The image guided radio therapy (IGRT) Imaging System based on cone-beam computer tomography (CBCT) can reach the goal of improving the accuracy of the radiotherapy. However, because the clinical registration between CBCT images and Planning CT images is carried out manually, it inevitably reduces radiation positioning accuracy to some extent. To tackle the problem, we proposed a new feature vector selection method for the CBCT image elastic registration in the framework of hierarchical attribute matching mechanism for elastic registration (HAMMER) algorithm. We analyzed the characteristics of HAMMER algorithm and used Canny operator which has a better edge detection and positioning performance to replace the noise-sensitive gradient amplitude. Therefore, we used a new attribute vector, which consisted of the intensity, Laplacian of the Gaussian and Canny operator, to ex tract the image feature points in CBCT and planning CT images. We also presented an adaptive feature-point selection method and the choice criteria of attribute vector weights. Experimental results showed that the new feature vector effectively avoided the noise interference resulted from scattering lines in CBCT images to improve registration accuracy, and it also decreased the required feature point numbers and reduced the computation redundancy, so that it provided a new approach for the clinical elastic registration of CBCT and Planning CT rapidly and accurately.
Algorithms ; Cone-Beam Computed Tomography ; Humans ; Radiotherapy ; methods ; Radiotherapy Planning, Computer-Assisted

AIM: To study the role of protein kinase B (PKB) in tryptase-induced gene expression on ECV304 cells. METHODS: The expression of PKB, transcript factor AP-1 and NF-?B P65, IL-8, JNK, p38MAPK, and the activity of PKB were measured using RT-PCR and Western blotting. RESULTS: Tryptase at concentration of 1 ?g/L increased the activity of PKB by promoting PKB phosphorylation, promoted the expression of PKB, chemokine IL-8, transcription factor AP-1 and NF-?B P65, however, no changes of JNK and p38MAPK was observed. PI3K specific inhibitor (LY294002) abolished the augment of PKB, NF-?B P65 and IL-8 expression. Antisense PKB cDNA transfection also abolished the augment of PKB, AP-1, NF-?B P65 and IL-8 expression. Though PAR2 antibody did not inhibit PKB expression, it did inhibit the phosphorylation by tryptase in ECV304 cells. CONCLUSION: These results indicate that tryptase can activate PKB through PAR2 receptor and subsequently NF-?B, AP1, IL-8 and PKB expression.

Objective To determine the vitamin D status in children with sepsis/severe sepsis in pediatric intensive care unit (PICU) in order to explor the association between vitamin D status and clinical outcomes,in turn to provide evidence for optimizing nutrition support.Methods It was a prospective,observational,multi-center study,carried out in patients with sepsis/severe sepsis from March 1,2013,to March 30,2014,in the PICUs of three tertiary-care children's hospitals.Total serum 25-hydroxy vitamin D [25 (OH) D] was measured by using an enzyme-linked immunosorbent assay at admission.The association of vitamin D status at admission with length of PICU length of stay,total hospital stay,in-hospital mortality,28-days mortality and costs were analyzed.Results A total of 194 patients includng 117 boys (60.3％)and 77 girls (39.7％) were enrolled.There were 96 patients with sepsis and 98 with severe sepsis.The mortality on discharge and 28 days were 6.7％ and 24.2％ respectively.The median vitamin D level was 9.79 ng/mL (5.32,18.46) at admission.Of them 77.8％ (151/194) had vitamin D deficiency and 50.5％ (98/194) had severe vitamin D deficiency.Patients with severe vitamin D deficiency,had higher mortality on discharge (P =0.011).Vitamin D status had no significant correlations with 28 days mortality,length of PICU stay,total hospital stay and costs.Conclusions More than three-quarters (77.8％) of children with sepsis/severe sepsis in PICUs had Vitamin D deficiency.Patients with severe vitamin D deficiency at admission had higher risk of mortality at discharge.

