Stereotactic body radiation therapy for small primary or recurrent hepatocellular carcinoma in 132 Chinese patients.

AIM: To evaluate the efficacy of stereotactic body radiation therapy (SBRT) in small hepatocellular carcinoma (HCC) patients. METHODS: From March 2009 to April 2015, we treated 132 small HCC patients with SBRT. Eligibility criteria included longest tumor diameter ≤5.0 cm; Child-Turcotte-Pugh (CTP) Class A or B; unfeasible, difficult or refusal to undergo other surgery or percutaneous ablative therapies; and tumor recurrence after other local treatment. The dose of 42-46 Gy in 3-5 fractions and 28-30 Gy in 1 fraction was prescribed. RESULTS: Of the treated patients, 114 were classified as CTP A and 18 as CTP B. Median tumor size was range 1.1-5.0 cm. The local control rate at 1 years was 90.9%. OS at 1, 3, and 5 years was 94.1%, 73.5%, and 64.3%, respectively. PFS at 1, 3, and 5 years was 82.7%, 58.3%, and 36.4%, respectively. Hepatic toxicity grade ≥3 was observed in 11 patients. Multivariate analysis revealed that CTP B was associated with worse OS (P < 0.001) and multiple nodules were associated with worse PFS (P = 0.001). CONCLUSIONS: SBRT is a promising alternative treatment for patients with primary or recurrent small HCC who are unsuitable for surgical resection or local ablative therapy.

Real-time hand gesture recognition using finger segmentation.

Hand gesture recognition is very significant for human-computer interaction. In this work, we present a novel real-time method for hand gesture recognition. In our framework, the hand region is extracted from the background with the background subtraction method. Then, the palm and fingers are segmented so as to detect and recognize the fingers. Finally, a rule classifier is applied to predict the labels of hand gestures. The experiments on the data set of 1300 images show that our method performs well and is highly efficient. Moreover, our method shows better performance than a state-of-art method on another data set of hand gestures.

Impairment of response inhibition to emotional face stimuli in individuals with subclinical depression.

Response inhibition, a crucial component of executive function, is closely related to personal impulse control, social adaption, and mental health. Previous studies have found response inhibition deficit in patients with major depressive disorder, but whether it also exists in individuals with subclinical depression (SD) remains unclear. This study aimed to identify the ability of response inhibition to emotional face stimuli both under explicit and implicit conditions in individuals with SD. Thirty-six subclinical depressed college students and 39 healthy individuals were recruited and administered the non-emotional, explicit, and implicit emotional stop-signal tasks (SSTs). Mixed-model analyses of variance were used to analyze the differences between and within groups. In implicit emotional SST, the results showed a significant longer stop-signal response time, a shorter stop-signal delay time, a shorter go reaction time, and a similar proportion of stop success in the SD group compared to healthy controls. However, the above indices showed no significant difference between the two groups in the non-emotional SST and explicit emotional SST. These findings suggest a possible defect of response inhibition in implicit emotional processing in individuals with SD, which may potentially serve as a marker of susceptibility to depression and thus be applied to early screening and intervention for major depressive disorder.

Effects of parental empathy and emotion regulation on social competence and emotional/behavioral problems of school-age children.

IMPORTANCE: Parents take the lead in parent-child interactions and their emotion regulation ability and empathy during parenting may be associated with children's emotional/behavioral problems. However, the specific mechanisms underlying these associations remain unclear. OBJECTIVE: The present study aimed to explore the effect of parental empathy and emotional regulation on social competence and emotional/behavioral problems in school-age children. METHODS: A questionnaire-based survey was conducted with 274 parents of 8-11-year-old children using Achenbach's Child Behavior Checklist, the Emotion Regulation Questionnaire, and the Questionnaire of Cognitive and Affective Empathy. RESULTS: Children with emotional/behavioral problems (n = 37) had relatively lower social competence than children in a matched control group (n = 37). Compared with the parents of children in the control group, parents of children with emotional/behavioral problems had significantly lower cognitive empathy scores, mainly manifested by low perspective-taking and online simulation abilities. Mediation analysis showed that parental cognitive empathy had an indirect effect on children's emotional/behavioral problems through children's social competence. INTERPRETATION: Parental empathy may have a subtle influence on the social competence of school-aged children, which further affects the severity of children's emotional/behavioral problems.

[Dose-effect relationship in treatment of chronic neck pain with the direct moxibustion of small moxa cone].

