Objective To effectively combine the results of resting state regional homogeneity(ReHo) fMRI studies in depression.Methods Literatures between 2003-2016 on fMRI of depression in PubMed,Web of Knowledge,EBSCO host medline,CNKI,CQVIP and Wanfang Med Online were taken as research objects.Screening the relevant data according to the included and excluded standard,then,software of AES-SDM was employed to do Meta analysis,in addition,the age,gender,duration of disease,the year of education and treatment were also analyzed.Results 23 articles met the standard,including 1 036 cases,of which 507 for the depression group,529 for the control group.Meta analysis showed the significant ReHo abnormalities of Default Mode Network(DMN) which centers on left precuneus,left superior frontal gyrus and right cingulate gyrus,in addition,left lenticular nucleus,left postcentral gyrus,left cerebellum and left fusiform gyrus had significant ReHo differences.In the regression analysis,gender,age,duration of disease,years of education,disease severity were all affected factors.The difference of cingulate gyrus was the most stable,and the duration of the disease significantly affected cingulate gyrus (SDM =2.777).Conclusion The abnormalities of DMN which centers on left precuneus,left,medial superior frontal gyrus and right cingulate gyrus are the most consistent in depression,the DMN is closely related to depression.

Background and purpose:Radiotherapy and endocrine therapy are both important parts of adjuvant therapy for breast cancer, yet few studies have been conducted focusing on the interaction between radiation and endocrine therapy. Up to now, no conclusion has been drawn on the timing sequence of adjuvant radiation and endocrine therapy, which is indeed crucial in clinical practice. This study intended primarily to investigate the effect of concurrent or sequential exemestane combined with radiation on radiosensitivity of MCF-7 cells and its possible mechanism,and further to provide rationale for optimal clinical treatment modality.Methods:MCF-7 cells were arranged into three trial groups: the radiation group, exemestane sequenced with radiation group and exemestane followed radiation group. Radiosensitivity was evaluated by clonogenic assay, cell proliferation was measured by MTT assay, the ability to induce cell apoptosis was evaluated by DAPI staining assay, the changes of Bcl-2 and Bax were detected by Western blot.Results:Sensitive enhancement ratios (SER) were 1.51 and 1.37 in the exemestane sequenced with radiation group and exemestane followed radiation group, respectively. Compared with the radiation group, the percentage of cellular proliferation inhibition and apoptosis increased obviously in the exemestane sequenced with radiation group and exemestane followed radiation group. Exemestane combined with radiation made the Bax protein increase obviously and the Bcl-2 protein lowered significantly.Conclusion:Exemestane can enhance the radiosensitivity of MCF-7 cells, whose mechanism might be relevant to the promotion of cellular apoptosis. However,the treatment sequence does not affect the outcome.

Objective: To investigate the efficacy and toxic reaction of the accelerated hyperfraction radiotherapy for esophageal carcinoma. Methods: Eighty patients with esophageal carcinoma were randomized into the conventional fraction group (CF,40 cases) and the accelerated hyperfraction group (AHF,40 cases) from January 1994 to May 1995. CF group received a fraction dose of 2 Gy once a day, 5 times a week and to a total dose of 70 Gy. AHF group received the same dose as the CF group during the first two thirds of the therapeutic course(40 Gy),then followed by a fraction dose of 1.5 Gy one time twice a day, with an interval of more than 6 hours, and to a total dose of 30 Gy. The total dose of 2 stages was 70 Gy. The same 10 mV linear accelerator X ray radiotherapy was used in both groups. Results: The 3 year actual survival and tumor local control rates in the group AHF were significantly improved compared with group CF, being 42.5% vs 25% and 52.5% vs 25% respectively. There were no significant differences in radiation reactions and complications between 2 groups. The radiation treatment could be completed without any break. Conclusion: The accelerated hyperfraction radiotherapy can improve the tumor local control and survival rates in esophageal carcinoma. The radiation reactions and complications with the AHF radiotherapy are not significantly greater than with the CF radiotherapy. The patients can tolerate the AHF radiotherapy. [

Objective To delineate and measure the left anterior descending coronary artery (LAD) on CT angiography (CTA) and evaluate the dose delivered to LAD by different radiotherapy techniques for left-sided breast cancer.Methods Twenty-nine left-side breast cancer women with mean age of 54.71 years (range:30-80 years) were included.CTA was performed, and LAD was contoured and the distances were measured between LAD and chest wall (posteroanterior diameter,PD), between LAD and internal mammary artery (horizontal diameter,HD), between LAD and interventricular groove (oblique diameter,OD) at the level of T7-T8,T8-T9,T9-T10 and at level of nipple and lower boundary of the breast.The dose delivered to LAD was calculated on three-dimensional plans for two patients with mastectomy whose chest wall and internal mammary chain (IMC) were irradiated and one patient with breast-conserving surgery who received whole breast irradiation.Results The LAD arose at the level of the third rib in 40% of patients and at the fourth rib in 60% of patients.The mean length of LAD was 7.49±0.58 cm.At the level of T7-T8,T8-T9,T9-T10,the mean PD were 2.99±1.11 cm, 1.26±0.65 cm,0.68±0.39 cm, the mean HD were 2.27±0.84 cm, 2.81±0.65 cm, 3.37±1.21 cm, and the mean OD were 0.47±0.25 cm,0.38±0.21 cm,0.42±0.19 cm respectively.At the level of the breast nipple and the lower boundary of the breast, the mean PD were 2.94±1.06 cm, 0.79±0.46 cm, the mean HD were 2.45±0.89 cm, 3.31±1.22 cm,and the mean OD were 0.56±0.30 cm,0.57±0.24 cm respectively.The mean dose to the LAD was 5 Gy and 14 Gy for patients with mastectomy whose IMC was irradiated with 9 MeV electron and whose IMC was irradiated with 6 MV photon tangential beams.The mean dose to the LAD was 26 Gy for patients with breast conserving surgery.Conclusions To contour the LAD, the interventricular groove could be the reference point.Tangential technique can be giving a higher dose of LAD when compared with other radiation techniques

