Image-guided radiotherapy(IGRT) is a new radiation technique ,following the three-dimensional conformal radiotherapy (3D-CRT)and intensity-modulated radiotherapy (IMRT).It is the important means to improve the accuracy and assure the quality of radiotherapy.IGRT develops and popularizes very quickly,and has superiority in treatment.

Objective To compare the T-lymphocyte subpopulations,complement C3,C4 and HBV-DNA in the peripheral blood of patients with chronic hepatitis B under different liver function.Methods A total of 136 patients with chronic hepatitis B were selected,the patients were divided into improved group and deteriorated group according to the changes of hepatic function.T-lymphocyte subpopulations,complement C3,complement C4 and HBV-DNA in two groups were determined.Results A total of 72 patients were included in improved group,64 patients were included in deteriorated group.CD4+ in deteriorated group was significantly decreased,and CD8+ was significantly increased compared with those in improved group(P<0.05),CD3+ had no statistical difference between the two groups(P>0.05).Complement C3 and complement C4 in deteriorated group decreased compared with those in the improved group(t=12.124,P=0.003;t=4.041,P=0.010).However,HBV-DNA had no statistical difference between two groups(t=-2.598,P=0.793 ).Conclusion Compared with T-lymphocyte subpopulations,complement C4 and HBV-DNA,complement C3 has a better sensitivity to reflect the damage of the hepatic function in patients with chronic hepatitis B.

Objectives　To investigate the relationship between homocysteine (Hcy), folic acid, vitamin B12(VitB12),lipids and the carotid artery atherosclerosis(CAAs) and the significance of their levels in predicting cardiac and cerebral vascular events of older patients. Methods　Both sides of the common carotid artery and internal carotid artery were measured by B-mode ultrasound in 74 examinees in A, B, C, and D groups and a control group. With fasting serum, cholesterol, triglyceriade, apolipoprotein AI(Apo AI), apolipoprotein B (Apo B), lipoprotein (a) ［Lp(a)］, creatinine, glucose, folic acid, Vit B12 and Hcy were detected. Results　When carotid artery atherosclerosis became severer, serum Hcy was higher. The levels of the control and A, B, C, D groups were (10.2±3.6) μmol/L, (11.5±4.4) μmol/L, (17.9±4.5) μmol/L, (24.7±10.3) μmol/L, and (41.4±22.3) μmol/L respectively. SNK test showed a significant difference between D and other groups (P>0.05). Folic acid and Vit B12 were negatively correlated with the severity of carotid artery atherosclerosis, but only A and D groups showed statistical significance. Spearman correlation coefficient showed that serum Hcy had significant negative correlation with folic acid and Apo AI(P=0.035 and P=0.000).Multiple linear regression analysis between CAAs and various risk factors showed Apo AI had negative correlation, but Apo B, Lp(a) and Hcy had positive correlation with CAAs, especially Hcy(P=0.009).Conclusion　Hyperhomocysteinaemia is an important risk factor of artery atherosclerosis and the degree of CAAs is highly correlated with Hcy concentration. Hcy, Apo AⅠ,Apo B, Lp(a) are sensitive and reliable indexes for evaluating and predicting CAAs.

Purpose To evaluate the diagnostic significance of non-contrast enhanced magnetic resonance angiography (NCE-MRA) for lower extremity arterial stenosis on a 3.0T MR scanner, in order to provide a reliable method for clinical application. Materials and Methods Thirty patients with arterial disease in lower extremity underwent NCE-MRA before contrast enhanced magnetic resonance angiography (CE-MRA). Image quality of the two methods was compared. The diagnostic accuracy for significant stenosis ( ≥50%) of NCE-MRA was assessed using CE-MRA as a golden standard. The consistency of the two methods in diagnosis of significant stenosis ( ≥ 50%) was analyzed. Results All patients successfully underwent both NCE-MRA and CE-MRA examination. There were 532 arterial segments detected by NCE-MRA. In the calf region, venous artifacts presented more frequently on CE-MRA (Z=4.92, P<0.01), while in the abdominal and the femoral regions, venous artifacts presented more frequently on NCE-MRA (Z=4.58 and 3.56, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NCE-MRA for the diagnosis of significant stenosis ( ≥ 50%) were 97.89%, 97.69%, 97.74%, 93.92% and 99.22%, respectively. There was good agreement (Kappa=0.94, P<0.05) between the two methods. Conclusion For the imaging of lower extremity arterial stenosis, NCE-MRA shows similar image quality and diagnostic accuracy with CE-MRA, thus can be used as an alternative method for lower extremity arterial stenosis in patients who have renal insufficiency or other contraindication of contrast media.

