Clinical features of hypopituitarism with nonalcoholic fatty liver disease after sellar tumor surgery in children / 临床肝胆病杂志

Objective To investigate the clinical features of hypopituitarism with nonalcoholic fatty liver disease (NAFLD) in children after sellar tumor surgery and the association between hypopitarism and NAFLD in children. Methods A retrospective analysis was performed for the clinical data of children with hypopituitarism and NAFLD after sellar tumor surgery who were followed up regularly in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2017 to December 2021, and their clinical features were analyzed. Results There were 32 children with regular follow-up and complete clinical data after sellar tumor surgery, and 10 children (31.25%) developed NAFLD, among whom there were 5 boys and 5 girls. Among these 10 children, 9 had craniopharyngioma and underwent surgical treatment, and 1 had germinoma and underwent local radiotherapy. The 10 children had a median age of 8.4(6.29.8) years at the diagnosis of hypopituitarism and a median age of 11.9(8.7-12.6) years at the diagnosis of NAFLD. The median number of years from the diagnosis of hypopituitarism to the diagnosis of NAFLD was 2.0(1.4-4.0) years. At the diagnosis of NAFLD, all 10 children had obesity, and body mass index (BMI) was increased by 7.26±4.25 kg/m 2 on average since the diagnosis of hypopituitarism; the 10 children had a mean fasting blood glucose level of 4.67±0.55 mmol/L, a mean fasting insulin level of 25.40±5.93 μIU/ml, and a mean HOMA-IR index of 5.26±1.29. Among these 10 children, 9 had hypertriglyceridemia, and 1 had elevated triglyceride, with a mean level of 3.08±1.09 mmol/L; 6 children had hypercholesterolemia, with a mean level of 5.67±1.25 mmol/L; 8 children had high-density lipoprotein cholesterolemia, with a mean level of 3.97±1.27 mmol/L. After the diagnosis of NAFLD, 2 children were treated with recombinant human growth hormone and metformin and achieved reductions in BMI, HOMA-IR, and triglyceride after treatment, and total cholesterol and low-density lipoprotein cholesterol were reduced to the normal range. Conclusion Children may experience weight gain, hypopituitarism, insulin resistance, and dyslipidemia after sellar tumor surgery, which may lead to the onset of NAFLD. Weight management and active pituitary hormone replacement therapy are recommended for such children, as well as routine screening and management of fatty liver disease.

The association between bisphenol A exposure and obesity/overweight in children and adolescents: dose-response Meta analysis / 中华预防医学杂志

Objective: To explore the relationship between bisphenol A (BPA) exposure and obesity/overweight in children and adolescents through Dose-response Meta analysis. Methods: Articles published up to September 1st 2021 were systematically searched in PubMed, Web of science, Scopus, Embase, Cochrane library, CNKI, Wanfang databases and VIP Chinese Science and Technology Journal by using "bisphenol A" "BPA" "obesity" "weight" "fat""overweight" "body mass index" "BMI" "waist circumference" (both in English and in Chinese) as keywords. Use Stata 15.1 software to calculate the pooled OR (95%CI), perform heterogeneity test, subgroup analysis, sensitivity analysis, publication bias and the exposure-response relationship fitting. Results: A total of 9 English articles were included from 1 948 articles retrieved, including 8 articles from American and 1 article from China. 15 614 children/adolescents and 3 446 obese/overweight cases were further used for Meta-analysis of dose-response relationship. Meta-analysis results showed that there was heterogeneity among the highest dose groups in different studies(I2=52.1%, P=0.033). The random effect model-analysis found that compared with those in the lowest group, the OR(95%CI) for those in the highest group of urine BPA was 1.56(1.18-1.94)for the risk of obesity/overweight in children and adolescents, but there was no linear or nonlinear dose-response relationship. Sensitivity analyses showed that the results were robust, Egger's test(P=0.263) and Begg's test(P=0.348) showed that there was no publication bias. Conclusion: Bisphenol A exposure may increase the risk of obesity/overweight epidemics in children and adolescent.

