Animals ; Breast Neoplasms ; metabolism ; Humans ; NF-kappa B ; metabolism ; Neoplasms ; metabolism ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptors, Notch ; metabolism ; physiology ; Signal Transduction

Apoptosis ; Cell Proliferation ; DNA Methylation ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; metabolism ; Membrane Proteins ; genetics ; metabolism ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms ; metabolism ; pathology ; Neovascularization, Pathologic ; Nerve Tissue Proteins ; genetics ; metabolism ; Promoter Regions, Genetic ; Receptors, Immunologic ; genetics ; metabolism ; Signal Transduction

Objective To evaluate left ventricular global longitudinal strain in endocardium,middle myocardium and epi cardium of patients with breast carcinoma treated with anthracyclines by two-dimensional layered strain technology.Methods Totally 20 breast cancer patients after surgery without chemotherapy (control group) and 32 breast cancer patients who were treated with anthracycline-based chemotherapy were enrolled.The patients treated with chemotherapy were performed transthoracic echocardiography 3 months and 5 months after chemotherapy.Global longitudinal strain (GLS) and each segment (apex,basis and media section) strain in 3 myocardial layers (endocardium,middle myocardium and epicardium) were measured by EchoPAC software.Results Compared with control group,with the extension of chemotherapy cycle,GLS of 3 myocardial layers reduced in breast carcinoma patients treated with anthracyclines (all P＜0.05),but left ventricular ejection fraction (LVEF) had no statistical difference (P＞0.05).Compared with control group,each layer of each segment of longitudinal strain decreased in breast carcinoma patients treated with anthracyclines (all P＜0.05),except the apex section.Conclusion Longitudinal layer-specific strain technology can accurate assess whole and local systolic function of 3 myocardial layers of left ventricular,which can provide a new method for judging myocardial damage.

Objective To approach the protective effect of dexmedetomidine on mechanically ventilated patients with pulmonary contusion. Methods A prospective randomly controlled trial was conducted. 70 mechanically ventilated patients with pulmonary contusion from January 2010 to December 2012 in the Critical Care Medicine of Foshan Hospital of Traditional Chinese Medicine were divided into a control group and a therapy group by the difference in number odd or even,with 35 patients in each group. Based on the same principles of comprehensive treatment,the control group used midazolam,and the therapy group used dexmedetomidine for sedation. The measured parameters included oxygenation index(PaO2/FiO2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6), and extra-vacular lung water index(EVLWI)for both groups on the1st and 5th day. The incidence of delirium,the time of mechanical ventilation,and the incidence of hypotension were observed in both groups. Results Compared with those on the 1st day,TNF-α,IL-6 and EVLWI on the 5th day were decreased significantly in both groups〔the control group TNF-α(ng/L):1.29±0.38 vs. 2.21±0.37,IL-6(ng/L):97.97±28.77 vs. 131.03±41.52,EVLWI (mL/kg):8.25±2.03 vs. 11.96±3.36;the therapy group TNF-α:1.06±0.33 vs. 2.32±0.37,IL-6:82.07±23.35 vs. 134.98±64.25, EVLWI(mL/kg):6.74±1.33 vs. 11.23±2.78, all P<0.05〕, PaO2/FiO2 was increased obviously〔mmHg(1 mmHg=0.133 kPa),the control group:285.80±30.65 vs. 213.00±33.70,the therapy group:315.00±34.50 vs. 229.50±37.00,both P<0.05〕,TNF-αand IL-6 had no significant difference compared between the therapy group and control group(TNF-α:1.06±0.33 vs. 1.29±0.38,IL-6:82.07±23.35 vs. 97.97±28.77), while EVLWI and PaO2/FiO2 in the therapy group had remarkable differences compared with those of the control group〔EVLWI(mL/kg):6.74±1.33 vs. 8.25±2.03,PaO2/FiO2(mmHg):315.00±34.50 vs. 285.80±30.65,both P<0.05〕. The incidence of delirium(8.57% vs. 22.86%)and time of mechanical ventilation(day:4.10±1.09 vs. 6.88±1.66)in the therapy group were decreased markedly compared with those of the control group,and the incidence of hypotension had no significant difference between treatment or control groups(17.14% vs. 14.29%,P>0.05). Conclusion Dexmedetomidine has protective effect on mechanically ventilated patients with pulmonary contusion, and it is an relatively ideal sedative drug for these patients.

