Objective To investigate and analyze the resources of radiotherapy in Beijing,in order to provide reference for the subject development,resources allocation and professional training of radiotherapy.Methods A questionnaire survey was conducted by on-site inspection,supplemented by telephone or e-mail investigation among the 33 hospitals with radiotherapy facilities to know the current status of distribution of radiotherapy institutions,radiotherapy facilities,human resources and number of patients treated.Results There were 52 linear accelerators,1 spiral CT machine,and 2 intraoperative radiotherapy machines in these 33 hospitals up to June 2010.Three-dimensional conformal or stereotaetic radiotherapy was carried out in 31 hospitals,intensity modulated radiation therapy(IMRT)in 19,image guided radiation therapy(IGRT)in 6,and volumetric modulated arc therapy(VMRT)in 2.The number of professional personnel(except nurses)was 495,including 214 radiation oncologists,78 radiotherapy physicists,and 203 radiotherapy technologists,and those with senior professional titles accounted for 52.3%,17.9%,and 1.5%,respectively.Conclusions Compared to the national level,the radiotherapy resources level is higher in Beijing,but the distribution of resources is imbalanced.The resource allocation should be optimized and training of the personnel should be strengthened so as to meet the growing needs of patients.

Objective To investigate the safety and validity of Neptune 3D-RTPS-A treatment planning system compared to Prowess TPS.Methods A total of 30 clinical tumor cases with radiotherapy planning on Prowess TPS from September 2009 to May 2010 were used.The contours, organs at risk and target volumes in Prowess TPS were transported into Neptune TPS, the same parameters setted in the two treatment planning systems.The results of comparison of the two TPS were calculated.Results All cases of clinical treatment planning were completed successfully by Neptune TPS, and the various functions of the design were achieved for fitting tumor conformal radiation therapy.The key parameters on radiation treatment were compared.The results are as follows:the differences of source skin distance ( SSD ) ＜0.5% , differences of Monitor Unites ＜0.5%, the differences of dose at isocenter ＜2%, the differences of five isodose lines surrounding area ＜ 3%, and the mean difference of distances of five isodose lines was 0.43 mm, the differences of the volume of PTV on 90% isodose line ＜ 2%, and the differences in V30of organs at risk ＜ 3%.Conclusions Neptune TPS could be qualified for clinical validity and safety by clinical verification.

A postulated suppression of T lymphocyte function by clonidine (an adrenogic receptor agonist) was explored by utilizing mitogen induced lymphocyte transformation of mouse spleen cells in vitro. Added at the onset of the culture or 24h later, clonidine (10-(?)-10-8 M ) did not suppress T lymphocyte transformation induced by ConA or PHA. It implies that there is a difference in the sensitivity for clonidine between T and B lymphocyte, as clonidine has been suggested to suppress the SRBC induced primary immune response of mouse spleen cells in a dose dependent manner.

Total glucosides of paeony root ( TGPs ) ( 5 ~40mg/kg, ip ) had a dose-related hypothermal effect in mice and rats, which was related to the environment temperature. But TGPs ( 40mg/kg, ip or iv ) showed no significant hypothermal effect in guinea-pigs or rabbits. TGPs ( 2, 4 mg/kg, icv ) had a potential hypothermal effect in rats. Chlopheniramine had antagonist effect on hypothermal effect of TGPs in mice and rats.

[Objective] To investigate the immigration and differentiation of neural stem cell in vivo after intravenous transplantation into adult rats with spinal cord injury.[Method]Lower ventricle tissue was obtained from new-born rats aged 14 to 16 days,and the target cells were identified after cultured in vitro,neural stem cells signed by Brdu was injected into model rats of full-cut spinal cord via tail vein one week after injury.CSEP test and BBB function evaluation were conducted 8 weeks later after transplantation.The specimens made from the injured spinal cord of rats were affused with 8% poly formaldehyde,which aimed to get pathology section and imunnohistochemical staining.[Result](1)According to BBB scores,functional recovery was found in injury group and transplantation group but did not reach normal level,while in transplantation group the functional recovers got the better.(2)cerebro-spinal evoked potential(CSEP)in control group and injury group disappeared,and the latency period of CSEP in transplantation group was prolonged,but control group was not interfered.(3)Compared with injury group,a large amount of Brdu positive cells existed at the injured part of spinal cord in the transplant group,which indicated that the engrafted NSCs could survive and migrate into the injured part,and some of them could differentiated into the glial fibriuary acidic protein(GFAP)and NF-200 positive cells that had characteristics of neuron or glial cell.[Conclusion]Neural stem cell can reach the injured part of spinal cord and replace the injured neuron or glial cell via intravenous transplantation,which enable the injured spinal cord to functionally recover to some extent.

