Objective To investigate the dosimetric differences between volumetric modulated arc therapy (VMAT) with a flattening filter (FF) and flattening filter-free (FFF) VMAT in fractionated stereotactic radiotherapy for brain metastases. Methods Seventeen patients with brain metastases were divided into FF-VMAT group (VMAT plans with the FF mode) and FFF-VMAT group (VMAT plans with the FFF mode). The two groups were compared in terms of target volume dose parameters (D_98%, D_2% and D_mean), the conformal index (CI), the gradient index (GI), the gradient, normal brain tissue dose parameters (V_5Gy, V_10Gy, V_12Gy and D_mean), monitor units, and beam-on time. Results Compared with the FF-VMAT group, the FFF-VMAT group had significantly lower GI (3.33 ± 0.37 vs 3.27 ± 0.35, P = 0.001), a significantly lower gradient [(0.85 ± 0.20) cm vs (0.84 ± 0.19) cm, P = 0.002], a significantly shorter beam-on time [(177.05 ± 62.68) s vs (142.71 ± 34.59) s, P = 0.001], and significantly higher D_2% [(65.69 ± 2.15) Gy vs (66.99 ± 2.03) Gy, P = 0.001] and D_mean [(58.77 ± 1.60) Gy vs (59.95 ± 1.43) Gy, P <0.001]. There were no significant differences in the CI, the D_98% of the target volume, the V_5Gy, V_10Gy, V_12Gy and D_mean of the normal brain tissue, and monitor units between FFF-VMAT and FF-VMAT. Conclusion FFF-VMAT can better protect the normal tissue around the target volume, reduce the beam-on time, and improve treatment efficiency.

Discovery of the RNA interference (RNAi) pathway has led to exciting new strategies for developing HIV treatment. This study was to find out the highly effective and conserved siRNA target sequences for improving RNAi-based therapy against the HIV-1. We constructed 30 shRNA expression plasmids for expressing different siRNAs targeted to HIV-1 vif and co-transfected them with the pNL4-3 to score for its ability to inhibit the expression of p24 protein of HIV-1. Then, the highly effective siRNAs targeting sequences were selected to align with 625 HIV-1 sequences in database including all HIV-1 subtypes to ana lyze their conserved character. In addition, vif37 the highly effective and most conserved target sequence was confirmed of its sequence-specific inhibition by independent reporter assays. MT-4 cell transduced with lentiviral shRNA-vif37 vector could inhibit HIV-1(NL4.3) replication in vitro. Moreover, MT-4-vif37 cloned from transduced MT-4 cell could stably express shRNA-vif37 and inhibit virus replication more efficiently when challenged with high titer virus. These results showed that RNAi has great potential as an antiviral gene therapy approach and supports the efforts to develop treatment for HIV-1-infected individuals.
Acquired Immunodeficiency Syndrome ; therapy ; Base Sequence ; Humans ; Lentivirus ; genetics ; Molecular Sequence Data ; RNA Interference ; RNA, Small Interfering ; chemistry ; genetics ; Virus Replication ; vif Gene Products, Human Immunodeficiency Virus ; antagonists & inhibitors ; genetics

AIM:To investigate the effects of ubiquitin-specific peptidase 9, X-linked (USP9X) down-regula-tion on apoptosis and invasion ability in gastric carcinoma cells, and to explore its possible molecular mechanisms. METH-ODS:USP9X small interfering RNA (siRNA) and control siRNA were used to be transfected into gastric carcinoma AGS cells. The cells were divided into 3 groups, including untreated AGS group, control siRNA group and USP9X siRNA group. The expression of USP9X at mRNA and protein levels in the AGS cells with different treatments was determined by real-time PCR and Western blot. The cell viability was analyzed by CCK-8 assay. Flow cytometry and Boyden chamber were employed to examine the apoptosis and invasion ability of the AGS cells. RESULTS:USP9X siRNA significantly down-regulated the expression of USP9X at mRNA and protein levels in the AGS cells. Down-regulation of USP9X markedly induced apoptosis and reduced invasion ability of the gastric carcinoma AGS cells. Notably, down-regulation of USP9X sig-nificantly reduced the protein expression of Mcl-1 and MMP-2, but markedly increased the protein level of Bax. CON-CLUSION:USP9X may be a key regulator for apoptosis and invasion in gastric carcinoma.

OBJECTIVETo evaluate the effect of bronchoalveolar lavage (BAL) through bronchoscopy in diagnosis and treatment of accidental inhalation of liquid and powdery foreign bodies in children.

METHODTwenty-one cases of accidental inhalation were classified into the following 4 groups according to the materials inhaled: 3 cases inhaled the lipidic material; 2 cases inhaled chemical material; 15 cases inhaled hydrosoluble materials; 1 case inhaled powdery material. Eighteen cases were hospitalized within 3 days after the accidents, which included 16 cases treated within 1 day in hospital. And 3 cases were hospitalized 3 days after the accident. After hospitalization, all patients were immediately treated with direct aspiration and lavage clearance method through bronchoscopy. The inhaled foreign materials were cleared as soon as possible, which reduced the absorption, stimulation and infection of respiratory mucosa. The therapeutic effect was evaluated by endoscopic findings, clinical manifestation, laboratory examination and chest imaging. At the same time, decision was made on the second BAL and the prognosis was estimated.

