【Objective】 To compare the clinical efficacy of percutaneous transforaminal endoscopic decompression （PEID） and percutaneous interlaminar endoscopic decompression （PETD） in the treatment of L5-S1 lateral recess stenosis. 【Methods】 We selected the patients in our center diagnosed with L5-S1 lateral recess stenosis from March 2018 to October 2019 and divided them into Group A and Group B according to the principle of prospective， single-blind， and randomized control （A： PETD； B： PEID）. The operation was performed by the same senior surgeon with mature spinal endoscopy technology. We recorded the basic information， operation duration， usage count of C-arm， hospital stay， VAS score and ODI index of lower back and lower limbs before operation and 3 days， 1 month， 1 year and the last follow-up after the operation， and the operative excellent and good rates （the last follow-up）. The angle of bony lateral recess was measured during pre- and postoperative CT. 【Results】 A total of 95 patients （A： n=48； B： n=47） successfully completed the operation and were followed up for at least 1 year. The two groups did not significantly differ in age， gender， hospital stay， or complication by lumbar intervertebral disc herniation， but PEID group had significantly shorter operation duration and fewer usage counts of C-arm （P<0.001）. VAS score of lower back and lower limbs， and ODI index were significantly reduced at 3 days，1 month， 1 year and the last follow-up after the operation， with no significant difference between the two groups at the same time； no statistical difference was found between the two groups in operative excellent and good rates at the last follow-up （P>0.05）. The postoperative bony side recess angle was significantly improved （P<0.05）， while there was no significant difference in either pre- or postoperative bony side recess angle between the two groups （P>0.05）. 【Conclusion】 Both PEID and PETD are effective strategies in the treatment of L5-S1 lateral recess stenosis and can achieve good clinical outcomes.

Objective To study the protective effects of vitamin E combined with Rhodiola rosea on the injury in mice skeletal muscle through hypoxia with exercise training and research the mechanism of action.Methods Forty ICR mice were randomly divided into control group and observation group,20 mice in each group.The control group was given Vitamin E (40 mg·kg-1·d-1),and the observation group was given Vitamin E (40 mg·kg-1·d-1)combined with Rhodiola rosea (20 g·kg-1·d-1);the rats in the two groups were treated with hypoxia (11.3%) for 4 weeks (5 ℃,15 m/min,60 min/d) after 15-day drug using.After the last training,all the mice were euthanized and then detected the gene of Bax and Bcl-2 mRNA through the RT-PCR in the skeletal muscle and the activity of GSH-PX,SOD,ROS,the concentration of MDA in the skeletal muscle.During the period (pretrain and 1,2,4 weeks) of hypoxia combined with exercise training,the CK,LDH in the serum were detected.Results The expression of CK and LDH in the observation group were lower than those of the control group (P<0.05).The activity of GSH-PX and SOD in the skeletal muscle of the observation group was significantly higher than that of the control group (P<0.05),while the ROS and MDA were lower than those of the control group(P<0.05);the expression of Bax mRNA and Bax/Bcl-2 of the observation group was significantly lower than that of the control group(P<0.05).While the expression of Bcl-2 mRNA was significantly higher than that of the control group(P<0.05).Conclusion Rhodiola rosea combined with Vitamin E can inhibit the expression of apoptotic genes by correcting the oxidation and hypoxia imbalance under hypoxia.

