Pediatric cancer is one of the leading causes of death in children around the world.Although radiotherapy is an important means of treatment for pediatric cancer,it causes acute or chronic adverse events that may affect patients' survival time and quality of life.As a novel and advanced radiation technique,proton therapy allows for precise dose delivery in target volume,significantly reducing the irradiation to surrounding tissues and organs.Studies have shown that proton therapy is well tolerated in the treatment of pediatric cancer,and it achieves good tumor control;proton therapy is superior to traditional radiotherapy in improving quality of life,protecting intelligence,and reducing the risk of secondary cancer.This article reviews the research advances in the application of proton therapy in the treatment of pediatric cancer.

OBJECTIVE:To establish the method for the determination of particle size distribution of Budesonide nasal spray, and to analyze the consistency of particle size distribution of spray samples. METHODS:Water was used as dispersant for mixing and dispersing(1800 r/min). The particle sizes [d(0.1),d(0.5),d(0.9)] corresponded to accumulative particle size of 10%,50%and 90%were used as characteristic value. The distribution of granularity was determined by laser scattering method. The consisten-cy of particle size distribution of samples from 2 manufacturers (A,B) were analyzed among different batches or same batch of same manufacturer by SAS 9.3 statistical software. RESULTS:The mean values of d(0.1),d(0.5) and d(0.9) were 3.96 μm, 29.58 μm and 67.10 μm in manufacturer A. The mean values of d(0.1),d(0.5)and d(0.9)were 2.00 μm,7.53 μm and 28.51 μm in manufacturer B. By analysis,there was great difference in particle size of samples from 2 manufacturers. The particle size of the samples from manufacturer A were larger than that of manufacturer B. The consistency among different batches from manufacturer B was better,and the consistency among same batch were all good from 2 manufacturers. CONCLUSIONS:The established meth-od is suitable for particle size distribution of Budesonide nasal spray and the consistency analysis of particle size distribution.

Diabetic peripheral neuropathy is one of the common chronic complications of diabetes, and TCM has unique advantages in the treatment of diabetic peripheral neuropathy. The article summarized the experimental research progress in the TCM intervention in treatment of diabetic peripheral neuropathy in recent years from the aspects of oxidative stress, metabolic disorders, neurological nutrition factor and neural microvascular dysfunction, with a purpose to provide better efficacy in clinical treatment.

Objective: To evaluate the applications and problems of statistical methods for articles published in《Chinese Circulation Journal》. Methods: We reviewed the statistical methods for original articles published in《Chinese Circulation Journal》in 2010, 2011 and 2015; general status with problems was analyzed and the situations were compared among different years. Results: A total of 404 articles were enrolled, statistical hypothesis testing was performed in 366 of them, 32 had descriptive statistics only and 6 articles were meta-analysis. The most frequently used statistical methods were student'st-test (57.4%), followed by chi-squared analysis (56.7%), analysis of variance (35.2%) and regression analysis (23.0%). The main statistical problems in Methods included in described method un-matched to really used method and insufifcient or wrong description. The proportion of insufifcient or wrong description in 2010 and 2011 was 36.6% (71/194), while in 2015 was 26.2% (55/210),P=0.02. The major wrong application of statistical approach was ignoring design with improper method and using unsatisifed precondition for speciifc analysis. The proportion of improper statistical method application in 2010 and 2011 was 19.1% (33/173), in 2015 was 19.7% (38/193),P=0.88. Conclusion: The quality of statistics was improved in 2015 than 2010 and 2011 for articles published in《Chinese Circulation Journal》; while there were still problems at certain degree, enhanced statistical review should be conducted in medical journals.

Objective To study the mental health condition of occupational female and influencing factors of mental health. Methods 827 occupational females in Dongguan city were investigated using the questionnaires, the contents included the basic personal information, mental health condition and influencing factors of mental health.Results The results showed that there existed higher ratio of mental disorder in people of age over 50 years, post-graduate educational background, monthly income levels of 4001 to 5000 yuan and divorced occupational females.Moreover, the influential factors on mental health of occupational females were correlated with age, culture degree,family population and society. Conclusion We should pay more attention to occupational females and take effective measure to relieve their mental stress. This is the demands of woman as well as society.

