Objective Compare the value of multislice CT perfusion imaging (MSCTPI)?color brain atlas (CBA)?visual evoked potential mapping (VEP-M) in the diagnosis of acute cerebral infarction.Methods After routine CT was performed,the 27 cases of acute cerebral infarction underwent MSCTPI?CBA?and VEP-M respectively.Results The examination of MSCTPI showed that abnormal perfusion changes were in accordance with clinical symptoms;the examination of CBA showed that in 32 scale local high power shadow presented on the power of ??? of lesion;the examination of VEP-M showed the prolongation of latency of P100?degrade of amplitude on the lesion of the chart,the power of the lesion degraded obviously on the map of distribution of power,and distribution asymmetry.Conclusion Combined use of MSCTPI?CBA?VEP-M in the diagnosis of acute cerebral infarction can remedy the defects and improve diagnostic rate of acute cerebral infarction further.

BACKGROUND: Linxian County of China is one of the areas with the highest incidence of esophageal cancer and gastric cardia cancer in the world, and nutrition-deficiency is widely existing in local people. In recent years, many researches around the world revealed that the cause of Parkinson disease (PD) is related to factors of gene, age, environment, diet, nutrition and smoking. More and more studies confirmed that primary hypertension may be in relation to vascular Parkinsonism (VP) and long-term hypertension was apt to VP.OBJECTIVE: To investigate the relationship between hypertension and clinical probable Parkinson disease (PPD) in nutrition-deficient population of Linxian County and provide a theoretical basis for early prevention and treatment of PD.DESIGN: Cross-sectional study.PARTICIPANTS: A total of 4 335 subjects aged over 55 years were selected. These subjects have taken part in the nutritional intervention study of Linxian County and first entered in the cohort study in 1985. They were enrolled in the nutritional intervention study in Linxian County in 1985.METHODS: A prospective cohort study was conducted. ①Case screening: PD questionnaire (used in American Gebai County) combined with general neurological examination were adopted. ②The diagnosis of PD: Clinical diagnostic criteria of UK Parkinson Disease Society Brain Bank were taken as the criteria for screening PD. Further evaluations were undertaken for clinical PPD and clinical possible PD on subjects who had PD symptoms.The diagnostic criteria of clinical PPD: Subjects were diagnosed as having clinical PPD if they presented any two of the following two cardinal features (resting tremor, hypermyotonia, bradykinesia and impairment of postural reflexes) or presented any one of the following features (resting tremor, hypermyotonia and bradykinesia). Diagnostic criteria of clinical possible PD: Subjects were diagnosed as having clinical possible PD when presented any one of the following four cardinal features (resting tremor, hypermyotonia, bradykinesia, and impairment of postural reflexes).③Definition of hypertension: Hypertension was defined as the systolic blood pressure (SBP) ≥ 140 mm Hg or the diastolic blood pressure (DBP) ≥ 90 mm Hg. Data were processed with linear trend test and nonconditional logistic regression.MAIN OUTCOME MEASURES: Status of final diagnoses on patients and relationship between hypertension and clinical PPD.RESULTS: A total of 4 335 subjects including 2 008 males (46.32%)and 2 327 females (53.68%) participated in the screening of PD.①Results of final diagnosis on patients: Among all the 4 459 survival participants,46 subjects were diagnosed as having PD, 118 as having clinical PPD and 78 as having clinical possible PD. After excluding patients with PD or clinical possible PD, only 118 patients were diagnosed as having clinical PPD. These patients and 4 217 normal controls were analyzed and a total of 2 035 patients had hypertension. ②There were statistical correlation between hypertension and clinical PPD, RR was 1.648 (1.147-2.638), which was 1.668 (1.145-2.432) after being adjusted by possible confounding factors including age, gender, smoking, drinking and so on, the association mentioned above still existed (χ2=7.463,P=0.006). Analysis of gender showed statistically significant differences between female patients with hypertension and clinical PPD(χ2=9.669 P=0.002), and RR before adjust ment was 2.347 (1.347-4.091), which was 2.346 (1.327-4.150) after being adjusted and correlation still existed. While there were no statistical corre lations between male patients with hypertension and clinical PPD (χ2 =0.697 ,P=0.404)but there was also an ascending trend in RR value. ③ With the blood pressure increasing, the RR value correspondingly in creased with the linear trend test (χ2=11.325 ,P=0.003). And there was sta tistical significance in raw and adjusted RR value of hypertension with the BP ≥ 140/90 mm Hg. Respective statistics of SBP and DBP showed a dose-response relationship between SBP and clinical PPD; When the SBP ≥ 140 mm Hg, there were statistical significances in values of raw RR or adjusted RR of hypertension (χ2=8.007 ,P=0.018). While there were no sta tistical significances in RR values before and after adjustment of DBP (χ2 =2.569,P=0.227). CONCLUSION: Hypertension is one of the risk factors of clinical PPD in female residents older than 55 and the incidence of getting clinical PPD is increased with the heightening of BP.

