Objective To evaluate the impact of different factors on long-term results in cervical carcinoma patients initially treated by surgery followed by radiotherapy. Methods In 1998, 525 cervical carcinoma patients were admitted, among whom 346 patients were first treated by surgery. 302 of these 525 patients were given postoperative radiotherapy. The stage distribution of these 302 patients were: stage I 142;stage Ⅱa 121;stage Ⅱb 23;and stage Ⅲa 16. ~ 60 Co ? or 6MV X-ray was used for radiotherapy. Perpendicular portals were alternately irradiated to 44-50Gy/4-5 week. Extending the portal, increasing the dose after constricting portal, adding intracavitary afterloading irradiation and adjuvant chemotherapy were carried out according to the different clinical requirements. Results The 5-year survival rate was 89.4%,77.7%,56.5% and 56.3% in stage I, Ⅱa, Ⅱb and Ⅲa lesion, respectively(?~2=22.22,P

It is recommended that cyclophosphamide combined with corticosteroids should be used as the first-line treatment of ANCA ( antineutrophil cytoplasmic antibody) associated with systemic vasculitis ( AASV) , however, cyclophosphamide has notable ad-verse reaction of causing pulmonary fibrosis ( PF) . In this paper, whether cyclophosphamide should be used in an AASF patient with PF was analyzed in order to decide whether AASV with PF is one of contraindications of cyclophosphamide in clinical practice.

Objective To compare the differences of target-volume(PTV) coverage and organ at risk (OAR) protection between three dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy(IMRT) for patients with pelvis metastasis of cervical cancer underwent radical hysterectomy and pelvic lymphadenectomy. To explore the optimal treatment methods for pelvis metastasis of cervical cancer.Methods 10 patients with pelvis metastasis of cervical cancer underwent radical hysterectomy and pelvic lymphadenectomy were selected for this study. The images scanned by CT were transferred to treatment planning system to generate 3DCRT and IMRT plans. The impacts of 3DCRT on PTV were compared with those of IMRT. Isodose line and dose volume histograms(DVH) were used to evaluate to the dose-distribution in PTV and OAR. Results For 95 % confidence interval, the margin from CTV to PTV was 1 cm. Conformal indexs (CIs) of PTV for 3, 4, 5 and 6 fields 3DCRT were 0.46, 0.67, 0.68 and 0.68, respectively. When beyond 4 fields, the advantage of adding fields was not significant. CIs of PTV for 5, 7, 9, 11 and 13 fields IMRT were 0.75, 0.83 0.84, 0.85 and 0.85, respectively. When beyond 9 fields, the advantage of adding fields was not significant. The maximum dose of the bowl and spine cord in IMRT plans were lower than that in the 3DCRT plans (P <0.05). Maximum dose of OAR had no significant differences (includingt the bone, recttum and bladder) between IMRT and 3DCRT plans. Conclusion For patients with pelvis metastasis of cervical cancer after radical surgery, 4 fields planning in 3DCRT and 9 fields planning in IMRT are feasible. At high dose levels, the IMRT plans can more significantly protect the bowl and spine cord and decrease the radiation volume of colorectal and urinary bladder at risk than 3DCRT, so IMRT may potentially diminish probability of the normal tissue complications.

Objective To investigate the feasibility and potential advantages of RapidArc applied to the radiotherapy of the postoperative rectal cancer.Methods 8 postoperative patients with rectal cancer were selected to be treated with a dose of 50Gy in fraction of 2Gy every time and 5 times a week.IMRT and RapidArc were used respectively to compare different target conformities,homogeneity index,dose-volume histogram data,treatment times and monitor units.Results The conformal index by RapidArc was 0.89±0.02 which was better than those by 5F-IMRT,0.87±0.02 (t =3.286,P ＜ 0.05),while the homogeneity index of target volume (1.060±0.005) and average dose [(52.55±0.76) Gy] by RapidArc were a little less than the homogeneity index of target volume (1.064±0.007) and average dose [(52.90±0.82) Gy] by 5F-IMRT (t =-1.459,-1.000,P ＞ 0.05).The exposure dose and mean dose of bladder and small bowel in high dose region by RapidArc were lower than those by 5F-IMRT,as well as bone marrow.The differences were statistical significant (P ＜ 0.05).The monitor units by RapidArc and by 5F-IMRT were (631±68) MU and (1046±146) MU,respectively (t =-5.830,P ＜ 0.05),while the mean treatment times were (78±5) s and (348±29) s,respectively (t =-26.358,P ＜ 0.05).Conclusion Compared with 5F-IMRT,RapidArc improves the target conformities and lowers the exposure dose for the organs at risk in high dose region while using fewer monitor units and less treatment time,which helps comforting patients and improving the efficiency.

