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International audience; The electrochemistry and spectroelectrochemistry of four tetrapositively charged and two tetranegatively charged porphyrins were characterized in two nonaqueous solvents (dimethyl sulfoxide and N,N-dimethylformamide) containing 0.1 M tetra-n-butylammonium perchlorate. The tetrapositively charged compounds are represented by the tetrapyridylporphyrins [TRPyPM]4+(X-)4, where R is a methyl or [2-[2-(2-methoxy)ethoxy]ethoxy]ethyl group, M = MnIIII, MnIIICl, CuII, or PdII, and X = I- or Cl-. The tetranegatively charged porphyrins are represented by the tetrasulfonato derivatives [TPPSMn(OAc)]4-(NH4+)4 and [TArPSMn(OAc)]4-(NH4+)4, where Ar = 4-O-[2-[2-(2-methoxy)ethoxy]ethoxy]ethylphenyl. Up to seven electrons can be added to the tetrapyridyl porphyrins in three to five reversible reductions, while up to four electrons can be added to the tetrasulfonato derivatives in four reversible processes. Three types of electrochemical behaviors are observed for reduction of the pyridinium groups on the tetrapyridyl porphyrins. One is for the manganese(II) complexes where the four equivalent pyridinium groups are reduced in a single overlapping four-electron-transfer step. Another is for the free-base porphyrin, where four well-separated one-electron reductions occur, while the third is for copper(II) and palladium(II) derivatives, where reduction of the four pyridinium groups proceeds in two well-separated two-electron-transfer steps. The electrochemical and spectroelectrochemical properties were also characterized for a 1:1 mixture of the tetrapositively and tetranegatively charged manganese porphyrins to investigate possible interactions between these two species. An interaction between the two porphyrins was indeed observed in both solvents after electroreduction of the four pyridinium groups, which led to a substantial change in the mechanism for reduction of the pyridinium groups from an initial single overlapping four-electron-reduction process to two well-separated two-electron-transfer processes.

Rationale The incidence of obstetric hemorrhage due to pernicious placenta previa (PPP) and placenta accreta is currently increasing in China. Parallel transverse uterine incision (PTUI) cesarean section (CS) is a novel technique designed to avoid transecting the placenta and control postpartum hemorrhage during CS in these patients in our hospital. A key point of anesthesia management related to PTUI CS involves keeping the uterus relaxed. General anesthesia (GA) has often been performed, and inhaled volatile anesthetics have traditionally been recommended for this purpose; however, GA may be contraindicated in patients with difficult airways. Patient concerns The patient was predicted to have a difficult airway, and GA may have resulted in potentially life-threatening complications. An alternative and safer method of achieving uterine relaxation during PTUI CS was thus required. Diagnoses The patient was diagnosed with PPP, and a predicted difficult airway was suspected preoperatively. Interventions PTUI CS was planned to control postpartum hemorrhage and preserve fertility during CS. Uterine relaxation during PTUI CS was achieved with intravenous nitroglycerin under combined spinal-epidural anesthesia. Outcome Intravenous nitroglycerin and combined spinal-epidural anesthesia achieved uterine relaxation during the time from delivery of the neonate to making the second transverse incision in the lower segment of the uterus during PTUI CS. Both the parturient and neonate were well and were discharged 4 days later. Lessions Intravenous nitroglycerin and combined spinal-epidural anesthesia may offer an alternative to GA for achieving uterine relaxation in patients with PPP and a predicted difficult airway undergoing PTUI CS to control postpartum hemorrhage.

A series of N-confused free-base meso-substituted tetraarylporphyrins was investigated by electrochemistry and spectroelectrochemistry in nonaqueous media containing 0.1 M tetra-n-butylammonium perchlorate (TBAP) and added acid or base. The investigated compounds are represented as (XPh)4 NcpH2 , in which "Ncp" is the N-confused porphyrin macrocycle and X is a OCH3 , CH3 , H, or Cl substituent on the para position of each meso-phenyl ring of the macrocycle. Two distinct types of UV/Vis spectra are initially observed depending upon solvent, one corresponding to an inner-2H form and the other to an inner-3H form of the porphyrin. Both forms have an inverted pyrrole with a carbon inside the cavity and a nitrogen on the periphery of the π-system. Each porphyrin undergoes multiple irreversible reductions and oxidations. The first one-electron addition and first one-electron abstraction are located on the porphyrin π-ring system to give π-anion and π-cation radicals with a potential separation of 1.52 to 1.65 V between the two processes, but both electrogenerated products are unstable and undergo a rapid chemical reaction to give new electroactive species, which were characterized in the present study. The effect of the solvent and protonation/deprotonation reactions on the UV/Vis spectra, redox potentials and reduction/oxidation mechanisms is discussed with comparisons made to data and mechanisms for the structurally related free-base corroles and porphyrins.