Objective To construct the DNA vaccine pIRES2-MLAA34-HSP70,and to detect its immune effect.Methods The acute monocytic leukemia associated antigen gene MLAA-34 and heat-shock protein (HSP)70 gene were extracted by using RT-PCR.The specific overlapping primer was designed,and the fusion gene MLAA34-HSP70 was amplified by using SOE-PCR technique.Then the DNA vaccine pIRES2-MLAA34-HSP70 was constructed,and BALB/c mice were immunized with this DNA vaccine.The splenic lymphocyte killing activity was detected by using MTT,levels of IL-2,IL-4 and IFN-γ were also detected by using ELISA.Results The MLAA34-HSP70 gene (2 956 bp) and the DNA vaccine pIRES2-MLAA34-HSP70 was amplified and constructed successfully.The killing efficiency of DNA vaccine pIRES2-MLAA34-HSP70 in U937 cells was significantly higher than that in other experimental groups and control group (P＜0.01),and levels of IL-4,IL-2 and IFN-γin DNA vaccine pIRES2-MLAA34-HSP70 group were significantly higher than those in the other experimental groups and control group (P＜0.01).Conclnsion The DNA vaccine pIRES2-MLAA34-HSP70 is constructed successfully.It is shown that the DNA vaccine induces strong humoral immunity,which could enhance immune responses to tumor cells and specificlly kill MLAA34 positive cells.

Objective To evaluate the effect of preoperative radiotherapy and postoperative brachy radiotherapy (POBRT) on patients with primary liver cancer(PLC). Methods 50 patients with PLC were randomly divided into 2 groups:(1)Radiotherapy group, 25 patients who underwent preoperative radiotherapy 14～17 days before hepatectomy and POBRT 3～10 days after hepatectomy ;(2)Control group,25 cases who underwent hepatectomy only. In radiotherapy group, before heptectomy, the single-dose 6Gy per time and 3 sessions were given to each patient. 3～6 ductus were placed for POBRT during operation,and 10Gy of POBRT per time and 2～4 sessions were given postoperatively. In control group,no radio cherapy was given before and after hepatectomy. Results In radiotherapy group, the cancer shrank significantly after preoperative radiotherapy (P

Objective:To systematically retrieve, evaluate, and summarize evidence on insomnia screening and assessment in adult malignant tumor patients.Methods:The clinical decisions, guidelines, and expert consensus on screening and assessing insomnia in malignant tumor patients were systematically searched in clinical decision support systems, guideline websites, literature databases, and professional association websites. This study conducted methodological quality evaluation and evidence extraction, translation, and integration.Results:A total of 8 articles were included, including three clinical decisions, two evidence-based guidelines, and three expert consensuses. After extracting and summarizing evidence, 38 pieces of evidence were obtained from three aspects of general management principles, insomnia screening, and insomnia assessment.Conclusions:The insomnia screening and assessment in adult malignant tumor patients should be standardized according to evidence-based standards and combined with specific clinical situations in China.

Objective To investigate the difference of Wechsler's cognitive test and its influencing factors in first-episode depression patients with and without sleep disorder.Methods 156 patients with de-pression were divided into two groups according to their sleep conditions,including sleep disorder group(n=77)and non-sleep disorder group(n=79).Wechsler Intelligence Scale(WAIS)and Wechsler Memory Scale(WMS)were used to assess the cognitive function,while Hamilton Depression Scale(HAMD-17) were used to assess depressive symptoms.Results (1)Sleep disorders group had lower scores on verbal IQ (95.51±16.45),performance IQ(90.94±13.87),FIQ scores(92.48±15.49)than those in the non-sleep disorder group((105.59±15.20),(96.19±13.62),(101.20±14.70)respectively),the differences were statistically significant(P<0.05).Sleep disorder group had lower scores in immediate memory(10.47 ± 3.88),short-term memory(49.87±14.35)and memory quotient(87.90±18.25)than those in the non-sleep disorder group((11.86±3.47),(56.52±13.03),(97.27±18.76)respectively),the differences were statisti-cally significant(all P<0.05).(2)Multivariate linear regression analysis showed that education and age ex-plained 24% of variance in verbal IQ(F=21.258,P<0.01).Education,sleep disorder factors explained 12.9% of variation in performance IQ(F=9.825,P<0.01).Education,sleep disorder factors explained 22.3% of variance in total IQ(F=22.847,P<0.01).Education,age,sleep disorder factors explained 28.4%of variation in short-term memory(F=23.850,P<0.01).Education and age explained 20.4% of variation in immediate memory(F=18.10,P<0.01).Education and sleep disorder factors explained 21.9% of variation in memory quotient(F=26.162,P<0.01).Conclusion The intelligence and memory impairment in first-epi-sode depression patients with sleep disorders is more serious,and the education,sleep disorder and age are the most important factors.