Objective To study how to design the treatment plan to reduce the influence of respiratory movement and the dose of heart and lung as few as possible,to improve the dosage distribution in the target area after radical mastectomy of breast cancer.Methods Twelve patients with breast cancer after radical mastectomy were selected.A dose of 50 Gy with 2 Gy every day and 5 times per week was prescribed.Based on the treatment planning system (TPS),4-field intensity modulated radiotherapy (4FIMRT) and hybrid intensity modulated treatment planning 2-field conformal radiotherapy (2FCRT) + 4FIMRT were designed respectively.The two plans were compared from the aspects of target conformity index (CI),the homogeneity index (HI) and exposure dose volume delivered to organ at risk.Results According to the hybrid plan of 2FCRT + 4FIMRT,HI was 1.08±0.01,which was superior to that from 4FIMRT (1.11±0.01,t =9.587,P ＜ 0.05).While CI was 0.74±0.08,based on the plan of 2FCRT+4FIMRT,which was slightly lower than that from 4FIMRT (0.80±0.03,t =2.497,P ＜ 0.05).Considering the dose volumes on ipsilateral lung in two plans,the values of V5,V10,Dmean of 2FCRT+4FIMRT plan were significantly less than those of 4FIMRT plan.V5,V10,Dmean from the former plan were 13 ％,23 ％,7 ％ less than those from the latter plan (t =6.002,P ＜ 0.05;t =6.826,P ＜ 0.05;t =3.645,P ＜ 0.05).Meanwhile,Dmean of contralateral lung,Dmean of heart,Dmean and V5 of contralateral breast from the 2FCRT +4FIMRT plan were all lower than those of 4FIMRT plan.Those differences between two plans were statistically significant (P ＜ 0.05).Differences of V20 and V30 of ipsilateral lung,and V30 of heart between two plans did not make sense by the statistics analysis (P ＞ 0.05).Conclusion Hybrid radiotherapy theoretically reduces the influence of respiratory movement,improves the uniformity of target dose and lowers the risk of complications of radiation therapy on breast cancer.

Objective To explore the status and influencing factors of the rescue posttraumatic growth of Chinese people' s armed forces soldiers in order to provide a new point of view for psychological intervention.Methods 424 soldiers who had executed earthquake rescue task were assessed with Posttraumatic Growth Inventory (PTGI),and the growth status between different groups were compared.Results (1) The average score of PTGI 21 items ranged from 2.72-3.72,and the score of most items were above 3,which implied the growth degree was between middle change and more change.8 items with highest score were focused on three dimensions which were labeled interpersonal relationship,appreciation of life and personal strength.(2) There was no significant difference between the total score of different rank groups (F=0.885,P＞0.05),which score were 3.43±0.66,3.50±0.62,3.50±0.79,3.30±1.11 respectively.The was significant difference in 4 dimensions and total score of PTGI between the group which had executed rescue task for more than 14 days and the other which had executed rescue task for less than 14 days,and the scores of the group which had executed rescue task for more than 14 days were higher (P＜0.05 or 0.01).Conclusion Almost all rescue soldiers perceives mental growth,such as the changes of interpersonal relationship,attitude of life,and personal strength particularly.The duration of rescue task might be a influencing factor of posttraumatic growth.

