Objective:To analyze the level and related factors of burden of care,quality of life in family members of patients with schizophrenia.Methods:Totally 312 family members of patients with schizophrenia in 5 blocks of Jing'an District,Shanghai,who consented the investigation,were investigated.Burden of care were evaluated with the Zarit Caregiver Burden Interview (ZBI),and quality of life of the relatives by World Health Organization Quality of Life BREF (WHOQOL-BREF) and Chinese Residents SWB abridged (SWBS-CC20).ZBI score equal or higher than 39 indicated a heavy burden of care,while the score less than 39 indicated a low burden of care.Results:Totally 199 cases (63.8％) were in a heavy burden,whose ZBI score was (52.1 ± 10.8),and 113 cases (36.2％) were in a low burden with a mean score of (23.1 ± 10.4).Their WHOQOL-BREF score and SWBS-CC20 score were lower than normal model (Ps ＜ 0.001).The burden was heavy to those whose spouse was involved (β =-7.76).Patient's age was negatively correlated with quality of life (β3 =-0.18).Relationship with the patient,education level and monthly family income were positively correlated with quality of life (β =1.65,1.68,1.66).Conclusion:Those families of patients with schizophrenia,who are aged,low educated,low paid,or whose spouse have been diagnosed with schizophrenia,may have a heavy burden of care,and low quality of life.

Objective To discuss the clinical effect of artificial pneumothorax combined with intercostal nerve block in alleviating chest pain occurring during and after percutaneous microwave ablation (MWA) for subpleural lung malignancy.Methods A total of 30 patients with subpleural lung malignancy were randomly and equally divided into group A (n=10),group B (n=10) and group C (n=10).The patients in group A received both artificial pneumothorax and intercostal nerve block before MWA.The patients in group B only received artificial pneumothorax before MWA,and the patients in group C only received intercostal nerve block before MWA.The degree of pain was evaluated by visual analogue scale (VAS) score during MWA,immediately after MWA and at 6 h,12 h and 24 h after WMA.The side effects after MWA were recorded.Results During MWA,no statistically significant differences in VAS scores existed between each other among the three groups (P=0.885).The VAS scores determined at 6 h,12 h and 24 h after MWA in group C were significantly increased (P=0.014,P=0.006 and P=0.006 respectively).No patient in group A and group B developed symptoms of chest tightness after artificial pneumothorax was performed.After treatment,a small amount of asymptomatic residual pneumothorax was still observed in 6 patients of group A and group B,which disappeared spontaneously in about one week.Another patient still showed massive pneumothorax even after thoracic gas suction,and the patient recovered after thoracic closed drainage for three days.No other serious complications related to artificial pneumothorax occurred.Conclusion Artificial pneumothorax combined with intercostal nerve block can effectively relieve the chest pain occurring during and after MWA in patients with subpleural lung malignancy,and clinically this technique is quite safe.(J Intervent Radiol,2017,26:269-273)

Objective To study the correlation between the mental health of family members of patients with schizophrenia and their coping style. Methods From December, 2014 to January, 2015, a total of 312 family members of patients with schizophrenia in 5 blocks were included. They were surveyed with self-made questionnaire, Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and Simplified Coping Style Questionnaire. The results were compared with the national normal model, and the correlation between SDS, SAS and the coping style was also analyzed. Results Compared with the normal model, the SDS (t=34.39, P<0.001), SAS (t=73.09, P<0.001) scores were higher in schizophrenia families, and they used positive coping style (n=128, 41%) less (t=-16.70, P<0.001), and more often used negative coping style (n=184, 59%) (t=-66.24, P<0.001). The SDS (r=-0.14, P<0.05), SAS (r=-0.15, P=0.01) scores were negatively correlated with positive coping style, the SAS score was positively correlated with negative coping style (r=0.27, P<0.001). Multivariate Lo-gistic regression analysis showed that women were prone to be anxiety and depressed compared with men (P<0.05); the divorcees were prone to be depressed compared with thoses not divorced. Education level and average monthly household income were factors influencing their coping style (P<0.05). Conclusion The mental health of family members of patients with schizophrenia is not optimistic, the female family members are more likely to be depressed and anxious than males. People with low education level and poor economic conditions more often use negative coping style, which need to be focused on, and to take appropriate and effective intervention.

