retina. Degeneration was found in the epithelial cells of lens at day 30 after radiation. During day 90 to 360 after radiation, lens capsule was thickened, degeneration of epithelial cells, and edema on the posterior surface were found, and cataract ensued. The injurious effect was dose-related. Conclusion High power EMP may cause posterior capsular opacity and subsequent cataract, and the injurious effect was dose-related.

retina. Posterior capsular edema and vacuoles were found. The main complication of lens injury was cataract. Conclusions High power EMP may cause serious injuries to optical system. Lens is the most sensitive organ to EMP injury, and may lead to cataract

The paper conducts a case study of Yangzhou No.1 People′s Hospital, introduces the practice of outpatient process opti-mization based on informatization support platform, analyzes the operation status of self-service outpatient service platform and existing problems.Based on the M/M/s model in queuing theory, the queuing model of payment for outpatient service in the hospital is construc-ted, the characteristics of queuing payment problems for outpatient service are revealed, the relationship between the sharing rate of self-service terminals and the average length of the queue in service windows, the average waiting time of patients.

Objective To observe the effects and feasibility of using walking and breathing exercises to help patients with chronic obstructive pulmonary disease in the community.Methods A hundred and one communitydwelling patients with moderate to severe chronic obstructive pulmonary disease were randomized into an experimental group (51 cases) and a control group (50 cases).The control group was given conventional pharmacotherapy,while the experimental group was given quantified walking (i.e.walking for a pre-set number of steps daily) and breathing exercises (15 minutes,3 sessions daily) to do at home for 48 weeks in addition to the conventional pharmacotherapy,.Both groups were evaluated before and after the 48 weeks of treatment using the 6-minute walk test (6MWT),a clinical COPD questionnaire,Medical Research Council (MRC) dyspnea scoring,a general anxiety/depression questionnaire and a pulmonary function test.In addition,days of hospitalization and incidence of acute exacerbation were also recorded and compared between the 2 groups.Results Among the 101 cases,92 (91.1％) completed the study (45 in the experimental group,47 in the control group,a difference which was not statistically significant).After treatment,the average 6MWT distance in the experimental group was significantly increased and significantly greater than that in the control group.No statistically significant intra-group or inter-group differences were observed with regard to the pulmonary function test or the MRC dyspnea scores.Intra-group comparison and inter-group comparison of the clinical COPD questionnaire scores and anxiety/depression scores did,however,reveal statistically significant differences.There was no significant difference in the average number of acute attacks or in the length of hospital stays.Conclusions Quantified walking and breathing exercises are effective and feasible therapy for patients with chronic obstructive pulmonary disease in the community.

Objective To compare set?up error and the positioning and error correction time between the infrared markers automatic positioning+ ExacTrac ( A) and the manual positioning+ cone?beam computed tomography ( CBCT) image?guided radiotherapy ( IGRT) ( B) in intensity?modulated radiotherapy ( IMRT) for lung cancer. Methods A total of 20 patients with lung cancer were randomly divided into Group A and Group B. In Group A, after automatic positioning, a group of orthogonal X?rays images were taken using kV X?rays, which matched digitally reconstructed radiographs to obtain errors before correction. In group B, after manual positioning, images were taken using CBCT, which matched reference computed tomography images to obtain errors before correction. The positioning and error correction time was recorded in both groups. After error correction, errors after correction were obtained in each group using IGRT. Between?group comparison was made using the paired t test. Results The errors in lateral, longitudinal, vertical, and spinning vertical directions were significantly reduced after correction in both Group A and B (A:1.8±1?3 vs. 0.4±0?1, P=0?000;2.7±1?9 vs. 0.5±0?1, P=0?000;2.8±1?7 vs. 0.4±0?1, P=0?000;1.6±1?0 vs. 0.3±0?9, P=0?000;B:2.6±1?9 vs. 0.5±0?5, P=0?000;3.1±2?5 vs. 0.6±0?6, P=0?000;2.1±1?8 vs. 0.5±0?5, P=0?000;0.9±0?7 vs. 0.3±0?1, P=0?000). There were no significant differences in errors after correction between Group A and Group B (0.4±0?1 vs. 0.5±0?5, P=0?204;0.5±0?1 vs. 0.6± 0?6, P=0?257;0.4± 0?1 vs. 0.5± 0?5, P=0?518;0.3± 0?9 vs. 0.3± 0?1, P=0?755 ) . However, the positioning and error correction time in Group A was significantly shorter than that in Group B (199.1±16?2 vs. 315.2±13?7, P=0?000). Conclusions The application of ExacTrac or CBCT IGRT can substantially reduce set?up errors and improve set?up accuracy in IMRT. In addition, the application of the ExacTrac system can substantially shorten the positioning and error correction time.

