Abstract：Objective To establish a sensitive，rapid and convenient method for the detection of dengue antigen and assist clinical diagnosis of dengue. Methods In this paper，we developed a rapid detection method for dengue antigen based on microfluidic immune magnetic beads. Solidwork software was used to design microfluidic chip，which was prepared by mechanical processing and chemical sealing. Immunomagnetic beads of dengue antibody were prepared by chemical coupling reaction. Using HRP ⁃TMB ⁃H2O2 as color system，dengue NS1 antigen was detected on microfluidic chip carrier by double antibody sandwich method. Finally，57 clinical samples were tested by the novel method and traditional ELISA kit，and the accuracy of the method was analyzed，and the advantages and disadvantages of the two methods were compared. Results 20 minutes was needed to detect dengue NS1 antigen by using the novel ELISA method，and the reaction system only needed 10 μg beads and 10 μL samples. In the verification experiment，the method could distinguish the negative from the positive obviously. The positive sample had color rendering，while the negative and blank samples had no color rendering. In terms of detection performance，the coincidence rate between the new ELISA method and the traditional ELISA method reached 100%. Conclusion The novel ELISA detection platform had the advantages of simple，rapid，reagent and sample saving，high sensitivity，good stability and high accuracy，and could be used for the detection of dengue antigen.

Objective To explore the outcome, recurrence rate and postoperative MRI of the modified microendoscopy discectomy (MED) and the conventional MED. Method A total of 107 patients with disc herniation treated from January 2005 to December 2009 were randomly divided into Group A (54 patients) and Group B (53 patients). The patients in Group A were treated with the modified MED that removed the prominent nucleus pulposus but did not access into the annulus. The patients in Group B were treated with traditional MED that removed the prominent nucleus pulposus and cut annulus fibrosus and removed the nucleus pulposus within the annulus fibrosus. The operation outcome, recurrence rate and lumbar spine MRI were compared for observing the morphological changes of intervertebral disc and its surrounding structures. Results All patients were followed up for 1-4 years ( average 2 years),which showed no recurrence in Group A but four patients with recurrence Group B. According to Japanese orthopedic association (JOA) scoring of low back pain, the efficacy was excellent in 51 patients (94%)and good in three (6%), with excellence rate of 100% in Group A; while the efficacy was excellent in 42 patients (79%), good in seven (13%) and poor in four (8%), with excellence rate of 92% in Group B. Videman semi-quantitative assessment of disc signal showed no significant difference of MRI in aspects of signal intensity, thickness, diameter of the spinal canal in Group A before and after operation but highlighted significant differences in protruding degree,spinal canal diameter and lateral recess diameter. Substantial differences of MRI in aspects of signal intensity, thickness, protruding degree, spinal canal diameter and width were observed before and after operation in Group B. There was no significant difference in spinal canal diameter. Conclusions Both methods have sound clinical efficacy. However, the modified MED procedures take advantages of minimizing the damage of disc structure, maintaining the relative stability of the spine and delaying the disc degeneration, which contributes to lower recurrence rate.

Objective To investigate the characteristics of personal injuries in motorcycle accidents in Chongqing area to provide the reliable information and reference basis for reducing the injury and death risk of the motorcycle accidents.Methods Two hundreds and thirteen cases of motorcycle traffic accident occurred in Chongqing area from January 2015 to June 2016 were deeply collected,the collected contents included the basicinformation,driver information and personal injury,etc.Then accident data were statistically analyzed.Results The death rate of motorcycle drivers was higher than that of the pillion passengers.The death causes of craniocerebral injuries and craniocerebral injuries complicating thoracic and abdominal organ injuries accounted for 58.8％ and 20 ％ respectively,the proportions of head and neck,chest and back,lower extremity,upper extremity,abdominal and pelvic part and perineal part MAIS ≥2 were 71％,59％,33％,25％,20％ and 7％ respectively.The perineal injury rate of motorcycle drivers was higher than that of the pillion passengers.The ratio of occurrence rates between lower extremity fracture to upper extremity fracture was 1.8 ∶ 1,the persons in motorcycles-trucks accidents were easier to suffer from vehicle crushing.Conclusion Head and chest injuries are important causes leading to motorcycle drivers and pillion passengers' death and injury.The perineal injury can serve as an important basis for identifying the drivers and pillion passengers in partial motorcycle accidents.

