Objective To summarize our clinical experience of prophylaxis and treatment for complications associated with catheterization of brachial artery. Methods 87 patients underwent endovascular treatment via brachial artery. Complications associated with catheterization of brachial artery were retrospectively analyzed. Results Under ultrasonic guidance the catheterization procedure of brachial artery was successful in all 87 patients. The success rate of cannulation was 100%. In 53 patients(61% ) ultrasonic guided cannulation was successful at the first attempt, the other 35 (39% ) with 2 or more than 2 times puncture. Complications associated with catheterization of brachial artery were detected in 16 cases. The complication rate was 18. 4%. Guidewire insertion into peri vascular compartment took place in 4 cases (4. 6% ). Episodes of local hematomas were noted in 11 cases( 12. 6% ) and in three of the 11 cases nerve injuries were detected (one of which was of late-onset type). Brachial artery pseudoaneurysm was found in 1 case(1.2%). Conclusion Familiarity with the anatomical features of the brachial access, skillful application of the techniques for the catheterization, full understanding of complications and sufficient preparation of treatment strategies can prevent those complications effectively.

Background and purpose:Accurate target delineation in IMRT setting has been a challenge for post-operative gliomas.The fusion technology with MR+CT image registration could improve the accuracy of target delineation,but there are no reports as to whether this technique could increase the stability of target delineation.This study was to investigate the accuracy of different fusion technologies with MRI+CT image registration so it could improve stability of target delineation of clinical target volume in patients with post-operative gliomas.Methods:The post-operative and pre-operative MRI+CT were registrated in nine patients with post-operative gliomas.Clinical target volume in the two registration images and localized CT images were delineated at 5 different times.The image registration accuracy and stability of target delineation were also quantitatively assessed.Results:The registration accuracy in 3D space was always less than 1.5 mm.The concordance index in CT+MRI(pre-matched),CT+MRI(post-matched)and CT(conv)were(68?9)%,(61?7)% and(41?12)% respectively.The same volumes delineated with three sets of images were(82?7)% for CT+MRI(pre-matched),(78?5)% for CT+MRI(post-matched)and(65?8)% CT(conv),respectively.Conclusions:The volume delineated according to pre-operative MRI registered with CT image have the largest volume and the best stability(P

Objective To evaluate clinical effects of endovascular angioplasty and stenting for treating lower extremity arteriosclerotic occlusion(ASO).Methods After the identification of the stenosis or occlusion by angiography via femoral artery access by percutaneous puncture or incision puncture,recanalization of the occlusion was done by ultrasound ablation or guildewire clearance.Then the percutaneous transluminal angioplasty(PTA) was performed and an endovascular stent was introduced.Results A total of 45 cases(53 legs) had undergone endovascular angioplasty and stenting.The procedure was technically successful in all the patients.The ankle brachial index(ABI) increased from 0.36?0.14 preoperatively to 0.77?0.21 on the 7 postoperative day((t=2.397),P=0.021).Follow-up checkups in all the cases for 6~54 months(mean,23 months) revealed a primary patency rate of 90.6%(48/53).Conclusions Endovascular angioplasty and stenting is a safe and effective method for treating lower extremity arteriosclerotic occlusion.

Objective: To observe differentially expressed genes in rat hippocampus irradiated by 6 MV X-rays during radiotherapy.Methods:After whole brain irradiation of 50 Gy in 25 fractions with 2 Gy per fraction,the capability of learning and memory was investigated in a shuttle box model,then rats were killed and the hippocampus were taken,mRNA from sham irradiation group and irradiation group were reversely transcribed to cDNA with incorporation of fluorescence dUTP(Cy5 and Cy3 dUTP) to prepare for hybridization probes.The mixed probes were hybridized to the cDNA microarray.Axon Genechix 4000 BandGenePix Pro3.0 software was used to scan and analyze the fluorescent signals. Results:①The active avoidance response of irradiated rats were lowered significantly.②Compared with the sham group,significant changes took place in 43 genes,among which 28 genes were upregulated and 15 down regulated,other genes did not change significantly.③Among the 43 malexpressed genes,16 were reported previously,others were newly found genes. Conclusion: The influence of ionizing radiation on learning and memory was a complex course,including many transduction factors and might be related to mitochondrial dysfunction.

Objective: The purpose of this study was to quantitatively assess the systematic and random errors in radiation therapy for pelvic tumor patients of different somatotypes and seek an individualized mathematic basis for defining the planning target volume(PTV) and planning organ at risk volume(PRV) in 3 dimensional space.Methods: Thirty patients with pelvic tumor were immobilized by thermoplastic body mask in a spine position and divided into four somatotypes according to their body mass indexes(BMI).CT simulations were performed and digitally reconstructed radiographs(DRR) were generated as the reference image.To define the appropriate PTV-and PRV-margins for intensity modulation radiated therapy(IMRT),inter-fractional set-up errors and intra-fractional organ motions were quantitatively evaluated in the right-left(R-L),anterior-posterior(A-P) and cranial-caudal(C-C) directions.And the frequency of shift in the three directions were observed.Results: For the pelvic tumor patients with different BMIs,the inter-fractional set-up errors of the emaciated,moderate,overweight and obese somatotypes were 1.8,1.8,2.2 and 2.7 mm in the R-L direction,2.2,1.8,3.6 and 2.8 mm in the A-P direction,and 2.4,2.1,2.7 and 2.6 mm in the C-C direction.The intra-fractional organ motions of the four somatotypes were 1.9,1.9,2.3 and 2.5 mm in the R-L,2.1,2.2,2.9 and 3.0 mm in the A-P,and 1.8,1.9,2.2 and 2.5 mm in the C-C direction.Conclusion: In the pelvic irradiation,the definition of PTV and PRV should be individualized.