Tangcao pill is commonly applied in adjuvant and even alternative therapy for patients with AIDS. However, the herb contains complex ingredients, but with unknown effect against anti-HIV drug and unknown function. Because CYP450 emzyme is the main metabolic enzymes of the drug, it is of important significance to study the regulation of CYP450 enzymes before and after the combined administration of Tangcao pill and EFV. Proteomics, due to its high throughout and high sensitivity, has been widely applied in CYP450 enzyme study. In this paper, liver microsomes were separated through differential centrifugation. Their proteins were separated through SDS-PAGE. The three protein bands that CYP450 enzymes were located were cut and identified by liquid chromatography tandem mass spectrometry. Totally 16 CYP450 isoenzymes were identified. Furthermore, in order to make a quantitative analysis on the effect of tang herb on CYP450 emzyme, the multiple reaction monitoring (MRM) technology based on MS was adopted. The CYP2C11 was selected based on the results of the mass spectrum identification of proteins. The characteristic polypeptides were obtained through searching Expasy blast database. The m/z of the fragment ions was less than 800. In the paper, the m/z of ion pairs of CYP2C11 were 711.5/232.1, 711.5/319.2, 711.5/466.2 and 711.5/595.3, and the m/z of ESAT-6 (internal standard, IS) were 735.5/215.3, 735.5/389.3, 735.5/460.3 and 735.5/524.3. The relative peak (analyte/IS) area was adopted for the relative quantitative analysis. Compared with the EFV single administration group, the EFV and Tangcao pill combined administration group showed a 1.6-fold increase in CYP2C11. The results of the paper indicated that Tangcao pill may affect drug metabolism by regulating metabolic enzymes such as CYP2C11, but the specific mechanism still unknown.
Animals ; Cytochrome P-450 Enzyme System ; chemistry ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Electrophoresis, Polyacrylamide Gel ; Male ; Microsomes, Liver ; chemistry ; drug effects ; enzymology ; Proteomics ; Rats ; Rats, Sprague-Dawley

Objective:To provide some thoughts for pharmaceutical treatment and care for the patients with pulmonary infection af-ter renal transplantation. Methods:Clinical pharmacists participated the whole treatment process of one case of pulmonary infection af-ter renal transplantation. According to the literatures combined with medical history, clinical symptoms and lab results, the drug treat-ment process of the patient was analyzed, and the key points of the optimized pharmaceutical care were summarized. Results: The pharmaceutical care included the dose adjustment of immunosuppressants at the early phase of the disease and after the improvement of clinical symptoms, attention paid to the interactions between multiple anti-infective drugs and immunosuppressive agents, dosage ad-justment based on the renal function of the patient, monitoring adverse drug reactions and drawing up personalized regimen. Conclu-sion:Through comprehensive medication monitoring, clinical pharmacists can help physicians develop timely and effective treatment programs and provide professional and effective pharmaceutical care for patients.

Objective To analyze the detected pathogens composition in positive blood culture samples and drug resistance in our hospital from January 2005 to December 2012 in order to accumulate the data information of pathogenic bacteria distribution and drug resistance in bacteremia .Methods The BD9240 and BacT /Alert3D 240 blood culture systems were used to perform the blood culture .The identification of isolated bacteria and the drug susceptibility test were conducted by using Microscan walkaway 40 sys‐tem and the Vitec2 compact system .The Data were analyzed by adopting the Whonet5 .6 software .Results In 1 829 positive bacte‐rial strains by blood culture ,986 strains were Gram negative bacilli ,accounting for 53 .9% ;721 strains were Gram positive coccus , accounting for 39 .4% ;104 strains were fungi ,accounting for 5 .68% .The resistant rate of staphylococcus to vancomycin ,linezolid and teicoplanin was 0% ,which to amoxycillin/clavulanic acid ,rifampicin ,amikacin ,sulfamethoxazole compound and chloramphenicol was lower than 40% .The sensitive of enterococcus to linezolid and teicoplanin was 100% ,but enterococcus faecium was resistant to vancomycin(2 .6% ) .The penicillin resistant rate of Streptococcus was 21 .7% .The resistant rates of E .coli and K lebsiella pneumo‐nia were 0% to imipenem and meropenem ,and less than 22% to amikacin ,piperacillin/tazobactam and cefoxitin .The resistant rates of salmonella to CLSI recommended five kinds of detection drug were less than 6 .5% .The resistant rates of pseudomonas aerugino‐sa were more than 25% to imipenem and more than 25% to meropenem .Conclusion The pathogens spectrum detected by blood culture is widespread .The resistance rates of different bacteria vary widely .

