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Objective To investigate the characteristics of target motion in esophageal cancer during normal breathing with four-dimensional computed tomography(4DCT). Methods Twenty patients with primary esophageal cancer received respiratory gated 4DCT to obtain the target motion during normal breathing and delineate the gross tumor volume (GTV). The center coordinate and volume of each GTV were measured and recorded to calculate the displacement of the GTV center and the change in volume in different respiratory phases. Results The displacement of the GTV center in each esophageal segment in superior-inferior direction (0.521±0.319 cm) was significantly greater than that in right-left direction (0.169± 0.083 cm) and that in anterior-posterior direction (0.167±0.095 cm)(all P<0.05). The maximum displacement of the GTV center in each direction was significantly different in different esophageal segments(all P<0.05).The displacement of the GTV center in each direction was not entirely consistent in different respiratory phases. The displacement of the GTV center in each direction in T50phase was greatest when T0phase was the reference phase. The volume of GTV had no significant changes at the end of the expiratory phase and the inspiratory phase (P=0.313). Conclusions The displacement of GTV center in each esophageal segment in superior-inferior direction is significantly greater than that in right-left direction and that in anterior-posterior direction and the displacement of GTV center in each direction is significantly different in different esophageal segments. Therefore, all the factors should be considered to develop a reasonable target for precise radiotherapy. For esophageal cancer in cervical and upper chest esophageal segment,it is reasonable to delineate ITV based on the fusion image of the images at the end of inspiratory phase and expiratory phase. The deformation of target volume of the esophageal cancer in the cervical and upper chest esophageal segment is not significant in the respiratory cycle.
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Objective To explore the effect of intensive statin on platelet activity and inflammation factors 24 h after rat myocar‐dial infarction .Methods Seventy Sprague‐Dawley rats were randomly divided into five groups (n= 14):Sham‐operated group (SHAM group);AMI group(control group) ,general group;intensive statin therapy group ;general and intensive statin therapy group;established AMI rat model by ligation of left anterior descending branch of coronary artery .The general group ,general and intensive statin therapy group was fed atorvastatin by 10 mg · kg -1 · d-1 with distilled water 2 mL by intragastric gavage daily for two weeks .The intensive statin therapy group ,general and intensive statin therapy group was fed atorvastatin by 50 mg/kg with distilled water 2 mL by intragastric gavage 12 h before surgery .Serum PAC‐1 ,CD62p ,TNF‐α,hs‐CRP was measured at the time of 24 h of postoperation .Results TNF‐α,hs‐CRP ,PAC‐1 and CD62p levels in control group were significantly higher than the SHAM group and intensive statin group 24 h after the LADS were ligated(P 0 .05);and there was no significant difference between normal group and control group in all the four factors (P>0 .05) .Conclusion Intensive statin therapy before acute myocardial infarction could decrease the level of inflammation factors and inhibit platelet activity postop‐eration .
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Objective To observe the efficacy of combination therapy with nimodipine and oxiracetam for type 2 diabetes melli‐tus(T2DM)patients with mild vascular cognitive impairment(mVCI) .`Methods Seventy‐two T2MD‐mVCI patients were divided into control group and observation group and each group was 36 cases .Control group was given routine treatment and nimodipine 40 mg ,3 times every day ;observation group was given oxiracetam 800 mg ,2 times every day ;the treatment course was 6 months .fast‐ing blood glucose(FBG) ,2 h postprandial hyperglycemia(2 h PBG) ,glycosylated hemoglobin A1C(HbA1C) ,C peptide level were recorded and MoCA cognitive function scale was used to evaluated patients cognitive function of each group before and after the treatment .Results Before the treatment ,both two groups with C peptide level were declined and mild cognitive impairment ,there were no statistically significant differences(P>0 .05) .After the treatment ,C peptide level ,MoCA scores and cognitive function sub‐scores of memory ,executive ,attention were significantly higher than before(P<0 .05);the observation group compared with the control group improved significantly(P< 0 .01) .Conclusion Combination therapy with nimodipine and oxiracetam could signifi‐cantly improve cognitive function in patients with T2DM‐mVCI ,its efficacy is superior to nimodipine .
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Objective To observe the expression of angiotensin Ⅱ type 2 receptor (AT2R) and coronary arterial remodeling in ischemia-reperfusion(I-R) injury rat after the renin -angiotensin blocker valsartan pretreatment .Methods 123 rats were random-ly divided into 3 groups :sham -operation group(sham) ,control group and valsartan group(ARB) .The control group and the sham group received the gavage of normal saline and the ARB group received valsartan gavage 10 mg/(kg · d) for 4 weeks before surger-y .The I-R injury rat model was established by thoracotomy for ligating the left anterior descending (LAD) coronary artery and re-moving the ligation after 30 min .The sham group was performed the thoracotomy without ligation .At the 4 timepoints of postoper-ative 3 ,7 ,14 ,28 d ,the left ventricular diastolic and systolic pressures were measured ,then the rats were killed for collecting the rat heart sample .The section was stained by sirius red .The collagen deposition in coronary arterial remodeling and coronary arterial pe-ripheral area ,and the dynamic change of location and expression of AT2R in the coronary artery were observed by the immunohisto-chemical streptavidinbiotin peroxidase complex (SABC) .Results The immunohistochemical analysis revealed that AT 2R was local-ized in the adventitia of coronary arteries with the radial distribution ,showing the higher density especially in large coronary arterial peripheral area ,the partial expression existed in the coronary arterai intima .The expression of AT2R was transient ,which on 7 d af-ter I-R operation in the control group reached the peak value ,while the expression peak value of AT2R in the valsartan group was higher and earlier than that in the control group .The heart diastolic function on 3 d after I-R operation was impaired ;the left ven-tricular end diastolic presure (LVEDP) in the valsartan group was significantly lower than that in the control group .The collagen deposition of coronary peripheral mesenchyma on postoperative 28 d in the valsartan group was significantly lower than that in the control group;the coronary peripheral collagen deposition in the control group was gradually increased with the time progression , which on postoperative 14 ,28 d was significantly higher than that in the sham group .Conclusion Valsartan could inhibit the coronary arterial remodeling for protecting the heart function possible by the transient high AT 2R expression after myocardial I-R injury .
