Radiobiological considerations in combining doses from external beam radiotherapy and brachytherapy for cervical cancer

The recommended radio-therapeutic treatment for cervix cancer consists of a first phase of external beam radiotherapy (EBRT) plus a second phase of brachytherapy (BT), the combined treatment being delivered within 8 weeks.In order to assess a comprehensive dosimetry of the whole treatment, it is necessary to take into account that these two phases are characterized by different spatial and temporal dosimetric distributions, which complicates the task of the summation of the two contributions, EBRT and BT. Radiobiology allows to tackle this issue pragmatically by means of the LQ model and, in fact, this is the usual tool currently in use for this matter.In this work, we describe the rationale behind the summation of the dosimetric contributions of the two phases of the treatment, EBRT and BT, for cervix cancer, as carried out with the LQ model.Besides, we address, from a radiobiological point of view, several important considerations regarding the use of the LQ model for this task. One of them is the analysis of the effect of the overall treatment time in the result of the global treatment. Another important question considered is related to the fact that the capacity of LQ to predict the treatment outcomes is deteriorated when the dose per fraction of the radiotherapic scheme exceeds 6–10 Gy, which is a typical brachytherapy fractionation. Finally, we analyze the influence of the uncertainty and the variability of the main parameters utilized in the LQ model formulation in the assessment of the global dosimetry.     

Reward ignorant modeling of dynamic treatment regimes

Personalized medicine optimizes patient outcome by tailoring treatments to patient‐level characteristics. This approach is formalized by dynamic treatment regimes (DTRs): decision rules that take patient information as input and output recommended treatment decisions. The DTR literature has seen the development of increasingly sophisticated causal inference techniques that attempt to address the limitations of our typically observational datasets. Often overlooked, however, is that in practice most patients may be expected to receive optimal or near‐optimal treatment, and so the outcome used as part of a typical DTR analysis may provide limited information. In light of this, we propose considering a more standard analysis: ignore the outcome and elicit an optimal DTR by modeling the observed treatment as a function of relevant covariates. This offers a far simpler analysis and, in some settings, improved optimal treatment identification. To distinguish this approach from more traditional DTR analyses, we term it reward ignorant modeling, and also introduce the concept of multimethod analysis, whereby different analysis methods are used in settings with multiple treatment decisions. We demonstrate this concept through a variety of simulation studies, and through analysis of data from the International Warfarin Pharmacogenetics Consortium, which also serve as motivation for this work.     

Haloalkane hydrolysis by Rhodococcus erythropolis cells: comparison of conventional aqueous phase dehalogenation and nonconventional gas phase dehalogenation

Biofiltration of air polluted by volatile organic compounds is now recognized by the industrial and research communities as an effective and viable alternative to standard environmental technologies. Whereas many studies have focused on solid/liquid/gas biofilters, there have been fewer reports on waste air treatment using other biological processes, especially in a solid/gas biofilter. In this study, a comparison was made of the hydrolysis of halogenated compounds (such as 1-chlorobutane) by lyophilized Rhodococcus erythropolis cells in a novel solid/gas biofilter and in the aqueous phase. We first determined the culture conditions for the production of R. erythropolis cells with a strong dehalogenase activity. Four different media were studied and the amount of 1-chlorobutane was optimized. Next, we report the possibility to use R. erythropolis cells in a solid/gas biofilter in order to transform halogenated compounds in corresponding alcohols. The effect of experimental parameters (total flow into the biofilter, thermodynamic activity of the substrates, temperature, carbon chain length of halogenated substrates) on the activity and stability of lyophilized cells in the gas phase was determined. A critical water thermodynamic activity (a(w)) of 0.4 is necessary for the enzyme to become active and optimal dehalogenase activity for the lyophilized cells is obtained for an a(w) of 0.9. A temperature of reaction of 40 degrees C represents the best compromise between stability and activity. Activation energy of the reaction was determined and found equal to 59.5 KJ/mol. The pH effect on the dehalogenase activity of R. erythropolis cells was also studied in the gas phase and in the aqueous phase. It was observed that pH 9.0 provided the best activity in both systems. We observed that in the aqueous phase R. erythropolis cells were less sensitive to the variation in pH than R. erythropolis cells in the gas phase. Finally, the addition of volatile Lewis base (triethylamine) in the gaseous phase and the action of the lysozyme in order to permeabilize the cells was found to be highly beneficial to the effectiveness of the biofilter.     

服务于人的生命科学和医学工作者必须坚持整体观*

在还原论、简化论的背景下,生理学和医学已经背离人体整体而从系统、器官、疾病等角度逐步细化,在带来医学科学进步的同时也显现出明显的缺陷和限制。从医学基础到临床各学科和分支学科之间亟需整合,人体健康管理、慢病预防、临床诊疗和功能康复等医学分支领域也亟需整合。人是不可分割的有机整体。作者以氧气需供代谢平衡为纲,以呼吸、血液循环、神经、代谢等系统联合一体化调控为基础,提出整体整合生理学医学新理论。唯物辩证地看待医学的专业细化和整合,以人为本,两者并重。医师应在继续强化专业化技术知识的同时,树立整体整合医学理念,以便为中国人民提供更优质和优化的防治医疗服务,并使之领先于世界。     

