Objective To evaluate the influence of Motivational Interview on function restore and life quality after artificial unilateral total hip replacement surgery. Methods A convenient sampling method was used for collecting 103 patients underwent artificial unilateral total hip replacement surgery for the study. Lottery method was used to divide these patients in to treatment group 53 cases and control group 50 cases. Intervention of both joint exercise and motivational interview was used for the treatment group, and routine health education was used for the control group in a large general hospital in Hangzhou. Results 1 month later, patients′joint function assessed with Harris score of the intervention group and control group were 62.40 ± 8.95 and 54.06 ± 9.61; 3 months later, intervention group was 82.25 ± 7.09 while control group was 74.60 ± 9.97, the difference was statistically significant (t=-4.559 and-4.451, P=0.000). Patients′life quality after 1 month was 485.54 ± 86.85 in intervention group and 400.69 ± 72.36 in control group;3 months later, the scores were 601.54 ± 73.49 and 543.08 ± 81.77, the difference was statistically significant (t=-5.370 and-3.821, P=0.000). Conclusions Motivational Interview was capable of improving joint function restore and quality of life through changing patients′ motivation, helping patients establishing and adhering to joint exercise.

Objective To apply RNA interference technique for reducing the expression of MDC1 gene in esophageal carcinoma cell line ECA109, observe the changes in cell cycle and radiosensitivity after radiation, and discuss related mechanisms. Methods Three pairs of effective interference sequences and negative control sequences were synthesized for MDC1 mRNA sequence, and a recombinant plasmid was constructed with the vector pSIH1?H1?copGFP. RT?PCR and Western blot were used to determine the expression levels of MDC1 mRNA and protein. Colony?forming assay was applied to measure radiosensitivity, flow cytometry to determine cell cycle, Western blot to determine the expression of CHK1 and CHK2 proteins, and laser scanning confocal microscope to observe the number of MDC1 blotches inside the nucleus. One?way analysis of variance was used to analyze the differences between groups. Results The pSIH1?H1?copGFP plasmid was constructed successfully and ECA109 cells were infected to obtain ECA109M cells with stable transfection. The expression levels of MDC1 mRNA and protein in ECA109M cells were lower than those in ECA109N and ECA109 cells ( P= 0. 032 and 0. 041, respectively ) . After 5?Gy radiation, ECA109M cells had a lower proportion of G2+M cells than ECA109N and ECA109 cells ( P=0. 026) . After 5?Gy radiation, ECA109, ECA109N, and ECA109M cells had similar expression levels of CHK1 and CHK2 proteins ( P= 0. 345 and 0. 451, respectively ) , and ECA109M cells had a lower expression level of CHK2 T68 protein than ECA109 and ECA109N cells ( P=0. 012) . ECA109 cells had a D0 value of 3. 06 Gy and an SF2 value of 0. 91;the D0 values for ECA109N and ECA109M cells were 2. 90 Gy and 1. 88 Gy, respectively, and the SF2 values for them were 0. 89 and 0. 84, respectively ( P=0. 021 and 0. 037, respectively ) . Conclusions RNA interference can reduce the expression levels of MDC1 protein and cell cycle?related proteins, release cell cycle arrest, and enhance radiosensitivity in esophageal carcinoma ECA109 cells.

Objective To inhibit the gene expression of signal transducer and activator of transcription factor 1 (STAT1) in human esophageal squamous cell carcinoma cell line Eca109 by RNA interference and investigate its effect on the radiosensitivity and cell cycle of Eca109 cells.Methods Interference vector pSTAT1-shRNA for STAT1 gene was designed and constructed.After being mixed with lentiviral packaging plasmids,the interference vectors were used to transfected 293T cells.Virus solution was collected to infect ECA109 cells.Real-time PCR and Western blot were used to measure the mRNA and protein expression levels of STAT1 in Eca109 cells.Colony formation assay and flow cytometry were used to evaluate the radiosensitivity and cell cycle distribution of Eca109 cells.Results All Eca109 cells were divided into blank control group,transfection-positive group,and transfection-negative group.The transfection-positive group showed significantly lower mRNA and protein expression levels of STAT1 than the other two groups.The values of D0,SF2,and Dq of transfection-positive group were 2.03 Gy,0.83,and 1.20 Gy,respectively,lower than those of blank control group (2.98 Gy,0.88,and 1.39 Gy) and those of transfection-negative cells (3.02 Gy,0.88,and 1.57 Gy).At 12 h,24 h,and 48 h after 4 Gy-irradiation,the transfection-positive group showed significantly higher percentage of G0 + G1 than the blank control group and transfection-negative group (34.13％ vs 22.03％ vs 22.27％,F =7.56,P =0.023 ; 43.80％ vs 28.40％ vs28.63％,F=10.01,P=0.012;53.20％ vs42.2％ vs41.83％,F＝10.73,P=0.010) and significantly lower percentage of G2 + M than the blank control group and transfection-negative group (14.33％ vs 32.23％ vs 32.23％,F=16.86,P=0.003;27.73％ vs 43.53％ vs 44.00％,F=26.62,P=0.001;14.23％ vs27.97％ vs27.93％,F=40.34,P=0.000).Conclusions RNAinterference of STAT1 in Eca109 cells does not affect the proliferation ability of Eca109 cells,and it can increase the radiosensitivity of Eca109 cells probably by regulating cell cycle after irradiation.