Bile acids (BAs) are produced in the liver and are the final product of cholesterol catabolism, with a wide range of biological effects. This article reviews the research advances in the synthesis, transport, and metabolism of BAs and the role of BAs in regulating hepatocytes and immunity via enterohepatic circulation, as well as the current research on traditional Chinese medicine in the regulation of BAs, in order to further understand the mechanism of action of BAs in affecting intestinal flora and liver function, expand the knowledge of its regulatory mechanism, explore the mechanism of action of traditional Chinese medicine and related pathways in regulating BAs, and provide new ideas for the prevention and treatment of liver-related systemic diseases by regulating BAs.

Objective To investigate the role and potential mechanism of high mobility group box-1 protein (HMGB1) on improving the chemosensitivity of gemcitabine-resistant pancreatic cancer PANC1 ceils.Methods Gemcitabine-resistant pancreatic cancer PANC1 (PANC1-GR) cell line was established by using increased gradient concentration of gemcitabine.The si-HMGB1-PANC1 and si-HMGB1-PANC1-GR cells were established by the transfection with HMGB1 siRNA using liposome.The 50％ inhibitory concentration (IC50) and Resistance index (RI) of gemcitabine in 4 PANC1 cell lines with or without HMGB1 siRNA transfection were determined and calculated by CCK-8 assay.Western blot assay was used to detect the protein expression of HMGB1 in PANC1 and PANC1-GR cells and the expression of autophagy marker protein Beclin1 in the 4 PANC1 cell lines.Flow cytometry assay was used to evaluate the apoptosis rate of 4 pancreatic caner cell lines.Results The gemcitabine-resistant pancreatic cancer cell line PANC1-GR was successfully established,which could grow stably and passage in media with 100 μmol/L gemcitabine.The IC50 of gemcitabine in PANC1,PANC1-GR,si-HMGB1-PANC1,and si-HMGB1-PANC1-GR cells lines were (4.7 ±0.4) μmoL/L,(166.5 ± 13.6) μmol/L,(3.2 ± 0.3) μmol/L,and (52.4 ± 8.4) μmol/L,respectively.The IC50 in PANC1-GR wassignificantly higher than that in PANC1,while the IC50 in the transfected cells was significantly lower than that in untransfected cells,and the differences were both statistically significant (bothP ＜ 0.01).The RI value of gemcitabine in transfected and untransfected PANC1-GR cells was 35.4 and 16.4.The relative protein levels of HMGB1 in PANC1 and PANC1-GR were 0.17 ± 0.08 and 0.38 ± 0.11.The expression of HMGB1 in PANC1-GR was obviously higher than that in PANC1,and the difference was statistically significant (P＜0.01).The relative protein levels of Beclin1 in PANC1,PANC1-GR,si-HMGB1-PANC1 and siHMGB1-PANC1-GR cells were 2.68 ± 0.23,3.28 ± 0.15,0.68 ± 0.23 and 0.78 ± 0.11,which in two transfected cells was greatly lower than those in untransfected cells.The apoptosis level was (34.58± 3.14)％,(79.56±3.58)％,(19.41± 1.53)％,and (34.57±2.94)％.The apoptosis level in the 2 transfected cell lines were significantly higher than those in the 2 untransfected cell lines,and the differences were both statistically significant (P ＜ 0.01).Conclusions The inhibition of HMGB1 could improve the chemosensitivity of gemcitabine in pancreatic cancer PANC1 cells,which might be mediated by the activation of autophagy.

Objective To investigate the timing of administration of Conbercept in the treatment of proliferative diabetic retinopathy (PDR) before operation and its effect on neovascularization vascular endothelial growth factor (VEGF).Methods 90 patients (90 eyes) with PDR who underwent vitrectomy (PPV) were randomly divided into groups A,B and C,with 30 cases in each group.Group A received no intravitreal injection of Conbercept before operation,group B received intravitreal injection of Conbercept 3 days before operation,and group C received intravitreal injection of Conbercept 5 days before operation.The operation condition,visual acuity level,concentration of vascular endothelial growth factor in aqueous humor and positive expression of vascular growth factor in neovascularization membrane were compared in the three groups.Results There was no significant difference in the incidence of iatrogenic hiatus during operation,transient high intraocular pressure and hyphema after operation in the three groups (P ＞ 0.05).Compared with group A,group B and C had shorter the operation time,less electrocoagulation,lower LogMAR BCVA (best corrected visual acuity) three months after operation (P ≤ 0.05).There was no significant difference in the concentration of vascular endothelial growth factor between group B and group C before vitreous injection (P ＞ 0.05).The expression of VEGF in aqueous humor of group B and group C was lower than that of group A (P ≤ 0.05),and the total positive expression rate of VEGF in neovascularization membrane of group B and group C was 76.67％ and 73.33％ respectively,lower than that of group A (100.0％,P ≤0.05).The vitreous re-bleeding of group B and group C was 6.67％ and 10.0％,lower than that of group A (32.14％,P ≤ 0.05).While there was no significant difference between group B and group C (P ＞0.05).Conclusions Vitreous injection of Conbercept before PPV in PDR patients can reduce the concentration of VEGF in aqueous humor and the positive expression rate of VEGF in neovascularization membrane,significantly improve visual acuity and reduce the incidence of postoperative complications.The effect of vitreous injection 3 and 5 days before PPV is basically the same.

