Objective To discuss the detail design of medical linear accelerator room to optimize the layout of radiation shield.Methods According to the optimization principle for medical exposure protection and national radiation protection related documents,the influence of detail design on room quality was analyzed.Optimization design was executed from theaspects of spatial layout,protection,shielding wall,decorating materials,labyrinth,control cabin,protective door,occupancy factor,purification ventilation,tennperature humidity control and etc.Results The design and layout of the roomwere optimized to eliminate hidden risksand reduce the design flaws to prevent adverse consequences due to design errors.Conclusion Detail design contributes to stable operation,enhanced quality and efficiency of medical linear accelerator room.

Objective To study the clinical efficiency and possible side effects of lower tidal volume combined with sustained inflation(SI) on acute respiratory distress syndrome (ARDS) for post operative carcinoma surgery patients.Methods Fifty one hypoxemia post operative carcinoma surgery patients from Jan.2007 to Dec.2009 in Cancer Hospital and Institute,Chinese Academy of Medical Sciences and Peking Union Medical College were included.Their cirrculation was stable.Mechanical ventilation could not be removed due to ARDS.Noninvasive continuous artery blood pressure ( NBP),pulse oximetric saturation ( SPO2 ),arterial blood gas ( ABG ) analysis,static compliance of respiratory system (Cst) were monitored and recorded.Patients were ventilated on volume control mode.Tidal volumes (VT) was set to 6 ml/kg.SI were conducted by continuous positive airway pressure of 35 cm H2O,sustaining for 40 seconds.Positive end-expiratory pressure (PEEP),FiO2,respiratory rate (F),Pplateau inspiratory pressures (Pplat),the peak inspiratory pressures (Ppeak),VT,Cst and ABG before SI applying and at 10 min,24 h,48 h after SI applying were measured.Results The level of PaO2 and FiO2 were significantly lowered,VT and Crs increased significantly,Ppeak,Pplat,and F were improved significantly at 10 min,24 h and 48 h after SI in all cases.No complication occurred.All patients were discharged without adverse event.Conclusions Hypoxemia of ARDS following carcinoma surgery could be improved by lower tidal volume combined with SI.

Objective To assess the value of selective renal arterial embolization in treating mononephrous renal angiomyolipoma. Methods 1 6 patients with mononephrous renal angiomyolipoma were retrospectively analyzed.To observe and analyze the changes in renal function,lesions reduction and its complications.Results Symptoms have been improved significantly after treatment,no se-rious complications were observed during operation and postoperation.The creatinine level in postoperation was lower than the pre-operative level,followed-up after 1year.Conclusion Selective renal artery embolization is a safe and effective method for the treat-ment of mononephrous renal angiomyolipoma.

Objective To evaluate the method and outcome of surgical treatment for refractory slow-transit constipation (STC). Methods Clinicopathologic data of 24 patients with severe STC which underwent (colectomy) in recent years were retrospectively analyzed. Results 18 of the patients underwent pancolectomy,and 6 underwent subtotal colectomy. All of the 14 STC patients complicated with outlet obstructive (constipation)(OOC) were corrected preoperatively by related surgery. The curative rate of surgical (treatment) was 95.8%,with an average of(3?1.9) times of bowel motion per day. The incidence of (abdominal) distention decreased from 75% to 12.5%. One patient who underwent ileorectal anastomosis (developed) recurrent constipation. Conclusions Colectomy produces satisfactory results in the majority of (patients) with refractory slow-transit constipation.Patients complicated with OOC should undergo energetic (preoperative) correction therapy,in order to ensure a satisfactory surgical outcome.

Objective To explore the value of lymphatic mapping (LM) and sentinel lymph node(SLN) analysis in laparoscopic colectomy for colon carcinoma. Methods Thirty-two patients with clinically localized colonic neoplasms were subjected to submucosal injection of isosulfan blue dye (0.5-1.0 mL) via a colonoscope during operation. Blue-stained lymphatics were visualized through the laparoscope and followed to the SLN,which was tagged. The colectomy was completed in standard fashion. All lymph nodes were stained by hematoxylin and eosin,and multiple sections of each SLN were examined by immunohistochemical (IHC) staining using cytokeratin antibody. Results At least one SLN was identified laparoscopically in all patients. The SLN accurately predicted the tumor status of the nodal basin in 94% of cases. In 8 cases (25%),an unexpected lymphatic drainage pattern altered the extent of mesenteric resection. The SLN was negative by HE staining in 4 (13%) cases,which were demonstrated positive for micrometastases through immunohistochemical staining. Conclusions SLN mapping during laparoscopic colon resection can alter the margins of resection and in combination with immunohistochemical staining may improve staging,which may more accurately assign patients to prospective protocols.

