Stereotactic body radiation therapy (SBRT) has been applied in extracranial metastases effectively,with the characteristics of concentrated dose distribution in target region,great dose gradient change in surrounding region and low dose in normal tissue beside target region.The radiation biology characteristics of SBRT,therapeutic mechanism,integration of SBRT into standard systemic therapy regimens have been studied further.

Objective To investigate the effect of blocking VEGF expression on the radiation sensitivity of esophageal cancer cell line TE-1 in vivo. Methods 32 male Balb/c/nu nude mice were randomly divided into four groups, including control group, radiation group, anti-VEGF group, and anti-VEGF + radiation group. The anti-VEGFcDNA cells were subcutaneously injected into the paw pats of mice (2 × 106/100 μl). The subcutaneous tumors were irradiated with 18 Gy of 60Co y-rays when the diameter of tumors varied from 0. 8 to 1.0 cm. The volume of the tumors was measured before and after irradiation, respectively. The expression level of VEGF mRNA and protein were examined by RT-PCR and Western blotting, respectively. Apoptotic cells were detected by electron micrographs. Results Latent period of the tumor formation of anti-VEGF group was lengthened compared with other groups(t = 13. 898,P ＜0.01 ). The volumes of tumor in anti-VEGF group [ ( 1207. 50 ± 97.07 ) mm3 ] and anti-VEGF +radiation group [ ( 1057. 5 ± 91.50 ) mm3 ] were not statistically different post-irradiation ( t = 1. 124, P ＞0.05 ) , but smaller than those in control group [ ( 5442. 50 ± 185.08 ) mm3 ] and radiation group [ (2922. 50 ± 152. 773)mm3 ] with statistical differences( t = 9. 475-21. 238, P ＜ 0. 01 ). The expression level of endogenous VEGFmRNA and protein in anti-VEGF group and anti-VEGF + radiation group were statistically different from control group and radiation group (F = 387.394, 13.519, P ＜ 0.01 ).Conclusions Antisense VEGF could inhibit the proliferation of esophageal cancer cell in the nude mice.Effect of blocking VEGF expression before irradiation on esophageal cancer xenografts might be limited.

Objective To observe the preventive and therapeutic effect of Yangyin Shengxue Mixture (Herbal decoction for nourishing yin and blood) on radiation-induced oral mucosal injury.Methods Sixty nasopharyngeal carcinoma patients were randomized into two groups: treatment group (30 cases) receiving Yangyin Shengxue Mixture three days before till one week after radiotherapy, and control group (30 patients) using conventional Tinidazole Gargle for prevention of oral-mucositis. Before and after treatment, the body weight, hemoglobin and state of infection of patients were examined. The time of occurrence of symptoms, degree of acute radiation mucositis and degree of pain were observed to evaluate the damage of oral mucosa according to RTOG standard for radiation injury of oral mucosa and Numeric Rating Scales (NRS). Results There were different degrees of radiation mucositis in both groups during radiotherapy, but the time of occurrence in the treatment group was significantly later than that of the control group (P

BACKGROUND: The cryopreservation of human ovarian tissue has become an attractive method to preserve female fertility. Human ovarian tissue experiences neovasculadzation after transplantation to recover blood supply, cryopreservation and resuscitation technique is a key for the neovascularization of human ovarian tissue following transplantation. OBJECTIVE: To investigate vascular endothelial growth factor (VEGF) expression and microvessel density in human ovadan tissue following novel needle immersed vitrification (NIV) and slow-freezing, to explore the influence of two cryopreservation methods play in the neovascularization of human ovarian tissue after transplantation. METHODS: Eight normal human ovarian tissues from patients with carcinoma of endometrium were cut into 12 fragments in the size of 1.5 mm × 1.5 mm × 1.0 mm, then randomly assigned to 3 groups: fresh control group, NIV group and slow-freezing group. In the NIV group, pieces of ovarian tissue stdps were dehydrated in an equilibration solution consisting of 7.5% ethylene glycol and 7.5% dimethyl sulfoxide in TCM-199 supplement with 20% fetal bovine serum and a vitrification solution consisting of 15% ethylene glycol, 15% dimethyl sulfoxide and 0.5 mol/Lsucrose, then were plunged in liquid nitrogen directly and sealed in liquid nitrogen-filled cryovials. For thawing, the needles holding ovadan tissues were serially transferred into 1.0, 0.5, 0.25 mol/L sucrose solution and TCM-199 supplemented with 20% fetal bovine serum. In the slow-freezing group, pieces of human ovadan cortex fragments were placed in a 1.8-mL cryovial containing 1 mL of TCM-199 medium supplemented with 0.1 mol/L sucrose, 20% fetal bovine serum and 1.5 mol/L dimethyl sulfoxide, the cryovials were placed in the programmable freezer and cryopreserved by preset slow-cooling protocol. For thawing, the ovarian tissue stdps were washed in a stepwise manner: 1.0 mol/L dimethyl sulfoxida + 0.1 mol/L sucrose, 0.5 mol/L dimethyl sulfoxide + 0.1 mol/L sucrose, 0.25 mol/L dimethyl sulfoxJde + 0.1 mol/L sucrose and 0.1 mol/L sucrose. The frozen-thawed and fresh controlled human ovarian tissues were cultured in vitro. The expression of VEGF and CD34, as well as microvessel density, was analyzed by immunohistochemistry. RESULTS AND CONCLUSION: There was patchy and mild expression of VEGF in the stromal cells of all the three groups before and after culture. The expression of VEGF increased and reached peak value after culture for 2 days, began to decrease after culture for 4 days and further attenuated after culture for 6 days in all the three groups. Compared with slow-freezing group, the expression of VEGF in NIV group was closer to that in fresh control group. Microvessel density of all the three groups increased and reached peak value after culture for 2 days, and the microvessel density of fresh control group and NIV group was significantly higher than that of slow-freezing group (P < 0.05). The microvessel density of slow-freezing group after culture for 4 days and that of all the three groups after culture for 6 days significantly decreased compared with after culture for 2 days (P <0.05). NIV is superior to slow-freezing to preserve stromal cells and extracellular matrix of human ovarian tissue, and plays less influence in VEGF expression and angiogenesis in human ovarian tissue.

