Ameliorative effect and mechanism of Sanwei ganlu on hepatic fibrosis in rats / 中国药房

OBJECTIVE To investigate the ameliorative effects and mechanism of Sanwei ganlu on hepatic fibrosis in rats. METHODS The rats were randomly divided into normal group， model group， silibinin group （positive control， 50 mg/kg）， and Sanwei ganlu low-dose， medium-dose， and high-dose groups （80， 250， 800 mg/kg）. Except for normal group， hepatic fibrosis rat models were established by intraperitoneal injection of CCl4 in the other groups of rats. Starting from the 6th week of modeling administration， they were given normal saline or corresponding drugs intragastrically at the same time. At the end of the ninth-week experiment， liver and spleen indexes of rats were calculated； the pathological structure and fibrosis changes of liver tissue were observed by HE， Masson and Sirus Red staining. The contents of alanine transaminase （ALT）， aspartate transaminase （AST）， procollagen type Ⅲ （PC Ⅲ）， collagen type Ⅳ （COL-Ⅳ）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） and IL-1β in serum， and hyaluronic acid （HA） and laminin （LN） in liver tissue were all detected. RESULTS Compared with the model group， the liver injury and collagen fiber deposition of rats were improved to different extents in Sanwei ganlu groups and silibinin group； the contents of ALT， AST， PC Ⅲ， COL-Ⅳ， IL-6， TNF-α and IL-1β in serum as well as the contents of HA and LN in liver tissue significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS Sanwei ganlu can alleviate the progression of hepatic fibrosis in rats， possibly by inhibiting the synthesis of collagen fiber， reducing transaminase content， down-regulating the levels of HA， LN， PC Ⅲ and COL-Ⅳ， and reducing the inflammatory response.

Anemia among rural children aged 3-6 in central China and its association with dietary behaviors / 中国学校卫生

Objective@#To understand the status of anemia among rural children aged 3-6 in central China and its relationship with dietary behavior, and to provide reference for prevention and intervention of anemia in rural children.@*Methods@#From April to June 2021, stratified cluster sampling was used to select 1 246 preschool children aged 3 to 6 years old in rural areas in central China. Peripheral blood of the ring finger was collected. Dietary behaviors regarding consumption of cereals and potatoes, fruits, vegetables, soy products, milk, animal foods, food diversity, and drinking water were investigated. Logistic regression analysis was used to analyze the association between anemia and dietary behaviors.@*Results@#The detection rate of anemia in rural children aged 3-6 in central China was 13.88%. The anemia detection rate of left behind children (19.00%) was higher than that of non left behind children (11.27%), and the difference was statistically significant ( χ 2=13.93, P <0.01). Logistic regression analysis showed that the proportion of left behind children ( OR=1.28, 95%CI =1.16-1.56) with anemia was higher than that of non left behind children ( P <0.01). Consumption of animal food intake ≥3 times/week ( OR=0.82, 95%CI =0.69-0.91), and ≥2 kinds of vegetables ( OR= 0.86, 95%CI =0.71-0.93) were associated with lower rate of anemia ( P <0.05).@*Conclusion@#The detection rate of anemia in rural children aged 3-6 years in central China is relatively high, especially in left behind children. Dietary literacy of caregivers should be further improved regarding increased intake of animal foods and vegetables to reduce the risk for anemia in preschoolers.

Long-term clinical outcomes following total knee arthroplasty in patients with hemophilic arthropathy: a single-surgeon cohort after a 10- to 17-year follow-up / 中华医学杂志(英文版)