Objective To investigate the clinical value of fast track surgery (FTS) in donor in liver transplantation.Methods The clinical data of 214 donors for liver transplantation at the Renji Hospital of Shanghai Jiaotong University from January 2006 to November 2011 were retrospectively analyzed.All donors were divided into FTS group and conventional group.From January 2006 to May 2009,73 donors who received conventional perioperative management were in the conventional group,and 141 donors who received FTS from May 2009 to November 2011 were in the FTS group.The recovery of the donors in the 2 groups was compared.All data were analyzed using the chi-square test or t test.Results The operation time,time to out-of-bed activity,time to postoperative exsufflation,time to bowel movement,and duration of postoperative hospital stay were (178 ±37) minutes,(1.6 ± 1.0) days,(2.9 ± 1.6) days,(3.1 ± 1.5) days and (5.9 ± 1.9) days in the FTS group,which were significantly shorter than (167 ± 33) minutes,(3.6 ± 1.4) days,(4.6 ± 2.3) days,(4.5 ± 1.4) days and (7.6 ± 1.5) days in the conventional group (t =2.115,77.138,6.504,6.913,6.970,P ＜ 0.05).The hospital costs of the FTS group and the conventional group were (1.8 ±0.6) × 104 yuan and (2.2 ±0.4) x 104 yuan,respectively,with a significant difference between the 2 groups (t =73.038,P ＜ 0.05).The volumes of operative blood loss of the FTS group and the conventional group were (130 ± 47)ml and (138 ± 46)ml,with no significant difference between the 2 groups (t =1.251,P ＞ 0.05).The rate of satisfaction of the donors in the FTS group and conventional group were 98.6％ (139/141) and 89.2％ (74/83),respectively,with a significant difference between the 2 groups (x2 =9.94,P ＜ 0.05).Conclusion FTS is safe,economical and can reduce stress,decrease hospital costs and promote early recovery of donors in liver transplantation.

Objective:To observe the effects of genistein on proliferation and apoptosis of human non -small cell lung cancer cell line A549/DDP.Methods:①MTT assay was applied to evaluate the resistance index of A 549/DDP cell line to cisplatin and half in-hibitory concentration ( IC50 ) .②Inhibition rate of A549/DDP cell proliferation and IC 50 value were evaluated by MTT assay after treat-ment with 0, 1.25, 2.5, 5.0, 10, 20, 40, 60, 80 μg/ml genistein for 48 hour respectively.③A549/DDP cell cycle and apoptosis were evaluated by flow cytometry after treatment with 6.25, 12.5, 25 μg/ml genistein for 24 hours respectively.Results:①In expo-sing to cisplatin, the IC50 of A549 and A549/DDP was 33.6 μmol/L and 76.9 μmol/L respectively.The resistance index was 2.3. Cell growth inhibition rate increased following the cisplatin concentration increasing gradually .②A549/DDP growth inhibition rate in-creased at first and later decreased gradually following treatment with the genistein dose increased .The IC50 of A549 and A549/DDP was about 85.1 μg/ml and 80.2μg/ml respectively.③After treatment with 6.25, 12.5, 25μg/ml genistein for 24 hours, there were more A549/DDP cells arresting and showing apoptosis along with the genistein dose increased .Conclusion: Genistein can inhibit A549/DDP proliferation, cause A549/DDP arresting in G2/M phase and induce A549/DDP cell apoptosis with dose dependently .

OBJECTIVE:To provide reference for standardizing the clinical use of carbapenem antibiotics and controlling drug-resistant bacteria infection. METHODS:The detection of 3 kinds of carbapenems-resistant Gram-negative bacillus in our hospi-tal during 2011-2016 were analyzed retrospectively. The consumption,target cure rate and treatment course of carbapenem antibiot-ics were analyzed statistically. The correlation between detection rate of drug-resistant bacteria with the consumption of carbapenem antibiotics was investigated by Pearson test. RESULTS:During 2011-2016,1222 strains of carbapenems-resistant Acinetobacter bauman (CRAB),655 strains of carbapenems-resistant Pseudomonas aeruginosa (CRPA) and 53 strains of carbapenem-resistant Escherichia coli (CRE) were detected in our hospital. The detection rates increased from 23.88%,8.92%,0.09% in 2011 to 80.34%,35.74%,0.97% in 2016. The types of carbapenem antibiotics in our hospital were mainly imipenem and meropenem. The consumption of them increased from 4222,145 g in 2011 to 7218,4387 g in 2016. The both target cure rates were all lower than 60%,and the proportion of the patients with treatment course >14 d was more than 65%. The detection rates of CRAB,CR-PA and CRE were positively correlated with the consumption of carbapenem antibiotics (r>0.9,P<0.05). CONCLUSIONS:The detection rate of carbapenems-resistant Gram-negative bacillus and drug consumption increase year by year in our hospital,and they have certain correlation. The target cure rate of carbapenem antibiotics in our hospital is in low level,and there is a long treatment course. They are should be standardized in the clinic. The selection of carbapenem antibiotics should be strictly followed clinical in-dications so as to reduce the generation of drug-resistant strains.

