Abstract: Objective To evaluate the key quality control and protective performance test of Halcyon medical linear accelerator. Methods WS 674-2020Specification for Testing of Quality Control in Medical Linear Accelerator（ According to the hereinafter WS 674-2020） ， referred to and the manufacturer´s manual the performance of the first Halcyon medical linear accelerator in Results ， ， Hunan Province was tested. The results showed that all ten indicators of the accelerator including dose deviation ， ， （ ， ， ， - repeatability linearity daily stability and symmetry the results were 0.10% 0.03% 0.04% 0.50% and 100.50% 100.80% ）， - - respectively met the requirements of WS 674 2020. The results of manufacturer quality control indicators such as dose rate ， ， stability in beam gantry rotation isocenter and mechanical position accuracy megavolt image parameters and cone beam computer tomography image parameters met the requirements of the manufacturer´s regulations. Due to the special structure and ， - ： function of the accelerator it is difficult to detect the parameter required by WS 674 2020 as below the radiation leakage - ， ， ， ， outside the M zone the uniformity the indicators related to the light field the offset of the radiation beam axis the zero scale Conclusion - position of the rotating motion scale and others. It is difficult to carry out complete testing according to WS 6742020 for Halcyon medical linear accelerator and it is urgent for the state to issue relevant testing standards to standardize and strengthen the quality control testing of various accelerators.

BACKGROUND:Recombinant adeno-associated virus serotype 9 has a high affinity in myocardial tissue, and the expression of recombinant adeno-associated virus serotype 9-enhanced green fluorescent protein (rAAV9-eGFP) in the aorta of atherosclerosis mice is not clear. OBJECTIVE:To explore the optimal time point of rAAV9-eGFP expression in the aorta of atherosclerosis mice. METHODS:Atherosclerosis model was established with high-fat diet in 30 ApoE-/-mice for 16 weeks. Among them, 25 mice were injected with 5.0×1011 vg (virus genomes) rAAV9-eGFP through the tail vein, while the remaining 5 mice were injected with saline, serving as the control group. The virus-transfected mice were kil ed at 14, 21, 28, 35 and 60 days after transfection, and aortic tissue was harvested. The expression of enhanced green fluorescent protein was detected with laser scanning confocal microscope. Western blot assays were used to detect the expression of enhanced green fluorescent protein in aorta. The expression of enhanced green fluorescent protein in vivo was observed and the optimal expression time point was determined. RESULTS AND CONCLUSION:rAAV9-eGFP effectively transfected the aorta of atherosclerosis mice, enhanced green fluorescent protein was expressed in aortic tissue, and the expression intensity increased gradual y with the increasing transfection time. The highest expression level was found at 35 days after transfection and then maintained stable at 60 days. There were significant differences at different time points after transfection (P<0.001). These data indicate that rAAV9-eGFP can be effectively expressed in the aorta of atherosclerosis ApoE-/-mice and rAAV9-eGFP can be regarded as the optimal vector in the treatment of atherosclerosis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma in Situ ; virology ; Carcinoma, Squamous Cell ; virology ; Female ; Human papillomavirus 16 ; isolation & purification ; Human papillomavirus 18 ; isolation & purification ; Humans ; Microarray Analysis ; methods ; Middle Aged ; Papillomaviridae ; isolation & purification ; Papillomavirus Infections ; diagnosis ; Paraffin Embedding ; Polymerase Chain Reaction ; methods ; Uterine Cervical Neoplasms ; virology

