Objective To study the effects of different dose 6 MV and 10 MV photons for classic conformal radiotherapy on cervical cancer patients with different height and weight,in order to provide guidance for clinical irradiation energy choosing for different patients.Methods Twenty-one recruited patients were divided into obese and non-obese group according to the body mass index (BMI).The 4-field classic conformal radiotherapy plans was designed and applied in both groups and the results were compared.Statistical analysis was carried out on the dosimetric parameters.Results The treatment plan of 10 MV photons could both reduce the maximum and minimum dose (Dmax and Dmin) of the target area PTV and increase the conformal and heterogeneity index (CI and HI),and change the median dose (D50) for non-obese patients,while it could not reduce the mean dose (Dmeen) for two groups.It was more effective in reducing Dmax and increasing HI for obese patients.The plan could also reduce the dose of organs at risk (OAR) near the PTV.Using 10 MV photons plan could more effectively reduce the low isodose volume of the patients and machine hops.Conclusions The 10 MV photons plan has many advantages in classic conformal radiotherapy for obese cervical cancer treatment.

Sequential monitoring of the levels of serum interleukin-2(IL-2),soluble interleukin-2 receptor(sIL-2R)and interleukin-6(IL-6)were conducted in 60 patients for 2 months after renal transplantation.The results showed that the levels of serum IL-2,sIL-2R and IL-6 were increased significantly several days prior to the clinical diagnosis in the patients with acute rejection,which were much higher than those in CsA-induced nephrotoxicity group.The levels of IL-2,slL-2R and IL-6 in the patients with rejection sensible to methylprednisolone came down to the pre-rejection levels several days after the treatment.It was concluded that sequential monitoring of serum IL-2,sIL-2R and IL-6 of renal allograft recipients are helpful for the early diagnosis and differential diagnosis of acute rejection as well as the evaluation of methylprednisolone in the treatment of antirejection.

Objective To explore the mediating effects of college students＇ online social support on the relationship between online self-disclosure and internet altruistic behavior.Methods Using cluster random sampling,the self-disclosure questionnaire for Chinese undergraduates with their internet friend,the online social support scale of adolescence and the internet altruistic behavior scale of undergraduates were applied to 351 college students.Results The score of college students＇ online self-disclosure,online social support and internet altruistic behavior were respectively(2.22±0.45),(2.93±0.59) and (2.04±0.46).The college students＇ online self-disclosure,online social support and internet altruistic behavior were positively correlated with each other (P＜0.01).College students＇ online self-disclosure not only predicted internet altruistic behavior directly,but also predicted internet altruistic behavior indirectly through online social support.The direct effects and indirect effects were 0.200 and 0.265.The ratio of the mediating effect on the total effect was 57％.The fit index of mediation model was x2/df=2.87,RMSEA =0.07,CFI =0.94,TLI =0.93,GFI=0.92,IFI=0.94,NFI=0.91.Conclusion The college students＇ online self-disclosure not only affects the interuet altruistic behavior directly,but also can take the same effect on online social support indirectly.

Objective To investigate the clinical effects of a modified splenocaval shunt combined with pericardial devascularization ( PCDV ) in the treatment of gastroesophageal variceal bleeding. Methods From 1997 to 2007, 168 patients with gastroesophageal variceal bleeding caused by portal hypertension were treated at the People's Hospital of Shaanxi Province. Among all the patients, 90 received a splenocaval shunt + PCDV(combined group) and the remaining 78 received PCDV (PCDV group). Changes in intra- and postoperative hemodynamics of the portal venous system were detected by Doppler color flow imaging, and free portal pressure was measured intraoperatively. All data were analysed using analysis of variance, the paired t test and chi-square test.Results The mortality was 3% (3/90) in the combined group and 5% (4/78) in the PCDV group, with no significant difference between the two groups (x2 = 0.038, P ＞0.05 ). The postoperative rebleeding rate was 6%(5/79) in the combined group, which was significantly lower than 13% (8/60) in the PCDV group (x2 =4.824,P ＜ 0.05 ). The incidence of hepatic encephalopathy was 6% (5/79) in the combined group and 7% (4/60) in the PCDV group, with no significant difference between the two groups ( x2 = 0.072, P ＞ 0.05 ). The 1-, 3-, 5-,and 10-year survival rates were 97% (77/79), 92% (55/60), 80% (16/20) and 60% (3/5) in the combined group, and 97% (58/60), 83% (40/48), 73% (22/30) and 53% (8/15) in the PCDV group, respecitvely,with no significant difference between the two groups ( x2 = 0.731, P ＞ 0.05 ). The intra- and postoperative portal pressures in the combined group were (38.8±4.2) cm H20 ( 1 cm H2O =0. 098 kPa) and (33.1 ± 1.5) cm H2O,with a significant difference ( t = 8. 574, P ＜ 0.05 ). The intra-and postoperative portal pressures in the PCDV group were (38.9±2.5) cm H2O and (34.6±2.6) cm H2O, with a significant difference (t =6. 530, P ＜0.05 ). There was also a significant difference in postoperative portal pressure between the two groups ( t = 2. 859,P ＜ 0.05 ). The intra-and postoperative diameters of the portal vein in the combined group were (1.40 ± 0.41 )cm and ( 1.22 ± 0. 15) cm, respectively, with a significant difference ( t = 2. 608, P ＜ 0.05 ). The intra-and postoperative portal venous flows in the combined group were (1280 ±350) ml/min and (830±360) ml/min, with a significant difference ( t = 5. 668, P ＜ 0. 05 ). The intra-and postoperative diameters of the portal vein in the PCDV group were ( 1.41 ±0.32) cm and ( 1.27 ±0.32) cm, respectively, with no significant difference between the two groups (t = 1. 637, P ＞ 0.05 ). The intra-and postoperative portal venous flows in the combined group were ( 1350 ± 380) ml/min and (980 ± 290) ml/min, with a significant difference ( t = 4. 096, P ＜ 0.05 ). There was no significant difference in postoperative portal venous flow between the two groups ( t = 1.871, P ＞ 0.05 ).Conclusions The modified splenocaval shunt combined with PCDV is safe and effective with a low rate of recurrent rebleeding. The clinical outcome and rational hemodynamic changes show that the combined procedure of splenocaval shunt and PCDV is a good choice for treatment of gastroesophageal variceal bleeding.