BACKGROUND@#Total knee arthroplasty (TKA) can reduce severe joint pain and improve functional disability in hemophilia. However, the long-term outcomes have rarely been reported in China. Therefore, this study aimed to evaluate the long-term outcomes and complications of TKA in Chinese patients with hemophilic arthropathy.@*METHODS@#We retrospectively reviewed patients with hemophilia who underwent TKA between 2003 and 2020, with at least 10 years of follow-up. The clinical results, patellar scores, patients' overall satisfaction ratings, and radiological findings were evaluated. Revision surgery for implants during the follow-up period was recorded.@*RESULTS@#Twenty-six patients with 36 TKAs were successfully followed up for an average of 12.4 years. Their Hospital for Special Surgery Knee Score improved from an average of 45.8 to 85.9. The average flexion contracture statistically significantly decreased from 18.1° to 4.2°. The range of motion (ROM) improved from 60.6° to 84.8°. All the patients accepted patelloplasty, and the patients' patellar score improved from 7.8 preoperatively to 24.9 at the last follow-up. There was no statistically significant difference in clinical outcomes between the unilateral and bilateral procedures, except for a better ROM at follow-up in the unilateral group. Mild and enduring anterior knee pain was reported in seven knees (19%). The annual bleeding event was 2.7 times/year at the last follow-up. A total of 25 patients with 35 TKAs were satisfied with the procedure (97%). Revision surgery was performed in seven knees, with 10- and 15-year prosthesis survival rates of 85.8% and 75.7%, respectively.@*CONCLUSIONS@#TKA is an effective procedure for patients with end-stage hemophilic arthropathy, which relieves pain, improves knee functions, decreases flexion contracture, and provides a high rate of satisfaction after more than ten years of follow-up.

Nimbolide targeting SIRT1 mitigates intervertebral disc degeneration by reprogramming cholesterol metabolism and inhibiting inflammatory signaling

Inflammation, abnormal cholesterol metabolism, and macrophage infiltration are involved in the destruction of the extracellular matrix of the nucleus pulposus (NP), culminating in intervertebral disc degeneration (IDD). Whether nimbolide (Nim), a natural extract, can alleviate IDD is unclear. In this study, we demonstrated that Nim promotes cholesterol efflux and inhibits the activation of the nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways by activating sirtuin 1 (SIRT1) in nucleus pulposus cells (NPCs) during inflammation. Thus, Nim balanced matrix anabolism and catabolism of NPCs. However, the inhibition of SIRT1 significantly attenuated the effects of Nim. We also found that Nim promoted the expression of SIRT1 in RAW 264.7, which enhanced the proportion of M2 macrophages by facilitating cholesterol homeostasis reprogramming and impeded M1-like macrophages polarization by blocking the activation of inflammatory signaling. Based on these results, Nim can improve the microenvironment and facilitate matrix metabolism equilibrium in NPCs. Furthermore, in vivo treatment with Nim delayed IDD progression by boosting SIRT1 expression, modulating macrophage polarization and preserving the extracellular matrix. In conclusion, Nim may represent a novel therapeutic strategy for treating IDD.

Chemical constituents from leaves of Jatropha curcas / 中草药·英文版

OBJECTIVE@#To investigate the chemical constituents from the leaves of Jatropha curcas and evaluate their inhibition on lipopolysaccharide (LPS)-activated BV-2 microglia cells.@*METHODS@#The n-BuOH extract of the leaves of J. curcas was isolated by macroporous adsorption resin, silica gel, ODS, column chromatography and semi-preparative HPLC. The structures of the compounds were identified by MS, NMR, ECD, and other spectroscopic methods. In addition, anti-neuroinflammatory effects of isolated compounds were evaluated by measuring the production of nitric oxide (NO) in over-activated BV-2 cells.@*RESULTS@#Seventeen compounds, including (7R,8S)-crataegifin A-4-O-β-D-glucopyranoside ( 1), (8R,8'R)-arctigenin ( 2), arctigenin-4'-O-β-D-glucopyranoside ( 3), (-)-syringaresinol ( 4), syringaresinol-4'-O-β-D-glucopyranoside ( 5), (-)-pinoresinol ( 6), pinoresinol-4'-O-β-D-glucopyranoside ( 7), buddlenol D ( 8), (2R,3R)-dihydroquercetin ( 9), (2S,3S)-epicatechin ( 10), (2R,3S)-catechin ( 11), isovitexin ( 12), naringenin-7-O-β-D-glucopyranoside ( 13), chamaejasmin ( 14), neochamaejasmin B ( 15), isoneochamaejasmin A ( 16), and tomentin-5-O-β-D-glucopyranoside ( 17) were isolated and identified. Compounds 2, 4 and 8 significantly inhibited the release of NO in BV-2 microglia activated by LPS, with IC50 values of 18.34, 29.33 and 26.30 μmol/L, respectively.@*CONCLUSION@#Compound 1 is a novel compound, and compounds 2, 3, 8, 14- 17 are isolated from Jatropha genus for the first time. In addition, the lignans significantly inhibited NO release and the inhibitory activity was decreased after glycosylation.