Objective: To study the accuracy of MRI-CT image registration in order to find a more effective method of image fusion and a standard for the evaluation of post-operative intra-cranial tumor radiotherapy.Methods: Twenty-four patients with intra-cranial tumor underwent MR T1-weighed sequence and post-operative location CT scan under the same location condition.The trans-axial MR T1-weighed sequence and CT image were registered and the correlation between registration scores and errors was analyzed by the method of Tris-Axes Landmark.The linear registration errors were observed in the three-dimensional space of every patient.Results: An improved linear correlation was found between registration scores and errors(r=-0.985,y=-0.551 3x+5.351 4).The registration met the clinical standard when the scores exceeded 6.61.Conclusion: Tris-Axes Landmark is a preferable registration method to be used in clinical radiotherapy for rapid and precise evaluation of MRI-CT image registration accuracy.

To predict and identify the dominant B‐cell epitopes of conserved region of Treponema pallidum repeat protein F (TprFN ) and provide the basis for development of polyvalent epitope‐based syphilis vaccine ,the amino acid sequence of TprFN was obtained from GenBank and analyzed with comprehensive meta‐analysis Mobyle ,ABCpred and IEDB online software .The peptides containing predicted epitopes were artificially synthesized . To obtain and measure the titers of antibodies against TprFN ,New Zealand rabbits were immunized with recombinant protein TprFN expressed in E .coli and identified by Western blot (WB) .Sera from TprFN‐immunized rabbits ,syphilis patients ,and normal human and normal rabbits were used to deter‐mine the immunoreactivity and specificity of 7 predicted peptides of TpFN by indirect ELISA .Comprehensive meta‐analysis of online software showed that P1 (43‐62AA) ,P2(57‐71AA) ,P3(81‐88AA) ,P4(89‐103AA) ,P5(125‐138AA) ,P6(231‐251AA) and P7(268‐279AA) might be the B‐cell epitopes .A protein was expressed in a soluble form and identified as TpFN by WB .The ELISA indicated that P1 and P3 were active with TprFN‐immunized rabbit sera and syphilis patient sera but not with negative control sera .These results indicate that P1 and P3 are the potential dominant B‐cell epitopes .

Objective To evaluate the effect and toxicity of lipiodol-arsenic trioxide emulsion on the treatment of primary hepatic carcinoma. Methods Arsenic trioxide 20mg and lipiodol were fully mixtured into lipiodol-arsenic trioxide emulsion,which were injected into hepatic artery by catheters in 58 patients with primary hepatic carcinoma. If the patients' conditions progressed(tumor got larger or AFP increased),Anthracyctine would be used simultaneously. The effect and toxicity were observed. Results After 1～3 times of thera-py only with lipiodol-arsenic trioxide emulsion in all of 58 patients,objective response rate was 20.7% with 12 eases of PR,36 cases of NC and 10 cases of PD. AFP decreased from(11109.36±2920.82) IU/mL to(10001.61±2880.67) IU/mL averagely(P>0.05). An-thracycline was applied in 22 patients,and tumors got smaller in 16 cases after that. AFP decreased from (13901.11±4862.26) IU/mL to(5470.63±2597.79) IU/mL averagely(P< 0.05). The major toxic side effect were pyrexia, nausea and vomiting, pain in hepatic re-gion,mild bone marrow depression and hepatic damage. No irreversible toxic response occurred. Conclusion Lipiodol-arsenic trioxide emulsion injection via hepatic artery by catheters is effective and less toxic to treat primary hepatic carcinoma.

Objective: To evaluate the efficacy and safety of low dose sublingual nifedipine dripping pills (5 mg) in treating moderate and severe hypertension in comparison with normal dose (10 mg) of sublingual nifedipine dripping pills. Methods: This study was designed as a randomized, double-blind, positive drug parallel controlled, multi-center, non-inferiority clinical trial. Patients with moderate and severe hypertension were enrolled by 14 clinical trial centers, randomly divided into the trial group (sublingual 5 mg nifedipine dripping pills) and the control group (sublingual 10 mg nifedipine dripping pills). The changes in blood pressure were monitored continuously within 2 hours after the initial administration, repeated the dose in 20 minutes interval after the initial administration for up to additional 3 doses (maximum 4 doses) if the antihypertensive efficacy was not satisfactory. The efficacy of antihypertensive therapy between the two groups was evaluated by repeated administration rates and blood pressure changes at 60 minutes post the initial administration, and the safety of treatment was evaluated by recording adverse event rate of the two groups. Results: The anti-hypertensive effective rates at 60 minutes after sublingual administration were 83.5% (202/242) and 86.7% (208/240) respectively between the trial group and control group (χ²=1.307, P=0.253) . On the aspect of antihypertensive effectiveness at 60 minutes after single dose of sublingual administration, the anti-hypertension effective rates of the trial group and the control group were 85.6% (154/180) and 87.2% (164/188) respectively (χ²=0.221, P=0.639). Prevalence of the repeated administration was also similar between the two groups (25.6%(62/242) in the trial group and 21.7% (52/240) in the control group, χ²=1.043, P=0.307). On the safety aspect, there was no adverse events/reactions in the trial group, but there were 15 cases of adverse events/reactions occurred in control group (6.25%, χ²=15.611, P<0.001). Conclusions In the treatment of moderate to severe hypertension, the antihypertensive efficacy of low dose nifedipine dripping pills is similar to that of conventional dosage, and the safety profile of low dose nifedipine dripping pills is better than that of the conventional dose.