(Ver)-induced human retinal pigment epithelium (RPE) cells apoptosis.hours to induce RPE cells apoptosis.The expression of apoptotic effector gene caspase-3 was assessed by reverse transcription polymerase chain reaction (RT-PCR).Single cell was measured using fluorescence indicator Fura-3/AM with MetaFluo4.5/coolsnapfx/IX70 intracellular Ca2+ fluorescence imaging system.RPE cells and it significantly increased after co-cultured with Ver.The fluorescence in resting RPE cells was strong and distributed throughout the cells.The nucleus appeared more fluorescent than the cytoplasm.Calcium fluorescence of RPE cells attenuated after co-cultured with Ver.[Ca2+]i homeostasis might play pivotal roles in Ver-induced RPE cells apoptosis.

Objective To investigate whether the accelerator image beam line (IBL) full scan and extend field of view(EFOV) scan mode megavoltage cone beam CT(MV CBCT) images can be used for dose calculation in adaptive radiotherapy.Methods The large aperture CT and MV CBCT were used to scan the CIRS 062M electron density modules,the CT value was established to electron density curves in the Pinnacle treatment planning system.Also,CT and MV CBCT were used to scan the head and neck,chest,abdomen and pelvis phantom.The intensity modulated radiotherapy(IMRT) plans were made with CT images and transplanted to MV CBCT images.The dose of targets and organs with their electron density curves was calculated,and two type IMRT plans with different CT images were compared.Results The dose distribution of head and neck phantom was acceptable,compared with the reference plan,the difference was within 3 ％.The dose distribution of chest and.pelvis was significantly reduced from reference plans,and the difference was 5％ and 10％ separately.This difference was beyond the scope of clinical acceptance.Conclusions MV CBCT images of accelerator IBL full scan mode in patients with head and neck site scan could be used for dose calculation in adaptive radiotherapy,chest and pelvic sites in EFOV mode scanning MV CBCT images could only be used for image guidance.

Objective To observe the therapeutic efficacy of intravitreal ranibizumab combined with laser photocoagulation for the treatment of macular edema associated with ischemic branch retinal vein occlusion (BRVO).Methods Together 60 patients (60 eyes) with BRVO in Anshan City Central Hospital were included and divided into three groups,20 patients with intravitreal ranibizumab treatment as A group,20patients with retinal laser photocoagulation treatment as B group,and another 20 patients with intravitreal ranibizumab combined with retinal laser photocoagulation therapy as C group,followed by the preoperative observation of the best corrected visual acuity (BCVA),slit lamp,fundus and intraocular pressure examination,fundus fluorescein angiography (FFA),optical coherence tomography (OCT).One day after the surgery,BCVA,slit lamp and intraocular pressure examination were conducted,and 1 month,2months,3 months after the surgery,observation of BCVA,slit lamp,fundus and intraocular pressure examination were performed.Then,OCT was used to determine the status of macular edema.And finally,BCVA and central macular thickness (CMT) in the three groups were statistically analyzed by observing the above indicators.Results The BCVA at 1 month,2 months,and 3 months after treatment was higher than before treatment in all three groups,and the differences were statistically significant (all P ＜ 0.05).The BCVA of A group was 0.26 ±0.14 and 0.26 ±0.14 at 2 and 3 months after treatment,respectively,which was significantly better than that of B group (0.39 ±0.10 and 0.40 ±0.10) (all P ＜0.05).At 3 months after treatment,the BCVA in C group was 0.14 ±0.11,which was significantly higher than that in A group (0.26 ±0.14) (P＜0.05).The BCVA of C group was 0.30 ±0.13,0.20 ±0.12,0.14 ± 0.11 at 1 month,2 months and 3months after treatment,respectively,which was better than that of B group (0.43 ±0.10,0.39 ± 0.10,0.40 ± 0.10),and the differences were statistically significant (all P ＜0.05).The postoperative CMT was significantly reduced when compared with preoperation in all three groups (all P ＜ 0.05).The CMT at 1 month,2 months and 3 months after treatment in C group was (318.85 ± 71.48)μm,(287.15 ± 56.71) μm and (255.05 ± 60.90)μm,respectively,which was better than that in A group [(347.00 ± 67.59) μm (305.10 ± 47.44) μm and (282.40 ± 36.26) μm],and B group [(417.05 ± 63.94) μm,(394.80 ±57.18) μm,and (375.90 ± 55.10) μm],with significant differences (all P ＜ 0.05).At 2 months and 3 months after treatment,CMT in A group was better than that in B group,and the difference was statistically significant (P ＜ 0.05).Conclusion The efficacy of retinal laser photocoagulation combined with intravitreal ranibizumab in the treatment of BRVO macular edema is better than simple retinal laser photocoagulation and simple intravitreal ranibizumab.