Objective To evaluate the effect of phosphatidylinositol-3 kinase inhibitor LY294002 combined with dichloroacetate on apoptosis in human pulmonary arterial smooth muscle cells (SMCs) and AKT/GSK-3β/HK-2 signaling pathway.Methods Human pulmonary arterial SMCs were seeded into culture plates at a density of 2 x 104 cells/ml after 3-5 passages.After being incubated for 72 h,the SMCs were cultured in the medium supplemented with 0.2％ fetal bovine serum for 24 h to induce starvation prior to experiments.The cells were then randomly divided into 6 groups (n =6 each) using a random number table:control group (group C),positive control group (group F),LY294002 group (group L),different concentrations of dichloroacetate groups (D1 and D2 groups),and LY294002 combined with dichloroacetate group (group LD1).In group C,the cells were cultured in the medium supplemented with 0.2％ fetal bovine serum.In F,L,D1,D2 and LD1 groups,the cells were cultured in the medium supplemented with 10％ fetal bovine serum.LY294002 2 μmol/L was added to the medium in group L.Dichloroacetate l0 and 20 mmol/L were added to the medium in D1 and D2 groups,respectively.In group LD1,LY294002 (2 μmol/L) was added,and 30 min later dichloroacetate 10 mmol/L was added to the medium in LD1 group.The cells were incubated for 48 h.Flow cytometry was used to measure the cell apoptosis and mitochondrial membrane potential.The expression of phosphorylated AKT (p-Akt),phosphorylated glycogen synthase kinase 3β (p-GSK-3β),and hexokinase-2 (HK-2) was detected using Western blot.Apoptosis rate was calculated.Results Compared with group C,apoptosis rate was significantly increased,and mitochondrial membrane potential was decreased in D2 and LD1 groups,the expression of p-Akt,p-GSK-3β and HK-2 was up-regulated in group F,and no significant changes were found in apoptosis rate and mitochondrial membrane potential in F,L and D1 groups.Compared with group D2,apoptosis rate was significantly increased,mitochondrial membrane potential was decreased,and the expression of p-Akt,p-GSK-3β and HK-2 was down-regulated in LD1 group.The expression of p-Akt,p-GSK-3β and HK-2 was significantly lower in D2 and LD1 groups than in group F.Conclusion LY294002 combined with dichloroacetate can promote apoptosis in human pulmonary arterial SMCs possibly through blocking AKT/GSK-3β/HK-2 signaling pathway.

Objective To evaluate the anatomic changes and dosimetric variations of patients with nasopharyngeal carcinoma (NPC) during the course of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) by comparison of the dosimetric differences with or without replanning.Methods Twelve cases with NPC treated with SIB-IMRT underwent repeated CT scans after 20- 25 fractions of the initiation of therapy.The original treatment plan ( Plan1 ) based on the first CT scan ( CT1 ) and the second IMRT plan (Plan 2) based on the second CT scan (CT2) were calculated with an inverse planning system (Pinnacle3,Philips Medical System).In addition,the hybrid IMRT plan,Planl (CT2),was generated by deformable registration with MIMVISTA software,and the doses in Plan 1 ( CT1 ) and Plan 2 ( CT2 ) were accumulated based on CT2.The dosimetric differences were compared among the Plan 1 ( CT1 ),Plan 1 (CT2) and Plan 1 + 2(CT2).Results Compared with CT1,the mean volumes of the right and left parotid glands in the CT2 were significantly smaller by ( 24.6 ± 11.9 ) ％ and ( 35.1 ± 20.1 ) ％,respectively.Compared with Plan 1 ( CT1 ),the dose received by 95％ of the target ( D9s ) to PGTV,PTV1 and PTV2,and mean dose (D ) to PGTV,and PTV2 were all significantly lower in the Plan 1 (CT2),indicating that the doses to targets decreased without replanning.With repeated CT and replanning after 25 fractions as shown in Plan 1 + 2 (CT2),the doses to targets would be improved.The doses to normal tissue were increased without replanning,although no statistical significance was observed.In 5 of 12 cases,the doses to the spinal cord and brainstem exceeded the constraint without replanning,while the corresponding values decreased with replanning.Conclusions During the course of IMRT for cases with NPC,the volumes of the targets and parotid glands decrease significantly.Mid-treatment CT scanning and replanning should be recommended to ensure adequate doses to the targets and safe doses to the normal tissues.

Objective To establish a human adrenocortical carcinoma (ACC)cell line ACC-LWL, and investigate its cell phenotypes and expression of tumor associated antigens, to detect sensitivity of ACC-LWL against adoptive immune cells. Methods Fresh tumor tissues from the resection of a human ACC were primary cultured and passed generation to generation so as to achieve stable growth in vitro. For analyzing its biological characteristic, the cell cloning formation in soft agar, chromosome and tumorigenesis were tested. Flow cytometric analysis was carried out for phenotype analysis and RT-PCR examination for MN/CA9 and HLA-A2 genes expression. PBMC from 4 healthy donors (2 HLA-A2+ or 2 HLA-A3+) co-cultured with IL-2 (200 U/ml)and the tumor cell lysate of ACC-LWL (20 μg/ml) in vitro to generate CTL. After 14 day stimulation, CTLs were incubated with ACC-LWL with a E/T ratio of 10:1 for 4 hours at 37 ℃. Cytotoxicity was measured with MTr assay. Results One human ACC cell line had been established that showed the characteristics of malignant cells. The cells grew a solid tumor in nude mice. ACC-LWL had a high expression of MHC-Ⅰ, weakly expression of Her2/neu and MHC-Ⅱ, no expression of CD80 or CD86. RT-PCR showed that ACC-LWL expressed MN/CA9 and HLA-A2 genes. CTL, either HLA-A2+ or HLA-A3+, had the capability of killing ACC-LWL in vitro. Conclusion This newly established ACC would provide a useful target in vitro and in vivo for investigations related to human ACC.