RESULTTwenty-one cases had dyspnea of certain degree. The bronchial mucous membrane of all the 21 cases showed hyperemia, edema and exudate attached. Lavage fluid looked like broth and contained much of the inhaled material. After two to five times treatment, 18 cases were cured (86%), but 3 cases died (14%). One of these 3 cases fell into an oil well, 1 into mosquito repellent solution, another into manure pit. The patients who could not survive had severe airway obstruction, which was difficult to clean and made the problem deteriorated progressively. One of the patients was sent to a hospital 3 days after the accident and another case developed fungal infection, pneumothorax and finally respiratory failure.

CONCLUSIONBAL through bronchoscopy is necessary for children who accidentally inhaled liquid and powdery materials. This treatment is safe and effective in diagnosis and treatment of such problems in children. The effect of treatment is influenced by types of inhaled material, the time of lavage clearance through bronchoscopy, and certain complications, such as infection etc.

Bronchoalveolar Lavage ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Foreign Bodies ; therapy ; Humans ; Infant ; Inhalation Exposure ; Male ; Powders

Objective To observe the effects of Gandouling on reactive oxygen species (ROS) level, the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) mRNA and protein of neural stem cells of the mice cultured in high concentration copper. Methods The model of neural stem cells of the mice was cultured in vitro with high concentration copper. The experimental rats were randomly divided into blank control group, model group, and Gandouling low-, medium-, and high-dose groups. Each medication group was given relevant concentration of Gandouling serum for gavage. The MTT was adopted to test proliferation level on neural stem cells; flow cytometer was used to examine the change of ROS level in cells; qPCR was used to measure the expression of Nrf2 mRNA;Western blot was used to measure the change of the level of protein Nrf2 in cells. Results Compared with the blank control group, the proliferation rate of neural stem cells was significantly decreased, ROS levels were significantly increased, and Nrf2 gene and protein expression was significantly decreased (P＜0.01). Compared with the model group, neural stem cells proliferation rate was significantly increased, ROS levels were significantly reduced, and Nrf2 gene and protein expression was significantly increased (P＜0.05, P＜0.01). Conclusion Gandouling can promote the proliferation of neural stem cells in mice by reducing ROS content in high copper-loaded mice and up-regulating Nrf2 expression.

Objective To evaluate the feasibility,reliability,validity and responsiveness of a Chinese Menopause Rating Scale (CMRS).Methods Cross-sectional survey and convenience sampling were adopted. Participants:women with menopause syndrome and those in menopause but without menopause syndrome were recruited.All participants were asked to complete the CMRS,Kupperman Index,WHOQOL-BREF and MENQOL.The Self-control observation design was adopted when the responsiveness was evaluated.Patients were treated with TCM for weeks.MRSTCM was evaluated before and after the treatment.Results (1) Feasibility:3343 participants including 2320 patients and 1023 menopause women,were surveyed in 8 different settings.The recovery rate of CMRS was 100%,with a response rate as 99.7%.The completion of the CMRS took 10.30 minutes on average.(2)Reliability:Cronbach's alpha of CMRS,soma dimension,psychology dimension and community dimension of CMRS were 0.93,0.87,0.89 and 0.73 respectively,with the correlation coefficient of split half of the CMRS.Soma dimension,psychology dimension and community dimension were 0.92,0.89,0.86 and 0.73 respectively and the test-retest correlation coefficient of MRSTCM,the soma dimension,psychology dimension and community dimension were as 0.88,0.91,0.85 and 0.77 respectively.(3) Validity:CMRS was established on the basis of connotation of menopause syndrome,and a series of steps were adopted to modify the scale.CMRS was applicable for patients with menopause syndrome.CMRS seemed to have had good content-related validity.The result of exploratory factor analysis was accorded with the theory frame of CMRS by and large.The correlations between CMRS and KI,CMRS and WHOQOLBREF,CMRS and MENQOL seemed good.The CMRS was able to discriminate between groups of people with or without menopausal syndrome and bad good discriminative validity.(4) Responsibility:The CMRS was measured based on 174 patients with menopausal syndrome before and after the TCM therapy.Our result showed that the CMRS having the ability to measure the clinically important differences.Conclusion CMRS was suitable for outcome assessment of menopausal syndrome.This primary research proved that the CMRS had good feasibility,reliability,validity as well as responsiveness.

