Objective To investigate the impact of palliative radiotherapy to the prognosis of patients with stage Ⅳ non-small cell lung cancer (NSCLC).Methods Two hundred and forty-four cases of stage Ⅳ NSCLC were collected from our hospital.The study group (n =129) received the treatment of primary tumor and metastases palliative radiotherapy after chemotherapy.The control group (n =115) received only chemotherapy.Followed-up and compared 1-year and 2-year survival rate of the patients,and explored the factors affecting palliative radiotherapy.Results The 129 patients in the study group were followed up for 2 years,and 16 patients survived and 110 patients died.Three patients were lost to follow-up.The median survival time was 8 months.1-year and 2-year survival rates was 29.46％ (38/129) and 12.40％ (16/129) respectively.In the control group,7 patients survived,and 106 patients died.Two patients were lost to follow up.The median survival time was 6 months.1-year and 2-year survival rates was 11.30％ (13/115) and 6.09％ (7/115)respectively.Survival rates between the two groups were significantly different (x2 =8.451,P =0.014)Univariate regression analysis found that factors affecting the prognosis of stage Ⅳ NSCLC were KPS score (x2 =5.057,P =0.031),occurrence of brain metastases (x2 =4.781,P =0.029),number of organs of metastasis (x2 =6.341,P =0.010),and the primary stove radiotherapy dose (x2 =5.893,P =0.015) ; Cox regression model analysis showed that the number of organs of metastasis (HR =1.719,95％ CI 为 1.172-3.126,P =0.008),the primary focal radiotherapy dose (HR =1.560,95％ CI 为 1.082-2.761,P =0.022) were independent prognostic factors.Conclusion Palliative radiotherapy plays a role of prolonging survival time in the treatment of Ⅳ NSCLC.In palliative radiotherapy,we should pay attention to the control of the primary tumor and metastases radiotherapy dose,therefore prolonging the survival time of patients.

BACKGROUND:Inducing factor and chondrogenic microenvironment is a primary factor, which influences chondrogenic differentiation and chondrogenesis of bone marrow-derived mesenchymal stem cells (MSCs). OBJECTIVE:To explore the feasibility of in vivo chondrogenesis by co-culture of bone marrow-derived MSCs and chondrocytes. DESIGN, TIME AND SETTING:A randomized controlled animal experiment was performed at Department of Pathology, Stomatological Hospital, Fourth Military Medical University of Chinese PLA between September 2004 and March 2005. MATERIALS:Fifteen New Zealand rabbits of clean grade were used for cell-scaffold construct transplantation. The rabbits were randomly divided into co-culture, chondrocyte, and bone marrow-derived MSC groups, with 5 rabbits in each group. Five neonatal New Zealand rabbits, aged 1-3 days, were used for isolation and culture of bone marrow-derived MSCs and chondrocytes. Polyglycolic acid (PGA) scaffold material (Shanghai Yikuo Company, China) has a fiber diameter of 15 μm, with an average interval of 150-200 μm, an interval porosity of 97% and 2-mm thickness. METHODS:In the co-culture group, bone marrow-derived MSCs and chondrocytes were mixed at a ratio of 3:1. The mixed cells were seeded onto a pre-wetted PGA scaffold (5 mm×5 mm )at the ultimate concentration of 6.0×1010 L-1. Dulbecco's modified Eagle's medium (DMEM) supplemented with fetal bovine serum was dropwise added to peripheral compound for 1 week of culture. In the chondrocyte, and bone marrow-derived MSC groups, chondrocytes and bone marrow-derived MSCs of the same ultimate concentration were seeded respectively onto the PGA scaffold. Then, the cell-scaffold constructs were transplanted into subcutaneous tissue of adult rabbits. MAIN OUTCOME MEASURES:Gross observation and hematoxylin-eosin & Masson staining of neo-cartilage were performed after in vivo culture for 8 weeks. RESULTS:Cell in all groups had a fine adhesion to the scaffold. In both co-culture and chondrocyte groups, the cell-scaffold constructs could maintain the original size and shape during in vivo culture and formed homogenous mature cartilage after 8 weeks of in vivo culture. Furthermore, the neo-cartilages in both groups were similar to each other in gross appearance and histological features. In the bone marrow-derived MSCs group, connective tissue rather than cartilage was found during in vivo culture. CONCLUSION:Chondrocytes can provide a chondrogenic microenvironment to induce a chondrogenic differentiation of bone marrow-derived MSCs and thus promote the chondrogenesis of bone marrow-derived MSCs in vivo.