Objective To evaluate in vitro transfection of anti-nuclear factor-κB ( NF-κB) ribozyme gene to human umbilical vein endothelial cells (HUVECs) and human aortic smooth muscle cells (HASMCs) mediated by recombinant adeno-associated virus 9 carrying enhanced green fluorescent protein gene ( rAAV9-EGFP-R65 ) and to study their effects on cell proliferation and NF-κB P65 expression.Methods HUVECs and HASMCs were respectively transfected with rAAV9-EGFP-R65 at different multiplicity of infection ( MOI=1 ×105 , 1 ×106 and 1×107).The expression of EGFP was observed with fluorescence microscopy .Flow cytometry was performed to evaluate the transfection efficiency .Alamar Blue assay was used to measure the proliferation of the transfected cells.Western blot was used to detect NF-κB P65 expression .Results The fluorescence intensity was enhanced along with an increased MOI and an extended time of transfection .HUVECs and HASMCs transfected with rAAV 9-EGFP-R65 began to express EGFP at 24 h after transfection .The expression peak appeared on the sixth day in HUVECs, and the fifth day in HASMCs.The efficiencies of transfection in HUVECs at MOI of 1×105, 1×106 and 1×107 on the sixth day were (1.40±1.20)%, (12.30±1.35)%and (52.80±2.05)%, respectively.The trans-fection efficiencies of HASMCs on the fifth day were (5.30±1.04)%, (18.30±2.24)% and (52.40±3.21)%at MOI of 1×105 , 1×106 and 1×107 .Cell growth and morphology were not affected by transfection .Alamar Blue assay confirmed that there was no significant difference in the absorbance value between the transfected cells and two types of control cells .Western blot assay showed that the expression of NF-κB P65 was decreased by the trans-fection of rAAV9-EGFP-R65 in HUVECs and HASMCs .Conclusion rAAV9-EGFP-R65 can be efficiently trans-fected into two types of human vascular cells .It shows no inhibitory effects on cell proliferation , but can repress NF-κB P65 expression.

BACKGROUND:The formation of atherosclerotic lesions in apolipoprotein E knockout mice is similar to that of human systemic atherosclerosis, and apolipoprotein E knockout mice are ideal animals for current establishment of atherosclerosis models.
OBJECTIVE:To research the pathological process of atherosclerosis in apolipoprotein E knockout mice aged different weeks, and to explore the effect of different diets on the occurrence and development of atherosclerosis in apolipoprotein E knockout mice.
METHODS:Male apolipoprotein E knockout mice aged 8 weeks old were randomly divided into two groups, and fed with high fat diet and normal diet, respectively, for 8, 12, 16, 20, and 24 weeks.
RESULTS AND CONCLUSION:Serological detection revealed that serum total cholesterol, triglycerides and low density lipoprotein levels were significantly higher in different weeks of mice of high fat diet group than in the normal diet group (P<0.05), in a time-dependent manner. Gross and frozen oil red O staining showed that atherosclerotic plaque area of lumen was significantly larger in the high fat diet group than in the normal diet group (P<0.05), in a time-dependent manner. At this time, significant differences in plaque area of lumen at each week were detected between both groups (P<0.05). Apparent lipid plaque was visible in aorta at 16 weeks of high fat diet in mice. Results demonstrated that apolipoprotein E knockout mice of atherosclerosis were successful y established. The formation of lipid streaks and fiber hyperplasia was faster in high fat diet group than in the normal diet group.