Objective To investigate the effects of inhibition of MDC1 protein expression on xenografted tumors in nude mice,and to observe the histopathological and cellular changes in nude mice.Methods Three pairs of effective and control short hairpin RNA targeting MDC1 mRNA were designed and cloned into the pSIH1-H1-copGFP vector.Real-time PCR and Western blot were used to determine the mRNA and protein expression of MDC1.After selection by copGFP reporter gene,cells were divided into negative transfection group (ECA109-N) and MDC1 transfection group (ECA109-M).The transfected cells were injected into nude mice.The mice were divided into ECA109 group,ECA109-N group,and ECA109-M group.Each group was divided into irradiation subgroup and non-irradiation subgroup.The changes in tumor size after irradiation were evaluated in each group.Western blot was used to measure the expression of CHK1,CHK2,and CHK2T68 in xenografted tumors.Flow cytometry was used to analyze the cell cycle distribution and apoptosis of tumor cells in nude mice.The variance analysis was used to compare the mean of multiple groups,and the SNK-q test was used in the two two groups.Results The pMDC1-shRNA plasmid was successfully constructed and used to transfect ECA109 cells.ECA109-M cells were obtained by stable transfection with the recombinant plasmid.All inoculated nude mice survived with visible xenografted tumors at the underside of the paw in about one week.There was no swelling and wound in inoculation sites.There was no significant difference in tumor size between different groups (P＞0.05).The tumor growth in the ECA109 group and the ECA109-N group significantly slowed down after irradiation with a dose of 15 Gy (P＜0.05).Compared with the other two groups,the ECA109-M group had a significant smaller tumor size,significantly slower relative tumor growth,and significantly higher growth inhibition (all P＜0.05).The q value of the ECA109-M group was 1.36.In the ECA109-M group,there were no significant changes in the protein expression of CHK1 and CHK2 after irradiation (P＞ 0.05);however,the phosphorylation of CHK2T68 protein was significantly reduced after irradiation (P＜0.05).There were no significant differences in cell cycle distribution or the proportion of apoptotic cells in tumor tissue between the three groups (P＞0.05).Conclusions Inhibition of MDC1 protein expression by RNA interference can effectively inhibit the growth of xenografted tumors after irradiation in the nude mice by increasing their radiosensitivity.

Objective To investigate the effect of ischemia and ischemia/reperfusion(I/R)in rat heart on matrix metalloproteinase-1(MMP-1).Methods The I/R animal models were established by shutting down and reopening the anterior interventricular branch with a silver clamp,then the distribution and amount of MMP-1 of the normal and I/R rat hearts were observed by immunohistochemical staining and Western blotting and analyzed by computer image analysis.Results 1.Immunohistochemical staining showed MMP-1 existed mainly in the cardiac matrix.There were strong positive reactions in fibrocytes,smooth muscle cells of the blood vessel and endotheliaI cells of capillaries.MMP-1 didn't show distinct changes 30 minutes after ischemia,while its concentration increased dramatically 60 minutes after ischemia.The positive reaction of MMP-1 increased 30 minutes after I/R,and 60 minutes after I/R there was large fusion areas in MMP-1 existing reglons.2.Quantitative analysis showed no dramatic changes of MMP-1 after ischemia for 30 minutes(P＞0.05),while dramatic changes were seen 60 minutes after ischemia(P＜0.05).MMP-1 changed dramatically 30 minutes and 60 minutes after I/R.3.Western blotting showed that there were no distinct naked-eye-observable changes.The bands of MMP-1 became widened 30 minutes after I/R,and became obviously widened 60 minutes after I/R.Conclusion 1.MMP-1 is secreted by fibrocytes,smooth muscle cells and endothelial cells of cardiac tissue under physiological conditions,and cardiomyocytes has the potential to secrete MMP-1 under ischemia or I/R.2.The longer time the heart ischemia lasts,the greater MMP-1 concentration will increase.Reperfusion can increase MMP-1 concentration to an even higher level,which may be the main cause of the collagen destruction after heart I/R.

