Objective To analyse the ultrastructural and metabolic changes of brain injury after single-fraction high-dose radiation in rabbits by means of proton 1-hydrogen) magnetic resonance spectroscopy ~1H MRS) ,in order to provide the basic theory for early detection of radiation-induced brain injury.Methods Experimental model of single-fraction high-dose radiation-injured brain was established in 40 rabbits , which were randomly divided into 4 groups and underwent 10, 15, 20 Gy and 30 Gy radiation , respectively. Proton MRS in a clinical MR imager was used to ascertain the amount of whole-brain N-acetylaspartic acid NAA), lactic acid Lac), choline Cho), creatine Cr) before and within 8 weeks after focused single-fraction high-dose irradiation therapy. Metabolic maps of NAA, Lac, Cho and Cr were created from MRS data set. Detection of irradiation injury among the tested models was assessed by receiver operating characteristic analysis and by quantitative signal intensity changes. The peak values of NAA , Lac , Cho and Cr on MRS before and after radiation were measured. Histopathology and electron microscope were used to ascertain changes of the ultrastructural organization in the irradiated area.the results were compared and statisti-cally analyzed. Results Initially MRS was found a slightly decrease. Until obviously change was detected, statistical significance variation of MRS occurred. A significant decrease in~1H MRS occurred at the early stage of brain injury induced by single-fraction high-dose irradiation.Conclusion ~1H MRS may be regarded as a noninvasive and sensitive means for the detection of early radiation-induced brain injury.

Objective To investigate the expressions of transforming growth factor beta-1 (TGF-β1) and nuclear factor kappa B (NF-κB) in patients with chronic obstructive pulmonary disease (COPD),and to explore the mechanism of pathogenesis in COPD.Methods A total of 40 patients undergoing lung resections for pulmonary tumor were selected.Patients were divided into 2 groups according to COPD diagnostic criteria:the control group [patients without COPD,13 males,7 females,with an average age of (61.7±8.8) years] and the COPD group [patients with COPD,15 males,5 females,with an average age of (60.5 ± 9.4) years].Peripheral lung tissues from tumor lesions were detected in this study.The qualitative and quantitative expressions of NF-κB were determined by immunohistochemistry and Western blot,respectively.TGF-β31 mRNA level was determined by reverse transcription polymerase chain reaction (RT-PCR).Results The levels of TGF β1 mRNA and NF-κB protein and the NF-κB nucleus positive rate were significantly higher in the COPDgroup than in the control group [(0.42±0.11) vs.(0.34±0.13),(0.24±0.08) vs.(0.12±0.04),57.9％ vs.26.7％,respectively,all P＜0.05].The TGF-β31 mRNA level was positively correlated with the NF-κB protein expression in the 2 groups (r=0.497,0.618,both P＜0.01).The ratio of 1 second forced expiratory volume/forced vital capacity (FEV1/ FVC) was negatively correlated with TGF-β1 mRNA level and NF-κB protein expression (r=-0.624,r=-0.659,both P ＜0.01) in the COPD group.Conclusions The expression levels of NF-κB and TGF-β1 are significantly increased in patients with COPD,and there is a positive correlation between TGF-β1mRNA level and NF-κB protein expression.NF-κB may participate in regulating TGF-β1 mRNA expression and in contributing to the airway remodeling,thereby in effecting pulmonary function.

Objective:To analyze influence factors in patients with acute myocardial infarction (AMI) undergoing e‐mergency percutaneous coronary intervention (PCI ) .Methods:Clinical data of 656 patients ,who received emer‐gency PCI because of AMI in our hospital from Jan 2005 to Jan 2015 ,were retrospectively analyzed .Short -term prognosis ,including incidence rates of heart failure (HF) ,cardiogenic shock (CS) ,arrhythmias and mortality , were compared and analyzed among these patients from onset related factors ,coronary disease and vascular reope‐ning time etc .Results:Mean onset age of men was significantly younger than that of women (P<0.05) .Incidence rate of AMI in winter and spring was significantly higher than those in summer and autumn (χ2 = 6.244 , P=0.012) .According to complicated with hypertension ,DM ,dyslipidemia and smoking or not ,patients were divided into corresponding disease group and normal group ;only incidence rates of CS (37.78% vs .29.62% ) and arrhyth‐mia (47.78% vs .38.24% ) in DM group were significantly higher than those of non -DM group ,mortality rate of dyslipidemia group was significantly lower than that of normal blood lipid group (0.73% vs .3.69% ) , P<0.05 or< 0.01 ,there were no significant difference in incidence rates of other events between normal group and disease group (P>0.05 all) .Incidence rate of arrhythmia in RCA group was significantly higher than those of LAD group , LCX group and multi -vessel group (56.36% vs .31.55% ,37.50% ,34.38% ) ,mortality of LM group was signifi‐cantly higher than those of LAD group ,RCA group and LCX group (25.00% vs .1.79% ,0.91% ,0% ) , P<0.05 or <0.01. Incidence rate of HF in 10~12h group was significantly higher than those of 0~3h ,4~6h and 7~9h group (79.46% vs .61.70% ,66.81% ,64.78% ) ,incidence rate of arrhythmia was significantly lower than those of 0~3h ,4~6h and 7~9h group (32.14% vs .55.32% ,43.81% ,44.65% ) ,and incidence rate of CS was significant‐ly higher than that of 0~3h group (35.27% vs .21.28% ) , P<0.05 or <0.01. Conclusion:Onset age ,season and DM ,coronary disease extent ,vascular reopening time are risk factors influencing short‐term prognosis of AMI .