Objective To estimate the efficacy and safety of Voriconazole as antifungal prophylaxis of invasive fungal infection ( IFI) for malignant hematology patients. Methods The randomized controlled trials of Voriconazole treatment in invasive fungal infection for malignant hematology patients (ended in September 2014) were searched from Cochrane library, Medline, Embase, Pubmed, CBM, CNKI, Blood database. The meta analysis were performed by RevMan5.0. Results Ten literatures reported in 1 773 cases, in which there was significantly difference in effective rate between Voriconazole and other antifungal agents such as Amphotericin-B, Itraconazole, Micafungin and Fluconazole(P < 0.000 01); Four literatures indicated that there was significantly difference in adverse event rate between Voriconazole and amphotericin-B (P < 0.00 001); no significantly difference in adverse event rate between Voriconazole and amphotericin-B(P = 0.57); no significantly difference in adverse event rate between Voriconazole and Micafungin (P = 0.69); no significantly difference in adverse event rate between Voriconazole and Fluconazole (P = 0.70); Subgroup analysis indicated that adverse event rate between Voriconazole and Itraconazole is P=0.001, P = 0.17 respectively. Conclusion Voriconazole showed relative high efficient and low toxicity characteristics in treatment of malignant hematology accompanied by invasive fungal infection. But with its widely clinical application, the clinical value of Voriconazole needs to be further tested.

Objective To study CT numbers correction of kilo?voltage cone?beam CT (KV?CBCT) images for dose calculation. Method Aligning the CBCT images with plan CT images, then obtain the background scatter by subtracting CT images from CBCT images. The background scatter is then processed by low?pass filter. The final CBCT images are acquired by subtracting the background scatter from the raw CBCT. KV?CBCT images of Catphan600 phantom and four patients with pelvic tumors were obtained with the linac?integrated CBCT system. The CBCT images were modified to correct the CT numbers. Finally, compare HU numbers between corrected CBCT and planning CT by paired T test. Evaluate the image quality and accuracy of dose calculation of the modified CBCT images. Results The proposed method reduces the artifacts of CBCT images significantly. The differences of CT numbers were 232 HU, 89 HU, 29 HU and 66 HU for air, fat, muscle and femoral head between CT and CBCT respectively (P= 0?? 39,0?? 66,0?? 59,1).The differences of CT numbers between CT and CBCT was reduced to within 5 HU. And the error of dose calculation with corrected CBCT images was within 2%. Conclusions The CT numbers of corrected CBCT are similar with plan CT images and dose calculations based on the modified CBCT show good agreement with plan CT.

Objective To evaluate the image quality and registration accuracy of a three?dimensional ( 3D ) dynamic phantom in four?dimensional computed tomography ( 4DCT ) and four?dimensional cone?beam computed tomography ( 4DCBCT) . Methods The Computerized Imaging Reference Systems Dynamic Thorax Phantom Model 008A was scanned to get 4DCT and 4DCBCT images. Two balls with different diameters ( ?= 1 cm and ?= 2 cm) were used to simulate tumors with different sizes. The motion mode of the balls was 3D sinusoidal motion at 0?25 Hz ( the amplitudes along the x, y, and z axes were ±1?0 cm, ±0?4 cm, and ±0?2 cm, respectively). Gross target volumes (GTVs) from 10?phase bins, internal gross target volumes (IGTV), and target volumes on maximum intensity projection (MIP) and mean intensity projection (MeanIP) images were contoured and calculated. Target volumes on 4DCT or 4DCBCT images were compared with the static and dynamic volumes of the balls ( VS and VD ) . The matching index ( MI) of target volumes between the 4DCT and 4DCBCT images was analyzed after rigid image registration. Results The GTV in each phase of the image was larger than VS . The difference between the average GTV derived from 10 phases of 4DCT or 4DCBCT images and Vs of the small ball was larger than that of the large ball ( 35?03% vs. 22?66%;32?62% vs. 17?00%) . All the IGTVs and target volumes on MIP images were slightly larger than VD , but target volumes on MeanIP images were smaller than VD . The average MI of 10?phase bins of the small ball was smaller than that of the large ball ( 66?76% vs. 82?21%) . Moreover, MIs of IGTV,MIP, and MeanIP of the small ball were also smaller than those of the large ball ( 77?39% vs. 90?29%;75?90% vs. 89?28%;74?47% vs. 82?74%) . Conclusions In the case of a relatively small tumor volume and a relatively large motion amplitude, 4DCT and 4DCBCT should be used with caution for comparison of image registration.

