Objective To compare the dosimetric differences among three-dimensional conformal radiotherapy(3D-CRT),intensity-modulated radiotherapy(IMRT)and RapidArc for prophylactic carnial irradiation(PCI)in small cell lung cancer(SCLC)patients.Methods Ten patients with SCLC were enrolled into this study.3D-CRT,9-field IMRT(IMRT)and double arc RapidArc plans were designed and optimized for each patient.The goal was to deliver 25 Gy to ≥ 95％ of the planning target volume(PTV)while the same normal-tissue dose constraints were achieved.The dose distribution and conformal index (CI),homogeneity index(HI)of target volume,the maximum dose(D2 ％),the minimum dose(D98 ％),target coverage of PTV(V95 and V100),and Dmean and Dmax of organs at risk(OAR)were analyzed by using the dose volume histogram(DVH).The monitor units and delivery time were also evaluated.Results All plans met the clinical requirements.PTV dosimetric parameters(CI,HI,D2％,D98％,V95 and V100)of RapidArc and IMRT were superior to those of 3D-CRT with significant difference(P＜0.05).The maximum doses to the optic nerves,brainstem and the mean dose to the parotid glands of the IMRT and RapidArc plans were all significantly lower than those of the 3D-CRT plan(P＜0.05),while 3D-CRT plan provided the lowest maximum doses and mean dose of the lens and eyes(P＜0.05).Compared with IMRT plan,no obvious advantage in PTV dosimetric parameters could be observed in RapidArc plans.In terms of organ sparing,no statistical difference was observed between IMRT and RapidArc plans.The number of monitor units for 3D-CRT,IMRT and RapidArc were 287.8,1388.8 and 346.6,respectively.Conclusions Compared with 3D-CRT,IMRT and RapidArc show better dosimetric quality.The 3D-CRT plan has a significantly lower dose on the lens and eyes,less MU and shorter delivery time than IMRT and RapidArc plans.

Objective:To observe influence of exercise rehabilitation combined diet guidance on cardiac function and quality of life (QOL) in patients after heart valve replacement .Methods:A total of 120 patients after heart valve replacement were selected and randomly divided into control group (n=60 ,received routine health education ) and experiment group (n=60 ,received diet guidance and exercise rehabilitation based on routine health education ) .After discharge ,patients re‐ceived outpatient follow‐up for six months ,body weight ,cardiac function and QOL on six months after surgery were fol‐lowed up and observed in two groups ,and the results were statistically compared .Results:Compared with control group six months after discharge ,there were significant rise in left ventricular ejection fraction [ (51.75 ± 9.30)% vs .(57.73 ± 6.13)% ] andoxygenmetabolicequivalent [(7.05±1.85)METsvs.(11.34±2.18)METs],andeachitemscoreofQOL and total score of QOL [ (4.98 ± 0.40) scores vs .(6.49 ± 0.53) scores] ,P<0.05 or <0.01;and significant reduction in body weight [(67.75 ± 10.67) kg vs .(61.25 ± 10.34) kg] in experiment group ,P<0.01. Conclusion:Exercise rehabili‐tation combined diet guidance can avoid rapid increase in body weight after surgery ,promote recovery of cardiac function and improve quality of life after surgery in patients with heart valvular diseases .

Objective To evaluate the effect of positive experience intervention on anxiety, depression and quality of life among rural empty nesters. Methods A total of 115 rural empty nesters were divided into the intervention group (n=58) and the control group (n=57). Both groups received routine community activities. In addition, participants in the intervention group received positive experience intervention. Geriatric Depression Scale, Self-Rating Anxiety Scale and 12-item Short-Form Health Survey were adopted to measure the related items before and after the intervention. Results The intervention group showed a significant decrease in anxiety (1.54±0.07) and depression (7.28±3.82), compared with the control group (1.64±0.09, 11.81±6.38), the difference was significant (t=-5.960,-4.613, P<0.01). The Physical Component Summary (PCS) and Mental Component Summary (MCS) was 47.01±6.47 and 52.13±6.22 in the intervention group, which were significantly higher than those in the control group (41.37±8.71, 48.71±6.13), the differences were significant (t=3.937, 2.970, P < 0.01). Conclusions Positive experience intervention can decrease anxiety and depression, and improve quality of life of rural empty nesters.

