Optical coherence tomography (OCT)is thought to be the most effective tool for recognizing form of vul-nerable plaques and evaluating endothelium coverage after percutaneous coronary intervention (PCI)so far.OCT can be used to guide stent implantation,evaluate endothelium proliferation status in stent,explore causes for in-stent restenosis and detect stent late malapposition and in-stent thrombosis etc.

Objective To investigate the clinical value of negative pressure vacuum cushion combined with thermoplastic body membrane in radiotherapy for Wilms tumor in children.Methods A total of 42 pediatric patients with Wilms tumor who received radiotherapy after surgery were enrolled in the study and were randomly divided into two groups according to the fixation positions:group A and group B.During radiotherapy, the patients in group A were fixed with negative pressure vacuum cushion, and those in group B were fixed by negative pressure vacuum cushion combined with thermoplastic body membrane.The setup errors, short-term effects, adverse reactions, and prognosis were compared between the two groups.ResultsGroup B showed significantly lower translational errors and rotational errors, as well as significantly higher rates of ≤3 mm and ≤5 mm errors, compared with the group A (P=0.04,0.04,0.04,0.03,0.00,0.04,0.04,0.00,0.04).Group B also showed significantly higher complete remission rates and response rates than group A (P=0.02,0.04).There were no significant differences in the adverse reaction rates (P=0.75) and the overall survival (OS) rates at 2 and 3 years (P=0.68,0.74) between the two groups.Group A had the MPTV values in left-right (LR) direction (x-axis), superior-inferior (SI) direction (y-axis), and anterior-posterior (AP) direction (z-axis) being 5.74 mm, 5.93 mm, and 5.94 mm, respectively, and group B had the MPTV values at LR, SI, and AP directions being 4.21 mm, 5.71 mm, and 4.61 mm, respectively.Conclusions In the radiotherapy positioning for Wilms tumor in children, fixation limbs with negative pressure vacuum cushion combined with thermoplastic body membrane effectively reduces the setup errors and improves the effect of radiotherapy, so it holds promise for clinical application.

OBJECTIVE: To investigate the clinical application value of cone-beam CT (CBCT) online correcting technology in volume modulated radiation therapy (VMRT) for nasopharyngeal carcinoma (NPC). METHOD: Fifty NPC patients applying head neck and shoulder thermoplastic body membrane fixing device were eligible for treatment VMRT, these patients would accept a couple of CBCT scanning by on board imager (OBI) in a fixed time each week after initial setup and after online correcting during the first three week for radiotherapy, CBCT images and DRR images constructed by CT simulation were carried out registration,which could calculate the setup errors of initial setup and after online correcting. RESULT: Fifty patients were accepted 150 scanning after initial setup and 150 scanning after online correcting respectively, the errors after initial setup were (-1.24 ± 1.25)mm in X direction, (1.19 ± 1.85)mm in Y direction, (1.49 ± 1.70) mm in Z direction. The setup errors after online correcting were (-0.13 ± 0.29)mm in X direction, (0.10 ± 0.47)mm in Y direction, (0.17 ± 0.36)mm in Z direction. The setup errors after online correcting were significantly lower than the errors after initial setup in X direction (P < 0.05), Y direction (P < 0.05), Z direction(P < 0.05). The M(PTV) value after online correcting were 0.46 mm, 0.53 mm and 0.59 mm in X, Y and Z directions respectively. CONCLUSION The use of CBCT online correcting technology can significantly reduce the setup errors of VMRT for NPC and improve the treatment effect.
Carcinoma ; Cone-Beam Computed Tomography ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated

Objective To investigate the changes of the serum level of highly sensitive C-reactive protein (hs-CRP)in patients with cerebrovascular disease and its clinical significance. Methods The serum level of hs-CRP in 60 patients with acute cerebral infarction and 60 patients with acute cerebral hemorrhage and 40 healthy persons were determined.All the patients were scored by clinic neurological deficit scale(NDS),and were compared in groups. Results The serum level of hs-CRP in patients with acute cerebral infarction and with acute cerebral hemorrhage were significantly higher than that in normal controls(t=19.712 13.217 P <0.01).There was no obvious difference between the patients with acute cerebral infarction and with acute cerebral hemorrhage. Conclusion The serum level of hs-CRP was closely correlated with the severity of cerebrovascular disease.

