Objective To investigate the effect and safety of Huoxue Yishen Decoction and Western medicine in treatment of chronic glomerulonephritis,in order to provide the basis for clinical diagnosis and treatment.Methods 67 cases with chronic glomerulonephritis admitted in People's hospital of Lanxi City from September 2012 to November 2013 were randomly divided into control group (n=32)and treatment group (n=35). The control group were given dipyridamole tablets,fosinopril sodium tablets,anti-infection and other symptomatic treatment and water electrolyte and acid-base balance disorders were corrected.Observation group were added Huoxue Yishen Decoction on the basis of control group treatment.A course of treatment was 4 weeks and all patients were treated for 2 courses. Results After treatment,the symptom score in treatment group (9.34 ±4.27 )was significantly lower than control group(13.35 ±5.64),and the difference was statistically significant (P<0.05).24 h protein,SCr and BUN in treatment group were significantly lower than control group,and the difference was statistically significant (P<0.05 ).The total effective rate of treatment group (91.43%)was significantly higher than control group(28.12%),the difference was statistically significant (P<0.05).Conclusion Huoxue Yishen Decoction combined with Western medicine in treatment of chronic glomerulonephritis can significantly improve renal function,it is effective and safety and has important value in clinical research.

Objective To investigate the accuracy of CTVision image-guided stereotactic body radiation therapy (SBRT) for non-small cell lung cancer (NSCLC).Methods 10 lung SBRT patients were imaged with CTVision before and after irradiation for acquiring and analyzing the three-dimensional set-up error data sets in our department from October 2010 to May 2012.Gross tumor volumes (GTVs) were contoured on pre-and post-SBRT CT sets and combined for generating internal gross tumor volumes (IGTVs).Planning target volume (PTV) margin was calculated,and IGTVs and PTVs were compared for off-line verification of accuracy of SBRT.A paired t-test statistical analysis was conducted with the datasets using SPSS 17.0.Results 80 CT image sets were totally obtained.Setup errors was significant difference before and after radiotherapy in the left-right,superior-inferior and anterior-posterior directions,that were (-0.10±1.30) mmand (-0.15±1.31) mm (P=0.720),(0.18±1.32) mm and (0.18±1.43) mm (P =1.000) and (-0.08 ± 1.19) mm and (-0.13 ± 1.18) mm (P =0.750),respectively.IGTVs of ten patients were smaller than corresponding PTVs (13.53 cm3 and 37.84 cm3,P =0.000).Conclusion Accuracy and safety of SBRT could be verified by imaging with CTVision before and after delivery for non-small cell lung cancer.

Objective To investigate the efficacy and toxicity of stereotactic ablative radiotherapy for stage Ⅰ peripheral non-small cell lung cancers.Methods Thirty six patients of stage Ⅰ peripheral non-small cell lung cancers were treated with stereotactic ablative radiotherapy.The prescription dose was 12 Gy per fraction ×4 fraction in one to two weeks.The 100％ planning target volume (PTV) was covered by the isodose curve of 95％ prescription dose.Organs at risk and their respective tolerance doses used during treatment planning were developed from the research scheme of the Radiation Therapy Oncology Group 0236.Before the radiation delivery,all patients were scanned by the fan beam CT or the cone beam CT for image guidance and registration.The follow-up for the patients was given to observe the toxicity and efficacy of stereotactic ablative radiotherapy (SABR).Results The median follow-up time was 18.7 months (range of 4 to 36 months).After treatment,the overall response rate was 88.9％,with complete response (CR) 17 cases(47.2％),partial response (PR) 15 cases(41.7％),and stable disease (SD) 4 cases(11.1％).The estimated overall survival rate at 1 and 3 years was 92.3％ (95％ confidence interval [CI],86.3％ ～97.1％) and 85.3％ (95％ CI,80.5％ ～90.6％).The estimated local control rate at 3 years was 90.2％ (95％ CI,85.7％ ～94.8％).There was no gradeⅢ or above toxicity related to treatment.Conclusions The stereotactic ablative radiotherapy attains good local control and survival efficacy for the stage Ⅰ peripheral non-small lung cancer patients.It is well tolerated owing to low toxicity.

