Objective To explore the feasibility of blood oxygen level-dependent (BOLD) MRI to detect the chronic hepatitis b-induced early kidney injury. Methods Seventeen clinically diagnosed chronic hepatitis b patients with early kidney injury and 10 healthy volunteers were enrolled in this preliminary study. The 17 patients underwent dynamic nuclear renography and then subdivided into stage 1 kidney injury group (n=7) and stage 2 kidney injury group (n=10). All of the enrolled subjects underwent BOLD examination and T2* relaxation rates (R2*) of renal cortex and medulla of split kidney, and the ratio between them (R2*med/cor) were measured separately. One-way analysis of variance (ANOVA) were performed on the control group and chronic hepatitis b patients group (kidney injury stage 1 and stage 2 group) to compare the difference of renal cortical and medullary R2*values and R2*med/cor ratio. ROC curves were used to evaluate the efficacy of renal cortical and medullary R2* values and R2*med/cor ratio to diagnose the chronic hepatitis b-induced kidney injury. Results The cortical R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were(16.87 ± 0.74)/s,(17.88 ± 0.73)/s,(20.29 ± 2.87)/s, respectively;the medullar R2*values of control group, stage 1 kidney injury group and stage 2 kidney injury group were (28.07±1.03)/s,(31.14±2.49)/s,(32.81±3.28)/s, respectively;R2*med/cor of the of control group, stage 1 kidney injury group and stage 2 kidney injury group were 1.67 ± 0.09, 1.75 ± 0.16, 1.63 ± 0.13, respectively, and the differences among the three groups were statistically significant (F values were 17.779, 19.170 and 3.439 , all P<0.05). Furthermore, the renal cortical and medullary R2* values of chronic hepatitis b patients were significantly higher than the control group, and the the renal cortical R2* value of the patients in stage 2 kidney injury group was also higher than the stage 1 kidney injury group. The area under curve (AUC) of ROC of the renal cortical and medullary R2*values and R2*med/cor to diagnose chronic HBV hepatitis-induced early kidney injury were 0.903, 0.949 and 0.526, respectively. Conclusion It's feasible and has great value to use renal BOLD MRI for the diagnosis of chronic hepatitis b-induced early kidney injury, and the renal cortex is more sensitive than the medulla to the kidney injury.

Objective To explore the distribution of inflam m atory cells and positive expression of P-se-lectin glycoprotein ligand-1 (PSG L-1) in infant brainstem tissue from hand-foot-m outh disease related fatal brainstem encephalitis. Methods Tw enty brainstem sam ples from infants suffered from brainstem en-cephalitis w ere collected as the experim ental group. Ten brainstem sam ples from infants died of non-brain diseases and injuries w ere collected as the control group. The distribution of inflam m atory cells and the expression of PSG L-1 in the tw o groups w ere exam ined by im m unohistochem ical m ethod. The characteristics of the positive cells w ere observed. Results In brainstem tissue of the experim ental group, there w ere sleeve infiltrations of inflam m atory cells around the vessels and in the glial nodule. Microglia was the m ost and following was neutrophils around the vessels and in the glial nodule. There was a significant statistical difference am ong m icroglias, neutrophils and lym phocytes (P<0.05). There was no sleeve infiltration in the control group. PSG L-1 protein was expressed w idely in inflam m atory cells in the experim ental group, especially in the inflam m atory cells around the vessels and in the glial nodule. B ut PSG L-1 positive staining could be observed significantly less in the control group com paring with the experim ental group (P<0.05). Conclusion Microglia is the m ain type of inflam m atory cells involved in the progress of the fatal disease. Moreover, PSG L-1 could participate in the pathogenesis of hand-foot-m outh disease related fatal brainstem encephalitis.