Objective: To investigate the relationship between lipid control level and in-stent restenosis (ISR) in patients after percutaneous coronary intervention (PCI). Methods: A total of 211 coronary artery disease (CAD) patients who received primary PCI in our hospital from 2012-01 to 2012-12 were studied. All the patients took oral dual anti-platelet therapy and statins routinely, and they received coronary angiography (CAG) re-examination at (3-12) months after PCI. According to CAG ifndings, the patients were divided into 2 groups: ISR group,n=25 and Non-ISR group,n=186. Blood levels of TC, TG, HDL-C, LDL-C were detected and compared before primary PCI and after CAG re-examination between 2 groups. Results: The baseline information such as age, gender, hypertension, family history of CAD, pre-operative diagnosis of coronary syndrome, smoking and drinking conditions were similar between 2 group,P>0.05; the pre-operative TC, TG, HDL-C, LDL-C were similar between 2 group,P>0.05. CAD patients combining with diabetes mellitus (DM) in ISR group (36.0%) was higher than that in Non-ISR group (17.7%),P=0. 03. Multivariate logistic regression analysis showed that at post PCI, no TC reduction (OR=1.07, 95% CI 0.38-2.62,P=0.04), LDL-C ≥ 1.8 mmol/L or the reduction less than 50% (OR=11.33, 95% CI 3.62-35.52,P<0.01), combining with DM (OR=3.00,95% CI 1.04-8.67,P=0.04) were positively related to ISR. Conclusion: Without TC reduction and nonstandard LDL-C level were the risk factors of ISR occurrence in CAD patients after PCI, DM complication may signiifcantly increase the risk of ISR.

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.

Objective To observe the early changes in the area of the foveal avascular zone (FAZ) and macular vascular density (MVD) in diabetic patients using optical coherence tomography angiography (OCTA) and its clinical significance.Methods This was a retrospective study.Totally 33 patients with diabetes mellitus were enrolled,including 13 patients with no-diabetic retinopathy (NDR group) and 20 patients with nonproliferative diabetic retinopathy (NPDR group) according to the international clinical grading criteria of diabetic retinopathy.Additional 26 healthy subjects with matched age were enrolled in the control group.All the subjects underwent the 3 mm ×3 mm scanning of macular retina by OCTA for obtaining 4 levels of macular vascular density map.And the area of the FAZ and the MVD were measured.Results The area of FAZ was(0.392 ± 0.028) mm2 in the NDR group and (0.410 ± 0.019) mm2 in the NPDR group,respectively,and the difference was statistically significant compared with the control group (0.314 ± 0.025) mm2 (all P =0.000),and there was statistically significant difference between the NDR group and NPDR group (P =0.010).The MVD in the superficial retinal layer,deep retinal layer,outer retinal layer and choroidal capillary layer was 0.500 ±0.012,0.553 ±0.007,0.393 ±0.005,0.651 ±0.006 in the NDR group,and 0.484 ± 0.012,0.522 ± 0.007,0.397 ± 0.007,0.642 ± 0.007 in the NPDR group,respectively,and the difference was statistically significant compared with the control group (0.518 ±0.014,0.572 ±0.008,0.385 ±0.005,0.666 ±0.007) (all P =0.000);there were statistically significant differences in MVD between the NDR group and NPDR group in the superficial retinal layer,deep retinal layer and choroidal capillary layer (all P =0.000),but not in the outer retinal layer (P =0.065).Conclusion OCTA suggested that the early retinal microcirculation impairment in the macula in patients with diabetes,which changes with the progression of the disease.

OBJECTIVETo investigate the expression of COX-2 and BCL-2 in transitional mucosa adjacent to rectal carcinoma, and to determine whether precursor event exists in the transitional mucosa.

METHODSMucin histochemical method (HID/AB) was used to determine the distal mucosa 2 cm away from rectal carcinoma in 54 patients with rectal cancer. Immunohistochemical method was employed to detect the expression of BCL-2 and COX-2 in the rectal cancer specimen, transitional mucosa (TM), non-transitional mucosa (NTM), and 20 cases of normal rectal mucosa. Student's t-test and Chi-square test were preformed.