Characteristics of exposure to microplastics via ingestion and inhalation among Chinese children / 上海预防医学

Objective To evaluate the characteristics of exposure to micro- and nano-plastics （MPs） via food ingestion and inhalation among Chinese children including 6-7 years old school children in Pudong New Area of Shanghai. Methods Articles published until March 2021 were searched on PubMed， Web of Science， Scopus， China National Knowledge Infrastructure （CNKI）， Wanfang and Weipu databases. The exposure levels of MPs by food ingestion and inhalation pathways were estimated by referring to the Chinese children food consumption and breathing rates data. The characteristics of children’s exposure to MPs in China were compared with that in the United States. In addition， the consumption of bottled water， tap water and salt intake among children aged 6-7 years was determined in a cohort of children and adolescents in Pudong New Area of Shanghai. The characteristics of exposure to MPs through food intake and inhalation among them were investigated. Results A total of 5 786 samples from 38 studies were retrieved. Annual intake of MPs among Chinese children was estimated to range from 159 400 to 204 637 MPs from food ingestion， depending on age and sex. When inhalation exposure is also considered， the annual MPs intake increased to 164 635 to 213 032 MPs， which were larger than the values in American persons. Ingestion of MPs posed the largest health risk to male Chinese adults. With the questionnaire survey data， the estimated annual total exposure amount through food intake alone is 116 272‒120 334 MPs for 6 to 7 years old school children in Pudong New Area. With addition of inhalation exposure， the annual total exposure amount is 121 300‒125 983 MPs， which is lower than the average exposure level in the whole country. The discrepancy could be mainly due to the different drinking habits between the local children and others. Overall， tap drinking water， seafood，bottled water， and air represented four substantial vectors of daily MPs exposure in Chinese children. Conclusion Ingestion and inhalation of MPs pose higher health risk to Chinese children in comparison to American children. The level of exposure to MPs among 6 to 7 years old school children in Pudong New Area of Shanghai is lower than that in the same age group of children across the whole country. The attempt to lower the MPs levels in drinking water and seafood would represent the most effective means to help reduce the MPs exposure risk to Chinese children.

Network pharmacology study of flavone extracts of Silybum marianum in the treatment of nonalcoholic fatty liver disease / 药学学报

To investigate the therapeutic effect and molecular mechanism of the main flavonoid components of Silybum marianum (S. marianum) on nonalcoholic fatty liver disease (NAFLD), we identified nine flavonoids in S. marianum through TCMSP, PubChem database and corresponding literatures. The potential therapeutic targets of NAFLD were predicted by SwissTargetPrediction, GeneCards and Venny 2.1.0 platform, while the protein-protein interaction (PPI) network of potential targets was analyzed using String platform and Cytoscape software. Then GO and KEGG pathway enrichment analysis were performed using David 6.8 database, followed by molecular docking verification using AutoDock software. In vitro, components with higher degree value in the "components-targets-pathway" network were chosen for further analysis. L02 cells were used to establish lipid accumulation model and treated with different components. Furthermore, the effects of four pure active compounds from S. marianum on lipid accumulation in hepatocytes were analyzed by oil red O staining. The results showed that the main nine flavonoids extracted from S. marianum contained 24 potential NAFLD targets. Several critical pathways closely related to NAFLD process were identified by GO and KEGG enrichment analysis, including phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) pathway, type 2 diabetes pathway, tumor necrosis factor (TNF) pathway and insulin resistance pathway. The results of molecular docking further indicated that the core components displayed strong binding abilities with key targets respectively, and silandrin showed better binding activity as compared to other components. The results obtained from L02 cells showed that the lipid accumulation was reduced by treatment with isosilybin A, isosilybin B, silydianin and silychristin, while the activity of isosilybin B was better than that of isosilybin A. Taken together, we concluded that the main flavone components of S. marianum could improve lipid accumulation through multiple signaling pathway in hepatocytes, and this could be a potential new strategy for the treatment of NAFLD.

Progress in dose algorithm research for proton therapy planning system / 中华放射医学与防护杂志

Proton therapy can deliver highly conformal dose distribution to the targeted organs or tissues while minimizing radiation exposure to surrounding normal tissues. These characteristics of proton therapy have great significance for reducing patients′ radiation injuries. Proton therapy has to be performed based on accurate calculation of the dose distributions inside the patients′ body and the proton treatment planning system is thus an indispensable part of proton therapy. The paper intends to provide a review on recent progress in dose algorithm research for proton therapy planning system.