Five nitrophenylporphyrins were investigated as to their electrochemical properties in CH 2 Cl 2 containing 0.1 M TBAP. The investigated compounds are represented as ( NO 2 Ph )x Ph 4-x PorM , where Por represents the dianion of the porphyrin macrocycle, Ph is a phenyl group on meso-position of the macrocycle, NO 2 Ph is a meso-substituted nitrophenyl group, M = 2 H , Pd II or Zn II and x = 1 or 2. Each porphyrin undergoes an initial one electron reduction at E1/2 = -1.07 to -1.12 V where the added negative charge is almost totally localized on the meso-nitrophenyl group of the compound. This reversible reduction is then followed by one or more irreversible reductions of the nitrophenyl anion at more negative potentials which overlap with reduction of the conjugated porphyrin macrocycle. The initial one electron addition was monitored by thin-layer UV-vis spectroelectrochemistry which confirmed formation of a reduced nitrophenyl group in each case but also gave spectral evidence for a linkage of the one-electron reduction products in the case of the Zn derivatives, giving Zn porphyrin dimers or arrays which are characterized by a 14–15 nm red-shifted Soret band and two well-defined Q-bands, consistent with conversion from an unreduced four coordinate Zn II nitrophenylporphyrin to a five-coordinate Zn II complex with an unreduced porphyrin macrocycle.

Rationale:Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth.Patient concerns:We present a rare case of FGCC, which extended from the right neck i

Rationale: The incidence of pernicious placenta previa (PPP) and placenta accreta (PA) is increasing in China. Excessive blood loss in these women is an important cause of maternal death and emergency hysterectomy. Performing a traditional cesarean section (CS) in women with PPP is stressful for obstetricians because avoiding cutting the placenta is difficult. As a result, sudden life-threatening bleeding may be encountered. Therefore, there is an urgent need to establish a novel operative method for PPP and PA that is safe for both the mother and neonate, and less stressful for the surgeon. Patient concerns: We report an extremely rare case of PPP and PA complicated with anemia and an unexplained decrease in the hemoglobin (Hb) levels after transfusion of 3 units of allogeneic red blood cells. Diagnoses: The patient was diagnosed with unexplained anemia, and hemolysis resulting from donor red blood cell transfusion was suspected preoperatively. Interventions: To minimize blood loss for safety, a new operative technique, parallel transverse uterine incisions (PTUI) in CS (PTUI CS), was used under general anesthesia in this case. Inhaled volatile sevoflurane was used for uterine relaxation during PTUI. Cell salvage was also used. Outcomes: PTUI CS combined with cell salvage effectively reduced bleeding and preserved the uterus in our patient. Sevoflurane was effective for uterine relaxation during PTUI CS. Lessons: If PPP and PA are suspected, placental magnetic resonance imaging is recommended for definitively determining whether a transverse fundal incision can be made. If feasible, we strongly recommend that PTUI CS combined with cell salvage are used to minimize bleeding for high-risk patients with PPP and PA complicated with anemia and an unexplained decrease in Hb levels after transfusion of 3 units of allogeneic red blood cells. Anesthesiologists should be vigilant to maintain uterine relaxation from the time of delivery of the neonate to a second transverse incision in the lower segment of the uterus. This is a key element of successful PTUI CS. Additionally, the use of intraoperative cell salvage is recommended when it can be expected to reduce the likelihood of donor red cell transfusion.

The purpose of this study is to evaluate the sensitivities of 3D diode arrays to setup error for patient-specific quality assurance (QA) of volumetric-modulated arc therapy (VMAT). Translational setup errors of ± 1, ± 2, and ± 3 mm in the RL, SI, and AP directions and rotational setup errors of ± 1° and ± 2° in the pitch, roll, and yaw directions were set up in two phantom systems, ArcCHECK and Delta4, with VMAT plans for 11 patients. Cone-beam computed tomography (CBCT) followed by automatic correction using a HexaPOD 6D treatment couch ensured the position accuracy. Dose distributions of the two phantoms were compared in order to evaluate the agreement between calculated and measured values by using γ analysis with 3%/3 mm, 3%/2 mm, and 2%/2 mm criteria. To determine the impact on setup error for VMAT QA, we evaluated the sensitivity of results acquired by both 3D diode array systems to setup errors in translation and rotation. For the VMAT QA of all patients, the pass rate with the 3%/3 mm criteria exceeded 95% using either phantom. For setup errors of 3 mm and 2°, respectively, the pass rates with the 3%/3mm criteria decreased by a maximum of 14.0% and 23.5% using ArcCHECK, and 14.4% and 5.0% using Delta4. Both systems are sensitive to setup error, and do not have mechanisms to account for setup errors in the software. The sensitivity of both VMAT QA systems was strongly dependent on the patient-specific plan. The sensitivity of ArcCHECK to the rotational error was higher than that of Delta4. In order to achieve less than 3% mean pass rate reduction of VMAT plan QA with the 3%/3 mm criteria, a setup accuracy of 2 mm/1° and 2 mm/2° is required for ArcCheck and Delta4 devices, respectively. The cumulative effect of the combined 2 mm translational and 1° rotational errors caused 3.8% and 2.4% mean pass rates reduction with 3%/3 mm criteria, respectively, for ArcCHECK and Delta4 systems. For QA of VMAT plans for nasopharyngeal cancer (NPC) using the ArcCHECK system, the setup should be more accurate.