Objective To investigate the related factors of early neurological deterioration in eld-erly patients with thrombolysis for acute occlusive stroke of large intracranial vessels.Methods Clin-ical materials of 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels were retrospectively analyzed.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of patients within 72 hours after thrombectomy,and the pa-tients were divided into deterioration group and non-deterioration group.The baseline materials were compared between the two groups,the factors of early neurological deterioration were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of risk.Results Among 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels,92 cases(19.17％)had early neurological deterioration;the blood glucose level,white blood cell count,incidence of dysphagia,and incidence of coma in the deterioration group were sig-nificantly higher than those in the non-deterioration group(P＜0.05);the Logistic regression analy-sis showed that high level of blood glucose(95％CI,1.203 to 1.478),high level of white blood cell count(95％CI,1.159 to 1.408),dysphagia(95％CI,7.049 to 31.475),and coma(95％CI,8.375 to 43.195)were risk factors for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels(OR＞1,P＜0.05).ROC curve results showed that blood glucose,white blood cell count,dysphagia,and coma had certain predictive val-ue for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels[the area under the curve(AUC)was 0.733,0.708,0.707 and 0.701];the ROC curve showed AUC was 0.934,indicating that the model was reliable and stable.Conclusion Early neurological deterioration in elderly patients with thrombolysis for acute occlu-sive stroke of large intracranial vessels may be related to factors such as blood glucose,white blood cell count,dysphagia,and coma.Early risk assessment and relevant intervention measures can be taken clinically to improve prognosis.

Objective To investigate the related factors of early neurological deterioration in eld-erly patients with thrombolysis for acute occlusive stroke of large intracranial vessels.Methods Clin-ical materials of 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels were retrospectively analyzed.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of patients within 72 hours after thrombectomy,and the pa-tients were divided into deterioration group and non-deterioration group.The baseline materials were compared between the two groups,the factors of early neurological deterioration were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of risk.Results Among 480 elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels,92 cases(19.17％)had early neurological deterioration;the blood glucose level,white blood cell count,incidence of dysphagia,and incidence of coma in the deterioration group were sig-nificantly higher than those in the non-deterioration group(P＜0.05);the Logistic regression analy-sis showed that high level of blood glucose(95％CI,1.203 to 1.478),high level of white blood cell count(95％CI,1.159 to 1.408),dysphagia(95％CI,7.049 to 31.475),and coma(95％CI,8.375 to 43.195)were risk factors for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels(OR＞1,P＜0.05).ROC curve results showed that blood glucose,white blood cell count,dysphagia,and coma had certain predictive val-ue for early neurological deterioration in elderly patients with thrombolysis for acute occlusive stroke of large intracranial vessels[the area under the curve(AUC)was 0.733,0.708,0.707 and 0.701];the ROC curve showed AUC was 0.934,indicating that the model was reliable and stable.Conclusion Early neurological deterioration in elderly patients with thrombolysis for acute occlu-sive stroke of large intracranial vessels may be related to factors such as blood glucose,white blood cell count,dysphagia,and coma.Early risk assessment and relevant intervention measures can be taken clinically to improve prognosis.

OBJECTIVETo translate the English version of The Premature Ejaculation Diagnostic Tool (PEDT) into Chinese, evaluate its reliability and validity, and analyze its feasibility in the diagnosis of premature ejaculation (PE).

METHODSFollowing the forward-backward translation procedure, we developed the Chinese version of PEDT, which was then revised by andrologists and bilingual linguists. We enrolled subjects with or without PE from 15 urological or andrological clinics in China and obtained the information about their demographic characteristics, PEDT scores, and intra-vaginal ejaculation latency time (IELT). We evaluated the internal consistency of PEDT using Cronbach alpha, was examined its reliability and stability by test-retest analysis, analyzed its correlation with IELT by Spearman correlation analysis, and tested its sensitivity and specificity by receiver operating characteristic ( ROC) analysis.

RESULTSTotally, 570 PE patients (aged [30.66 ± 7.11] years) and 226 non-PE men (aged [33.01 ± 5.41] years) were recruited, with the mean IELT of (1.34 ± 0.54) min in the former and (11.09 ± 7.5) min in the latter group. The Cronbach's alpha of the Chinese version of PEDT was 0.79, and the test-retest correlation coefficient was 0.75 (P < 0.01). The PEDT score was negatively correlated with IELT (Spearman's p = -0.52, P < 0.01). When the cutoff value of PE diagnosis was defined as 7.5, the sensitivity and specificity of PEDT were 0.80 and 0.78, and when as 8.5, they were 0.72 and 0.89, respectively.

CONCLUSIONThe Chinese version of PEDT was demonstrated to have good internal consistency, reliability, and validity, as well as a high predictability for PE. It can be used as a reliable and convenient tool to screen PE among Chinese men.

Adult ; Aged ; Asian Continental Ancestry Group ; China ; Ejaculation ; Feasibility Studies ; Humans ; Language ; Male ; Middle Aged ; Premature Ejaculation ; diagnosis ; ROC Curve ; Reaction Time ; Reproducibility of Results ; Sensitivity and Specificity ; Translations