Objective To observe the changes of lung function before and after radiotherapy with the lung perfusion of single-photon emission computed tomography and compare the difference between radiotherapy plans conducted by functional imagines and anatomical imagines in radiotherapy of patients with non-small-cell lung cancer.Methods A total of 36 patients (26 males and 10 females,aged 36-80 years) with lung cancer diagnosed as stage Ⅰ to stage Ⅲ non-small cell lung cancer confirmed by histological proof were selected.The lung perfusion image was delivered to radiotherapy planning system and the two plan (plan1 and plan 2) were made by lung perfusion image fusion.Plan 1 was only based on the anatomical informations and no lung perfusion images of SPECT considering.Plan 2 was optimized based on the lung perfusion image to reduce the irradiation dose of the normal tissues.The differences of protecting lung function between plan 1 and plan 2 were compared.Results 36 patients were stratified for clinical stage.FV10,fV20,fV30,MLD and PTV90/fV20 were decreased significantly after optimized with IMRT (all P =0.000).FV20,fMLD were decreased by (4.89±2.0) ％,(1.74 ±0.9)％.The IMRT plan based on the lung perfusion fusion images of SPECT could reduce the irradiation dose of normal lung tissues and the incidence of radiation pneumonitis.Conclusions Radionuclide pulmonary perfusion imaging can assess effectively the effect of tumor to regional pulmonary artery perfusion function before radiotherapy and reduce the irradiation dose of normal lung tissue in lung cancer patients undergoing IMRT.

Objective To express human inducible eostimulator (ICOS) extracellular region and IgG Fc fusion protein, and analyze their function in allogenie lymphocyte proliferation in vitro and in vivo. Methods Human ICOS extraeellular region and IgG Fc fragment were cloned into a soluble expression vector. ICOS-Ig fusion protein was expressed and purified in CHO cells. To monitor primary MLR, Balb/c spleen T cells were isolated as responder cells, and irradiated C57BL/6 spleen cells as stimulator cells. 50 μg/ml ICOS-Ig or IgG was added to primary MLR cultures. The cells responsive rates were detected by 3 H-TdR methods. ELISA tested supernatants for eytokines (IL-2,IL-4, IL-10 and IFN-γ). T cells of each group in primary MLR were cultured as responder cells for secondary MLR, and irradiated C57BL/6 (donor) or C3H (third party) spleen cells as stimulator cells. Similar indexes were detected in secondary MLR. Then vital dye CFSE was used to study alloreactive T cell proliferation in vivo. CFSE-labeled C57BL/6 spleen cells were transferred to irradiated Balb/c mice. Mice were then intraperitoneally injected with 0. 2 mg IgG, ICOS-Ig or CsA each day.At the 3rd day after transfection, the spleen cells of the mice were harvested to detect CD4+ CFSE+ and CD8+ CFSE+ by FACS. Results In primary MLR, ICOS-Ig inhibited allogenic T-cell proliferation with inhibition rate being (58 ± 8)% in 50 μg/ml, and increased IFN-γ secretion. In secondary MLR, ICOS-Ig specifically inhibited the proliferation of donor spleen cells with inhibition rate being (42±8)%, and in ICOS-Ig group the levels of IL-4 and IL-10 were lower and the level of IFN-γ higher than in IgG group. However, ICOS-Ig didn't inhibit the proliferation of third-party spleen cells. In the CFSE dye assay, CFSE intensity of CD4+ and CD8+ T cells in ICOS-Ig and CsA groups was stronger than that in control group (P < 0. 05), while CFSE intensity in combined treatment group were even stronger than that in ICOS-Ig and CsA groups (P<0. 05). Conclusion ICOS-Ig could inhibit allo-reactive T cell proliferation in vitro and in vivo, and induce donor-specific T cell hyporesponsiveness specifically.

AIM To investigate the effect of cisplatin on apoptosis in Scaber cell. METHODS The apoptotic cells were detected by TUNEL,HE,eletronic micrpscopy. RESULTS Treatment of Scaber cells with CDDP resulted in characteristics typical of apoptosis. CDDP induced apoptosis of Scaber cells in time and concentration dependent manner. To further investigate the mechanism of apoptosis induced by CDDP, the expressions and activity of apoptosis associated proteins such as bcl 2, bax and caspase 3 were examined using S P method.The results showed: CDDP caused time and concentration dependent decreases in bcl 2 and increased in bax proteins.CDDP bcl 2 and its translocation to perinuclei and nuclei. The expression of caspase 3 in Scaber cell were determined during apoptosis induced by CDDP. CONCLUSION Our investigetion showed that the apoptosis induced by CDDP is related to the increase of bax protein, and the decrease of bcl 2 protein. and its translocation to perinuclei and nuclei.