Objective To explore the clinical outcomes of surgical treatment of brachial plexus cord terminal branch injuries combined with rupture of major upper limb vessels and discuss the optimal timing and surgical procedures.Methods From June,2007 to June,2012,there were 9 cases of the brachial plexus cord terminal branch injuries with concomitant major vessel injuries.Two cases had combined subclvian arterial injuries,1 had combined the first part of axillary arterial injuries,1 had the third part of axillary arterial injuries and 5 had brachial arterial injuries.Depending on the region,type and severity of the injuries,nerve and vascular reconstruction was done simultaneously in the acute phase of the injuries in 3 cases and in the subacute phase in another 2 cases.In 4 cases,the vessels were repaired acutely while nerve reconstruction was carried out in a second stage.Results Nine patients were followed-up from 50 to 78 months with an average of 61.8 months.There was no necrosis of the affected limbs.CTA showed that all the artificial blood vessels were patent after surgery.Nerve functions recovered to various extents.The muscle strength was recovered to grade 3 or better in 9 patients,except 3 cases in which the intrinsic muscles were control by ulnar nerve.(S) or better sensory recovery was seen in all repaired nerve area in 4 patients,and S3 or better sensory recovery was seen in part of the repaired nerve area in 5 patients.Conclusion The brachial plexus cord terminal branch injury is rare and complicated,which request a reasonable treatment program.Under the guideline of saving life first,primary and simultaneous reconstruction of both the nerves and vessels should be attempted by microsurgical treatment whenever possible for improving the success rate of surgery and a better functional recovery.

Cross-talk of intracellular signaling pathways that share common components (hubs) is organized in form of a bow-tie network topology.Signaling cross-talk is functionally pleiotropic for target genes regulation, resulting in functional redundancy, synergism and antagonism, which should be precisely controlled to prevent signaling 'leaking' or 'spillover'.Thus, the biological system has evolved multiple insulating mechanisms to achieve stimulus-specific response that maintains intracellular homeostasis.The insulation mechanism of signaling cross-talk suggests: (1) the functional duality of cross-talk molecules that determine cell fate requires selectively targeting dysregulated cross-talk molecules while protecting the normal ones from off-target or unintended effects, and we propose them as the targetable cross-talk molecules;(2) cross-talk molecules are usually carried on the macromolecular complex as their functional platforms, thus the structural plasticity of conformational changes at the interaction surface of cross-talk molecules asks for intensive work on the relationship study between drug binding and biological activity, which we propose as the accessible cross-talk molecules.Therefore, signaling cross-talk and its insulation mechanism play instructive leading roles in resolving the bottlenecks of current drug R&D and improve the clinical outcome.

Objective To study whether there is a correlation between the content of neutrophil gelatinase-asociated lipocalin (NGAL) and extravascular lung water index (EVLWI) in patients with acute lung injury (ALI) induced by septic shock.Methods We prospectively collected 110 patients with septic shock from December 2013 to June 2015,who had already completed the initial fluid resuscitation within 6 hours according to the guide.In accordance with whether combined with ALI,patients were divided into two groups:non ALI group was A group (n =61),and ALI group was B group (n =49).Baseline information,EVLWI and other indexes of hemodynamic monitored by PICCO of each group was collected prior to admission in intensive care unit.EVWI and the content of NGAL in alveolar lavage fluid,which detected by ELISA,were gathered after the initial fluid resuscitation.Results There were no significant differences at the baseline level between the two groups (P ＞ 0.05).The risk factors of EVLWI in patients with septic shock were analyzed by multivariate linear regression analysis.The risk factors contained fluid balance,NGAL,cardiac index (CI),Global end diastolic volume index (GEDI),human albumin (ALB),globulin (GLO).The results showed that EVLWI had linear regression with NGAL and GEDI.The equation of linear regression were Y(NGAL) =2.017 + 0.035X,and Y(GEDt) =-0.671 + 0.004X,respectively.Correlation analysis indicated that there was significantly positive correlation between EVLWI and GEDI (r=0.835,P=0.000)and between NGAL and GEDI (r=0.489,P=0.000).In contrast,after immobilization of GEDI,we did not find any significant correlation between EVLWI and NGAL (r =0.381,P =0.060).Conclusions In case of fluid infusion volume is relatively too much,there is a strong correlation between NGAL in alveolar lavage fluid and EVLWI levels for early fluid resuscitation in patients with sepetic shock.