The purposes of this study were to perform tests for the ArcCHECK QA system, and to evaluate the suitability of this system for IMRT and VMAT verification. The device was tested for short term reproducibility, dose linearity, dose rate dependence, dose per pulse dependence, field size dependence, out of field dependence and directional dependence. Eight simple plans that each used four beams of different field sizes as well as IMRT and VMAT plans for various organs of 10 patients were measured by ArcCHECK. The phantom data was then compared with ion chamber measurements and planned results. The ArcCHECK diodes performed well for all tests except directional dependence, which varies from a minimum of −4.9% (seen only when the beam is incident on the diode at 180°) to a maximum of 9.1% (approximately at 105°). For simple plan verification, the absolute dose pass rates of γ index (3%/3 mm) were almost identical. They had an average pass rate of 94.6% ± 1.3% when the field size was ≤20 cm in the X direction (right to left direction), but the pass rate fell rapidly when the field size was >20 cm in the X direction. For all patient-specific IMRT and VMAT QA, the pass rates exceeded 95% and 93%, respectively, and high reproducibility of these results has been observed from week to week. The comparative measurements show that the ArcCHECK QA system is completely suitable for clinical IMRT and VMAT verification.

The system of absolute value equations $Ax+B|x|=b$, denoted by AVEs, is proved to be NP-hard, where $A, B$ are arbitrary given $n\times n$ real matrices and $b$ is arbitrary given $n$-dimensional vector. In this paper, we reformulate AVEs as a family of parameterized smooth equations and propose a smoothing-type algorithm to solve AVEs. Under the assumption that the minimal singular value of the matrix $A$ is strictly greater than the maximal singular value of the matrix $B$, we prove that the algorithm is well-defined. In particular, we show that the algorithm is globally convergent and the convergence rate is quadratic without any additional assumption. The preliminary numerical results are reported, which show the effectiveness of the algorithm.

A 24-year-old woman at 29 weeks’ gestation, and with psychiatric symptoms, was admitted to hospital and diagnosed as having anti-N-methyl-d-aspartate receptor encephalitis. After 4 weeks of immunotherapy with little effect, an emergency cesarean section was performed at 33+4 weeks gestation under general anesthesia. The parturient was intubated after rapid sequence induction with etomidate, remifentanil and succinylcholine. Anesthesia was maintained with sevoflurane and remifentanil. Except for low weight, the infant was normal at birth. The surgery went uneventfully and teratoma or other masses were not found. The parturient was sent to ICU for further treatment without extubation after surgery. She was extubated on the 6th day after surgery and was transferred to the general ward of the neurology department to control her seizures. After the seizures were controlled, she was discharged home on the 80th postoperative day and her neurological symptoms had slowly improved half a year later. This case report presents the anesthetic considerations in patients with anti-NMDAR encephalitis undergoing cesarean section.

Purpose To study the inter- and intrafraction tumor reproducibility with active breath control (ABC) utilizing cone-beam computed tomography (CBCT), and compare validity of registration with two different regions of interest (ROI). Methods and materials Thirty-one lung tumors in 19 patients received conventional or stereotactic body radiotherapy with ABC. During each treatment, patients had three CBCT scanned before and after online position correction and after treatment. These CBCT images were aligned to the planning CT using the gray scale registration of tumor and bony registration of the thorax, and tumor position uncertainties were then determined. Results The interfraction systematic and random translation errors in the left–right (LR), superior–inferior (SI) and anterior–posterior (AP) directions were 3.6, 4.8, and 2.9 mm; 2.5, 4.5, and 3.5 mm, respectively, with gray scale alignment; 1.9, 4.3, 2.0 mm and 2.5, 4.4, 2.9 mm, respectively, with bony alignment. The interfraction systematic and random rotation errors with gray scale and bony alignment groups ranged from 1.4° to 3.0° and 0.8° to 2.3°, respectively. The intrafraction systematic and random errors with gray scale registration in LR, SI, AP directions were 0.9, 2.0, 1.8 mm and 1.5, 1.7, 2.9 mm, respectively, for translation; 1.5°, 0.9°, 1.0° and 1.2°, 2.2°, 1.8°, respectively, for rotation. The translational errors in SI direction with bony alignment were significantly larger than that of gray scale ( p Conclusions With CBCT guided online correction the interfraction positioning errors can be markedly reduced. The intrafraction errors were not diminished by the use of ABC. Rotation errors were not very remarkable both inter- and intrafraction. Gray scale alignment of tumor may provide a better registration in SI direction.