OBJECTIVE:To observe clinical efficacy and safety of Xuebijing injection combined with octreotide and ulinastatin in the treatment of acute severe pancreatitis.METHODS:A total of 150 patients with acute severe pancreatitis admitted to emergency department of our hospital during Jan.2012-Jan.2016 were divided into control group,drug control group and observation group according to therapy method,with 50 cases in each group.All patients were treated with fasting,gastrointestinal decompression time,antibiotics,blood purification and other conventional treatment.Control group additionally received Cctreotide acetate injection 0.1 mg intravenously,tid,on the basis of conventional treatment.Drug control group additionally received Ulinastatin for injection 100 000 U added into 10％ Glucose injection 250 mL,ivgtt,bid,on the basis of control group.Observation group additionally received Xuebijing injection 100 mL added into 10％ Glucose injection 100 mL,ivgtt,bid,on the basis of drug control group.Three groups were treated for 10 days.The clinical indexes as fotal response rates,gastrointestinal decompression time,abdominal pain relief time,length of stay were observed in 3 groups.Related serum indexes (AMY,WBC,IL-6,CRP,TNF-α) before and after treatment and the occurrence of compliance during treatment were compared among 3 groups.RESULTS:The total response rate of observation group was 90.0％,which was significantly higher than 72.0％ of drug control group and 52.0％ of control group,with statistical significance (P＜0.05).The gastrointestinal decompression time,abdominal pain relief time and length of stay in observation group were significantly shorter than drug control group and control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in the serum levels of AMY,WBC,IL-6,CRP or TNF-α among 3 groups (P＞0.05).After treatment,above serum indexes of 3 groups were decreased significantly,and observation group was significantly lower than the drug control group and control group,with statistical significance (P＜0.05).The incidence of ARDS,shock and acute renal failure in observation group were significantly lower than drug control group and control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of sepsis,abdominal abscess or MODS among 3 groups (P＞0.05).CONCLUSIONS:Xuebijing injection combined with octreotide and ulinastatin show significant therapeutic efficacy for acute severe pancreatitis,can effectively control inflammation progress,improve clinical symptoms and promote disease recovery with good safety.

OBJECTIVETo clone and sequence the cDNA of squalene epoxidase gene in Eleutherococcus senticosus.

METHODTotal RNA of E. senticosus was extracted by the improved isothiocyanate method and reverse transcripted into cDNA. The primers were designed depending on the reported SE cDNA sequences of Panax ginseng. The SE cDNAs in E. senticosus was amplified using RT-PCR strategy.

RESULTSequencing results showed two different cDNA fragments (SE1, SE2) with 1665, 1629 bp each ORF which encoded 554,542 amino acids, respectively. The identities of nucleotides and amino acids between SE1, SE2 were 91.49%, 92.55%. SE1, SE2 had the highest amino acids similarity to the SE1 of P. notoginseng, 93.45%, 94.87% respectively. SE1, SE2 both had a FAD binding domain. The deduced speculated amino acids of SE1, SE2 each had 2,4 membrane-spanning helices.

CONCLUSIONThe two SE sequences in E. senticosus were firstly separated and reported, which has made foundation for E. senticosus secondary metabolite engineering researches.

Amino Acid Sequence ; Cloning, Molecular ; DNA, Complementary ; chemistry ; genetics ; Eleutherococcus ; enzymology ; genetics ; Isoenzymes ; classification ; genetics ; Molecular Sequence Data ; Phylogeny ; Plant Proteins ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA ; Sequence Homology, Amino Acid ; Squalene Monooxygenase ; classification ; genetics

OBJECTIVETo clone calmodulin (CaM) gene in Eleutherococcus senticosus, and study the effect of endophytic fungi on expression amount of CaM gene.

METHODThe CaM full length cDNA sequence was cloned by rapid amplification of cDNA ends (RACE). The gene was analyzed and corresponding structure and functions were predicted by the bioinformatics methods. The expression amount of CaM gene affected of endophytic fungus P116-1a, P116-1b, P1094 and P312-1 was detected by RT-PCR.

RESULTThe full length of CaM cDNA was 856 bp containing an ORF of 450 bp that encoded a protein of 149 amino acids. The homologous of predicted protein was almost 100% with plants like Panax ginseng and Daucus carota. RT-PCR results showed that endophytic fungus improved CaM expression amount significantly (P<0.05). The highest expression amount of CaM occurred 90 d after reinoculated with endophytic fungi P1094, up to 2.96 times of the control.

CONCLUSIONThe CaM gene of E. senticosus was successfully cloned for the first time. The results demonstrated that endophytic fungus of E. senticosus improved CaM expression amount significantly.