Background and objectiveEpidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), which targets EGFR, plays an important role in non-small cell lung cancer (NSCLC) treatment. Patients with somatic acti-vating mutations in theEGFR gene exhibit signiifcant initial response but eventually develop resistance to TKI. hTe second mutation (T790M) of theEGFR gene is the possible main cause of drug resistance. hTe aim of this study is to investigate the effect of ionizing radiation on EGFR-TKI resistance caused by T790M mutation in NSCLC cell lines.MethodsWe selected H1975 and H3255 as research subjects and tested the mutation states by real-time PCR analysis. Radiosensitivity was deter-mined by clone-forming test, and drug resistance was detected in different groups by MTT assay.Results H1975 is anEGFR double mutant (L858R plus T790M), whereas H3255 is anEGFR single mutant (L858R). hTe cell survival fractions of H1975 and H3255 did not vary in different treatment groups (P=0.952). hTus, T790M mutation did not affect the radiosensitivity of NSCLC cell lines. hTe IC50 of H1975 in the 2.5 Gy group [(0.678; 2±0.373) μmol/L] was statistically signiifcant compared with that in the 0 Gy normal control group [(3.520±0.821) μmol/L] (P=0.008). hTe drug tolerance of the H1975 cell line by 89.5 dropped to 39.2 times.ConclusionIonizing radiation can reduce TKI resistance caused by T790M mutation in NSCLC cell lines. Our results provide a research basis for futurein vivo and clinical studies. Radiotherapy combined with EGFR-TKI treatment can be a promising strategy to overcome T790M-mediated drug resistance.

BACKGROUNDIt is desirable to minimize the risk of adverse radiation effects associated with percutaneous coronary intervention. The aim of this study was to determine the impact of prolonging the interval between coronary angiography and percutaneous coronary intervention on X-ray-induced DNA double-strand breaks in blood lymphocytes using γ-H2AX immunofluorescence microscopy.

METHODSBlood samples of eight patients were taken before the first exposure to ionizing radiation, 10 minutes, 20 minutes, 30 minutes, 1 hour, and 24 hours after the last exposure to determine the γ-H2AX foci repair kinetics. Fifty-eight patients undergoing percutaneous coronary intervention were randomized to an intermittent radiation exposure group and a continuous radiation exposure group. Blood samples were taken before coronary angiography and 15 minutes after the last exposure. By enumerating γ-H2AX foci, the impact of prolonging the interval on DNA double-strand breaks was investigated. Student t-test was used to compare the difference in DNA double-strand breaks between the two groups.

RESULTSAn increase in foci was found in all patients received percutaneous coronary intervention. The maximum number of γ-H2AX foci was found 10-20 minutes after the end of the last exposure. There was no statistically significant difference between the two groups in γ-H2AX foci at baseline. On average there were (0.79 ± 0.15) γ-H2AX foci induced by interventional X-rays per lymphocyte in the continuous radiation exposure group and (0.66 ± 0.21) in the intermittent radiation exposure group after exposure (P < 0.05).

CONCLUSIONSA significant number of γ-H2AX foci develop following the percutaneous coronary intervention procedures. The number of X-ray-induced DNA double-strand breaks may be decreased by prolonging the interval time between coronary angiography and percutaneous coronary intervention to 30 minutes.

Adult ; Coronary Angiography ; adverse effects ; DNA Breaks, Double-Stranded ; radiation effects ; Dose-Response Relationship, Radiation ; Female ; Humans ; Lymphocytes ; metabolism ; radiation effects ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; adverse effects

BACKGROUNDScheuermann's disease (SD) is a spinal disorder and includes both a classic form and an atypical form. Interestingly, its existence among the general population as well as the disc disease patients is common. One of our previous studies showed that about 18% of the hospital staff members meet the SD criteria. On the other hand, another study has demonstrated that 95.2% of the symptomatic thoracolumbar disc herniation (STLDH) patients meet the SD criteria, which suggests that STLDH is very likely a special form of SD. The purpose of this study was to discriminate the factors contributing to the development of STLDH by comparing STLDH patients with the healthy SD-like hospital staff members.

METHODSThis is a retrospective study including 33 STLDH patients who met the SD criteria and 30 SD-like hospital staff members. The STLDH group was chosen from a group of patients who underwent surgery after a diagnosis of STLDH (T10/11-L1/2) at our hospital between June 2007 and June 2010. SD-like hospital staff members were chosen from a database created in 2007, which contained a lumbar MR and low back pain (LBP) questionnaire of 188 hospital staff members. The demographic and radiologic characteristics were compared between groups.

