OBJECTIVE To investigate and analyze the kinetics of serological marks and virus load of the follow-up blood donors. METHODS The quantitation of HBV DNA of 6 HBsAg negative and DNA positive blood donors was detected by Roche PCR Monitor,and the donors were genotyped and traced by serological tests. RESULTS(Three of 6 follow-up) donor samples were seroconverted after more than 40 days follow-up study.The viral loads were with range of(35-1.8)?10~4 copies/ml,1 of 6 donors had acute infection,the peak load was(1.8?10~4 copies/ml),3 of 6 were with lower level HBV carrier with fluctuating viral load ranged 100-500 copies/ml.One donor had decreasing viral load,when HBsAg converted to positive,virus wasn′t detected.The last one had fluctuating virus load below(100 copies/ml),intermittently falling below the threshold of the assay. CONCLUSIONS It is necessary to implement HBV DNA detection for blood screening,and further strengthen the safety of blood transfusion.

0.05).However,during the thawing process of the APCs,four out of ten and three out of eleven APCs samples appeared aggregative reaction after cryo-preservance for 4 and 5 years,respectively.The majority of the samples extensively lost their factor Ⅲ activities in the fifth year storage.When fresh,liquid platelets were stored at room temperature(22 ℃),the in vitro adhesion and agglutination gradually decreased and statistic differences were observed in 72 h(P

Objective To explore the efficacy of endoscopic sphincterotomy with small incision combined with balloon dilatation (sEST+EPBD)in the treatment of patients with choledocholithiasis and juxtapapillary duodenal diverticula (JPDD).Methods From January 2011 to January 2015 ,149 patients with choledocholithiasis and JPDD who underwent endoscopic retrograde cholangio-pancreatography (ERCP)were enrolled.Among them,60 patients were in sEST+EPBD group and 89 were in endoscopic sphincterotomy (EST)group.Success rate of ERCP and first-time stone removal,changes of total bilirubin (TBil)and direct bilirubin (DBil)levels,as well as the incidence of postoperative complications between the two groups were compared.Chi-square test or t-test was performed for statistical analysis. Results The ERCP success rate sEST+EPBD group was 100.0% (60/60),and the first-time success rate of stone removal was 91 .7%(55/60);correspondingly,ERCP success rate of EST group was 98.9%(88/89),and the success rate of first-time stone removal was 77.5 %(69/89).There was no statistically significant difference in success rate of ERCP between the two groups (χ2 =0.19,P =0.410).The first-time success rate of stone removal of sEST +EPBD group was higher than that of EST group,and the difference was statistically significant (χ2 =5 .53,P =0.020).After operation,the TBil level of sEST+
EPBD group was (152.62 ±109.04 )μmol/L,which was lower than that before operation ((266.02 ± 143.31)μmol/L),and the difference was statistically significant (t =4.88,P <0.01 ).After operation, the DBil level of sEST +EPBD group was (87.13 ±65 .90)μmol/L,which was lower than that before operation ((175 .70 ± 100.53 )μmol/L),and the difference was statistically significant (t = 5 .71 ,P <0.01).After operation,the TBil level of EST group was (251 .90 ±247.90)μmol/L,which was lower than that before operation ((340.20 ±176.20 )μmol/L),and the difference was statistically significant (t=2.74,P <0.05).After operation,the DBil level of EST group was (168.10±140.60)μmol/L,which was lower than that before operation ((228.40 ±139.60 )μmol/L),and the difference was statistically significant (t = 2.87,P = 0.005).The complication rate of sEST + EPBD group after operation was 8.3%(5/60),which was lower than that of EST group (20.2%,18/89 ),and the difference was statistically significant (χ2 =3.88,P =0.049 ).Conclusion sEST+EPBD could increase the first-time success rate of stone removal in patients with choledocholithiasis and JPDD,and it is a safe and effective treatment.