不同供氮水平下水曲柳（Fraxinus mandushurica Rupr.）幼苗根系呼吸季节动态

根呼吸是林木根系获得吸收养分和水分所需能量的重要生理活动.为了探讨林木根系呼吸速率的季节变化及其影响因素,采用离体根系法(Li-6400-06叶室连接到Li-6400便携式CO2/H2O分析系统)研究了水曲柳(Fraxinus mandushurica Rupr.)苗木各径级根呼吸速率在不同供氮水平下季节变化规律.结果表明:水曲柳苗木根呼吸速率表现出明显的季节动态,且与气温的季节变化规律相同,其中比根呼吸速率在0.5732 μmolCO2 · g-1 · s-1(直径≤2 mm,10月份)～7.1861 μmolCO2 · g-1 · s-1(直径≤2 mm,7月份)之间变化,表面积呼吸速率也是7月份最高,达到0.6848 μmolCO2 · cm-2 · s-1(直径>5 mm),10月份最低,仅为0.0132 μmolCO2 · cm-2 · s-1(直径≤2 mm);比根呼吸速率随根直径变大而降低,表面积呼吸速率变化规律则完全相反.供氮水平对水曲柳苗木根呼吸速率的影响随气温升高明显增强,其在6～8月份各径级根系中均达到显著水平(0.00072mm)Q10值范围为2.07～2.96,Q10值随根系径级增大而降低的现象表明水曲柳苗木细根对温度变化反应更为敏感;细根Q10值在供氮水平间差异显著(P=0.0392<0.05),粗根则不明显,表明土壤供氮水平主要影响细根的Q10值变化.     

Experience with establishment and operation of reed bed treatment for small communities in the UK

The design and development of constructed reed beds for secondary, tertiary and storm outflow treatment is described from the experience of a major water utility in the Midland region of the UK. There were only two trial sites in 1987, but 125 sites by June 1995. The problems and their resolution with the establishment ofPhragmites in gravel filled beds are described.Two secondary treatment systems with horizontal subsurface flow beds arranged in terraces show that dilute sewage can be treated to a good secondary standard, but that nitrification is likely to be only partially complete. The example of four tertiary treatment applications showed that, for beds sized at 0.7 to 1.2 m²/pe, effluents consistently averaged better than 5 mg/l BOD₅ and 10 mg/l TSS. Three sites showed improved removal of ammonium nitrogen (N) after the first year, with better than 50% removal. One site, treating highly nitrified secondary effluent, showed a small net increase in ammonium-N even after 4 years. Samples taken by the regulatory authority from 79 sites confirm the ability of the system to meet tight standards for BOD₅. A comparison made of the performance of storm reed beds during three storm events showed relatively consistent removal of BOD, TSS, ammonia nitrogen and TON.     

Engineering cell alignment in vitro

Cell alignment plays a critical role in various cell behaviors including cytoskeleton reorganization, membrane protein relocation, nucleus gene expression, and ECM remodeling. Cell alignment is also known to exert significant effects on tissue regeneration (e.g., neuron) and modulate mechanical properties of tissues including skeleton, cardiac muscle and tendon. Therefore, it is essential to engineer cell alignment in vitro for biomechanics, cell biology, tissue engineering and regenerative medicine applications. With advances in nano- and micro-scale technologies, a variety of approaches have been developed to engineer cell alignment in vitro, including mechanical loading, topographical patterning, and surface chemical treatment. In this review, we first present alignments of various cell types and their functionality in different tissues in vivo including muscle and nerve tissues. Then, we provide an overview of recent approaches for engineering cell alignment in vitro. Finally, concluding remarks and perspectives are addressed for future improvement of engineering cell alignment.     

TACE 联合其他介入手段治疗肝癌伴门静脉癌栓

肝癌是世界范围内恶性程度最高的恶性肿瘤之一。门静脉癌栓的出现加速了肝功衰竭以及门静脉高压的发生概率,严重影响了肝癌患者的预后,临床上对于肝癌合并门静脉癌栓的诊疗尤为棘手。传统的治疗手段对于肝癌合并门静脉癌栓的疗效欠佳,且创伤大、住院时间长、并发症多。介入治疗因其创伤小、住院时间短、并发症少,疗效确切等优势逐渐被人们认可。以往单独应用经导管肝动脉化疗栓塞术(Transcatheter Arterial Chemoembolization,TACE)治疗肝癌取得了可喜的成果,随着介入治疗的发展,TACE联合其他介入手段治疗肝癌伴门静脉癌栓引起了越来越多的学者重视。本文回顾了近几年来国内外的相关文献,对TACE联合其他介入手段治疗肝癌合并门静脉癌栓的方式及疗效做一综述,以期对肝癌的临床诊疗工作提供一些帮助。     

Application of alkaline treatment for sludge decrement and humic acid recovery

A new method was introduced to reduce waste activated sludge and extract humic acid for liquid fertilizer. Sludge was disintegrated with NaOH (0.4 g/g dry solid, 8 h) and then centrifuged to obtain the supernatant. The residual sludge was then dewatered, while the supernatant was used to extract humic acid with an ultrafiltration membrane. The results showed that the alkaline treatment dissolved more than half of the sludge organic matter, which was composed of 24% humic acid by mass. After the supernatant was concentrated 20 times using a membrane with a molecular weight cutoff of 1000, the retentate contained 94.5% of the dissolved organics and could be used to produce humic acid fertilizer. Additionally, only 26% of the NaOH was consumed and the residual NaOH in the permeate flux could be reused. Due to the removal of water and organics, the dewatered sludge could be reduced by 60% when compared to samples that did not receive the alkaline treatment.