Objective:To investigate the effect of miR-150 gene deletion on the breeding and hematologic parameters of mice. Methods:The nest litter size,wean rate and weight changes of miR-150 knock out (miR-150ko) and C57BL/6J mice were com-pared. The hematology indexes were analyzed by automated blood cell counter, the serum biochemical parameters were analyzed by automatic biochemical analyzer. Results:The nest litter size and wean rate of miR-150ko mice were significantly decreased compared with that of C57BL/6J mice. The number of total white blood cells,intermediate cells,neutrophils,and the percentage of neutrophils and intermediate cells were significantly increased in miR-150ko mice compared with that of C57BL/6J mice. However,the number and per-centage of platelets and lymphocytes decreased significantly in miR-150ko mice. In addition,the levels of serum glucose and TC were in-creased significantly in miR-150ko mice compared with that of C57BL/6J mice. Conclusion: miR-150 gene deletion impairs the breeding and has complex impact on hematologic parameters of mice.

Objective:To explore the microRNA profile changes in the development of NKT cells.Methods: Differently developmental stage of NKT cells in mouse thymus were sorted by flow cytometry.Total RNA were extracted,reversely transcribed and pre-amplified.TaqMan low density microRNA assay and single real-time PCR were applied to detect the expression changes of microRNAs in the developmental process of NKT cells.Results: There were total 92 microRNAs whose expression changed significantly during the development and maturation of NKT cells.Among them,increasly expressed microRNAs were 71,including 36 microRNAs whose expression continuously increased;decreasly expressed microRNAs were 21,including 12 microRNAs whose expression continuously decreased.In addition,single real-time PCR analysis showed that the expression of Let-7f,miR-150,miR-24,miR-29 increased,while the expression of miR-223 and miR-155 decreased during the development and maturation of NKT cells.Conclusion: NKT development and maturation is accompanied by expression changes of large amount of microRNAs,indicating that specific microRNA regulates NKT development and function.

AIM: To observe the degree of gastric mucosal injury following limb ischemia/reperfusion(LIR),and to investigate the mechanism of gastric mucosal injury and the influence of the series of brief ischemia/reperfusion of hind limbs of rats on gastric mucosal injury. METHODS: Referring to Rosenthal's method, the model rats which underwent 4 hours of ischemia and 4 hours of reperfusion in hind limbs were made. The indexes of gastric mucosal injury after LIR and ischemic preconditioning (IPC) + LIR were determined. The morphologic changes were observed with light microscope and transmission electron microscop respectively. The GMBF,histologic lesion score, gastric barrier mucus, phospholipids, hexosamine, nitric oxide and nitric oxide synthase in mucus were measured in different groups. RESULTS: Serious damage in gastric mucosa was observed under microscope and EM after LIR. But less serious damage was observed in the IPC group. After LIR, compared to the control group, the GMBF and the content of gastric barrier mucus, phospholipids and hexosamine in mucus decreased significantly. There was significant difference in most indexes between the control group and the IPC group, but compared to LIR group, the histologic lesion score decreased significantly and the GMBF and the content of gastric barrier mucus, phospholipids, hexosamine ,nitric oxide and nitric oxide synthase in mucus increased significantly. CONCLUSION: LIR caused the gastric mucosa injury. IPC alleviated the damage of gastric mucosa following ischemia/reperfusion in hind limbs.