Objective To explore the ultrasound performance and related factors on the role of normal living rabbit's liver by laser ablation. Methods The rabbit's liver tissue were ablated by Echolaser integrated laser interventional ultrasound system, and the necrosis of the lesion and performance of pathology and anatomy were observed. Results The outline of the lesion was ellipse like. The two-dimensional US showed regular hyperecho area in the center, mild strong echo in the peripheral and mild attenuation backward. Contrast enhanced ultrasound (CEUS) showed a filling defect of contrast media in the ablated area. After dissection, the center of the lesion was slag-like carbon, the peripheral was necrosis area; HE staining showed: the center of the lesion was cavity like and dye-free,peripheral area was irregular red staining, the surrounding area was infiltrative inflammatory cells. Different power and time leaded to differences of the ablative effect and lesion size:the more power and time,the bigger of the ablative size. The ablative effect and lesion size was stable in 3 W 10 min and 5 W 6 min groups and caused the complete necrosis of the zone, there existed statistical differences among the two groups. Conclusions Laser ablation can cause fast, precise, effective and safe necrosis of the liver tissue, and the more power and time, the bigger of the ablative size.

and indexes of the ROI which had significant difference between the groups. Results In the white matter regions, MD, D∥and D⊥in many regions of AD group were increased significantly than the control group, and the differences were statistically significant. MD and D ⊥ showed more abnormalities, including the SCC, PCB, and FWM. Meanwhile, MK, K∥and K⊥in many regions of AD were decreased, and the differences were statistically significant. K ⊥ showed more abnormalities, including the SCC, FWM and TWM. In the gray matter regions, MD, D∥and D⊥of hippocampal of the AD group were all increased than the control group. However, it showed that MK and K⊥of the thalamus in AD group were 0.99 ± 0.10, 1.00 ± 0.11, respectively, and both increased than the control group (the value of MK and K⊥were 0.90±0.06, 0.90±0.07, respectively), and the differences were statistically significant (t values was 3.31, 3.57 respectively, and both P values were<0.01). The indexes of different ROI had correlations with the MMSE scores. There were more regions in kurtosis indexes correlated with the MMSE scores than the diffusion indexes. The strongest correlation among the analyses was MK of the SCC (r=0.73, P<0.05). Conclusions This study based on DKI found the complex alterations aroused by microstructural changes were not only in the white matter but also the gray matter of the AD patients, especially the increased kurtosis of the thalamus, and this suggested that the microstructural complexity of it was increased. Moreover, it also suggested that indexes of DKI had varied sensitivity in detecting different diffusion alterations.

Objective To evaluate the applications of magnetic resonance cholangiopancreatography (MRCP) after fat meal in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty cases of the preoperative donors for living liver transplantation were included and all had the corresponding intraoperative cholangiography (IOC) information. The MRCP of the donors for living liver transplantation was performed before and after fat meal (two fried eggs). The visualization and diameter of the secondary bile duct were analyzed before and after the fat meal. The results of the biliary branching pattern by MRCP after fat meal were compared with the corresponding IOC results. The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of MRCP after the fat meal in distinguishing normal and any type of variant biliary anatomy were calculated. Results In all cases,82% of the 50 cases in MRCP before the fat meal could meet the diagnosis needs of the preoperative evaluation,and 100% of the 50 cases in MRCP after the fat meal could meet the diagnosis needs. There was significant difference in the demonstration quality and diameter of the secondary bile duct in MRCP before and after the fat meal (P＜0. 05). MRCP showed accurate anatomy of the biliary system, using IOC as the reference standard, in 49(98%) subjects. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 98%,94. 7%, 100%, 10% and 96. 9%,respectively. Conclusion The MRCP after fat meal can clearly demonstrate the secondary bile duct and perfectly meet the needs of the preoperative evaluation of the living liver transplantation. The MRCP after fat meal and routine MRCP should be considered complementary to one another in order to avoid complications in living liver transplantation donors.