Objective To compare the clinical effects between the two-level ladder ultrafiltration and sequential dialysis for hemodialysis patients with excessive water retention.Methods According to our hospital standard,23 patients with water retention during treatment with dialysis from January 2010 to September 2011 were selected.And they conducted a total of 198 dialysis.Both the two-level of high-level segment and sequential ultrafiltration step dialysis were set for 1 hour.Ultrafiltration accounted for one-third of the total,and the remaining two-thirds of the amount of ultrafiltration was completed in the remaining time.The blood pressure,ultrafiltration volume completed,plasma osmotic pressure,detection of vascular access pressure,and other observed indicators during dialysis were compared.Results The occurrence of hypotension and muscle spasms in two-level ladder ultrafiltration was slightly more than that in sequential dialysis,ultrafiltration volume completed actually in two-level ladder ultrafiltration was a little less than sequential dialysis.However,the difference was not statistically significant ( P ＞ 0.05 ).It took more time during sequential dialysis simple ultrafiltration,occasionally dialysis fluid stopped flowing and dialyzer and the trail tube lack of incubation,and some patients could not adapt to it.Amount of heparin( [7.48 ± 1.73 ] mg/h vs[6.25 ± 1.36] mg/h,t =5.374,P ＜ 0.01 ),venous pressure ( [ 128.62 ± 10.53 ] mm Hg vs [ 96.35 ± 11.84 ] mm Hg,t =20.166,P ＜ 0.01 ),trausmembrane pressure( [ 236.84 ± 23.65 ] mm Hg vs [ 175.94 ± 24.72] mm Hg,t =17.516,P ＜ 0.01 ) were significantly higher than those in the high level of ultrafiltration period.Mean arterial pressure ( MAP ) ( [ 100.48 ± 5.78 ] mm Hg vs [ 102.54 ± 5.39 ] mm Hg,t =2.571,P ＜ 0.05 ) and plasma osmotic pressure ( [ 311.42 ± 7.36] mOsm/( kg · H2O ) vs [ 3 1 7.31 ± 6.89 ] mOsm/( kg · H2O ),t =5.774,P ＜ 0.01 ) in high level period were significantly lower than those in the singal ultrafiltration period,and the MAP difference was higher than that in the singal ultrafiltration period ( [ 11.46 ± 6.53 ] mm Hg vs [ 9.42 ± 5.46 ] mm Hg,t =2.385,P ＜ 0.05 ).There is less symptomatic hypotension and other adverse reactions.Conclusion Two dialysis ultrafiltration method can both be used for patients with excessive water retention,they can reduce the ultrafiltraion complications and achieve ultrafiltration targets.Two-level ladder ultrafiltration with dialysis and ultra.filtration unity is more likely to be adopted by the clinic.

The expensive production of bioethanol is because it has not yet reached the 'THREE-HIGH' (High-titer, high-conversion and high-productivity) technical levels of starchy ethanol production. To cope with it, it is necessary to implement a high-gravity mash bioethanol production (HMBP), in which sugar hydrolysates are thick and fermentation-inhibitive compounds are negligible. In this work, HMBP from an atmospheric glycerol autocatalytic organosolv pretreated wheat straw was carried out with different fermentation strategies. Under an optimized condition (15% substrate concentration, 10 g/L (NH4)2SO4, 30 FPU/g dry matter, 10% (V/V) inoculum ratio), HMBP was at 31.2 g/L with a shaking simultaneous saccharification and fermentation (SSF) at 37 degrees C for 72 h, and achieved with a conversion of 73% and a productivity of 0.43 g/(L x h). Further by a semi-SFF with pre-hydrolysis time of 24 h, HMBP reached 33.7 g/L, the conversion and productivity of which was 79% and 0.47 g/(L x h), respectively. During the SSF and semi-SSF, more than 90% of the cellulose in both substrates were hydrolyzed into fermentable sugars. Finally, a fed-batch semi-SFF was developed with an initial substrate concentration of 15%, in which dried substrate (= the weight of the initial substrate) was divided into three portions and added into the conical flask once each 8 h during the first 24 h. HMBP achieved at 51.2 g/L for 72 h with a high productivity of 0.71 g/(L x h) while a low cellulose conversion of 62%. Interestingly, the fermentation inhibitive compound was mainly acetic acid, less than 3.0 g/L, and there were no other inhibitors detected, commonly furfural and hydroxymethyl furfural existing in the slurry. The data indicate that the lignocellulosic substrate subjected to the atmospheric glycerol autocatalytic organosolv pretreatment is very applicable for HMBP. The fed-batch semi-SFF is effective and desirable to realize an HMBP.
Biofuels ; Carbohydrates ; chemistry ; Cellulose ; chemistry ; Ethanol ; metabolism ; Fermentation ; Furaldehyde ; chemistry ; Glycerol ; chemistry ; Hydrolysis ; Triticum