Objective To analyze the effects of Cavity Preparation Skill Evaluation System (CPSES) in pre-clinical dental cavity preparation assessment.Methods Twenty one dental undergraduates in Medical School of Nankai University were chosen in this study.After cavity preparation training,students' cavity preparation skills were evaluated systematically.The outline form and depth of 21 left mandibular first molar class Ⅰ cavity preparation made by students were evaluated by CPSES system and evaluators' visual assessment.The evaluation results were analyzed using GraphPad InStat statistical software(V3.1) with paired t test (test level α=0.05) and correlation analysis to study the application effects of the CPSES system.Results The evaluation results generated from CPSES system and evaluators' visual assessment for class Ⅰ dental cavity preparation skill evaluation showed significant difference(two tailed P value 0.0050,t=3.156) and certain correlation on cavity preparation assessment(two tailed P value 0.0837,r=0.386 2).Conclusion Application of cavity preparation skill evaluation system in undergraduate endodontic teaching can deepen and strengthen the students' understanding of cavity preparation requirements and help students master cavity preparation knowledge and skills better.

OBJECTIVE: To study a better surgical approach for the resection of tumor in the anterior skull base and the fronto-orbito-ethmoidal region. METHOD: Extend external frontal sinus approach was made in the lesion side. The incision can be extended outward to the nasal side or superciliary arch according to the tumors extent and size so as to get a full exposure of tumors of anterior skull base, fronto-orbito-ethmoidal region, or exterior margin of arcola. RESULT: From January 1998 to December 2003, 28 patients suffered tumors of anterior skull base and fronto orbito-ethmoidal region were received tumors resection through this approach. Postoperatively, no death or recurrence have occurred up to now in 8 cases of benign tumors, and the one-year survival rate was 95% (19/20), the three-year survival rate was 61.5% (8/13), and the five-year survival rate was 57.1% (4/7) in 20 cases of malignant tumors. CONCLUSION This approach provide good exposure. Bleeding is little, operation field is clear, operating is easy re-establish skull base is convenience, surgical trauma is small, and reaction is mild when using decohesion tumors and block blood supply in skull base method. We believe this approach is a better method for resection of tumors in anterior skull base and the fronto-orbito-ethmoidal region.
Adolescent ; Adult ; Aged ; Craniotomy ; methods ; Female ; Frontal Bone ; surgery ; Frontal Sinus ; surgery ; Humans ; Male ; Middle Aged ; Skull Base ; surgery ; Skull Base Neoplasms ; surgery ; Young Adult

OBJECTIVE: To summarize the effect of different treatment of cervical lymph node on the prognosis of patients with clinically negative neck (cN0) supraglottic laryngeal carcinoma (SGLC), and to explore the significance of selective neck dissection of levels II, III and(or) IV on SGLC patients with cN0 neck. METHOD: A retrospective analysis was undertaken for 83 supraglottic laryngeal squamous cell carcinoma patients with cNo from January 2003 to May 2007 at the Department of Otolaryngology, First Affiliated Hospital of Zhengzhou University. All medical records was complete and all primary tumor were resected by surgery, the follow-up time was at least 5 years or until patients died. The patients' five year survival rate was compared between the selective neck dissection group and other three groups (neck radiotherapy group, combined therapy group and 'wait and see' policy group). RESULT: The rate of cervical lymph node metastasis of cN0 supraglottic carcinoma patients with cN0 neck was 30.77%, and with the increasing of T stage, the rate of cervical lymph node metastasis increased gradually. The cervical lymph node recurrence rate of intervention groups was significantly lower than that of 'wait and see' group (P < 0.05). No significant difference (P > 0.05) of 5-year survival rate between selective neck dissection group, neck radiotherapy group, combined therapy group was observed, the difference was significant between selective neck dissection group and observation group (P < 0.05). CONCLUSION Selective neck dissection is one of effective measures to process neck lymph node for cN0 SGLC clinically.
Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Neck Dissection ; methods ; Neoplasm Staging ; Prognosis ; Retrospective Studies

Objective To explore the effect of prognosis of consolidation radiotherapy for patients after R0 resection of local recurrence after radical mastectomy. Methods Totally 110 breast cancer patients with local recurrence receiving R0 resection were admitted and treated in our hospital from January 1st, 2003 to November 30th, 2015 were retrospectively analyzed. Results The median local progression time of 74 patients receiving consolidation radiotherapy ( 67.3％) was remarkably better than that of those without radiotherapy(36 patients, 32.7％), and the difference was statistically significant (χ2 =8. 526, P<0.05). Meanwhile, there was no statistically significant difference (P>0.05) of distance disease-free survival and overall survival between the radiotherapy group and the non-radiotherapy group. Multifactor analysis indicated that pseudo-adjuvant endocrine therapy (χ2 =7.541,95％CI:27.1％ -80.4％, P <0.05), DDFS(≥2 years vs. <2 years,χ2 =4.068,95％CI:101.4％ -267％,P<0. 05) and pseudo-adjuvant radiotherapy(χ2 =14.126, 95％CI:21.7％ -80.4％, P <0. 05 ) were the independent risk factors affecting the OS of patients with local recurrence after R0 resection. Conclusions For the patients with local recurrence after R0 resection of local recurrence, it is recommended that consolidation radiotherapy should be done and the radiation field should include the same side of the chest wall and clavicle area lymphatic drainage area.

Objective:To investigate the radiation field and dose selection of patients with isolated chest wall recurrence (ICWR) after modified radical mastectomy, and analyze the prognostic factors related to subsequent chest wall recurrence.Methods:Clinical data of 201 patients with ICWR after mastectomy admitted to the Fifth Medical Center, Chinese PLA General Hospital from 1998 to 2018 were retrospectively analyzed. None of the patients received postoperative adjuvant radiotherapy. After ICWR, 48 patients (73.6%) underwent surgery and 155 patients (77.1%) received radiotherapy. Kaplan-Meier method was used to calculate the post-recurrence progression-free survival (PFS) rates and the difference was compared by log-rank test. Multivariate analysis was performed using Cox regression model. Competing risk model was adopted to estimate the subsequent local recurrence (sLR) rates after ICWR and the difference was compared with Gray test. Multivariate analysis was conducted using F&G analysis. Results:With a median follow up of 92.8 months after ICWR, the 5-year PFS rate was 23.2%, and the 5-year sLR rate was 35.7%. Multivariate analysis showed that patients with surgery plus radiotherapy and recurrence interval o F>12 months had a lower sLR rate. Patients with recurrence interval o F>48 months, local plus systemic treatment and surgery plus radiotherapy had a higher PFS rate. Among the 155 patients who received chest wall radiotherapy after ICWR, total chest wall irradiation plus local boost could improve the 5-year PFS rate compared with total chest wall irradiation alone (34.0% vs. 15.4%, P=0.004). Chest wall radiation dose (≤60 Gy vs.>60 Gy) exerted no significant effect upon the sLR and PFS rates (both P>0.05). In the 53 patients without surgery, the 5-year PFS rates were 9.1% and 20.5%( P=0.061) with tumor bed dose ≤60 Gy and>60 Gy, respectively. Conclusions:Local radiotherapy is recommended for patients with ICWR after modified radical mastectomy of breast cancer, including total chest wall radiation plus local boost. The radiation dose for recurrence should be increased to 60 Gy, and it should be above 60 Gy for those who have not undergone surgical resection. In addition, patients with ICWR still have a high risk of sLR, and more effective treatments need to be explored.

Powdery mildew (Pm) caused by the infection of Blumeria graminis f.sp.tritici (Bgt) is a worldwide crop disease resulting in significant loss of wheat yield.To profile the genes and pathways responding to the Bgt infection,here,using Affymetrix wheat microarrays,we compared the leaf transcriptomes before and after Bgt inoculation in two wheat genotypes,a Pm-susceptible cultivar Jingdong 8 (S) and its near-isogenic line (R) carrying a single Pm resistant gene Pm30.Our analysis showed that the original gene expression status in the S and R genotypes of wheat was almost identical before Bgt inoculation,since only 60 genes exhibited differential expression by P =0.01 cutoff.However,12 h after Bgt inoculation,3014 and 2800 genes in the S and R genotype,respectively,responded to infection.A wide range of pathways were involved,including cell wall fortification,flavonoid biosynthesis and metabolic processes.Furthermore,for the first time,we show that sense-antisense pair genes might be participants in wheat-powdery mildew interaction.In addition,the results of qRT-PCR analysis on several candidate genes were consistent with the microarray data in their expression patterns.In summary,this study reveals leaf transcriptome changes before and after powdery mildew infection in wheat near-isogenic lines,suggesting that powdery mildew resistance is a highly complex systematic response involving a large amount of gene regulation.