Objective: Intrauterine balloon aortic valvuloplasty (IUBAV) has been used to correct critical aortic valve stenosis. Evaluation of the intervention-related risk is necessary. The purpose of this study was to establish an experimental goat model for ultrasound-guided IUBAV intervention and investigate the immediate and long-term effects of IUBAV on the fetus, gestational outcome and mother’s safety. Study Design: Fifteen pregnant goats with twin gestation in the 2nd and 3rd trimester were anesthetized to establish the surgical procedure. One fetus of the twins received IUBAV intervention, the other served as a control. The data were collected at three time points: immediately before and after IUBAV, and 24 h after birth. Critical organs including the heart, brain, lung and liver from the fetuses/newborns were collected after IUBAV or 24 h after birth. Results: IUBAV intervention immediately induced a significant decrease of pH and Ca2+, as well as an increase of blood glucose and lactic acid levels (p < 0.05). IUBAV also caused an increase in stress hormones (epinephrine 1-fold, norepinephrine 4-fold, and cortisol 1-fold; p < 0.05). Following the operation, all of the mother goats recovered, but in 60% (6/10) preterm delivery occurred. Neither pathological changes in fetal critical organs nor a significant difference in metabolism or growth parameters were detected between IUBAV and control kids. Conclusions: Ultrasound-guided IUBAV intervention induced a strong but transient stress response in the operated fetus, which did not result in irreversible histological changes in the fetus or the mother, but may disrupt the continuation of normal gestation in the long term. Preterm delivery is the major risk in this goat IUBAV model.

Rationale Wilson's disease (WD), or hepatolenticular degeneration, is an autosomal recessive disorder with a prevalence of 1:50,000 to 1:100,000 live births. Patient concerns A 26-year-old primipara with WD was admitted to our hospital, due to awaiting delivery. Her main symptoms were slightly higher total bile acid (TBA) and bilateral depressed edema of lower limbs. Diagnosis She was at 38 weeks and 4 days of gestation with a 15-year history of WD, controlled with penicillamine in the past and replaced by zinc preparations from three months before pregnancy. Outcomes General anesthesia was successfully administered for a female with WD undergoing cesarean delivery. Lesson General anesthesia can be administered in an asymptomatic primigravida with WD. Appropriate anesthetics choice can effectively minimize the rates of complications and sequelae.

Background and purpose Online adaptive correction in image-guided intensity-modulated radiotherapy appeared to be a promising approach for precision radiation treatment in head and neck tumors. This protocol was designed to evaluate the clinical feasibility and effect of online cone beam computed tomography (CBCT) guidance in IMRT of nasopharyngeal cancer (NPC). Methods and materials The Elekta Synergy system, which integrates an X-ray volumetric imager (XVI), was used to deliver radiation treatment for 22 cases of NPC. The acquired CBCT was registered to the planning CT for online and offline analysis. The systematic and random setup errors, as well as planning target volume (PTV) margin, were calculated at different correction threshold levels. The impact of online setup correction on dosimetry was evaluated by simulation of pre-correction errors. Results The correction-of-setup-errors frequencies for 1, 2 and 3mm thresholds were 41.3–53.9%, 12.7–21.2% and 6.3–10.3%, respectively. Online correction was effective at the 2mm threshold level for all three axes. The pre-correction systematic errors for the whole group ranged 1.1–1.3mm, and the random errors were also 1.1–1.3mm. After online correction, the systematic and random errors ranged 0.4–0.5mm and 0.7–0.8mm, respectively, in the three directions. The PTV margins for the pre-correction, pretreatment and post-treatment positions were 3.5–4.2mm, 1.6–1.8mm and 2.5–3.2mm, respectively, in three directions. Analysis of hypothetical dosimetric change due to a translational isocenter shift of 3mm showed that if no correction was applied, the mean maximum dose to both the brain stem and spinal cord would be increased by 10Gy, the mean dose to the left and right parotids would be increased by 7.8 and 8.5Gy, respectively, and the dose to target volumes would be decreased: 4Gy for 95% GTV and 5.6Gy for 95% CTV 60. Conclusions CBCT-based online correction increased the accuracy of IMRT for NPC and reduced irradiated margins, by decreasing both the systematic and random errors. Online CBCT correction reduces the radiation dose to normal tissue and creates room for further dose escalation of tumors.

The synthesis of a series of β-functionalized push-pull dibenzoporphyrins was realized. These porphyrins display subtle push-pull effects, demonstrating the exceptional tunability of their electronic and electrochemical properties. The UV-vis spectra of these porphyrins show unique absorption patterns with shouldered Soret bands and extra absorptions in the Q-band region. Stronger electron-withdrawing groups display more significant bathochromic shifts of the Soret bands. The fluorescence spectra of these porphyrins show strong near-IR emission bands (600-850 nm). In particular, fluorescence quenching effect was observed for pyridyl carrying push-pull porphyrin 4c in the presence of an acid. TFA titration study of 4c using UV-vis and fluorescence spectroscopy reveals that the fluorescence quenching can be mainly attributed to the protonation of the pyridyl groups of 4c. The versatile synthetic methods developed in this work may open a door to access a large number of functionalized organic materials that are currently unavailable. The structure-property studies provided in this work may provide useful guidelines for the design of new generations of materials in dye-sensitized solar cells, in nonlinear optical applications, as fluorescence probes, as well as sensitizers for photodynamic therapy.

