Background and purpose:When the patients with nasopharyngeal carcinoma (NPC) receive radiotherapy, their thyroids are inevitably involved. As a result, thyroid damage occurs. This study aimed to explore the effects of intensity modulated radiation therapy (IMRT) on dynamics of thyroid blood flow in patients with NPC.Methods:A total number of 68 patients with NPC were enrolled in the study who received primary treatment of radical radiation and chemotherapy from Jul. 2012 to Oct. 2013. And the TMN stage was fromⅡ toⅣc according to UICC 2010. The treatment method consisted of 2 cycles of TPF induction treatment, concurrent radiation therapy (IMRT) with 2 cycles of DDP and 2 cycles of adjuvant therapy sequentially. Before radiotherapy, at the end of radiotherapy, 3 and 6 months after radiotherapy, serum free triiodothyronine (FT3), free thyroxin (FT4) and thyroid-stimulating hormone (TSH) concentrations of all cases were detected by electrochemiluminescence. The highest systolic velocity, mean velocity, minimum diastolic velocity, resistance index, and the value of all thyroid diameter lines were measured by type-B ultrasound.Results:All the patients were followed up for 6 months. Hypothyroidism: the incidence of immediate clinical hypothyroidism after radiotherapy was 5.9%; 3 months later, the incidence was 13.2%; and 6 months later, the incidence was 26.5%. The difference in volume change between before radiotherapy and at the end of radiotherapy had no statistical signiifcance (P>0.05). The difference in volume change between 3 and 6 months after radiotherapy had statistical signiifcance (P<0.05). The difference in FT3, FT4 and FSH between the end of radiotherapy and before radiotherapy had no statistical signiifcance, while there was statistically signiifcant difference between at the end of radiotherapy and 3 months after radiotherapy. The thyroid volume correlated with the average dose at the end of radiotherapy, 3 and 6 months after radiotherapy as shown by the single factor correlation analysis (P<0.05). The results of sinlge factor correlation analysis also showed that the occurrence of hypothyroidism correlated with thyroid dose-volume parameter V40 at the end of radiotherapy (P<0.05). The correlation between hypothyroidism and the average dose on thyroid 6 months after radiotherapy was demonstrated by independentt test (P<0.05). Hypothyroidism had no correlation with thyroid artery systolic maximum velocity and resistance index at the end of radiotherapy, 3 and 6 months after radiotherapy (P>0.05).Conclusion:The incidence of hypothyroidism may increase with time after radiotherapy. The volume may decrease with the increased dose of radiotherapy and the follow-up time. The patients with NPC after radiotherapy should be tested for thyroid lesions routinely. The thyroid dose-volume parameter V40 may be a predictor for acute radioactive thyroid lesions. The study did not reveal temporarily that hypothyroidism was associated with thyroid ultrasound blood lfow velocity.

Background Glycogen synthase kinase-3β (GSK-3β)plays an important role in glucose metabolism,and it may be affect the occurrence of diabetic retinopathy(DR).ObjectiveThe present study was to investigate the effect of valsartan and fluvastatin on the expression of GSK-3β in retina of diabetes rat model.MethodsDiabetes mellitus models were induced by intrapenetoneal injection of streptozotocin(STZ) in 47 clean Sprague-Dawley(SD) rats and were then randomedly divided into 4 groups.Ten other normal rats were served as normal control group.Sodium carboxy methyl cellulose solution,valsartan,fluvastatin,valsartan+fluvastatin and sodium carboxy methyl cellulose solution was given by oral once per day for 12 weeks respectively in diabetes control group ( n =12),valsartan group ( n =12 ),fluvastatin group ( n =11 ),valsartau + fluvastatin group ( n =12 ) and normal control group.Twelve weeks after administration of drugs,blood glucose was measured and compared among various groups,and the expression of p-GSK-3β ( Ser-9 ) protein in retina was quantified and located by Western blot and immunohistochemistry,respectively.Results Twelve weeks after use of drugs,the level of blood glucose was(5.28±0.30),(26.08±3.33 ),(26.03 ±2.66 ),(25.90± 2.86 ),(25.99 ± 2.14 ) mmol/L in the normal control group,diabetes control group,valsartan,fluvastatin,valsartan + fluvastatin group,respectively,showing a significant difference among the 5 groups ( F =110.74,P＜0.01 ).Western blot showed that the grey value of p-GSK-3β ( Ser-9 ) /β-actin in retina in the diabetic control group was significant higher than the normal group(2.774±0.139 vs 1.927±0.111,q =15.79,P＜0.01 ),and that in valsartan,fluvastatin,valsartan+fluvastatin group was lower than the diabetic control group ( 1.895 ±0.090,2.051 ± 0.113,1.537 ± 0.071 vs 2.774 ± 0.139 ) ( q =1 3.69,13.48,23.06,P ＜ 0.01 ).The grey value of p-GSK-3β (Ser-9)/β-actin in the valsartan+fluvastatin group was declined in comparison with the valsartan group and fluvastatin group ( q =6.67,9.58,P＜0.01 ).Immunohistochemistry showed that the p-GSK-3β(Ser-9) protein was expressed all over the retinal layers and obviously in retinal ganglion cell layer(GCL) in normal control group.But the p-GSK-3β(Ser-9) protein was expressed significantly in diabetic control group.The expression of p-GSK-3β (Ser-9)protein was attenuated both in valsartan and fluvastatin groups and further attenuated in valsartan + fluvastatin group. Conclusions p-GSK-3β (Ser-9) protein is overexpressed in GCL of retina of diabetes rat.Both valsartan and fluvastatin can inhibit the expression of p-GSK-3β (Ser-9) and even getting stronger when they combined.