Objective:To analyze the prognosis of patients with isolated regional recurrence (RR) after mastectomy, and evaluate the efficacy of radiotherapy and identify the optimal radiation target volumes.Methods:Clinical data of 144 patients with first isolated RR after mastectomy between 2001 and 2018 were retrospectively analyzed. All patients had not received post-mastectomy radiotherapy. The primary endpoints consisted of the subsequent locoregional recurrence (sLRR), distant metastasis (DM), progression-free survival (PFS) and overall survival (OS).Results:With a median follow-up of 82.5 months after RR, the 5-year sLRR, DM, PFS and OS rates for the entire group were 42.1%, 71.9%, 22.9% and 62.6%, respectively. Local plus systemic therapy was an independent favorable prognostic factor for sLRR ( P<0.001) and PFS ( P=0.013). The sLRR rate in the surgery plus radiotherapy group was the lowest ( P<0.001). Surgery plus radiotherapy significantly reduced the 5-year risk of recurrence within the initially involved nodal regions ( P<0.001). Patients with chest wall irradiation obtained the 5-year subsequent chest wall recurrence rate of 12.1% compared to 14.8%( P=0.873) for those without chest wall irradiation. The subsequent supraclavicular recurrence rate was lower in patients with prophylactic supraclavicular irradiation than that without prophylactic supraclavicular irradiation (9.9% vs. 23.8%, P=0.206). The incidence rates of initially uninvolved axillary and internal mammary nodal recurrence were below 10% regardless of prophylactic irradiation or not. Conclusions:Patients with RR alone have an optimistic 5-year OS in the contemporary era. Comprehensive locoregional treatment including surgery and radiotherapy combined with systemic therapy is recommended. The chest wall, axillary and internal mammary nodal prophylactic irradiation should not be routinely performed for all patients with RR. The value of supraclavicular prophylactic irradiation remains to be evaluated.

Objective:To analyze the prognostic factors of breast cancer patients with isolated chest wall recurrence (ICWR) after mastectomy, and investigate the optimal treatment.Methods:A total of 201 breast cancer patients with ICWR after mastectomy who were treated in Cancer Hospital, Chinese Academy of Medical Sciences and the Fifth Medical Center Chinese PLA General Hospital from October 1998 to April 2018 were retrospectively analyzed. The median follow-up was 92.8 months and survival data were obtained.Results:Among 201 patients with ICWR, 103 patients developed subsequent locoregional recurrence (sLRR) and 5-year cumulative sLRR rate was 49.1%; 134 patients developed distant metastasis (DM) and 5-year DM rate was 64.4%; 103 patients died, the median progression-free survival (PFS) was 17.4 months and the 5-year PFS rate was 23.2%; the median overall survival (OS) was 62.5 months and the 5-year OS rate was 52.1%. Multivariate analysis showed that the recurrence interval ( HR=2.17, 95% CI: 1.26-3.73) and the locoregional treatment ( HR=1.59, 95% CI: 1.05-2.40) were the independent prognostic factors for sLRR. The initial HER2 status ( HR=1.60, 95% CI: 1.03-2.48) was the independent prognostic factor for DM. The recurrence interval ( HR=1.99, 95% CI: 1.30-3.04), the locoregional treatment ( HR=1.99, 95% CI: 1.43-2.76) and the treatment modalities after recurrence ( HR=1.70, 95% CI: 1.18-2.46) were the independent prognostic factors for PFS. The initial HER2 status ( HR=1.69, 95% CI: 1.02-2.81), the recurrence interval ( HR=1.85, 95% CI: 1.15-2.98) and the treatment modalities after recurrence ( HR=2.48, 95% CI: 1.56-3.96) were the independent prognostic factors for OS. Conclusions:Breast cancer patients after ICWR have an optimistic OS until now, but the risk of sLRR and DM is high. Comprehensive treatment modalities including surgery, radiotherapy and systemic therapy improve the outcome of breast cancer patients with ICWR after mastectomy.