Objective To investigate the clinical therapeutic effect of Chaishi fever particles on patients with epidemic encephalitis B and to study the machanism of anti-inflammatory.Methods One hundred and twenty one patients with epidemic encephalitis B admitted to the Second Clinical Medical College of Henan University of Chinese Medicine from January 2014 to May 2017 were enrolled, and they were divided into a routine treatment group (60 cases) and a traditional Chinese medicine (TCM) treatment group (61 cases) by random number table. The patients in routine treatment group were given symptomatic support and comprehensive treatment for 15 days, while those in the TCM treatment group were given as that of routine group with the addition of Chaishi fever particles 8 g, 4 times every day, orally taken for consecutive 15 days. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-10) in the serum of two groups were determined by enzyme-linked immunosorbent assay (ELISA), and the clinical therapeutic effect, complications and sequelae in two groups after treatment were observed.Results Compared with the routine treatment group, after treatment the time of body temperature recovering normal (days: 5.8±1.2 vs. 7.5±1.7), the coma time (days: 5.5±1.3 vs. 6.8±1.6), the remission time of convulsion (days: 5.2±1.4 vs. 6.5±1.5), and the length of stay in hospital (days: 22.6±1.9 vs. 25.2±1.8 ) were significantly shorter in TCM treatment group (P < 0.05). After treatment, the levels of serum tumor TNF-α and IL-1β were decreased, IL-10 was increased in both groups, moreover, compared with the routine treatment group, the changes were more obvious in TCM treatment group [TNF-α (μg/L): 11.4±3.6 vs. 14.6±3.5, IL-1β (μg/L): 22.3±6.2 vs. 26.2±5.6, IL-10 (μg/L): 225.2±19.2 vs. 186.2±21.5, allP < 0.05]. In addition, compared with the routine treatment group, the total effective rate was higher [98.3% (60/61) vs. 90.0% (54/60),P < 0.05], and the incidence of sequelae was lower [1.64% (1/61) vs. 13.3% (8/60),P < 0.05] in TCM treatment group.Conclusion The Chaishi fever particles can effectively treat the patients with epidemic encephalitis B and the action is related to the inhibition of inflammatory reaction.

Objective:To explore influence of position of myocardial infarction and coronary artery lesions in patients with acute ST elevation myocardial infarction (STEMI) ,and the relationship among heart failure ,arrhythmia and severity of coronary artery lesion .Methods :Clinical data of 224 patients ,who hospitalized in our hospital because of STEMI and received coronary angiography from Jan 2009 to Jun 2011 ,were retrospectively analyzed .General data of patients were collected ,and SYNTAX score was used to reflect severity of coronary artery lesion ,and the rela‐tionship among heart failure ,arrhythmia and SYNTAX scores were analyzed .Results:Incidence rate of heart fail‐ure in patients with infarction relate artery left anterior descending artery (LAD) AND/or left main coronary artery (LM) was significantly higher than that of patients with right coronary artery (RCA) (57.0% vs .39.7% , P=0.017) ,incidence rate of arrhythmia in patients with RCA was significantly higher than that of patients with left circumflex artery (LCX) (37.0% vs .6.3% , P=0.016);incidence rates of arrhythmia (48.4% ) ,shock (54.8% ) were highest in patients with inferior wall/right ventricle than those of other position , P<0.05 or <0.01.SYNTAX scores in patients with heart failure and arrhythmia were significantly higher than those of patients without heart failure and arrhythmia respectively [ (18.7 ± 9.1) scores vs .(15.4 ± 8.6) scores ,(19.7 ± 9.0) scores vs .(16.1 ± 8.8) scores , P<0.01 both] .Conclusion:Incidence rates of heart failure ,cardiogenic shock and arrhythmia are related to coronary artery lesions position and degree and myocardial infarction position in STEMI patients .