BACKGROUND: Limb ischemia reperfusion (LIR) as a stressor leads to gastric mucosal injury, and then results in the occurrence of stress ulcer.OBJECTIVE: To observe the effects of LIR on gastric mucosal injury, investigate part of the mechanism, and the role of several transient limb ischemia in the occurrence of gastric mucosal injury.DESIGN: A randomized grouping design and controlled animal experiment.SETTING: Department of Pathophysiology of North China Coal Medical College.MATERIALS: The experiment was carried out in the pathophysiological laboratory of North China Coal Medical College from January to June 2002. Fifty-four healthy adult male Wistar rats were randomly divided into three groups with 18 rats in each group. Ischemia reperfusion (I/R) group: The rats were duplicated into models according to the Rosenthal method that under superficial anesthesia with ether, the roots of both hindlimbs were ligated by wrapping with rubber strap, blood flow was blocked for 4 hours and then recovered to perfusion for 4 hours, and finally killed by bleeding from abdominal aorta. Ischemic preconditioning group: Before model establishment, blood flow of both hindlimbs was blocked for 5 minutes, and then recovered to perfusion for 5 minutes, which was repeated for four times, and the following operations were the same as those in the I/R group. Control group: The operations were the same as those in the I/R group,but both hindlimbs were ligated at relaxation without blocking the blood flow.METHODS: Sections of gastric mucosa were prepared, and then observed under light microscope and electron microscope, and the index of gastric mucosal injury was determined according to the Guth standard. The colorimetric assay was performed with 721 spectrophotometer at 650 nm, and the amount of gastric combining mucus was calculated.Meanwhile, the blood flow of gastric mucosa, contents of phospholipid and hexosamine in gastric mucus, content of nitric oxide in plasma and gastric tissue and activity of nitric oxide synthase (NOS) in gastric mucosa were determined.MAIN OUTCOME MEASURES: Index of gastric mucosal injury, amount of gastric combining mucus, blood flow of gastric mucosa, contents of phospholipid and hexosamine in gastric mucus, contents of nitric oxide in plasma and gastric tissue and NOS activity in gastric mucosa.RESULTS: All the 54 rats were involved in the analysis of results. ① In the I/R group, gastric mucosal injury was serious, edema, hyperemia, erosion and disintegration of gland of mucosal glands were observed, infiltration of inflammatory cells (formation of ulcer) was observed in basal and inferior mucosa. In the ischemic preconditioning group, the gastric mucosa was complete, and the damaged severity was milder than that in the I/R group; Under electron microscope, the organell structures of gastric parietal and chief cells were incomplete and destroyed. The cell injuries in the ischemic preconditioning group were milder than those in the I/R group (index of injury: 18.00±10.71, 34.00±15.01, P＜ 0.01). ② The blood flow and combining mucosal amount of gastric mucosa, contents of phospholipid and hexosamine in gastric mucus in the ischemic preconditioning group and I/R group were all obviously lower than those in the control group [(2.12±0.56), (10.84±2.56), (25.52±2.97) mL/(kg·h); (2.01±0.91), (2.79±0.73), (3.99±0.87) mg;(7.68±1.95), (9.74±1.04), (11.98±1.98) mg/g; (3.83±1.18), (5.42±0.47), (5.76±1.21) mg/g, P ＜ 0.05, 0.01], those the above indexes were all higher in the ischemic preconditioning group than in the I/R group. ③ The contents of nitric oxide in plasma and gastric tissue and NOS activity in gastric mucosa in the ischemic preconditioning group and I/R group were significantly lower than those in the control group [(250.0±5.6), (270.0±11.3), (210.0±7.4) μmol/L; (9.34±0.67), (11.34±1.00), (7.50±0.67) μ kat/g, P ＜ 0.01], those were also signficantly higher in the ischemic preconditioning group than in the I/R group.CONCLUSION: As a stressor, LIR can lead to gastric mucosal injury, and cause stress ulcer.Ischemic preconditioning can alleviate the gastric mucosal injury following LIR

Objective To investigate the clinical efficacy of transthoracic echocardiography (TTE) in catheter interventional treatment of congenital heart disease. Methods 57 patients with congenital heart disease were selected by preoperative TTE screening and then received Amplatzer occluder interventional treatment under X-ray monitoring. 23 of them were atrial septal defect (ASD), 29 were ventricular septal defect (VSD), 4 were patent ductus arteriosus (PDA), and one was VSD complicated with ASD. Results All the patients were treated successfully. The occlusion effect was observed by follow-up immediately after the procedure, and one week, one month, three months, six months, and one year after the procedure. The position of the occluder did not change, the surrounding of the occluder has no residual shunt. 3 cases of ASD and 2 of VSD were failed to plugged. Conclusions TTE has important clinical values in selection of the patients with indication , intraoperative detection of the release of Amplatzer, and postoperatve assessment of the efficacy.