Objective To explore the clinical characteristics of portal vein thrombosis(PVT) after splenocaval shunt plus devascularization in treatment of portal hypertension and find Out ways for its prevention.Methods The formation,diagnosis,treatment of PVT and variceal rehemorrhage in 110 patients with portal hypertension who received splenocaval shunt plus devascularization procedures (Combined Group)and 92 patients subjected to pericardial devascularization operation(PCDV Group) were retrospectively analyzed.Meanwhile,the effect of two procedures on PVT was compared.Results The incidence of PVT was 10.0%in combined group and 22.8%in PCDV group (P<0.05).The rebleeding rate from esophagogastric varices because of PVT in combined group was 3.6%,which was significantly lower than that of 10.8%in PCDV group(P<0.05).Conclusion Splenoeaval shunt plus devascularization is a better choice to decrease the incidence of PVT.The postoperative anti-coagulation therapy in the early stage is important for the prevention of PVT.

Objective To evaluate the effects,hemodynamies and hepatic functional reserve of a combined procedure of modified pmximal splenocaval shunt and pericardial devascularlzation (PCDV) in the treatment of portal hypertension.Methods From 1997 to 2007,a total of 255 patients with cirrhotic portal hypertension received combined (135 cases) or PCDV procedure (120 cases,) in our hospital.The clinical results were retrospectively analyzed.Changes of hemodynamics of the portal venous system were studied by Doppler color flow imaging and intraoperative free portal pressure (FPP) measurement.The hepatic functional reserve was evaluated by indocyanine green (ICG) retention ratio and functional hepatic flow(FHF).Results Postoperative mortality was 2.2% in combined group and 4.3% in PCDV group.The long term rebleeding rate was 5.5%as revealed by follow-up in combined group,which was significantly lower than that in PCDV group of 14.1%(P<0.05).The incidence of encephalopathy was 6.4%and 5.4%in combined group and PCDV group respectively(P>0.05).The 1-,3-,5-and 10 year-survival rates were 96.4%,90.0%,81.3%and 62.5% in combined group and 95.7%,86.7%,75.0%,57.1%in PCDV group.In combined group,the FPP、PVF and FHFwere(32.0±1.5)cm H_2O、(880±260)ml/min and(430±1 80)ml/min respectively,a significant decrease when compared with preoperative parameters (P<0.05),while R_(15) (30%±4%)increased (P<0.01).The similar results were observed in PCDV group postoperatively (P<0.05).Compared to PCDV group,the decrease of FPP in combined group was more significant(P<0.05),but the PVF,FHF and R_(15) were not significantly different (P>0.05).Conclusions The combined procedure is safe and effective in treatment of portal hypertension with better clinical outcome,moderate homodynamic changes and good maintenance of hepatic functional reserve.