How to Exert Role of Radiotherapy in Treatment of Pancreatic Cancer / 肿瘤防治研究

Radiotherapy plays an important role in the treatment of all stages of pancreatic cancer, and some therapeutic effects have been obtained. At present, it needs to be considered and practiced in many aspects that how to play the role of radiotherapy in the treatment of pancreatic cancer. It is related to the choice of dose mode, the accuracy of irradiation, the cooperation of other treatment methods and other factors. The emergence of precision radiotherapy technology and the subsequent change in the idea of radiotherapy will further improve the role of radiotherapy in the treatment of pancreatic cancer. Based on the relevant literatures at home and abroad and our own experience, this paper reviews the role of precision radiotherapy for pancreatic cancer.

Comparison of methods for enriching urine proteins / 生物工程学报

The abundance of proteins in human urine is low and easily to be masked by high-abundance proteins during mass spectrometry analysis. Development of efficient and highly selective enrichment methods is therefore a prerequisite for achieving deep coverage of urine protein markers. Notably, different experimental methods would affect the urine protein enrichment efficacy and the coverage of urine proteome. In this study, ultrafiltration, nitrocellulose membrane enrichment and saturated ammonium sulfate precipitation were used to process 10 mL urine samples from five healthy volunteers and five bladder cancer patients. The urine proteins were enriched and separate by SDS-PAGE to compare the purification efficiency of different methods. Moreover, the peptide identification effects of different purification methods were analyzed by mass spectrometry to determine the best method for enriching urine protein histones. Saturated ammonium sulfate precipitation method outperformed the ultrafiltration and the nitrocellulose membrane enrichment methods in terms of the protein enrichment efficacy and quality. The interference of highly abundant albumin was reduced, whereas the amount of low-abundance protein was increased, and the sensitivity of mass spectrometry identification was increased. The saturated ammonium sulfate precipitation method may be applied for large-scale urine processing for screening clinical diagnostic markers through proteomics.

Advances in radiotherapy for pancreatic cancer from 2019 to 2020 / 临床肝胆病杂志

With the rapid development of radiotherapy equipment, imaging technology, and artificial intelligence, radiotherapy has entered the era of precision therapy. Radiotherapy is one of the important methods for the treatment of pancreatic cancer, and rapid progress has been made in related concepts and technical models of radiotherapy in recent years. With reference to the latest advances in radiotherapy technology and the change of radiotherapy dose mode, which the experts in the field of radiotherapy are concerned with, this article reviews and analyzes recent articles and points out that multimodal images play an important role in guiding radiotherapy for pancreatic cancer, and the dose mode of radiotherapy develops to high-dose hypofractionated radiotherapy. The effect of neoadjuvant radiotherapy has been further confirmed, and strong chemotherapy with the combination of multiple drugs is the main radiotherapy regimen for pancreatic cancer.

Prevalence of nutritional risk among 1 500 hospitized patients with gynecologic tumor / 中华临床营养杂志