Objective To evaluate the clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure caused by chronic glomerulonephritis. Methods Sixty-three patients with chronic renal failure due to chronic glomerulonephritis, after receiving a 2-week-long conventional treatment, were randomly divided into alprostadil group (n=20, with alprostadil injection at 10μg/d for 2 weeks), sequential treatment group (n=21, with alprostadil injection at 10μg/d for 2 weeks and oral beraprost sodium at 20μg three times a day for 12 weeks), and strengthened sequential treatment group (n=22, with alprostadil injection at 20 μg/d for 2 weeks and a double dose of oral beraprost sodium for 12 weeks). Urinary albumin excretion rate (UAER), cystatin C (Cys C), blood urea nitrogen, creatinine, fibrinogen, D-dimer, prothrombin time (PT), and platelets were tested before and after the treatment, and the changes in urinary albumin discharge rate, serum creatinine, and glomerular filtration rate were determined. Results The patients in strengthened sequential treatment group showed a significantly decreased change rate of urinary albumin discharge rate (P<0.01) than those in the other two groups. In the two sequential treatment groups, especially the strengthened treatment group, the change rate of glomerular filtration rate increased significantly compared with that in alprostadil group (P<0.01). Strengthened sequential treatment resulted also in significantly decreased increment of serum creatinine compared that in the other 2 groups (P<0.01). After 14 weeks of treatment, fibrinogen and D-dimer were decreased in all the 3 groups (P<0.05) to a comparable level between the 3 groups (P>0.05), and prothrombin time (PT) or platelet showed no significant changes (P>0.05). Conclusion Sequential treatment with alprostadil and beraprost sodium can improve the glomerular filtration rate and decrease urine albumin excretion rate, serum creatinine increase rate, and lower blood fibrinogen and D-dimer levels, thus delaying the progression of chronic renal failure caused by chronic glomerulonephritis. This therapy shows a dose-related effect with good clinical safety.

Objective To evaluate the clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure caused by chronic glomerulonephritis. Methods Sixty-three patients with chronic renal failure due to chronic glomerulonephritis, after receiving a 2-week-long conventional treatment, were randomly divided into alprostadil group (n=20, with alprostadil injection at 10μg/d for 2 weeks), sequential treatment group (n=21, with alprostadil injection at 10μg/d for 2 weeks and oral beraprost sodium at 20μg three times a day for 12 weeks), and strengthened sequential treatment group (n=22, with alprostadil injection at 20 μg/d for 2 weeks and a double dose of oral beraprost sodium for 12 weeks). Urinary albumin excretion rate (UAER), cystatin C (Cys C), blood urea nitrogen, creatinine, fibrinogen, D-dimer, prothrombin time (PT), and platelets were tested before and after the treatment, and the changes in urinary albumin discharge rate, serum creatinine, and glomerular filtration rate were determined. Results The patients in strengthened sequential treatment group showed a significantly decreased change rate of urinary albumin discharge rate (P<0.01) than those in the other two groups. In the two sequential treatment groups, especially the strengthened treatment group, the change rate of glomerular filtration rate increased significantly compared with that in alprostadil group (P<0.01). Strengthened sequential treatment resulted also in significantly decreased increment of serum creatinine compared that in the other 2 groups (P<0.01). After 14 weeks of treatment, fibrinogen and D-dimer were decreased in all the 3 groups (P<0.05) to a comparable level between the 3 groups (P>0.05), and prothrombin time (PT) or platelet showed no significant changes (P>0.05). Conclusion Sequential treatment with alprostadil and beraprost sodium can improve the glomerular filtration rate and decrease urine albumin excretion rate, serum creatinine increase rate, and lower blood fibrinogen and D-dimer levels, thus delaying the progression of chronic renal failure caused by chronic glomerulonephritis. This therapy shows a dose-related effect with good clinical safety.