Objective To determine the planning target volume margins of head and neck cancers treated by image guided radiotherapy (IGRT).Methods 464 sets cone beam computed tomography (CBCT) images before setup correction and 126 sets CBCT images after correction were obtained from 51 head and neck cancer patients treated by IGRT in our department.The systematic and random errors were evaluated by either online or offline correction through registering the CBCT images to the planning CT.The data was divided into 3 groups according to the online correction times.Results The isocenter shift were 0.37 mm±2.37 mm, -0.43 mm±2.30 mm and 0.47 mm±2.65 mm in right-left (RL), anterior-posterior (AP) and superior-inferior (SI) directions respectively before correction, and it reduced to 0.08 mm±0.68 mm, -0.03 mm±0.74 mm and 0.03 mm±0.80 mm when evaluated by 126 sets corrected CBCT images.The planning target volume (PTV) margin from clinical target volume (CTV) before correction were:6.41 mm,6.15 mm and 7.10 mm based on two parameter model, and it reduced to 1.78 mm,1.80 mm and 1.97 mm after correction.The PTV margins were 3.8 mm,3.8 mm,4.0 mm;4.0 mm,4.0 mm,5.0 mm and 5.4 mm,5.2 mm,6.1 mm in RL, AP and SI respectively when online-correction times were more than 15 times, 11-15 times,5-10 times.Conclusions CBCT-based on online correction reduce the PTV margin for head and neck cancers treated by IGRT and ensure more precise dose delivery and less normal tissue complications.

Objective To discuss the set-up isocenter error based on kilovolt cone beam computed tomography (KVCBCT) and to investigate dose deviation led to set-up isocenter error. Methods 21 cases of nasopharyngeal carcinoma ( NPC ) treated with image guided intensity modulated radiotherapy (IG-IMRT)were investigated. The online KVCBCT scan, rigid image registration, set-up error was gained for 376 sets before radiotherapy. We sampled ten and fifteen setup isocenter error in the 376 sets randomly. Without changing beam angle,fields size and leaf sequences and dose weight et al. , we only replaced new isocenter and accumulated the new plan for ten or fifteen plans. We compared the percentage deviation between ten,fifteen times accumulated plans and normal ten , fifteen times plans. Results All 376 sets of KVCBCT image were analyzed for 21 cases. Under the condition of non-correction, the setup isocenter errors are 0. 75mm ± 1.13 mm, 0. 92 mm ±2. 15 mm,0. 82 mm ± 1.24 mm in left-right, superior-inferior and anteriorposterior directions respectively. So, we developed the margins which were 4 mm,6 mm、4 mm in three directions respectively from clinical tumor volume to planning tumor volume (PTV) calculated by two parameters model. In the fifteen accumulated plan, the deviation in the dose of 95% PTV (D95) was -7. 5% - - 11.9%, and the deviation in the D50 was -5. 1% - -8. 2%. Conclusions It is possible of small effects to normal organs and targets because of small error of patient displacement in one fraction.However, many small errors can led to considerable dose difference in targets and normal tissue in thirty fractions of all treatments period. So, according to two parameters model, PTV margin can be designed new planning and depended on IG-IMRT technique, which it will be significantly reduced these dose differences.

Objective To determine the advantages of laparoscopic cholecystectomy (LC) by establishing pneumoperitoneum under direct vision. Methods A 1cm incision was made just below the umbilicus; lifting and cutting out of the peritoneum at the line alba abdominis with direct vision; then a 10mm trocar was inserted into the pneumoperitoneum cavity.Results There were 107 patients underwent LC.Of them, 93 patients suffered from chronic cholecystitis with gallstone, 6 from acute cholecystitis with gallstone, and 8 from cystopolyps. Among them, 16 patients had previous abdominal operations. Two patients with atrophic cholecystitis converted to open cholecystectomy(OC) owing to the unclear bile duct anatomy. The average operation time was 45min. Postoperative complications included pulmonary infection in 3 patients, bile leakage in 1( due to the titanic clip falling off),but no bile duct injury or other severe complications occurred;and no mortality in this series. Conclusions Establishing pneumoperitoneum under direct vision has following advantages:rapid and safe,and favorable to avoid the severe trocar-related complications.

