Objective:To investigate a potential role of Toll-like receptor 4(TLR4) ,a pathogen pattern recognition receptor, in the early phase of severely burned rats. Methods: Rats burn model(30% of total body surface area[TBSA],Ⅲgrade) were established with vapor at 108 C for 8 seconds. Rats were sacrificed before and 2,5,12,24,48 and 72 h after burning, and the spleen specimens and peripheral blood samples were harvested. TLR4 mRNA and TNF-?mRNA expression in splenocyte was measured by reverse-transcription PCR(RT-PCR); the expression of TLR4 protein were measured by Western bloting; the endothelial toxicity concentration in plasma was detected by limulus lysate test. Results: It was found that the expression of TLR4 mRNA.TNF-?mRNA,TLR4 protein,and the level of ET were significantly increased in burned group compared with normal control group. The expression of TLR4 mRNA and protein peaked at 8 h after burning, the expession of TNF-?mRNA peaked at 12 h.and the level of ET peaked at 8 h after burnings the peak values of them were (3. 66?0. 51),(2. 27?0. 19), (1.65?0. 23),and (11. 68?2. 63) Eu/ml, respectively, all significantly higher than those of the control group(P

Objective To investigate the clinical value of ultrasound markers in screening fetal trisomy 21.Methods From Jan.2001 to Dec.2011,a retrospective study about sonographic information of 138 fetuses diagnosed as trisomy 21 was taken in the First Affiliated Hospital of Sun Yat-sen University.All fetuses were divided into 3 groups:isolated ultrasound markers,non-isolated ultrasound markers,and isolated structural malformations or other abnormalities.The relationship between trisomy 21 and ultrasound markers as well as structural anomalies or other abnormalities was analyzed.Results Sonographic anomalies were detected in 132 fetuses(95.7％,132/138),including ultrasound markers and structural malformations or other abnormalities.One hundred and twenty cases(87.0％,120/138)had ultrasound markers,38(31.7％,38/120)had one marker and 82(68.3％,82/120)had more than one marker (P ＜ 0.01).Fifty-one fetuses(37.0％,51/138)had isolated ultrasound markers and non-isolated markers were found in 69 fetuses(50.0％,69/138).Only 12 fetuses(8.7％,12/138)had isolated structural malformations or other abnormalities.In 20 fetuses on whom the first-trimester ultrasound screening were performed,all had ultrasound markers,95％(19/20)had thickened nuchal translucency and 55％ (11/20)had nasal bone hypoplasia.The most common ultrasound markers on the second-trimester screening were nasal bone hypoplasia,which accounted for 41.9％(52/124)cases,followed by thickened nuchal fold (25.0％,31/124),short fenurs and humerus(24.2％,30/124),echogenic intracardiac focus(16.1％,20/124),mild ventriculomegaly(15.3％,19/124),hyperechoic bowel(12.9％,16/124),mild renal pyelectasis(12.1％,15/124).Furthermore,thc common structural malformations or other abnormalities were as follows:cardiac defects(33.1％,41/124),digestive system(26.6％,33/124).Condusions Ultrasound markers are valuable for screening fetal trisomy 21.The fetuses of trisomy 21 usually had more than one ultrasound markers or associated with other abnormalities.Combinations of ultrasound markers with the results of serum screening and maternal age are necessary for evaluation.

Objective To analyze the influence of the mean energy and the full-width of half msximum(FWHM)of incident electron beam intensity distilbution(assumed Gaussian distribution)on depth dose curves and off-axis ratios and to derive a most optimal combination of mean energy and FWHM of incident electron beam intensity distribution.Methods The study simulated 6 MV photon beam produced by Varian 600C medical linear accelerator with OMEGA/EGSnrc by matching the relative error of calculated and measured depth dose curves past depth of maximum dose and off-axis ratios at a depth of 10.0 cm in water within 2%.Results The depth dose curves were relatively insensitive to the mean energy past depth of maximum dose and the FWHM of the incident electron beam intensity distribution.Dose profiles were sensitive tO the mean energy and FWHM.The dose profiles horns decreased as the mean energy and tlle FWHM of the ineident electron beam intensity distilbution increased.The calculated value of the depth dose curves matched well with the measured value.The calculated value of the off-axis ratio was consistent with the measured value within the radiation field.However, the maximum errors of individual measurement points in the penumbra region and OUt of the field reached 18.5%.Conclusions In the field.the most optimal combination of mean energy and FWHM of incident electron beam intensitv distribution Can be derived, however,can not be derived out of the field and in the penumbra region.

