Volumetric modulation arc radiotherapy with flattening filter-free beams compared with conventional beams for nasopharyngeal carcinoma:a feasibility study

There is increasing interest in the clinical use of flattening filter-free(FFF) beams.In this study,we aimed to investigate the dosimetric characteristics of volumetric modulated arc radiotherapy(VMAT) with FFF beams for nasopharyngeal carcinoma(NPC).Ten NPC patients were randomly selected to undergo a RapidArc plan with either FFF beams(RA-FFF) or conventional beams(RA-C).The doses to the planning target volumes(PTVs),organs at risk(OARs),and normal tissues were compared.The technical delivery parameters for RapidArc plans were also assessed to compare the characteristics of FFF and conventional beams.Both techniques delivered adequate doses to PTVs.For PTVs,RA-C delivered lower maximum and mean doses and improved conformity and homogeneity compared with RA-FFF.Both techniques provided similar maximum doses to the optic nerves and lenses.For the brain stem,spinal cord,larynx,parotid glands,oral cavity,and skin,RA-FFF showed significant dose increases compared to RA-C.The dose to normal tissue was lower in RA-FFF.The monitor units(MUs) were(536 ± 46) MU for RA-FFF and(501± 25) MU for RA-C.The treatment duration did not significantly differbetween plans.Although both treatment plans could meet clinical needs,RA-C is dosimetrically superior to RA-FFF for NPC radiotherapy.

Is 1.28 parts per million biomarker specific for neural progenitor cells?

Nuclear magnetic resonance-visible mobile lipid, at 1.28 parts per million （ppm）, is thought to be due to mobile lipid droplets formed in cells and has been considered unique for neural progenitor cells. However, this idea remains controversial. The present study examined the 1.28 ppm biomarker in other stem cells and non-stem cells, and explored the relationship between 1.28 ppm biomarker and mobile lipid droplets. 1H nuclear magnetic resonance spectroscopy of EC109 cells, mesenchymal stem cells （MSCs） and adipogenic cells differentiated from MSCs was performed. Results show that 1.28 ppm biomarker was observed in human MSCs, but was absent from EC109 cells. Following adipogenic differentiation induced for 2 weeks, the 1.28 ppm biomarker climbed remarkably, with mobile lipid droplet generation, suggesting that the 1.28 ppm biomarker is not specific for neural progenitor cells because it is also observed in MSCs and adipogenic-induced differentiated cells. Moreover, it is possible to monitor MSCs differentiation following cell transplantation, using 1.28 ppm biomarker changes.

Nuclear magnetic resonance spectroscopy is highly sensitive for lipid-soluble metabolites

Although the water-soluble metabolite profile of human mesenchymal stem cells is known, the lipid profile still needs further investigation. In this study, methanol-chloroform was used to extract lipid-soluble metabolites and perchloric acid was used to extract water-soluble metabolites. Fur- thermore, a dual phase extraction method using methanol-chloroform and water was used to obtain both water and lipid fractions simultaneously. All metabolite extractions were analyzed on a 9.4T high-resolution nuclear magnetic resonance spectrometer. Metabolite resonance peaks were as- signed in the acquired spectra according to the chemical shift, and the extraction efficiency of dif- ferent methods was compared. Results showed that in the spectra of water-soluble extracts, major metabolites comprised low molecular weight metabolites, including lactate, acetic acid, fatty acids, threonine, glutamic acid, creatine, choline and its derivatives, while in the spectra of lipid-soluble extracts, most metabolites were assigned to fatty acids. Among the different extraction procedures, perchloric acid was more efficient in extracting water-soluble metabolites and methanol-chloroform was efficient in extracting organic components compared with the dual phase extraction method. Nuclear magnetic resonance spectroscopy showed that as low as 0.7 mg organic yield was enough to obtain clear resonance peaks, while about 6.0 mg water-soluble yield was needed to obtain rela- tively favorable spectral lines. These results show that the efficiency of extracting water and lipid fractions is higher using perchloric acid and methanol-chloroform compared with dual phase ex- traction and that nuclear magnetic resonance spectroscopy is highly sensitive for analyzing lipid-soluble extracts.

Quantitative analysis of glutamate compounds in the swine brain following central analgesics nasal spray using proton magnetic resonance spectroscopy and linear combination model