AIM: To investigate the surgical methods of Helveston syndrome.
METHODS: Fifteen cases ( 30 eyes ) with Helveston syndrome were studied. Surgical method was selected according to the degree of superior oblique muscle overaction and dissociated vertical deviation (DVD).
RESULTS: Binocular superior oblique intrathecal tenectomy was performed in 8 patients (16 eyes). Follow-up period after surgery was 1-3a. Those 8 patients got A-sign correction, of which 3 patients (6 eyes) got DVD vanished and 5 patients (10 eyes) got DVD alleviation. None of the 8 cases needed another operation for DVD. Binocular superior rectus recession and binocular lateral rectus recession with vertical offsets was performed in 4 patients (8 eyes). Follow-up period after surgery was 1-3a. The 4 patients got A sign correction and with orthophoria, of which 1 patient ( 2 eyes ) got DVD vanished and 3 patients ( 6 eyes) got DVD alleviation. None of the 4 cases needed another operation for DVD. Binocular lateral rectus recession and vertical offsets was performed in 3 patients (6 eyes). Follow-up period after surgery was half a year, with orthophoria, no A sign, DVD weakened, and no second operation was needed. CONCLUSION: Surgical procedures for Helveston syndrome can be selected according to the degree of superior oblique muscle overaction and DVD.

Objective To study the effect of combined 1,25-dihydroxyvitamin D31,25(OH)2D3 and celecoxib on growth, call cycle and apoptosis in breast cancer cell line Hs578T.Methods We compared cell numbers by using MTT method , analyzed cell cycle percentage and apoptosis with flow cytometric.Results Both with 1,25(OH)2D3 and celecoxib could inhibite tumov growth,induc apoptosis in a dose-time-dependent manner. comparing with 1,25(OH)2D3 alone,combination wse of the two drugs had a additive effect but was inferior to cececoxib alone. The combination use of 10-8mol/L1,25(OH)2D3 and celecoxib group is more effective than the combination use of 10-7mol/L1,25(OH)2D3 and celecoxib group. Conclusion 1,25(OH)2D3 and celecoxib could be a new drug for the prevention and treatment of breast cancer.

Objective To explore the relationship between high altitude de-adaptation syndrome and training burnout of plateau-garrisoned soldiers after returning to the plain.Methods A total of 140 plateau-garrisoned soldiers who had returned to the plain were chosen by random cluster sampling and measured with the Training Burnout Test.They were divided into two groups according to the occurrence of acute mountain sickness.We compared the differences in training burnout between the two groups and analyzed the relationship between acute mountain sickness and training burnout. Results ①The incidence of high altitude de-adaptation syndrome of plateau-garrisoned soldiers was 80.00% after returning to the plain.There was statistically significant difference between plateau soldiers after returning to the plain,the plateau stability-keeping forces that returned to the plain (78.36%) (χ2 =0.188, P=0.664) and plateau migrants who returned to the plain (75.10%) (χ2 =1.279, P=0.258).Main symptoms of high altitude de-adaptation were fatigue (12.86%), dizziness (11.43%) and meakness (10.00%).②Compared with soldiers who had no high altitude de-adaptation syndrome, victims of de-adaptation syndrome had higher scores of training burnout, physical and psychological exhaustion and training-alienation (P<0.01).Compared with soldiers who had normal body mass indexes, those who were overweight had higher incidence of altitude de-adaptation (P<0.05).③The regression equation between plateau de-adaptation syndrome and training burnout of plateau soldiers after returning to the plain (P<0.01) is:Training burnout =0.498 ×plateau de-adaptation syndrome -0.126 ×age+0.038 ×length of military service +0.069 ×educational degree+0.029 ×body mass index.Conclusion There exist correlations between high altitude de-adaptation syndrome and training burnout of plateau soldiers after returning to the plain.Reducing the occurrence of high altitude de-adaptation syndrome can help reduce the degree of training burnout.

The neurotoxin β-amyloid (Aβ) is the main hallmark of Alzheimer′s disease (AD). Recent evidence suggests that, in common sporadic or late-onset forms of AD, elevated brain Aβ levels are caused by impaired clearance rather than overproduction. The cell surface receptor′s low-density lipoprotein receptor-related protein-1 (LRP1) has been reported to not only play a role in Aβ endocytosis, but also exist in the blood-brain barrier system, peripheral blood, liver, kidney and other tissues and organs, and transport Aβ to the cerebrospinal fluid or blood system by passing through the blood-brain barrier or the blood-cerebrospinal fluid barrier effectively, and finally clear it out of the body through peripheral tissues and organs. In this review, the role of LRP1 in the peripheral transport and clearance of Aβ is described, and it may be a safe and effective way to reduce Aβ in the brain and even improve cognitive dysfunction.

