[A multicenter randomized prospective study of concurrent chemoradiation with 60 Gy versus 50 Gy for inoperable esophageal squamous cell carcinoma].

Objective: To determine whether 60 Gy is superior to standard 50 Gy for definitive concurrent chemoradiation(CCRT) in esophageal squamous cell carcinoma (ESCC) using modern radiation technology in a phase Ⅲ prospective randomized trial. Methods: From April 2013 to May 2017, 331 patients from 22 hospitals who were pathologically confirmed with stage ⅢA-ⅣA ESCC were randomized to 60 Gy or 50 Gy with random number table. Total of 305 patients were analyzed, including 152 in 60 Gy group and 153 in 50 Gy group. The median age was 63 years, 242(79.3%) males and 63(20.7%) females. The median length of primary tumor was 5.6 cm. The clinical characteristics between two groups were comparable. All patients were delivered 2 Gy per fraction, 5 fractions per week. Concurrent weekly chemotherapy with docetaxel (25 mg/m(2)) and cisplatin (25 mg/m(2)) and 2 cycles consolidation chemotherapy with docetaxel (70 mg/m(2)) and cisplatin (25 mg/m(2), d1-3) were administrated. The primary endpoint was local/regional progression-free survival (LRPFS). The data were compared with Pearson chi-square test or Fisher's exact test. Results: At a median follow-up of 27.3 months, the disease progression rate was 37.5% (57/152), 43.8% (67/153) in the high and standard-dose group, respectively (χ(2)=1.251, P=0.263). The 1, 2, 3-year LRPFS rate was 75.4%, 56.8%, 52.1% and 74.2%, 58.4%, 50.1%, respectively (HR: 0.95, 95%CI: 0.69-1.31, P=0.761). The 1, 2, 3-year overall survival rate was 84.1%, 64.8%, 54.1% and 85.4%, 62.9%, 54.0%, respectively (HR: 0.98, 95%CI: 0.71-1.38, P=0.927). The 1, 2, 3-year progression-free survival rate was 70.8%, 54.2%, 48.5% and 65.5%, 51.9%, 45.1%, respectively (HR: 0.93, 95%CI: 0.68-1.26, P=0.621). The incidence rates in toxicities between the two groups were similar except for higher rate of severe pneumonitis in high dose group (χ(2)=11.596, P=0.021). Conclusions: The efficacy in disease control is similar between 60 Gy and 50 Gy using modern radiation technology concurrent with chemotherapy for ESCC. The 50 Gy should be recommended as the regular radiation dose with CCRT for ESCC.

Tradeoffs of integrating real-time tracking into IGRT for prostate cancer treatment.

This study investigated the integration of the Calypso real-time tracking system, based on implanted ferromagnetic transponders and a detector array, into the current process for image-guided radiation treatment (IGRT) of prostate cancer at our institution. The current IGRT process includes magnetic resonance imaging (MRI) for prostate delineation, CT simulation for treatment planning, daily on-board kV and CBCT imaging for target alignment, and MRI/MRS for post-treatment assessment. This study assesses (1) magnetic-field-induced displacement and radio-frequency (RF)-induced heating of transponders during MRI at 1.5 T and 3 T, and (2) image artifacts caused by transponders and the detector array in phantom and patient cases with the different imaging systems. A tissue-equivalent phantom mimicking prostate tissue stiffness was constructed and implanted with three operational transponders prior to phantom solidification. The measurements show that the Calypso system is safe with all the imaging systems. Transponder position displacements due to the MR field are minimal (<1.0 mm) for both 1.5 T and 3 T MRI scanners, and the temperature variation due to MRI RF heating is <0.2 degrees C. The visibility of transponders and bony anatomy was not affected on the OBI kV and CT images. Image quality degradation caused by the detector antenna array is observed in the CBCT image. Image artifacts are most significant with the gradient echo sequence in the MR images, producing null signals surrounding the transponders with radii approximately 1.5 cm and length approximately 4 cm. Thus, Calypso transponders can preclude the use of MRI/MRS in post-treatment assessment. Modifications of the clinical flow are required to accommodate and minimize the substantial MRI artifacts induced by the Calypso transponders.

Unintended consequence of plant transformation: biolistic transformation caused transpositional activation of an endogenous retrotransposon Tos17 in rice ssp. japonica cv. Matsumae.