Feasibility of three-dimensional-printed template-guided 125I seed brachytherapy and dosimetric evaluation in patients with malignant tumor

Objective: The objective of the study is to test whether three-dimensional (3D)-printed template can be used reproducibly for guiding malignant tumors brachytherapy and study the dosimetric consistency and adequacy between pre- and post-plan. Materials and Methods: Between January and December 2016 in our hospital, a total of 14 patients underwent 3D-printed template-guided brachytherapy. All the patients were fixed into position using a vacuum cushion before undertaking a computed tomography (CT) scan. After the preplan was designed, the templates were printed. The tumors were punctured through predesigned needle holes. Following this, another CT scan was used to confirm the locations of needles, and then the 125 I radioactive seeds were implanted into the tumor according to the preplan. Postplan was performed after the operation. Data of the D90 (minimum absorbed dose of 90% target volume), V90 (90% prescription dose coverage volume percentage of target volume), V100, V150, and seed number pre- and post-operation were collected and compared. Results: The mean D90, V90, V100, V150, and seed number preoperation were 94.96 ± 16.43 Gy, 94.64% ± 1.43%, 91.21% ± 1.59%, 65.01% ± 5.78%, and 46.67 ± 21.87, respectively. The mean D90, V90, V100, V150, and seed number postoperation were 91.97 ± 17.54 Gy, 93.35% ± 2.45%, 89.35% ± 3.21%, 63.40% ± 6.36%, and 46.60 ± 22.85, respectively. No significant difference between pre- and post-operation was observed across the data (P >0.05). Conclusion: For immobilized malignant tumors, 3D-printed template can be used reproducibly. The dose parameters in preplan can be achieved easily and satisfactorily by 3D-printed template guided brachytherapy, and it may become an easily reproducible standardized procedure in the future

Study on the conversion between CT hounsfield units and relative stopping power in proton therapy and the improvement in adipose tissue / 中华放射医学与防护杂志

Objective@#To introduce a method for calibrating the conversion from CT Hounsfield units (HU) to relative stopping power (RSP) for proton therapy, and improve the precision of the conversion in the region for adipose tissues.@*Methods@#The HU and RSP values of human tissues were calculated by a stoichiometric calibration method. Animal tissue was used to simulate subcutaneous adipose tissue of patients, and the HU and RSP of the animal tissue were measured. The effect of subcutaneous adipose tissue on conversion between HU and RSP were analyzed by piecewise fitting.@*Results@#The precision of conversion curve was improved significantly with the measured HU and RSP of adipose tissue in the fitting. The effect caused by different choice in different ionization energy was less than 0.6%, and the effect of proton energy differential was less than 0.8%.@*Conclusions@#The precision of conversion curve for the transformation of HU into RSP in adipose tissues could be improved by taking subcutaneous adipose tissue into account, which would reduce the range error of proton beams when such tissues are present in the target volumes or in the beam path.

Study on the conversion between CT hounsfield units and relative stopping power in proton therapy and the improvement in adipose tissue / 中华放射医学与防护杂志

Objective To introduce a method for calibrating the conversion from CT Hounsfield units (HU) to relative stopping power ( RSP) for proton therapy, and improve the precision of the conversion in the region for adipose tissues. Methods The HU and RSP values of human tissues were calculated by a stoichiometric calibration method. Animal tissue was used to simulate subcutaneous adipose tissue of patients, and the HU and RSP of the animal tissue were measured. The effect of subcutaneous adipose tissue on conversion between HU and RSP were analyzed by piecewise fitting. Results The precision of conversion curve was improved significantly with the measured HU and RSP of adipose tissue in the fitting. The effect caused by different choice in different ionization energy was less than 0. 6％, and the effect of proton energy differential was less than 0. 8％. Conclusions The precision of conversion curve for the transformation of HU into RSP in adipose tissues could be improved by taking subcutaneous adipose tissue into account, which would reduce the range error of proton beams when such tissues are present in the target volumes or in the beam path.