Objective To investigate the value of coronary computed tomography angiography(CCTA)for the non-invasive discrimination of chronic total occlusion(CTO)and subtotal occlu-sion(SO).Methods A total of 134 elderly patients undergoing CCTA and invasive coronary angio-graphy in our hospital from January 2019 to December 2021 were enrolled,and assigned into CTO group(62 cases)and SO(72 cases)according to the results of the examinations.Occlusion length,shape of proximal stump(blunt/conical),and collateral vessels were measured as anatomical find-ings.Transluminal attenuation gradient was obtained by a post-processing software.Univariate and multivariate logistic regression analyses were performed to explore factors related to CTO.Re-stricted cubic splines with three knots at the 10th,50th,and 90th percentiles were used to flexibly model the association of the factors with CTO,and ROC curve was plotted to evaluate the per-formance.Results Diabetes(OR=0.423,95％CI:0.186-0.963),occlusion length(OR=1.088,95％CI:1.031-1.148)and blunt-shaped stump(OR=2.453,95％CI:1.042-5.773)were inde-pendent predictors for discriminating CTO and SO(P＜0.05,P＜0.01).ROC curve analysis showed that the AUC value of occlusion length in the discrimination was 0.718(95％CI:0.634-0.792,P=0.001).Conclusion CCTA can be used to discriminate CTO and SO in elderly patients.

Objective To compare the efficacy and toxicity of paclitaxel and carboplatin regimen concurrent chemoradiotherapy and radiotherapy alone in the treatment of stage Ⅲ cervical cancer.Methods A retrospective analysis of 158 patients with stage Ⅲ cervical cancer who were admitted to Shanxi Provincial Cancer Hospital from May 2009 to October 2012 was conducted.According to different treatment methods,86 patients were in the concurrent chemoradiotherapy group and 72 patients were in the radiotherapy group.The efficacy and adverse reactions of the two groups were compared.Results The effective rate (complete remission + partial remission) in the concurrent radiotherapy group and radiotherapy group was 95.3％ (82/86) and 84.7 ％ (61/72),respectively,and the difference was statistically significant (x2 =5.15,P =0.023).The 1-,2-,3-,and 5-year survival rates of the concurrent radiotherapy group and radiotherapy group were 93.0 ％ (80/86),77.9 ％ (67/86),68.6 ％ (59/86),60.5 ％ (52/86),and 81.9 ％ (59/72),61.1％ (44/72),41.7 ％ (30/72),36.1％ (26/72),respectively,and the differences were statistically significant (x2 values were 4.55,5.29,11.56,9.30,all P ＜ 0.05).The short-term adverse reactions in the concurrent chemoradiotherapy group and radiotherapy group were mainly myelosuppression and gastrointestinal reactions,and the incidence of myelosuppression was 87.2 ％ (75/86) and 50.0 ％ (36/72),respectively,and the difference was statistically significant (x2 =25.96,P ＜ 0.01);the incidence of gastrointestinal reactions was 91.9 ％ (79/86) and 20.8 ％ (15/72),respectively,and the difference was statistically significant (x2 =82.04,P ＜ 0.01).The incidence of radiation proctitis in the concurrent radiotherapy and chemotherapy group was 17.4 ％ (15/86) and 16.7 ％ (12/72),respectively,and the difference was not statistically significant (x2 =0.017,P =0.89);the incidence of radiation cystitis was 7.0 ％ (6/86) and 5.6 ％ (4/72),respectively,and the difference was not statistically significant (x2 =0.134,P =0.71).Conclusion Paclitaxel and carboplatin regimen chemotherapy combined with radiotherapy can improve the survival rate of patients with stage Ⅲ cervical cancer,and the adverse reactions are tolerable.

OBJECTIVETo investigate the prevalence and distribution characteristics of dyslipidemia among Shandong residents aged 18-69 years.

METHODSThe levels of triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and total cholesterol (TC) were determined in fasting serum of 5 ml venous blood for subjects aged 18-69 years who were selected by multi-stage stratified cluster random sampling from 20 counties in July, 2011 in 140 counties of Shandong province. The prevalence of dyslipidemia, hypercholesterolemia, high blood LDL-C, low blood HDL-C and hypertriglyceridemia were analyzed by the complex weighting. The prevalence of dyslipidemia, hypercholesterolemia, high blood LDL-C, low blood HDL-C and hypertriglyceridemia were compared for different characteristics by Rao-Scott χ(2).

