Objective To investigate the effect of 18F-fluoro-deoxy-2-glucose hybrid positron emission tomography images combined CT image(I8F-FDG PET-CT) on gross target volumes in non-small-cell lung cancer (NSCLC). Methods Forty six patients with pathological defined NSCLC were included in the study. All patients were divided into three groups according to image features; lymphatic metastasis group(18 cases) , ate-lectasis group( 16 cases) , solitary focus group(12 cases). The gross target volumes by CT and by PET-CT (GTVct and GTVPET_CT)were compared with volume differentials and coherence. We also compared the coherence among the three groups. Results The median GTVCT and median GTVPET-CT of atelectasis group was 160.813 cm3 and 108.838 cm3(t = 13.592,P<0.05). The median GTVCT and median GTVPET-CT of lymphatic metastasis group was 65.233 cm3 and 84. 367cm3 (t = 2. 768, P < 0.05 ). In the solitary focus group , median GTVCT was 21.7 cm3,and median GTVPET-CT was 19.6 cm3 (t =0. 684,P >0.05). There was statistic difference in coherence among the three groups (lymphatic metastasis group 0.561, atelectasis group 0. 698, solitary focus group 0.740). Conclusion There are varying degrees of difference between GTVCT and GTVPET-CT in both volume differentials and coherence . Compared to CT, PET-CT could improve the accuracy of radio-therapy. Patients with lymphatic metastasis would most likely benefit from it.

BACKGROUND: The full three-dimensional finite element model can not only establish a realistic three-dimensionalmodel, but also can simulate the osteotomy on the model. Analysis of biomechanics guides the clinical operation.OBJECTIVE: To establish a three-dimensional finite element model of ankylosing spondylitis kyphosis and provide an effective digital platform for further studies.METHODS: A 30-year-old male patient with ankylosing spondylitis kyphosis participated voluntarily in the current study. CTimages obtained from CT transverse scanning from C1 to the sacrococcyx were imported into Mimics 17.0 software toestablish a three-dimensional geometric model of the posterior spine. The geometric model was then imported into Studio Geomagic 2013 software. For the subsequent optimization of image processing, the posterior spine convex geometry wasestablished on the three-dimensional geometric model. We used Unigraphics NX 8.5 to establish the spinal kyphosis surfacemodel, then added modeling of calcification of the ligaments, partial resection of useless sacral bone, and finally, imported themodel into ANSYS 15.0 finite element analysis software, then added the ligaments and set the parameters of the material,generating a complete three-dimensional finite element model of ankylosing spondylitis.RESULTS AND CONCLUSION: A three-dimensional finite element model of complete ankylosing spondylitis wassuccessfully established. Using the ten-node approach, we generated 398370 tetrahedral elements, and 668538 nodes.This will provide a reliable digital platform for the next step of biomechanical analysis.

Objective Objective To evaluate the efficacy and comphcations of late course acceler- ated hypofractionated three dimensional conformal radiation therapy (3DCRT) for patients with stageⅢnon small cell lung cancer (NSCLC). Methods Sixty patients with stageⅢNSCLC were randomized into 2 groups: Late course accelerated hypofractionated 3DCRT group(group A—30 patients) and conventional fractionated radiation therapy group (group B—30 patients). In group A, 30 patients, at first, received a dose of 40 Gy at 2 Gy per fraction, 5 times a week, which followed by late course accelerated hypofractionat- ed 3DCRT with a dose of 16-20 Gy at 4 Gy per fraction, 3 times a week. In group B, 30 patients received a dose of 60-66 Gy at 2 Gy per fraction, 5 times a week. Chemotherapy, including vinorelbine and cisplatin, was given one cycle during radiotherapy and 3 cycles after radiotherapy for all patients. Results Group A had a higher complete response rate (47% vs 20%, P

Objective: To evaluate the efficacy of granulocyte(-macrophage) colony stimulating factor[G(M)-CSF] inthe treatment of concomitant chemoradiotherapy-induced oral mucositis in locally advanced head and neck cancer patients.Metheds: Fifteen patients with locally advanced head and neck cancer was received concomitant chemoradiotherapy, whilewhite blood cell count were less than 1. 5?10~9/L with grade Ⅲ/Ⅳ oral mucositis, they were subcutaneously given G(M)-CSF at dose of 100-300?g daily for 3～10 days. Results: After administration of G(M)-CSF, all of the patients had anaugmantation of white blood cell count more than 5. 0?10~9/L. Complete healing of oral mucositis occurred in 1 patient(CR), partial in 8 patients(PR), whereas 6 patients had no change and none was progressive, the objective response rate(CR+PR) was 60%. Condusions: G(M)-CSF is proved effective for oral mucositis caused by concomitant chemoradio-therapy in locally advanced head and neck cancer patients.