OBJECTIVETo observe the clinical effect of anatomic shape bracket splints designed by 3D-MAX software.

METHODSHealthy adult volunteers' forearms and wrist data were measured and processed by 3D-MAX software. Then we designed and made anatomic shape bracket splints. Totally 60 distal radial fracture patients were equally assigned to the test group and the control group. After manual reduction, patients in the test group used anatomic shape bracket splints, while those in the control group used common splints. The palmar dip angle, ulnar fleet angle, and radius height of standard X-ray in normal and lateral positions were measured after treatment, at 1, 3, and 6 week after treatment, respectively. Meanwhile, the incidence of complications was recorded during the whole treatment process.

RESULTSCompared with the control group, the palmar dip angle and ulnar fleet angle were larger in the test group after one week of treatment (P < 0.05). The radius height of the treatment group was higher after one, three, and six weeks of treatment (P < 0.05). Compared with the control group, the incidence of complications was obviously less in the test group (P < 0.05).

CONCLUSIONSAnatomic shape bracket splints designed by 3D-MAX software fit local anatomic features and need no more shaping. Its easier use with lesser complications could maintain the stability of bone fracture better.

Adult ; Humans ; Imaging, Three-Dimensional ; Radius ; Radius Fractures ; therapy ; Splints ; Wrist Joint

Objective To research the feasibility of using three-dimensional CT (3DCT) associated with active breathing control (ABC) in determination of the individual internal tumor volume (ITV) for hepatocellular carcinoma (HCC) comparing the four-dimensional CT (4DCT).Methods After 4DCT scans of 15 HCC patients who had accepted TACE,completed the 3DCT scans associated with ABC in three ways of breathing:free breathing ( FB),end inspiration hold ( EIH),end expiration hold (EEH).4DCT images were sorted into 10 phases and the maximum intensity projection (MIP) images were constructed.The GTVs were manually contoured on 4DCT and 3DCT images (labeled as GTV0,GTV10.….GTV90,GTVMIP,,GTVFB,GTVEIH and GTVEEH).GTV0…GTV90,GTV0 and GTV50,GTV0,GTV20 and GTV50,GTVEIH and GTVEEH were respectively merged into IGTV1,IGTV2,IGTV3,IGTV4.The volume and geometry displacement of GTVs and IGTVs were compared.Results All patients were compatible with the ABC technique and completed the CT scans in two ways.The motion of diaphragm measured between 4DCT and 3DCT images was not significantly different ( 1.39 cm and 1.39 cm,t =-0.02,P =0.983 ),it was similar to the volume difference among GTV0,GTV20,GTV50,GTVEIH,GTVEEH and GTVFB (56.4,54.6,55.5,55.6,55.2,59.7 cm3,F =0.01,P =1.000 ).The comparison result of volume difference among IGTV1,IGTV2,IGTV3,IGTV4 and GTVMIP (77.9,71.4,73.4,72.3 and 66.3 cm3,F =0.02,P =1.000)were similar to the differences of geometry displacement in x,y and z axial among them (F =0.48,0.04,0.02,P =0.750,0.997,0.999,respectively).Conclusion The application of 3DCT associated with ABC in determination of the individual IGTV for HCC is feasible and safe comparing to 4DCT.

OBJECTIVETo explore the relationship between blood stasis (BS) syndrome and coronary lesion in patients with coronary heart disease (CHD).

METHODSSyndrome types of 500 patients collected from multiple centers whose diagnosis of CHD confirmed by coronary angiography were differentiated. And the relationship between BS syndrome, its subtypes, and coronary lesion (affected branches, degree of constriction) were analyzed.

RESULTSThe affected branches of coronary artery in patients of BS syndrome was 2.28 +/- 0.28, while that in the non-BS syndrome patients was 2.07 +/- 0.86, showing significant difference between them (P < 0.05); as compared to patients of non-BS syndrome, the coronary lesions in patients of BS syndrome were mostly multi-vascular, and of more severe degree (P < 0.05). In patients of various BS syndrome subtypes, the average number of affected coronary branches in patients of yang-deficiency subtype was 2.58 +/- 0.65, which was significantly more than the number in patients of other BS syndrome subtypes. The constriction degree of coronary lesions in patients of yang-deficiency BS syndrome subtype were mostly severe or moderate, and single branch lesion was rarely seen, as compared with those in patients of phlegm-stasis obstruction subtype, the difference was significant (P < 0.05). The corresponding correlative analysis showed that close correlation was found between yang-deficiency subtype of BS syndrome and severe coronary constriction with the correlation distance of 0.1899.

CONCLUSIONRelationship between BS syndrome and coronary lesion (its number of branches and degree of constriction) truly exists to a certain extent.

Adult ; Aged ; Coronary Angiography ; Coronary Disease ; diagnosis ; diagnostic imaging ; Coronary Thrombosis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged