Radiation pneumonitis (RP) is the most common adverse event of thoracic radiotherapy, which primarily occurs within the 3 months after the beginning of radiotherapy. RP can not only negatively affect the pulmonary function and quality of life of patients, but also limit the prescribed dose and the implementation of radiotherapy plan, lower the radiotherapy efficacy and even lead to death. Currently, multiple studies have been conducted to explore the predictive factors of RP. In this article, clinical predictive factors including dosimetric parameters, peripheral blood cells along with cytokines and pulmonary function parameters were classified and illustrated, aiming to provide valuable predictive indicators for clinical use and reduce the incidence of RP.

The traditional SPECT has been considered unable to quantitatively analyze due to the limitations of device performance and reconstructing algorithm. Because of the development of SPECT devices, the emergence of SPECT/CT, and the improvement of reconstructive algorithms, SPECT can be used for quantitative analysis like PET. The current quantitative SPECT researches focus on the usefulness of quantitative SPECT technology in clinical diagnosis and the guidance and evaluation of radionuclide therapy. This review summarizes the development of SPECT quantification, the current status of quantitative SPECT researches in clinical diagnosis and radionuclide therapy, as well as the limitations and advantages of SPECT quantification.

Multifetal pregnancies with monochorionicity are more complicated, for which pregnancy monitoring and intrauterine intervention are of great importance. For dichorionic triamniotic triplets with MC twin, multifetal pregnancy reduction measures included cardiac injection of potassium chloride at 11 to 14 weeks of gestation for reduction to monochorionic singleton, and radiofrequency ablation after 16 weeks of gestation to preserve the dichorionic diamniotic twins. Moreover no significant difference was observed in the pregnancy outcomes between the two methods. Fetalscopic laser surgery can significantly improve the perinatal prognosis of multiple pregnancies complicated by twin-to-twin transfusion syndrome. Umbilical occlusion and transection can be used for the reduction of triplets containing monochorionic monoamniotic twins to avoid fetal death caused by entanglement of the umbilical cord. Cardiac injection of potassium chloride is appropriate for reducing the two fetuses in the same chorionic sac for trichorionic quadruamniotic pregnancy. Selective fetal reduction is applicable for MC triplets or quadruplets pregnancy, however, relevant studies are all with a small sample size, which requires full consultation and individualized treatment.

To investigate the clinical effect of pantoprazole combined with traditional Chinese medicine for gastroesophageal reflux. A total of 50 cases of gastroesophageal reflux selected from January 2019 to December 2019 in Aviation General Hospital were randomly divided into the control group and the observation group. The control group was given pantoprazole, and the observation group was given traditional Chinese medicine combined with pantoprazole. Both groups were treated for 28 days. The recovery of clinical symptoms, status of esophageal mucosa by endoscopy and the incidence of adverse reactions were compared between the two groups. The clinical symptoms and status of esophageal mucosa in both group were obviously improved. Efficiency of the observation group was significantly higher than that of the control group( P<0.05). No serious adverse reactions happened during treatment. Pantoprazole combined with traditional Chinese medicine has definite clinical effects in the treatment of gastroesophageal reflux, which can improve the clinical symptoms and the recovery of esophageal mucosa of patients with high safety.

Extracellular vesicles (EV) miRNAs are a class of small non-coding RNAs that are encapsulated in membrane-containing vesicles from a variety of cells, and which can mediate intercellular communication and transfer of functional molecules. EV miRNAs in circulation can be served as novel molecular markers for cancer diagnosis, monitoring and prognosis, and also the most promising liquid biomarkers for clinical translation and utility currently, while optimal research strategy is crucial for identifying valuable EV miRNAs in clinical study. Moreover, EV miRNAs have recently also been implicated in cancer progression as direct regulators of metabolic reprogramming, mesenchymal-to-epithelial transition, angiogenesis, anti-cancer immune response and drug resistance in the tumor microenvironment. Study on some key EV miRNAs involving in those processes may highlight their potential utility as liquid biopsies in early diagnosis, companion diagnosis, metastasis, therapeutic control, prognosis analysis as their therapeutic potential for patients with cancer.