This study is to report the study of protective effects of myricitrin against oxidative stress-induced apoptosis of vascular endothelial cells and the investigation of the possible mechanisms of action of myricitrin. The model of H2O2-induced apoptosis of vascular endothelial cells was used to determine the protective effects of myricitrin. The levels of LDH, MDA and the activities of SOD, NO were measured using the respective kits. The H2O2-induced apoptosis of vascular endothelial cells was detected using MTT reduction, TUNEL assay, JC-1 and ROS staining. The activation of Caspase-3 was also measured by fluorometry. The expression of apoptosis-related proteins was determined with Western blotting assay. Myricitrin had significant protective effects against H2O2-induced apoptosis of vascular endothelial cells in a time- and dose-dependent manner. The results show that myricitrin could attenuate H2O2-induced decrease in the activities of SOD (P < 0.01). Myricitrin could decrease the levels of LDH, MDA and increase cell viability and the mitochondrial membrane potential (P < 0.01). Myricitrin had protective effects in a dose-dependent manner between 32 micromol x L(-1) to 64 micromol x L(-1). Myricitrin pretreatment could attenuate H2O2-induced increase of p-ERK. Moreover, myricitrin pretreatment could up-regulate the expression of the anti-apoptotic protein Bcl-2, down-regulate the expression of the pro-apoptotic protein Bax, and decrease the expression of Caspase-3, 9. In conclusion, myricitrin had significant protective effects against H2O2-induced apoptosis of vascular endothelial cells. Myricitrin can enhance the activities of anti-oxidative enzymes and decrease the production of free radicals. The possible mechanisms of action of myricitrin are due to myricitrin-mediated inhibition of phosphorylation of the apoptosis signaling pathways-related kinase ERK, up-regulation of the expression of the anti-apoptotic protein, and down-regulation of the expression of the pro-apoptotic protein.

Objective:To investigate the value of bedside transthoracic echocardiography(TTE) in volume reactivity assessment of children with septic shock.Methods:A total of 41 children aged from 1 to 5 years with septic shock requiring mechanical ventilation admitted to PICU from January 2017 to June 2020 were prospectively included.Under the condition of complete mechanical ventilation, full sedation and analgesia, and no spontaneous breathing(tidal volume 8 to 10 mL/kg), volume expansion was given to children.Hemodynamic indexs such as cardiac index(CI), stroke volume index(SVI) and stroke volume variability(SVV) were measured before and after volume expansion by noninvasive cardiac output monitoring(NICOM) and TTE.Moreover, aortic flow velocity time integral variable degrees(ΔVTI), inferior vena cava variability(ΔIVC) and inferior vena cava dilation index(dIVC) were also measured by TTE.Patients were considered to be responsive to volume expansion if SVI NICOMincreased≥15%.Based on the responsiveness of volume expansion, all the patients were divided into response group and non-response group.The value of SVV TTE, ΔVTI, ΔIVC, dIVC, ΔCVP and SVV NICOMin predicting volume responsiveness were analysed. Results:(1) There were 23 cases in response group and 18 cases in non-response group.Before volume expansion, there were no statistically significant differences in general hemodynamic indexes HR, MAP, CVP, EF, CI NICOM, and CI TTEbetween two groups( P>0.05). (2) In response group, HR, MAP, CI, SVI and CVP were all improved after volume expansion( P<0.001). In non-response group, only CVP was significantly increased after volume expansion, while other indexes were not improved( P>0.05). (3)Before the volume expansion, SVV TTE, ΔVTI, ΔIVC, and dIVC in response group were higher than those in non-response group( P<0.001). After volume expansion, these indicators were significantly reduced in response group.In non-response group, only ΔIVC significantly reduced after volume expansion.(4) The receiver-operating characteristic curve analysis showed that the area under the curve of SVV TTEand ΔVTI was 0.971, with 12.04% as the threshold, the sensitivity was 0.957 and the specificity was 0.944. The area under the curve of ΔIVC was 0.981, with 25.98% as the threshold, the sensitivity was 0.870 and the specificity was 1.000.The area under the curve of dIVC was 0.980, with 29.86% as the threshold, the sensitivity was 0.870 and the specificity was 1.000. The area under the curve of ΔCVP was 0.778, with 2.5 cmH 2O(1 cmH 2O=0.098 kPa) as the threshold, the sensitivity was 0.913 and the specificity was 0.556. The area under the curve of SVV NICOMwas 0.874, with 12.50% as the threshold, the sensitivity was 0.869 and the specificity was 0.778. Conclusion:The dynamic indexes SVV, ΔVTI, ΔIVC and dIVC monitored by TTE have good accuracy in evaluating children′s volume responsiveness, among which the accuracy of ΔIVC and dIVC is relatively the highest; the value of ΔCVP in predicting volume responsiveness is limited.

Objective To investigate the clinical features and the prognosis after surgical treatment for hilar cholangiocarcinoma (HCC).Methods The surgical therapy and follow-up result were retrospectively analyzed on 98 cases of hilar cholangiocarcinoma admitted into our hospital from January 1995 to January 2005.Differences between groups were evaluated using Chi-square analysis or Student t-test according to the data type.Survival rate was calculated with Kaplan-Meier method,and using the log-rank test.Results Among 98 patients,83 patients underwent surgical treatment (radical resection in 33,palliative resection in 16,and nonresectional internal or external bile duct drainage in 34),15 patients underwent conservative therapy.The 1-,3-,5-year survival rates were 79％,42％,and 17％ in the resection group and 88％,54％,and 24％ in the radical resection group,respectively.The 1-,3-year survival rates were 55％,and 9％ in palliative resection group,respectively,and none of the patient survived for over 5 years.There were significant differences in the survival rate among the radical resection group and the palliative resection group (log-rank test,P ＜ 0.001).Conclusions Radical resection improves the prognosis of hilar cholangiocarcinoma.