Objective To measure the volumetric changes precisely during stereotactic ablative radiotherapy for early-stage and oligo-metastatic lung tumors and optimize the treatment plan timely.Methods From October 2011 to October 2014, 66 patients with 71 early-stage or oligo-metastatic lung tumors received SABR.Median age was 66 years.To measure the volume of tumors, the verification images were registered before each treatment fraction with stimulation images by reference to bone structure.Tumors volume was measured by the first verification images, and were defined as the reference when evaluating the trend of tumors volume change during SABR treatment.Generalized estimated equations were used to analyze the trend of the change of tumors volume over time with several possible predictors.The primary plan (P-plan) was modified when the biological effective dose (BED) of a tumor reached 60 Gy and volume change reached 25％.The modified plan was named as M-plan.Paired t-test was used to compare the dose of organs at risk (OAR) between M-plan and P-plan.Results In 71 tumors, 49 (69％) tumors showed volumetric shrinkage, 21 (30％) tumors showed enlargement and 1 tumor showed invariance.Generalized estimated equation showed no statistical significance (P =0.281) for the volumetric shrinkage of lung tumors.M-plan was made in 26 tumors.Of these tumors, 21 tumors decreased over 25 ％ and the result of paired t-test showed V5 of lung, Dmax and D1.2 cm3 of spinal cord, Dmax and D5 cm3 of esophagus and D30 cm3 of chest wall were statistically different between two plans(t =3.139 ～11.939 ,P＜0.05).5 tumors enlarged over 25％ and the result of paired t-test showed V5 and V20 of lung,Dmax and D1.2cm3 of spinal cord, Dmax of esophagus and D30cm3 of chest wall were statistically different between the two plans(t =-10.436--2.518, P ＜ 0.05).Conclusions Size of lung tumors changed dynamically during SABR, but it is unnecessary to modify treatment plans for all tumors.The tumors which showed obvious volumetric change may benefit from modifying treatment plans.

Objective To identify Anaplasma species circulating among livestock and rodents from Xitianmu Mountain area in Zhejiang province , Southeastern China and to analyze variations regarding to their 16S rRNA gene.Methods Samples of spleen, liver and blood were collected to extract DNAs .The 16S rRNA gene fragments of Anaplasma species were amplified by using a nested PCR and then sequenced .Ho-mology analysis was conducted by using BLAST program .The multiple sequence alignment and phylogenetic analyses comparing with the sequences of other Anaplasma species in GenBank were conducted by using MEGA 5.0 software.Results The 16S rRNA gene fragments of Anaplasma were detected in 1 cattle, 8 goats, 5 Rattus confucianus, 1 Apodemus agrarius, 1 Berylmys bowersi and 1 squirrel out of 129 animals. The natural infection rate of Anaplasma was 13.2% in animals from Xitianmu Mountain area in Zhejiang . The alignment and phylogenetic analyses indicated that there were at least four Anaplasma species prevalent in livestock and rodents from Xitianmu Mountain area , including Anaplasma phagocytophilum, Anaplasma marginale, Anaplasma centrale and Anaplasma bovis.Moreover, there was a variant that obviously differed from Anaplasmma bovis and other Anaplasma sp.in GenBank.Conclusion The Anaplasma infection was detected among livestock and rodents from Xitianmu Mountain area in Zhejiang province .A newly discovered variant in rodents was likely to be a novel species .More close attention should be paid to Anaplasma infec-tion among human in Xitianmu Mountain area .