A series of europium triple-decker complexes containing phthalocyanine and nitrophenyl-corrole macrocycles were synthesized and characterized by spectroscopic and electrochemical methods in nonaqueous media. The examined compounds are represented as Eu2[Pc(OC4H9)8]2[Cor(Ph)n(NO2Ph)3-n], where n varies from 0 to 3, Pc(OC4H9)8 represents the phthalocyanine macrocycle, and Cor indicates the corrole macrocycle having phenyl (Ph) or nitrophenyl (NO2Ph) meso substituents. Three different methods were used for syntheses of the target complexes, two of which are reported here for the first time. Each examined compound undergoes five reversible one-electron oxidations and 3-5 one-electron reductions depending upon the number of NO2Ph substituents. The nitrophenyl groups on the meso positions of the corrole are highly electron-withdrawing, and this leads to a substantial positive shift in potential for the five oxidations and first reduction in CH2Cl2, PhCN, or pyridine as compared to the parent triple-decker compound with a triphenylcorrole macrocycle. The measured E1/2 values are linearly related to the number of NO2Ph groups on the corrole, and the relative magnitude of the shift in potential for each redox reaction was used in conjunction with the results from thin-layer spectro-electrochemistry to assign the initial site of oxidation or reduction on the molecule. The nitrophenyl substituents are also redox-active, and each is reduced to [C6H4NO2](-) in a separate one-electron transfer step at potentials between -1.12 and -1.42 V versus saturated calomel electrode.

Four nitrated N-confused free-base tetraarylporphyrins were synthesized and characterized by electrochemistry and spectroelectrochemistry in nonaqueous media. The examined compounds are represented as NO2 (Ar)4 NcpH2 , where NO2 (Ar)4 Ncp is the dianion of a tetraaryl N-confused porphyrin with an inner carbon bound NO2 group and Ar is a p-CH3 OPh, p-CH3 Ph, Ph or p-ClPh substituent on each meso-position of the macrocycle. UV/Vis spectra and NMR spectroscopy data indicate that the same form of the porphyrin exists in CH2 Cl2 and DMF which is unlike the case of non-NO2 N-confused porphyrins. The Soret band of NO2 (Ar)4 NcpH2 exhibits a 30-36 nm red-shift in CH2 Cl2 and DMF as compared to the spectrum of the non-NO2 N-confused porphyrins. The first two reductions and first oxidation of NO2 (Ar)4 NcpH2 are reversible in CH2 Cl2 containing 0.1 M TBAP. The measured HOMO-LUMO gap averages 1.65 V in CH2 Cl2 and 1.53 V in DMF, with both values being similar to those of the non-NO2 substituted compounds. The nitro group on the inverted pyrrole is itself not reduced within the negative potential limit of CH2 Cl2 or DMF, but its presence significantly affects both the UV/Vis spectra and redox potentials.

Two series of diphosphoryl-substituted porphyrins were synthesized and characterized by electrochemistry and spectroelectrochemistry in nonaqueous media containing 0.1 M tetra-n-butylammonium perchlorate (TBAP). The investigated compounds are 5,15-bis(diethoxyphosphoryl)-10,20-diphenylporphyrins (Ph)2(P(O)(OEt)2)2PorM and 5,15-bis(diethoxyphosphoryl)-10,20-di(para-carbomethoxyphenyl)porphyrins (PhCOOMe)2(P(O)(OEt)2)2PorM where M = 2H, Co(II), Ni(II), Cu(II), Zn(II), Cd(II), or Pd(II). The free-base and five metalated porphyrins with nonredox active centers undergo two ring-centered oxidations and two ring-centered reductions, the latter of which is followed by a chemical reaction of the porphyrin dianion to give an anionic phlorin product. The phlorin anion is electroactive and can be reoxidized by two electrons to give back the starting porphyrin, or it can be reversibly reduced by one electron at more negative potentials to give a phlorin dianion. The chemical conversion of the porphyrin dianion to a phlorin anion proceeds at a rate that varies with the nature of the central metal ion and the solvent. This rate is slowest in the basic solvent pyridine as compared to CH2Cl2 and PhCN, giving further evidence for the involvement of protons in the chemical reaction leading to phlorin formation. Calculations of the electronic structure were performed on the Ni(II) porphyrin dianion, and the most favorable atoms for electrophilic attack were determined to be the two phosphorylated carbon atoms. Phlorin formation was not observed after the two-electron reduction of the cobalt porphyrins due to the different oxidation state assignment of the doubly reduced species, a Co(I) π anion radical in one case and an M(II) dianion for all of the other derivatives. Each redox reaction was monitored by thin-layer UV-visible spectroelectrochemistry, and an overall mechanism for each electron transfer is proposed on the basis of these data.

