Objective To develop a beam orientation optimization algorithm for the gantry orientation in three-dimensional conformal radiotherapy(3 DCRT).Methods Patients' data were imported from the Pinnacle v 7.2 treatment planning system.including the DICOMRT and dose distribution files.These imported files were merged using a uniforiB coordinate system.The algorithm determined the optimized beam weight for each beam group and optimized the beam orientation with genetic algorithm.The optimized parameters,including the optimized beam orientations and weights,were exposed back to the Pinnacle v 7.2 to compare with the conventional 3DCRT plan.The optimized algorithm was implemented with our in-house program. The dose distributions, the DVH diagram and the conformity index of two lung cancer patients were compared. Results for the two lung cancer patients,the conformity index of the optimized plan(0.59 and 0.7)was higher than the conwentional 3DCRT plan(0.36 and 0.58).The maximum dose in spinal cord was reduced by 17.8%and 22.4%,the lung V20 reduced by 3.12%and 4.35%,and V30 reduced by 4.47%and 1.49%.For the brain tumor patient. the dose of lens and eyes was also decreased significantly. Conclusion This beam orientation optimization can be used as an assistant planning tool.

RAGE (receptor for advanced glycation end products) is a multiligand receptor on the cell surface.Ligand-RAGE inter-actions activate several signal transduction pathways that propa-gate cellular oxidative stress and inflammatory response.RAGE expressed on the CD4 + T cells has been identified as a central transduction receptor which affects the activation,proliferation, migration and differentiation of the cells.In addition,blockade of RAGE suppressed the development of multiple immune-related
disorders mediated by CD4 + T cells.These studies highlight the importance of RAGE and its ligands for CD4 + T cells.This arti-cle briefly reviews the role of RAGE and its ligands on the prolif-eration,migration and differentiation of CD4 + T cells and sum-marizes the related research progress.

Objective To explore the clinical efficacy of enteral nutrition combined with traditional Chinese medicine (TCM) acupuncture and moxibustion for treatment of craniocerebral trauma complicated by gastric paralysis.Methods A prospective study was conducted.One hundred and sixty-seven patients with craniocerebral trauma complicated by gastric paralysis admitted to the Department of Neurological Critical Care Medicine in Affiliated Hospital of the Logistics University Chinese People's Armed Police Force from January 2013 to October 2015 were divided into single group (83 cases) and combined group (84 cases) according to the random number table method.The basic treatment program was the same in the two groups.On the basis of gastrointestinal decompression,a nasojejunal tube was indwelled in the digestive canal of the patients in single group,and the nutrient food could be given by dripping slowly and continuously through the tube into the body,while in the combined group,they were additionally treated by acupuncture and moxibustion at auricular point,zusanli and neiguan acupoints,1 time a day,each time 30 minutes.Both groups were treated consecutively for 30 days,and then the clinical efficacies were evaluated.Before and after treatment in both groups,the changes of total serum protein (TP),pre-albumin (PA),hemoglobin (Hb) were observed;the incidences of reflux,vomiting,abdominal distension,diarrhea,pulmonary infection and intestine derived infection were also evaluated.Results After treatment the levels of TP,PA,Hb were significantly higher in combined group than those in the single group [TP (g/L):36.97 ± 2.17 vs.33.14± 2.13,PA (mg/L):215.19 ± 7.91 vs.203.15 ± 6.12,Hb (g/L):126.73 ± 11.17 vs.117.61 ± 11.24,all P ＜ 0.01].The numbers of patients with reflux,vomiting,abdominal distension,diarrhea were significantly lower in combined group than those in the single group,respectively (the number of patients had reflux being 15 cases vs.31 cases,vomiting 13 cases vs.28 cases,abdominal distension 17 cases vs.29 cases,diarrhea 17 cases vs.31 cases) and pulmonary infection (17 cases vs.29 cases),intestine derived infection (4 cases vs.12 cases),all the above comparisons showing statistically (all P ＜0.05).Conclusions Enteral nutrition combined with acupuncture and moxibustion treatment can effectively enhance the patients' nutritional status,reduce gastrointestinal dysfunction and the incidence of complications,thus the prognosis of patients with craniocerebral trauma complicated by gastric paralysis is obviously improved.

