Stereotactic body radiation therapy (SBRT) adopts different tumor-killing mechanisms from the conventional fractionated radiotherapy.In SBRT,a single high-dose radiation can destroy the membrane of tumor cells and induce the release of tumor-associated antigen,also named in situ tumor vaccine,which stimulates the immune system to kill the residual tumor;a single-fraction radiation with a dose larger than 8-10 Gy can induce rapid apoptosis of vascular endothelial cells via the acid sphingomyelinase pathway at 1-6 hours after radiation,which causes tumor vascular occlusion and secondary tumor-killing effects.In order to understand whether SBRT improves the clinical treatment outcomes via the above mechanisms,this paper reviews the clinical research advances in SBRT for primary liver cancer.

Objective To Screen out incidence of vitamin K deficiecy and complicated with hemorrhage in newborn patients, infant patients and normal neonates, and also study on the treatment of vitamin K deficiency. Methods Using emzymoimmunoelectrophoresis to test PIVKA Ⅱ in umbilical and vein blood. Results The incidence of vitamin K deficiency in normal neonates, newborn patients (≤ 5 days) and infants patients (25~60 days) are 31.2%,47.6% and 31.8%. The incidence of hemorrhage in newborn patients (≤5 days) is 26.0%, infant patients (25~60 days) is 66.6%. Intramuscular injection of vitamin K 1 1 mg is the proper dosage to prevent and treat vitamin K deficiency. Conclusion The neonates right after birth or about 25 days after birth, especially those of breast feeding and who are getting lievr and gall diseases should receive vitamin K 1 to prevent vitamin K deficiency.

Objective To make a comparison between the outcome of modified Soave procedure and laparotomy on Hirschsprung disease(HD)in children.Method Chose the 21 eases who underwent transanal modified Soave procedure(modified Soave procedure group)and 25 eases had done by laparotomy (laparotomy group)from January 2001 to January 2007,clinical data of two groups were compared.Results Modified Soave procedure group showed lower level of IL-6 and CRP[(10.7±1.6)ng/L,(27.7±4.1)mg/L]on 48 h postoperation than laparotomy group[(22.0±2.3)ng/L,(73.7±15.0)mg/L](P ＜ 0.01).The mean operative time,hospital stay,the mean time of anal aerofluxus and the cost of hospitalization in modified Soave procedure group were much shorter than those in laparotomy group(P＜ 0.01).While the complication rate of two groups had no statistical difference.Moreover,there were no significant difference of rectal high pressure zone length and resting anal canal pressure between two groups at 1 year after operation.Conclusion Transanal modified Soave procedure for HD is a minimal invasive surgery,especially in young patients with short-segment type and common type of HD.

Objective To explore the effect of different doses of dobutamine on acute lung injury (ALI) in rabbits with septic shock and to clarify the possible mechanism.Methods The rabbits model of septic shock was made by cecal ligation and puncture combined with intravenous injection of endotoxin,70 male New Zealand white rabbits were randomly divided into five groups (14 rabbits in each groups):shamc operation group (group A),ALI group (group B),dobutamine low-dose group (group C),dobutamine medium-dose group (group D) and dobutamine high-dose group (group E),7 rabbits from each group were sacrificed 3 h and 6 h after septic shock.The level of cyclic adenosine monophosphate (cAMP) in lung tissue was detected by ELISA.The expression of aquaporin 5 (AQP5) protein was determined by western blotting.The wet to dry weight (W/D) ratio was measured.The pathological and ultrastructural changes of lung tissue were evaluated by optical microscopy and electron microscope,and lung injury score was assessed.The differences among the different groups were analyzed by one-way ANOVA (LSD test).Results The level of cAMP and expression of AQP5 protein in lung tissue at 3 h and 6 h were dramatically lower in group B than those in group A (3.53 ±0.43) pmol/mLvs.(21.18 ±0.62) pmol/mL; (0.44 ± 0.04) pmol/mLvs.(0.99±0.06)pmol/mL; (2.71±0.56)pmol/mLvs.(21.78±0.62)pmol/mL; (0.29 ±0.05) pmol/mLvs.(0.91 ±0.06) pmol/mL; all P ＜0.001,while the W/D ratio was obviously higher in group B than those in group A (all P ＜0.001).Compared with group B,the level of cAMP and AQP5 protein expression in lung tissue were significantly increased at 6 h in group C (8.48 ±0.61) pmol./ mLvs.(2.71±0.56) pmol/mL,P＜0.01; (0.49 ±0.04) pmol/mLvs.(0.29 ±0.05) pmol/mL,P=0.001 and at3 hand6 hin groupDandE (10.86±0.66) pmol/mLvs.(3.53±0.43) pmol/mL; (0.60±0.05) pmol/mLvs.(0.44±0.04) pmol/mL; (13.80±0.49) pmol/mLvs.(2.71±0.56) pmol/mL; (0.64 ± 0.03) pmol/mLvs.(0.29 ± 0.05) pmol/mL; (15.57 ± 0.60) pmol/mL vs.(3.53±0.43) pmol/mL; (0.91 ±0.05) pmol/mLvs.(0.44 ±0.04) pmol/mL; (19.30±0.42) pmol/mL vs.(2.71 ±0.56) pmol/mL; (0.89 ±0.08) pmol/mL vs.(0.29 ±0.05) pmol/mL; all P ＜ 0.01,while the W/D ratio in group E was decreased obviously (P =0.002; P =0.001).Compared with group C and D,the level of cAMP and the expression of AQP5 protein at 3 h and 6 h in group E increased significantly (all P ＜0.01.The pathological and ultrastructural changes of lung tissue were more intensive in group B than those in group A and the lung injury scores were obviously higher (P ＜0.01).The degree of lung pathological and ultrastructural lesion was ameliorated after administration of dobutanmine.Additionally,histological scores decreased significantly (P ＜ 0.01).Conclusions Our study demonstrated that dobutamine could improve ALI induced by endotoxin,the mechanism of protective effect may involve in increasing the level of cAMP and up-regulating the AQP5 protein expression,and high-dose dobutamine had better effects.