Background:Helicobacter pylori( Hp)is listed as Group 1 human carcinogen. Transcription factor FOX family plays important role in the development of tumor,and FOXA1 is a key target transcription factor of some microRNAs( miRNAs). Aims:To investigate the relationship of Hp infection with expression of FOXA1 in gastric mucosal tissues. Methods:Eighty patients undergone gastroscopy from Jan. 2014 Sept. 2014 were enrolled. Hp infection was detected by 14 C-urease breath test( 14 C-UBT),modified Giemsa staining and bacterial culture. Expression of FOXA1 in gastric mucosal tissues was determined by immunohistochemical SP method. Results:FOXA1 expression in Hp positive tissues was significantly higher than that in Hp negative tissues(73. 8% vs. 47. 4%;χ2 =4. 81,P<0. 05). Conclusions:High expression of FOXA1 in gastric mucosal tissues suggests that miRNAs pathway may be one of the molecular mechanisms of Hp infection leading to gastric intraepithelial neoplasia even gastric cancer.

Objective To study diagnosis significance of neutrophil surface adhesion molecules including CD11b,in type 2 diabetes mellitus patients with cytomegalovirus (CMV)infection.Methods Blood samples from 139 cases of type 2 diabetes mellitus patients were collected including 99 male and 40 female cases between Septem-ber 2011 and January 2015.Healthy male 20 cases and female 13 cases were collected as healthy control group from outpatients in the same period.Type 2 diabetes mellitus patients were divided into high active CMV infection group, CMV infection group and the negative control group,and healthy group as normal control group according to CMV -pp65 antigen detection.Neutrophil surface adhesion molecule CD11b was analyzed by flow cytometry and compared respectively.ROC curve of CD11b in 2 diabetes mellitus patients was made.Results The expression ratio of CD11b in high active CMV infection group and CMV infection group in type 2 diabetes mellitus patients was (41.25 ± 5.33)%.There was significant difference (P =0.019)compared with negative control group (61.13 ±5.28)% and there was significant difference (P =0.009)compared with negative control group (64.21 ±6.02)%;optimal cut -off value of CD11b in high active CMV infection group was 45.65%,the sensitivity was 100.00%,the specificity in high active CMV infection group was 60.12%,and the area under the receiver -operating curve(ROC)was 0.628;optimal cut -off value of CD11b in CMV infection group was 70.21%,the sensitivity of CD11b was 87.69%,the specificity of CD11b was 99.22%,and the area under of ROC of CD11b was 0.991.Conclusion The neutrophils CD11b expression in type 2 diabetes mellitus patients with CMV infection is down regulation.CD11b expression can be used as a laboratory diagnosis basis of CMV infection.

Child ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; diagnosis ; Male ; Priapism ; etiology ; surgery

OBJECTIVE: To study the influences of different cleaning methods on the quality of P.notoginseng and provide the basis for standard original processing methods of P.notoginseng. METHODS: The P.notoginseng roots were processed with different methods including drying without washing, drying and polishing, fresh cleaning before drying, and cleaning after drying. The influences of different cleaning methods on the drying time, drying rate, density, appearance properties and active components of P.notoginseng roots were compared. RESULTS: The appearance quality and hygiene indicators of P.notoginseng roots were bad when the fresh roots were dried without washing. When the roots were polished after drying without washing, the skin of P.notoginseng roots was worn down. It also resulted in a great loss of drying rate and content of dencichine of P.notoginseng roots, with decreasing rates of 10.0% and 18.1%, respectively. Cleaning after drying of P.notoginseng roots resulted in wear and tear off of epidermis and decrease of the total ash, alcohol extraction components, saponin of Re, dencichine and soluble sugars. The decreasing rates were 9.9%-17.7%, 8.3%-15.9%, 63.9%-70.8%, 12.5%-36.1%, and 27.3%-37.4%, respectively. And the longer the roots being cleaned after drying, the more the components lost. Cleaning before drying of P.notoginseng roots shortened the drying time, raised the hygiene and appearance traits, and reduced the loss of active ingredients. CONCLUSION: That the roots of P.notoginseng be processed after flushing may be a more suitable method than the traditional processing method. In order to decrease the loss of active components, ensure the appearance properties, and keep the safety of clinical medication, cleaning before drying should be promoted vigorously.