Objective To investigate the efficacy of prostaglandin E1 administered via the pulmonary artery for treatment of pulmonary hypertension in patients.Methods Thirty ASA Ⅱ or Ⅲ patients undergoing offpump coronary artery bypass grafting complicated with pulmonary hypertension,with pulmonary arterial systolic pressure (PASP) ＞ 40 mm Hg,were randomly divided into 2 groups (n =15 each):administration via the central vein group (group C) and administration via the pulmonary artery group (group P).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufentanil.The patients were tracheal intubated and mechanically ventilated.Swan-Ganz catheter was placed via the right internal jugular vein for monitoring of hemodynamic parameters after induction of anesthesia.The central vein and pulmonary artery were cannulated for infusion of prostaglandin E1.Prostaglandin E1 was infused at a rate of 20-50 ng· kg-1 · min-1 starting from the end of skin incision until PASP was decreased to 20-30 mm Hg.Heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),PASP,pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) were recorded at 5 rain before administration (To) and 5 min after administration (T1).The pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR) were calculated.The amount of prostaglandin E1 consumed was recorded.Results Compared with group C,the amount of prostaglandin E1 consumed was significantly reduced,PASP and PVR were decreased at T1,while MAP and SVR were increased at T1 in group P(P ＜ 0.05).Conclusion Administration via the pulmonary artery can increase the potency of prostaglandin E1 for treatment of pulmonary hypertension and exerts no influence on the systemic hemodynamics.

Objective To evaluate the cardioprotective effect of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting. Methods Forty-six ASA Ⅱ or Ⅲ patients aged 37-64 yr weighing 54-81 kg undergoing off-pump coronary artery bypass grafting were randomized into 2 groups ( n = 23 each): control group (group C) and dexmedetomidine group (group D) . Dexmedetomidine was infused at 0.5 μg·kg-1·h-1 starting after induction of anesthesia until the end of operation in group D. Radial artery was cannulated and Swan-Ganz catheter placed via right internal jugular vein. HR, MAP, mean pulmonary arterial pressure, pulmonary capilary wedge pressure, central venous pressure, and cardiac output were recorded and stroke volume index, left and right ventricular stroke work index, systemic vascular resistance and pulmonary vascular resistance were calculated at the beginning of operation (T1 ), immediately (T2 ) and at 30 min after reestablishment of coronary blood flow (T3 ) and the end of operation (T4 ) . Venous blood samples were taken before induction of anesthesia (T0 , baseline) , at T4 and 4 h (T5 ) and 24 h (T6 ) after operation for determination of plasma concentration of cardiac troponin I by ELISA. Results Stroke volume index and left ventricular stroke work index were significantly higher at T4 while systemic vascular resistance was lower at T34 in group D than in group C. Plasma cardiac troponin Ⅰ concentration was significantly lower at T6 in group D than in group C. Conclusion Dexmedetomidine infusion at 0.5 μg ·kg-1·h-1 during operation can protect myocardium in patients undergoing off-pump coronary artery bypass grafting.