ObjectiveTo study the efficacy of using multileaf collimators with different position and different degree in the treatment of nasopharyngeal carcinoma (NPC) using intensity-modulated radiotherapy techniques.Methods Ten patients withNPC were administered andanalyzed.Thepenumbra characteristics, dose of target, and radiation conformal indexes (CI) of mode T1 and mode T2 were measured and compared using dose volume histogram generated by Varian Eclipse three-dimensional planning computer system. Mode T1 :The angles of seven coplanar beams were 0°, 52°, 106°, 160°, 212°, 258°and 308°,respectively. There were no restriction on the position and degree of multileaf collimators. Parameters were set and optimized. Mode T2 :The beam angles and the parameters were as same as mode T1. According to the actual situations, the position and the degree of the multileaf collimators were changed. Then thedose optimization was performed. Results Target dose coverage in both mode T1 and T2 could be clinically accepted, and the CI were 0. 82 and 0. 83(t = -0. 25, P =0. 815). The maximum dose reductions in the lens, eyes, optic nerves and corneas were 28. 7% (t = 4. 80, P = 0. 000), 2. 7% (t = 2. 99, P = 0. 021),1.4%(t= 1.05,P=0.032), and 30.5% (t=2.99,P=0. 020), respectively. However, the mean dose and V35 of the parotid were increased by 0. 6% (t = - 2. 82, P = 0. 043) and 9.9% (t = - 2. 05, P =0. 038). ConclusionsOpimization of multileaf collimators can reduce the scattering and leaking rays. Compared with mode T1 ,controlling the position and degree of multileaf collimators could reduce the radiation dose to the eyes and optic-nerves, especially to the lens.

Objective To assess the feasibility for the automated treatment planning verification system Mobius3D (M3D) to perform an independent 3D dose calculation in intensity-modulated radiotherapy (IMRT) for cervical cancer.Methods Twenty patients with cervical cancer were randomly selected.With treatment planning systems (Pinnacle,Version 9.2;Eclipse,Version 13.5),all IMRT plans were divided into 7 fields to meet the dosimetric goals.The optimized plans were exported to the M3D server.The percentage differences in the volume of region of interest (ROI) and the dose calculation of target volume and organ at risk (OAR) were evaluated for the two treatment planning systems,and theγ passing rate was used to assess the accuracy of M3D calculation.Results The difference in the volume of ROI for Pinnacle 9.2 to M3D was less than that for Eclipse 13.5 to M3D,with maximum differences of 0.22％±0.69％ and 3.5％±1.89％ for Pinnacle 9.2 and Eclipse 13.5,respectively.The differences in the dose calculation of target volume and OAR for the two treatment planning systems to M3D were within ± 1％.After recalculating by M3D,the dose difference between Pinnacle 9.2 and M3D was smaller than that between Eclipse 13.5 and M3D,but the mean differences were all within ±3％.The γ passing rates for target volume and OAR were more than 95％ on average.Conclusions The method of utilizing the automated treatment planning verification system to validate the accuracy of plans is convenient.It can be used as a secondary check tool to improve accuracy in IMRT dose calculation.