RESULTSThe prevalence of dyslipidemia among 15 350 subjects was 22.70% (3 572), with higher in males (26.91% (2 110/7 683)) than in females (18.41% (1 462/7 667)). The prevalence of hypercholesterolemia was 3.39% (n=582), with higher in Eastern Shandong (4.59% (185/3 704)). The prevalence of high blood LDL-C was 0.56% (n=94), with higher in Eastern Shandong (0.79% (32/3 074)). The prevalence of low blood HDL-C was 11.41% (n=1 789). The prevalence of hypertriglyceridemia was 13.02% (n=2 059), higher in urban residents (16.54% (814/4 804)) than in rural (11.52% (1 245/10 546)) (χ(2)=71.54, P<0.001). The difference between the prevalence of low blood HDL-C and hypertriglyceridemia was not significant among Eastern Shandong, Central-South and Northwest.

CONCLUSIONDyslipidemia rate was higher among adult residents in Shandong province. The rate was higher for men than for women. The prevalence of hypercholesterolemia and high blood LDL-C were higher in Eastern Shandong than the other areas. The hypertriglyceridemia and low blood HDL-C were two major types of dyslipidemia.

Adolescent ; Adult ; Aged ; Body Weight ; China ; epidemiology ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Dyslipidemias ; epidemiology ; Female ; Humans ; Hypercholesterolemia ; epidemiology ; Hypertriglyceridemia ; epidemiology ; Male ; Middle Aged ; Prevalence ; Rural Population ; Triglycerides ; blood ; Urban Population ; Young Adult

Objective: To explore the clinical symptoms of effective blood volume deficiency caused by ultrafiltration in hemodialysis patients with chronic renal failure, and to analyze the changes of blood pressure during the formation of symptoms. Methods: From October 2016 to February 2019, 146 patients with maintenance hemodialysis were selected from the Yangquan coalmine group General Hospital for 39 658 hemodialysis.There were 3527 cases of clinical symptoms of definable hypovolemia.The characteristics of clinical symptoms in the early stage of dialysis (>0-≤60 min), medium (>60-≤180 min) and late (>180-≤240 min) were analyzed.To define the hypotension, hypertension and maintenance blood pressure in dialysis, and to count the incidence of various blood pressure when clinical symptoms appear.The mean arterial pressure (mean arterial pressure, MAP) measured at the onset of the disease was compared with (MAP) at the onset of dialysis, and the evolution of (MAP) was classified.The dialysis interval weight gain≥5% or<5%, was counted for the onset of the condition caused by dialysis ultrafiltration.To analyze the clinical symptoms of hemodialysis caused by ultrafiltration speed and excess. Results: The incidence of clinical symptoms was 8.9% (3527/39658). The clinical symptoms caused by the insufficiency of effective blood volume are manifested in each period of dialysis, and have the characteristics of disease.Blood pressure index can not accurately reflect the correlation of clinical symptoms.There were 493 cases of effective blood volume deficiency during dialysis >0-≤60 min.Among them, 341 cases of hypotension, accounting for 69.1% (341/493), 79 cases of hypertension, accounting for 16.1% (79/493), 73 cases of maintaining blood pressure, accounting for 14.8% (73/493). The incidence of clinical symptoms was increased when dialysis was >60-≤180 min, which was related to continuous or excessive ultrafiltration.There were 1306 cases in total, including 1003 cases of hypotension, accounting for 76.8% (1003/1306); 179 cases of hypertension, accounting for 13.7% (179/1306); 124 times of maintaining blood pressure, accounting for 9.5% (124/1306). Dialysis>180-≤240 min is the high incidence period of clinical symptoms, which is related to continuous ultrafiltration and exceeding the setting of dry body mass.There are 1728 cases in total, including 1408 cases of hypotension, accounting for 81.5% (1408/1728); hypertension is reduced, but there are still cases of stubborn hypertension.When the clinical symptoms of hypovolemia occurred, 1989 cases were hypotension, which was easy to attract clinical attention; 763 cases were hypotension, which was stable before the clinical symptoms appeared, and then the blood pressure dropped suddenly; 446 cases were significantly higher than before the clinical symptoms appeared, which made it difficult to judge the clinical symptoms; 329 cases maintained the blood before the dialysis pressure.Excessive water retention in the whole process of dialysis has clinical symptoms, the total number of times increased significantly.The incidence of common water retention was less than that of dialysis>180-≤240 min.The osmotic pressure of plasma colloid and crystal affects the refilling of plasma, the change of ultrafiltration mode and the change of dialysis temperature on blood pressure and blood volume. Conclusion Because of the characteristics of the disease and the particularity of the treatment, the hemodialysis ultrafiltration process is prone to the related clinical symptoms caused by insufficient effective blood volume.However, the occurrence of clinical symptoms is not synchronous with the change of blood pressure.To improve the understanding of clinical symptoms of insufficient blood volume, to achieve early detection and early treatment is conducive to the safe treatment of follow-up hemodialysis and better completion of ultrafiltration target value.