Serum glycosyl protein and glucose levels were concomitantly measured in 35 DACVD patients, 59 ACVD patients and in a control group of 65 healthy subjects. Our data revealed statistically significant differences in serum glucose between the ACVD group and control group (P0.05).Hyperglycosemia occurring in ACVD may be a response, or really means diabetes mellitus. Our data indicated that determination of serum glycosyl protein may be useful for the differential diagnosis of diabetic neuropathy from the reactive hyperglycosemia in ACVD.

Objective Onto investigate the significance of the pleth variability index (PVI) in predicting hypotension after epidural anesthesia for cesarean delivery. Methods Sixity seven pregnant women, with ASAⅠ~Ⅱ, aged 19 ~ 34 years, were enrolled for elective cesarean delivery. SBP, BDP, MAP, HR, PI and PVI were measured at 5 min after the parturients arrived in the operation room. SBP, BDP, MAP and HR were measured every 3 min after epidural anesthesia. According to the change rate of SDP or MAP was higher than 30% or not, the parturients were divided into two groups (the hypotension group and the non-hypotension group). Results No significant differences were found in parturients'age, body height, weight, BMI, gestational weeks, SDP, DBP, MAP and HR before anesthesia between two groups. The PVI in the hypotension group was significantly higher than that in the non-hypotension group (P<0.05). A receiver operator characteristic curve analysis showed the area under curve was 0.888 when PVI was used for boundary value. When PVI over 17.35 was used as the occurrence of hypotension, the sensitivity of PVI was 0.727, and specificity was 0.895. Conclusion PVI can be used to predict the occurrence of hypotension after epidural anesthesia for cesarean delivery.

Objective:To characterize the imaging distortion of the 1.5T magnetic resonance imaging-guided linear accelerator (MR-Linac) and to analyze the influence of MR-Linac and peripheral devices on the geometric distortion.Methods:Specialized MRI imaging distortion phantom and analysis software were applied. The baseline of imaging distortion within diameter spherical volume (DSV) around the center of the magnet was established. The influence of the beam generation system, mechanical system and peripheral devices on the imaging distortion was analyzed. The long-term stability of imaging distortion was tested on the MR-Linac.Results:Imaging distortion of the MR-Linac was increased with the increasing distance to the center of the magnet. Within DSV 400 mm, few test points surpassed 1 mm imaging distortion in 3D directions. However, imaging distortion surpassed 2 mm in part of region within DSV 400-500 mm, with the largest distortion over 7 mm. Imaging distortion of the MR-Linac remained unchanged within 7 months after installation. And the influence of the MR-Linac and peripheral devices on the imaging distortion was only observed in the overall largest distortion within DSV 400-500 mm.Conclusions:Cautions should be taken during the application of high-field MR-Linac in patients whose tumor location is over 20 cm from the ISO center. Imaging distortion of the MR-Linac remains stable within 7 months after installation. The influence of the MR-Linac and peripheral devices on the imaging distortion is trivial, which can be neglected in clinical practice.

Objective To investigate the biological features of the mouse bone marrow stromal stem cells (BMSCs) transfected by humanβnerve growth factor(β-NGF) .Methods BMSCs of GFP transgenic mouse were isolated and cultured .Theβ-NGF re-combinant plasmid vectors were transferred into the cultured BMSCs by LipofectamineTM 2000 .The expression of β-NGF was detec-ted with ELISA .Results The β-NGF recombinant plasmid vectors were successfully transferred into BMSCs of GFP transgenic mouse ,the expression of β-NGF in transfected cells appeared .In addition ,the expression ofβ-NGF could effectively protect the BM-SCs which were injured in transfection process .Conclusion BMSCs of GFP transgenic mouse after transfecton with human β-NGF have the proliferation and differentiation capacity ,and possess the expression ability of β-NGF protein .