Objective To investigate whether tolterodine combined with pelvic floor electrical stimulation is more effective than tolterodine alone in the treatment of wonen with overactive bladder(OAB) and the underlying mechanism.Methods Seventy-three female patients with OAB were recruited from our hospital during Oct.2009 to Dec.2010 and prospectively studied,of whom 39 cases were given tolterodine(2 mg each time,twice daily for4 weeks)alone while the other 34 cases were given tolterodine combined with pelvic floor electrical stimulation for the treatment of OAB.Data on urgency,incontinence,micturition frequency,nocturia episodes and voided volume were collected before and after 4 weeks' treatment using a week micturition diary.Results The differences of changes of OAB symptoms between the 2 groups had statistical significance (P ＜ 0.05).Patients in the tolterodine combined with pelvic floor electrical stimulation group reported treatment benefit than the tolterodine group in the micturitions and the volume voided per micturition(P ＜ 0.05).There were no difference in the number of urgency episodes per 24 hours,incontinence episodes and nocturnal episodes (P ＞ 0.05).Conclusion A combination of toterodine with pelvic floor electrical stimulation could significantly improve the OAB symptoms,and is a potential therapy for female patients with OAB.

BACKGROUND:At present, the anatomic reconstruction of coracoclavicular ligament is a trend for the treatment of acromioclavicular joint dislocation. Endobutton plate is a new and effective surgical method found in recent years. Although the recent curative effect is satisfactory, as a method of internal fixation, its rigid fixation does not conform to the requirements of the biomechanics. Furthermore, a randomized control ed clinical study and systematic evaluation are absent.
OBJECTIVE:To systematical y evaluate clinical outcomes and safety between endobutton plate and the other surgical methods for treatment of acromioclavicular joint dislocation.
METHODCochrane (2014-01), PubMed (1966-01/2014-03), Medline (1966-01/2014-03), EMbase (1984-01/2014-03), CNKI (1979-01/2014-03), VIP (1989-01/2014-03) and Wanfang (1989-01/2014-03) databases were searched by computer. Six Chinese journals about orthopedics were searched by hand. References of relevant literatures were searched. Randomized control ed trials that were related to different surgical methods for the treatment of acromioclavicular joint dislocation were col ected. In accordance with inclusion criteria, some literatures were included and their qualities were assessed strictly. Meta-analysis was performed with RevMan 5.2 software from the Cochrane Col aboration.
RESULTS AND CONCLUSION:Final y 7 published studies with randomized control ed trials met al the inclusion criteria. A total of 359 patients were included, containing 152 cases of endobutton plates fixation, 149 cases of clavicle hook plate fixation, and 58 cases of screw fixation. Except two researches addressed the comparison among three surgical ways, the remaining were about two ways. Meta-analysis showed that the excellent rate was better in endobutton plates fixation than in clavicle hook plate fixation (P=0.0002) and in screw fixation (P=0.009). Compared with other fixation methods, there were significant differences in shoulder joint pain (P=0.01), but no significant difference was detected in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection (P=0.44, P=0.10, P=0.37, P=0.21, P=0.96). Results indicated that, the efficiency of endobutton plates fixation for acromioclavicular joint dislocation was better than clavicle hook plate fixation and screw fixation, and caused less shoulder pain than clavicle hook plate fixation. There was no significant difference in operation time, upper limb muscle strength, bleeding amount, redislocation and surgical wound infection among the three methods. Due to the limited number of cases in this study, the multicenter, large-sample and long-term clinical randomized control ed studies are needed to increase the strength of the evidence.

