Objective:To analyze the relationship among smoking, levels of homocysteine (Hcy), cystatin C (CysC), C reactive protein (CRP) and coronary heart disease (CHD) onset in young people.Methods:A total of 152 patients, who received selective coronary angiography because of chest pain in our hospital, were enrolled, and all subjects were <45 years old.According to examination results, they were divided into CHD group (n=100) and non-CHD group (n=52).Clinical data were analyzed in both groups, and Logistic multi-factor regression analysis was used to analyze independent risk factors for CHD in young people.Results:Compared with non-CHD group, there were significant rise in percentages of men (30.8% vs.65.0%), smoking (46.1% vs.68.0%) and hypertension (34.6% vs.51.0%), levels of CysC[(0.85±0.16) mg/L vs.(1.34±0.28) mg/L], CRP [(1.26±0.85) mg/L vs.(6.93±0.85) mg/L] and Hcy[(7.16±1.16) mol/L vs.(20.85±2.16) mol/L],P<0.05 or <0.01;multi-factor Logistic regression analysis indicated that male, hypertension, smoking, Hcy, CysC and CRP were risk factors for CHD in young people (OR=1.34~3.42, P<0.05 or <0.01).Conclusion:Male, smoking, total cholesterol, homocysteine, Cys C and C reactive protein are risk factors for CHD in young people.Therefore, these risk factors should be eliminated, or its risk should be reduced.

Mesenchymal chondrosarcoma originated in the primitive mesenchymal tissue .It usually devel-ops in the short bones such as hand ,foot and body bone ,while extremeIy rare in the orbit .We report a case of mesenchymal chondrosarcoma of the orbit which is confirmed by pathology .

Objective To construct secreting type human TRAIL(shTRAIL) gene vector pcDNA3.1-HRE/Egr1-shTRAIL mediated by hypoxia/radiation double sensitive promoter,and observe the effect of hypoxia and radiation on shTRAIL.Methods HRE upper and lower strands were gotten by chemical synthesis,double strands HRE was gotten by PCR;pMD19T-Egr1 was digested by SacⅠ and Hind Ⅲ,then Egr1 was obtained,pshuttle-shTRAIL was digested by Kpn Ⅰ and BamH Ⅰ,then shTRAIL was obtained;HRE/Egr1 double sensitive promoter mediated shTRAIL expression vector pcDNA3.1-HRE/Egr1-shTRAIL was constructed by gene recombination technique,it was identified correctlly by enzyme digestion,PCR and sequencing.A549 cells were divided into normal,hypoxia(0.1%),irradiation(6 Gy) and hypoxia + irradiation groups.Results After enzyme digestion by BamH Ⅰ and Sma Ⅰ,the fragments which lengthes were 1284 bp and 4 998 bp,2 292 bp and 3 990 bp were obtained;the vector was amplified by PCR with Egr1 and shTRAIL primer,the products which lengthes were 469 bp and 820 bp were obtained;pcDNA3.1-HRE/Egr1-shTRAIL was sequenced,the result was same to designed,this demonstrated that the construction was right.The vectors were transfected into A549 cells of adenocarcinoma of lung,the expression levels of shTRAIL mRNA and protein were increased after treated with hypoxia and radiation,it had statistically significant differences compared with normal group(P

Objective To preliminarily explore the delineation of clinical target volume in intensity-modulated radiotherapy for para-aortic lymph node metastases in patients with gynecological malignancies.Methods A retrospective analysis was performed on 56 gynecological tumor patients with para-aortic lymph node metastases who were admitted to our department from January 2010 to September 2016.The number and distribution of metastatic para-aortic lymph nodes were determined by imaging method.Results A total of 108 positive para-aortic lymph nodes were found in the 56 patients,with 1-4(mean,2) positive para-aortic lymph nodes per patient.The mean diameter of positive para-aortic lymph nodes was 2.3 cm (1.2-4.0 cm).A total of 20 metastatic lymph nodes (19%) were located at the L4 level,38(35%) at the L3 level,44(41%) at the L2 level,and 6(5%) at the L1 level.There were 71 metastatic lymph nodes (66%) at the left side of the para-aortic region,20 metastatic lymph nodes (19%) between the abdominal aorta and the vena cava,and 17 metastatic lymph nodes (15%) at the right side of the inferior vena cava.Conclusions For patients with gynecological malignancies,nodal contouring for the para-aortic region should not be defined by a fixed circumferential margin around the vessels.The left side of the para-aortic region should be covered adequately;the upper target should be extended up to the renal artery,and needs to be further extended for patients who have nodal involvement near the renal arteries and veins.