Objective To verify the daily delivery accuracy of volumetric-modulated arc therapy (VMAT) and achieve the process quality control (PQC) of linac using statistical process control (SPC)technology.Methods The log files of all treatments were taken out from the linac system.An in-house software which created by Matlab 7.14 was used to analyze the daily parameters accuracy and the mechanism and dose delivery accuracy of the linac for each VMAT,and an daily evaluation report was automatically created for the linac.The stability of the linac and the deviation of the delivery accuracy for various cancer sites were also analyzed.To achieve the process quality control of hnac using SPC technology,the control limit of each parameter was calculated by Johnson alternation and the single value control charts were drawn.Results 76 patients mainly with nasopharyngeal carcinoma,cervical carcinoma,rectal cancer and laryngeal cancer,got the treatment daily with VMAT technology,and a total of 2 446 arcs were delivered by the linac in continuous 16 days.The gantry angle error,y and x collimator position error,MLC leaf position error and dose delivery error were 0.49°,0.09 mm,0.38 mm,0.31 mm,0.05 MU,respectively.Compare to the nasopharynx,uteri,rectal and larynx cancer,it can be seen that the variation factors of dose delivery and gantry angle errors for various cancer sites were higher,which was 8.10％ and 4.54％,respectively.Through the process quality control of the linac,it was found that all the parameters were in control.While some abnormal points arose (the error was greater than UCL),and the ratio of the gantry angle which was out of control (0.45％) was the highest in all parameters.Conclusions linac delivery accuracy could be monitored and verified during the whole VMAT treatment for each patient,and the daily running condition of linac could be monitored.Through the introduction of SPC technology and the control charts,the process quality control of linac in VMAT could be achieved.It is a financial and valid method for the daily quality assurance of linac.

OBJECTIVETo evaluate the clinical effect of arthroscopic excision of the os subfibulare in anterior-lateral ankle pain.

METHODSFrom December 2005 to Augest 2014, 16 patients suffering from pain associated with an os subfibulare in the anterior-lateral side of their ankles were reviewed. Among the patients,11 patients were male and 5 were female, with a mean age of (33.5 ± 15.6) years old. The mean maximum diameter of os subfibulare was (0.70 ± 0.26) cm. All the patients underwent excision of the osseous fragments, and had anatomic reconstruction of the anterior talofibular ligament if the anterior-lateral ankle was instable. The average follow-up period was (18.0 ± 4.5) months. To analyze the surgical outcome, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot pain and function scales,visual analogue scale (VAS) and Tegner activity scale were assessed preoperatively and postoperatively.

RESULTSAOFAS scales were preoperative 60.15 ± 14.52 and postoperative 92.35 ± 5.73. There was a significant difference between them (t = -8.251, P = 0.000). The mean VAS score were preoperative 7.35 ± 0.46 and postoperative 2.45 ± 0.98. Statistical significance was also notable (t = 18.105, P = 0.000). Tegner score was significantly increased from preoperative 2.87 ± 1.12 to postoperative 5.78 ± 1.06 (t= -7.548, P = 0.000).

