Kawasaki disease(KD) is a childhood acute self-limiting systemic vasculitis.It is an autoimmune disease.It has replaced rheumatic fever as the most common disease of children with acquired heart disease.Further study of the pathogenesis of KD,help to improve the individualized treatment and prognosis of the disease.The current study on KD,corfirmed its susceptibility to disease and clinical symptoms associated with multiple gene loci,there may be multiple signal paths involved.This paper reviews the recent advances in the genetic and immunological mechanisms of KD.

Objective To verify and adjust the leaf position accuracy of a multi-leaf collimator (MLC) in a linear accelerator.Methods Ionization chamber arrays ( StarTrack, IBA) were used to measure the leaf position accuracy of a MLC in a linear accelerator (Precise, ELEKTA) and adjust the leaves out of tolerance.Results After the adjustment of leaf position of the MLC, the analysis of the verification films taken at the offset position showed that the leaf position of the MLC was accurate.Conclusions The method developed in this study is convenient and simple for measurement and calibration of leaf position of the MLC in the linear accelerator, which meets the MLC position accuracy requirement for the linear accelerator.

Objective To investigate the occurrence situation and related influencing factors of obesity among children aged 6-17 years old in Chengde City.Methods The random sampling method was adopted to extract 16 811 children from 10 primary and middle schools in urban and rural areas of this city.The physical examinations were carried out.The incidence rates of over weight and obesity in different ages,sexes and areas were calculated.The risk factors for childhood obesity were preliminarily screened through questionnaire.And the Logistic regression analysis was conducted for further analyzing the risk factors for childhood obesity.Results Among 16 811 sampled children,the overweight rate was 13.09％ and the obesity rate was 12.1％.The overweight rate and obesity rate in boys were higher than those in girls;which had no statistically significant difference between urban and rural areas(P＞0.05);the incidence rates of overweight and obesity in adolescence were higher than those in preadolescence.The multivariate Logistic regression analysis showed that parental overweight,like to drink sugary drinks and watching television for long time might be the risk factors for childhood obesity.Conclusion The overweight rate and obesity rate among children aged 6-17 years old in this city are higher.Reasonable diet,correct life style and increasing exercise can partially reduce the incidence of children obesity.

Objective To discuss the application of digital simulation positioning machine in radiation oncology. Methods We used digital simulation positioning machine to shoot isocenter reset digital simulator images of 0 degrees direction and 90 degrees direction, 10 × 10 cm2 rectangular field and actual time radiation field with any field number. Compared the images taken with the TPS corresponding DRR image through bone marker matching to measure the error of isocenter and actual time radiation field , the linear accelerator Iview-GT system with the same method was shot in rectangular field simulator the same field number EPID image , and the TPS corresponding DRR image. Finally, we compared the measured error of the digital simulator positioning machine with the error of Iview-GT system image. Results The result of measured isocenter error of the digital simulator positioning machine was better than EPID image error (P=0.000). Conclusion The application of digital simulation positioning machine in radiation oncology can be more accurate to measure the error and correct the position deviation, however, it can also make the radiotherapy and the treatment more accurate.

Non-coding RNA refers to a class of RNAs that cannot encode proteins, and they play a very important role in regulating cellular activities. Pulmonary arteryhypertension is a group of diseases characterized by progressive elevation of pulmonary vascular pressure. Its pathogenesis is complex and its influencing factors are numerous. The study found that non-coding RNA, as a transcription product that does not participate in translational functions, plays an important role in the pathogenesis of patients with pulmonary arteryhypertension. With regard to the more well-studied and relatively mature circRNAs, lncRNAs, and miRNAs in non-coding RNAs, this article review the pathophysiological processes involved in the formation of pulmonary arteryhypertension.

Objective To explore the mechanism,clinic features and treatment of type Ⅳ cardiorenal syndrome.Methods The clinical data of one patient with cardiorenal syndrome characterized with chest distress was analyzed.Results After combination treatment,the symptoms were relieved,the amount of physical activity was increased,and the functions of heart and kidney were improved.Conclusions Active,prompt and rational multidisciplinary care can control the progression of cardiorenal syndrome,increase survival rate and improve life quality.

Objective To explore the short term treatment effectiveness and the side-effect of radiotherapy combined with two kinds of chemotherapy scheme on nasopharyngeal carcinoma patients with stage Ⅲ and Ⅳa.Methods One hundred and fifty nasopharyngeal carcinoma cases with stage Ⅲ/Ⅳa were randomly divided into A and B group.Patients in A group (75 cases) were received radiotherapy combined with 2 courses ((21-28) d/course) paclitaxel (135 mg/m2) + cis-platinum complexes (DDP) 80 mg/m2 chemotherapy concurrently,while patients in B group (75 cases) were received radiotherapy combined with 6 courses DDP 30 mg/m2 per week chemotherapy concurently.The short term treatment effectiveness and the sideeffect of radiotherapy combined with two kinds of chemotherapy scheme were observed.Result After the treatment,the primary lesion complete remission(CR) rate in A group and B group were 68％ (51/75),52％ (39/75).The CR rate of lymph node of neck in A and B group was 64.0％ (48/75),48.0％ (36/75) and 45.3％ (34/75),20.0％ (15/75) of primary lesion and lymph node of neck.The differences were significant(x2=4.25,3.90,10.94 ;P ＜0.05).After 3 months of treatment,there was no significant difference between A and B group in terms of CR rate of the primary lesion,lymph node of neck and primary lesion and lymph node of neck (P ＞0.05).During the treatment,the rate of bone marrow depression at grade Ⅲ in A group and B group were 38.67％ (29/75) and 21.33％ (16/75),21.33％ (16/75) and 6.67％ (5/75) in terms of the rate of grade gastrointestinal reaction at stage Ⅲ,46.66％ (35/75) and 21.33％ (16/75) regarding of oral cavity mucomembranous injury at stage Ⅲ,21.33％ (16/75) and 9.34％ (7/75) in terms of the rate of radioactivity skin destruction at stage Ⅲ.All differences were significant (P ＜ 0.05).During the short-term follow up (1-3 years),both the rate of local recurrence and the rate of metastasis in A group was as same as that in B group(P ＞0.05).Conclusion During the treatment,the side-effect of approach of paclitaxel (135 mg/m2) + DDP 80 mg/m2 in stage Ⅲ/Ⅳa nasopharyngeal carcinoma patients is more severity than that of DDP 30 mg/m2 per week chemotherapy.However,there is no significant difference in terms of the short term treatment effectiveness.The prospective efficacy needs to be further investigation.

ObjectiveTo investigate the feasibility and optimal condition of isolation,purification and expansion of mesenchymal stem cells(MSCs) derived from human umbilical cord blood in vtro.MethodsHuman umbilical cord blood(HUCB) was collected from full term deliveries scheduled,all samples were obtained sterilely with 20 U/ml preservative free heparin.The cord mononuclear cells were isolated with lymphocyte separation medium(density 1.077 g/ml),purified and expanded with MesencultTM medium and acidic environment to produce adherent layer.The surface antigen expression of MSCs was detected with flow cytometry.ResultsThe HUCB-derived mononuclear cells,when seeded in specific medium,gave rise to adherent cells,which exhibited either an osteoclast or mesenchymal-like phenotype.After passage 3,these cells were able to be purified and expanded.6.6×105 primary MSCs reached a number of 9.9×10<>sup8 after 10 expanded passage.Flow cytometry showed that MSCs did not express antigens CD34,CD11a and CD11b,but express strongly CD29 and weakly CD71,which was identical to human bone marrow-derived MSCs.ConclusionMSCs in HUCB can be cultured and expanded in vitro,and could be a source of stem cells for experimental and clinical application.