Objective A preliminary study on a new discovered proteomic fingerprint correlated with anxiety disorders, which M/Z range from 15000 to 16800. Methods 221 cases of neoplasm patients from April of 2004 to now were divided into anxious group and non-anxious group according to their scores using self-rating anxiety scale (SAS), and all the patients' sera were detected utilizing SELDI-TOF-MS. The data were analyzed with supported softwares. Results Compared the mass spectra of anxious group(n=49) and non-anxious group (n=172), 2 clusters were captured which M/Z range from 15 000 to 15 380 and 15 700 to 16 800 respectively. The coincidence with SAS was 75.51%. The M/Z range from 15 700 to 16 800 was the most frequent, then the second range from 15 000 to 15 380 and 15 700 to 16 800 which was doublet cluster, the least range from 15 000 to 15 380. The same fingerprints were captured in non-anxious group and their intensity was different. Conclusion The M/Z range from 15 000 to 16 800 was protein fingerprint correlated with anxiety disorders.

Objective To investigate the survival rate in elderly patients with long-term catheters hemodialysis.Methods A total of 127 elderly patients receiving maintained hemodialysis were included in this study.Patients were divided into two groups according to catheter location:long term indwelling internal jugular vein catheter group and long term indwelling vena iliac external catheter group.The baseline anthropometric and laboratory parameters were measured.The catheter dysfunction and catheter related complications were observed.Results The incidence of catheter dysfunction was higher in iliac vein catheter group than in internal jugular vein catheter group (51.5 ％ vs.24.5％,x2 =8.459,P=0.015),and there were no significant differences in the catheter related infection rate and cardiovascular (CVD) event rate between the two groups.Kaplan-Meier survival curves showed that mean survival time was lower in vena iliac external catheter group than in internal jugular vein catheter group (1.9 years vs.2.5 years,x2 =10.847,P=0.001),and still was lower after controlling the catheter dysfunction and cardiovascular events (x2 =9.915,P=0.002;x2=4.368,P =0.037).Multivariate logistic regression analysis showed that levels of hemoglobin,creatinine,systolic blood pressure,parathormone and age were the independent risk factors for mortality in elderly patients with long term catheter hemodialysis.Conclusions There is a high incidence of CVD events in elderly patients with long-term catheter hemodialysis.The incidence of catheter dysfunction is higher and the survival rate is lower in elderly patients with long-term indwelling vena iliac external catheter hemodialysis.

Objective To investigate the survival of older patients with iliac vein tunneled cuffed catheters on maintenance hemodialysis. Methods A total of 70 older patients with external iliac vein tunneled cuffed catheters on maintenace hemodialysis were included in this study, there were 94 patients with internal jugular vein tunneled cuffed catheters as control group. The baseline anthropometric and 1aboratory parameters were measured. The catheter dysfunction and catheter related complications were documented. Results There were lower survival rate and catheter survival in the external iliac vein group compared with internal jugular vein group(χ2=13.714, P<0.01; χ2=13.093, P<0.01). Compared with internal jugular vein group, there was lower rate of catheter infection in external iliac vein group(χ2=9.416, P<0.01); In addition, there were higher rate of cardiovascular disease(CVD) events and catheter dysfunction among patients in external iliac vein group (χ2=7.492, P<0.01; χ2=5.912, P<0.05). Furthermore, the incidence of catheter dysfunction and cardiovascular disease events were the independent risk factors of mortality for older patients with iliac vein tunneled cuffed catheters on maintenance hemodialysis by Cox regression model. Conclusions Patients with iliac vein tunneled cuffed catheters have a shorter survival time. Those with catheter dysfunction or cardiovascular disease events are in higher risk of mortality.

Adolescent ; Asthma ; drug therapy ; genetics ; immunology ; Child ; Child, Preschool ; Female ; Gene Expression Regulation ; drug effects ; Glucocorticoids ; therapeutic use ; Humans ; Immunoglobulin E ; blood ; Infant ; Interleukin-12 ; genetics ; Interleukin-13 ; genetics ; Male ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction

Objective To evaluate the clinical effect of reversed nasolabial flap pedicled with superior labial artery for the recon-struction of nasal and infraorbital defects .Methods From September 2006 to May 2013 ,13 cases with large nasal and infraorbital defects were reconstructed by the reversed nasolabial flap pedicled with superior labial artery .In all patients these defects were re-sulted by the excision of carcinomas .The disease course ranged from 2 months to 28 years .The size of nasal and infraorbital defects was from 2 .0 cm × 1 .2 cm to 4 .0 cm × 3 .6 cm .All defects were restored by the reversed nasolabial flap pedicled with superior labial artery in 10 cases and by the island flap in 3 cases .The size of flap was similar to that of defects .The donor areas were sutured di-rectly .Results All flaps were completely survived .The incision at the donor and accepted sites healed in the first stage .In 4 pa-tients flap revision was performed after 6-12 months because of mild swelling at the pedicles of skin flaps .Patients were followed up for 4-60 months (the mean was 28 .4 months) .All patients were satisfied with the nasal ventilatory function and appearance , flap texture and color .No obvious scars were found at donor sites .Conclusion Reversed nasolabial flap pedicled with superior labial artery is a better choice to repair the nasal and infraorbital defect after excision of carcinomas .

Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (rTMS) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency rTMS for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P<0.05). The USN degree of patients in the treatment group decreased significantly after the treatment (P<0.05), while patients in the controlled group had no difference (P>0.05). Conclusion USN induced by stroke could be improved obviously through low frequency rTMS.