Objective To compare two different dumping cooking methods (boiling vs.frying) in their effect on postprandial glucose level in diabetic patients using continuous glucose monitoring (CGM).Methods 10 type 2 diabetes mellitus (T2DM) in-patients in the Department of Endocrinology of Peking Union Medical College Hospital between February and May 2011 were enrolled,whose fasting and preprandial glucose levels were controlled with a insulin pump.On day 2 and day 4 in the study period,the patients were given fried dumplings and boiled dumplings for lunch respectively,with the same nutrient contents.The starch digestibility of these two kinds of dumplings were compared using in vitro resistant starch digestion,measuring the concentrations of rapidly digestible starch,slowly digestible starch,and resistant starch.CGM was used to record blood glucose changes,in order to evaluate glycemic effect of these two dumpling cooking methods on postprandial glucose levels at 9 time points (0,15,30,60,90,120,150,180,and 240 minutes),peak blood glucose,and area under the curve (AUC) in 4 time periods (0-60,63-120,123-180,and 183-240 minutes).Results The percentage of rapidly digestible starch was remarkably lower in fried dumplings than in boiled dumplings (30.8％ vs.77.0％),but the content of slowly digestible starch in fried dumplings was higher than that in boiled ones (63.7％ vs.20.7％),and the content of resistant starch in both dumplings were similarly low (1.9％ and 2.3％).The average time to the peak glucose value was shorter in fried dumplings compared with boiled dumplings [(93 ± 53) minutes vs.(156 ± 61) minutes,P =0.02],but the average glucose levels at all the 9 time points and the AUC in all the 4 time periods were not significantly different (all P ＞ 0.05).Conclusions Compared with fried dumplings,boiled dumplings show faster starch digestion,but long time to the peak postprandial glucose level.Fried dumplings may raise the glucose level faster than boiled dumplings do in T2DM patients.

Objective To investigate the prevalence of nutritional risk,malnutrition(undemutrition),overweight/obesity,and application of nutritional support in hospitalized patients with endocrine disorders.Methods Adult patients in Department of Endocrine of Peking Union Medical College Hospital(PUMCH)from September to December 2008 were consecutively enrolled.Nutrional Risk Screening 2002(NRS2002)war per-formed on the next morning after admission and nutritional support evaluation was performed on the 14th day of ad-mission or on the discharge day.The relationship between nutritional risk and nutritional support Was analyzed.Nu-tritional risk was defined as NRS2002 score≥3,and body mass index(BMI)<18.5 ks/m2 defined as unclernut-rition.Results A total of 152 patients were enroled,and NBS2002 scoring was performed in all patients.The prevalence of undernutrition Was 7.9%and the nutritional risk was 27.6%.The prevalence of nutritional risk in the elderly inpotients(≥60 years old)was significantly higher than in younger patients(18-59 years old)(36.8%vs 20.2%,P=O.023).Nine patients(21.4%)with NRS2002≥3 received nutrition support,and 12patients(10.9%)with NRS2002<3 received nutritional support.The average PN:EN ratio was 1:3.2.Conclu-siom NRS2002 is afeasible nutritional risk screening tool for inpatients with endocrine disorders.A large propor-tion of inpotients were at nutritional risk or undemutrition in the Department of Endocrine of PUMCH. The application of nutritional support currently is somehow inappropriate.Evidence-based guidelines are required to improve this situation

Objective To quantitatively analyze the image quality of megavoltage cone-beam CT (MVCBCT) under different scanning conditions to provide reference in clinical applications. Methods Si-emens ONCOR linear accelerator with MVCBCT was used to scan the phantom under different conditions. The image quality was evaluated in terms of image noise, uniformity, spatial resolution, contrast resolution, the number of Monitor Units(MUs) used in imaging,and the size of the reconstruction matrix. The comparison of the image quality between MVCBCT and conventional simulator CT was also analyzed. Results The image noise was decreased with the increase of the number of MUs. The uniformity index showed that the system u-niformity was weakly dependent on MU numbers or the size of the reconstruction matrix. Except for the ima-ges with 5 MUs,all other images had the spatial resolution of 0.4 lp/mm with a reconstruction matrix of 256 ×256. Better low contrast resolution was achieved by using more MUs. For typical pelvis and head-and-neck patients,the imaging dose at the center was 0.8 cGy/MU and 0.7 cGy/MU, respectively,and the maxi-mum dose was about 1.2 cGy/MU. For typical abdomen patients,the image maximum dose and center dose was 1.3 cGy/MU and 0.7 cGy/MU,respectively. Conclusions The image quality of MVCBCT is inferior to the conventional kilo-voltage CT. However,with the optimization of the parameters in imaging,we can a-chieve sufficient image contrast in the bone,air and some soft-tissue structures with low imaging dose to pa-tients. Such images can be used for IGRT.