Kidney injury and decreased chemosensitivity of tumor cells are obstacles with cisplatin (CDDP) chemotherapy. Down-regulation of the organic cation transporter 2 (OCT2) and multidrug resistance-associated protein 2 (MRP2) is a key means to alleviate CDDP-induced kidney injury and increase chemosensitivity. Astragaloside IV (AS IV) is obtained from the well-known traditional Chinese herb Astragalus membranaceus. This study explored the role of AS IV in preventing kidney injury and enhancing the antitumor effect of CDDP by suppressing OCT2 expression in kidney and MRP2 in tumors. This project was reviewed and approved by the Animal Ethics Committee of the First Hospital of Jilin University. The effects of AS IV on CDDP inhibition of tumor growth and promotion of apoptosis were assessed in Lewis lung tumor (LLC)-bearing mice by H&E and TUNEL staining. Kidney injury was assessed by serum biochemical parameters and H&E staining. We used Western blotting and immunohistochemistry assays to detect OCT2 and MRP2 expression in kidney and tumor. The concentration of CDDP in kidney and tumor was measured by HPLC-MS/MS. AS IV enhanced CDDP chemosensitivity by increasing tumor cell apoptosis and slowing tumor growth, and decreased kidney injury as evidenced by lower blood creatinine (Cr) and blood urea nitrogen (BUN). Co-administration of AS IV suppressed MRP2 overexpression induced by CDDP in tumor tissues and may be an important mechanism for enhancing CDDP chemosensitivity. Moreover, AS IV reduced CDDP-induced kidney injury in mice along with suppression of OCT2 expression in kidney. The concentration of CDDP was increased in tumor but decreased in kidney. In total, AS IV not only enhanced the antitumor effect of CDDP by suppressing MRP2 expression in tumor cells, but also decreased kidney injury induced by CDDP. The results provide new insight into the combined use of a chemotherapy drug and natural ingredients to treat cancer.

OBJECTIVETo investigate the relationship of gut flora and gut-derived endotoxin with minimal hepatic encephalopathy (MHE).

METHODSPatients with hepatitis B virus-related liver cirrhosis (HBV-LC) were screened for MHE using the number connect test-A (NCT-A) and digital symbol test (DST) and divided into the following groups: HBV-LC with (+) MHE (n = 26) and HBV-liver cirrhosis without (-) MHE (n = 25); in addition, one healthy immediate family member of each patient in the HBV-LC + MHE group was enrolled as a control. Each participant provided fecal and blood samples. PCR amplification and 454 pyrosequencing were used to detect bacterial 16S rRNA in feces. Turbidimetric Limulus amebocyte lysate assay was used to detect level of endotoxin in serum. The significance of inter-group differences was assessed by one-way ANOVA or Student's t-test.

RESULTSThe three groups showed different distributions of gut flora. The differences in the microbial communities' members and distributions were related to disease or health status, but not to the patient's genetic makeup or diet. In particular, the HBV-LC + MHE patients showed significantly lower amounts of different bacterial species and abundance of these species than the other two (non-MHE) groups (P less than 0.05). The healthy control family members had a richer diversity of gut flora than their counterparts with HBV-LC + MHE (P less than 0.05). The HBV-LV + MHE patients also had higher serum levels of endotoxin.

CONCLUSIONDevelopment of minimal hepatic encephalopathy in patients with HBV-LC may be related to a gut flora disorder or higher levels of endotoxin in serum.

BACKGROUND: The perioperative hemorrhage of knee surgeries is a difficulty in clinic, and the efficacy of tranexamic acid to reduce postoperative bleeding has attracted more attention, but choosing which administrations remains controversial. OBJECTIVE: To investigate the efficacy of tranexamic acid by intravenous injection or articular injection for reducing the perioperative hemorrhage of total knee arthroplasty. METHODS: Sixty patients undergoing unilateral total knee replacement were enrolled, and were then randomized into three groups (n=20 per group): no tranexamic acid administration (group A); intravenous dropping of 15 mg/kg tranexamic acid before tourniquet application plus 10 mg/kg tranexamic acid at 3 hours postoperatively (group B); articular injection of 50 mL saline diluted with 1 g tranexamic acid through a drainage tube (group C). Two-hour closure of drainage tube was performed in all patients. The postoperative dominant and hidden blood loss, blood transfusion rate, pulmonary embolism as well as lower extremity deep venous thrombosis were recorded. RESULTS AND CONCLUSION: (1) The dominant and hidden blood loss in the groups B and C were significantly less than those in the group A (P < 0.05); the dominant blood loss showed no significant difference between groups B and C (P > 0.05); the group B exhibited a significantly less hidden blood loss compared with group C (P < 0.05). (2) The blood transfusion rate in the groups B and C was significantly lower than that in the group A (P < 0.05). (3) No pulmonary embolism or lower extremity deep venous embolism occurred during 3-month follow-up. (4) That is to say, tranexamic acid can obviously reduce perioperative blood loss and blood transfusion rate without pulmonary embolism or lower extremity deep venous thrombosis, and intravenous administration exerts better clinical effectiveness.