Objective To investigate the effects of different lighting(sulfur lamp, heat radiation lamp, fluorescent lamp and LED lamp) on reproductive system in depressive male rats.Methods CUMS depressive model of rats was established through the stimulations of chronic unpredictable mild stress(CUMS), then they were randomly divided into 5 groups:depressive model group, sulfur lamp group, heat radiation lamp group, fluorescent lamp group and LED lamp group.After 45 d of continuous illumination, serum was collected and reproductive organs were removed from rats, then the organ index of testicle,epididymis,seminal vesicle and kidney was calculated, the concentrations of testosterone (T), estradiol (E2), prolactin (PRL) and progesterone (PROG)in the serum were detected by ELISA, the histomorphological lesion of testicle was observed under microscope with hematoxylin-eosin (HE) staining, the expression of melatonin receptors (Mel 1a), 3β-HSD and P450scc of testicle were detected by Western blot.Results The organ index of testicle, epididymis and seminal vesicle, the concentration of T, E2,PRLand PROG, and the expression of Mel 1a, 3β-HSD and P450scc in the depressive rats were significantly lower than that of the controls(P<0.05), and the seminiferous tubules of the testis of depressive rats were atrophied.However, the level of T, E2, PRL and PROG were increased,the cell morphology of the testicle was improved, and the expression of Mel 1a, 3β-HSD and and P450scc were upregulated after the sulfur lamp lighting in the depressive male rats compared with depressive model group (P<0.05).Conclusions The testis structure and functions of depressive male rats are improved by sulfur lamp lighting.

Objective To retrieve and analyze the available evidence on prevention of needlestick injuries among healthcare workers and summarize the best available evidence.Methods We searched the BMJ best practice,Uptodata,Cochrane Library(2014),Joanna Briggs Institute Library,Registered Nurses' Association of Ontario,Scottish Intercollegiate Guidelines Network,National Guideline Clearinghouse,and complementally searched the PubMed,EM-base,CNKI and Centers for Disease Control to collect literatures including guideline,evidence summary,best practice information sheet,recommended practice and systematic review.Results Nine references were selected including a clinical decision support system,3 evidence summaries,2 recommended practices and 3 systematic review.Finally,7 items of best evidence were summarized,including:wearing double gloves,never recapping needles,using blunt-tip suture,using a neutral zone for passing sharp device,adopting the safety features of sharps,using sharp disposal containers,and continuous education for needlestick injuries.Conclusion Healthcare workers should regulate their behaviors of using sharp instruments during clinical practice and guarantee personal safety by consulting high level evidence.

Pine pollen is a kind of Chinese materia medica with the homology of medicine and food, rich in a variety of nutrients and bioactive ingredients. It has the efficacy of hemostasis by convergence and eliminating dampness and astringing sores. Research showed that pine pollen is able to protect certain organs, regulate metabolism, enhance immunity and resist antioxidation and aging. This article reviewed pine pollen related research from the aspects of main components, pharmacological effects and clinical application, in order to provide references for further study and development and utilization.

Objective To evaluate the role of spinal phosphatidyl-inositol 3-kinase/Akt (PI3k/Akt) signaling pathway in the maintenance of bone cancer pain (BCP) in rats and its relationship with microglial activation.Methods Forty healthy female Sprague-Dawley rats,weighing 180-200 g,were randomly divided into 5 groups (n =8 each):sham operation group (group S) ; PI3K inhibitor LY294002 group (group L) ; group BCP; BCP + dimethyl sulfoxide (DMSO) group (group BCP + D) ; BCP + LY294002 group (group BCP + L).BCP was induced by inoculating Walker 256 mammary gland carcinoma cells into the medullary cavity of the left tibia.At 7-9 days after inoculation,LY294002 2.5 μg/10 μl was injected intrathecally in L and BCP + L groups,normal saline 10 μl was injected intrathecally in S and BCP groups,and 5％ DMSO 10 μl was injected intrathecally in BCP+ D group once a day.Mechanical paw withdrawal threshold (MWT) was measured at 1 day before inoculation and 1,3,5,7,8 and 9 days after inoculation.The rats were sacrificed after MWT was measured on day 9 after inoculation and the L4-6 segments of the spinal cord were removed to determinate the activation of spinal microglia using immunofluorescence.Results Compared with group S,MWT was significantly decreased,and the activation of spinal microglia was increased in BCP,BCP + D and BCP+ L groups.Compared with BCP and BCP + D groups,MWT was significantly increased,and the activation of spinal microglia was decreased in BCP + D group.Conclusion Spinal PI3K/Akt signaling pathway is involved in the maintenance of BCP possibly through activating microglia in spinal dorsal horns of rats.