Objective To analyze the long?term efficacy of intensity?modulated radiotherapy (IMRT) with or without chemotherapy in treatment of 454 patients with nasopharyngeal carcinoma (NPC) and its influencing factors. Methods A retrospective analysis was performed on the clinical data of 454 patients with non?metastatic NPC who received IMRT with or without chemotherapy in our center from 2007 to 2012. Prescribed doses of 69. 96?73. 92 Gy in 33 fractions, 69. 96 Gy in 33 fractions, 60. 06 Gy in 33 fractions, and 50. 96 Gy in 28 fractions were applied to nasopharyngeal gross tumor volume, cervical metastatic lymph nodes, high?risk drainage area, and low?risk drainage area, respectively. In all patients, 438 received induction chemotherapy, 420 concurrent chemotherapy, and 216 adjuvant chemotherapy, most of which were based on cisplatin and taxol. The Kaplan?Meier method was used for calculating survival rates and the log?rank test was used for survival difference analysis and univariate prognostic analysis. The Cox model was used for the multivariate prognostic analysis. Results The 3?year sample size was 210. The 3?year overall survival ( OS ) , local recurrence?free survival, nodal relapse?free survival, progression?free survival, and distant metastasis?free survival ( DMFS) rates were 88. 1%, 91. 0%, 90. 7%, 80. 5%, and 85. 1%, respectively. Age, T stage, and N stage were influencing factors for the OS rate ( P=0. 011;P=0. 005;P=0. 033);T stage and N stage were influencing factors for the disease progression?free survival ( P=0. 017;P=0. 005) and DMFS ( P=0. 012;P=0. 019) . The grade≥3 acute and late adverse reactions included hematological toxicity , oral mucositis , xerostomia , dysphagia , and brain injury . Conclusions IMRT promotes the long?term survival rates in patients with NPC. The distant metastasis is the major reason for treatment failure. The adverse reactions induced by IMRT combined with chemotherapy are tolerable.

BACKGROUND: This study was undertaken to measure the concentration of adiponectin (APN) in serum and induced sputum in patients with chronic obstructive pulmonary disease (COPD during acute exacerbation (AECOPD) and at stable stage and to determine the role of APN as a marker of inflammation in the pathogenesis of COPD. METHODS: All the patients in this prospective study were enrolled from October 2008 to October 2009, including 30 male AECOPD patients from the emergency department, 30 male stable COPD patients from the department of respiratory diseases, and 30 healthy non-smoking male controls from the department of medical examination. The serum and induced sputum were collected from each patient. All of the patients had normal weight (BMI range 18.5-24.9 kg/m2). Patients with severe bronchial asthma, bronchiectasis or autoimmune disease were excluded. Cell count and classification was performed for the induced sputum. The concentrations of APN, IL-8, IL-6 and TNF-α were measured by ELISA. Pulmonary function was tested among the three groups. Comparisons between the groups were conducted by Student's t test, ANOVA analysis or nonparametric test. Correlation analysis was carried out by Pearson's product-moment correlation coefficient test or Spearman's rank-order correlation coefficient test. RESULTS: The concentrations of APN in the serum or induced sputum in AECOPD patients were significantly higher than those in stable COPD patients or healthy non-smoking controls (P<0.01). The concentration of APN in stable COPD patients was significantly higher than that in healthy non-smoking controls (P<0.01). For the AECOPD patients, APN was positively correlated with IL-8 and TNF-α in the serum and induced sputum (r=0.739, 0.734, 0.852, 0.857 respectively, P<0.05). For the stable COPD patients, APN was also positively correlated with IL-8 and TNF-α in the serum and induced sputum (r=0.751, 0.659, 0.707, 0.867 respectively, P<0.05). In addition, for the AECOPD patients, APN was positively correlated with the percentage of neutrophils in the induced sputum (r=0.439, P<0.05). CONCLUSIONS: APN is involved in the process of systematic and airway inflammation of COPD. This process is related to neutrophils in the airway, IL-8 and TNF-α. APN could be used as a new marker for inflammation of COPD.