RESULTSThere was no statistical difference in sex, age, and height between the two groups. The STLDH patients had higher body weight, boby mass index, and thoracolumbar kyphotic angle than SD-like hospital staff members. In addition, STLDH patients had more levels of Schmorl's nodes (3.5±1.7 vs. 2.0±1.9, t = 3.364, P = 0.001) and irregular endplateson (4.0±1.9 vs. 2.7±1.9, t = 2.667, P = 0.010) compared to the SD-like hospital staff members.

CONCLUSIONSHigher body weight, higher body mass index, larger thoracolumbar kyphosis, and more Schmorl's nodes and irregular endplates on MR may be associated with the development of STLDH in "SD-like people."

Adult ; Female ; Healthy Volunteers ; Humans ; Intervertebral Disc Displacement ; diagnostic imaging ; Middle Aged ; Radiography ; Retrospective Studies ; Scheuermann Disease ; diagnostic imaging ; Thoracic Vertebrae ; diagnostic imaging ; pathology

Objective To evaluate the survival and adverse effects of adjuvant concurrent temozolomid (TMZ) combined with radiochemotherapy in postoperative patients with high grade intracranial glioma.Methods 84 postoperative patients with high grade intracranial glioma were randomly divided into the observation group (42 cases including 25 grade Ⅲ cases and 17 grade Ⅳ cases) and the control group (42 cases including 23 grade Ⅲ cases and 19 grade Ⅳ cases).All patients were treated with concurrent radiochemotherapy after surgical operations,the total radiation dose was 60-66 Gy.The patients in observation group were given daily oral TMZ 75 mg/m2 during radiotherapy.4 weeks after radiotherapy,all of the patients received 6 cycles of TMZ,each cycle lasted 5 days with 28 days interval between each cycles.150 mg/m2 of TMZ was given for the first cycle for 5 days,followed by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed.Results The overall response rates (CR+ PR) were 71.7 ％ (33/46) in the observation group,and 32.6 ％ (15/46) in the control group,and with significant difference between the two groups (P ＜ 0.001).The 1,2 and 3 year survival rates of patients in the observation group were 71.7 ％,47.8 ％,36.9 ％,and 56.5 ％,26.1％,15.2 ％ in the control group.The significant differences were found in 2-year and 3-year survival rates between the two groups (P =0.031,0.018).The median recurrent period in the observation group were 22 and 12 months in the control group,and with singnificant difference (P =0.015).The main side effects were limited to grade Ⅰ or Ⅱ.Conclusions Concurrent TMZ combined with radiotherapy in the treatment of high grade gliomas has better clinical efficacy,and can improve the 2-year and 3-year survival rates.Patients tolerate the strategy well and no severe toxicities are observed.

Objective To observe the effect of EGFR mutation on radiation induced DNA repair in pulmonary adenocarcinoma ceils.Methods A549 cells with wild-type EGFR and H1975 cells with mutated-type of EGFR were irradiated by 4 Gy of 6 MV X-rays.After irradiation,the formation of nuclear γ-H2AX foci was assayed with immunostaining method,the level of DNA-PKcs-EGFR interaction was detected with coimmunoprecipitation,and nuclear RAD51 expression and EGFR nuclear translocation were detected using Western blot.Results DNA repair in the H1975 cells was significantly lower than that in A549 cells.In the irradiated H1975 cells,there was no EGFR translocation with further nuclear DNA-PKcs binding,and the expression of nucleus RAD51 was not altered.But in the irradiated A549 cells,EGFRDNA-PKcs interaction and nucleus RAD51 were increased.Conclusions Lung adenocarcinoma cell line with mutations in the tyrosine kinase domain (TKD) of EGFR exhibits a high radiosensitivity due to the reduction of the non-homologous end-joining (NHEJ) and homologous recombination (HR) DNA DSB repair kinetics.

