As an advanced conformal therapy, Intensity-modulated radiotherapy (IMRT) can increase the gain ratio of radiotherapy and improve the local control of the tumor. This paper applies genetic algorithm to optimization of IMRT inverse planning. The algorithm model and simulation result are introduced.

Objective To study the effect of allodecedllular sheath extracellular matrix(ASECM) for repairing of the hernia. Methods 12 dogs were randomly divided into two groups:(1)ASECM repairing group (ASECM group), 6 dogs; (2) artificial materia (AM) repairing group (Control group), 6 dogs. Abdominal wall defect of 3cm?5cm area was made on both of right and left abdomen in ASECM group and control group. The defect of left abdomen was not repaired as a self-control. The defect of right abdoment was repaired by ASECM in ASECM group , and by AM in control group . Microscopically, imunohistochemical study and electroscopy were performed 2,8,16 weeks after operation in both ASECM group and control geoup. Results A hernia could be seen on the defect of left abdominal wall in both groups 2 days after operation, but no hernia was found on the defect of right abdominal wall. In ASECM group , microscopy showed that the number of fibroblast cells (FBC) growing in the ASECM increased graduately 2～8 weeks after operation, but decreased 16 weeks after operation, and no inflammatory cells infiltration was seen at any time;electroscopically, the ASECM was filled with clear ranked thin collegen 16 weeks after operation. Contrarily, in control group, microscopy showed that the amount of covering the superficialness of AM increased graduately 2～8 weeks after operation, but not many FCs could be seen inside the AM, and inflammatory cells infiltration was found at every time postoperativly. Electroscopically, FCs grew to cover the superficialness as reaction of host to the foreign body ,and the AM had not merged with host tissues. Immuohistochemical study showed that there were typy I and III collegen presented in the repairing materias. Conclusions ASECM can provide a fram for the host FCs growth, So the ASECM can be mixed together with host tissues to provide a good intensive potency against hernia recurrence, and ASECM might be an ideal tissue-engineering materia for repairing hernia.

OBJECTIVETo explore the predictive value of high-sensitivity C reactive protein (hsCRP) in middle-aged population during the peripheral arteriosclerosis.

METHODSRandom sampling method was used in the study. In 2006-2007 Kailuan Group health examination of 101,510 employees, using stratified random sampling method to select 5,852 as observational cohort included, in the final with a standard queue 5,440 in December 2009. This study selected to participate in the 2012-2013 health examination cohort as the research object, in accordance with the inclusion criteria ultimately selected survey 3,978, select the epidemiological investigation, physical examination, laboratory testing data analysis. Of the 3 978 subjects, 2,282 were male and 1,696 were female, and the baseline age was (53.80±11.14) years. According to the baseline hsCRP quartile level was divided into four groups for comparison of baseline data, using multiple linear regression analysis between hsCRP and brachial-ankle pulse wave velocity (baPWV). Area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the prediction of hsCRP levels in peripheral arteriosclerosis.

RESULTSWith increase of hsCRP levels, the survey of baseline levels of baPWV showed increasing trend, (1,445.49±300.55), (1,494.46±307.94), (1,547.67±320.34), (1,621.32±342.53) cm/s, respectively. Multiple linear regression results showed that age, by logarithmic transformation of hsCRP (lghsCRP) level, systolic blood pressure and fasting blood glucose for each additional unit, baPWV levels were increased 266.47, 58.00, 5.02, 39.79 cm/s (P<0.001), and BMI for each additional unit, baPWV level decreased 9.52 cm/s (P=0.030). The prediction of hsCRP in peripheral artery showed that lghsCRP level of AUC to 0.59 (95% CI: 0.57-0.61), lower than the age and systolic blood pressure predicted value AUC (95% CI) of 0.69 (0.67-0.71), 0.75 (0.73-0.77), respectively.

CONCLUSIONThe hsCRP level could not predict the peripheral arteriosclerosis alone, and the combined age and systolic blood pressure level could have better predictive value.

Ankle ; Ankle Brachial Index ; Biomarkers ; Blood Flow Velocity ; Blood Pressure ; C-Reactive Protein ; Female ; Humans ; Male ; Middle Aged ; Peripheral Arterial Disease ; Pulsatile Flow

We report a case of cutaneous and subcutaneous phaeohyphomycosis caused by Exophiala jeanselmei after renal transplantation in Guangdong. A 66-year-old man who had a renal transplantation 6 years ago was admitted in October 2011 for the presence of 16 nodules (0.5-1.5 cm) found on his right middle finger, wrist and forearm for 5 months. Microscopic examination of the purulent exudate showed segmented and branched brown mycelium, and tissue biopsy and PAS staining showed fungal hyphae. The isolate was processed for morphological identification and molecular sequence analysis. A black colony was found after culture of the isolate on SDA at 26 degrees Celsius;, and small culture identified the isolate as Exophiala jeanselmei. ITS sequence analysis of the isolate showed a 100% homology with Exophiala jeanselmei. E-test strip was used in drug sensitivity test, and the isolate was sensitive to amphotericin B, voriconazole, itraconazole and fluconazole, but resistant to 5-flucytosine and caspofungin. Good response was obtained with surgical intervention, local injection and systemic antifungal treatment.
Aged ; Exophiala ; pathogenicity ; Humans ; Kidney Transplantation ; adverse effects ; Male ; Phaeohyphomycosis ; etiology ; Postoperative Complications

Objective: To investigate the prognostic impact of alterations of epidermal growth factor receptor(EGFR) and MGMT in glioblastoma. Methods: The retrospective study included 161 supratentorial glioblastomas diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University from 2009 to 2015. EGFR and EGFRvⅢ protein expression was detected by immunohistochemistry; EGFR amplification was detected by fluorescence in situ hybridization; MGMT promoter methylation was detected by pyrosequencing. The change of molecular genetics EGFR and MGMT and outcome were assessed statistically. Results: There were 161 patients, including 85 (52.8%) males and 76 (47.2%) females. The mean age was 53 years, and the median overall survival was 13 months. The integrated classification of glioblastoma included 16 IDH-mutant, 134 wild type, and 11 NOS. The rate of overexpression of EGFR protein was 32.9%(53/161), and that of EGFR amplification was 37.5%(18/48). There was high concordance between immunohistochemistry and FISH(85.4%, Kappa=0.475, P<0.01) and between the level of EGFR protein and EGFR amplification (P<0.01). Twelve cases showed EGFRvⅢ expression, and all also showed EGFR protein overexpression; 149 cases were EGFRv Ⅲ wild type, and EGFR protein overexpression was seen in 27.5%(41/149) of cases. There was no correlation between EGFR and EGFRv Ⅲ expression. Of all cases, 70.2%(106/151) showed MGMT promoter methylation by pyrosequencing. The changes of molecular genetics of EGFR and MGMT were not related. EGFR amplification and protein overexpression had no significant relationship with prognosis. Patients with EGFRv Ⅲ-mutant had shorter survival time than the EGFRv Ⅲ-wild type(P=0.014); patients with MGMT promoter methylation had better prognosis than without (PFS:P=0.002,OS:P=0.006),and MGMT promoter methylation was an independent predictor for overall survival (HR=0.269, 95%CI 0.124-0.583, P=0.001). Conclusions EGFR protein expression by immunohistochemistry correlates with the status of EGFR amplification. Patients with EGFRv Ⅲ-mutant tumors have poorer prognosis than that with EGFRv Ⅲ-wild type tumors. MGMT promoter methylation is closely associated with prognosis and an independent predictor for overall survival.