Objective To evaluate the prognostic significance of 3 clinical stage system in 3-dimensional conformal radiotherapy (3DCRT) for esophageal squamous cell carcinoma. Methods From January 2004 to August 2007, 179 cases of esophageal squamous cell carcinoma were treated with 3DCRT.Before radiation, each patient was staged with UICC 2003 TNM stage, stage of Chinese esophageal cancer cooperation group (cooperation group' stage), and Zhu's clinical stage respectively. Concordance of each clinical stage and prognosis was analyzed with SPSS 11.5. Results In 179 cases of esophageal cancer,Concordance was better in T stage ( Kappa = 0. 271 ) than in TNM stage ( Kappa = 0. 167 ) between cooperation group' stage and Zhu's stage. Among them, 98 cases was staged with UICC stage, concordance of T stage was better between UICC-T and cooperation group' T stage (Kappa =0. 261 ) than between UICCT and Zhu's T stage (Kappa = 0. 045 ) ;concordance of TNM stage was better between UICC-TNM and Zhu's TNM stage ( Kappa = 0. 597 ) than between UICC-TNM and cooperation group' TNM stage ( Kappa =0. 299 ). With multivariate analysis, T ( χ2 value is 11.58, 26. 00 and 51.05, all P ＜ 0. 01 ), N ( χ2 value is 15.28, 16. 10 and 16. 10,all P＜0. 01), M (χ2 value is 5.59, 27.78 and 27.78,all P＜0. 01), and TNM (χ2 value is 15.77, 34,35 and 51. 10,all P＜0. 01 ) stage in 3 kinds of clinical stage were independent prognostic factors. In UICC stage, T1-T3 was difficult to definite and the prognosis was not significantly different in T1 -T3 stage. Conclusions In this study, 3 kinds of clinical stage could evaluate prognosis of esophageal cancer after radiotherapy;cooperation group' stage and Zhu's stage need further application, with further accuracy needed.

Objective To investigate the effects of BMI-1 expression inhibition by RNA interference on the radiosensitivity of esophageal cancer TE-13 cells and its mechanism.Methods The siRNA based on the sequence of BMI-1 mRNA was synthesized to transfect cultured TE-13 cells as BMI-1 siRNA group,a negative one was synthesized to transfect cultured TE-13 cells as negative control group (NC group),and untransfected TE-13 cells were named as control group.The expression of the BMI-1 mRNA and protein in TE-13 cells was measured by quantitative real-time PCR and Western blot,respectively.The cell proliferation and the radiosensitivity of TE-13 cells were measured by MTS and colony-forming assay,respectively.Flow cytometry was used to analyze cell cycle and apoptosis.The expression of BCL-2 and BAX in TE-13 cells was measured by Western blot.Comparison between groups was made by analysis of variance.Results The BMI-1 siRNA group had significantly lower expression of BMI-1 mRNA and protein than the control group and the NC group (P=0.000,0.000).The proliferation of TE-13 cells in the BMI-1 siRNA group decreased significantly after irradiation (P=0.031).The colony-forming assay showed that the BMI-1 siRNA group had a significantly higher radiosensitivity than the control group and the NC group (P=0.000).After irradiation,the BMI-1 siRNA group had a significantly lower percentage of cells in G2/M phase than the control group and the NC group (P=0.000,0.000).The BMI-1 siRNA group had a significantly increased apoptosis rate (P=0.000,0.000),significantly reduced expression of BCL-2(P=0.000,0.000),and significantly increased expression of BAX after irradiation (P=0.000,0.000).Conclusions BMI-1 siRNA can inhibit the expression of BMI-1 gene in esophageal cancer TE-13 cells,eliminate the cell cycle arrest in G2/M phase,induce cell apoptosis after ionizing irradiation in vitro,and increase the radiosensitivity,which may be related to the regulation of the expression of BCL-2 and BAX.