Purpose: This study aimed to evaluate the diagnostic value of combined fine-needle aspiration (FNA) with core needle biopsy (CNB) in thyroid nodules. Methods: FNA and CNB were performed simultaneously on 703 nodules. We compared the proportions of inconclusive results and the diagnostic performance for malignancy among FNA, CNB, and combined FNA/CNB for different nodule sizes. Results: Combined FNA/CNB showed lower proportions of inconclusive results than CNB for all nodules (2.8% vs. 5.7%, P<0.001), nodules ≤1.0 cm (4.9% vs. 7.3%, P=0.063), nodules >1.0 cm (2.0% vs. 5.0 %, P<0.001), nodules ≤1.5 cm (3.8% vs. 7.9 %, P<0.001), and nodules >1.5 cm (2.1% vs. 3.9 %, P=0.016). The sensitivity of combined FNA/CNB in predicting malignancy was significantly higher than that of CNB (89.0% vs. 80.0%, P<0.001) and FNA (89.0% vs. 58.1%, P<0.001) for all nodules. Within American College of Radiology Thyroid and Imaging Reporting and Data System grades 4-5, in the subgroup of nodules ≤1.5 cm, combined FNA/ CNB showed the best sensitivity in predicting malignancy (91.4%), significantly higher than that of CNB (81.0%, P<0.001) and FNA (57.8%, P<0.001). However, in the subgroup of nodules >1.5 cm, the difference between combined FNA/CNB and CNB was not significant (84.2% vs. 78.9%, P=0.500). Conclusion Regardless of nodule size, combined FNA/CNB tended to yield lower proportions of inconclusive results than CNB or FNA alone and exhibited higher performance in diagnosing malignancy. The combined FNA/CNB technique may be a more valuable diagnostic method for nodules ≤1.5 cm and nodules with a risk of malignancy than CNB and FNA alone.

Objective To investigate the characteristics of blood routine in 129 patients with COVID-19, and analyze the correlation between blood routine parameter changes and clinical classification. Methods A total of 129 COVID-19 patients were recruited and their blood samples were collected at the beginning and the end of treatment.The neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), lymphocyte-to-monocyte ratio(LMR) and C-reactive protein(CRP) were determined and used to calculate Δ NLR, Δ PLR, Δ LMR.The differences in these parameters were compared between the non-severe group (93 cases) and the severe group (36 cases).In addition, the relationship between the changes in blood routine test result and the prognosis of patients was determined. Results The average age of 129 patients was 46.9±17.4 years old, and the ratio of male to female was 1.2 ∶ 1.Thirty-five (35) cases (27.1%) had leucopenia (< 4×10⁹/L) and 59 cases (45.7%) had lymphopenia (< 1.1×10⁹/L).There were statistically significant differences in age, treatment days, blood routine indexes between these two groups.In all the patients, the differences between before and after treatment were statistically significant in the following: leukocyte number, neutrophil cell percentage, lymphocyte number, lymphocyte percentage, monocyte number, monocyte percentage.The differences in RBC, HGB, CRP, and NLR between the two groups before and after treatment were also statistically significant (P < 0.05). Conclusion The older COVID-19 patients have lower number of lymphocytes, higher NLR and PLR, lower LMR and higher CRP.They have a higher risk of progressing to severe disease.After treatment, there is an increase in the number of granulocytes, especially the number of lymphocytes, while a decrease in CRP and NLR.The change of lymphocyte count, NLR and CRP levels can predict the risk of severe COVID-19 and evaluate the therapeutic effect.