Objective:To investigate the prevalence of nutritional risk among hospitalized patients with gynecologic tumor and provide a reference for nutritional intervention.Methods:Hospitalized patients with gynecologic tumor in a grade A class 3 hospital in Beijing were consecutively enrolled from December 2016 to December 2017. Nutritional risk was measured by nutritional risk screening 2002(NRS 2002)within the first 24 h after admission. The relevant influencing factors were analyzed.Results:A total of 1 500 hospitalized patients who met entry criteria and obtained informed consent were consecutively enrolled. The prevalence of nutritional risk was 23.1%, and 53.1 % patients had at least one nutrition-related problem. The analysis of relevant influencing factors showed that patients of age under 30 years and over 50 years( χ2=108.014, P<0.01), malignancy( χ2=112.197, P<0.01), low differentiation pathological type( χ2=251.392, P<0.01), chemotherapy( χ2=339.999, P<0.01)accompanied with vomiting( χ2=121.402, P<0.01), diarrhea( χ2=49.920, P<0.01)had the relatively high prevalence rate of nutritional risk. Pathological stage and operation had no significant effect( P>0.05). Conclusions:The prevalence of nutritional risk among hospitalized patients with gynecologic tumor is relatively high. The main relevant influencing factors include age, kinds of diseases, pathological type, chemotherapy, vomiting and diarrhea.

Preliminary analysis of efficacy and safety of intensity-modulated radiotherapy for stage ⅣA thymoma / 中华放射肿瘤学杂志

Objective To preliminarily evaluate the efficacy and safety of intensity-modulated radiotherapy (IMRT) in the treatment of inoperable stage ⅣA thymoma.Methods A retrospective analysis of 15 patients with inoperable stage ⅣA thymoma receiving IMRT from January 2010 to December 2017 was performed.Among them,9 patients were male and 6 female,aged 31-83 years with a medianof 59 years.The dose of radiotherapy was 50 Gy/60 Gy/70 Gy/ 15-20 fractions for PTV/CTV/GTV.The short-term efficacy,overall survival rate and adverse reactions were analyzed.Results The follow-up rate was 100％.The median follow-up time was 48 months.The short-term partial remission rate was 93％(14/15).The 1-,3-and 5-year overall survival rates were 100％,75％ and 75％,respectively.One patient presented with grade 3 hematological reaction.Four patients died of tumors.Conclusion Preliminary findings demonstrate that IMRT is an efficacious and safe treatment of stage ⅣA thymoma,which can be applied for patients with unresectable thymoma.

SOCS3 Attenuates GM-CSF/IFN-γ-Mediated Inflammation During Spontaneous Spinal Cord Regeneration / 神经科学通报·英文版

SOCS3, a feedback inhibitor of the JAK/STAT signal pathway, negatively regulates axonal regrowth and inflammation in the central nervous system (CNS). Here, we demonstrated a distinct role of SOCS3 in the injured spinal cord of the gecko following tail amputation. Severing the gecko spinal cord did not evoke an inflammatory cascade except for an injury-stimulated elevation of the granulocyte/macrophage colony-stimulating factor (GM-CSF) and interferon gamma (IFN-γ) cytokines. Simultaneously, the expression of SOCS3 was upregulated in microglia, and unexpectedly not in neurons. Enforced expression of SOCS3 was sufficient to suppress the GM-CSF/IFN-γ-driven inflammatory responses through its KIR domain by attenuating the activities of JAK1 and JAK2. SOCS3 was also linked to GM-CSF/IFN-γ-induced cross-tolerance. Transfection of adenovirus overexpressing SOCS3 in the injured cord resulted in a significant decrease of inflammatory cytokines. These results reveal a distinct role of SOCS3 in the regenerating spinal cord, and provide new hints for CNS repair in mammals.

Difference in intestinal microbiome between children with atopic dermatitis and healthy children / 中华皮肤科杂志