Objective To investigate the value of prophylactic irradiation to the lymphatic drainage area in radical three-dimensional conformal radiotherapy (3DCRT) and to evaluate the efficacy and adverse effects of 3DCRT with different clinical target volumes.Methods A retrospective analysis was performed on the records of 219 esophageal cancer patients without distant metastasis who received 3DCRT from January 2005 to December 2010.One hundred and five patients received involved-field irradiation (IFI) with a total dose of 54-66 Gy;114 patients received elective nodal irradiation (ENI) with a total dose of 46-52 Gy; the prescribed dose to the primary lesion was 56-70 Gy.The Kaplan-Meier method was used to calculate local control (LC) and overall survival (OS) rates,and the log-rank test was used for univariate prognostic analysis.Results The 1-,3-,and 5-year sample sizes were 219,172 and 67,respectively.The 1-,3-,and 5-year LC rates for IFI group were 63.0％,39.1％,and 27.2％,respectively,versus 70.5％,53.3％,and 51.7％ for ENI group (x2 =6.22,P =0.013) ;the 1-,3-,and 5-year OS rates for IFI group were 67.6％,24.9％,and 15.0％,respectively,versus 73.7％,45.1％,and 26.0％ for ENI group (x2=5.04,P =0.025).The univariate stratified analysis showed that the LC and OS rates were significantly higher in the ENI group than in the IFI group for patients with middle-or lower-thoracic primary lesion or N0 disease (P=0.007,0.015;P=0.054,0.013).Conclusions For esophageal cancer patients with middle-or lower-thoracic primary lesion or without lymph node metastasis,prophylactic irradiation to the lymphatic drainage area can increase LC and OS rates.

ObjectiveTo analyze the outcomes and prognostic factors of advanced esophageal carcinoma treated by three-dimensional conformal radiotherapy (3DCRT).MethodsFrom Jul 2001 to Dec 2006.375 patients with esophageal carcinoma treated by 3DCRT were retrospectively analyzed of which Ⅰ stage 9,Ⅱ stage 106,Ⅲ stage 158,Ⅳstage 102.The short-term effect,1-,3-,5-year local regional control rates and survival rates were investigated.The local regional control rates and survival rate were calculated by the Kaplan-Meier method. Univariate prognostic factor was analyzed by Logrank method.Multivariate prognostic factor was analyzed using Cox regression model.ResultsThe follow-up rate was 94.7％.The numbers of patients followed-up with 5 years was 191.The 1-,3-and 5-year local control rates were 80.5％,53.7％,44.9％respectively.The 1-, 3-and 5-year survival rates were 67.2％,29.4％,19.0％respectively.Univariate analysis showed the significant prognostic factors included the degree of dysphagia,tumor length,the largest diameter of lesion in CT image,T stage,N stage,clinical TNM stage,grades of acute radiation-induced esophagitis and grades of acute radiation-induced pneumonery ( x2 =46.75,18.52,30.24,42.53,32.71,75.68,7.13,4.64,P =0.000,0.000,0.000,0.000,0.000,0.000,0.008,0.031 ).Multivariate analysis revealed tumor length,clinical TNM stage,chemotherapy and grades of acute radiationinduced esophagitis were independent prognostic factors (x2 =6.70,18.00,4.87,1.1 8,P =0.030,0.000,0.027,0.011 ).Conclusions3DCRT is effective and feasible in treatment of the advanced esophageal carcinoma.Tumor lesion length,clinical TNM stage,chemotherapy and grades of acute radiation-induced esophagitis are independent prognostic factors for survival of patients.

Objective To evaluate the predictive values of different systems for clinical staging of esophageal carcinoma in one group of patients and improve the criteria for T staging,and to provide a basis for accurate clinical staging. Methods A retrospective study was performed in 701 patients with esophageal carcinoma who received radical radiotherapy in our hospital. The prognosis was performed according to American Joint Committee on Cancer ( AJCC) tumor-node-metastasis staging system,Chinese 2004 staging system,the draft of Chinese 2009 staging system,and gross tumor volume of the primary tumor (GTV-T). Results In terms of T stage,patients evaluated according to the AJCC staging system were in relatively early stages;23. 1% of them were in stage T1,and the survival curves of T3 and T4 patients were close to each other;the survival curves plotted according to the Chinese 2004 staging system were well separated, but relatively few patients were in stages T1 and T4 , yielding an uneven distribution;according to the draft of Chinese 2009 staging system, the survival curve of T3 patients intersected that of T4 patients, and up to 43. 2% of patients were in stage T4.The new T staging was performed based on GTV and the extent of tumor invasion into the adjacent tissue and organ, and the results showed that there was no intersection between survival curves and a relatively balanced T stage distribution. In terms of N staging,patients were divided into stages N0 ,N1 ,and N2 . The TNM staging was performed by a combination of N staging and new T staging, resulting in significant separation between survival curves ( P=0. 000) . Conclusions The combination of T staging,which is based on GTV and the extent of tumor invasion,and N staging,which is based on metastasis of lymph nodes, can accurately predict the survival of non-surgically treated patients with esophageal carcinoma.