Ubiquilin 1 (UBQLN1) plays an essential role in the regulation of protein degradations which is involved in the pathophysiology of neurodegenerative diseases and cancer. This study aimed to investigate the expression level of UBQLN1 in gastric cancer and evaluated the relationship between its expression and clinicopathological characteristics, as well as prognostic of patients with gastric cancer. Immunohistochemistry (IHC) was used to detect the expression levels of UBQLN1 in 179 pairs of gastric cancer and adjacent normal tissues. The UBQLN1 was significantly upregulated in gastric cancer tissue. High UBQLN1 expression was associated with high histological grade, invasion, lymph node metastasis, and tumor node metastasis (TNM) stage III (P

Identification of biomarkers is important not only for cancer diagnosis, prognosis and treatment, but also provides new insight into cancer biology. The aim of this study was to evaluate the clinical significance of miR-301a in patients with triple-negative breast cancer (TNBC). The expression level of miR-301a was examined by quantitative reverse transcription polymerase chain reaction in 118 pairs of TNBC and adjacent noncancerous tissues. The relationships between miR-301a expression and clinical features, and prognosis of patients with TNBC were analyzed. miR-301a was upregulated in cancer tissues compared with adjacent noncancerous tissues. Furthermore, the level of miR-301a was positively correlated with tumor size, depth of invasion, TNM stage and LNM. High miR-301a expression was significantly associated with larger tumor size and LNM. Multivariate analysis suggested that miR-301a expression was an independent prognostic factor for the survival of patients with TNBC, and the effect remained significant after further stratified by clinical features. In conclusion, miR-301a may be involved in the progression of TNBC and has strong potential to serve as a biomarker for the prognosis of TNBC.

Background To analyze the feasibility of active breath control (ABC), the lung tumor reproducibility and the rationale for single-breath-hold cone beam CT (CBCT)-guided hypofraction radiotherapy. Methods Single-breath-hold CBCT images were acquired using ABC in a cohort of 83 lung cancer patients (95 tumors) treated with hypofraction radiotherapy. For all alignments between the reference CT and CBCT images (including the pre-correction, post-correction and post-treatment CBCT images), the tumor reproducibility was evaluated via online manual alignment of the tumors, and the vertebral bone uncertainties were evaluated via offline manual alignment of the vertebral bones. The difference between the tumor reproducibility and the vertebral bone uncertainty represents the change in the tumor position relative to the vertebral bone. The relative tumor positions along the coronal, sagittal and transverse axes were measured based on the reference CT image. The correlations between the vertebral bone uncertainty, the relative tumor position, the total treatment time and the tumor reproducibility were evaluated using the Pearson correlations. Results Pre-correction, the systematic/random errors of tumor reproducibility were 4.5/2.6 (medial-lateral, ML), 5.1/4.8 (cranial-caudal, CC) and 4.0/3.6 mm (anterior-posterior, AP). These errors were significantly decreased to within 3 mm, both post-correction and post-treatment. The corresponding PTV margins were 4.7 (ML), 7.4 (CC) and 5.4 (AP) mm. The changes in the tumor position relative to the vertebral bone displayed systematic/random errors of 2.2/2.0 (ML), 4.1/4.4 (CC) and 3.1/3.3 (AP) mm. The uncertainty of the vertebral bone significantly correlated to the reproducibility of the tumor position (P 0.05). Conclusions Using ABC for single-breath-hold CBCT guidance is an effective method to reduce the PTV margin of hypofraction radiotherapy for lung cancer. Using ABC, the tumor position was significantly altered relative to the vertebral position. The reproducibility of the tumor position was affected by the vertebral bone but not by the relative tumor position or the total treatment time.

The crystallographic NC(α), C(α)C′ and NC(α)C′ backbone parameters of 43 oligopeptides and the NC(α)C′ angles of 37 proteins were compared with peptide conformational geometry surfaces derived from ab initio calculations of N-acetyl N′-methyl alanine amide. The calculated values were obtained by spline-function representations of ab initio dipeptide conformational geometry maps which allow one to predict backbone bond lengths and angles in peptides and proteins as functions of the o[NC(α)]/ψ[C(α)C′]-torsions. When the parameters are ordered by regions in o/ψ-space defined by a 30° grid and region-average values calculated, the rms deviations between the crystallographic and calculated parameters in the most populated regions of the oligopeptides are 0.009A, 0.013A and 1.2°, for NC(α), C(α)C′ and NC(α)C′ respectively; and 1.2° for the NC(α)C′ angles in proteins. The flexibility in o/ψ-space is significant for the NC(α)C′ angles (observed variations of > 8°), but of lesser importance for the bond lengths (conformational variations of ∼0.02 A ). Thus, torsion dependent ideal geometry functions are recommended for the former, but not necessarily the latter, for use in various areas of protein study, such as protein crystallography and empirical molecular modeling procedures.

The maintenance of the balance between oxygen supply and oxygen consumption is a key measure in preventing acute kidney hypoxic/reoxygenation injury. Morphine can inhibit metabolism and reduce the oxygen consumption. We tried to investigate the protective effects of morphine hypoxic preconditioning on acute kidney hypoxic/reoxygenation injury in rabbit and its influence on expression of caspase-3 protein. Kidney hypoxic and reoxygenation were induced by making the tested rabbits inhale 8% oxygen for three hours firstly, and then putting them in the air to breathe in normal oxygen for another three hours. Morphine hypoxic preconditioning was induced by administering morphine 3 mg/kg, and then hypoxic of 8% oxygen was induced. Caspase-3 protein expression in renal tissue was assessed by immunohistochemical method. In the present study, the expressions of caspase-3 protein were significantly higher in saline-control hypoxic group than in morphine hypoxic preconditioning group ((29.3+/-5.7)% vs. (12.16+1.23)%, P0.05). These observations suggested that morphine hypoxic preconditioning can protect rabbit against acute kidney hypoxic/reoxygenation injury by decreasing expression of caspase-3 protein.