BACKGROUND： In localized brain proton magnetic resonance spectroscopy （^1H-MRS）, metabolite levels are often expressed as ratios, rather than absolute concentrations. Frequently, the denominator is creatine, which is assumed to be stable in normal, as well as many pathological, states. However, in vivo creatine levels do not remain constant. Therefore, absolute metabolite measurements, which provide the precise concentrations of certain chemical compounds, are superior to metabolite ratios for determining pathological and evolutional changes. OBJECTIVE： To investigate the feasibility of quantification analysis of brain metabolite changes caused by central analgesics nasal spray using the ^1H-MRS and linear combination model （LCModel） methods. DESIGN, TIME AND SETTING： This neuroimaging, observational, animal study was performed at the Laboratory of the Department of Medical Imaging, Second Affiliated Hospital, Medical College, Shantou University, China from July to December 2007. MATERIALS： Butorphanol tartrate nasal spray, as a mixed agonist-antagonist opioid analgesic, was purchased from Shanghai Hengrui Pharmacy, China. A General Electric Signa 1.5T System （General Electric Medical Systems, Milwaukee, WI, USA） and LCModel software （Stephen Provencher, Oakville, Ontario, Canada） were used in this study. METHODS： MRS images were acquired in ten healthy swine aged 2 weeks using single-voxel point-resolved spectroscopic sequence. A region of interest （2 cm × 2 cm × 2 cm） was placed in the image centers of maximum brain parenchyma. Repeated MRS scanning was performed 15-20 minutes after intranasal administration of 1 mg of butorphanol tartrate. Three settings of repetition time/echo time were selected before and after nasal spray administration 3 000 ms/30 ms,1 500 ms/30 ms, and 3 000 ms/50 ms. Metabolite concentrations were estimated by LCModel software. MAIN OUTCOME MEASURES： ^1H-MRS spectra was obtained using various repetition time/echo time settings. Concentrations of glutamate compounds （glutamate ＋ glutamine）, N-acetyl aspartate, and choline were detected in swine brain prior to and following nasal spray treatment. RESULTS： The glutamate compounds curve was consistent with original spectra, when a repetition time/echo time of 3 000 ms/30 ms was adopted. Concentrations of glutamate compounds, N-acetyl aspartate, and choline decreased following administration. The most significant reduction was observed in glutamate compound concentrations from （9.28 ± 0.54） mmol/kg to （7.28 ± 0.54） mmol/kg （P 〈 0.05）. CONCLUSION： ^1H-MRS and LCModel software were effectively utilized to quantitatively analyze and measure brain metabolites. Glutamate compounds might be an important neurotransmitter in central analgesia.

恶性胃肠道间质瘤CT特点与临床病理分析比较:影像学表现与恶性潜能相关性分析(英文)

Objective: In this pictorial essay, we described the clinical, pathologic, and computed tomographic (CT) findings of malignant gastrointestinal stromal tumors (MGISTs) and attempt to establish the correlation between radiologic appearance and malignant potential. Methods: This retrospective analysis included 20 patients receiving treatment for MGIST between 2008 and 2010. The diagnosis was established by pathology and immunohistochemistry. All these patients underwent preoperative CT. Clinical presentation, pathology and CT images were analyzed. Helical CT images were reviewed for morphologic features such as tumor size, number and location, tumor margins, necrosis, degree of enhancement and metastasis. Results: Gastrointestinal bleeding, abdominal pain and discomfort, and without clinical symptom were common findings and were observed in 9 (45%), 6 (30%), and 5 (25%) of the 20 patients. 8 (40%) tumors were located in stomach, and 10 (50%), 1 (5%) and 1 (5%) were located in small intestine, mesentery and peritoneum, respectively. Male to female ratio was about 1:2. The size of MGIST ranged from 2.6 cm to 17.5 cm with a mean of 8.7 cm. All tumors density was inhomogeneous and heterogeneous enhancement. MGISTs with highly malignant located in small intestine were about 30% higher than stomach. The "satellite" tumours were found in 6 cases with high malignant risk. 7 cases were suffered from liver metastasis, and 4 cases went with seeding into the abdominal cavity, 1 cases went with lymph node metastasis. Histologically, 19 cases (95%) were of spindle cell type. Immunohistochemical stains demonstrated a strong positivity for both c-kit (CD117) and CD34s enhancement in 19 (95%). Conclusion: Clinical expression is varied in MGIST patients. Female might be predominance in MGIST. The GISTs located in small intestine would tend to be more aggressive. The satellite tumours, necrosis and cystic degeneration were strongly benefit for MGIST diagnosis. Furthermore, intestinal obstruction doesn't support the diagnosis. Lymph node metastasis and calcification is rare.

Enzyme-free photothermally amplified fluorescent immunosorbent assay(PAFISA)for sensitive cytokine quantification

Cytokine monitoring has attracted great attention due to its significance in the diagnosis and treatment of many diseases,such as tumors,microbial infections,and immunological diseases.Enzyme-linked immunosorbent assay(ELISA)is one of the most popular methods in cytokine detection,ascribing to the lavish signal amplification methods in the ELISA platform.In addition to classical enzymes,other signal amplifiers such as fluorescent probes,artificial nano-enzymes,and photothermal reagents have been applied to reduce the detection limit and produce more sensitive ELISA kits.Due to the accumulative effect of heat,photothermal reagents are promising materials in the signal amplification of ELISA.However,the lack of efficient photothermal generation material at an aggregate scale may delay the further development of this area.In this contribution,based on an efficient organic photothermal aggregate material,an enzyme-free photothermally amplified fluorescent immunosorbent assay system consisting of an assay microfluidic chip and detecting platform was developed.The photothermal nanoparticles with highly efficient photothermal conversion by harvesting energy via excited-state intramolecular motions and enlarging molar absorptivity were successfully prepared.The detection concentration at 50 pg/mL of interleukin-2 was achieved,realizing a signal improvement of detection limits by 20-fold compared to that of previously reported photothermal ELISA.The microscopic imaging integrated with plane sweeping technology provided high spatial resolution and precision,indicating the potential of achieving high throughput profiling at the microscale.Moreover,as an alternative excitation source,light-emitting diode not only provided a more affordable and miniaturized detection system but also revealed the great feasibility of intramolecular motion-induced photothermy nanoparticles for biological analyses.

Digital Karyotyping with Whole Genomic Sequencing for Complex Congenital Disorder

Complex congenital disorders may be caused by multiple genetic alterations and/or environmental hazards. Diagnosis and management of these diseases are usually difficult. Robust next-generation sequencing （NGS） technologies provide unprecedented opportunities to maximize mutation detection and improve genetic counseling and clinical management. Targeted or whole exome sequencing （WES） mainly detects protein-coding DNA sequence aberrations and is the major DNA sequencing technology that is entering clinical practice （Liu et al., 2014）.