Objective To compare the dosimetric difference of volumetric modulated arc therapy (VMAT) plans for the loco-regionally advanced nasopharyngeal carcinoma (NPC) patients using 6 MV X-ray flattening filter-free (FFF) and flattening filter (FF) modes.Methods Ten previously treated patients with loco-regionally advanced nasopharyngeal carcinoma were retrospectively included and replanned using FFF and FF VMAT,respectively.Meeting all clinical criteria,the dose-volume histograms (DVH),dose distribution of target volume and organs at risk (OARs),target conformity index (CI),total monitor unites (MUs) and treatment time were compared across the plans.Results VMAT plans suing either FFF and FF modes can meet the clinical objectives.The maximum and mean target dose of FFF VMAT plans were significantly higher than that of FF VMAT plans (t =-0.31,-O.35,P ＜ O.05).Yet the planning target volume (PTV) CI of FF mode was slightly better than of FFF mode (t =5.42,P ＜0.05).The maximum doses of lenses in FFF VMAT plans were lower than that of FF VMAT plans (t =25.87,17.45,P ＜ 0.05),and other OARs displayed no significant difference.The mean total MUs of FFF and FF VMAT plans were (699 ± 16) and (628 ± 12) MUs respectively.The mean treatment time of two modes were consistent (about 2 min).Conclusions The plan qualities of FFF and FF VMAT plans were comparable and both clinically acceptable.The OARs at the edge of radiation field,such as lens,could be spared better using FFF VMAT mode.The total MUs of FFF VMAT plans were higher than FF VMAT plans,yet were delivered within the same time.

To study the cost-effectiveness of temozolomide combined with radiotherapy in the treatment of glioblasto-ma. Methods:According to the clinical trial data, cost-effectiveness and sensitivity of the results was analyzed based on the domestic cost and consumption level. Results:Temozolomide combined with radiotherapy could prolong one month of overall survival with the additional cost of RMB 58 959. 7 yuan in each case when compared with radiotherapy alone. Conclusion:Temozolomide combined with radiotherapy has no advantage on cost-effectiveness when compared with radiotherapy alone.

OBJECTIVEThis study measures the glutaredoxin (Grx) gene and protein expression in umbilical vein endothelial cells upon exposure to Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide (LPS). The involvement of the Akt-signaling pathway is also determined.

METHODSEA-hy926 cells were pretreated with 1,000 ng · mL⁻¹ P. gingivalis LPS for 4, 12, 18, and 24 h, and then real-time reverse transcription polymerase chain reaction was employed to detect Grx1 expression. The effect of Grx on Akt activity was investigated using Western blot for the control, LPS (1,000 ng · mL⁻¹ LPS), and carmus- tine (BCNU) groups (1,000 ng · mL⁻¹ LPS, and the EA-hy926 cells were pretreated with 25 μmol · ml⁻¹ BCNU for 30 min).

RESULTSGene expression of Grx1 significantly increased in LPS group compared with that in the control group. The Grx1 expression reached the peak level in 12 h, and the variation between the expression in 4 and 12 h was significant (P < 0.05). After 12 h, the protein levels of Grx and phosphorylated-Akt (p-Akt) significantly increased in the LPS group (P < 0.05), whereas the BCNU group showed a considerable decrease in both Grx and p-Akt expression levels (P < 0.05). Moreover, a slight difference was observed in the total Akt protein levels in the three groups (P > 0.05).

CONCLUSIONGrx expression increased upon exposure of EA-hy926 cells to the LPS. Akt activity could be inhibited by BCNU (a Grx inhibitor), which indicated that Akt might act as a downstream regulator of Grx.

Endothelial Cells ; Glutaredoxins ; genetics ; Humans ; Lipopolysaccharides ; pharmacology ; Oxidative Stress ; drug effects ; Phosphorylation ; Porphyromonas gingivalis ; pathogenicity ; Proto-Oncogene Proteins c-akt ; drug effects ; Signal Transduction ; drug effects ; Umbilical Veins

Objective To investigate the infection prevention effect of prophylactic use of antibiotics for cancer inpatients with leukocyte count ≤ 1 × 109/L.Then to provide the basis for rational use of antibiotics.Methods It was retrospectively surveyed that the infection situation and prophylactic usage of antibiotics in the 426 cancer inpatients with leukocyte count ≤ 1 × 109/L caused by radiotherapy and chemotherapy.Results In the 426 inpatients,the infection rates of patients with and without prophylactic use of antibiotics were 11.0％ and 20.9％ respectively.The difference was statistically significant (x2 =6.815,P =0.009).The leukocyte count median values of patients with and without infection were 0.73 × 109/L and 0.77 × 109/L respectively.The difference had no statistical significance(Z =-1.257,P =0.209).The main infection sites were lower respiratory tract,upper respiratory tract and gastrointestinal tract with infection rates of 48％,12％ and 11％,respectively.The top five pathogens were Klebsiella pneumonia,Enterobacter cloacae,Escherichia coli,Enterobacter aerogenes and Staphylococcus aureus.The most use of antibiotics were cephalosporin.Conclusion When the leukocyte counts of cancer inpatients are less than or equal to 1 × 109/L induced by chemotherapy and radiotherapy,reasonable prophylactic use of antibiotics can reduce hospital infection rates.