Background and purpose To evaluate the feasibility and validity of cone beam computed tomography (CBCT) and active breath control (ABC) by long breath-holding in hypofraction radiotherapy of liver tumor. Methods and materials Twenty-four patients received hypofraction radiotherapy of liver tumor with long breath-holding at end-inhale; four prescriptions were used: 6Gy×7 ( n =8), 10Gy×4 ( n =7), 5Gy×9 ( n =6), 4Gy×10 ( n =3). For each fraction, all patients received pre-correction CBCT scans with ABC, some patients received post-correction and post-treatment CBCT. The interfraction and intrafraction liver positioning errors on medial–lateral (ML), cranial–caudal (CC) and anterior–posterior (AP) directions were obtained. The theoretic margin from clinical target volume (CTV) to planning target volume (PTV) was calculated based on post-treatment error. The dosimetric parameters of PTV and normal tissue were compared between ABC and free breathing (FB). Results The interfraction error in liver positioning showed system errors (Σ) of 3.18mm (ML), 6.80mm (CC) and 3.05mm (AP); random error ( σ ) of 3.03mm (ML), 6.78mm (CC) and 3.62mm (AP). These errors were significantly reduced with CBCT guided online correction. The intrafraction systematic error was 0.72mm (ML), 2.21mm (CC), 1.49mm (AP), and random error was 2.30mm (ML), 3.58mm (CC), 2.49mm (AP). Dosimetric parameters such as PTV, the liver's volume included by 23, 30Gy isodose curve (V23, V30), mean dose to normal liver (MDTNL) and mean dose to cord were significantly larger for FB ( P Conclusion Liver radiotherapy with long time breath-holding at end-inhale is an effective method to reduce liver motion, PTV and dose to normal tissue. Interfraction and intrafraction liver positioning errors were substantial. CBCT guided online correction of positioning error is recommended for liver radiotherapy with end-inhale ABC.

Image guided radiotherapy (IGRT) is a new precise radiotherapy applied in clinic. The aim of this study is to evaluate the impact of using active breath control (ABC) and stereotactic body frame on reducing the positioning error and increasing treatment precision during radiotherapy for pulmonary cancer.Seven patients with pulmonary recurrences or metastasis after prior treatment were enrolled. A total number of 13 tumor targets received irradiation, with a fraction dose of 7Gy treated every other day to a total of 7 fractions. X-ray beam volume CT was done at every fraction for correction of positioning error at 3 dimensions.The errors between pre-treatment positioning and treatment planning at left-right, anterior-posterior and cephalic-caudal directions were 0.30cm±0.14cm, 0.22cm±0.15cm and 0.28cm ±0.21cm, respectively. The positioning error was reduced after correction by volume CT and after treatment but the errors between pre-correction, post-correction and post-treatment had no statistical significance at all 3 directions. Eight targets had complete response, 4 targets had partial response, and 1 had no change.Image guided hypofractionation radiotherapy with ABC and stereotactic body frame has the advantage of increasing radiation dose and reducing overall treatment time and radiation toxicity.

Hot spots and cold spots always appear in the matched region of electron-photon fields. The degree of this kind of dose heterogeneity depends on the physical characteristic of a treatment unit and the energy of electrons. In this paper, a set of dosimetric parameters have been measured on electron rays and x rays for the Elekta Precise treatment unit and the Elekta Synergy treatment unit, respectively. The hot spots and cold spots in the region of perpendicular electron-photon matching fields have been analysed quantitatively. The method to extend penumbra for photon beam profiles was proposed for improving the dose uniformity in the matched regions. And the dose profiles in the matched regions for different treatment units were compared. The results showed that there were stronger hot spots and cold spots for treatment unit with smaller penumbra for photon beams either under the condition of unmodified photon beam profile or the condition of modified photon beam profile.

Purpose To study the intrafraction tumour position error utilizing cone beam CT (CBCT) in patients receiving radiotherapy. Methods and materials Fifty-four patients were treated with Elekta Synergy S system, including 19 head and neck, 25 thoracic and 10 abdominal-pelvic tumours. All patients received CBCT after initial setup and some of them received CBCT after correction and after treatment. CBCT were registered to planning CT and errors of isocenter position on the left-to-right (LR), superior–inferior (SI) and anterior–posterior (AP) directions were analyzed. Results After treatment the systematic ( Σ ) and random uncertainty ( σ ) increased, the increments of tumour Σ were 0.1–0.3, 0.2–0.5 and 0.2–0.6mm, respectively, while the increments of σ were 0.1–0.3, 0.2–0.4 and 0.1–0.4mm, respectively, for the head and neck, thoracic and abdominal-pelvic tumours. Based on 380 paired pre- and post-treatment CBCT, the intrafraction errors (mean±SD) in the LR, SI and AP directions were −0.1±0.9, −0.3±1.0 and −0.2±0.7mm, respectively, for head and neck tumours, −0.1±1.2, −0.1±1.9 and 0.1±1.3mm, respectively, for thoracic tumours, −0.1±1.1, 0.2±1.4 and −0.1±1.5mm, respectively, for abdominal-pelvic tumours. Isotropic planning margins of 3.4, 6.1 and 5.4mm were generated with linear addition of internal margin (IM) to CTV for the head and neck, thoracic and abdominal-pelvic tumours, respectively, while margins were only 2.4, 4.4 and 3.9mm, respectively, if IM was added in quadrature. Conclusions Utilizing CBCT measurements before and after treatment to detect intrafraction tumour position errors was clinically feasible. The detected intrafraction errors could be applied to improve the accuracy of radiation delivery.