Objective To construct a rat model of nonalcoholic fatty liver disease (NAFLD) by feeding rats fat-rich diet and analyze the effect of insulin resistance (IR)in the development of NAFLD. Methods Male SD rats were randomly divided into normal diet group (NG, n =24) and fat-rich diet group (FG, n =24). At the end of feeding for2 weeks, 4 weeks, 6 weeks or 8weeks, 6 rats in NG and FG were randomly took out. Their weight were recorded, then the serum fasting blood sugar, fasting insulin, triglyceride, total cholesterol, ala-nine aminotransferase and aspartate aminotransferase were measured, and the fasting insulin resistance index and liver index (liver weight (g)/body weight(g) × 100%)was calculated. Then liver tissues were homogenized, and muleic dialdehyde and superoxide dismutase were determined. The hepatic steatosis in all rats was assessed according to the results under light microscope. Results The body weight of rats in NG increased faster than those in FG after six weeks. The liver index of rats in FG was markedly higher than that in NG since the second weekend. The rats in FG began to have hepatocyte steatosis from the second weekend, had insulin resistance, hyperlipidemia, dysfunction of liver and lipid peroxide of liver from the fourth weekend, suffered mild fatty liver from the sixth weekend, and developed to moderate fatty liv-er from the eighth weekend. Conclusions NAFLD with IR model was successfully developed by feeding SD rats with an improved rich-fat diet for 6 weeks. IR may play an important role in the development of NAFLD.

Objective To construct and identify replication deficient recombinant adenovirus expressing human c-Jun N-terminal kinase(JNK)by homologous recombination adenovirus dominant-negative type JNK(Ad-DN-JNK).Methods The linearized recombinant shuttle vector pAdTrack-CMV-DN-JNK Was co-transformed with backbone vector pAdEasy-l into bacteria BJ5183 for recombinant adenoviral vector.The recombinant adenoviral vector was transfected into HEK293 packing cells tO construct replication deficient recombinant adenovirus,and then the recombinant edenovirns WaS detected by PCR and DNA sequencing.Western blot analysis was utilized to detect the Cxpression of Ad-DN-JNK and the level of insulin receptor substrate l Serine307 phosphorylation.Results JNK recombinant adenoviral vectorcould be effectively transfeeted into HEK 293 cell and successfully packed by intracellular enzyme.The expression of green fluorescent protein(GFP)Was observed on the 5th day after transfection.The fragment of JNK gene waS amplified by PCR and identified by sequencing.The titer of the prepared Ad-DN-JNK is 2.5×1010 pfu/ml.The animal experiment confirmed that constructed Ad-DN-JNK could be effectively expressed in liver tissue.Conclusion The research successfully constructed recombinant adenoviral vector and recombinant adenoviral particle.Animal experiment demonstrated the Ad-DN-JNK could effectively mediated the expression of DN-JNK gene and down-regulated the level of IRSlscfine307 phosphorylation.The achievement laid a foundation for further investigation of the function and application of JNK.

Objective To compare and analyze the characteristics of intensity-modulated arc therapy (IMAT) versus fixed-gantry intensity-modulated radiotherapy (IMRT) in the treatment of cervical esophageal cancer.Methods Ten patients treated in our radiotherapy center were selected for this study.Based on the identical CT and planning target volume (PTV), two IMAT plans were generated with Eclipse ver8.6 planning system.IMAT1 consisting of a single 359.8° rotation, and IMAT2 consisting of two coplanar 359.8° rotations.PTV were prescribed to 60 Gy in 30 fractions.Planning objectives for PTV,corresponding with the IMRT plans, were V98 larger than 97% and V110 no more than 15%.The maximum dose of spinal-cord was constrained below 45 Gy.One-way ANOVA were applied to dose-volume values for PTV and OAR from DVH.Results There were no significant differences between IMRT and IMAT in PTV D98, V98, CI or total-lung V5, V10, V30, V40, V50 and mean lung dose (all P > 0.05).However, the differences were significant in terms of D2, V110 and HI of PTV, V20 of the total-lung (all P<0.05).On the MU,IMRT = 1174.8 MU,IMAT1 =709.7 MU,and IMAT2 =803.8 MU (F =39.25,P =0.000).On the treatment time,IMRT= 14.9 min,IMAT1 = 1.9 min, and IMAT2 =2.66 min (F=45.14,P=0.000).Conclusions IMAT is equal to IMRT in dosimetric evaluation.Due to much less MU and delivery time,IMAT is an ideal technique in treating patients by reducing the uncomfortable influences which could effect the treatment.However, IMAT1 is slightly inferior to IMAT2.