Objective To establish a fast and accurate method for measurement of leaf position accuracy of dynamic multi-leaf collimator (MLC) using electronic portal imaging device (EPID) and EBT3 film dosimeter.Methods A Varian 6 MV accelerator was used with the gantry angle and the collimator angle fixed at zero degree.A total of 11 sliding window MLC fields were designed.Each field contained a group of strip fields with the same width.The width of a strip field ranged from 1 mm to 10 mm and the distance between two adjacent strip fields was 20 mm.The relationship between the width of the strip field (band width) and the full width at half maximum (FWHM) was calibrated using EPID and EBT3 as measurement tools.A field with a band width of 5 mm was designed in the same way and several MLC leaf deviations were made in different positions.EPID and EBT3 film dosimeter were used to analyze the leaf position accuracy.Results A good linear relationship between band width and FWHM was achieved when the band width was larger than 4 mm.The accuracy of band width,distance between peaks,and MLC leaf position were determined as ±0.2 mm,±0.1 mm,and ±0.1 mm by EPID and ±0.3 mm,±0.2 mm,and ± 0.2 mm by EBT3 film dosimeter,respectively.Conclusions This study provides a fast and accurate method for the measurement of MLC leaf position accuracy using EPID or EBT3 film dosimeter,which is helpful for quality assurance of MLC.

Objective To establish a quantitative evaluation of quality control image for the onboard imaging system of medical linear accelerator.Methods An MV planar image of electronic portal imaging device (EPID) is acquired by both Elekta iViewGT and Varian aS1000,and a kV planar image and cone-beam computed tomography (CBCT) images of CBCT are acquired by both Elekta X-ray volume imaging (XVI) and Varian On-board Imager (OBI).Phantoms used here included Las Vegas,TOR18FG,and Catphan504.A series of image quality indicators were evaluated by analyzing the images mentioned above using a quantitative method.Results A quantitative value was calculated to represent the contrast resolution of EPID.A modulation transfer function (MTF) to describe spatial resolution and a quantitative value representing contrast resolution were calculated for the kV planar image.As for the CBCT system,a series of quantitative results of noise,uniformity,CT value accuracy,and contrast resolution and a MTF were calculated to represent the performance of CBCT system.Conclusions Based on common phantoms,a complete set of quantitative methods to evaluate the image quality of EPID and CBCT has been developed,which could provide a very good reference for the establishment of quality control system for image-guided radiotherapy.

Objective To analyze the characteristics of change in plasma cholesterol level in patients with sepsis, and to explore its relationship with prognosis and its clinical significance. Methods A retrospective analysis was conducted. 568 patients with sepsis admitted to Department of Critical Care Medicine of Beijing Friendship Hospital Affiliated to Capital Medical University from August 2013 to August 2015 were enrolled, and 475 patients without sepsis hospitalized in the same period served as the control. The basic clinical data of the two groups were collected, and the results of blood fat and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with multivariate logistic model regression analysis. Results Compared with non-sepsis patients, the levels of plasma total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C) in the patients with sepsis were significantly lower [TC (mmol/L): 2.5±1.2 vs. 3.4±1.4, t = 4.274, P = 0.021; HDL-C (mmol/L): 1.6±0.9 vs. 2.5±0.8, t = 3.413, P = 0.018], and that of low density lipoprotein cholesterol (LDL-C) showed no statistically significant difference (mmol/L: 1.9±0.9 vs. 2.1±0.9, t = 0.749, P = 0.614). In the patients with sepsis, the patients in death group (n = 227) were older than those of the survival group (n = 341, years: 74.3±15.5 vs. 65.5±17.5, t = 4.037, P = 0.012), serum creatinine (SCr) was higher than that of survival group (μmol/L: 251.0±115.6 vs. 167.4±108.7, t = 3.254, P = 0.023), the levels of plasma TC, HDL-C and LDL-C were significantly lower than those of survival group [TC (mmol/L): 2.2±1.6 vs. 2.9±1.1, t = 3.057, P = 0.023; HDL-C (mmol/L): 1.4±0.8 vs. 1.9±0.8, t = 4.692, P = 0.016; LDL-C (mmol/L): 1.7±0.7 vs. 2.0±0.8, t = 2.541, P = 0.038]; there was no significant difference in the proportion of male, body mass index (BMI), based disease, intensive care unit (ICU) hospitalization time, the severity of the disease and other biochemical indexes between two groups. With single factor analysis with indicators of statistical significance as a covariate into binary logistic regression equation, the results show that age was the risk factor of death in patients with sepsis [odds ratio (OR) = 1.024, 95% confidence interval (95%CI) = 1.010-1.048, P = 0.009], and TC was the protective factor on the prognosis of patients with sepsis (OR = 0.747, 95%CI = 0.682-0.811, P = 0.013). Conclusions Plasma cholesterol levels in patients with sepsis were significantly lowered, and the levels in death group was significantly lower than that in the survival group. TC may be used as a clinical indicator to assess the outcome of patients with sepsis.