Objective:To investigate the changes of thymic lymphocyte procyanidin(TSLP)and interleukin-4(IL-4),interleukin-10(IL-10)and interleukin-13(IL-13)in the lung tissue of young rats infected with respiratory syncytial virus,and to investigate the changes of TSLP and Th2 Correlation.Methods:18 Wistar rats were randomly divided into RSV infection group and normal group,9 rats in each group.Application of RSV virus droplets nasal modeling,saline diarrhea as a control.The lung tissue of rats was taken for pathological observation;the load of syncytial virus at different time points and the expression of TSLP in lung tissue were detected by Real-time quantitative polymerase chain reaction(q-PCR);at the same time,the expression of TSLP at the protein level was detected by Western blot.The levels of cytokines IL-4,IL-10 and IL-13 in serum were measured by enzyme-linked immunosorbent assay(ELISA).And the relationship between TSLP and IL-4,IL-10 and IL-13 was analyzed by Spearman correlation.Results:Compared with the normal control group,the rats in the model group showed symptoms such as poor mental state,rough hair,decreased activity and shortness of breath after intranasal infection,and the symptoms were aggravated.Pathological observation showed that the alveolar wall was thickened in the model group,and a large number of lymphocytes,plasma cells,eosinophil infiltration.q-PCR was used to detect the syncytial virus load in model group,and reached the peak at about 5 days,then decreased gradually.RSV infection increased the secretion of TSLP in rat respiratory tract.q-PCR and Western blot showed that TSLP concentration in model group was higher than that in control group(P<0.05).The levels of IL-4,IL-10 and IL-13 in the serum of the model group were higher than those in the control group(P<0.05).Spearman correlation analysis showed that TSLP was positively correlated with IL-4 and IL-10 expression in RSV model group,and there was no correlation between TSLP and IL-13 expression.Conclusion:RSV infection in rat lung tissue can induce increased expression of TSLP,while promoting the occurrence of Th2 type of inflammatory response and the expression of related cytokines,in order to further study of RSV infection caused by bronchiolitis and asthma and other respiratory diseases,the mechanism of action and clinical treatment laid the foundation.

Objective To observe apoptosis and proliferation of intestinal epithelial cells and to explore the mechanism of protective effects of rhubarb monomers on intestinal epithelial cells in septic rats.Methods Eighty male Sprague-Dawley (SD) rats (230-250 g) under anesthesia and sedation were subjected to cecal ligation and perforation (CLP).After surgical preparation,rats were randomly (ramdom number) divided into 8 groups (n =10 each):a sham group (A) [normal saline (NS) gavage];a sepsis group (B) (NS gavage);group C (ip dexamethasone 0.5 mg/kg immediately after CLP) (C);and rhubarb monomer 100 mg/kg in NS treated groups including:rhein group (D),emodin group (E),3,8-dihydroxy-1-methyl-anthraquinone-2-carboxylic acid group (F),1-O-caffeoyl-2-(4-hydroxy-O-cinnamoyl)-D-glucose group (G),and 3,8-dihydroxy-1-methyl-anthraquione group (H).Animals were sacrificed 24 hrs after treatment.Intestinal histopathology,apoptosis (TUNEL) and proliferation of intestinal epithelial cells (proliferating cell nuclear antigen,PCNA) were measured.Multiple comparisons were carried out with one-way analysis of variance (ANOVA).Results Histopathology revealed injury to the intestinal mucosal villi induced by sepsis in group B compared with group A.The injury was significantly ameliorated in groups C,D,E,F,G,and H compared with group B.The apoptosis index in group B was significantly higher than that in group A (P ＜ 0.05) and the apoptosis index in groups C,D,E,F,G,and H was significantly lower than that in group B (P ＜ 0.05).The PCNA positive index in group B was significantly lower than that in group A (P ＜ 0.05),but was significantly higher in groups C,D,E,F,G,and H than that in group B (P ＜ 0.05).Conclusion Rhubarb monomers can promote the proliferation of mucosal cells and prevent apoptosis of intestinal mucosal cells.In addition,rhubarb monomers may play a role in protecting the intestinal barrier function.