Objective To construct replication deficient recombinant adenovirus expressing human c-Jun N-terminal kinase by homologous recombination.Methods The linearized recombinant shuttle vector pAdTrack-CMV-WT-JNK was co-transformed with backbone vector pAdEasy-1 into bacteria BJ5183 for recombinant adenoviral vector.The recombinant adenoviral vector was transfected into HEK293 packing cells to construct replication deficient recombinant adenovirus,and then the recombinant adenovirus was detected by PCR and DNA sequencing.Results JNK recombinant adenoviral vector was effectively transfected into HEK 293 cells and was successfully packed by intracellular enzyme.The expression of green fluorescent protein(GFP)was observed on the 5th day after transfection.The fragment of JNK gene was amplified by PCR and identified by sequencing.The animal experiment confirmed that Ad-WT-JNK was effectivety expressed in liver tissue. Conclusion The research successfully constructed recombinant adenoviral vector and recombinant adenoviral particle.And the achievement laid a foundation for further investigation of the function and application of JNK.

Objective To compare the dosimetric differences of target volume and organ at risk between intensity-modulated arc therapy (IMAT) and simultaneously integrated boost intensity-modulated radiotherapy (SIB-IMRT) in nasopharyngeal carcinoma. Methods IMAT and SIB-IMRT treatment plans of 10 nasopharyngeal carcinoma cases were generated by Varian Eclipse ver8. 6 treatment planning system. The dosimetric parameters of target volume and organ at risk (OAR), the monitor units (MU) and treatment time were compared between IMAT and SIB-IMRT treatment plan. Results The conformal index ( CI ) of PTV, PTV1, PTV2 of IMAT and SIB-IMRT were 0. 71 and 0. 75 ( Z = - 2. 32, P ＜ 0. 05 ), 0. 54 and 0. 59 (Z= -2.56,P＜0.05), 0.71 and 0.78(Z= -2.52,P＜0.05), respectively. the homogenous index (HI) of PTV, PTV1, PTV2 of IMAT and SIB-IMRT were 10.5 and 11.2(Z= -0. 84,P＞0.05),13. 1 and 17. 1(Z= -1.68,P＞0.05) and 14. 1 and 13.3(Z= -1. 01,P＞0.05) respectively;the brain-stem mean does were 3512. 8 cGy ± 406. 2 cGy and 3384. 3 cGy ± 361.3 cGy ( Z= - 1.82, P ＞ 0. 05 ); the brain-stem maximum dose were 5528. 1cGy ± 192. 9 cGy and 5727. 5 cGy ± 356. 3 cGy ( Z = - 1.12, P ＞ 0. 05 ); the maximum dose of spinal-cord were were 4186. 1cGy ± 88.7 cGy and 4390. 2 cGy ± 74. 9 cGy ( Z =-2. 38 ,P ＜ 0. 05 ). There were no significant differences between parotid dose and normal tissue ( P ＞0. 05. ) MU were 606 ± 96 and 1308 ± 213 for IMAT and SIB-IMRT ( Z= - 2. 52, P ＜ 0. 05 ). Conclusions The IMAT plan showed a better conformal index than SIB-IMRT plan, with the same dosimetric parameters of the target volume and OAR. The IMAT plan could reduce normal tissues dose, monitor units and treatment time in the treatment of nasopharyngeal carcinoma.

Objective To evaluate the performace of fixed field Intensity modulated radiation therapy (IMRT) and RapidArc in the radiotherapy for multiple intracranial metastases.Methods The clinical data of 10 patients with multiple intracranial metastases,8 male and 2 female,aged 65-73,were used to design 3 plans:fixed field IMRT,RapidArc with single Arc (RA1),and RapidArc with double Arc (Arc 2).Dose-volume-histogram analysis was used to compare dose results,monitor unit,and delivery time.Results All 3 plans met the clinical requirements.The best target conformity and homogeneity were observed in the RA2 plan (Z = -2.803,- 2.904,P ＜ 0.05) and there were no statistical differences between the IMRT plan and RA1 plan.The maximum doses to the lens,eyes,and brainstem of the two RapidArc plans were all significantly lower than those of the IMRT plan(Z = -2.803--2.191 ,P ＜0.05),and the maximum dose to the optic nerves of the RA2 plan was significantly lower than that of the IMRT plan (Z = -2.293,-2.701 ,P ＜0.05).Compared with the IMRT plan,the average monitor units of the RA1 and RA2 plans were reduced by 29% and 24%,respectively,and the delivery time of these plans were significantly shorter by 84% and 69%,respectively.Conclusions Compared to the IMRT plan,RapidArc plans with single or double Arcs show similar or better effects in the target dose distribution,reduction of irradiation doses on organs at risk and,moreover,significant decrease of the monitor units and delivery time.