Objective To evaluate set-up errors by megavoltage cone-beam CT in head and neck cancers treated with precision radiotherapy. Methods From April 2007 to March 2008, 22 patients with nasopharyngeal carcinoma (15 patients) ,parotid carcinoma (4 patients) and brain glioma (3 patients) were enrolled, among whom 7 patients underwent three-dimensional conformal radiotherapy (3DCRT) and 15 received intensity modulated radiotherapy (IMRT). The radiation dose was 56. 0 -70.4 Gy in 28 -32 fractions within 6 -7 weeks. Megavoltage cone-beam scan was performed weekly before treatment. The isocenter displacement was calculated by comparing megavoltage cone-beam CT and planning CT in left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions. Results Totally 129 sets of megavoltage cone-beam CT images were obtained for 22 patients. The frequency of isocenter shift more than 0. 3 cm,0. 4 cm and 0. 5 cm were 28,15 and 9, respectively. The maximum mean set-up error was found in CC, which was about 0. 1 cm more than that in LR and AP. The frequency of isocenter shift direction was almost identical in LR and CC, which was more frequent (about 75%) in the posterior direction. Conclusions During the course of radiation of brain tumor and head and neck cancer, the enlarging tendency of set-up errors has been found in all the three directions. The isocenter shift in AP was more frequent to the posterior direction.

Objective To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T_3/ N +, staging Ⅱ - Ⅳ. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4.46, P = 0.000 ; t = - 3.45, P =0.000). Conclusions In the irradiation of post-operative gastric cancer, the maximum displacement of organ motions induced by respiration is in S-1 direction and the minimum in R-L direction under free breathing. The use of ABC can reduce the motions significantly in S-I and A-P directions, and the same changes exist in both inter-and intra-fraction treatment.

SCLC can spare more volume of the normal lungs and e-sophagus, and has the ability of dose escalation.

Objective To analysis the genomic sequence of a novel human leukocyte antigen (HLA)-B*3818 allele.Methods Full length genomic sequence of an unknown HLA-B allele was cloned,followed by bi-directional sequencing and the specificity of the antigen coded by this novel allele was defined by microcytotoxicity assay.The frequency and haplotype of this novel allele was acquired by population census and parentage analysis.Results The full length genomic sequence of this novel HLA-B*3818 allele with accession number FJ561482 differs from HLA-B*380201 by two nucleotide changes in exon 4 and intron 5,respectively.One change is located at nt 660 in exon 4 where C→A alternation,which results in an amino acid substitution from Asp(GAC)to Glu(GAA)at codon 196.This alternation is a new single nucleotide polymorphism compared with all other HLA-B alleles.Another is located at genomic position 2133 in intron 5(A→C).Except for this substitution,the intron sequences of HLA-B*3818 allele are identical to those of other HLA-B*38 alleles including HLA-B*380101,B*380201 and B*3814.The serological specificity of HLA-B*3818 is B38 and the frequency of this new allele is less than 0.000 5 in Chinese Han population.The parentage analysis showed the haplotype of novel allele is A*030101-Cw*010201-B*3818-DRB1*1312-DOB1*060101.Conclusion The simultaneous mutations in exon and intron were found in the Hovel HLA-B*3818 allele,and so it can present more sequence information for studies and applications associated with HIA genes by analyzing the genomic sequences of novel HLA alleles.