Objective:To study the social psychology of people when facing severe acute respiratory syndrome(SARS),a sudden social crisis.Methods:Using the social psychological methods,we analyzed the manifestations,causes and hazards of the public fear derived from the outbreak of SARS in China.Results:Sudden outbreak of SARS made people full of uncertainty and fear,and such fear would bring adverse effects to the society.It affected not only the daily life of people,but aslo their physical, mental stability and behavior reaction.Conclusion:SARS makes us realize the importance of psychology and psychiatry to individuals and to the society.It is imperative to establish a comprehensive provention and intervention system of diseases to maintain the social stability and the well being of individuals.

Objective To analyze the changes of lymphocyte subsets in peripheral blood of patients with drug eruption . Methods 18 newly diagnosed patients were served as the drug eruption group ,and were subdivided into cephalosporin group (n=9) ,penicillin group(n=5) and Chinese medicine group(n=4) according to different sensitizing drugs .20 healthy people were taken as the control group .Flow cytometry were utilized to detect the percentages and absolute counts of T lymphocytes (CD3+ ,CD3+CD4+ and CD3+CD8+ ) ,B lymphocytes ,natural killer cell(NK) and natural killer T lymphocytes(NKT) in their peripheral blood . Results Differences of percentages of T lymphocytes (CD3+ ,CD3+ CD4+ ) ,B lymphocytes ,NKT cells between the drug eruption group and the control group showed statistical significant (P<0 .05) .Difference of percentages of CD3+ CD8+ lymphocytes of pa-tients between the drug eruption group and the control group demonstrated no statistical significant (P>0 .05) ,while that of abso-lute counts of T and B lymphocytes of patients was statistical significant between the drug eruption group and the control group (P<0 .05) .Conclusion The percentages of CD3+ ,CD3+CD4+ lymphocytes of patients with drug eruption decrease ,while those of NKT cells increase ,which may be related to the patients′immune regulation .

AIM:To investigate whether angiotensin-(1-7) [Ang-(1-7)] protects H9c2 cardiac cells against high glucose (HG)-induced injury and inflammation by inhibiting the interaction between Toll-like receptor 4 (TLR4) acti-vation and necroptosis .METHODS:The expression levels of receptor-interacting protein 3 ( RIP3;an indicator of necrop-tosis) and TLR4 were determined by Western blot .Cell viability was measured by CCK-8 assay.The activity of lactate de-hydrogenase ( LDH) in the culture medium was measured with a commercial kit .The releases of interleukin-1β( IL-1β) and tumor necrosis factor-α( TNF-α) were measured by ELISA .The intracellular level of reactive oxygen species ( ROS) was analyzed by 2 ’ , 7 ’-dichlorfluorescein-diacetate ( DCFH-DA ) stating followed by photofluorography .Mitochondrial membrane potential ( MMP) was examined by rhodamine 123 staining followed by photofluorography .RESULTS:After the H9c2 cardiac cells were treated with HG (35 mmol/L glucose) for 24 h, the expression of RIP3 was obviously increased . Co-treatment of the cells with 30μmol/L TAK-242 (an inhibitor of TLR4) attenuated the up-regulation of RIP3 induced by HG.Furthermore, the expression of TLR4 was significantly increased after the cells were exposed to HG for 24 h, and co-treatment of the cells with 100μmol/L necrostatin-1 ( Nec-1;a specific inhibitor of necroptosis ) and HG for 24 h attenua-ted the up-regulation of TLR4 expression induced by HG .Moreover, 1μmol/L Ang-(1-7) simultaneously blocked the up-regulation of the RIP3 and TLR4 induced by HG.On the other hand, co-treatment of the cells with 1μmol/L Ang-(1-7), 30 μmol/L TAK-242 or 100 μmol/L Nec-1 and HG for 24 h attenuated HG-induced injuries and inflammatory response , leading to the increase in the cell viability , and the decreases in the activity of LDH , ROS generation , MMP loss as well as the releases of IL-1βand TNF-α.CONCLUSION:Ang-(1-7) protects H9c2 cardiac cells against HG-induced injury and inflammation by inhibiting the interaction between TLR 4 activation and necroptosis .