Objective To observe the effect of adenosine A1 receptor (A1AR) on the megalin defect in type 1 diabetic mice with early kidney disease.Methods 7-8 week-old,baseline body weight and fasting blood glucose matched wild type (WT) C57BL/6J mice were selected,and randomly divided into two groups:control group (n=6) and WT DM group (n=6).In the same way,male A1AR knock-out C57BL/6J mice were selected as A1AR-/-DM group (n=6).DM model was established by intraperitoneal injection of streptozocin.The blood glucose (BG),body weight (BW),kidney weight (KW),24 h proteinuria (24hUP) and albumin creatine ratio (ACR) were measured at 4 weeks.The renal pathological lesion was observed and the expression of megalin in proximal tubules was examined by immunohistochemistry.The expression of caspase-1,IL-18 and A1AR were detected by Western blotting.Results At 4th week,compared with WT control mice,the BG,BW,KW and 24hUP of WT DM mice were increased significantly (n=6,P ＜ 0.01),with the pathological glomerular enlargement,mesangial cell proliferation,extracellular matrix accumulation and renal tubule hypertrophy being observed.Immunohistochemistry revealed decreased expression of megalin,an important multiligand protein receptor on the brush border of proximal tubular epithelial cells in WT DM mice,which was correlated with 24hUP (r=-0.645,P ＜ 0.01).Compared with the control mice,the expressions of caspase-1,IL-18 and A1AR were significantly increased in WT DM mice (P ＜ 0.05).For A1AR-/-DM mice,more serious pathological lesion and megalin defect,together with increasing of casapase-1 and heavier proteinuria were observed than those in WT DM mice.Conclusion A1AR may play a protective role in megalin expression of diabetic mice with early kidney disease,in which the mechanism may be associated with caspase-1 related pyroptosis pathway.The details need further exploration.

Objectives To explore the clinical application of deceleration capacity of rate (DC), acceleration capacity of rate (AC) and heart rate variability (HRV) in children with precardial distress of unknown origin. Methods A total of 56 children with precardial distress of unknown origin and 63 healthy children aged 6 to 17 years were examined by 24 h dynamic elec-trocardiogram, and the indexes of DC and HRV were compared between these two groups. Results DC value of children with precardial distress is less than that of the control group (P<0.05), AC value is greater than that of the control group (P<0.05), and heat rate (HR) is greater than that of the control group (P<0.05). No statistical differences were observed in the indexes of HRV between the two groups. The indexes of DC show a signiifcant positive correlation with HRV in children with precardial distress(r=0.27~0.40, P<0.05), while appear a negative relation with HR (r=-0.46, P=0.000). In contrast, the indexes of AC show a signiifcant negative correlation with HRV (r=-0.57~-0.34, P<0.05), and appears a positive relation with HR(r=0.61, P=0.000). HR value is higher in male children less than 12 years old with precardial distress than that of age-matched males in control group, and RMSSD is lower than the latter. DC value of male children more than 12 years with precardial distress is lower than that of age-matched males in control group, while AC value is higher than that of the latter;DC value is signiifcant lower in fe-male children more than 12 yeares with precardial distress than that of age-matched females in the control group (P<0.05). Con-clusions The activity of vagus nerve in children with precardial distress of unknown origin is decreased. DC value is signiifcantly lower than that of control group, and shows correlation with indexes of HRV. There is no signiifcant difference in DC and HRV value between male and female children with precardial distress. DC value is lower in children aged 12 or older with precardial distress than that of age-matched children in the control group, which indicates adolescents are vulnerable to autonomic nerve functional disorder.