Objective To explore the applicability of the childhood autism spectrum test (CAST) of children in Mainland China according to autism screening,in order to provide the effective reference for the identification and diagnosis of autism spectrum disorders of children.Methods Two hundreds and fifty-two typical developing children,and 61 autistic children who were confirmed by psychological clinic of Child Healthcare Clinic,Shenzhen Luohu District Maternal and Child Health Care Hospital who were conformed with diagnosis standards of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition(DSM-5) by using CAST Chinese version were assessed,and the reliability and validity analysis were made on the CAST scale.The receiver operating characteristic curve was drew to determine the optimal threshold value,and the sensitivity,specificity and positive predictive value were calculated.Results CAST Chinese version had good reliability,Cronbach's α was 0.880.Split-half reliability coefficient r was 0.821,and the whole scale calibration reliability coefficient was 0.902.There was statistically significant difference between items and the total score(P＜0.05).The consistency between the CAST ≥4 years old children and diagnosis standards of DSM-5 reached 0.884(P=0.000).The consistency 3-＜4 years old children and diagnosis standards of DSM-5 reached 0.867 (P=0.000).Among the screening of the children who were ≥4 years old,the cut off was 15 scores that the sensitivity and specificity were best.With the children of 3-＜4 years old,a designated cut-point should be 17 scores.Conclusions There are good reliability and validity of CAST,which can be used to mainland China,as well as to screen autistic children more than 3 years old.

Objective To explore the effects and mechanism of cigarette smoke extract (CSE) on the proliferation of air?way smooth muscle cells (ASMCs) and the expression of CCAAT/enhancer-binding protein (CEBPα) and calreticulin. Meth?ods (1) The ASMCs were stimulated with different concentrations of CSE for twenty-four hours. According to the concentra?tions of CSE,the cells were divided into control group, 2.5%CSE group, 5%CSE group and 10%CSE group. The prolifera?tion of ASMCs was measured by MTT colrimetric method. The CEBPαmRNA was analyzed by RT-PCR. Western bloting as?say was performed to detect the levels of CRT and CEBPαprotein. (2) In 10%CSE group, transfection of the siRNA respec?tively for negative control or calreticulin was performed in accordance with instructions. The cell proliferation and the expres?sion of calreticulin and CEBPαwere compared in negative control siRNA group and calreticulin siRNA group. Results (1) With the increasing of the concentrations of CSE, the protein expression of CEBPαdecreased gradually (P<0.05), while the proliferation of ASMCs and the protein expression of calreticulin increased (P<0.05), but the expression of CEBPαmRNA in ASMCs showed no significant difference in groups with different concentrations of CSE (P>0.05). (2) Under the 10%CSE, the expression of CEBPαwas significantly higher in CRT siRNA group than that in negative control group (P<0.05),but the cell proliferation and CRT were significantly lower in the calreticulin siRNA group than those in negative control siRNA group (P<0.05). Conclusion The CSE exposure contributes to the expression of calreticulin protein,and then inhibits the translation of CEBPαmRNA,thus promotes the proliferation of ASMCs.

Objective:This study aims to analyze the relationship between the effect of induction chemotherapy and the timing of radiotherapy in limited-disease or limited-stage small-cell lung cancer (LSCLC). Methods: Data from 148 LSCLC patients who re-ceived induction chemotherapy and radiotherapy between January 2009 and December 2012 were retrospectively analyzed. The effect of two to three cycles of induction chemotherapy was evaluated according to the RECIST version 1.1, which includes complete re-sponse (CR), partial response (PR), stable disease, and progressive disease. CR and PR were used to calculate response rate. The pa-tients were divided into early and late groups based on immediate radiotherapy after two to three cycles of induction chemotherapy. The survival rate was analyzed using the Kaplan-Meier method. Log-rank test and Cox regression model were used to evaluate the influenc-ing factors of the survival rate. Results: The median overall survival (OS) and progression-free survival (PFS) were 22.8 and 13.0 months, respectively. The early and late radiotherapy groups exhibited OS of 34.0 and 18.0 months, respectively, and corresponding PFS of 16.8 and 10.9 months. In the subgroup analysis, for the patients who responded to the induction chemotherapy, the early and late radiotherapy groups showed median OS of 18.0 and 19.5 months, respectively, and corresponding PFS of 19.4 and 11.7 months. For the patients who had no response to the induction chemotherapy, the early and late radiotherapy groups exhibited median OS of 18.0 and 9.5 months, respectively, and corresponding PFS of 12.4 and 10.3 months. Conclusion:All LSCLC patients who received two to three cycles of induction chemotherapy should receive radiotherapy as soon as possible after chemotherapy, regardless of their response to the induction chemotherapy.