BACKGROUND: As a cytokine highly expressed in internal organs, visfatin could be used as a biomarker of systemic inflammation response for chronic obstructive pulmonary diseases, but few studies have reported the use of visfatin in severe pneumonia. The present study was undertaken to determine the plasma levels of visfatin in patients with severe pneumonia. METHODS: A total of 70 patients, including 40 patients with severe pneumonia (group A) and 30 patients with non severe pneumonia (group B) who had been admitted to the ICU from June 2009 to June 2010, were enrolled in this prospective study. And another 30 healthy physical examinees served as healthy controls (group C). Patients were excluded if they suffered from severe diseases of the heart, brain and kidney, cancers, autoimmune diseases, or received special treatment in the latest month. The plasma levels of visfatin, IL-6, IL-8 and TNF-α were measured by ELISA, while the level of CRP was determined by immuneturbidimetry, and the routine blood test was performed. Blood gas analysis and Acute Physiology and Chronic Health Evaluation II (APACHE II) were performed in patients with pneumonia. Comparisons between the groups were conducted by Student's t test, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson's correlation test or Spearman's rank-order correlation test. RESULTS: The plasma level of visfatin in group A was significantly higher than that in groups B and C (P<0.001), and the level of visfatin in group B was significantly higher than that in group C (P<0.001). The plasma level of visfatin was positively correlated with CRP, TNF-α, APACHE II and PMN％ in patients with severe pneumonia (rho=0.653, r=0.554, r=0.558, r=0.484, respectively, P<0.05 for all), while it was negatively correlated with PaO2 and PaO2/FiO2 (rho=?0.422, r=?0.543, respectively, P<0.05 for all). CONCLUSION: Visfatin may be involved in the systematic inflammation response in patients with severe pneumonia as a pro-inflammatory cytokine, and it is valuable in assessing the severity of pneumonia..

OBJECTIVE: To discuss and summarize the major characteristics, autopsy examination, and scene investigation in infant homicide cases. METHODS: From 2008 to 2013 in Suzhou, the information of seven detected infant homicide cases were collected and analyzed. RESULTS: The criminal suspects were victims' mothers with young ages and pregnancies were premarital. Infant homicide cases occurred at the same location of the delivery. The infants died of mechanical asphyxia in the majority of the cases. Most bodies were naked and their umbilical cords were not cut by iatrogenic method and didn't connect with the bodies. CONCLUSION The standardization of forensic investigation can improve the analysis and detection of infant homicide cases.
Asphyxia ; Autopsy ; China ; Criminals ; Death ; Forensic Medicine ; Homicide ; Humans ; Infant ; Retrospective Studies

OBJECTIVETo study the protective effect of carbon monoxide (CO) inhalation on the serious limb ischemia/reperfusion (I/R) injury, and which effects caused to shock in rats.

METHODS36 SD rats were randomly divided into I/R, I/R + CO (RC), sham operation (S) groups. I/R injury models were made by the occlusion of the femoral artery for 8 h and the reperfusion for 12 h, 10 d. Before reperfusion of 2 h, RC group started to breathe medical air containing CO (the volume fraction of CO: 0.075%) continuously, until after reperfusion for 4 h, a total of inhalation 6 h. S, I/R groups exposed to air, breathe freely. Caudal artery pressures (CAP), ten days survival rate, serum lactate dehydrogenase (LDH) and creatine kinase (CK) activity, limb wet - to - dry weight ratio (W/D) and the pathologic changes of limb were observed.

RESULTSOnce the reperfusion started, the CAP decreased rapidly in I/R group, and the mean reduced to(5.3259 +/- 0.3832) kPa when reperfusion for 8 h. Compared to I/R group, the CAP decreased slower and smaller in RC group, moreover, its mean reduced to (8.3300 +/- 0.4224) kPa when reperfusion for 8 h. The 10 d survival rate in I/R group was that 8 rats died all between reperfusion for 13 - 20 h. Only 1 rat died in RC group and the other 7 rats were still alive when reperfusion for 10 d. Compared to I/R group, the pathological features of the ischemic limb were significant ly improved, and the figures of W/D, serum LDH and CK value were remarkable lower in RC group (P < 0.05).