Efficacy of intensity-modulated radiotherapy combined with chemotherapy for nasopharyngeal carcinoma in children and adolescents / 中华放射医学与防护杂志

Objective To evaluate the treatment outcomes and toxicities of intensity-modulated radiation therapy (IMRT) combined with chemotherapy for children and adolescents with nasopharyngeal carcinoma.Methods Forty-three nasopharyngeal carcinoma patients less than 19 years old were recruited between April 2010 and April 2016.All patients were treated with IMRT (total dose 61.2-76 Gy) combined with cisplatin based chemotherapy.The Kaplan-Meier test was used to calculate overall survival (OS) and progression-free survival (PFS).The patient's clinical characteristics,side effects and longterm effects of treatment were retrospectively analyzed.Results Among 43 patients,there were 29 (67.4％) male and 14 (32.6％) female,and the median age was 14 years old (range,6-18 years).According to AJCC 7thstaging system,2 patients were in stage Ⅱ,26 in stage Ⅲ,7 in stage ⅣA and 8 in stage Ⅳ B.All patients were confirmed as non-keratinizing carcinoma.The positive rates of EB virus VCAIgA was 53.8％ (7/13),and Rta-IgG was 60.0％ (6/10) before treatment.The median radiation dose was 70 Gy (range,61.2-76 Gy) to the primary tumor.Thirty-three (76.7％) patients received neoadjuvant chemotherapy,with 20 (46.5％) and 36 (83.7％) patients treated by concurrent and adjuvant chemotherapy,respectively.With a median follow-up of 24 months (range,3-76 months),the 5-year OS and PFS ratios were 75.3％ and 64.7％,respectively.There were 5 patients (11.6％) occurred to bone metastasis within 2 years after treatment.Hypothyroidism was reported in 47.4％ (9/19) patients after IMRT.Conclusions Nasopharyngeal carcinoma in childhood and adolescence is mostly locally advanced diseases with poor differentiation.IMRT combined with chemotherapy produce a well treatment outcome with good tolerance in children and adolescents patients.The most common treatment failure bone metastasis.Radiation-induced hypothyroidism is common.

Determination of Nicotinate-curcumin Ester and Its Nanoparticles by HPLC / 中国药师

Objective: To provide basis for the preparation process study by establishing an HPLC determination method for nicotinate-curcumin ester.Methods: A C18 column(250 mm×4.6 mm,5 μm) was used at 30℃ with the mobile phase of acetonitrile-0.5% acetic acid glacial(65∶35) at a flow rate of 1.0 ml·min-1.The UV detection wavelength was 280 nm.Results: The good linear relationship of nicotinate-curcumin ester was shown within the range of 5.200-104.000 μg · ml-1(r=0.9999 4), The average recovery of nicotinate-curcumin ester and its nanoparticles was 100.1% and 100.9%with RSD of 1.260% and 0.995 0%(n=6), respectively.Conclusion: The method is convenient, accurate and reproducible, and suitable for the determination of nicotinate-curcumin ester nanoparticles and the studies on the preparation technology.

Gene mutation analysis of X-linked hypophosphatemic rickets / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the frequency and type of PHEX gene mutations in children with X-linked hypophosphatemic rickets (XLH), the possible presence of mutational hot spots, and the relationship between genotype and clinical phenotype.</p><p><b>METHODS</b>Clinical data of 10 children with XLH was retrospectively reviewed. The relationship between gene mutation type and severity of XLH was evaluated.</p><p><b>RESULTS</b>PHEX gene mutations were detected in all 10 children with XLH, including 6 cases of missense mutation, 2 cases of splice site mutation, 1 case of frameshift mutation, and 1 case of nonsense mutation. Two new mutations, c.2048T>C and IVS14+1delAG, were found. The type of PHEX gene mutation was not associated with the degree of short stature and leg deformity (P=0.571 and 0.467), and the mutation site was also not associated with the degree of short stature and leg deformity (P=0.400 and 1.000).</p><p><b>CONCLUSIONS</b>Missense mutation is the most common type of PHEX gene mutation in children with XLH, and c.2048T>C and IVS14+1delAG are two new PHEX gene mutations. The type and site of PHEX gene mutation are not associated with the severity of XLH.</p>

