0.05). There was no significant difference in radiation reaction and squeal between two groups. Conclusions The clinical results of LCAH radiotherapy may be improve the three year of local control rate than conventional CF in stage Ⅲ~Ⅳa but do not improve the survival rate of three years.The radiation reaction and sequela was similar,is worth further study.

AIM: Constructing plasmid that expresses human plasminogen kringle 5 gene to analyze the gene expression in E.coli. METHODS: The gene of human plasminogen kringle 5 was inserted into plasmid PBV220 EcoRI site by gene manipulation techniques and was transformed to E.coli TGI. The gene expression was observed by SDS-PAGE. RESULTS: Expression vector PBVK5 was constructed, and human plasmingen kringle 5 gene product was obtained at 42℃ induction. CONCLUSLON: Expression product of human plasminogen kringle 5 gene was soluble form of proteins, and the expression amount was 9.8% in E.coli TGI total proteins.

Objective:To explore the correlation between hepatitis B virus (HBV) infection and deep infection after spinal internal fixation surgery and analysis of pathogenic bacteria.Methods:One hundred and eighty-four patients who underwent spinal internal fixation with HBV infection in Xiaogan First People′s Hospital of Hubei Province from January 2013 to January 2019 were selected as the HBV infection group, and 184 patients who underwent spinal internal fixation with non-HBV infection were selected as the non-HBV infection group. The incidence of deep infection and the distribution of pathogenic bacteria were compared between 2 groups. The influencing factors of postoperative deep infection and HBV reactivation in patients with HBV infection were analyzed by single factor analysis and multi-factor Logistics regression analysis.Results:The incidence of deep infection after spinal internal fixation surgery in HBV infection group was significantly higher than that in non-HBV infection group: 19.57% (36/184) vs. 9.24% (17/184), and there was statistical difference ( P<0.01). The pathogenic bacteria of deep infection in both groups were mainly acinetobacter bausinensis, klebsiella pneumoniae, staphylococcus aureus, staphylococcus epidermidis. There was no statistically significant difference in the distribution of pathogenic bacteria between 2 groups ( P>0.05). The deep infection incidences in age ≥ 65 years, operation time ≥ 3 h, intraoperative blood loss ≥ 1000 ml, CD 4+/CD 8+<1.4, total lymphocyte count<0.7 × 10 9/L, liver function abnormalities (AST>40 U/L or ALT>50 U/L), HBV-DNA (+) patients with HBV infection were significantly higher: 27.16%(22/81) vs. 13.59%(14/103), 28.77%(21/73) vs. 13.51%(15/111), 31.15%(19/61) vs. 13.82%(17/123), 29.69%(19/64) vs. 14.17%(17/120), 27.78% (20/72) vs. 14.29%(16/112), 7/18 vs. 17.47%(29/166), 30.43%(21/69) vs. 13.04%(15/115), and there were statistical differences ( P<0.05 or <0.01). Multivariate Logistic regression analysis showed that intraoperative blood loss (≥ 1 000 ml), CD 4+/CD 8+(<1.4), total lymphocyte count (<0.7 × 10 9/L), and HBV-DNA (+) were independent risk factors for deep infection after spinal internal fixation in patients with HBV infection ( P<0.01 or <0.05). The HBV reactivation incidence in age ≥ 65 years, operation time ≥ 3 h, intraoperative blood loss ≥ 1 000 ml, liver function abnormalities, HBV-DNA (+), postoperative deep infection patients with HBV infection were significantly increased: 33.33% (27/81) vs. 18.45% (19/103), 34.25% (25/73) vs. 18.92% (21/111), 34.43% (21/61) vs. 20.33% (25/123), 8/18 vs. 22.89% (38/166), 34.78% (24/69) vs. 19.13% (22/115), 41.67% (15/36) vs. 20.95% (31/148), and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that intraoperative blood loss (≥ 1 000 ml), HBV-DNA (+) and postoperative deep infection were independent risk factors for HBV reactivation after spinal internal fixation in patients with HBV infection ( P<0.05 or <0.01). Conclusions:HBV infection significantly increases the incidence of deep infection after spinal internal fixation surgery, and the independent risk factors are intraoperative blood loss (≥1 000 ml), CD 4+/CD 8+ (<1.4), total lymphocyte count (<0.7 × 10 9/L), and HBV-DNA (+). Spinal internal fixation surgery can cause HBV reactivation, and its independent risk factors are intraoperative blood loss (≥ 1 000 ml), HBV-DNA (+) and postoperative deep infection.