Objective:To establish an automatic segmentation network based on different receptive fields for gross target volume (GTV) and organs at risk in patients with nasopharyngeal carcinoma.Methods:Radiotherapy data of 100 cases of nasopharyngeal carcinoma including CT images and GTV and organs at risk delineated by the physicians were collected. Ninety plans were randomly selected as the training dataset, and the other 10 plans as the validation dataset. Firstly, the images were subject to three data augmentation methods including center cropping, vertical flipping and rotation (-30°to 30°), and then input into MA_net networks proposed in this study for training. The model performance of networks was assessed by the number of network parameters (NP), floating-point number (FPN), the running memory (RM) and Dice index (DI), and eventually compared with DeeplabV3+ , PSP_net, UNet+ + and U_Net networks.Results:When the input image was in the size of 240×240, MA_net had a NP of 23.20%, 20.10%, 25.55% and 27.11% of these 4 networks, 50.02%, 19.86%, 6.37% and 13.44% for the FPN, 40.63%, 23.60%, 11.58% and 14.99% for the RM, respectively. For the DI of GTV, MA_net was 1.16%, 2.28%, 1.27% and 3.59% higher than these 4 networks. For the average DI of GTV and OAR, MA_net was 0.16%, 1.37%, 0.30% and 0.97% higher than these 4 networks.Conclusion:Compared with those four networks, the proposed MA_net network has slightly higher Dice index with fewer parameters, lower FPN and smaller RM.

Organ system based integrated teaching model has been adopted in several medical schools, and these schools face some challenges in this teaching process. In order to provide new sights for organ system based integrated teaching reform in eight-year medical education program, ex-ploration of setting up three-staged-dimensional integrated teaching models was conducted in urinary system by hematuria, and designing related teaching objectives, teaching programs and assessment form to optimize teaching quality in this teaching methods, according to characteristics of the urinary systemic diseases, cultivating objectives of eight-year medical education program and teaching experi-ence of Xiangya School of Medicine.

Objective:To investigate the clinical feasibility of the Unity radiotherapy system guided by magnetic resonance imaging.Methods:Twenty-four patients were enrolled and received a total of 384 fractions of treatment at Unity system. According to the treatment site, all patients were divided into head-neck, abdomen-thorax, pelvic, spine and limb groups. The patients were set-up without external laser. And then, the time required at different stages in online treatment process and the registration error of each fraction were separately calculated. The geometric deformations of MR images were weekly measured by using MR geometric deformation phantom. At last, the Arccheck was used to perform the dose verification of reference plan, online plan and offline plan.Results:The mean duration of radiotherapy in the five groups were 29.1, 27.6, 26.6, 25.6 and 32.0 min, respectively. The set-up errors in the left-right, superior-inferior and anterior-posterior direction in the five groups were: head-neck group (0.08±0.06 cm, 0.16±0.13 cm, 0.08±0.05 cm), abdomen-thorax group (0.23±0.18 cm, 0.50±0.47 cm, 0.12±0.1 cm), pelvic group (0.25±0.19 cm, 0.32±0.25 cm, 0.11±0.09 cm), spine group (0.46±0.38 cm, 0.26±0.26 cm, 0.13±0.07 cm) and limb group (0.33±0.30 cm, 0.34±0.23 cm, 0.08±0.06 cm), respectively. In the central region, the geometric deformation of MR was less than 0.3 mm, and that of the sphere with a diameter of 500 mm was less than 2.1 mm. The meanγ pass rate of the reference plan, online plan and offline plan were 97.92%, 97.84% and 94.58%, respectively.Conclusions:MR-guided radiotherapy has great potential for clinical application, whereas the process of Unity system is relatively complex. The synergy of different departments has a great impact on the treatment, which needs further optimization.