Calmodulin ; chemistry ; genetics ; metabolism ; Cloning, Molecular ; Eleutherococcus ; classification ; genetics ; metabolism ; microbiology ; Endophytes ; physiology ; Fungi ; physiology ; Gene Expression Regulation, Plant ; Molecular Sequence Data ; Phylogeny ; Plant Proteins ; chemistry ; genetics ; metabolism

Objective To compare the value of monoexponential and biexponential models in the preoperative evaluation of myometrial invasion in endometrial carcinoma.Methods 35 cases of endometrial carcinoma were examined by diffusion weighted imaging (DWI) with monoexponential model (b=0,800 s/mm2)and biexponential model (b=0,50,100,150,200,400,600,800,1 000,1 200,and 1 500 s/mm2),including 14 cases of deep myometrial invasion and 21 cases of non-deep myometrial invasion.The values of apparent diffusion coefficient (ADC),pure diffusion coefficient,perfusion related diffusion coefficient and the microvascular volume fraction were measured by the Matlab software.These parameters of two groups were compared and analyzed,respectively.Results The D value and the ADC value in the deep myometrial invasion group of endometrial carcinoma were lower than those in the non-deep myometrial invasion group,and the differences were statistically significant (both P<0.001).There was no significant difference between the two groups in the f value(P=0.600)and D?value(P=0.600).The AUC of ADC value and D value for the differential diagnosis of endometrial carcinoma with and without deep myometrial invasion were 0.9 1 3 and 0.9 6 9,respectively.Based on the Youden index and its corresponding optimal cut-point,the sensitivity of ADC value and D value were 90.48% and 100%,respectively,and the specificity of ADC value and D value were both 85.71% in differential diagnosis of endometrial carcinoma with and without deep myometrial invasion. Conclusion The ADC value in monoexponential model and the D value in biexponential model can be both used to evaluate deep myometrial invasion of endometrial carcinoma,among which D value is better.

Objective:To discuss how to make the surgical strategy for tibial tubercle fracture associated with bicondylar tibial plateau fracture.Methods:Data of thirty-five patients of tibial tubercle fractures associated with bicondylar tibial plateau fractures who were treated from October 2014 to May 2018 were retrospectively analyzed. There were 26 males and 9 females with an average age of 37.6 years (range, 21-68 years). According to Schatzker classification in tibial plateau fracture, 16 cases were type V and 19 cases were type VI. According to the integrity of tibial tubercle fracture and cortical bone of the proximal tibia in bicondylar tibial plateau fracture, they were divided into four types: type A, tibial tubercle fracture fragment and cortical bone of the proximal tibia are both complete; type B, tibial tubercle fracture fragment is complete but cortical bone of the proximal tibia is comminuted; type C, tibial tubercle fracture fragment is comminuted but cortical bone of the proximal tibia is complete; type D, both of them are comminuted. The surgical approaches and fixation methods of all the tibial tubercle fractures were according to the four different types. There were 22 cases with type A and B that were treated via an anterolateral and a medial incision, 13 cases with type C and D were treated via an anterior midline and a medial incision. There were 4 cases belonging to type A fixed with lag screws singly, 18 cases with type B fixed with 1/4 tubular plates, 7 cases with type C and 6 cases with type D fixed by 1/4 tubular plates combined with lag screws.Results:Thirty-five patients were followed up for 16.8 months (range, 12-24 months). All fractures healed with an average time of 4.7 months (range, 3-6 months). Loss of reduction didn’t occur in 34 cases except one. According to Rasmussen radiographic evaluation, the average score was 14.1 (range, 10-18) and clinical outcomes were rated with excellent in 11 cases, good in 19, fair in 5. The excellent and good rate was 85.7% (30/35) . The mean Hospital for Special Surgery (HSS) scores of all cases were 86.8 (range, 64-98) and the functional scores were excellent in 22 cases, good in 10 cases and fair in 3 cases with the excellent and good rate of 91.4% (32/35) . Surgical complications included fat liquefaction in 2 cases, superficial wound infection in 1, loosening of implant in 1and traumatic arthritis in 1.Conclusion:This kind of tibial tubercle fracture associated with bicondylar tibial plateau fracture is rare and special. Therefore, the preoperative plan should be made by considering the morphological features of the tibial tubercle fragments and the cortical bone of the proximal tibia. The middle longitude approach is the best way to expose tibial tubercle fragments which should be fixed with 1/4 tubularplate and/or lag screws.