Objective To compare the analgesic effects of epidural Morphine versus lumbosacral plexus block in patients undergoing hip joint replacement.Methods A total of 94 ASA Ⅰ ～ Ⅱpatients undergoing hip surgery with combined spinal epidural anesthesia(CSEA) were selected and randomized into 4 groups:Group M received a single epidural injection of 2 mg Morphine for analgesia,Group MN1 received an epidural injection of 1 mg Morphine combined with lumbosacral plexus block,Group MN2 received an epidural injection of 2 mg morphine combined with lumbosacral plexus block,and Group N received lumbosacral plexus block.All patients were administered intramuscular parecoxib for 3 days after surgery and,if the visual analogue scale(VAS)≥4,additional intramuscular tramadol.Patient-controlled intravenous analgesia(PCIA) was applied if pain relief was insufficient after Tramadol treatment.Postoperative analgesic effects,the ability to ambulate and side effects were monitored.Results VAS scores gradually increased in the 4 groups after surgery and were higher between the morning of the 1st day and the evening of the next day than at 4 hours after surgery in all the 4 groups.There were no significant differences in VAS scores between rest and exercise conditions in any of the 4 groups.Ambulatory VAS scores were lower in Groups MN1 and MN2 than in Groups M and N 6 hours after surgery,while resting VAS scores had no significant differences between the 4 groups.Resting and ambulatory VAS scores were both lower in Groups MN1 and MN2 than in Groups M and N 6 hours after surgery,while they had no significant differences between either Groups MN1 and MN2 or Groups M and N 4-8 hours after surgery.Resting and ambulatory VAS scores were lower in Groups M,MN1 and MN2 than in Group M on the morning of the day after surgery,and more patients in Group N needed early tramadol and PCIA for rescue analgesia.Muscle strength was lower in Groups MN1 and MN2 than in Groups M and N 4 hours and on the morning of the day after surgery.No significant differences between the groups were found in standing ability 6 hours after surgery and in motor activity on the morning of the day after surgery.The incidence of urinary retention was higher in Groups M and MN2 than in Groups MN1 and N,and was higher in Group MN1 than in Group N.The incidence of pruritus was higher in Groups M and MN2 than in Group N.There was no significant difference in Ramsay sedation scores and postoperative nausea and vomiting (PONV) between the groups.Conclusions Epidural morphine combined with lumbosacral plexus nerve block can provide better analgesic effects than a single dose of epidural morphine or lumbosacral plexus nerve block in elderly patients undergoing hip joint replacement.Although the synergy of the combination has certain influence on early muscle strength recovery,it does not affect early postoperative rehabilitation training.With the combined use of parecoxib and lumbosacral plexus nerve block,epidural injection of 1 mg and 2 mg morphine provides similar analgesic effects,but epidural injection of 2 mg morphine results in a higher incidence of urinary retention.Thus,a small dose of epidural morphine combined with lumbosacral plexus nerve block is recommended for postoperative analgesia in elderly patients receiving hip joint replacement.

Animals ; CD4-Positive T-Lymphocytes ; immunology ; Humans ; Periodontal Diseases ; immunology ; pathology ; T-Lymphocytes, Regulatory ; immunology ; Th1 Cells ; immunology ; Th17 Cells ; immunology ; Th2 Cells ; immunology

In this study, Professor Yan Zhenghua's recipes for treating heart diseases were collected to determine the frequency and association rules among drugs by such data mining methods as apriori algorithm and complex system entropy cluster and summarize Pro- fessor Yan Zhenghua's medication experience in treating heart diseases. The results indicated that frequently used drugs included Salviae Miltiorrhizae Radix et Rhizoma, Parched Ziziphi Spinosae Semen, Polygoni Multiflori Caulis, Ostreae Concha, Poria; frequently used drug combinations included "Ostreae Concha, Draconis Os", "Polygoni Multiflori Caulis, Parched Ziziphi Spinosae Semen" , and "Salviae Miltiorrhizae Radix et Rhizoma, Parched Ziziphi Spinosae Semen". The drug combinations with the confidence of 1 included "Dalbergiae Odoriferae Lignum-->Salviae Miltiorrhizae Radix et Rhizoma", "Allii Macrostemonis Bulbus-->Parched Ziziphi Spinosae Semen", "Draconis Os-->Ostreae Concha", and "Salviae Miltiorrhizac Radix et Rhizoma, Draconis Os-->Ostreae Concha". The core drug combinations included" Chrysanthemi Flos-Gastrodiae Rhizoma-Tribuli Fructus", "Dipsaci Radix-Taxillus sutchuenensis-Achyranthis Bidentatae Radix", and "Margaritifera Concha-Polygoni Multiflori Caulis-Platycladi Semen-Draconis Os".
Drug Interactions ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; chemistry ; history ; therapeutic use ; Entropy ; Heart Diseases ; drug therapy ; history ; History, 20th Century ; History, 21st Century ; Humans

