1. The multidrug resistant of renal cell cancer is probably induced by double-functions of bcl and MDR1.

Objective:To study the impact on dose accuracy for the treatment planning by manually assigning accurate electron density for CT image-based tumor tissues and organs at risk.Methods:Twenty cases of retrospective postoperative cervical cancer radiotherapy plans were selected. The body electron density of the corresponding organs was derived from the ICRU 46 report and assigned in the treatment planning system (Monaco5.11, Sweden), including the bladder, rectum, intestine, kidney, spinal cord, femoral head, and ilium. The original plans were double-arc volumetric modulated arc therapy plan (360° VMAT), using Monte Carlo algorithm, the calculation grid was 0.3 cm × 0.3 cm × 0.3 cm, and the minimum subfield width was 0.6 cm. Keep the original plan fluence unchanged and recalculate the dose to generate a new plan. The two-dimensional dose distribution and dose-volume histogram (DVH) were used to compare the differences between the two plans. The difference was compared between the two group plans by using the dosimetry parameters and DVH two dimension curve.Results:For the planning of assigning bulk electron density (Plan RED), the deviation of the patient′s target dose parameters and the original plan (Plan ref) was <2%, and the average deviation of all target regions D2, D98, Dmean was < 0.7%, only 2 of the 180 data were between 2% and 3%. The average deviation of V20, V30, D1 cm 3, Dmean of the bladder, rectum, and small intestine, the original Plan ref was less than 0.6%, and 4 out of 240 data had values > 2%. Plan RED′s average hop count was 0.9% higher than Plan ref, and the total number of subfields remains unchanged. The planned dose generated by manually assigning the electron density in Plan RED was higher than that in Plan ref, but met the clinical requirements. The two-dimensional curves of the DVH diagram for targets and OARs almost completely overlapped, and there was no obvious difference in the dose distribution diagram of the same cross section. The statistical result of all parameters showed that the difference in planned dose parameters between the two groups was not statistically significant( P>0.05). Conclusions:The overall deviation of dose accuracy between Plan RED and Plan ref is <2%, which meets the clinical requirements and provides a reference for realizing MRI-only treatment planning.

Xiaotianxin acupoint is located at the middle root of the palm, in the depression of the junction between the major and minor thenar eminence. Manual operation includes kneading, pinching, pounding, pinching-kneading method, and it has the effect of clearing heat and promoting urination, tranquilizing fringt and mind, brightening vision, dredging meridians, sweating and releasing muscle, clinical indications of infantile convulsions, night crying, hot urine, jaundice, strabismus, low vision. This paper, by reviewing ancient and modern literatures, the positioning, operation methods and clinical application of Xiaotianxin acupoint are combed and analyzed. The mechanism of the acupoint should be explored from two aspects of traditional and modern medicine, in order to understand the acupoint comprehensively and deeply. And it will provide a theoretical basis for the treatment of diseases by Xiaotianxin, and guide the clinical application through theoretical research.

Objective To measure and analyze the neutron dose equivalent rate produced by an IORT accelerator with 9 and 12 MeV electron energyies,and compare them with those from a Siemens Primus linear accelerator with the same electron energy,in order to provide data reference for the risk of secondary cancer induced by radiotherapy.Methods Using the neutron detector LB6411,the neutron dose equivalent rates produced by the IORT accelerator of 9 and 12 MeV were measured on some key locations,such as the head of the accelerator,cylinder bottom,patient plane with electron energies 9 and 12 MeV.The similar measurements were also performed on the same locations on a Siemens conventional accelerator.The data were collected and analyzed and the result wer compared between the two accelerators.Results Neutron dose equivalent rates from the IORT accelerator with 9 MeV energy were (51.8±3.1),(45.5 ±1.5),(70.5 ±4.9) and (68.2±3.3) μ Sv/h near the head of the accelerator,cylinder bottom,patient plane,with 5.9％,5.4％,17.8％ and 21.5％ lower than at 12 MeV,respectively.The dose equivalent rates at the similar locations from the Siemens Primus accelerator were (277.3 ±1.2),(285.1 ±1.6),(185.1 ±1.8) and (182.8 ±2.4) μSv/h at 9 MeV,with 48.8％,47.6％,48.7％,52.2％ lower than those at 12 MeV,respectively.At the energy of 12MeV,the neutron equivalent dose rate from the IORT was lower by a factor of about 10 than for Siemens Primus accelerator.Conclusions The neutron dose equivalent rates generaged by both the IORT and the Siemens Primus are higher at 12 MeV than at 9 MeV,which would lead to an increased risk of secondary cancer to patients.The traditional medical accelerator produces much higher neutron dose equivalent rates than the intraoperative electron accelerator,for which the appropriate shielding should be takn.