Objective@#To investigate the difference in intestinal microbiome between children with atopic dermatitis (AD) and healthy children.@*Methods@#Totally, 35 children with AD were enrolled from the Department of Dermatology, Jiading Hospital of Traditional Chinese Medicine from April 2015 to April 2017, and 27 healthy children served as control group. Total DNA was extracted from the feces of the subjects, and the V3-V4 region of the 16S rRNA gene of the bacteria was amplified by PCR. High-throughput sequencing was performed using the Illumina Miseq sequencing platform to analyze the diversity of bacterial flora. The top 15 abundant bacteria were determined at phylum, genus, and species levels, and compared between the two groups. Statistical analysis was carried out using Wilcoxon rank sum test.@*Results@#The intestinal microbiome in the two groups mainly consisted of Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria. At the phylum level, the abundance of Bacteroidetes and Fusobacteria was significantly lower in the AD group (29.16% ± 19.96%, 0.06% ± 0.17%, respectively) than in the healthy control group (39.06% ± 15.98%, 0.50% ± 1.71%, respectively, P = 0.042, 0.041) . At the genus level, the abundance of Bacteroides was significantly lower in the AD group (23.77% ± 18.08%) than in the healthy control group (33.1% ± 15.75%, P = 0.029) . There was no significant difference in the distribution of the top 15 abundant species between the two groups (all P > 0.05) .@*Conclusion@#There are some differences in the composition of intestinal microbiome and relative abundance of bacteria between children with AD and healthy children.

Analysis of risk factors for male type 2 diabetes mellitus patients with erectile dysfunction complicated with depression / 中国基层医药

Objective@#To explore the risk factors associated with depression in type 2 diabetes mellitus (T2DM) patients with erectile dysfunction (DMED).@*Methods@#A total of 60 male DMED patients in Kangning Hospital Affiliated to Wenzhou Medical University were enrolled.They were divided into group A (DMED with depression, 40 cases) and group B (DMED without depression, 20 cases) according to the results of self-rating depression scale (SDS). The comorbidity rate of DMED and depression was calculated.Baseline index, blood glucose control index, sex hormone index and blood lipid biochemical index were compared between the two groups.Pearson correlation analysis was used to judge the correlation between SDS scale scores and the indicators.Finally, these indicators were substituted into logistic regression analysis to find out the factors that may cause the comorbidity of DMED and depression.@*Results@#The age of the patients in group A was older than that in group B[(55.95±6.33)years vs.(44.15±5.08)years, t=7.242, P=0.000], the course of T2DM in group A was longer than that in group B [(10.28±0.94)years vs.(4.38±0.60)years, t=29.467, P=0.000]. The fast plasma glucose (FPG)[(10.24±1.55)mmol/L vs.(8.22±1.15)mmol/L, t=5.153, P=0.000], fasting insulin (FIns) [(21.34±2.58)mU/L vs.(17.35±2.13)mU/L, t=5.967, P=0.000] and glycosylated hemoglobin (HbAlc) [(8.75±1.05)% vs.(6.55±0.84)%, t=8.146, P=0.000] in group A were higher than those in group B. Testosterone (TT) level in group A was lower than that in group B [(1.89±0.24)ng/mL vs.(2.46±0.31)ng/mL, t=-7.855, P=0.000]. The luteinizing hormone (LH) [(12.95±1.14)U/L vs.(8.53±0.70)U/L, t=18.515, P=0.000] and follicle-stimulating hormone (FSH) [(19.55±1.83)U/L vs.(15.40±1.47)U/L, t=8.808, P=0.000] in group A were higher than those in group B. Pearson analysis showed that the SDS scale score was positively correlated with age, T2DM duration, FPG, Fins, HbAlc, LH, FSH (r=0.310, 0.503, 0.465, 0.583, 0.676, 0.355, 0.540, P=0.002, 0.008, 0.017, 0.022, 0.030, 0.026, 0.011), and negatively correlated with TT level (r=-0.713, P=0.028). Logistic regression analysis showed that the age, the course of T2DM and TT were the independent risk factors which caused the comorbidity of DMED and depression.@*Conclusion@#In male T2DM patients, the independent risk factors for DMED with depression are age, long duration, and low TT level.