ObjectiveTo explore the relationship between β2-adrenergic receptor (β2-AR) gene Arg16Gly polymorphism and essential hypertension (EH) in elder (≥60 years old).Methods150 old healthy controls and 115 old patients with EH (all of them without kin relation) were selected to test genotype of β2-AR by the technique of polymerase chain reaction-restriction fragment length polymorphism (PCR-PFLP).ResultsThe frequencies of three genotypes (Arg/Arg, Arg/Gly and Gly/Gly) were 22.81%, 53.51% and 23.68% in the EH group and 27.33%, 67.33% and 5.33% in the controls respectively. The frequencies of Arg and Gly allele were 49.56 % and 50.44% in the EH group, and 61.00% and 39.00% in the controls. There was a significant difference in distribution of alleles/genotypes between EH group and controls ( P<0.05).Conclusionβ2-AR Arg16Gly gene polymorphism is possibly associated with hypertension in this study population.

With the increasing morbidity of brain injury suffered from different causes,a large number of researchers focus on the recovery of the post-brain-injury.Based on the brain plasticity theory,this paper reviewed some possible recovery mechanisms of the post-brain-injury,including changes in neural cells,functional reorganization,functional compensation,changes in the excitability of cortex,and specific skills learning.

Functional electrical stimulation (FES) has already used in many aspects of rehabilitation medicine, including the rehabilitation of motor function especially after stroke or spinal cord injury. This paper reviewed the parameters for and the effects on motor function rehabilitation.

Objective To assess the value of Heidelberg retina tomograph-Ⅱ(HRT-Ⅱ)and optical coherence tomography(OCT)on making a diagnosis of macular edema in patients with background diabetic retinopathy.Methods Eighty eyes of 40 patients with background diabetic retinopathy were divided into the macular edema group and non-macular edema group according to examination of fluorescein fundus angiography(FFA).Macular thickness was measured by OCT and edema index was invested by HRT-Ⅱ.The results were analyzed by statistics test.Results The Kappa value of OCT examination on diagnosis for macular edema of background diabetic retinopathy was bigger than the HRT-Ⅱ.Making FFA as the diagnosis standard of macular edema,OCT examination showed P=0.0001,HRT-Ⅱ examination showed P=0.0856.Conclusion OCT and HRT-Ⅱ can be used to quantitate the macular edema of the diabetic retinopathy patients.OCT is better in the final diagnosis for macular edema than HRT-Ⅱ,and HRT-Ⅱ has higher misdiagnosis rate and lower missed diagnosis rate.HRT-Ⅱ can be used to screen macular edema patients with diabetic retinopathy.

ObjectiveTo investigate the effects of intravenous fentanyl combined with scalp nerve block with ropivacaine on the hemodynamic response to skin incision during craniotomy.Methods43 ASA Ⅰ～Ⅱ patients scheduled for selective frontotemporal craniotomy were randomly assigned into 3 groups: the isoflurane group(group I,n=14), the fentanyl group (group F, n=15) and the fentanyl-ropivacaine group (group B, n=14 ).Anesthetic induction was performed with IV remifentanil 2 μg/kg, propofol 2 mg/kg, and vecuronium 0.1mg/kg. Group F received fentanyl 3 μg/kg 5 min before skin incision .Group B received the same doses of fentanyl prior to skin incision as well as scalp nerve block with 1% ropivacaine before induction. Anesthesia was maintained with isoflurane. The "up and down" method was used to determine MAC-BAR in each group.ResultsThe end-tidal isoflurane concentration blocking sympathetic response to incision in group I, F and B were 2.0%,1.8%,1.0% respectively.The MAC-BAR of group I, F and B were 1.7 MAC,1.55 MAC,0.8 MAC respectively. The end-tidal isoflurane concentration blocking sympathetic response to incision and MAC-BAR of group B decreased obviously compared with that of group I and F(P<0.05).ConclusionIntravenous fentanyl combined with scalp nerve block with ropivacaine can successfully reduce the hemodynamic response to skin incision.