Objective The purpose of this study is to investigate the method to reduce the radiation dose to the neck skin in the Tomotherapy treatment plans for early-stage nasopharyngeal carcinoma.Methods The 17 patients with early-stage nasopharyngeal carcinoma that have been treated by the Tomotherapy were selected randomly for this skin sparing study.The neck skin sparing region was generated as an internal margin of 3 mm from the out body contour,excluding the intercrossed area with the targets.Candidate patients were planned using TP and NP method respectively:the TP group was planned with the traditional method.The new neck skin region was considered as an organ at risk (OAR) for planning dose constrain in NP group.The dosimetric metrics of targets and OARs,monitor units (MU) and delivery time were compared as the end points of these two groups.Results The two treatment plan groups satisfied the clinical requirement.There were no significant differences for D98,D95 and D2 of the targets (P ＞ 0.05).The Dmax of brainstem,D1cc of spinal cord,D of right parotid were higher in NP group than in theTPgroup (t =2.47,2.34,2.77,P＜0.05).The Dmax of left mandible joint was lower than TP group(t =2.30,P ＜ 0.05).The V30,V40,V50 and V60 of the skin were considerably lower than TP group (t =8.37,6.02,5.82,4.89,P ＜ 0.05).The mean MU and mean delivery time per fraction of NP group were 6.3％ and 8.1％ less than that of TP group respectively.Conclusions The neck skin region should be delineated as an OAR to be spared in the Tomotherapy treatment planning for early-stage nasopharyngeal carcinoma.This method can reduce the skin radiation dose effectively,alleviate the skin reaction,and improve the life quality of patients in radiotherapy.

Objective To compare the neck skin dose between fixed-field dynamic intensity-modulated radiation therapy (dlMRT),volumetric modulated arc therapy (VMAT),and helical tomotherapy (HT) in the treatment of early-stage nasopharyngeal carcinoma.Methods A total of 16 early-stage nasopharyngeal carcinoma patients undergoing radiotherapy were enrolled as subjects.The neck skin was delineated by contraction of the outer edge of neck by 3 mm.Dose planning was made by the traditional method (TP group)and a new method (NP group),in which the neck skin was considered as the organ at risk.Dmean and V5-V70 for the neck skin were recorded.The paired t-test was used to analyze the differences between two plans in each radiotherapy method.An analysis of variance was used to compare the same plan between the three radiotherapy methods.Results The HT group had significantly higher Dmean and V5-V70 for the neck skin than the dIMRT group and the VMAT group (P=0.00,0.00,0.00,0.00,0.00,0.00,0.00,0.02).Using dIMRT,the D and V10-V60 for the neck skin were reduced by 7％,8％,22％,25％,38％,59％,and 85％ in the NP group than in the TP group (P=0.00,0.00,0.00,0.00,0.00,0.00,0.00).Using VMAT,the D and V20-V40 for the neck skin were reduced by 4％,19％,29％,and 34％ in the NP group than in the TP group (P=0.02,0.01,0.02,0.01).Using HT,the V30-V60 for the neck skin were reduced by 20％,29％,50％,and 67％ in the NP group than in the TP group (P=0.00,0.00,0.00,0.00,0.03).Conclusions In the treatment of early-stage nasopharyngeal carcinoma,HT causes a higher radiation dose to the neck skin than dIMRT and VMAT,while dIMRT and VMAT have similar neck skin doses.The neck skin dose can be significantly reduced with the neck skin as the organ at risk.