Objective To evaluate the treatment efficacy,toxicities and prognostic factors of nasopharyngeal carcinoma ( NPC ) treated with intensity modulated radiation oncology ( IMRT ).Methods Between January 2006 and August 2008,300 patients with pathologically diagnosed NPC from 6 center received IMRT.The number of patients with stage Ⅰ,Ⅱ,Ⅲ and Ⅳa+b disease (UICC/AJCC 2002 staging system) were 6,45,141 and 108,respectively.The prescription doses were as follows:70-74 Gy/30f toplanning target volume of primary nasopharynx tumor ( PTVRλ),68-70 Gy/30f to planning target volume of positive lymphnode (ptvnd),60-64 Gy/30f to higher risk region (PTV1),50-54 Gy/30f to lower risk region (PTV2).Patients with stage Ⅲ and Ⅳa+b disease also received cisplatin-based chemotherapy.Cox method was used for Multivariate analysis.ResultsThe follow-up rate was 99.7％.The 4-year rate of local control,regional control,metastasis-free survival (DMFS),disease-free survival (DFS) and overall survival (OS) was 94.0％,95.5％,87.4％,80.8％,86.1％,respectively.Mucositis was the most severe acute toxicity,with 18.0％grade 1,48.7％grade 2,33.3％grade 3.No patient suffered from grade 4mucositis.Xerostomia was the most common late toxicity,with 12.0％ grade 0,75.7％ grade 1,12.3％grade 2.No grade 3-4 xerostomia was observed.There were 18,15 and 42 patients failed in local,regional and distant metastasis,respectively.Multivariate analysis showed that N stage was the only prognostic factor for OS (x2 =5.17,P=0.023),DMFS (x2 =6.91,P=0.009) and DFS (x2 =8.15,P=0.004) in these patients.ConclusionsIMRT can improve the treatment efficacy of NPC.The acute and late toxicities were tolerated.Distant metastasis becomes the main treatment failure.N stage is a significant prognostic factors.

Objective To explore the expression pattern of Micall2a gene during the early development of zebrafish embryos and the effect of this gene on zebrafish vascular development.MethodsWhole embryo in situ hybridization was used to detect Micall2a expression levels at different stages of early embryo development of Tg (fli:GFP) transgenic (labeled with green fluorescent protein) and wild type zebrafish (AB). Micall2a gene expression was downregulated by microinjection of a morpholine antisense oligonucleotide, and real-time fluorescent quantitative PCR was used to detect mRNA expression of the gene at different developmental stages of zebrafish embryos. Laser confocal microscopy was used to observe and analyze vascular phenotypic changes in zebrafish after the downregulation of Micall2a. ResultsMicall2a was expressed in the brain, heart, and vascular system of zebrafish embryos at the 24th, 36th, and 48th hours post fertilization. The mRNA level of Micall2a increased after microinjection of morpholine antisense oligonucleotides, inhibiting vascular development in zebrafish embryos, resulting in internode angiogenesis defects in zebrafish. ConclusionDownregulation of Micall2a expression inhibits the development of blood vessels in zebrafish.

Objective: To investigate the factors associated with CD4⁺ /CD8⁺ T lymphocyte ratio normalization in acquired immunodeficiency syndrome (AIDS) patients after antiretroviral therapy (ART). Methods: The data of 1 188 human immunodeficiency virus (HIV)/AIDS patients from the national ART reporting system in Yuxi City, Yunnan Province between January 1, 2006 and December 31, 2016 were retrospectively collected and analyzed. The rate of CD4⁺ /CD8⁺ T lymphocyte ratio normalization after ART was calculated by lifetable. Cox proportional hazard models were used to analyze the factors associated with CD4⁺ /CD8⁺ T lymphocyte normalization in AIDS patients after ART. The Wilcoxon rank sum test was used for comparison between groups. Results: The follow-up time was 3.8 (1.0-10.8) years. CD4⁺ /CD8⁺ T lymphocyte ratio normalization was documented in 95 patients with the rate of 1.89 per 100 person-years (95% confidence interval(CI) 1.52-2.27) after ART. The average time from ART to CD4⁺ /CD8⁺ T lymphocyte ratio normalized was 9.4 years. The cumulative normalization rate was 0.02 for the first year, 0.06 for the third year, 0.11 for the fifth year, 0.19 for the seventh year and 0.37 for the ninth year. By Cox proportional hazard models, the probability of CD4⁺ /CD8⁺ T lymphocyte ratio normalization in patients infected HIV by heterosexual contacts was 3.709 (95%CI 1.781-7.726) times higher than those by intravenous injection. The probability of CD4⁺ /CD8⁺ T lymphocyte ratio normalization in patients with baseline CD4⁺ T lymphocytes of 350-499 and more than 500 cell/μL groups were 2.792 (95%CI 1.196-6.519) and 3.832 (95%CI 1.648-8.913) times higher than those with baseline CD4⁺ T lymphocytes less than 200 cell/μL, respectively. The probability of normalization after ART in patients with higher baseline CD4⁺ /CD8⁺ T lymphocyte ratio was higher than those with baseline CD4⁺ /CD8⁺ T lymphocyte ratio≤ 0.20 (hazard ratio>1, all P<0.01). Conclusion The CD4⁺ /CD8⁺ T lymphocyte ratio normalization in AIDS patients after ART is associated with baseline CD4⁺ T lymphocyte counts, baseline CD4⁺ /CD8⁺ T lymphocyte ratio and HIV transmission mode.