CONCLUSIONInhaling exogenous low-dose CO has a reverse regulation in the blood pressure decline caused by serious limb I/R injury in rats. And at the same time, it can effectively prevent the occurrence of shock, reduce physical damage, significantly increase the survival rate of animals.

Administration, Inhalation ; Animals ; Carbon Monoxide ; administration & dosage ; pharmacology ; Creatine Kinase ; blood ; Extremities ; blood supply ; L-Lactate Dehydrogenase ; blood ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; physiopathology ; prevention & control ; Shock ; etiology ; prevention & control

Objective To find out the iodine nutritional status of children in Xiamen island, and to provide the scientific basis for iodine supplimentation. Methods On March 2010, thyroids of all children aged 6to 12, from primary school on the Xiaodeng island of Xiamen were examined by palpation, urinary iodine, iodine content of salt athome and IQ level were tested, and were collected 20 households, iodine content of drinking water was tested randomly. Results IQ testing and thyroid palpation were carried out among a total of 156 children, the goiter rate of children was 1.28% (2/156), the mean IQ was 110; 154 urine samples were taken, the median urinary iodine was 219.1 μg/L; a total of 153 salt samples were tested, and the qualified rate of iodized salt was 87.58%(134/153), and the mean iodine content in the tap water was 4.52 μg/L Conclusions Iodine nutritional status of the island residents is better, and there are no such problems as excessive iodine.

Objective To report the microsurgical outeome of the meningiomas located in the eranio- cervical junction.Methods Seven eases of meningiomas arising from the craniocervical junction operated with microsurgical technique by use of the posterior approaehes including the suboccipital approach,the lower lateral suhoecipital approach and for lateral approach.Reviewed the related ariieales and were analysed relative to their approach selection and outcomes were analysed.Results The tumors ranged in size from 0.8 to 4.8 cm and the tumors location with 2 cases posterior,3 cases anterior and 2 cases lateral to the brain stem.3 in 7 cases were operated by use of the suboccipital approach,2 in 7 cases with the lower lateral suboccipital ap- proach and 2 in 7 cases with farlateral approach.Total excisions were got in 6 of 7 cases,4 in 6 cases with Simpson gradeⅠand 2 in 6 cases withⅡ.The subtotal excision was got in 1 of 7 cass.Follow-up with 6 ca- ses between 6 to 36 months,the occupied symptoms in 6 cases improved good.No remnant tumor and recur- rent were found in the MRI follow-up.Conclusion By using of the proper posterior approaches,the micro- surgical outonmes of the meningiomas arising from craniocervical junction are good.

BACKGROUND:Titanium and titanium aloy are used mostly in artificial joints, fracture fixation, and oral transplantation, while there are complex cases of insufficient bone mass in these areas. The deepened research of stem cels offers a solution for bone injury to promote new bone formation. The biocompatibility of titanium and stem cels and optimization of titanium surface modification have aroused people's attention. OBJECTIVE:To investigate whether the biocompatibility of titanium and human adipose-derived mesenchymal stem cels can be improved by type I colagen modification of titanium sheets. METHODS:The experiment was divided into two groups. Modification group: titanium sheet was modified with type I colagen; control group: titanium sheet was not modified with type I colagen. Human adipose-derived mesenchymal stem cels at passage 6 were implanted into titanium sheet in two groups. Then we calculated the number of adherent cels in two groups at 1, 2 and 4 hours after implantation, and compared the celladhesion rate. MTT assay was used to observe the proliferation of cels on titanium sheet at 2, 4, 6 and 8 days after implantation. DNA and protein content of cels were detected at 3, 6, 9 days after implantation. The growth of human adipose-derived mesenchymal stem cels seeded upon the titanium sheets was observed under scanning electron microscope at 6 days. RESULTS AND CONCLUSION:When the cels were cultured for 1 hour and 2 hours, the number of adherent cels in the modification group was higher than in the control group (P < 0.05). The absorbance of cels in two groups was increased as the culture time, as detected by MTT assay. The modification group had a significantly higher absorbance value than the control group at 4, 6, 8 days (P < 0.05). DNA and protein contents of the cels in the modification group were higher than that in control group at 6 and 9 days (P < 0.05). At 6 days, the number of adherent cels and secretion of adherent stromal cellmatrix in the modification group were significantly better than that in control group, observed by scanning electron microscopy. Type I colagen modified titanium sheets have good surface activity and biocompatibility, and can promote the proliferation of human adipose-derived mesenchymal stem cels.