ObjectiveTo investigate the effects of dexmedetomidine on cerebral oxygen and glucose metabolism in patients undergoing mitral valve replacement under cardiopulmonary bypass (CPB).Methods Fiftyeight ASA Ⅱ or Ⅲ patients of both sexes aged 32-64 yr weighing 52-90 kg undergoing mitral valve replacement were randomly divided into 2 groups (n =29 each): control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was infused iv at 0.5 μg· kg- 1 · h- 1 starting after tracheal intubation until the end of operation in group D,while in group C equal volume of normal saline was infused instead of dexmedetomidine.Blood samples were collected from radial artery and jugular venous bulb for blood gas analysis and determination of glucose and lactate concentrations before CPB (T1,nasopharyngeal temperature =36 ℃ ),during CPB (T2,nasopharyngeal temperature =30 ℃ ),immediately and 30 min after restoration of spontaneous heart beat ( T3,T4 ).Arterial O2 content ( CaO2 ),arteriovenous O2 content difference ( Da-jvO2 ),cerebral extraction of O2 ( CEO2 ),arteriovenous glucose and lactate content differences (Da-jvGlu and Da-jvLac) were calculated.ResultsThe Da-jvO2 and CEO2 were significantly decreased at T2 in group D as compared with group C.There was no significant difference in CaO2,Da-jvGlu and Da-jvLac between the 2 groups.ConclusionDexmedetomidine can reduce cerebral O2 metabolism and help maintain the balance between cerebral O2 supply and demand but has no effect on cerebral glucose metabolism in patients undergoing mitral valve replacement under CPB.

Background and purpose:Esophageal cancer(EC) is one of the most common cancers that account for cancer-related deaths and over 400,000 new cases has been diagnosed per year.The morbility of small cell carcinoma of the esophagus(SCEC) is very low.This paper was to study was the clinical characteristics,treatment and prognosis of undifferentiated small cell carcinoma of the esophagus(SCEC).Methods:From 1961 to 2003,743 patients with SCEC were treated in different hospitals.The number of small cell carcinoma of the esophagus seen accounted for 1.38% of esophageal cancer treated in those hospitals in the same period.the average age was 56.8(range,51 to 66).511 of patients were male and 232 female.2 of them had primary tumor in the cervical proportion of the esophagus,68 in the upper thoracic proportion,420 in the mid thoracic proportion,252 in the lower proportion and 1 in the whole esophagus.88 patients were treated by surgery alone,23 by radiotherapy alone,24 patients by chemotherapy alone and all other of patients were treated by combined modality.Results:The median survival was 12.4 months for all patients,with 10.8 months for surgery,6.2 months for radiotherapy,6.6 months for chemotherapy,14.7 months for surgery combined with radiotherapy,16.1 months for surgery combined with chemotherapy,12.3 months for chemoradiotherapy and 16.2 months for surgery combined with chemoradiotherapy,respectively.The survival rates at 1,2,3,4,and 5 years were 56.4%、27%、19.3%、11.1%、(9.7%) for the whole group,respectively.Conclusions:We recommend that combined modality should be used for SCEC.The combination of surgery and multi-drug chemotherapy may improve the treatment outcomes for the patients with early stage SCEC.

Objective:To characterize the memory B lymphocytes activalion by nonspecific antigen of different phylogeny antigen.Methods:Three groups were immunized by same quantity different antigens,which were ovalbumin,milk and ostrcean extract to intitule A,B,C,respectively,as basic immunity.After one week,across immunity was performed with A,B and C antigen as secondary immunity,the subgroups were divided.Basic antibodies were determined with ELISA before and after secondary immunity.Results:Antibodies after secondary immunity increase 10%～25% than that before secondary immunity in subgroups which antigens were different when basic and secondary immunity.There were significant difference compare with control groups (P

Objective To investigate the effect of fascia iliaca compartment nerve block ( FICB) to early analgesia and emergence agitation for children after the operation of femur fractures, and compare with fentanyl.Methods Totally 36 cases of children, which scheduled for the one-sided femur fractures surgery were selected after the approval from the Institutional Review Board of the hospital.They were randomly di-vided into two groups:FI group ( FICB group) and FE group ( Intravenous fentanyl group) .Patients in both groups were received ultrasound guided FICB immediately after the induction of general anesthesia, 1 ml/kg ropivacaine ( Naropin) was given in the FI group and 1 ml/kg saline in the FE group, sevoflurane was used for the anesthesia maintenance and 1 μg/kg intravenous fentanyl in FE group, instead of the same volume saline in FI group at 10 min before the surgery finished, and patients were sent to postanesthesia care unit ( PACU) after extubation.Keep a record of the duration of the operation and extubation, the pain scores and the Pediatric Agitation and Emergence Delirium ( PAED) scores were recorded at just arrived at PACU ( T0 ) , 10 min ( T1 ) , and 20 min ( T3 ) after PACU, also included the duration in PACU and the postopera-tively side effects.Results At the time of T0 and T1 , the pain scores in FI group was significantly lower than the FE( P <0.05), there was no difference between two groups from the age of 3 to 8 at T2 ( P >0.05), but it was still lower in FI group from the age of 8 to 14( P <0.05);The PAED scores at the three time points were always lower in FI group when it was compared with FE group;the same trend occurred for the duration of extubation and PACU( P <0.05).Conclusions FICB can effectively reduce emergence agitation and the pain scores for the children undergoing the surgery of femur fractures during the early time after the operation, which is better than the intravenous fentanyl.