Objective To evaluate the methods of carrying out radiotherapy quality control (QC) and quality assurance (QA) in the whole province. Methods From 1995, radiotherapy quality control center of Zhejiang province (the guiding team consists of specialists in radiation oncology of the province) has carried out a QC and QA program including evaluation of administration, departmental infrastructure, equipment, staff and treatment for 28 centers in the whole province. The regulation and scoring system were designed and first informed to every center, with the 28 centers checked and examined by the guiding team from 1999 to 2000. Results Great variations in equipment and staff were observed among participating centers. Equipment condition was not very satisfactory. Most of the treatment protocols were reasonable except that the indication for radiotherapy was not strict enough in some centers. Conclusions It is feasible for the radiotherapy quality control center to check and examine the department of radiation oncology in the whole province. Good QC and QA is invaluable to standardize the treatment protocol and ensure the radiotherapy quality and also helpful to carry out multi center study in the future.

The principal investigator responsibility system has been progressively under implementation at some of the domestic medical universities. However, since there are big differences between military medical universities and civilian ones in terms of organizational structures, tasks to be committed, functions and personnel systems, military medical universities have to consider own characteristics and well handle the following four pairs of relations in the process of implementing principal investigator responsibility system: the relation between the subject groups and the teaching and research sections, the relation between the subject research and the discipline construction, the relation between the subject research and the personnel training, and the relation between the collective assessment and the individual assessment in the process of performance assessment.

Objective To evaluate the role of spinal sigma-1 receptors in the maintenance of bone cancer pain (BCP) in rats and the relationship with extracellular signal-regulated kinase (ERK).Methods Part Ⅰ Twenty-four female Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups using a random number table:sham operation group (S group,n =4) and BCP group (n =20).BCP was induced by inoculating Walker 256 mammary gland carcinoma cells into the medullary cavity of the right tibia.Four rats were sacrificed on day 10 after inoculation in S group or on day 3,5,7,10 and 14 after inoculation in BCP group,and the L4-6 segments of the spinal cord were removed to measure the expression of sigma-1 receptors by Western blot.Part Ⅱ Forty female Sprague-Dawley rats,weighing 180-220 g,were randomized into 4 groups (n =10 each) using a random number table:sham operation group (S group),sigma-1 receptor inhibitor BD1047 group (BD group),BCP group,and BCP + BD1047 group (BCP + BD group).On day 10 to 14 after inoculation,normal saline 20 μl was injected intrathecally once a day in S and BCP groups,or BD1047 120 nmol/20μl was injected intrathecally once a day in BD and BCP + BD groups.Mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured one day before inoculation,on day 3,5 and 7 after inoculation,and on day 10,12 and 14 after administration.After measurement of MWT on day 14 after inoculation,the rats were sacrificed and the L4-6 segments of the spinal cord were removed to determine the expression of phosphorylated ERK (p-ERK) by Western blot.Results Part Ⅰ Compared with group S,the expression of sigma-1 was significantly up-regulated and peaked on day 10 after operation in group BCP.Part Ⅱ Compared with S group,no significant changes were found in MWT and p-ERK expression at each time point in BD group,and MWT was decreased and p-ERK expression was up-regulated in BCP and BCP + BD groups.Compared with group BCP,after intrathecal injection of BD1047,MWT was significantly increased and the expression of p-ERK was down-regulated in BCP + BD group.Conclusion Spinal sigma-1 receptors are involved in the maintenance of BCP in rats possibly through promoting phosphorylation of ERK.

Objective To investigate clinical features , outcomes and prognosis gerontol delirium . Methods Patients with gerontol delirium diagnosed between January 2011 and January 2013 were identified by a retrospective review of records in the Nanjing General Hospital of Nanjing Military Command .Totally 132 patients were included , 59 females and 73 males, with a median age of 71.4 years (range 65-97).The diagnostic criteria were based on the DSM-Ⅳ and Delirium Rating Scale.Dementia, depression, mental retardation and other cognitive dysfunction were excluded .General condition of patients , etiology , clinical features , treatment and prognosis were all performed using the SPSS 20.0 for windows.A P value of <0.05 was considered as significant . Results Disturbance of consciousness were observed in all 132 patients.Old age, coma and serious infection in the course , endotracheal intuba-tion and(or) tracheotomy, a variety of basic diseases all come up with poor prognosis . Conclusion Delirium progresses quickly. Etiological treatment can help to control the conditions of delirium .