OBJECTIVE: To evaluate the effectiveness in treatment of chronic neck pain with the direct moxibustion of small moxa cone and explore the dose-effect relationship in treatment of chronic neck pain with different small moxa cones. METHODS: A total of 120 patients with chronic neck pain were randomized into a 3-moxa-cone group, a 5-moxa-cone group, a 7-moxa-cone group and a sham-moxibustion group, 30 cases in each one. Fengchi (GB 20), Tianzhu (BL 10), Jingbailao (EX-HN 15), Jianzhongshu (SI 15) and Jianjing (GB 21) were selected in each of the groups. The direct moxibustion with 3, 5 and 7 moxa cones as well as the sham-moxibustion therapy were provided successively in each of the above groups. In the sham-moxibustion group, the lower 1/3 section of moxa cone (about 1.5 mm in length) was soaked in wanhua oil before used in treatment. In each group, the treatment was given twice a week, for 10 treatments totally. Separately, before treatment, after treatment and in 1-month follow-up, the scores of the Northwick Park neck pain questionnaire (NPQ), the scores of McGill pain questionnaire (MPQ) and the local pressure pain threshold (PPT) were observed in each group. After treatment and in 1-month follow-up, the therapeutic effects were evaluated in each group. RESULTS: After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were reduced as compared with those before treatment separately (all P<0.01), PPT values were increased as compared with those before treatment (all P<0.01). But the differences were not statistically significant in the sham-moxibustion group as compared with those before treatment (all P>0.05). After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were lower as compared with the sham-moxibustion group separately (all P<0.05), PPT values were higher as compared with the sham-moxibustion group (all P<0.05). After treatment, the NPQ score and MPQ score in the 7-moxa-cone group were lower than the 3-moxa-cone group and PPT values was higher than the 3-moxa-cone group (all P<0.05). After treatment and in 1-month follow-up, the therapeutic effects in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were better than the sham-moxibustion group separately (all P<0.05). But, the therapeutic effects were not significantly different in comparison among the moxibusiton groups (P>0.05). CONCLUSION: The direct moxibustion therapy with different small-moxa-cones effectively relieves chronic neck pain. There is a trend of improvement of the therapeutic effects with increase of the numbers of moxa cones.

Stereotactic body radiotherapy using CyberKnife for locally advanced unresectable and metastatic pancreatic cancer.

AIM: To evaluate the efficacy and toxicity of stereotactic body radiotherapy using CyberKnife for locally advanced unresectable and metastatic pancreatic cancer. METHODS: From June 2010 to May 2014, 25 patients with locally advanced unresectable and metastatic pancreatic cancer underwent stereotactic body radiotherapy. Nine patients presented with unresectable locally advanced disease and 16 had metastatic disease. Primary end-points of this study were overall survival, relief of abdominal pain, and toxicity. RESULTS: Fourteen patients were treated with a total dose of 30-36 Gy in three fractions and the remainder with 40-48 Gy in four fractions. Median follow-up was 11 mo (range: 2-25 mo). The median survival duration calculated from the time of stereotactic body radiotherapy for the entire group, the locally advanced group, and the metastatic group was 9.0 mo, 13.5 mo, and 8.5 mo, respectively. Overall survival was 37% and 18% at one and two years, respectively. Abdominal pain relief was achieved within 2 wk of completing radiotherapy in the patients who received successful palliation (13 of 20 patients had significant pain). Five patients (20%) had grade 1 nausea, and one (4%) had grade 2 nausea. No acute grade 3+ toxicity was seen. CONCLUSION: Stereotactic body radiotherapy using the CyberKnife system is a promising, noninvasive, palliative treatment with acceptable toxicity for locally advanced unresectable and metastatic pancreatic cancer.

Immunohistochemical characterization of the epidermoid formation in the middle ear.

OBJECTIVE: To study the incidence, size, and origin of epidermoid formations after accurately characterizing them by cytokeratin immunohistochemical analysis. STUDY DESIGN: A strategy of screening sections for possible epidermoid formations in the entire eardrum area in paraffin-embedded, serially sectioned developing temporal bones was used. Unstained adjacent sections were subjected to immunohistochemical staining, to provide accurately identified epidermoid formations for a study of their appearance and size in relation to age. METHODS: The immunohistochemical expression patterns for epidermoid cytokeratins of several antibodies at different gestational ages were determined. Then, epithelial structures suspected as epidermoid formations were characterized as epidermoid with age-appropriate antibodies in 36 paraffin-embedded temporal bones from 19 cases with an age range of 6 gestational weeks to 15 months postpartum using a novel method of antigen retrieval by heating sections in a 70 degrees C water bath. RESULTS: Each of 22 temporal bones ranging in age from 16 weeks gestation to 8 months postpartum contained one or more, often numerous, epidermoid formations. Sizes of epidermoid formations increased significantly with increasing age. The formations were found anywhere in the annular lateral wall region of middle ear, but the majority were in the anterosuperior region. A further study of the interface between annular external canal epidermis and middle ear epithelium in a larger group suggested that epidermoid formations arise at approximately 16 gestational weeks from the external canal epidermis. CONCLUSION: The findings indicate that epidermoid tissue in the middle ear normally originates from external canal epidermis at approximately the 16th gestational week and grows before disappearing.