Objective:To investigate the expression of human epidermal growth factor receptor 4 (HER4) and metastasis-related protein (MMP-9) in human esophageal carcinoma tissues, and their relationship with clinicopathological features of the disease. Methods:Immunohistochemical Envision technique was applied to detect the expressions of HER4 and MMP-9 in 45 specimens of esophageal carcinoma tissues, paracancerous tissues and normal tissues. Statistical method was used to analyze the association of the positivity of HER4 with clinical pathological index and MMP-9 expression.Results:The positive rates of HER4 expression were 73.3%, 33.3%, and 2.2% in 45 specimens of esophageal carcinoma tissues, paracancerous tissues, and normal tissues, respectively. The expression of HER4 was correlated with TNM stage and lymph node metastasis (P<0.01), but not correlated with histological grade (P>0.05). The expression of MMP-9 correlated with T stage, invasion depth, TNM stage, and lymph node metastasis (P<0.05). Conclusion:The expression of HER4 is apparently different in esophageal carcinoma tissues, paracancerous tissues, and normal tissues. Its positive expression in esophageal carcinoma tissues is correlated with TNM stage and lymph node metastasis. The expression of MMP-9 in esophageal carcinoma tissues is correlated with the T stage, TNM staging, and lymph node metastasis. The positive expression of HER4 in esophageal carcinoma tissues is associated with the expressions of MMP-9.

The animal models used in the experimental research of Traditional Chinese Medicine (TCM) to prevent and treat T2DM are mainly spontaneous and induced. The experimental research of TCM in the prevention and treatment of type 2 diabetes can be divided into Chinese medicine compound, Chinese medicine and its extract, Chinese medicine monomer. The mechanism is mainly through regulating intestinal flora, increasing insulin content, lowering blood sugar, lowering blood lipids, improving glucose tolerance, and improving gluconeogenesis, antioxidant, inhibit cell apoptosis, etc. play the role of preventing and treating T2DM in multiple links and multiple targets.

The effect of obesity on idiopathic central precocious puberty (ICPP) girls is still under discussion.The relationship between body mass index (BMI) and sexual hormone levels of gonadotropin-releasing hormone (GnRH) stimulation test in ICPP girls is controversial and the underlying mechanism is unclear.This study aims to further explore the independent effect of excess adiposity on peak luteinizing hormone (LH) level of stimulation test in ICPP girls and the role of other related factors.A retrospective cross-sectional study was performed on 618 girls diagnosed as having ICPP,including 355 cases of normal weight,99 cases of overweight and 164 cases of obese.The results showed that obese group had more progressed Tanner stage and no significant difference (P=0.28) in LH peak was found as basal LH value was used as a covariate.The obese group had higher total testosterone (TT),adrenocorticotrophic hormone (ACTH),17-α hydroxyprogesterone (17-αOHP) and androstendione (AN),with significantly increased fasting insulin (FIN) and homeostasis model of assessment for insulin resistance index (HOMA-IR).Stratified analysis showed inconsistency of the relationship between BMI-standard deviation score (BMI-SDS) and LH peak in different Tanner stages (P for interaction=0.017).Further smoothing plot showed linear and non-linear relationship between BMI-SDS and LH peak in three Tanner stages.Then linear regression model was used to analyze the relationship between BMI-SDS and LH peak in different Tanner stages,with and without different confounding factors being adjusted.In B2 stage,BMI-SDS was negatively associated with LH peak.In B3 stage,when BMI-SDS ＜1.5,as BMI-SDS increased,the level of LH peak decreased (model Ⅰ:β=-1.8,95％ CI=-4.7 to 1.1,P=0.214).When BMI-SDS ≥1.5,BMI-SDS was significantly positively associated with LH peak (model Ⅰ:β=4.5,95％ CI=1.7 to 7.4,P=0.002).In B4 stage,when BMI-SDS ＜1.5,BMI-SDS was negatively associated with LH peak (model Ⅰ:β=-11.6,95％ CI=-22.7 to-4.5,P=0.049).When BMI-SDS ≥1.5,BMI-SDS was positively associated with LH peak (model Ⅰ:β=-4.2,95％ CI=-3.3 to 11.7,P=0.28).It is concluded that there is an independent correlation between BMI-SDS and LH peak of stimulation test in ICPP girls,their relationships are different in different Tanner stages,and the effect of BMI-SDS can be affected by adrenal androgens,estradiol and glucose metabolism parameters.