Objective To investigate the P2X3 receptor expression in L6-S1 dorsal root ganglion (DRG)and bladder detrusor in a rat model of neurogenic bladder and urethra. Methods Eighty Sprague-Dawley rats wererecruited and randomly divided into a sacral injury group, a suprasacral injury group and a control group. Spinal tran-section was performed to establish the animal model of neurogenic bladder and urethra in rats of the sacral injurygroup and suprasacral injury group. Check the P2X3 receptor expression in DBG and bladder detrusor among thethree groups by Western blot test at 20 days after model establishment. Results P2X3 receptor expression in L6-S1DRG of sacral injury group was significantly less than that of the suprasacral injury group, which was in turn signifi-cantly higher than that of the control group. P2X3 receptor expression in bladder detrusor of sacral injury group wassignificantly lower than that of the suprasacral injury group, which was in turn significantly higher than that of thecontrol group. Conclusion There was close relationship between P2X3 receptor expression and dysfunction of blad-der and urethra.

Objective To explore the role of radiotherapy in the treatment of primary central nervous system lymphoma. Methods Clinical data of 60 patients diagnosed with primary central nervous system lymphoma from September 2010 to December 2017 were retrospectively analyzed. Among them, 50 cases were diagnosed by histopathological examination after stereotactic biopsy or tumor resection and 10 patients were diagnosed by gadolinium enhanced magnetic resonance imaging ( MRI) . Fifty-two patients underwent chemotherapy, and 45 of them received methotrexate-based chemotherapy, 25 received rituximab-based regimen. Twenty-seven patients were given with planned whole brain radiotherapy, while 33 patients were not. Salvage radiotherapy was delivered in 9 patients after treatment failure. Results The median follow-up time was 28 months ( 5-70 months) . The median overall survival time and median progression-free survival time of the whole patients was 22 months ( 5-65 months) and 13 months ( 5-55 months) , respectively. The 4-year overall survival rate and progression-free survival rate were 61% and 33%, respectively. The 4-year overall survival rates between patients with and without planned whole brain radiotherapy were 68% and 54% ( P=0.083) . The 4-year progression-free survival rates between patients with and without planned whole brain radiotherapy were 47% and 20% ( P=0.014) , respectively. Patients with and without salvage whole brain radiotherapy had a 4-year overall survival of 49% and 68%, respectively ( P=0.398) . Among patients who received whole brain radiotherapy, patients with a lower dose of ≤36 Gy had a similar overall survival compared with those with a higher dose of>36 Gy ( 80% vs. 45%, P=0.136) . Conclusions Radiotherapy is part of the comprehensive treatment of primary central nervous system lymphoma. Planned radiotherapy may bring clinical benefits to patients during the comprehensive therapy. However, the irradiation dose to the whole brain should not be too high because of neurotoxicity.

Objective To compare the clinical efficacy and safety between stereotactic ablative radiotherapy (SABR) and surgery in the treatment of early-stage non-small cell lung cancer (NSCLC).Methods A total of 227 patients who were initially diagnosed with early-stage NSCLC and with complete clinical data admitted to Henan Cancer Hospital between June 2012 and December 2016 were recruited and assigned into the SABR (n=73) and surgery groups (n=154).Kaplan-Meier method was used to calculate survival rate and survival comparison was performed using the log-rank test.Chi-square test was adopted to compare the baseline data between two groups.Results All patients completed corresponding treatment.The samples of SABR group and operation group were 74 and 155 cases respectively.The 1-year and 3-year overall survival (OS) rates in the SABR and surgery groups were 97.2％,81.9％ and 96.5％,78.2％ (P=0.603),respectively.The 1-year and 3-year progression-free survival (PFS) rates in the SABR and surgery groups were 90.1％,66.9％ and 89.2％,66.9％ (P=0.565),respectively.The 1-year and 3-year locoregional recurrence free survival rates in the SABR and surgery groups were 92.8％,84.0％ and 96.5％,90.8％ (P=0.133),respectively.The 1-year and 3-year distant metastasis-free survival rates in the SABR and surgery groups were 97.2％,75.4％ and 89.2％,69.8％ (P=0.095),respectively.Conclusions SABR and surgery yield similar OS,PFS,locoregional recurrence-free and distant metastasis-free survival rates in the treatment of early-stage NSCLC.Therefore,SABR is an alternative treatment for patients with early-stage NSCLC.