Objective To explore the methods for early diagnosis and treatment of blunt pancreatic injury.Methods The clinical data of 32 patients with blunt pancreatic injury treated in our hospital from Janurery 2004 to Janurery 2009 were retrospectively analyzed.Results The conformity diagnosis rate of CT was 79.3%.Four cases received nonoperative treatment including 3 cases of grade I and 1 of grade II injury.A total of 28 cases with blunt pancreatic injury underwent operation: 5 grade I and 7 grade II cases underwent debridement and drainage;among the patients with grade Ⅲ injury,4 underwent distal pancreatectomy in combination with splenectomy,and 2 pancreatectomy with spleen preservation;amongst the 5 patients with grade Ⅳ injury,4 underwent Roux-en-Y pancreaticojejunostomy and 1 underwent distal pancreatectomy in combination with splenectomy;of the 5 patients with grade Ⅴ injury,1 case was operated on using duodenorrhaphy and diverticulization,2 underwent the Whipple′s procedare and 2 had damage control surgery.Three patients died of multiple organ failure,and complications occurred in 19(76.0%).Pancreatic fistula and pancreatic pseudocysts were the main complications.Conclusions In the absence of major pancreatic ductal injury,and the clinical conditions were stable,pancreatic injuries can be treated with nonoperative management.Operative treatment is suitable for severe blunt pancreatic injury.Appropriate operation,based on patient condition and the classification of pancrecatic trauma,is the key to increase the cure rate and decrease mortality rate.

OBJECTIVEThe purpose of the present study was to investigate the in vitro effects of baicalin on induction of apoptosis in human prostate cancer cell line DU145.

METHODHuman prostate cancer cell line DU145 was treated with different concentration of baicalin in vitro. The apoptosis rate was determined by FACS analysis, cell cycle distribution was detected by flow cytometry, morphological changes and protein analysis were determined by means of electron microscope techniqueand immunohistochemical techniquerespectively.

RESULT50micromol x L(-1) and 125 micromol x L(-1) of baicalin dose-dependently induced apoptosis and inhibited the proliferation of prostate cancer cell DU145 in a dose and time-dependent manner. DNA flow cytometric analysis indicated that baicalin induced a arrest in G1 phase, showing a typical apoptosis peak. Electron microscopy detected a characteristic appearance of the apoptotic cells morphology. Immunohistochemical analysis revealed that induction of apoptosis by ways of inhibition of the bcl-2, loss of the Bax, and upregulation of Fas.

CONCLUSIONThe results indicate that baicalin may induce apoptosis and inhibit proliferation of prostate cancer cells, and has direct anti-tumor effects on human prostate cancer cells.

Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Flavonoids ; isolation & purification ; pharmacology ; G1 Phase ; Humans ; Male ; Plants, Medicinal ; chemistry ; Prostatic Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Scutellaria ; chemistry ; bcl-2-Associated X Protein ; fas Receptor ; metabolism

OBJECTIVE: To explore the curative effect and origin of antrochoanal polyp (ACP) with various approaches. METHOD: Fifty-seven patients with ACP were included in the study. All the ACP patients were examined by preoperative endoscopy and computer tomographic (CT) scans. The patients were treated by various endoscopic approaches including endoscopic middle meatus antrostomy, inferior meatus antrostomy combined with endoscopic middle meatus antrostomy or endoscopic medial maxillectomy combined with endoscopic middle meatus antrostomy respectively. The relationship between polyp location in middle meatus and lesions in the antrum was explored during the surgery. Pathological examination was carried out and patients were regularly followed up after operation. RESULT: Fifty-seven ACP develops from antral cyst. In 22 cases of endoscopic middle meatus antrostomy, two patients relapsed. In 17 cases of inferior meatus antrostomy combined with endoscopic middle meatus antrostomy, one patients relapsed. In 18 cases of endoscopic medial maxillectomy combined with endoscopic middle meatus antrostomy, no one relapsed. CONCLUSION Our data indicated that the ACP mainly originates in antral cyst, and capsule wall herniates to middle meatus through the antral ostium. ACP are common in unilateral, rare in both sides. The endoscopic approaches of middle meatus antrostomy and inferior meatus antrostomy combined with endoscopic middle meatus antrostomy might guarantee good prognosis. If the cyst is on the anterior wall of maxillary sinus, the approach of endoscopic medial maxillectomy can obtain a better vision and completely remove the lesions.
Cysts ; surgery ; Endoscopy ; Humans ; Maxillary Sinus ; surgery ; Nasal Polyps ; surgery ; Nasal Surgical Procedures ; methods ; Tomography, X-Ray Computed

objective To explore the correlation of single nucleotide polymorphism (SNP) frequency of adiponectin(APN)in patients with type Ⅱ diabetes(T2DM)and its complications,investigate whether the SNP is a risk factor of inheritance of T2DM,and to set up a highly efficient.accurate, economical and practical screening assay to detect the mutation of APN in clinical practice.Methods According to the diagnostic criteria of T2DM,patients with coronary heart disease(CHD),hypertension (HP),and diabetic nephropathy(NE)were recruited into this study.In simple,12DM group,T2DM-HP, T2DM-CHD.T2DM-NE and the control group.serum biochemistry items are measured.The technique of denaturing high-performance liquid chromatography(DHPLC)was used to detect SNPs of ANP gene.Results After all fragments amplified in the reglen of promoter of APN gene were compared with APN GeneID:9370 sequence recorded in GenBank,point mutation has been identified(-11377G/C).The frequency of genotypes of GG,GC,and CC are 5.16%,42.25%,52.58%and 3.4%.32.75%,63.85%,respectively in the groups of T2DM and control.The frequency of G allele was related to the incidence of T2DM,and is a risk factor of T2DM.The relative risk of GC to CC in developing T2DM is much high than that in the control group (OR=0.55).By comparing the clinical data of different groups of genotype in T2DM,it was observed that the genotype affected systolic blood pressure,BMI,abdominal circumference, and waist-buttock ratio(P=0.015).After optimizing the experimental conditions.it was found column temperature 6 0℃ was the best when using DHPLC technology to estimate SNP of APN gene.Conclusion SNP (-11377G/C) of APN gene G allele has a definite correlation with complications of hypertension in T2DM patients,and may contribute to the genetic risk for type 2 diabetes.

Chinese stomatology education mode is different from foreign oral education mode,with its own characteristics and some deficiencies.By comparing to the mature oral ( dental ) medical education system,we can learn from the successful experience from American modern oral medical education mode while preserving their advantages to carry forward the Chinese stomatology education.For this purpose,we analyze the academic structure,curriculum,teaching methods,continuing education,basic training,clinical practice,career prospects between Sino-US oral medical education system.Some suggestions on educative reform were also made.

Objective To evaluate the diagnosis, treatment and prognosis of primary duodenal carcinoma. Methods The clinical data of 41 cases with primary duodenal carcinoma admired during 2000-2007 were analyzed retrospectively. Results Clinical manifestation was not specific, including abdominal pain, abdominal distention, jaundice, bowel obstruction or bleeding. The correct diagnosis rate of endoscopy, duodenography, ultrasound and CT was 86%, 90%, 20% and 33% respectively. 23 cases underwent pancreaticoduodenectomy, 6 cases received segmental duodenectomy, 9 cases received bypass operation and 3 cases underwent biopsy. Overall postoperative 5-year survival rate was 18%. Univariate analysis revealed that the operation types, tumor histology, depth of tumor invatian, lymphatic invasion correlated with prognosis. Multivariate analysis showed that only the operative types, depth of tumor invasion and lymphatic invasion were independent prognostic factors. Conclusions Duodenography and endoscopy are major methods for diagnosis of primary duodenal carcinoma. Pancreaticoduodenectomy is the choice of therapy for primary duodenal carcinoma.