Clinical analysis and genetic diagnosis of short-limb inherited short stature diseases in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To analyze the clinical manifestations, bone X-ray findings and genetic analysis results of three short-limb inherited short stature diseases: achondroplasia (ACH), hypochondroplasia (HCH) and pseudoachondroplasia (PSACH).</p><p><b>METHODS</b>The clinical manifestations, bone X-ray findings, and genetic analysis results of 10 children with genetically confirmed short-limb inherited short stature diseases, including 4 cases of ACH 3 cases of HCH, and 3 cases of PSACH, were analyzed.</p><p><b>RESULTS</b>The 10 patients had a mean body height of -3.69±1.79 SD, a mean sitting height/standing height ratio of 0.65±0.03, and a mean finger spacing/body height ratio of 0.93±0.04. Four ACH cases and 3 PSACH cases showed typical bone X-ray findings; one HCH case showed a smaller sciatic notch, and another HCH case showed no widening of interpedicular distance. G380R mutation in FGFR3 gene was detected in 3 of 4 ACH cases, and Y278C mutation in the other ACH case, N540K mutation in FGFR3 gene was detected in 3 HCH cases, and heterozygous mutations in COMP gene were detected in 3 PSACH cases.</p><p><b>CONCLUSIONS</b>Children with ACH and PSACH have severer short stature and skeletal deformities than children with HCH, who have mild, atypical clinical manifestations. Bone X-ray and genetic analysis are helpful for the diagnosis and differential diagnosis of the three diseases. The mutational hotspots in two genes are involved in the three diseases, which is conducive to clinical genetic diagnosis.</p>

Clinical application of M-CHAT and CHAT-23 for autism screening / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To analyze and compare Modified Checklist for Autism in Toddlers (M-CHAT) and Checklist for Autism in Toddlers-23 (CHAT-23) in terms of clinical applicability, and to provide a basis for the understanding of early specific clinical manifestations of children with autism.</p><p><b>METHODS</b>A total of 350 children aged 18-36 months who visited the Department of Developmental Pediatrics of Shengjing Hospital of China Medical University were enrolled as subjects. Of the 350 children, 284 who had not been previously diagnosed with autism were screened according to the two checklists. Sixty-eight confirmed cases of autism (including two of the 284 screening subjects diagnosed with autism) were assigned to the autism group, and 278 of the 284 screening subjects (except six children diagnosed with autism, mental retardation or cerebral palsy) were assigned to the control group. The two groups were compared with respect to the positive rate for each item in the checklists. The efficacy of the M-CHAT and CHAT-23 assessment criteria was evaluated by comparative analysis.</p><p><b>RESULTS</b>The autism group showed the highest positive rate for Item 9. There were significant differences between the two groups in terms of the positive rates for all items except Item 16 (P<0.05). When the assessment criterion was that autism was confirmed if there were positive results for at least 3 of a total of 23 items, M-CHAT showed the lowest rate of missed diagnosis (0%); when the assessment criterion was that autism was confirmed if there were positive results for at least 6 of a total of 23 items, CHAT-23 showed the lowest rate of misdiagnosis (1.77%). The specificity of M-CHAT is lower than that of CHAT-23 (P<0.05). There was no significant difference in sensitivity between the two checklists (P>0.05).</p><p><b>CONCLUSIONS</b>CHAT-23 is more suitable than M-CHAT for clinical autism screening due to higher specificity, as well as having the advantages of low cost, easy completion,high efficiency and easy result judgment.</p>

Clinical applications of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in carcinoma of unknown primary / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Carcinoma of unknown primary (CUP) encompasses a heterogeneous group of tumors with varying clinical features. The management of patients of CUP remains a clinical challenge. The purpose of this study was to evaluate the clinical applications of integrated (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) information in patients with CUP, including detecting the occult primary tumor and effecting on disease therapy.</p><p><b>METHODS</b>One hundred and forty-nine patients with histologically-proven metastases of CUP were included. For all patients, the conventional diagnostic work-up was unsuccessful in localizing the primary site. Whole-body PET/CT images were obtained approximately 60 minutes after intravenous injection of 350 - 425 MBq of (18)F-FDG.</p><p><b>RESULTS</b>In 24.8% of patients, FDG PET/CT detected primary tumors that were not apparent after conventional workup. In this group of patients, the overall sensitivity, specificity, and accuracy rates of FDG PET/CT in detecting unknown primary tumors were 86.0%, 87.7%, and 87.2%, respectively. FDG PET/CT imaging also led to the detection of previously unrecognized metastases in 29.5% of patients. Forty-seven (31.5%, 47 of 149) patients underwent a change in therapeutic management.</p><p><b>CONCLUSIONS</b>FDG PET/CT is a valuable tool in patients with CUP, because it assisted in detecting unknown primary tumors and previously unrecognized distant metastases, and optimized the management of these patients.</p>

Value of regular and dual-time-point FDG PET/CT imaging in detecting recurrence and metastasis after a curative esophagectomy in esophageal carcinoma / 中华放射肿瘤学杂志