Little is known about the distribution of Rhodococcus equi in the soil environment of native horses in China. One hundred and eight soil samples were collected from native-horse farms in the Hulun Beier grasslands of eastern Mongolia, the Xilin Goler grasslands of southern Mongolia, and Tongliao city in Inner Mongolia of China for investigating the distribution of R. equi in these regions. The isolation rates of R. equi from soil samples from the Hulun Beier and Xilin Goler grasslands ranged from 25.9% to 30.0%. In contrast, isolation rates from soil samples from Tongliao city was as high as 82.3% and the mean number of R. equi in soil samples from Tongliao city was 10 times more than those of samples from the grasslands. The 488 isolates were examined using PCR for the presence of genes that encode virulence-associated 15 000-17 000 antigen protein (VapA) and the 20 000 antigen protein (VapB). All isolates were negative for virulence-associated proteins. Plasmid profiles of these avirulent isolates showed that cryptic plasmids of various sizes were present with an incidence of 13.3% to 21.5%. The results of the present study contrast with those of our recent study, in which we reported that R. equi was absent from Mongolian horses in Ulaanbaatar, Mongolia. It is suggested that the difference between the results of these two studies is due to the mobile pasturing system in Mongolia and nonmobile pasturing system in Inner Mongolia.

AIM:To determine the biological feature of circulating endothelial cells (CECs) in acute promye-locytic leukemia ( APL) patients before and after treatment , and to analyze the relationship between CECs and the clinical characteristics .METHODS: The CECs were sorted from peripheral blood by magnetic-activated cell sorting and then counted by 3-color flow cytometry.The cells were identified by immunofluorescence staining for the expression of CD 146, CD31, CD144, VEGFR-2, CD45 and CD133.The CECs were cultured in vitro, and the tube formation and colony-forming rate were determined .RESULTS:Increased quantity of CECs was observed in CD 34 positive group and group with WBC >10 ×109/L (P<0.05).The quantity of CECs had a significant difference among low risk , medium risk and high risk groups (P<0.05).The positive rate of CD133 and quantity of CECs significantly reduced in 32 APL patients when they gain complete remission after treatment (P<0.05).The amount of tube formation and colony-forming rate were significant-ly reduced after treatment (P<0.05).The ratio of CECs quantity from APL patients after treatment to that before treatment had a negative correlation with arsenic concentration in urine on day 7 during As2O3 treatment (P<0.05).CONCLU-SION:Accurately counting CECs may be helpful for evaluating prognosis and designing treatment strategy .

Objective To evaluate the accuracy of 3D models of patients with complex congenital heart disease(CHD) printed by domestic 3D priuters based on cardiac CT data.Methods From April 2018 to June 2018,our hospital used domestic 3D printers to print the hearts of 50 patients with complex CHD.The median age of the patients was 24 months(1 month to 61 years),and the diseases included pulmonary atresia,right ventricular double outlet and transposition of aorta.3 measurement sites(150 in total) were selected for each patient.Pearson correlation coefficient calculation,paired t test and Bland-Altman analysis were performed.Results Pearson correlation coefficient is 0.997.The difference of the measured value of CT-model was tested for normality.P was 0.2 of the D test.The Q-Q graph showed that the data point and the theoretical line were highly overlapped.The mean difference was (-0.07 ± 0.67) mm,P =0.196.In Bland-Altman analysis,the consistency boundary value interval of the difference was(-1.29 mm,1.16 mm) between which there were 143/150(95.33％) points.Conclusion 3D models of patients with complex CHD printed by domestic 3D printers based on cardiac CT data have good accuracy.

Objective:To study the position of computed tomography(CT)slice of marker points of radiotherapy,which was determined by control scan(CS)method,on the application effect of patients with head and neck tumors who received radiotherapy.Methods:Based on Control Scan(CS)method,a calculator program of mark-point slice position was made,which was an enterprise WeChat program that could be used in calculating position and CT position scan of patients with head and neck tumor(slice thickness was 3mm).A total of 60 patients with head and neck tumor were selected,and the patients who underwent CT positioning scan by using CS method were divided into observation group,and patients who underwent CT position scan by using conventional method were divided into control group,with 30 cases in each group.The number of cases with three metal marker points displayed at the same slice,and the number of slices containing the CT images of marker point between the located CT scan were compared.Results:The number of patients in the observation group and the control group who showed three markers at the same level at the same time were respectively 26 cases and 13 cases,and observation group increased by 13 cases(43.4%)than control group,and the difference was significant(x2=12.382,P<0.05).The number of CT images with only 1 slice of observation group and control group were respectively 4 cases and 0 cases,which increased by 4 cases(13.3%)than the control group,and the difference was significant(x2=2.411,P<0.05).Conclusions:The CT localization scan of radiotherapy,which uses CS to assist patients with head and neck tumor,can precisely calculate and obtain the primary position of target of CT localization scan.It can take the images of 3 mental marker points of patient who receives radiotherapy to occur at the same CT slice as soon as possible,which has better application effect.It can effectively improve the convenience and work effectiveness of radiotherapy.