AIM To determine the relationship between the elevation of endogenous inhibitor of nitric oxide synthase (NOS)N G,N G-asymmetric dimethylarginine (ADMA) and metabolic control in diabetic rats. METHODS Diabetes was induced in Sprague-Dawley rats by a single intraperitoneal injection of streptozotocin. At 72 h after injection, half of diabetic rats received insulin treatment for 8 weeks (20 U?kg -1?d -1,ih, bid). Serum levels of ADMA were measured by high-performance liquid chromatography. Thoracic aortic rings from non-diabetic age-matched control, untreated diabetic, and insulin-treated diabetic rats were tethered in isolated organ baths,contracted with 1 ?mol?L -1 phenylephrine, and challenged with either the endothelium-dependent vasodilator acetylcholine or the endothelium-independent vasodilator sodium nitroprusside. Serum concentrations of glucose, glycosylated serum protein, and malondialdehyde, derived from lipid peroxidation were also examined to estimate metabolic control.RESULTS Serum levels of ADMA significantly elevated in untreated diabetic rats compared with control rats. This elevation of ADMA was accompanied by impairment of relaxation response to acetylcholine but not sodium nitroprusside in aortic rings. Chronic insulin treatment not only prevented the elevation of serum ADMA, but also improved the impaired endothelium-dependent relaxation in diabetic rats. Serum levels of glucose, glycosylated serum protein, and malondialdehyde were significantly increased in parallel with the elevation of ADMA in untreated diabetic rats compared with control rats. These parameters were normalized after diabetic rats received insulin treatment. CONCLUSION These results provide the first evidence that the elevation of endogenous inhibitor of NOS in streptozotocin-induced diabetic rats is close related to metabolic control of the disease.

AIM To explore possible action mechanism of antidepressants. METHODS Using flow cytometry, the cell proliferation was detected. The proliferation of hippocampal progenitor cells and level of brain derived neurotrophic factor (BDNF) were measured by immunohistochemistry. RESULTS Treatment with N methyl D aspartate (NMDA) 600 ?mol?L -1 for 3 d significantly decreased the percentage of S phase in PC12 cells, while in the presence of classical antidepressants, desipramine (DIM) or fluoxetine (FLU) 1, 5 ?mol?L -1 , the percentage of S phase increased. Furthermore, the proliferation of hippocampal progenitor cells, as well as the BDNF level in dentate gyrus (subgranular zone) significantly decreased in chronically stressed mice for 24 d, while chronic administration with DIM or FLU 10 mg?kg -1 (ip) normalized it. Meanwhile, the BDNF level in dentate gyrus also elevated after DIM or FLU treatments. CONCLUSION Up regulation of the hippocampal neurogenesis is the common action mechanism for antidepressants, which may be closely related to the elevation of BDNF level at the same time.

AIM Xiaobuxin-Tang (XBXT) is a traditional Chinese herbal decoction which is composed of Haematitum, Flos Inulae, Folium Phyllostachydis Henonis and Semen Sojae Preparatum. The present study was to investigate if the total flavonoids extracted from XBXT (XBXT-2) had antidepressant effect. METHODS Forced swimming tests in mice and rats, and learned helplessness (LH) model of rats were adopted to affirm the antidepressant effect of XBXT-2 with the test on spontaneous motor activity. Plasma corticosterone level in the LH rats was measured with ELISA. RESULTS Single administraton of XBXT-2 at the doses of 50 and 100 mg·kg-1 (ig) significantly decreased the duration of immobility time in the forced swimming tests in mice and rats. Researches on LH model of rats indicated that XBXT-2 at doses of 50 and 25 mg·kg-1 markedly reduced the number of escape failure in shuttle box. Meanwhile, the plasma corticosterone level of the LH rats was significantly decreased. XBXT-2 50-200 mg·kg-1 had no effects on spontaneous motor activity in mice. CONCLUSION XBXT-2 possesses significant antidepressant-like effect. The mechanism may involve the inhibition of the hyperaction of the hypothalamic-pituitary-adrenal axis.

ObjectiveThe purpose of this study was to analyze the outcomes of surgical treatment of displaced intra-articular calcaneal fractures (ICFs) in children and its characteristics.MethodsBetween January 2004 and October 2008,we review the results of 9 displaced,intra-articular fractures in 8 skeletally immature patients,who were treated with open reduction and internal fixation in our hospital.There were 7 males and 1 female,with the mean age of 13.1 years(range:10 to 15 years).Preoperative radiographs and computed tomographic scans were used to classify fractures.Clinical and radiographic evaluation were performed in postoperative follow-up visits.The functional outcomes were assessed with use of the modified American Orthopaedic Foot and Ankle Society(AOFAS) ankle and hindfoot score.The published literatures of child ICFs treated with ORIF were reviewed.ResultsIn the series,there were 4 tongue-type and 5 joint depression-type fractures according to Essex-Lopresti classification,and according to Sanders classification,we found 5 type-Ⅱ fractures,3 type-Ⅲ and 1 type-Ⅳ fractures.The mean follow-up time was 47.4 months (range:21 to 72 months).All fractures healed within 2 to 4 months.The average preoperative and postoperative Bohler angles were 5.7 and 33.1 degrees respectively,and the mean Gissane angles were 106.5 and 128.0 degrees respectively.The mean modified-AOFAS score was 65.2 points(range:53 to 68 points).Skin necrosis was found in one foot.After the review of literatures,78.6％ (48/61) of displaced ICFs were male in children.Based on the Sanders classification,36 of 67 (53.7％) were type-Ⅱ fractures,25 of 67 (37.3％) were type-Ⅲ and 6 of 67 (9.0％) were type-Ⅳ; And 15 of 37 (40.5％) were tongue-type,22 of 37 (59.5％) were joint depression-type fractures according to Essex-Lopresti classification.ConclusionMost children with displaced ICFs treated with ORIF had a good clinical outcome with few complications.The children and adolescents that were exposed to high-energy trauma suffer calcaneal fractures that were similar to adult fracture patterns.