Difference in intestinal microbiome between children with atopic dermatitis and healthy children / 中华皮肤科杂志

Objective To investigate the difference in intestinal microbiome between children with atopic dermatitis(AD)and healthy children. Methods Totally, 35 children with AD were enrolled from the Department of Dermatology, Jiading Hospital of Traditional Chinese Medicine from April 2015 to April 2017, and 27 healthy children served as control group. Total DNA was extracted from the feces of the subjects, and the V3-V4 region of the 16S rRNA gene of the bacteria was amplified by PCR. High-throughput sequencing was performed using the Illumina Miseq sequencing platform to analyze the diversity of bacterial flora. The top 15 abundant bacteria were determined at phylum, genus, and species levels, and compared between the two groups. Statistical analysis was carried out using Wilcoxon rank sum test. Results The intestinal microbiome in the two groups mainly consisted of Firmicutes, Bacteroidetes, Proteobacteria and Actinobacteria. At the phylum level, the abundance of Bacteroidetes and Fusobacteria was significantly lower in the AD group(29.16％± 19.96％, 0.06％± 0.17％, respectively)than in the healthy control group(39.06％± 15.98％, 0.50％± 1.71％, respectively, P=0.042, 0.041). At the genus level, the abundance of Bacteroides was significantly lower in the AD group(23.77％± 18.08％)than in the healthy control group(33.1％± 15.75％, P=0.029). There was no significant difference in the distribution of the top 15 abundant species between the two groups(all P>0.05). Conclusion There are some differences in the composition of intestinal microbiome and relative abundance of bacteria between children with AD and healthy children.

Acute adverse reactions observation of craniospinal irradiation with helical tomotherapy in patients with medulloblastoma / 肿瘤研究与临床

Objective To investigate the acute adverse reactions of craniospinal irradiation with helical tomotherapy in medulloblastoma patients and its risk factors. Methods A total of 20 patients with medulloblastoma who received craniospinal irradiation with helical tomotherapy between October 2012 and September 2016 in Air Force General Hospital were selected. The acute adverse events of 20 patients during the treatment were record. According to National Cancer Institute Common Terminology Criteria Adverse Events (NCI-CTCAE) version 4.0, the adverse reactions were divided into the mild group (grade 0-Ⅱ) and severe group (grade Ⅲ-Ⅳ) adverse reactions. And the risk factors were also analyzed. Results The non-hematological adverse reactions included fatigue (55％), vomiting (45％) and headache (25％). The hematological adverse reactions included leukopenia (95％), thrombocytopenia (55％) and lower hemoglobin (45％), and the incidence of severe adverse reactions was 35％ (7/20), 20％ (4/20) and 0 ( 0/20 ) , respectively . Leukopenia occurred in 18 patients ( 90％) at the beginning of radiotherapy within 2 weeks, and thrombocytopenia occurred in 8 patients (40％) at the beginning of radiotherapy after 2 weeks. Single factor analysis showed that there were no statistical differences in hematological adverse events of gender, age and radiation dose of spinal cord (all P>0.05). The incidence of leukopenia for the patients who received the chemotherapy before the radiotherapy was higher than that for the patients without the chemotherapy before the radiotherapy (P< 0.05). Conclusions The hematological adverse reactions were the major acute adverse events during the craniospinal irradiation with helical tomotherapy in patients with medulloblastoma. Theincidence of leukopenia and thrombocytopenia is common, and the incidence of hematological adverse reactions is higher after the chemotherapy. Thus, the close monitoring of hemogram change and treatment of hematological adverse reactions in time during the radiotherapy should be taken into the consideration.

Clinic observation of bone metastasis treated with apatinib combined with radiotherapy / 国际肿瘤学杂志

Objective To evaluate the clinical efficacy and safety of apatinib combined with radiotherapy in patients with bone metastasis.Methods Thirty-one patients admitted to Radiation Oncology of the First Affiliated Hospital of Anhui Medical University with bone metastasis were recruited from April 2016 to February 2017.All patients were received apatinib 500 mg/d orally combined with radiotherapy (30 ～40 Gy/10 ～20 F).until disease progression or intolerable toxicity occurred.Clinical efficacy and safety were observed.Results The total response rate was 93.55％ (29/31),25.81％ (8/31) had complete response,58.06％ (18/31) had moderate response,9.68％ (3/31) had mild response,and 6.45％ (2/31) had no response;The time to exert its effect after the treatment was 6 days,and its median maintenance time was 7 months.The lesions complete response was 3.23％ (1/31),partial response was 51.61％ (16/31),became stable in 13 patients (41.94％),and deteriorated in 1 patient (3.23％),and the total control rate was 96.78％.The patients Karnofsky score increased obviously after the treatment (83.71 ± 5.77 vs.78.87 ± 7.49),and the difference was statistically significant (t =4.23,P =0.006).The median local progression-free survival and median overall survival were 6 months and 7 months,respectively.The main adverse reactions were hypertension,hand-foot syndrome,proteinuria and bone marrow depression.The rates of hypertension,hand-foot syndrome,proteinttria and bone marrow depression were 35.48％ (11/31),25.81％ (8/31),16.13％ (5/31),and 16.13％ (5/31),respectively.Conclusion Radiotherapy combined with apatinib is effective and tolerable for bone metastasis patients.