Objective:To analyze the risk factors of fatal outcome in patients with severe COVID-19.Methods:The clinical characteristics of 107 patients with severe COVID-19 admitted in Renmin Hospital of Wuhan University from February 12 to March 12, 2020 were retrospectively analyzed. During the hospitalization 49 patients died (fatal group) and 58 patients survived (survival group). The clinical characteristics, baseline laboratory findings were analyzed using R and Python statistical software. The risk factors of fatal outcome in patients with severe COVID-19 were analyzed with multivariate logistic regression.Results:Univariate analysis showed that the two groups had statistically significant differences in age, clinical classification, dry cough, dyspnea and laboratory test indicators ( P<0.05 or <0.01). The random forest model was used to rank the significance of the statistically significant variables in the univariate analysis, and the selected variables were included in the binary logistic regression model. After stepwise regression analysis, the patient’s clinical type, age, neutrophil count, and the proportion of CD3 cells are independent risk factors for death in severe COVID-19 patients. Dry cough is an independent protective factor for the death of severe COVID-19 patients. Conclusion:COVID-19 patients with fatal outcome are more likely to have suppressed immune function, secondary infection and inflammatory factor storm. These factors may work together in severe patients, leading to intractable hypoxemia and multiple organ dysfunction and resulting in fatal outcome of patients. The study indicates that timely intervention and treatment measures against above factors may be effective to save the lives of patients with severe COVID-19.

Objective:To evaluate the pancreatic subclinical dysfunction after intensity-modulated radiation therapy (IMRT) for gastric cancer by analyzing biochemical indexes and pancreatic volume changes, and to reduce the dose of pancreas by dosimetric prediction and dose limitation.Methods:30 patients with gastric cancer who received 45 Gy postoperative adjuvant radiotherapy were retrospectively selected. The pancreas was delineated and its dose and anatomical relationship with planning target volume (PTV) were evaluated. Fasting blood glucose, serum lipase and amylase, and pancreatic volume changes before and after radiotherapy were analyzed. The correlation between the changes of biochemical indexes and volume and pancreatic dose was evaluated by Pearson analysis. The threshold of the dosimetric prediction was obtained by receiver operating characteristic (ROC) curve. Finally, the feasibility of dosimetric limitation in IMRT was assessed.Results:The pancreatic volume of 30 patients was 37.6 cm 3, and 89.0% of them were involved in PTV. D mean of the pancreas was 45.92 Gy, and 46.45 Gy, 46.46 Gy and 45.80 Gy for the pancreatic head, body and tail, respectively. The fasting blood glucose level did not significantly change. The serum lipase levels were significantly decreased by 66% and 77%(both P<0.001), and the serum amylase levels were significantly declined by 24% and 38%(both P<0.001) at 6 and 12 months after radiotherapy. Pancreatic volumes of 22 patients was decreased by 47% within 18 months after radiotherapy. ROC curve analysis showed that pancreatic V 45Gy had the optimal predictive value for the decrease by 1/3 of serum lipase and amylase levels at 6 months and serum amylase level at 12 months after radiotherapy, and the cut-off value was V 45Gy<85%. Pancreatic D mean yielded the optimal predictive value for the decrease by 2/3 of serum lipase level at 12 months after radiotherapy, and the cut-off value was D mean<45.01 Gy. After" whole pancreas" and" outside PTV pancreas" dose limit, V 45Gy of the pancreas was decreased by 11% and 7%, D mean of the pancreas was declined by 2% and 2%, and D mean of the pancreatic tail was decreased by 3%, respectively. Conclusions:Serum lipase and amylase levels significantly decline at 6 and 12 months after adjuvant radiotherapy for gastric cancer, and pancreatic volume is decreased significantly within 18 months after radiotherapy. Pancreatic V 45Gy<85% and D mean<45.01 Gy are the dose prediction values for the decrease of serum lipase and amylase levels. The dose can be reduced to certain extent by dosimetric restriction.