Objective To study the safety and efficacy of damage control using percutaneous transhepatic biliary drainage (PTBD) in acute cholangitis of severe type (ACST) secondary to intrahepatic choledocholithiasis.Methods The clinical data of 8 patients who received PTBD after hospital admission followed by conventional surgery for ACST when their general condition improved were retrospectively studied.Results All patients received PTBD successfully and the amount of bile drained was 100-400 ml in the first day.The general condition of these 8 patients became better after 24 h and the total bilirubin decreased for about 25-100 mmol/L after 48 h.Three patients with a platelet count of less than 20 × 109/L showed an improved count to more than 50 × 109/L 72 h after PTBD.All patients were operated at different times after the PTBD:2 received T-tube drainage,3 T-tube drainage combined with left hepatectomy,and 3 choledochojejunostomy.Seven patients recovered uneventfully,but 1 developed hepatic failure with the total billurubin rose to more than 200 μmol/L.He was discharged home with the PTBD tube.During the waiting time of 7 days to 3 months before surgery,the tubes were kept patent and no mortality or morbidity such as bleeding,bile leakage,and peritonitis occurred.Conclusions PTBD was a safe and efficacious procedure for patients who were in a serious condition with ACST secondary to intrahepatic choledocholithiasis.It was more likely to be successful as it is minimally invasive and therefore well-tolerented.It reduced the biliary pressure,relieved the ongoing sepsis,and was a good preparatory procedure before any conventional surgery.

BACKGROUND:Abnormal activation of lymphocytes and nuclear factorκB-dependent non-specific inflammation are two major manifestations of joint damage in rheumatoid arthritis. Co-stimulatory signal CD40/CD40L is the dominant co-stimulatory factor in the recognition and activation of T cel s. IκBαeffectively inhibits nuclear factorκB pathway, prevent the inflammation in the central link, and suppress the damage caused by inflammatory factor in the synovial tissue.
OBJECTIVE:To investigate the therapeutic effect of double gene co-expressing adenovirus vector on arthritis based on an arthritis model rat transfected by CD40LIg-IRES2-IκBαco-expressing adenovirus vector.
METHODS:The pAdCD40LIg-IRES2-IκBαco-expressing adenovirus vector was established. Arthritic model was established through multi-subcutaneous injections of complete Freund's adjuvant of type col agen II (1 g/L) into Wistar rats. Then 20 arthritic rats were divided into two groups:untreated group and transfection group, receiving an injection of saline and pAdCD40LIg-IRES2-IκBαadenovirus vector to distal joint cavity of limbs, respectively.
RESULTS AND CONCLUSION:At 14 days post-transfection, compared with the untreated group, the mean arthritis index score, the CD40L expression of lymphocytes in synovial fluid, the nuclear factor-κB p65 expression in synovial tissue, and levels of interleukin-2, interleukin-6, tumor necrosis factor-α, matrix metal oproteinase-3 and matrix metal oproteinase-9 in synovial fluid of rats in transfection group were significantly lower than those in untreated group. Focal transfection of the CD40LIg-IκBαco-expression adenovirus vector can effectively inhibit arthritic symptoms, and reduce the expressions of inflammatory cytokine in synovial fluid and inflammatory molecule in synovial tissue of arthritic rats, which shows good therapeutic effect.

Objective The magnetic beads direct adsorption method was used to extract the cell-free DNA (cfDNA) from three kinds of human humoral biological samples, including urine, saliva and blood, as to provide a reference for forensic cfDNA research and forensic inspection. Methods The cfDNA was isolated from humoral samples by centrifuging, and the cfDNA was extracted with the method of magnetic beads direct adsorption. Then the samples were sequentially amplified with Identifiler-Plus amplication kit, and the STR genotyping was detected by ABI 3500 Analyzer. Results The cfDNA was detected from all the three kinds of samples. The detection rate of cfDNA from the blood samples was 100%, the saliva was 90%, and the urine was 70%. Conclusion The results suggest that human humoral biological samples contain cfDNA. What's more, the magnetic beads direct adsorption method can be used to extract cfDNA efficiently and conveniently.

Objective To investigate the revascular and transplanted effects of islet grafts after co-transplantation with vascular endothelial cells ( ECs) in diabetic rats. Methods The rat ECs and islet cells were isolated and purified, then subcutaneously co-transplanted to the inbred SD male rats with diabetes mellitus, the group of islets transplanted alone, group of phosphate buffered solution, and group of normal rats served as control. Islet grafts revascularization degree, islet cells activity and apoptosis were observed by immunohistochemical double staining of CD31, insulin and factor associated suicide (Fas) antibody. The results of intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test (IPITT), the blood glucose and insulin levels of the rats and the survival time of the islet grafts were compared. Results The blood glucose concentrations of IPGTT and IPITT, the blood glucose and insulin levels of rats analyzed by multivariate analysis in the ECs and islets transplantation group were better than those in the islets transplantation alone group (P<0.05). The islet grafts mean survival time of the ECs and islets transplantation group was longer than that of the islets transplantation alone group (P<0.05). On the 7th day after transplantation, mean microvascular density of islet grafts per square millimeter in the ECs and islets transplantation group was 26.4 ± 6.1, significantly greater than that in the islets transplantation alone group 18.3 ± 5.7 (P<0.05). In the ECs and islets transplantation group, insulin staining intensity was higher than that in the islets transplantation alone group (P<0.05), while factor associated suicide(Fas) staining intensity was lower than that in the islets transplantation alone group ( P<0. 05 ). Conclusion Co-transplantation with ECs could promote the revascularization of islet grafts and improve the effect of islet transplantation.