Objective To measure stress distribution of the main bone architecture of the normal adult cadaveric foot and discuss the effect of plantar ligament injury on stress distribution. Methods Seven fresh adult cadaveric feet were used and 10 strain gauges attached to the bones of the longitudinal foot arch,including the calcaneus,navicular,medial cuneiform,1-5 metatarsal trunk,the distal part of the tibia and fibular,respectively.After the loading Was added to 700 N by almighty test machine,resistance strainmeter was used to measure surface strain of these bones.The results were processed statistically. Results The strain was varied based on different bone segments attached and increased with loading.Tensile force was always found at the medial part of the navicular,the distal part of the tibia and fibular,while the others showed compression all the time.Peak strain was found at calcaneus.followed by the second and third metatarsal.Strain on the surface of the bone segments changed greatly with different ligament injury(P＜0.05).Conclusion The bone surface stress of the longitudinal foot arch changes significantly when the plantar ligament is injured.

Objective To explore the operative methods of open reduction and fixation for the cuboid fractures. Methods The study involved 12 patients with cuboid fractures treated from October 2006 to October 2008. There were seven males and five females, at average age of 38.5 years (range 18-70 years). All patients had closed fractures, including 10 with compression fracture and two with sagittal fractures. The surgical treatments included open reduction, internal fixation by plate, screw or K-wire.Results Ten patients were followed up for 15 months on average ( range 12-24 months), which showed one stage wound healing, with mean time of bone union for 10 weeks ( range 8-15 weeks). No infection was found in any patient. The weight load walk began at 12 weeks ( range 8-18 weeks), with no obvious pain. According to American orthopaedic foot and ankle society (AOFAS) midfoot scale, the mean score was 88.6 (range 73-100). Conclusion Anatomic reduction and stable internal fixation of the cuboid fractures is the key point for recovery of foot form, stabilization and function of the feet.

Objective To evaluate the clinical effectiveness of early interfering of yellow-water on Deep Venous Thrombosis (DVT) in lower extremities of hip fracture patients after operation. Methods 60 patients with hip fracture were recruited into a control group and a treatment group randomly. The control group was treated with low molecular heparin,while the treatment group was treated additionally with yellow-water on that basis. The status of pain, swelling levels, vascular color doppler ultrasound and safety of medication were reviewed after two weeks. Results There was 23.3% cure rate and 60.0% significant improvement rate in the treatment group, and 13.3% cure rate and 40.0% significant improvement rate in the treatment group. The therapeutic effect in the treatment group was better than the control group, with significant difference (P＜0.05 ) . Conclusion Yellow-water was effective in early interfering in DVT in lower extremity due to its quickness in eliminating swelling and alleviating pains with no stimulus feeling.

AIM: To investigate the effect and the mechanism of apolipoprotein (a) [apo (a) ] on proliferation of vascular smooth muscle cells ( VSMCs). METHODS: All VSMCs used in experiments were serial subcultured from primary cells and were identified by immunohistochemistry staining of a - actin. Cell growth assay was observed as cell counting and MTT assay. Western blotting was also employed to detect the related mechanism. RESULTS: All cells used in experiments were confirmed as VSMCs. Although apo (a) enhanced VSMCs proliferation, this effect was attenuated by anti -integrin α_vβ_3, LM609.Use these reagents alone had no effect on VSMCs growth. The results of Western blotting demonstrated that focal adhesion kinase (FAK) was activated by apo (a) and the expression of total or phosphorylated transforming growth factor β_1 (TGF -β_1) was also decreased. However, these effects described above were all blocked by LM609.CONCLUSION: Apolipoprotein (a) enhances VSMCs proliferation and this effect is mediated by integrin α_vβ_3, which activates FAK and attenuates TGF - β_1 and phospho -TGF - β_1 expression.