Objective:To study effects of large dose thymopeptides on T cell subpopulations of patients with malignant tumor under radiotherapy.Methods:Fifty one patients with malignant tumor under radiotherapy were divided into 2 groups with 100 mg and 200 mg thymopeptides respectively.The patients we re given thymopeptides,100 mg/d or 200 mg/d,iv, for 10 days.The positive percent ages of CD4,CD8,CD25 and CD56 in T cells of peripheral blood before and after thymopeptide treatment were determined by flow cytometry.Results:The positive percentages of CD4 and CD25 in T cells of peripheral bl ood after 100 mg/d thymopeptide treatment were significantly higher than those befor e thymopeptide treatment (P<0.05),while those of CD4，CD8，CD25 and CD56 in T cells of peripheral blood after 200 mg/d thymopeptide treatment all increased significantly (P<0.05 or P<0.01). Conclusion:These results suggest that large dose of thymopeptides can increase i mmune function of patients with malignant tumor under radiotherapy,and the curat ive effect of 200 mg/d thymopeptides is better.

ObjectiveTo assess the current situation of postgraduates knowledge about medical research design and optimize the curriculum setting of research design.MethodsAn investigation was carried out in the postgraduates of 2011 using questionnaires in a medical university..The questionnaire ineluded basic information of participants and cognition of basic methods of research design.ResultsA total of 473 postgraduates participated in the investigation.Among them,311 systematically learned medical statistics before enrollment,and 275 ( 58.14％ ) once participated in scientific researches.Most of them ( ＞80％ ) knew about the 10 basic methods of research design listed in the questionnaire,but only a few of them were familiar with them,and some even didn't know about the methods.ConclusionWe should pay attention to the culture of scientific research thought in statistical design,strengthen the practice of research design teaching,and the curriculum of research design should be led into undergraduate course.

Objective:To study whether sacral lymph nodes should be included in the target volume delineation for those patients with early (stageⅠB-ⅡA) uterus cervix cancer during postoperative radiotherapy. Methods:Forty-six patients with early uterus cervix cancer were given postoperative three dimensional conformal radiation therapy (3D-CRT) in our department for one month after radical resection. The patients were randomly divided into two groups. The sacral lymph nodes were not included in the target volume delineation in the treatment group. But they were delineated in control group. All the patents had no radiotherapy-related contraindications and signed the consent agreement. The patients were followed up. The local controlling rate and the incidence and degree of radioactive proctitis were compared between the two groups. Results:The local controlling rate of the two groups had no significant difference(t=0.000, P=1.000). The doses received by the 5% and 95% volume of the rectum(V_5, V_95), the average dose, and the minimum dose had significant difference between the two groups(t_(V5)=2.169, P_(V5)=0.041; t_(V95)=4.036, P_(V95)=0.001;t_(mean)=2.236, P_(mean)=0.036; t_(min)=2.265, P_(min=0.034), but the maximum dose received by the rectum had no obvious difference (t_(max)=0.518, P_(max)=0.610). The incidence of radioactive proctitis had significant difference between the two groups(t=2.174, P=0.190). Conclusion:For the early uterus cervix cancer patients who have recurrent risk after radical surgery, sacral lymph nodes should not be included in the delineation of target volume during 3D-CRT in order to decrease the incidence of radioactive proctitis.