Objective:To investigate the effect and mechanism of periodontal ligament stem cell (PDLSC) from inflammatory environment on the secretion of interleukin-1β (IL-1β) by macrophages.Methods:PDLSCs were pretreated with lipopolysaccharide (LPS) in order to simulate the inflammatory environment. Human monocyte cell line (THP-1) cells were treated with conditioned media collected from healthy and inflammatory PDLSCs respectively and divided into conditioned medium of health PDLSC (CM-H) group and conditioned medium of LPS-PDLSC (CM-LPS) group. After 24 h of co-culture, the condition media were abandoned and THP-1 cells were then cultured for another 24 h. The expression of IL-1β in THP-1 cells supernatant was detected by enzyme-linked immunosorbent assay (ELISA). Quantitative real time-PCR (qRT-PCR) was used to detect the expression of glucose regulated protein 78 (GRP78), activating transcription factor-6 (ATF6), inositol requiring enzyme 1 (IRE1), protein kinase R-like endoplasmic reticulum kinase (PERK), CCAAT enhancer binding protein homologous protein (CHOP), activating transcription factor-4 (ATF4) and X box binding protein 1 spliced (XBP1s), which were all related with endoplasmic reticulum stress (ERS), in THP-1 cells. The expressions of proteins GRP78 and CHOP were detected by Western blotting. Furthermore, THP-1 cells, which pretreated with ER inhibitor 4-phenylbutyrate (4-PBA) for intervention experiments were grouped by various concentrations of 4-PBA including groups 0 (control group), 1, 10 and 20 mmol/L and treated with condition medium of inflammatory PDLSC. ELISA was used to detect IL-1β expression and qRT-PCR to detect expression of ERS related genes.Results:ELISA results showed that the expression of IL-1β in THP-1 cells of group CM-LPS [(31.35±2.11) ng/L] was significantly higher than group CM-H [(8.19±1.51) ng/L] ( t=12.60, P<0.01). qRT-PCR results showed that the relative expressions of GRP78, ATF6, IRE1, PERK, CHOP, ATF4 and XBP1s genes in THP-1 cells of group CM-LPS (1.782±0.070, 1.387±0.204, 1.404±0.119, 1.777±0.187, 1.325±0.156, 1.295±0.066 and 1.137±0.149, respectively) were significantly higher than those in group CM-H ( P<0.05). In the 4-PBA intervention experiment, compared with group 0 mmol/L, the expressions of GRP78, IRE-1, ATF-6, PERK and CHOP were significantly lower in group 1, 10 and 20 mmol/L ( P<0.05). Moreover, compared with control group [(31.23±1.98) ng/L], the expression of IL-1β in THP-1 cells were significantly lower in group 10 mmol/L [(21.20±0.37) ng/L] and group 20 mmol/L [(23.85±1.80) ng/L] ( P<0.05) with ERS inhibited. Conclusions:PDLSC from inflammatory environment could promote IL-1β secretion of macrophages through upregulating macrophages ERS.

Objective:To investigate the effect of low dose lipopolysaccharide (LPS)-treated human periodontal ligament stem cells (HPDLSC) on the expression of macrophage pro-inflammatory factors and the mechanism involved.Methods:The primary HPDLSCs were obtained from healthy third molar periodontal ligament tissue. Phosphate buffer saline (PBS), 100 μg/L or 10 mg/L of LPS were used to treat HPDLSCs for 48 h, and their conditioned media were respectively co-cultured with THP-1-derived macrophages for 48 h. The corresponding experimental groups were PBS-treated HPDLSC-derived conditioned medium (CM-C) group, low dose LPS-treated HPDLSC-derived conditioned medium (CM-L) group, and high dose LPS-treated HPDLSC-derived conditioned medium (CM-H) group. Quantitative real-time PCR was performed to explore the mRNA expressions of macrophage interleukin (IL)-6, IL-8, IL-12, tumor necrosis factor-α (TNF-α) in the CM-C, CM-L and CM-H groups, and the expressions of nuclear factor (erythroid-derived 2)-like 2 (NRF2), glutamate-cysteine ligase catalytic subunit (GCLC), NAD(P)H quinone dehydrogenase 1 (NQO1) and heme oxygenase 1 (HO-1) in the CM-C and CM-L groups. Meanwhile, Western blotting was used to detect the change of nuclear and cytoplasmic NRF2 and the levels of GCLC and HO-1 in the CM-C and CM-L groups. The 2′, 7′-dichlorofluorescein probe was adopted to detect the reactive oxygen species (ROS) levels of macrophages in the CM-C and CM-L groups and the data were characterized by the mean fluorescent intensity (MFI).Results:The mRNA expressions of macrophage pro-inflammatory factors IL-6, IL-8, IL-12 and TNF-α in the CM-H group (2.332±0.594, 3.601±0.639, 2.120±0.677 and 2.468±0.236) were significantly upregulated compared with those in the CM-C group (1.000±0.321, 1.000±0.151, 1.000±0.059 and 1.000±0.095) ( P<0.05); while the relative mRNA levels of IL-6, IL-12 and TNF-α in the CM-L group (0.056±0.002, 0.215±0.024 and 0.567±0.071) were much lower than those in the CM-C group (1.000±0.209, 1.000±0.220 and 1.000±0.220) ( P<0.05). At the mRNA level, the expression of NRF2 was significantly increased in the CM-L group (1.864±0.198) compared with that in the CM-C group (1.000±0.094) ( P<0.05). At the protein level, the cytoplasmic NRF2 and nuclear NRF2 were increased in CM-L group (1.175±0.104 and 1.308±0.082) compared with those in the CM-C group (1.000±0.025 and 1.000±0.049) ( P<0.05). Furthermore, the antioxidative genes, i.e. GCLC and NQO1, localized in NRF2 downstream, were significantly upregulated in the CM-L group (1.786±0.278 and 1.444±0.078) compared with the CM-C group (1.000±0.139 and 1.000±0.226) ( P<0.05). The protein levels of GCLC and HO-1 were augmented in the CM-L group (1.159±0.036 and 1.412±0.075) in contrast with those in the CM-C group (1.000±0.050 and 1.000±0.013) ( P<0.05). In addition, the MFI in the CM-L group (123 419±1 302) was significantly lower than that in the CM-C group (139 193±1 241) ( P<0.05). Conclusions:Low-dose LPS-treated HPDLSCs could regulate oxidative stress response through activating the NRF2 signaling pathway of macrophages and further downregulating the expressions of macrophage pro-inflammatory factors.