Objective To assess the clinical efffects off Ipratropium bromide combined with atomization inhalation of budesonide via a ventilator with a Y-shaped connector on acute exacerbation off chronic obstructive pulmonary disease (AECOPD).Methods A total off 62 AECOPD patients treated at our hospital from June 2013 to September 2014 were randomly divided into the experimental group (n=31,treated with ipratropium bromide combined with atomization inhalation of budesonide) and the control group (n =31,treated with the same amount of saline).Results The airway pressure of mechanical ventilation,the time of mechanical ventilation and the time of staying in the intensive care unit all showed significant differences between the experimental and control groups [(25.4±5.2) cmH2O vs.(38.1±3.4) cmH2O,(6.5±1.3) d vs.(6.8±1.4) d,(8.9±2.1) d vs.(9.5±1.5) d,t=10.934,0.960,1.108,respectively,P＜0.05 for all].The rate of tracheotomy was lower in the experimental group than in the control group (17/31 or 54.8％ vs.20/31 or 64.5％,x2 =0.603,P＜0.05).Conclusions Ipratropium bromide combined with budesonide inhalation under mechanical ventilation via a Y-shaped connector has ffavorable clinical effects on AECOPD.

Objective To investigate the prenatal diagnosis and phenotypic assessment strategies for fetal supernumerary marker chromosomes and derivative chromosomes. Methods Five cases of fetal supernumerary marker chromosomes and one case of fetal derivative chromosomes were diagnosed in the First Affiliated Hospital of Sun Yat-Sen University from March 12, 2010 to November 9, 2012 by conventional chromosome banding, fluorescence in situ hybridization (FISH) and spectral karyotyping (SKY). These cases were retrospectively reviewed. Combined with the results of ultrasonography, abnormal phenotypes and pregnancy outcomes were evaluated in these cases. Results All of the five supernumerary marker chromosomes were de novo, in which two were mosaic and the remaining three cases were non-mosaic. Of these five cases, two were type 47, XX+mar and ultrasound indicated abnormal phenotypes. FISH and SKY confirmed that they were derived from chromosome 4 and 22, respectively. The other three cases were marker chromosome with Turner syndrome karyotype (abnormal phenotypes were not found by ultrasound), in which two cases were derived from chromosome Y (by FISH) and one case was identified as ring chromosome X (by FISH and SKY). One de novo derivative chromosome was verified as a product of reciprocal translocation between chromosome 2 and 6 (by FISH and SKY). Induced abortion was performed in all cases between 25 and 32 gestational weeks. Conclusions By combining conventional chromosome banding, FISH and SKY, the origin and content of supernumerary marker chromosomes and derivative chromosomes can be identified. On this basis, clinical phenotype evaluation and genetic counseling may be offered with the ultrasonographic result.

The present paper is to verify the accuracy of DPM, a Monte Carlo-based dose calculation algorithm, in homogeneous and inhomogeneous tissues. DPM was applied to calculate (1) depth dose curves and off-axis ratios at a depth of 10 cm in water using a 6 MeV photon beam with a 3 cm x 3 cm field and phase space file simulated Varian 60 degrees C medical linear accelerator with a 10 cm x 10 cm field at SSD = 100 (cm); (2) depth dose curves using 6 MeV photon beam in inhomogeneous tissues, such as water (6 cm)/lung (6 cm)/water (8 cm) with a 3 cm x 3 cm field and water (6 cm)/ bone (2 cm)/water (12 cm) with a 10 cm x 10 cm field; (3) depth dose curves using 6 MeV photon beam based on the CT data of a patient's head and abdomen. The doses based on DPM are compared to the doses calculated by DOSXYZnrc under the same condition. The error was within 3% in water phantom while the error was within 3% in inhomogeneous tissues, except a few points. It has been concluded that the DPM can accurately predict the dose to homogeneous and inhomogeneous tissues.
Algorithms ; Computer Simulation ; Humans ; Monte Carlo Method ; Photons ; Radiation Dosage ; Radiometry ; methods ; Radiotherapy Planning, Computer-Assisted ; methods ; Software