CONCLUSIONIrrespective of the size of os subfibulare, in patients with pain or instability associated with the os subfibulare, arthroscopic excision combined with reconstruction of ther anterior talofibular ligament or not was effective in restoring ankle function and eliminating pain.

Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Arthroscopy ; methods ; Female ; Fibula ; surgery ; Humans ; Lateral Ligament, Ankle ; surgery ; Male ; Middle Aged

Tumor immune microenvironment is an important microecology for tumor development, where tumor-associated macrophages are the most abundant immune cells in the tumor immune microenvironment, with high plasticity and heterogeneity. Under the regulation of various environmental factors, tumor-associated macrophages can differentiate into different subgroups. Though complex and variable, all these environmental factors ultimately regulate tumor-associated macrophages by influencing the temporal and spatial heterogeneity of these cells’ internal components, structure, and functions. Mitochondrion are important organelles, responsible for energy production, metabolism, and centers of multiple signal transduction. More and more studies have found that mitochondria can regulate cell functions through various mechanisms such as morphological change, metabolic reprogramming, intermediate metabolites or mitochondrial genetic material. Mitochondrial disorders are involved in many diseases and pathological processes. Here, we review the mechanisms by which mitochondria regulate the polarization of macrophages and thus reshape the tumor immune microenvironment. Further, we discuss and prospect the current status of macrophage mitochondria-related tumor immunotherapy.

OBJECTIVETo detect the gene promoter methylation, mRNA and protein expression levels of E-cadherin and beta-catenin in primary and metastatic tumor samples of nasopharyngeal carcinoma (NPC), and to investigate the mechanism of invasion and metastasis of neoplastic cell in NPC.

METHODSTwenty-one patients with NPC were studied. The samples of primary tumor and paired lymph node metastatic tumor were collected and examined for aberrant gene promoter methylation in E-cadherin by DNA Methylation-specific polymerase chain reaction (MSP). Reverse transcriptase polymerase chain reaction (RT-PCR), Western blotting and immunohistochemical staining were adopted to detect mRNA and protein levels of E-cadherin and beta-catenin.

RESULTS(1) The gene promoter methylation in E-cadherin was 52.4% (11/21) in primary tumor of NPC, and 80.9% (17/21) in lymph node metastatic tumor, which existed significant difference (P < 0.05). (2) In primary tumor, about 80% (0 approximately 100%) neoplastic cells expressed E-cadherin protein on the average, which was significantly higher than that of metastatic tumor (50% on the average, P = 0.004). The expression levels of beta-catenin protein were high in both primary and metastatic tumors, but with no statistic difference (P = 0.698). (3) By Western blotting analysis, the relative intensity of protein expression in E-cadherin was significantly higher in primary tumor (206.7 +/- 32.7) compared to that of metastatic tumor (65.0 +/- 15.9), while the expression of beta-catenin protein showed no difference between them (P = 0.754). (4) mRNA expression level of E-cadherin was higher in primary tumor than that of metastatic tumor.No remarkable difference was found for the mRNA expression of beta-catenin.

CONCLUSIONS(1) Downregulation of mRNA and protein expression of E-cadherin may play a critical role in neoplastic cell invasion and metastasis in NPC. The aberrant promoter methylation of E-cadherin may ultimately alter the mobility and scattering of tumor cells in NPC. (2) Downregulation of E-cadherin alone may be enough for the tumor cell to lose intercellular adhesions which results in tumor cell invasion and metastasis. However, mutant beta-catenin could also involve in this progress. (3) The detection of gene promoter hypermethylation of E-cadherin should be evaluated in the screening and surveillance of NPC.

Adult ; Aged ; Cadherins ; biosynthesis ; genetics ; Cytoskeletal Proteins ; biosynthesis ; genetics ; DNA Methylation ; Down-Regulation ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; genetics ; metabolism ; pathology ; Neoplasm Invasiveness ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Trans-Activators ; biosynthesis ; genetics ; beta Catenin