To find antibacterial candidate compounds, eighteen novel sulfonamide derivatives containing a fused-ring were designed and synthesized on the basis of previous studies, with structures confirmed by ¹H NMR, ¹³C NMR and MS. Antibacterial activities of the products were evaluated by the agar dilution method. The results show that these derivatives have different degrees of inhibitory activity on the tested bacteria, with the compounds IIi and IIr the most potent. The MIC of IIi for S. aureus, E. coli and MRSA was 8, 32 and 16 μg·mL^-1, respectively, and the MIC of the IIr was 8, 64 and 32 μg·mL^-1, respectively. The anti-MRSA activities of the two compounds is significant and is worthy of further structural optimization and study.

In this cross-sectional survey,2 682 traffic policemen in Tianjin were enrolled,and they were tested with Occupational Stress Inventory-Revised (OSI-R) and Symptom Checklist 90 (SCL-90).Body mass index,blood pressure,fasting blood glucose,triglycerides,and high-density lipoprotein-cholesterol ( HDL-C ) were also determined at the same time. Correlation analysis showed that body mass index was positively correlated with somatization ( r =0.039,P =0.045 ),hostility ( r =0.046,P =0.01 8 ),and psychoticism ( r =0.041,P =0.036).Systolic blood pressure was positively correlated to somatization (r =0.056,P =0.004 ),obsessive-compulsiveness ( r =0.044,P =0.023 ),interpersonal sensitivity ( r =0.041,P =0.034 ),depression ( r =0.039,P =0.043),anxiety ( r =0.055,P =0.004 ),and psychoticism ( r =0.051,P =0.009 ).Diastolic blood pressure was positively correlated to somatization ( r =0.047,P =0.015 ),interpersonal sensitivity ( r =0.042,P =0.030 ),anxiety ( r =0.050,P =0.010 ),and psychoticism ( r =0.047,P =0.014 ).Fasting blood glucose was positively correlated to somatization ( r=0.042,P=0.028 ).Multiple regression analysis showed that occupational stress factors were role boundary,physical environment,responsibility,recreation,role ambiguity,role overload,and cognitive coping.Among these factors,role ambiguity and cognitive coping reduced occupational stress while others increased the stress.The results of the unconditional logistical regression analysis showed that there is an independent association of metabolic syndrome with somatization,role insufficiency,and physical strain for the task and body tension ( P＜0.01).

To investigate the mechanism by which Schisandra Chinensis mediates the phenotypic transformation of microglia via microRNA-124 (miR-124)-based regulation of the Toll-like receptor 4 (TLR4) pathway, a model was established using lipopolysaccharide (LPS) stimulation of BV2 cells. Cells were treated with different doses of Schisandra Chinensis extract (SCE). MiR-124 inhibitors and negative control sequences (NC inhibitor) were transfected into LPS-induced BV2 cells and treated with SCE. The MTT assay was used for cell activity detection; an NO kit was used to measure NO release; ELISA kits were used to measure the levels of interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α). Microglia markers, including ionized calcium binding adapter molecule-1 (IBA-1) and arginase-1 (Arg-1), and the nuclear translocation of nuclear factor-kappa B (NF-κB) were evaluated by immunofluorescent staining. NF-κB p65, IBA-1, Arg-1, TLR4, myeloid differentiation primary factor 88 (MyD88), inhibitor of nuclear factor-kappa B kinases-α (IKK-α), IL-10, TNF-α were detected by immunoblot. SCE at concentrations ranging from 31.25 to 250 μg·mL^-1 had no significant effect on cell activity. SCE treatment significantly inhibited NO release induced by LPS (P < 0.001, P < 0.01), increased the level of IL-10 (P < 0.05), and decreased the level of TNF-α (P < 0.001). In addition, SCE significantly reduced the expression of TNF-α, IBA-1, TLR4, and MyD88 (P < 0.01, P < 0.001) and elevated the expression of IL-10, Arg-1, NF-κB P65 and IKK-α (P < 0.001, P < 0.01, P < 0.05). SCE treatment could also promote the expression of miR-124 (P < 0.01). However, transfection with the miR-124 inhibitor increased TNF-α (P < 0.001), decreased the level of IL-10 (P < 0.05), increased the mRNA level and the protein expression of TNF-α and IBA-1 (P < 0.05, P < 0.01, P < 0.001), and decreased the mRNA level and protein expression of IL-10 and Arg-1 (P < 0.001, P < 0.01). In addition, the inhibition of TLR4 and MyD88 was attenuated. In conclusion, SCE appears to inhibit the activation of TLR4 signaling pathway by upregulating miR-124 so as to inhibit microglia M1 polarization and promote microglia M2 polarization.