Objective:To explore an ideal method for establishing a mouse model of chronic atrophic gastritis (CAG).Methods:CAG mouse models were established with five different modeling methods ( N-methyl- N′-nitro- N-nitrosoguanide (MNNG), sodium salicylate, sodium deoxycholate, Helicobacter pylori infection, and combinations of them) in BALB/c and C57 mice. The effect of each modeling method was evaluated by histological observation of gastric mucosa, plasma biochemical parameters, inflammatory response score, and the expression of anti-inflammatory factors. Results:The results of histological observation of gastric mucosa showed that all of the 5 methods could successfully establish CAG mouse models. In BALB/c mice, compared with the healthy control group, significant features of CAG accompanied with intestinal metaplasia was found in the model group established by combination of MNNG-free drinking, 2% sodium salicylate and 20 mmol sodium deoxycholate. From the results of serological detection, compared with the normal control group, the mRNA expression levels of related anti-inflammatory factors interleukin-2, interleukin-10, interleukin-13 and growth differentiation factor-15 of each model group decreased, which indicated that the mice of each CAG model group had different degrees of inflammation. The results of plasma biochemical parameters indicated that plasma gastrin of each group decreased and the ratio of pepsinogen Ⅰ and pepsinogen Ⅱ significantly dropped. The above results demonstrated that in BLAB/c mice, MNNG-free drinking, 2% sodium salicylate and 20 mmol sodium deoxycholate was better than other four modeling methods. For C57 mice, it was also found that simple chemical drug mutagenesis and Helicobacter pylori replication method both could successfully establish CAG models. No matter from pathological observation, relative expression of anti-inflammatory factors and analysis of plasma biochemical parameters, the effects of combination of the two methods was better. Conclusion:The CAG mouse model established by MNNG-free drinking, 2% sodium salicylate and 20 mmol sodium deoxycholate can provide a certain reference for the establishment and application of mouse model in CAG experiments in the future for pharmacological research.

Objective To evaluate the influencing factors and early recovery quality in elderly patients with gastrointestinal tumor resection by the quality of recovery-40 questionnaire (QoR-40 questionnaire). Methods One hundred and forty- two elderly patients who had underwent gastrointestinal tumor resection from February to June 2017 were selected. The patients were over 65 years old. Their body mass index was (22.98 ± 3.20) kg/m2, and American Society of Anesthesilogists (ASA) wasⅡorⅢgrade. The patients were assessed with QoR-40 questionnaire on the first and second day after operation, and the factors affecting the total score of QoR-40 questionnaire on the first and second day after operation were analyzed. Results Compared with those on the first day after operation, the scores of emotional status, physical comfort, psychological support, physical independence, pain and total score of QoR-40 questionnaire on the second day after operation were significantly higher: 42 (39, 43) scores vs. 40 (38, 42) scores, 53 (52, 54) scores vs. 52 (50, 53) scores, 35 (35, 35) scores vs. 35 (34, 35) scores, 15 (13, 15) scores vs. 14 (12, 15) scores, 34 (33, 35) scores vs. 33 (32, 34) scores and 178 (173, 182) scores vs. 174 (169, 177) scores, and there were statistical differences (P<0.01). On the first day after operation, the total score of the QoR-40 questionnaire was related with the type of operation (P<0.05), and it was not related with age, sex and anesthesia (P>0.05);on the second day after operation, the total score of QoR-40 questionnaire was related with age and operation type (P<0.05), and it was not related with sex and anesthesia (P > 0.05). Conclusions The early postoperative period score of QoR-40 questionnaire in patients with colorectal tumor resection and age less than 70 years old is higher, and the recovery quality after operation is relatively good, suggesting that the operation type and age may be an important factor affecting the early recovery quality of the elderly patients with gastrointestinal tumor resection.