Objective To evaluate the clinical value of regular and dual-time-point 18-fluorodeoxyglucose positron emission tomography-CT(FDG PET/CT)imaging for recurrence and metastasis in esophageal carcinoma(EC)after curative esophagectomy. Methods A retrospective study was done on 48 patients received curative esophagectomy, who underwent FDG PET/CT scans to detect doubtful recurrent or metastatic lesions. The diagnostic accuracy of FDG PET-CT was assessed with the help of pathological findings as well as clinical or follow-up data. Using Fisher's Exact Test from SPSS 11.5 to analyze the data.Results Of the 48 patients, after a median follow-up of 21.5 months, 61 sites of local and regional recurrence or metastasis were finally confirmed in 34 patients. The sensitivity, specificity and accuracy of regular FDG PET/CT imaging in detecting recurrence of all sites were 93.44%, 74.29% and 86.46%respectively. The specificity and accuracy of local recurrence and regional metastasis were 57.14% ,78.95% and 77.78% ,84.62%, respectively. The sensitivity, specificity and accuracy of dual-time-point FDG PET/ CT imaging in detecting local and regional recurrence(96.97% ,96.00% and 96.55%)were higher than those of regular FDG PET/CT(90.90%, 72.00% and 82.76%)and there were significant differences of specificity and accuracy(P = 0.049, P = 0.029). Conclusions Regular FDG PET/CT imaging is highly effective in detecting recurrence and metastasis in EC patients after curative esophagectomy despite the low specificity and accuracy. Dual-time-point FDG PET/CT imaging can elevate the specificity and accuracy.

Relationship between gene mutations and intelligence in children with Duchenne muscular dystrophy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the level of intelligence in children with Duchenne muscular dystrophy (DMD), and the relationship between the level of intelligence and gene mutations.</p><p><b>METHODS</b>One hundred and two children with DMD between January 2009 and March 2011 were enrolled. DMD gene detection was performed through the multiplex ligation-dependent probe amplification (MLPA) in 84 cases. The level and the structure of intelligence were evaluated by Chinese Wechsler Intelligence Scale for Children (C-WISC) in 50 children with DMD (≥6 years old; DMD group) and in 50 age-and gender-matched healthy children (control group).</p><p><b>RESULTS</b>The average intelligence quotient (IQ) was 84±21 in 102 children with DMD. Thirty patients (29.4%) had the full intelligence quotient (FIQ) less than 70. The FIQ, verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and the scores of 11 sub-tests of intelligence in the DMD group were significantly lower than those in the control group (P<0.01). The IQ in patients with gene mutations at exon 56-79 was the lowest (59.3±11.9), followed by in patients with gene mutations at exon 45-55 (88.6±1.9), at exon 1-29 (97.5±9.6) and at exon 30-44 (102.8±3.8) (P<0.01).</p><p><b>CONCLUSIONS</b>The FIQ, VIQ and PIQ in children with DMD are lower than those in healthy children. There is association between mental retardation and gene mutations.</p>

Advances of mechanical stimulation induced calcium response and transfer in osteoblasts / 医用生物力学

Calcium is not only the important signaling molecule within and between bone cells, but also the primary component of extracellular matrix in bone. It has been demonstrated during the past over 100 years that mechanical stimulations can regulate the molecular signal transduction and intercellular communication in bone cells as well as the bone mineralization and resorption at tissue level, but further more researches are still needed to give insight into the mechanism of mechanical stimulation-induced bone remodeling. This paper will summarize the related works on the following aspects: (1) the primary experimental approaches for studying mechanical stimulation induced calcium response and transfer in osteoblasts, (2) the calcium sources and mechanism of calcium response in osteoblasts, (3) the intercellular calcium transfer pathways and (4) characteristic parameters of calcium response and transfer in osteoblasts. Finally, several potential research directions in this field are presented in the paper.