Objective To analyze the characteristics and prognosis of intra-aortic balloown pump (IABP) supported percutaneous coronary intervention (PCI) in patients with Acute Coronary Syndrome (ACS) complicated with cardiogenic shock (CS).Methods 197 ACS patients complicated with CS patients received IABP supported PCI in Beijing Anzhen hospital from January 2014 to December 2015 were involved.According to the clinical results, all patients were divided into survival group and non-survival group.The clinical and laboratory parameters were compared between groups.Results Among the 197 patients enrolled, there were 162 patients in the survival group and 35 patients in the non-survival group.The mean age was (57.3±14.7) year-old, mean arterial blood pressure (MAP) on admission was (53.3±14.6) mmHg (1 mmHg=0.133 kPa).Percentage of diabetes comorbidity, cTnI level, oxygen index and MAP were significantly different between the survival and the non-survival groups (P<0.05).The symptom onset to balloon time and door-to-balloon time intervals were found delayed with significant difference in the non-survival group compared to the survival group (P<0.05).IABP improved hemodynamic parameters including blood pressure, cardiac function and oxygen index (P<0.05) in both groups.Duration of vasopressor usage, IABP implantation, percentage of invasive mechanical ventilation, length of stay in intensive care unit, acute kidney injury (AKI) and re-infarction were also significantly different between the two groups (P<0.05).Conclusions Adverse events risk is higher in ACS patients complicated with cordiogenic shock requiring IABP support for PCI.Patients with mortal outcomes are older, comorbid with diabetes mellitus and history of myocardial infarction and higher event rates of re-infarction and acute kidney injury during hospitalization.Intensive care should be implemented to reduce the incidence of adverse events.

Background Choroidal neovascularization (CNV) is a serious complication of many fundus diseases.A variety of factors are associated with CNV.Research showed that recombinant human endostatin ( rhendostatin ) can arrest the vascular endothelial growth factor (VEGF) pathway and inhibit the proliferation of endothelial cells and angiogenesis.Objective This study was to observe the inhibition of rh-endostatin on experimental CNV.Methods The CNV animal models were created by Argon laser with the wavelength 532 nm to irradiate the inferior retina away optical disc 1-2 DD for 25 spots in 32 eyes of 16 chinchilla rabbits.The laser parameters were as follows:power 800 mW,spot diameter 75 μm and time shutter 50 ms.The models were then divided into model control group and rh-endostatin group.Rh-endostatin was intravitreously injected via scleral incision in 16 eyes of 8 model rabbits at 1 week after photocoagulation.Fundus fluorescein angiography (FFA) and optical coherence topography(OCT) were performed at 1,2,4 weeks after photocoagulation respectively.The eyeballs were enucleated and the retinal sections were prepared for the histopathologieal examination,and the contents of VEGF and pigment epithelial derived factor(PEDF) in rabbit vitreous,and blood serum were detected by ELISA at 2,4 weeks after photocoagulation.Results Retinal edema and exudes were seen in 1 week and scarring in 4 weeks after photocoagulation.In rh-endostatin injection group,the hyperfluorescence masses were seen in the background phase and early arterial phase in 42％ (84/200) of spots in the first week.The fluorescence leakage was decreased in the rh-endostatin injection group compared with control group in the second week and ceased at the third week on the FFA after injection.Variety forms of hyperreflective zones were found below the retinal pigment epithelium on the seventh day after photocoagulation.But the partial vessel occlusion and fibroplasias were identified in the rh-endostatin injection group in the third week by the OCT.The histopathological examination showed that the morphological abnormality was mild in the rh-endostatin injection group in comparison with model group.The serum PEDF concentration was significantly elevated but the VEGF/PEDF values in vitreous and serum were declined in rhendostatin injection group compared with model group (P ＜ 0.0 1 ).Conclusions Argon laser photocoagulation could induce the experimental CNV in chinchilla rabbit.Intravitreous injection of rh-endostar can effectively inhibit laser-induced CNV in rabbit.