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Objective To investigate the effects of Shuxuetong Injection (SXT ) on expressions of cell apoptosis and TLR4 a-round ischemic area after focal cerebral infarction in rats and to discuss its neuroprotective mechanism on ischemia-induced brain in-jury .Methods The SD rats were subjected to establish the model of middle cerebral artery occlusion (MCAO)by nylon monofila-ment suture ,then were randomly divided into the sham-operated group ,the model group and the SXT treatment group ;the cell ap-optosis and the expressions of TLR4 mRNA and protein around ischemic area at 12 ,24 ,48 ,72 h after cerebral ischemia were detec-ted respectively by TUNEL test mediated with DNA ,RT-PCR and immunohistochemistry .Results In the model group ,the number of TUNEL positive cells ,the expressions of TLR4 mRNA and protein were gradually increased at 12 h ,reached the peak at 24 h , then decreased and were still higher than those in the sham-operated group(P<0 .01);in the SXT treatment group ,these expres-sions after 24 h were lower than those in the model group (P<0 .05)and declined as the treatment time increase(P<0 .05) .Conclu-sion In subacute stage of cerebral ischemia injury ,apoptosis is related with the expression of TLR4 ,SXT may inhibit apoptosis , down-regulate the expression of TLR4 around ischemic area ,this may be one of the mechanisms of neuroprotection .
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Aim To study the effect of simvastatin(Sim) on left ventricular remodeling and heart function in rats with myocardial infarction(MI).Methods Myocardial infarction models were successfully induced by ligation of anterior descending coronary artery.24 h later the survivals were randomly divided into 3 groups.① MI group;② 20 mg Sim group(20 mg?kg~(-1)?d~(-1));③ 40 mg Sim group(40 mg?kg~(-1)?d~(-1)).The rats with sham ligation formed sham group.After 8 weeks,hemodynamic parameters,blood serum lipids,the ratio of RV and LV weight to body weight(RVWI,LVWI) were examined.The pathomorphological change and the collagen volume fraction(CVF) were analyzed by PSR dyeing.Results There were no significant differences in values of serum lipids among 4 groups.Compared with sham group,the left ventricular end-diastolic pressure(LVEDP) was increased and left ventricular systolic pressure(LVSP) was depressed significantly in MI group; the RVWI and LVWI and the CVF in border infarcted zone and Ⅰ/Ⅲ ratio were increased in MI group too.Compared with MI group,Sim partially normalized LVSP and LVEDP;abated ventricular weight index;reduced CVF in non-infarction zone in both Sim groups.Conculusion Simvastatin improves LV remodeling and heart function in rats with MI,which is associated with the effect of limiting myocardial hypertrophy and interstitial fibrosis.
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Aim To assess the effect of HMG-CoA inhibitors simvastatin on collagen remodeling in rats after myocardial infarction. Methods Myocardial infarction models were induced by ligation of anterior descending coronary artery. 24 hours later the survivals were randomly divided into 3 groups: (1) MI group; (2) 20 mg Sim group(20 mg? kg-1? d-1); (3) 40 mg Sim group(40 mg? kg-1? d-1). Rats with sham ligation formed into Sham group. After 8 weeks, the ratios of LV and RV weight to body weight (RVWI, LVWI) were examined and the collagen content was detected. The type Ⅰ and type Ⅲ collagen volume fraction (CVF) and Ⅰ/Ⅲ ratio in infarcted and non-infarcted zones were examined with PSR dyeing; also the mRNA expressions of type Ⅰ and type Ⅲ collagen in non-infarcted zone (NIZ) were detected with RT-PCR.Results Comparing with Sham group,the RVWI and LVWI in MI group increased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were increased in MI group. The mRNA expressions of type Ⅰ and type Ⅲ collagen in NIZ in MI group were higher than those in Sham group. Comparing with MI group, the RVWI and LVWI in both Sim groups were decreased significantly. The type Ⅰ CVF and type Ⅲ CVF in NIZ and the Ⅰ/Ⅲ ratio were depressed in both Sim groups, and the mRNA expressions of collagens were also lower than those in MI group, but higher than those in Sham group. Conculusion Simvastatin could attenuate the development of myocardial interstitial fibrosis in non-infarction zone to improve myocardial interstitial remodeling in rats after MI.