Objective To review the diagnosis of idiopathic pulmonary hemosiderosis ( IPH),and to evaluate the efficacy of maintenance therapy with dose-adjusted 6-mercaptopurine (6MP) in IPH children. Methods The diagnosis of IPH was confirmed by in-patient examination and at least 1 year follow-up to exclude secondary causes of pulmonary hemorrhage. Fifteen children met the criteria of IPH and were enrolled. The age at diagnosis was 2-13 years ( median 7 years). Prednisone was administered at 2 mg/( kg·d) for 4 weeks in acute phase of the disease followed by taper. 6MP was also started at 60 mg/( m2·d) simultaneously and continued for 3 years. Results The diagnosis was delayed in most children, which was due to the lack of initial classical manifestation of the disease. The time between the onset of symptoms and diagnosis ranged from 2 weeks to 108 months ( median 8 months) . All the patients exhibited response to the initial treatment and prednisone was successfully tapered off. Only 1 of 8 patients with relative leucopenia (3 × 109/L -6 × 109/L) on 6MP maintenance recurred while 5 of 7 others recurred (P < 0. 05) during median 6-year (range 2. 5 - 9. 5 years) follow-up. Of the latter 5 patients who recurred,4 remained recurrence-free after adjusting the dose of 6MP upwards to keep relative leucopenia. Conclusions Diagnostic delayed is still a main problem in pediatric IPH. Most IPH children in our group tolerated maintenance treatment with 6MP and achieved long-term remission, and these suggested growth retardation on long-term steroids therapy could be avoided. Because of interindividual difference in 6MP metabolism, adjusting the dose of 6MP may be necessary for treatment of IPH children and avoid under-treatment or overtreatment in some children,and thus improve the prognosis. White blood count could be a simple and useful indicator to predict clinical response in most IPH children on 6MP.

Objective:To investigate the prognosis of cT3 and the subgroups of low rectal cancer patients who underwent neoadju-vant chemoradiotherapy (CRT) and evaluate whether all patients with cT3 low rectal cancer should undergo CRT. Methods:A total of 223 patients with cT3 low rectal cancer treated in the Department of Colorectal Surgery of Fujian Medical University Union Hospital from January 2008 to December 2012 were divided into neoadjuvant chemoradiotherapy group (CRT group) (115 cases) and no neoad-juvant chemoradiotherapy group (nCRT group) (108 cases) according to whether the patients underwent CRT. Afterward, the patients were retrospectively divided into three subgroups (mrT3a, mrT3b, and mrT3c) according to the proposed criteria of the Radiologic Soci-ety of North America (RSNA) by measuring the depth of mesorectal invasion (DMI) (DMI<5, DMI=5-10, and DMI>10 mm). The prog-noses of the two groups and their subgroups were compared. Results:The CRT and nCRT groups revealed no significant differences in the 3-year disease-free survival rate and the local recurrence rate for all the mrT3 patients (78.2%vs. 71.9%, P=0.608;4.4%vs. 8.5%, P=0.120) and mrT3a patients (82.4%vs. 81.8%, P=0.837;5.8%vs. 5.9%, P=0.658). On the contrary, for the mrT3b patients, the CRT and nCRT groups revealed significant differences in the 3-year disease-free survival rate (84.4%vs. 42.4%, P=0.032) and local recurrence rate (0.0%vs. 18.2%, P=0.014). For the mrT3b,c patients, the CRT and nCRT groups revealed no significant difference in the 3-year dis-ease-free survival rate (72.8%vs. 42.4%, P=0.060) but revealed a significant difference in the local recurrence rate (2.4%vs. 18.2%, P=0.021). COX regression analysis was utilized for 3-year disease-free survival, DMI and circumferential resection margin (CRM) were significant in the univariate analysis. Additionally, the multivariate analysis indicated that CRM is an independent impact factor (OR=2.249, CI 1.067-4.742, P=0.033). Conclusion:CRT can improve the prognosis of patients with mrT3b,c low rectal cancer but may not significantly influence the prognosis of patients with mrT3a and CRM-negative low rectal cancer;surgical treatment can be performed in these patients without CRT.