Genetic instability could be provoked as an unintended consequence of genetic engineering in plants. Here, we report that the rice endogenous long terminal repeat (LTR) retrotransposon Tos17 was transpositionally activated only in transgenic calli and their regenerated plants produced by biolistic transformation in rice (Oryza sativa L.) ssp. japonica cv. Matsumae. Moreover, the transpositional activity of Tos17 was sustained after plant regeneration in the T0 generation, and produced new germinal insertions. In contrast, the element remained totally quiescent in calli and regenerated plants from tissue culture of this genotype. Nonetheless, transcriptional induction and cytosine demethylation of Tos17 were found to have occurred with no significant difference in both kinds of calli, tissue culture alone and transgenic. This suggests that callus culture is likely to have played an important role in destabilizing Tos17 in the direction towards transpositional activation, but that biolistic transformation is the direct causal factor.

Correction: The atypical ubiquitin ligase RNF31 stabilizes estrogen receptor α and modulates estrogen-stimulated breast cancer cell proliferation.

Since the publication of the above article, the authors have noted that the input data in Fig. 6E is incorrect. The correct data are included in the below Fig. 6E. The mistake does not affect the conclusions of the paper as the levels of input proteins remain similar between samples. We apologise for any inconvenience caused by this error.

Prevalence of primary open-angle glaucoma among patients with obstructive sleep apnea.

OBJECTIVE: Our objective was to determine primary open-angle glaucoma (POAG) prevalence among obstructive sleep apnea (OSA) patients because the perioperative environment risks further damaging the optic nerve. STUDY DESIGN: We analyzed a "convenience sample" referred by Sleep Medicine for oral appliances because of continuous positive airway pressure intolerance. We determined the aggregate prevalence of the 3 POAG subtypes-"classic" open-angle glaucoma (COAG), normal-tension glaucoma (NTG), and open-angle glaucoma suspect (OAGS)-among the index population and compared it with that of same hospital's general population. Similarly determined were associations between OSA severity levels (apnea-hypopnea index [AHI]) and POAG subtypes. RESULTS: Among the study sample of 225 patients with OSA (96.4% male; mean age 58.5 ± 12.3 years), 47 (20.9%) had POAG, with a subtype distribution of COAG: 12 (25.5%), NTG: 8 (17.0%), and OAGS: 27 (57.4%). The POAG prevalence rate among medical center's general population was 2.5%, which was significantly less (P < .00001) than among those with comorbid OSA. Severity of the breathing disorder (AHI) failed to identify a significant correlation to any POAG subtype (P > .05). CONCLUSION: The significant prevalence of POAG among OSA sufferers suggests need for preoperative consultations from an ophthalmologist to determine eye health and possibly an anesthesiologist to avoid potential vision loss.

[Study of gonadotropin releasing hormone on suppressing migrationg and invationg of human nasopharyngeal carcinoma cells CNE2].

Objective:The aim of this study is to investigate the effect of gonadotropin releasing hormone (GnRH) on suppressing cell viability, apoptosis, migrationg and invationg of human nasopharyngeal carcinoma cells CNE2. Method:Nasopharyngeal carcinoma tissues and postnasal catarrh tissues were collected, the expression of GnRH positive cells and GnRH mRNA were detected by immunohistochemical staining and qRT-PCR. The human nasopharyngeal carcinoma CNE2 cells and immortalized nasopharyngeal epithelial cell line NP69 were cultured in vitro, and the expression of GnRH positive cells and GnRH mRNA were detected by immunohistochemical staining and qRT-PCR. The CNE2 cells were treated with GnRH with various concentrations 0 (Blank group), 10⁻², 10⁻¹, 10° nmol/L. The effects of GnRH on the viability, apoptosis, migration and invasion of CNE2 cells were detected by cell Counting Kit (CCK-8), flow cytometry, wound healing assay and transwell chamber assay in vitro. Result:The expression of GnRH positive cells and GnRH mRNA in nasopharyngeal carcinoma tissues were markedly down regulated than postnasal catarrh tissues (P<0.05). The expression of GnRH positive cells and GnRH mRNA in CNE2 cells were markedly down regulated than NP69 cells (P<0.05). Compared with blank group, GnRH can significantly inhibite the cell viability cells, apoptosis, migration and invasive ability (P<0.05 or P<0.01). Conclusion:GnRH significantly inhibited the cell viability, apoptosis, migration and invasive ability of CNE2 cells.

A novel mixture of propofol, alfentanil, and lidocaine for regional block with monitored anesthesia care in ophthalmic surgery.