ObjectiveTo detect the efficacy of compound matrine combined with intensity modulated radiotherapy (IMRT) for patients with locally advanced nasopharyngeal carcinoma (NPC). MethodsA total of 96 patients with locally advanced NPC were randomized into compound matrine combined with IMRT group (the therapeutic group) (n =48) and IMRT group (control group) (n =48). The nasopharyngeal DT and lymph nodes Dr were 66-78 Gy/(33-39 f)in 6-8 weeks,60-70 Gy/(30-35 f)in 6-8 weeks, respectively.The prophylactic dose of neck was 50-54 Gy.ResultsThe NPC efficacy of the therapeutic group was 93.8 ％(45/48)and control group was 79.2 ％(38/48).There was significant difference between the two groups in curative effect (P ＜0.05). The lymph nodes efficacy of the therapeutic group was 87.5 ％ (44/48) and control group was 75.0 ％ (30/48). There was significant difference between the two groups in curative effect (P ＜0.05). The side effects of mucosa were fewer in therapeutic group while the infection rate of pharynx oralis was higher in control group (P ＜0.01). ConclusionCompound matrine combined injection can improve shortterm curative effect of IMRT of locally advanced NPC and significantly decreased side effect of radiotherapy.

Objective: To observe the characteristics of dynamic changes of lysophosphatidic acid (LPA) levels in cerebrospinal fluid (CSF) in patients with subarachnoid hemorrhage (SAH) and its relationship with cerebral vasospasm (CVS) and to explore the pathogenesis of CVS. Methods: Sixty-seven patients with SAH diagnozed by clinical and accessory examinations were selected. The LPA levels in CSF were measured at 24 hours, day 7,14, and 28 respectively after the onset of symptoms,and they were compared with a control group. The correlation between LPA levels and CVS on the time course was also observed at the same time. Results: Of the 67 patients with SAH, a total of 29 patients (43.3%) occurred CVS, the average time of occurrence was 6. 6 days. There was no significant difference between the LPA levels in CSF in patients with SAH and the control group at 24 hours after the onset of symptoms; they were significantly higher than the control group at day 7 (P ＜0. 001); they were significantly higher than the control group at day 14 (P ＜ 0. 001), but they were significantly lower than those at day 7 (P ＜ 0. 01); they decreased to baseline at day 28, and there was significant difference compared with the control group. There was no significant difference between the LPA levels in the CVS group and those in the non-CVS group at 24 hours, they were significantly higher than those in the non-CVS group at day 7 (P ＜0. 001), they were still significantly higher than those in the non-CVS group at day 14 (P ＜0. 01); and there was no significant difference between the 2 groups at day 28. Conclusions: The LPA levels in CSF in patients with SAH increased significantly from day 7 to day 14 after the onset of symptoms, and they had obvious association with CVS on the time course. The detection of the LPA levels in CSF may have important significance in predicting the occurrence of CVS.

Objective: To observe differentially expressed genes in rat hippocampus irradiated by 6 MV X-rays during radiotherapy.Methods:After whole brain irradiation of 50 Gy in 25 fractions with 2 Gy per fraction,the capability of learning and memory was investigated in a shuttle box model,then rats were killed and the hippocampus were taken,mRNA from sham irradiation group and irradiation group were reversely transcribed to cDNA with incorporation of fluorescence dUTP(Cy5 and Cy3 dUTP) to prepare for hybridization probes.The mixed probes were hybridized to the cDNA microarray.Axon Genechix 4000 BandGenePix Pro3.0 software was used to scan and analyze the fluorescent signals. Results:①The active avoidance response of irradiated rats were lowered significantly.②Compared with the sham group,significant changes took place in 43 genes,among which 28 genes were upregulated and 15 down regulated,other genes did not change significantly.③Among the 43 malexpressed genes,16 were reported previously,others were newly found genes. Conclusion: The influence of ionizing radiation on learning and memory was a complex course,including many transduction factors and might be related to mitochondrial dysfunction.