Objective:To evaluate the performance of RapidArc technique on cervical cancer patients with various filling status of the bladder. Methods: Conventional fixed field intensity modulation radiated therapy (IMRT) is used as the benchmark. In 10 fe-males suffering from cervical cancer, two CT scans were performed for treatment planning:one with an empty bladder and the other with filled bladder. The prescribed dose was 50 Gy. The images of that with an evacuated bladder and that with filled bladder were planned in the dual-arc RapidArc and the 7-field IMRT, respectively. The implementor of the plan was the Varian TrueBeam linear ac-celerator. Dose-volume histogram was used to evaluate the data from each plan. Results:When the bladder was filled, IMRT and Rapi-dArc homogeneity were 1.05 and 1.04 (P>0.05), respectively. When the bladder was emptied, the homogeneity was 1.04 for both plans (P>0.05). With or without bladder filling, the conformity index was 0.71 and 0.73 for IMRT and RapidArc (P>0.05), respectively. The effect of V30 and V40 (volume for receiving doses of 30 and 40 Gy) on the intestine and the bladder was more favorable in a full than in an empty bladder. No significant difference between the two plans was observed. IMRT exhibited improved V30 on the rectum and on the bladder. RapidArc was much better in terms of monitor unit (MU) and deliver time. Conclusion:No significant differences in the homogeneity and conformity index between dual-arc RapidArc and 7-field IMRT were observed. Filled bladder is better than empty bladder in intestine and bladder protection in both RapidArc and IMRT. IMRT is better on V30 of the rectum and the bladder, whereas RapidArc improved MU and deliver time.

Objective To evaluate the effect of problem-based learning (PBL)versus tradi-tional methods in medical statistics. Methods Computer retrieval was conducted to search for con-trolled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software. Results A total of 21 articles were retrieved,but only 7 were included. The results of Meta analysis showed that there was no significant difference between PBL and traditional methods in both the passing rate of student's score (RR=1.09,95%CI=0.98-1.23,P=0.12>0.05)and the exact score (WMD=0.30, 95%CI=-0.06 -0.67,P=0.10>0.05). Conclusion PBL showed no better learning results in medical statistics compared with traditional methods.

Objective To investigate the infectious status,etiological spectrum and epidemiological characteristics of rotavirus (group A/B/C),calicivirus (novovirus Ⅰ/Ⅱ,sapovirus),astrovirus and enteric adenovirus in diarrhea cases below 5 years old from 2008 to 2015 in Henan provinces.Methods Totally 2541 stool samples were collected from cases below 5 years old in four sentinel hospitals.All stool specimens were tested for group A rotavirus by double antibody sandwich ELISA method.G/P genotyping of group A rotavirus was determined by nested multiplex PCR.Viral RNA was extracted from all samples and rotavirus (group B/C),calicivirus,astrovirus and enteric adenovirus were detected by two-step reverse transcription-polymerase chain reation (RT-PCR)/PCR.Results One thousand four hundred and twenty-one out of 2 541 samples were positive with a total positive rate of 55 .9%,among which,102 were mixed infection.The isolation rate of rotavirus was 36.0% (914 samples)(group A:785 cases,group B:36 cases,group C:93 cases),calicivirus was 12.1 % (308 samples)(novovirus Ⅰ:64 cases,novovirusⅡ:193 cases,sapovirus:51 cases),astrovirus was 5 .9% (151 samples),enteric adenovirus was 1 .9%(48 samples).The group A rotavirus gene type combinations were composed mainly of G9P[8],G2P[4], G3P[8 ],G1P [8 ]and most cases were identified from September to November and March to May. Novovirus Ⅱ was predominant in calicivirus and most cases were identifed between March and May. Rotavirus or calicivirus infection was mainly among children aged 4—12 months or 3—5 years, respectively.Clinical manifestations included fever,diarrhea,vomiting,dehydration.Gender and region distributions differed according to the types of pathogen.Conclusions Group A rotavirus and novovirus Ⅱare the major viral pathogen in diarrhea cases younger than 5 years old in Henan province.Different viral infections exhibit extinct epidemiologic and clinical characteristics.