Background Treatments for cancer spinal metastasis were always palliative. This study was conducted to investigate the safety and effectiveness of IG-IMRT for these patients. Methods 10 metastatic lesions were treated with conventionally-fractionated IG-IMRT. Daily kilovoltage cone-beam computed tomography (kV-CBCT) scan was applied to ensure accurate positioning. Plans were evaluated by the dose-volume histogram (DVH) analysis. Results Before set-up correction, the positioning errors in the left-right (LR), superior-inferior (SI) and anterior-posterior (AP) axes were 0.3 ± 3.2, 0.4 ± 4.5 and -0.2 ± 3.9 mm, respectively. After repositioning, those errors were 0.1 ± 0.7, 0 ± 0.8 and 0 ± 0.7 mm, respectively. The systematic/random uncertainties ranged 1.4–2.3/3.0–4.1 before and 0.1–0.2/0.7–0.8 mm after online set-up correction. In the original IMRT plans, the average dose of the planning target volume (PTV) was 61.9 Gy, with the spinal cord dose less than 49 Gy. Compared to the simulated PTVs based on the pre-correction CBCT, the average volume reduction of PTVs was 42.3% after online correction. Also, organ at risk (OAR) all benefited from CBCT-based set-up correction and had significant dose reduction with IGRT technique. Clinically, most patients had prompt pain relief within one month of treatment. There was no radiation-induced toxicity detected clinically during a median follow-up of 15.6 months. Conclusion IG-IMRT provides a new approach to treat cancer spinal metastasis. The precise positioning ensures the implementation of optimal IMRT plan, satisfying both the dose escalation of tumor targets and the radiation tolerance of spinal cord. It might benefit the cancer patient with spinal metastasis.

Two series of diphosphoryl-substituted porphyrins were synthesized and characterized by electrochemistry and spectroelectrochemistry in benzontrile, dichloromethane and pyridine containing 0.1 M tetra-n-butylammonium perchlorate. The investigated compounds are represented as 5,15-bis(diethoxyphosphoryl)-10,20-diphenylporphyrins and 5,15-bis-(diethoxyphosphoryl)-10,20-di(p-carbomethoxyphenyl) porphyrins (Chart). The porphyrins with non-redox active metal centers undergo two ring centered oxidations and two ring centered reductions, the latter of which is followed by a chemical reaction to give a phlorin anion. The phlorin anion is electroactive and can be reoxidized to give back the starting porphyrin or reversibly reduced to give a phlorin dianion. Each redox reaction was monitored by thin-layer UV-visible spectroelectrochemistry and an overall reduction mechanism is proposed. Figure 1

Purpose To investigate the effect of computed tomography (CT) using hepatic arterial phase (HAP) and portal venous phase (PVP) contrast on dose calculation of stereotactic body radiation therapy (SBRT) for liver cancer. Methods Twenty-one patients with liver cancer were studied. HAP, PVP and non-enhanced CTs were performed on subjects scanned in identical positions under active breathing control (ABC). SBRT plans were generated using seven-field three-dimensional conformal radiotherapy (7 F-3D-CRT), seven-field intensity-modulated radiotherapy (7 F-IMRT) and single-arc volumetric modulated arc therapy (VMAT) based on the PVP CT. Plans were copied to the HAP and non-enhanced CTs. Radiation doses calculated from the three phases of CTs were compared with respect to the planning target volume (PTV) and the organs at risk (OAR) using the Friedman test and the Wilcoxon signed ranks test. Results SBRT plans calculated from either PVP or HAP CT, including 3D-CRT, IMRT and VMAT plans, demonstrated significantly lower (p Conclusions Our data indicate that though the differences in dose calculation between contrast phases are not clinically relevant, dose underestimation (IE, delivery of higher-than-intended doses) resulting from CT using PVP contrast is larger than that resulting from CT using HAP contrast when compared against doses based upon non-contrast CT in SBRT treatment of liver cancer using VMAT, IMRT or 3D-CRT.

Purpose: Atlas‐based auto‐segmentation and model‐based auto‐segmentation were combined to improve accuracy of auto‐segmentation for thorax and abdomen cancer patient,herein referred to as AM 0.95 vs. 0.96 (p=0.42); 0.93 vs. 0.91 (p