Objective To explore the strategies of using psychological crisis intervention in public emergencies.Methods In the early stage,psychological crisis intervention concepts and behavioral responses were formed through literature research and qualitative research methods.Use three rounds of Delphi for expert advice.Three indexes including positive coefficient,authority and coordination were used to test the reliability of expert consultation.Results Overall,it passed 239 out of 269 entries.The first round passed item 210,modified item 18,no consensus item 41;In the second round,8 new entries were added,and 22 entries were deleted through 24 entries.In the third round,there were 5 entries and 16 entries were deleted.The authority coefficient was 0.859,indicating that the experts were very familiar with the items.The coordination coefficient of three rounds of consultations were 0.464,0.696,and 0.407 (P＜0.001)respectively,showing that the coordination degree of experts was excellent,the credibility of feedback was high,and results were highly reliable.Conclusions The strategies of field psychological crisis intervention for public emergencies developed in this study received the consensus by domestic psychological crisis intervention experts,it is will provide a basis for systematic,comprehensive and effective guidance for this work.

Objective To study the changes and mechanism of skin stem cells in microgravity.Methods The skin stem cells of SD rats were used to establish a suspension culture system and compare the proliferation of skin stem cells with 1G gravity.Results The simulated microgravity significantly affected the velocity of skin stem cell sphere proliferation in suspension culture,which was about 12%higher than the 1G gravity group.Transcriptome sequencing showed that 1673 genes were up-regulated and 1409 genes were downregulated;Calcium signaling;cytokine-cytokine receptor interaction and PPAR pathway were different in the two environments.Conclusion Simulation of microgravity can affect the proliferation behavior of skin stem cells in suspension culture by regulating the expression of key signaling pathways,which provides an experimental basis for further research in spatial microgravity environ ment.

Objective:To construct the nursing quality evaluation index system of hemodialysis vascular access, so as to provide reference for the evaluation and improvement of vascular access quality.Methods:Using the Donabedian three-dimensional structural quality evaluation tool, combined with literature search, semi-structured interviews, and Delphi method, expert consultation forms were sent via email, WeChat, and other means. Two rounds of consultation were conducted with 15 experts in clinical nursing, nursing management and medical work in the field of hemodialysis vascular access from 9 provinces and municipalities in China to determine the evaluation index system. The enthusiasm of experts was expressed by the effective response rate of the questionnaire, the degree of coordination of expert opinions was expressed by the coordination coefficient and coefficient of variation, and the degree of expert authority was expressed by the expert authority coefficient.Results:The effective response rates of the two rounds of expert inquiry questionnaires were both 100.00% (15/15). The judgment coefficient of expert consultation was 0.900, familiarity coefficient was 0.827, the authority coefficient was 0.864, and the coordination coefficients of the first, second, and third level indicators were 0.280, 0.267, and 0.206, respectively ( P<0.05). The final quality evaluation index system for hemodialysis vascular access nursing includes 3 primary indicators, 11 secondary indicators, and 39 tertiary indicators. Conclusions:The nursing quality evaluation index system for hemodialysis vascular access is reasonably set, the construction process is rigorous, and it has high scientificity and reliability. It can provide objective and quantifiable reference basis for the nursing quality evaluation of hemodialysis vascular access.

Objective To investigate the value of Cylex ImmuKnow immune cell function assay in the diagnosis of infection after liver transplantation. Methods The objects of this prospective study were 48 patients undergoing orthotopic liver transplantation (OLT) in Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University from July 2010 to December 2012. The informed consents of all patients were obtained and the ethical committee approval was received. According to whether the patients suffered clinical infection or not after OLT, they were divided into two groups:infection group (n=14) and non-infection group (n=34). Another 20 healthy people were enrolled as the control group. There were 11 males and 3 females in the infection group with a mean age of (47±10) years old. There were 29 males and 5 females in the non-infection group with a mean age of (45±9) years old. There were 10 males and 10 females in the control group with a mean age of (42±10) years old. Peripheral venous blood 2 ml was collected from the patients on the 7th day after OLT or from the healthy people when enrolled in control group. The adenosine triphosphate (ATP) level in cluster of differentiation (CD) 4+ lymphocyte was detected using Cylex ImmuKnow kit and the testing data were compared using t test. Results The ATP level in CD4+ cells was (178±58), (345±62), (467±84) mg/L in infection group, non-infection group and control group respectively. The ATP level in infection group was significantly lower than that in non-infection group (t =-4.6, P<0.05). The sensitivity of the Cylex ImmuKnow immune cell function assay in the diagnosis of infection after OLT was 0.79, the specificity was 0.85, the positive predictive value was 0.69, and the negative predictive value was 0.91. Conclusions Cylex ImmuKnow immune cell function assay can simply and quickly detect the immune cell function. It plays a role in monitoring and diagnosing the infection after OLT.