STUDY OBJECTIVE: The purpose of this study is to determine the efficacy and safety of sedation/analgesia using a mixture of propofol, alfentanil, and lidocaine. DESIGN: A retrospective case review was undertaken. SETTING: This study took place at a university medical center. PATIENTS: Eighty-nine American Society of Anesthesiologists physical status 1, 2, and 3 adult patients undergoing ophthalmic surgery with regional block and monitored anesthesia care were studied. INTERVENTION: Six milliliters of propofol, 2 mL of alfentanil, and 2 mL of 2% lidocaine (6-2-2 mixture) were freshly mixed. The bolus dose was determined based on the patients' age: 5 microg/kg of alfentanil (and 0.3 mg/kg of propofol) for patients older than 75 years; the dose increased 1 mug/kg per 10-year decrease in age; and up to 9 microg/kg of alfentanil (0.54 mg/kg of propofol) for patients younger than 45 years. Regional block was performed at 1 minute after bolus completion. Blood pressure (BP), Sa(O2), electrocardiogram, capnography, clinical signs of sedation, responses to block, need for airway support, nausea and vomiting (N/V), pain due to propofol infusion, recall, and patient and surgeon satisfaction were recorded. MEASUREMENTS AND MAIN RESULTS: Seventy-eight percent of patients achieved analgesia and sedation without adverse response to the block. Twelve percent achieved good analgesia and sedation with only eyebrow movement upon needle insertion. Twenty-seven percent had respiratory depression but were able to follow commands and maintain adequate ventilation. Two percent had brief apnea alleviated by chin lift or jaw thrust. None had pain because of propofol infusion or N/V. Before sedation, average systolic BP was significantly increased (P < 0.0001) compared with baseline. After sedation and block, systolic BP decreased 6% from baseline (P < 0.005). CONCLUSION: Adjusted for age and weight, the dose of the 6-2-2 mixture met the sedation requirements for most patients. With a low incidence of need for airway support, no pain during infusion, and no N/V, this novel mixture of propofol, alfentanil, and lidocaine provided adequate analgesia and sedation as well as hemodynamic stability for ophthalmic surgery under regional block.

RING finger protein 31 promotes p53 degradation in breast cancer cells.

The atypical E3 ubiquitin ligase RNF31 is highly expressed in human breast cancer, the most frequent neoplastic lethality among women. Here, RNF31 depletion in breast cancer cells in combination with global gene expression profiling revealed p53 (TP53) signaling as a potential RNF31 target. Interestingly, RNF31 decreased p53 stability, whereas depletion of RNF31 in breast cancer cells caused cell cycle arrest and cisplatin-induced apoptosis in a p53-dependent manner. Furthermore, RNF31 associated with the p53/MDM2 complex and facilitated p53 polyubiquitination and degradation by stabilizing MDM2, suggesting a molecular mechanism by which RNF31 regulates cell death. Analysis of publically available clinical data sets displayed a negative correlation between RNF31 and p53 target genes, including IGFBP3 and BTG1, consistent with RNF31 regulating p53 function in vivo as well. Together, our findings suggest RNF31 as a potential therapeutic target to restore p53 function in breast cancer.

A double-blind, placebo-controlled, randomized clinical trial of transdermal dihydrotestosterone gel on muscular strength, mobility, and quality of life in older men with partial androgen deficiency.

The efficacy and safety of androgen supplementation in older men remains controversial. Despite biochemical evidence of partial androgen deficiency in older men, controlled studies using T demonstrate equivocal benefits. Furthermore, the importance of aromatization and 5alpha reduction in androgen actions among older men remains unclear. Dihydrotestosterone is the highest potency natural androgen with the additional features that it is neither aromatizable nor susceptible to potency amplification by 5alpha reduction. Therefore, the effects of dihydrotestosterone may differ from those of T in older men. This study evaluated the efficacy and safety of 3 months treatment with transdermal dihydrotestosterone gel on muscle strength, mobility, and quality of life in ambulant, community-dwelling men aged 60 yr or older. Eligible men (plasma T < or =15 nmol/liter) were randomized to undergo daily dermal application of 70 mg dihydrotestosterone gel (n = 18) or vehicle (n = 19) and were studied before, monthly during, and 1 month after treatment. Among 33 (17 dihydrotestosterone, 16 placebo) men completing the study with a high degree of compliance, dihydrotestosterone had significant effects on circulating hormones (increased dihydrotestosterone; decreased total and free testosterone, LH, and FSH; unchanged SHBG and estradiol), lipid profiles (decreased total and low-density lipoprotein cholesterols; unchanged high-density lipoprotein cholesterol and triglycerides), hematopoiesis (increased hemoglobin, hematocrit, and red cell counts), and body composition (decreased skinfold thickness and fat mass; unchanged lean mass and waist to hip ratio). Muscle strength measured by isokinetic peak torque was increased in flexion of the dominant knee but not in knee extension or shoulder contraction, nor was there any significant change in gait, balance, or mobility tests, in cognitive function, or in quality of life scales. Dihydrotestosterone treatment had no adverse effects on prostate (unchanged prostate volumes and prostate-specific antigen) and cardiovascular (no adverse change in vascular reactivity or lipids) safety markers. We conclude that 3 months treatment with transdermal dihydrotestosterone gel demonstrates expected androgenic effects, short-term safety, and limited improvement in lower limb muscle strength but no change in physical functioning or cognitive function.