Clinical study of anterior controllable antedisplacement and fusion for the treatment of cervical ossification of posterior longitudinal ligament / 中华骨科杂志

Objective To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) for the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.Methods The data of 45 cases with cervical posterior longitudinal ligament ossification treated by ACAF from March 2017 to October 2017 were retrospectively analyzed,including 25 males and 20 females,age 45-68 years,average 57.5 years.There were 18 cases involving C3 vertebral body,30 cases involving C4 vertebral body,40 cases involving C5 vertebral body,34 cases involving C6 vertebral body,and 7 cases involving C7 vertebral body.The function of the neural function was evaluated by the Japanese Orthopaedic Association (JOA) scoring system at preoperation and latest follow-up.The curvature of the cervical spine was measured on the lateral X-ray film of the cervical spine,the maximum occupying ratio of the spinal canal was measured on the cross section of the CT scan,and compression of the cervical spinal cord was evaluated by the cervical MRI.Results Patients were followed up for 3 to 6 months (average,3.9 months).The improvement of neurological function was obtained in all the patients.The JOA score improvement rate at the latest follow-up was 71.3％±9.6％.The cervical lordosis was improved from preoperative 4.5°±3.8° to 10.3°±4.8° at the latest follow-up.The canal stenosis ratio was decreased from preoperative 54.3％±8.2％ to 12.5％±5.3％ at the latest follow-up.MRI showed that the cervical spinal cord was adequately decompressed in situ.No specific complications were identified that were associated with this technique.Conclusion The present study elaborates the surgical tips and demonstrates the satisfactory outcome of ACAF for the treatment of OPLL.This novel technique has the potential to serve as an alternative surgical technique for the treatment of cervical OPLL.

Serum CA19-9 as a predictive value and an effective evaluator for pancreatic cancer patients treated with hypofractionated tomotherapy combined with chemotherapy / 中华放射医学与防护杂志