Objective:To observe whether endothelial cells undergo pyroptosis in the inflammatory periodontal environment by using a model in vivo and in vitro, providing an experimental basis for indepth understanding of the underlying pathogenesis of periodontitis. Methods:According to the classification of periodontal diseases of 2018, gingival tissues were collected from periodontally healthy subjects and patients with stage Ⅲ-Ⅳ, grade C periodontitis, who presented Department of Oral and Maxillofacial Surgery and Department of Periodontology, School of Stomatology, The Fourth Military Medical University from April to May 2022. Immunohistochemical staining was performed to detect the expression level and distribution of gasdermin D (GSDMD), a hallmark protein of cell pyroptosis, in gingival tissues. Periodontitis models were established in each group by ligating the maxillary second molar teeth of three mice for 2 weeks (ligation group). The alveolar bone resorption was determined by micro-CT (mice without ligation treatment were used as the control group), and the colocalization of GSDMD and CD31 were quantitatively analyzed by immunofluorescence staining in gingival tissues of healthy and inflammatory mice. Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and treated with lipopolysaccharide (LPS) of Porphyromonas gingivalis (Pg) combined with adenosine triphosphate (ATP) at various concentrations of 0.5, 1.0, 2.5, 5.0, and 10.0 mg/L, respectively, and the 0 mg/L group was set as the control group at the same time. Scanning electron microscopy was used to observe the morphology of HUVECs. Western blotting was used to detect the expression of gasdermin D-N terminal domains (GSDMD-N) protein and immunofluorescence cell staining was used to detect the expression and distribution of GSDMD. Cell counting kit-8 (CCK-8) was used to detect the proliferative ability of HUVECs, and propidium iodide (PI) staining was used to detect the integrity of cell membrane of HUVECs. Results:Immunohistochemistry showed that GSDMD in gingival tissues of periodontitis was mainly distributed around blood vessels and its expression level was higher than that in healthy tissues. Micro-CT showed that alveolar bone resorption around the maxillary second molar significantly increased in ligation group mice compared with control subjects ( t=8.88, P<0.001). Immunofluorescence staining showed significant colocalization of GSDMD with CD31 in the gingival vascular endothelial cells in mice of ligation group. The results of scanning electron microscopy showed that there were pores of different sizes, the typical morphology of pyroptosis, on HUVECs cell membranes in the inflammatory environment simulated by ATP combined with different concentrations of LPS, and 2.5 mg/L group showed the most dilated and fused pores on cell membranes, with the cells tended to lyse and die. Western blotting showed that the expression of GSDMD-N, the hallmark protein of cell pyroptosis, was significantly higher in 2.5 and 5.0 mg/L groups than that in the control group ( F=3.86, P<0.01). Immunofluorescence cell staining showed that the average fluorescence intensity of GSDMD in 2.5 mg/L group elevated the most significantly in comparison with that in the control group ( F=35.25, P<0.001). The CCK-8 proliferation assay showed that compared to the control group (1.00±0.02), 0.5 mg/L (0.52±0.07), 1.0 mg/L (0.57±0.10), 2.5 mg/L (0.58±0.04), 5.0 mg/L (0.55±0.04), 10.0 mg/L (0.61±0.03) groups inhibited cell proliferation ( F=39.95, P<0.001). PI staining showed that the proportion of positive stained cells was highest [(56.07±3.22)%] in 2.5 mg/L group ( F=88.24, P<0.001). Conclusions:Endothelial cells undergo significant pyroptosis in both in vivo and in vitro periodontal inflammatory environments, suggesting that endothelial cell pyroptosis may be an important pathogenic factor contributing to the pathogenesis of periodontitis.