Realizations of fast 2-D/3-D image filtering and enhancement.

This paper proposes a novel algorithm for multidimensional image enhancement based on a fuzzy domain enhancement method, and an implementation of a recursive and separable low-pass filter. Considering a smoothed image as a fuzzy data set, each pixel in an image is processed independently, using fuzzy domain transformation and enhancement of both the dynamic range and the local gray level variations. The algorithm has the advantages of being fast and adaptive, so it can be used in real-time image processing applications and for multidimensional data with low computational cost. It also has the ability to reduce noise and unwanted background that may affect the visualization quality of two-dimensional (2-D)/three-dimensional (3-D) data. Examples for the applications of the algorithm are given for mammograms, ultrasound 3-D images, and photographic images.

MRI brain image segmentation by multi-resolution edge detection and region selection.

Combining both spatial and intensity information in image, we present an MRI brain image segmentation approach based on multi-resolution edge detection, region selection, and intensity threshold methods. The detection of white matter structure in brain is emphasized in this paper. First, a multi-resolution brain image representation and segmentation procedure based on a multi-scale image filtering method is presented. Given the nature of the structural connectivity and intensity homogeneity of brain tissues, region-based methods such as region growing and subtraction to segment the brain tissue structure from the multi-resolution images are utilized. From the segmented structure, the region-of-interest (ROI) image in the structure region is derived, and then a modified segmentation of the ROI based on an automatic threshold method using our threshold selection criterion is presented. Examples on both T1 and T2 weighted MRI brain image segmentation is presented, showing finer brain tissue structures.

[The method and development of computer-assisted surgery].

The methodology and the state of the art of Computer-Assisted Surgery (CAS) are introduced in this paper. Computer-assisted surgery is a new high technology which uses computer science, biomedical engineering, mechanism, mathematics, surgery, and so on. Its objective is to help surgeons use multimodal data, such as CT, MRI, DSA, PET, et al. in a rational and quantitative way in order to plan and perform medical intervention. Stereotactic localization method and registration are two cruxes in computer-assisted surgery. There are several methods for localization and registration. In recent ten years, computer-assisted surgery has been a cynosure of scientists. Some computer-assisted surgery systems have been used in clinical practice.

[Description of finger shape in the process of growing during infancy].

In this paper, a new method of estimating bone age is reported that is based on the use of spatial description parameters and fourier frequential descriptors, which presents the boundary shapes detected in finger bones X-ray films of 0-, 3-, 6-, 9-month baby according to their bone shape changes in different stages.

[A review on deformable model in medical image analysis].

This paper reviews the deformable model in medical image analysis and its applications in registration, motion tracking, segmenting and shape modeling.

[Application of time-frequency analysis on medical signal processing].

The frequency content of many biomedical signals can change rapidly with time. Conventional Fourier spectral analysis techniques are insufficient for analyzing the time-varying spectral content of these signals. By mapping a one-dimensional function of time(or frequency), the time-frequency representation can localize the signal energy in both the time and frequency directions. It has been shown that many biomedical signal problems may benefit from time-frequency analysis. The basic method of time-frequency analysis and its application in biomedical signals processing are introduced.

[Advances of research on stereo localization in computer assisted surgery].

In this paper several kinds of localization technologies used in computer assisted surgery are analyzed, especially the optical stereo localization methods. Finally directions of research and development in the field are given.

[Interactive 2D/3D image processing, registration and display system].

This paper presents an integrated system for interactive 2D/3D image processing, registration and display. The main image processing algorithm in the system is image filtering, enhancement, adaptive B-snake model, image registration, pseudo color representation and 3D volume rendering. The system provides good visulization interface and image tool.

[A review on registration and fusion of medical images].

Based on the criterion whether extracting the features of the image or not, the content and research status of medical image registration are discussed in this paper.

[The study of a frameless stereotactic localization method using DSA].

A frameless stereotactic localization method with DSA is introduced in this paper. A locating plate and four head marks are used in the method. Using two projection images of DSA, the three dimension coordinate of any point can be calculated referring to the reference locating coordinate system. The method is the theoretic basis of locating brain structure such as the blood vessel using DSA.