Objective:To investigate the predictive value of serum vascular endothelial growth factor (VEGF), squamous cell carcinoma-associated antigen (SCCAg) and miRNA let-7a in lymph node metastasis and postoperative recurrence in patients with laryngeal cancer.Methods:A total of 82 patients with laryngeal cancer in the Second Central Hospital of Baoding from November 2017 to October 2019 were selected as the research subjects, including 18 cases of lymph node metastasis (metastasis group) and 64 cases of non metastasis (non metastasis group). The blood routine was tested before operation, and the baseline data, serum VEGF, SCCAg and miRNA let-7a levels were compared between the two groups. Logistic regression was used to analyze the related influencing factors of lymph node metastasis in patients with laryngeal cancer. The correlation between serum VEGF, SCCAg, miRNA let-7a levels and clinicopathological characteristics was analyzed. The receiver operating characteristic (ROC)curve was used to analyze the value of each index and the combined diagnosis of lymph node metastasis in patients with laryngeal cancer. After 1 year of follow-up, the serum VEGF, SCCAg and miRNA let-7a levels of patients with or without recurrent laryngeal cancer were compared. ROC curve was used to evaluate the value of VEGF, SCCAg, and miRNA let-7a in predicting the recurrence of laryngeal cancer.Results:There were statistically significant differences in tumor node metastasis (TNM) stage, degree of infiltration, degree of differentiation, serum VEGF, SCCAg, and miRNA let-7a levels between the metastasis group and non metastasis group (all P<0.05). Serum VEGF, SCCAg, miRNA let-7a levels in patients with laryngeal cancer were related to TNM stage, degree of infiltration and degree of differentiation (all P<0.05). The combined diagnosis of serum VEGF, SCCAg and miRNA let-7a levels in the diagnosis of lymph node metastasis in patients with laryngeal cancer showed that the diagnostic sensitivity and specificity were 88.89% and 70.31%, respectively. The serum VEGF and SCCAg levels of patients with recurrence after operation were higher than those without recurrence, and the level of miRNA let-7a was lower than those without recurrence (all P<0.05). The sensitivity and specificity of combined serum VEGF, SCCAg and miRNA LET-7a levels in predicting postoperative recurrence of laryngeal cancer were 72.97% and 91.11%, respectively. Conclusions:VEGF, SCCAg, miRNA let-7a in patients with laryngeal cancer have a certain correlation with clinicopathological characteristics, which can assist in the diagnosis of lymph node metastasis and help clinical prediction of postoperative recurrence in patients with laryngeal cancer, and provide a reference for the formulation of clinical treatment plans.

Objective:To investigate the feasibilityof the adaptive radiotherapy using high-field MR-Linac systems for head neck cancers and perform the evaluation of target coverage and dose criteria.Methods:This study investigated 128 treatment plans of six patients who were treated on 1.5T MR-Linacsystems in Sun Yat-sen University Cancer Center in 2019, compared the differences in target coverage and dose criteria between the dose accumulation in the adaptive radiotherapy using MR-Linac systems and the reference plans, and evaluated the target coverage and dose criteria of each fraction of adaptive plan based on daily MRI anatomy.Results:There was no significant change in the target coverage and dose criteria for each treatment fraction(<1%). However, the change of lens dose was significant (maximum 98%). In addition, the result showed that there was no significant difference in target coverage and dose criteria between the dose accumulation in adaptive radiotherapy using MR-Linac systems and reference plans.In contrast, the average dose to lens was increased by 31.7%.Conclusions:It is feasible to perform adaptive radiotherapy using 1.5T MR-Linacsystems for head neck cancers according tothe evaluation of target coverage and dose criteria. Additionally, since the actual dose tolens was quite different from the reference plan, the lens exposure should be considered in clinical practice.

Objective:To summarize the clinical efficiency of paclitaxel drug coated balloon (DCB) in femoral popliteal artery disease.Methods:Retrospective analysis was made on 125 patients (141 limbs) admitted from Jun 2016 to Jul 2019 for femoral popliteal disease treated with DCB.Results:Median follow-up time was 19 months. The average lesion length was (138±78) mm, with an overall cumulative primary patency rate of 81.4% and 60.8% at 12 and 24 months postoperatively and f-TLR rates of 90.1% and 83.0%, respectively. In a total of 109 primary lesions, subgroup analysis showed that among the TASC C/D primary lesions, the primary patency rate was significantly lower in those with combined severe calcification and the f-TLR rate in those with popliteal involved lesions. TASC grade C/D lesions, severe calcified lesions were independent risk factors for patency, while hypertension was an independent protective factor.In-stent restenosis (ISR) target lesions involving the popliteal segment had a significantly worse prognosis than ISR of the superficial femoral artery.Conclusion:DCB in the treatment of lower femoral popliteal artery lesions can achieve a satisfactory medium-term patency outcome, while the efficacy for complex lesions still needs further improvement.