The root bark extract of Aralia taibaiensis is used traditionally for the treatment of diabetes mellitus in China. The total saponin extracted from Aralia Taibaiensis (sAT) has effective combined antihyperglycemic and hypolipidemic activities in experimental type 2 diabetic rats. However, the active compounds have not yet been fully investigated. In the present study, we examined effects of twelve triterpenoid saponins on AMP-activated protein kinase (AMPK) activation, and found that compound 28-O-β-D-glucopyranosyl ester (AT12) significantly increased phosphorylation of AMPK and Acetyl-CoA carboxylase (ACC). AT12 effectively decreased blood glucose, triglyceride (TG), free fatty acid (FFA) and low density lipoprotein-cholesterol (LDL-C) levels in the rat model of type 2 diabetes mellitus (T2DM). The mechanism by which AT12 activated AMPK was subsequently investigated. Intracellular ATP level and oxygen consumption were significantly reduced by AT12 treatment. The findings suggested AT12 was a novel AMPK activator, and could be useful for the treatment of metabolic diseases.
Acetyl-CoA Carboxylase ; Adenosine Triphosphate ; AMP-Activated Protein Kinases* ; Animals ; Aralia* ; Blood Glucose ; China ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Metabolic Diseases ; Models, Animal ; Oxygen Consumption ; Phosphorylation ; Rats ; Saponins ; Triglycerides

Objective:To explore the risk factors involved in gastritis, gastric intraepithelial neoplasia (GIN) and gastric cancer in Shihezi area.Methods:A total of 7 110 Han nationality patients who underwent gastroscopy at the First Affiliated Hospital of Shihezi University School of Medicine from January 2012 to December 2016 were selected as the research subjects. The data of patients were obtained through medical records and questionnaires. After excluding diseases related to esophagus and duodenum, a total of 4 429 cases were included in the retrospective analysis. Of which, 4 249 were gastritis, 93 were GIN, and 87 were gastric cancer. χ2 test, rank-sum test or Fisher exact probability method were used to analyze the differences of various factors in gastritis, GIN and gastric cancer. Univariate and multivariate logistic regression analysis were used to screen the risk factors for gastritis progression to GIN and gastric cancer. Results:χ2 test and rank sum test showed that there were statistically significant differences in gender, age, history of digestive diseases and distribution of Helicobacter pylori ( HP) infection among the groups of gastritis, GIN and gastric cancer ( P<0.05). The proportion of HP infection decreased gradually with the disease severity. Multivariate logistic regression analysis showed that male ( P<0.001, OR=2.251, 95% CI: 1.461-3.470), elderly ( P<0.001, OR=4.829, 95% CI: 2.241-10.409), a family history of gastric cancer ( P=0.002, OR=3.227, 95% CI: 1.537-6.774) and a history of digestive diseases ( P=0.034, OR=1.644, 95% CI: 1.037-2.607) were independent risk factors for gastritis progression to GIN. Male ( P<0.001, OR=3.254, 95% CI: 2.026-5.225), middle-aged ( P=0.022, OR=2.688, 95% CI: 1.153-6.265) and elderly ( P=0.002, OR=4.734, 95% CI: 1.750-12.807) were independent risk factors for gastritis progression to gastric cancer. In stratified analysis to exclude age and gender, smoking ( P=0.028, OR=4.060, 95% CI: 1.160-14.202) was found to be a risk factor for gastritis progression to GIN in young adults, and obesity ( P=0.032, OR=3.869, 95% CI: 1.121-13.356) was found to be a risk factor for gastritis progression to gastric cancer in women. Conclusion:The degree of HP infection in gastric tissues is negatively correlated with the severity of gastric diseases, suggesting that HP infection may be an early event inducing gastric cancer. Male, the elderly, people with a family history of gastric cancer and a history of digestive diseases, and young smokers in Shihezi are more likely to develop GIN, and male, middle-aged, elderly, and obese women are at increased risk of gastric cancer.