RESULTSNineteen patients with positive TM were found. COX-2 expression was identified in 81.5% of cancer tissue, 21.1% of TM, 17.1% of NTM, and 10.0% in normal mucosa. BCL-2 protein was found in 77.8% of cancer tissue, 21.1% of TM, 22.9% of NTM, and 5.0% of normal mucosa. The expressions of COX-2 and BCL-2 in TM were significantly different from tumor tissue[(0.737±0.895) versus (3.519±1.998), and (0.632±0.955) versus (2.833±1.756), all P<0.01]. However, there were no significant differences between TM and NTM or normal mucosa.

CONCLUSIONSExpressions of COX-2 and BCL-2 are non-specific in the transitional mucosa at the distal rectum. Evidence is not available in TM being precursor lesion.

Adult ; Aged ; Cyclooxygenase 2 ; metabolism ; Female ; Humans ; Intestinal Mucosa ; metabolism ; pathology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rectal Neoplasms ; metabolism ; pathology

OBJECTIVETo observe the distribution features of tender points in knee of patients with knee osteoarthritis in order to provide evidences for the treatment and diagnosis.

METHODSFrom November 2011 to December 2012,86 patients with knee osteoarthritis were recruited, including 21 males and 65 females, ranging in age from 45 to 85 years old, with an average of (59.98 +/- 8.23) years old. The course of disease ranged from 3 months to 15 years. The tender points and its distributions were determined by finger press carefully on their knees. Data of studying was analyzed by frequency statistics and Hierachical cluster analysis.

RESULTSThe distribution of tender points in the knee osteoarthritis was mainly in the interior region and anterior area such as in apex of patella, adductor tubercle and et al. According to the results of hierachical cluster analysis, the tender points could be divided into two categories the first cluster was in the interior region of knee, the second cluster was in the lateral region.

CONCLUSIONThe findings demonstrated that cluster analysis statistical method can be used for classification of the distribution of tender points. The distribution features of tender points in knee osteoarthritis are related to the anatomic site in knee.

Adult ; Aged ; Aged, 80 and over ; Cluster Analysis ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; complications ; Pain ; complications

Objective To compare the relative dose of small fields measured by clinically common detectors and those obtained from Monte Carlo simulation in order to obtain the accurate measurement method, and to modify the inappropriate detectors.Methods The percentage depth-dose distribution curve and profile (flatness and symmetry) curves were collected at 2 cm×2 cm, 3 cm×3 cm, and 4 cm×4 cm under 6-MV X-ray of Trilogy linear accelerator by CC13, PFD, SFD, and blue phantom.The results were compared with the stimulation results from Monte Carlo method (the current gold standard).The correction factors for the detectors with large error were calculated to provide reference data for clinical practice.Results The results measured by SFD detector were most close to the results from Monte Carlo simulation.The measurement errors of CC13 and PFD detectors were large.The correction factor in the penumbra for CC13 and PFD detector was 0.664-1.499.Conclusions SFD detector is better than CC13 and PFD detector in the measurement of small fields, but CC13 and PFD detector can provide reference data for clinical practice after the corresponding correction.

Objective: To explore the risk factors for ventricular aneurysm formation in patients after acute myocardial infarction (AMI).
Methods: Our research included 2 groups of AMI patients who received percutaneous coronary intervention (PCI)
in our hospital from 2012-04 to 2014-07 as Ventricular aneurysm group,n=146 and Control group,n=142, in which the AMI patients without ventricular aneurysm formation. The baseline condition with aneurysm related risk factors were analyzed and compared between 2 groups including age, gender, hypertension, hyperlipidaemia, diabetes, smoking, family history, MI history, anterior myocardial wall infarction, angina pectoris, left main (LM) disease, the lesion at proximal left anterior descending (LAD) artery, NYHA classiifcation III/IV, chest pain time ≥ 24 hours and ST-segment elevation ≥ 4 adjacent leads in ECG.
Results: Compared with Control group, the patients in Ventricular aneurysm group had the elder age (OR=1.023, 95% CI 1.000-1.046), higher incidence rates of smoking (OR=1.819, 95% CI 1.130-2.928) and anterior MI (OR=9.162, 95% CI 4.657-18.028), more patients with ≥ 4 adjacent ST-segment elevation (OR=6.571, 95% CI 2.426-17.798), while less patients with angina pectoris (OR=0.557, 95% CI 0.335-0.927, allP<0.05. With adjusted relating factors of age, gender, hypertension, diabetes and angina pectoris, the multivariate Logistic regression analysis indicated that smoking (regression coefifcient: 0.833, OR=2.301, 95% CI 1.283-4.125), anterior MI (regression coefifcient: 1.799, OR=6.041, 95% CI 2.831-12.894) were positively related to ventricular aneurysm formation.
Conclusion: Smoking and anterior MI were strongly related to ventricular aneurysm formation in patients after AMI.