Objective To observe the dynamic changes of serum CA19-9 level before and after the treatment of high-dose and low-fractionated Tomotherapy combined with chemotherapy for pancreatic cancer,and explore the corresponding prognostic,predictive and therapeutic effects.Methods The clinical characteristics and the survival of 75 patients with pancreatic cancer treated in the Department of Radiotherapy of Air Force General Hospital were analyzed retrospectively from December 2012 to June 2017.The effects of baseline CA19-9 and CA19-9 level at 4-6 weeks after the radiotherapy on patient prognosis were analyzed by Kaplan-Meier method and Log-rank test retrospectively.Results The median survival time (MST) was 13.8 months (2.0-58.0 months).The baseline serum CA19-9 was 1109 U/ml(4.70-70000 U/ml).The MST in the ＜ 1109 U/ml group and ≥ 1109 U/ml group were 14.0 months (95％ CI:10.04-22.96 months) and 9.0 months(95％ CI:7.75-13.25 months) respectively (x2 =6.31,P ＜0.05).The corresponding median progression-free survival (mPFS) was 7.0 months(95％ CI:5.58-8.42 months) and 5.0 months(95 ％ CI:3.81-6.20 months) respectively (x2 =8.51,P ＜ 0.05).The median CA19-9 level at 4-6 weeks after radiotherapy was 397.7 U/ml (11.02-43 250 U/ml).A total of 38 cases (38/49,77.6％) declined,and 11 cases (11/49,22.4％) increased.The MST of the declined and increased groups were 14.0 months(95％ CI:7.24-20.77 months) and 8.0 months(95％ CI:2.69-13.31 months) respectively (x2 =11.19,P ＜0.05).The corresponding mPFS were 5.5 months(95 ％ CI:4.05-6.95 months) and 4.0 months (95 ％ CI:1.98-6.02 months) respectively (x2 =9.12,P ＜ 0.05).The ROC curve determined that the cut-off for the decline of serum CA19-9 was 60.9％ at 4 to 6 weeks after radiotherapy.The MST of ≥ 60.9％ group and ＜ 60.9％ group were 33.5 months (95％ CI:0.24-66.76 months)and 9.0 months(95％ CI:6.92-11.08 months)respectively (x2 =13.80,P＜0.05).The corresponding mPFSwere 11.0 months(95％ CI:3.44-18.56 months)and 5.0 months(95％ CI:3.91-6.09 months)respectively (x2 =8.71,P＜0.05).Conclusions Patients with the baseline serum CA19-9 ＜ 1109 U/ml had a better outcome after hypofraction tomotherapy combined with chemotherapy.The decline of serum CA19-9 at 4-6 weeks after radiotherapy can serve as a prompt and effective predictor of the outcome and the progression of patients.The decline of serum CA19-9 ≥60.9％ in patients with pancreatic cancer is associated with a low possibility of disease progression in half a year,whose overall survival is better.

Feasibility of helical tomotherapy intensity-modulated radiation therapy applied in total marrow irradiation / 中华放射肿瘤学杂志

Objective To introduce the therapeutic procedures of helical tomotherapy based total marrow irradiation(HT-TMI), and validate the feasibility of TMI. Methods At 1 week before bone marrow transplantation,12 patients received TMI conditioning regimen at a prescriptive dose of 12 Gy in 3 times,once daily. Patient immobilization, CT simulation, target delineation, plan design and dosimetric verification were implemented in sequence according to the TMI procedures. The dosimetric paramaters of the target and normal tissues were analysed. The correlation between the dose verification and image-guided results was observed. Results Compared with total body irradiation(TBI), TMI could significantly reduce the irradiation dose to normal tissues. The median dose D50of all normal tissues except the oral cavity were lower than 6 Gy,where The D50of lens,brain,lung and liver are (1.8±0.1) Gy, (5.7±0.2) Gy, (5.2±0.2) Gy, and (4.6±0.2) Gy, respectively. Pass rate of γ Index was larger than 95% with 3mm/3% criterian for each section. The positioning error of head and neck was relatively lower than that of pelvis at x-axis,and was higher at z-axis.Conclusions Helical tomotherapy based TMI is a feasible and reasonable approach,which has evident dosimetric advantage.

Anterior controllable anteriodisplacement and fusion for treatment of severe cervical ossification of posterior longitudinal ligament / 第二军医大学学报

Objective To report a novel technique named anterior controllable antedisplacement and fusion (ACAF) for the treatment of severe ossification of the posterior longitudinal ligament of the cervical spine,which allows for direct decompression of the nerve without resection of the ossification,making up for deficiencies in traditional anterior or posterior decompression.Methods The main surgical procedures of the ACAF included treatment of intervertebral space,removal of the anterior part of vertebrae,installation of titanium plate and interbody fusion cages,bilateral osteotomies of the vertebrae,and antedisplacement of the vertebrae ossification complex.The clinical data of two patients undergoing this surgery for severe ossification of the posterior longitudinal ligament of cervical spine were collected and analyzed.Results ACAF enabled direct decompression of spinal cord and nerve root through antedisplacement of the vertebrae ossification complex.The two patients who underwent ACAF gained satisfactory restoration with decompression of spinal cord and good recovery of neurological function,with no specific complications.Conclusion ACAF surgery takes into account the effectiveness of anterior direct decompression and the safety of posterior indirect decompression.Preliminary results shows that it can be used for severe cervical ossification of the posterior longitudinal ligament.