BACKGROUND:In recent years, animal models of lumbar disc degeneration have been popularized to explore the effect of tissue engineering, cel engineering and genetic engineering technologies on intervertebral disc degeneration.
OBJECTIVE: To investigate the influence of biological patches on rabbit anulus fibrosus repair.
METHODS:L3-4, L4-5, L5-6 segments from rabbits were randomly divided into normal control group (the intervertebral disc was exposed correspondingly), control group (the annulus fibrosus was only cut with a surgical scalpel) and experimental group (the annulus fibrosus was cut and sutured with the surgical biomaterial). Six rabbits were selected randomly to take the lumbar X-ray and MRI preoperatively and 1, 2, 4, 8, 12 weeks postoperatively; one rabbit was chosen preoperatively and three rabbits selected respectively at 1, 2, 4, 8, 12 weeks postoperatively to execute hematoxylin-eosin and type II colagen immunohistochemistry.
RESULTS AND CONCLUSION:At postoperative 1, 2 and 4 weeks, the disc height index decreased significantly in the control and experimental groups. MRI and histopathological examination showed that the T2WI signal intensity and hematoxylin-eosin grading were both increased significantly in the control and experimental groups at 2 weeks after surgery (P < 0.05). With time, the number of nucleus pulposus cels gradualy reduced in the control and experimental groups. Annulus fibrosus defects were filed with granulation and fibrous tissues, and the biofilm was tightly fused with the annulus fibrosus. Findings from the type II colagen immunohistochemical staining showed that the histological staining of the nucleus pulposus was gradualy changed from positive to negative in the experimental and control groups. Therefore, cutting the annulus fibrosus can lead to severe disc degeneration at early period, and surgical biomaterials can be integrated with the annulus fibrosus wel to seal annulus fibrosus defects and further prevent nucleus pulposus protrusion. However, this approach cannot restrain the continuous process of disc degeneration.

OBJECTIVETo observe the expression of Ginkgo biloba Tablet (GbT) on scavenger receptor A (SRA) of the aortic wall and changes of serum inflammatory factors in atherosclerotic rats, and to explore its new mechanism for fighting against atherosclerosis (AS).

METHODSTotally 45 male Wistar rats were randomly divided into the control group, the model group, the GbT group, 15 rats in each group. Levels of blood glucose, blood lipids, blood calcium, serum C-reactive protein (CRP), soluble intercellular adhesion molecule-1 (slCAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured in all rats. The expression of SRA in the aortic wall of atherosclerotic rats was observed by immunohistochemical assay. The correlation between the expression of SRA and levels of in-flammatory factors was also observed.

RESULTSCompared with the control group, blood glucose and blood calcium obviously increased (P < 0.05); levels of TG, TC, and LDL-C were significantly elevated (P < 0.01); neointimal areas were significantly thickened, increased intima percentage was significantly enlarged, narrowed lumen index was significantly reduced; levels of CRP, sICAM-1, and sVCAM-1 were significantly elevated in the model group (all P < 0.01). Compared with the model group, blood glucose and blood calcium obviously decreased (P < 0.05); levels of TG, TC, and LDL-C significantly decreased (P < 0.01) in the GbT group. Aortic lumens were obviously narrower in the model group than in the GbT group (P < 0.05). SRA expressed at the aortic wall. The aforesaid 3 indices were significantly improved in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were significantly decreased in the GbT group than in the model group (P < 0.01). Serum levels of CRP, sICAM-1, and sVCAM-1 were positively correlated with the percentage of SRA positive expression area (r = 0.701, 0.604, 0.581, all P < 0.01).

CONCLUSIONSSerum levels of inflammatory factors in atherosclerotic rats were elevated, and the expression of SRA in the aortic wall was enhanced. The expression of SRA was closely correlated with serum levels of inflammatory factors. GbT could decrease serum levels of inflammatory factors and inhibit the expression of SRA.

Animals ; Aorta ; drug effects ; metabolism ; Atherosclerosis ; drug therapy ; Blood Glucose ; analysis ; C-Reactive Protein ; analysis ; Calcium ; blood ; Drugs, Chinese Herbal ; pharmacology ; Ginkgo biloba ; chemistry ; Intercellular Adhesion Molecule-1 ; blood ; Lipids ; blood ; Male ; Random Allocation ; Rats ; Rats, Wistar ; Scavenger Receptors, Class A ; metabolism ; Tablets ; Vascular Cell Adhesion Molecule-1 ; blood