Objective To investigate the correlations of serum total bilirubin level with infarct volume,severity and etiological typing in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to hospital from January 2012 to January 2014 were used as subjects of study.Their clinical and imaging data were collected,and serum total bilirubin levels were detected.The correlations of the serum total bilirubin levels with the infarct volume,severity and etiological typing were analyzed.Results A total of 290 patients with acute ischemic stroke were enrolled in the study.The patients were divided into either a large infarction group (≥1.8 cm3,n =145) or a small infarction group (＜ 1.8 cm3;n =145)according to the median cerebral infarction volume.The total bilirubin level of the large infarction group was significantly higher than that of the small infarction group (16.896± 7.761 μmol/L vs.13.039±4.477 μmol/L;t =5.185,P ＜ 0.001).Multivariate logistic regression analysis showed that the bilirubin highest quantile group (＞ 17.893 μmol/L) was an independent risk factor for large infarction (odds ratio [OR] 2.754,95％ confidence interval [CI] 1.028-7.375;P =0.044).According to the National Institutes of Health Stroke Scale (NIHSS) score,the patients were divided into a mild stroke group (NIHSS score ＜8;n =210) and a moderate to severe stroke group (NIHSS score≥ 8,n =80).The total bilirubin level of the moderate to severe stroke group was significantly higher than that of the mild stroke group (16.861 ±7.689)μmol/L vs.14.246 ± 6.019 μmol/L;t =3.052,P =0.002).Multivariate logistic regression analysis showed that the total bilirubin level was not an independent risk factor for moderate to severe stroke.Small artery occlusive stroke,large artery atherosclerotic stroke,and other definite causes of stroke were combined into non-cardioembolic stroke group (n =244).The total bilirubin level in the cardioembolic stroke group (n=46) was significantly higher than that in the non-cardioembolic stroke group (19.639±8.409 μmol/L vs.14.087 ±5.831 μmol/L;t =5.479,P＜0.001).Multivariate logistic regression analysis showed that the bilirubin highest quartile group (＞ 17.893 μmol/L) was an independent risk factor for cardioembolic stroke (OR 8.405,95％ CI 1.719-41.106,P =0.009).Conclusions The increased serum total bilirubin level is an independent risk factor for larger infarction and cardioembolic stroke.As an oxidative stress index,serum total bilirubin in acute stage can provide help for early identification of infarct volume and etiological subtype in patients with ischemic stroke.

Objective To observe the pathological change of visceral pleura in patients with chronic obstructive pulmonary disease (COPD), and to discuss the relationship between the changes and COPD airflow limitation. Methods A total of 70 patients received the pulmonary lobectomy or partial resection because of lung tumor in Tianjin Chest Hospital from May 2014 to August 2015 were selected in this study. According to the results of pulmonary function test, the patients were divided into COPD group [forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) <70%,n=40] and control group (FEV1/FVC≥70%,n=30). The lung tissues, which was not the lesion areas, were used to make tissue sections. The Elastica Van Gieson (EVG) method was used to stain the sections. The thickness of visceral pleural and the proportion of elastic fibers in visceral pleural were observed and calculated under a microscope in the two groups. Results The specimens were derived from upper and middle lobes in 22 cases of COPD group, and from lower lobe in 18 cases. Specimens were derived from upper and middle lobes in 17 cases of control group, and from lower lobe in 13 cases. There were no statistical differences in sampling sites between two groups (χ2=0.019,P>0.05). The visceral pleural thickness and the proportion of elastic fibers in visceral pleural were significantly thinner in COPD group than those of control group ( P<0.01). In both COPD group and control group, visceral pleural thickness was significantly thinner in upper and middle lobes than that of lower lobe (P<0.05), but the proportion of elastic fibers in visceral pleural of upper, middle lobes showed no statistical difference compared with that of the lower lobe (P>0.05). Conclusion The thinner visceral pleural and the reduction of elastic fibers in visceral pleural are one of the causes of expiratory airflow limitation in COPD patients.