Objective To investigate the modulation of ET-3 on the nuclear factor (NF)-κB/Bfl-1 antiapoptotic pathway in a malignant melanoma cell line A375. Methods Flow cytometry was performed to detect the apoptosis in cultured A375 cells after treatment with ET-3 of 100 nmol/L for 24 hours. ET-3 of various concentrations (0, 1, 10, 100 nmol/L) was used to treat some A375 cells with or without the pretreatment with the ETRB antagonist BQ788; after another 24-hour culture, RT-PCR and Western blot were conducted to examine the mRNA expression of Bfl-1 and protein expressions of Bfl-1 and ETRB, respectively. Results The 24-hour treatment with ET-3 of 100 nmol/L significantly reduced the apoptosis rate of A375 cells (F = 10.68, P ＜0.05). The mRNA and protein expressions of Bfl-1 were up-regulated by ET-3 in a concentration dependent manner (both P ＜ 0.01 ), while BQ788 significantly blocked the ET-3-induced up-regulation (F = 420.38,229.49, both P ＜ 0.01 ). The protein expression of pNF-κB in A375 cells was also enhanced by ET-3 of different concentrations (all P ＜ 0.05), but the enhancement was suppressed by BQ788, and there was a significant difference in the protein expression of pNF-κB between cells treated with ET-3 of 100 nmol/L and those treated with the combination of ET-3 of 100 nmol/L and BQ788 (F = 255.46, P ＜ 0.01 ). Conclusion ET-3/ETRB inhibits the apoptosis in A375 cells likely by activating the NF-κB/Bfl-1 anti-apoptotic pathway.

Objective To study the relationship between the level of serum thrombomodulin (TM ) ,radiation dose-volume factors with acute radiation pneumonitis (ARP) .Methods 54 patients with lung cancer were given the routine 3 -dimensional conformal radiation therapy(3DCRT) and chemotherpy ,20 cases received the concurrent radiochemotherapy and 34 cases were performed the the sequential chemotherapy .The serum TM level was measured with enzyme-linked immunosorbent assay(ELISA) before radio-therapy(B-RT) and at 30 Gy(M-RT) in radiotherapy .The ARP grade was evaluated according to the criteria of the Common Ter-minology Criteria for Adverse Events(CTCAE v3 .0) by the National Caner Institute(NCI) ,grade 2 or more was taken as ARP . The relationship between the serum TM level ,dose-volume factors with ARP was analyzed .Results 20 cases (37% ) had ARP .12 cases got grade 2 ARP and 8 cases had grade 3 .The occurrence rates of ARP in the minimal lethal dose (MLD) Gy <10 and >10 groups ,V5 < 50% and ≥ 50% groups ,V10 < 40% and ≥ 40% groups ,V20 < 25% and ≥ 25% groups ,V30 < 13% and ≥ 13%groups ,TM decrease group and TM increase group after 30 Gy radiation were 8% vs .62% ,7% vs .69% ,21% vs .75% ,28% vs . 56% ,15% vs .57% and 50% vs .13% respectively ,the differences had statistical significance (χ2 = 16 .83 ,22 .29 ,14 .05 ,3 .97 , 10 .08 ,6 .46 ,P<0 .05);in the ARP group and non-ARP group ,MLD ,V5 ,V10 ,V20 and V30 were (12 ± 2) vs .(9 ± 2) ,(58 ± 10) vs .(43 ± 10) ,(42 ± 8) vs .(30 ± 8) ,(23 ± 3) vs .(19 ± 6) ,(15 ± 4) vs .(11 ± 4) respectively ,the differences had statistical signifi-cance (t= -4 .96 ,-5 .27 ,-5 .70 ,-3 .37 ,-3 .61 ,P<0 .05) .Conclusion Multiple dose-volume parameters are associated with the occurrence rate of ARP .The patients with decreased serum TM level after radiotherapy are liable to develop ARP .