Objective To investigate the mechanism of caspase recruitment domain‐containing protein 9 (CARD9) in the early stage of acute pancreatitis(AP) .Methods Peripheral blood mononuclear cells (PBMC ) of 49 AP patients (33 mild acute pancreatitis (MAP ) patients and 16 severe acute pancreatitis (SAP) patients) were collected on the Day 1st ,3rd and 5th of hospitalization .Twenty healthy volunteers were enrolled in control group .The expression level of CARD9 ,B‐cell lymphoma(Bcl)‐10 ,p38 mitogen‐activated protein kinase (MAPK ) and p65 nuclear factor Kappa B (NF‐κB ) in PBMC of AP patients were detected by Western blotting .The co‐localization ,expression and binding between CARD9 and Bcl‐10 in PBMC of control group ,SAP group and MAP group on the Day 1st hospitalization were determined by cell immune‐fluorescence staining and co‐immuno precipitation method .Single factor analysis of variance and Mann‐Whitney test were performed for data comparison between groups .Pearson method was used for correlation analysis .Results The results of Western blotting indicated that the expression of CARD9 and Bcl‐10 in PBMC of SAP group on the Day 1st ,3rd and 5th of hospitalization (1 .12 ± 0 .05 ,1 .03 ± 0 .03 and 1 .01 ± 0 .01 ;1 .74 ± 0 .08 ,1 .72 ± 0 .10 and 1 .69 ± 0 .11) were all significantly higher than those of control group (0 .33 ± 0 .10 and 1 .02 ± 0 .11) and MAP group (0 .71 ± 0 .02 ,0 .55 ± 0 .06 and 0 .25 ± 0 .07 ;1 .15 ± 0 .03 ,1 .09 ± 0 .07 and 1 .01 ± 0 .04) ,and the differences were statistically significant (F= 35 .76 and 18 .20 ,all P< 0 .05) .The expression of p38 MAPK in PBMC of SAP group on the Day lst ,3rd of hospitalization (1 .88 ± 0 .08 、1 .68 ± 0 .11) were significantly higher than those of MAP group on the Day 1st ,3rd ,5th (0 .86 ± 0 .08 ,0 .77 ± 0 .10 ,0 .73 ± 0 .20) and healthy control group (0 .58 ± 0 .24 , F= 7 .24 ,all P < 0 .01) .The expression of p65 NF‐κB in PBMC of SAP group on the Day 1st ,3rd of hospitalization (1 .64 ± 0 .02 ,1 .55 ± 0 .03) were significantly higher than those of MAP group on the Day 3rd ,5th (1 .06 ± 0 .14 ,0 .87 ± 0 .20) and healthy control group (1 .17 ± 0 .13 ,F= 4 .51 ,all P< 0 .05) .The results of immune‐fluorescence staining indicated that CARD9 and Bcl‐10 co‐localized in nucleus .The results of co‐immuno precipitation showed that the binding degree between CARD9 and Bcl‐10 of SAP group was significantly higher than that of control group and MAP group . Pearson correlative analysis suggested that the level of p65 NF‐κB and p38 MAPK in PBMC of AP patients were positive correlated with the expression of CARD9 (r= 0 .692 and 0 .834 ,both P< 0 .01) .Conclusion CARD9 is positive correlated with NF‐κB and MAPK , which indicates CARD9 induced inflammatory cytokines by activating NF‐κB and MAPK signaling pathways in AP .

Objective:To compare the results of two different measures assessing prospective memory (PM) in elderly schizophrenia,and explore their diagnostic validity.Methods:Fifty patients who were diagnosed as schiz-ophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ)and 50 normal elderly people were enrolled in the study.Laboratory paradigm prospective memory task and the Chinese version of the Cambridge prospective memory Test (C-CAMPROMPT)were administered to measure thelevel of EBPM and TBPM.The Wechsler Adult Intelligence Scale-Fourth Edition,Continuous Performance Test-I-dentical Pairs were used to evaluate IQ and attention.Results:Whether in the laboratory paradigm or C-CAM-PROMPT,schizophrenia group performed worse than normal controls on PM total scores[7(0,16)vs.12(0,16),14 (4,34)vs.25(11,36)],EBPM[3(0,8)vs.6(0,8),7(2,16)vs.14(4,18)]and TBPM [3(0,8)vs.6(0,8),6(2,18) vs.12(4,18)],and patients had comparable performances in PM subtypes[-1.0(-2.2,1.0)vs. -1.0(-2.1, 0.8),-1.9(-3.4,0.8)vs. -1.8(-2.9,1.6)].In the C-CAMPROMPT,the scores of EBPM and TBPM were negatively related to age(r=-0.36 --0.40,P<0.001 ),but there was no significant relationship between PM performance and age in the laboratory paradigm task.The area under ROC curve of the laboratory paradigm and C-CAMPROMPT were 0.73 and 0.85.While 8 and 19 as the cut off value,the sensitivity were 0.60 and 0.74,and the specificity were 0.76 and 0.90,respectively.Conclusion:The two measures have confirmed that the elderly schizophrenia have comparable performances in EBPM and TBPM.Both the C-CAMPROMPT and the laboratory paradigm have moderate level of diagnostic validity,but the former is slightly higher and more susceptible to aging.