Calcium response in osteoblastic pattern without gap junction under flow shear stress / 医用生物力学

Objective To investigate the specific roles of gap junction and ATP in mechanical stimulation induced calcium transfer in osteoblasts. Methods The isolated osteoblastic pattern without gap junctions was established by using the micropatterning method. Then fluid shear stress was applied on cells using the flow chamber to observe and analyze the characteristic parameters of calcium response. Results Multiple calcium response still occurred in osteoblastic pattern without gap junction, but the response time to the first responsive peak was much longer than that with gap junction. When the intracellular and extracellular calcium ions were removed, only 40% cells responded to the mechanical stimulation, with single peak and multiple peaks accounting for 50%, respectively. If ATP pathway was blocked, only 20% cells responded, most of which showed single peak. Conclusions ATP was the major pathway mediating intercellular calcium transfer, while the gap junction was not the necessary one.

Dosimetric study of planning of intensity-modulated radiotherapy based on deformable registration for patients with nasopharyngeal carcinoma during the course / 中华放射医学与防护杂志

Objective To evaluate the anatomic changes and dosimetric variations of patients with nasopharyngeal carcinoma (NPC) during the course of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) by comparison of the dosimetric differences with or without replanning.Methods Twelve cases with NPC treated with SIB-IMRT underwent repeated CT scans after 20- 25 fractions of the initiation of therapy.The original treatment plan ( Plan1 ) based on the first CT scan ( CT1 ) and the second IMRT plan (Plan 2) based on the second CT scan (CT2) were calculated with an inverse planning system (Pinnacle3,Philips Medical System).In addition,the hybrid IMRT plan,Planl (CT2),was generated by deformable registration with MIMVISTA software,and the doses in Plan 1 ( CT1 ) and Plan 2 ( CT2 ) were accumulated based on CT2.The dosimetric differences were compared among the Plan 1 ( CT1 ),Plan 1 (CT2) and Plan 1 + 2(CT2).Results Compared with CT1,the mean volumes of the right and left parotid glands in the CT2 were significantly smaller by ( 24.6 ± 11.9 ) ％ and ( 35.1 ± 20.1 ) ％,respectively.Compared with Plan 1 ( CT1 ),the dose received by 95％ of the target ( D9s ) to PGTV,PTV1 and PTV2,and mean dose (D ) to PGTV,and PTV2 were all significantly lower in the Plan 1 (CT2),indicating that the doses to targets decreased without replanning.With repeated CT and replanning after 25 fractions as shown in Plan 1 + 2 (CT2),the doses to targets would be improved.The doses to normal tissue were increased without replanning,although no statistical significance was observed.In 5 of 12 cases,the doses to the spinal cord and brainstem exceeded the constraint without replanning,while the corresponding values decreased with replanning.Conclusions During the course of IMRT for cases with NPC,the volumes of the targets and parotid glands decrease significantly.Mid-treatment CT scanning and replanning should be recommended to ensure adequate doses to the targets and safe doses to the normal tissues.

Value of 18F-FETNIM PET-CT for detection of tumor hypoxia in non-small-cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the feasibility of [(18)F]fluoroerythronitroimidazole ((18)F-FETNIM) with integrated positron emission tomography and computed tomography (PET-CT) imaging in detection of hypoxia in non-small-cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>Forty-two patients with newly diagnosed NSCLC underwent (18)F-FETNIM PET-CT before treatment. Nineteen patients rested for approximately 120 minutes before undergoing PET-CT, 23 patients underwent 2 sequential PET-CT scans at 60 minutes and 120 minutes after intravenous injection (18)F-FETNIM. (18)F-FETNIM uptake was quantified by calculating the maximum standardized uptake value in the tumor (SUVmax-T) and contralateral normal lung tissue (SUVmax-N). Regions of interest (ROIs) were drawn in the tumor and contralateral position and the radioactivity ratio of tumor to normal (T/N) was calculated.</p><p><b>RESULTS</b>SUVmax-T (2.43 +/- 1.34) was significantly higher than SUVmax-N (0.87 +/- 0.46, P < 0.001) at 120 min. SUVmax-T (2.80 +/- 1.09) and SUVmax-N (1.16 +/- 0.56) at 60 min were significantly higher than SUVmax-T (2.61 +/- 1.10) and SUVmax-N (P < 0.01) at 120 min. T/N (2.56 +/- 0.71) at 60 min was higher than that at 120 min (2.48 +/- 0.60), but the difference between them was not significant (P = 0.324).</p><p><b>CONCLUSION</b>Our results indicate that (18)F-FETNIM PET-CT may be a useful tool for evaluating hypoxia and may be a means to target specifically tumor cells resistant to conventional treatment before and during ongoing therapy in NSCLC.</p>