Objective To measure and calculate the dose distribution (tissue absorbed dose) of mouth floor area while using 125I to treat sublingual gland carcinoma.Methods Phantom of head and neck was used to place the 125I radioactive seeds to simulate the sublingual gland carcinoma treatment.125I radioactive seeds of 29.6 and 25.9 MBq per seed were used as two groups,with 31 seeds in each group,and prescribed dose (peripheral matched dose) was 120 Gy.Thermoluminescence dosimetry (TLD) was used to measure the absorbed dose value in the simulated target and adjacent area.Gafchromic Eriochrome Black T (EBT) film was used to draw the dose distribution curve.Results Dose absorbed in the target area,target area center and the adjacent area one centimeter away from target reached 160 Gy,390-500 Gy,and 90-170 Gy,respectively.Dose of the skin ranged from 25 to 81 Gy,dose of mandible ranged from 7.9 to 67 Gy.No radiation cold spot was found.Conclusions 125I seeds could achieve an effective therapeutic dose distribution of the target area for sublingual gland carcinoma.Dose absorbed in the adjacent tissue is under safety limit.The radiation dose at mandible is lower,reducing the possibility of radiation damage to the bone.

Objective To cstimnate the diagnostic performance of computer tomography (CT) and magnetic resonance imaging (MRI) for detecting metastasis in pelvic lymph nodes with normal size in patients with bladder cancer.Methods hnaging of CT and MRI and clinical data of 118 patients who underwent radical cystectomy and pelvic lymphadenectomy were reviewed.The diagnostic efficacy of CT and MRI were analyzed when taking lymph nodes short axis diameter ≥0.3 cm and ≥ 1.0 cm respectively as diagnostic criterion of metastasis with corTelation of pathological results.Results 22.7％ (27/118) of patients were confirmed lymph nodes malignancies among 118 patients based on pathology.Totally 1 705 lymph nodes were detected in surgery and 119 of them were observed malignancy according to pathological presentation.The malignant nodes were mainly distributed in the perivesical (35.4％,41/119),internal iliac (12.6％,15/119),external iliac (30.3％,36/119),obturator region (21.0％,25/119) and presarcal region (1.7％,2/119).Imaging of CT and MRI showed that when taking nodes with ≥0.3 cm in maximum short-axis diameter (MSAD) as positive,the sensitivity (Se),specificity (Sp),and positive predictive values (PPV) were 16.0％,99.2％,54.2％ and 56.5％,99.2％,86.7％ respectively.While taking MSAD≥1.0 cm as malignant,the Se,Sp and PPV of CT and MRI were 6.2％,99.9％,83.3％ and 13％,100％,100％ respectively.When taking MSAD ≥0.3 cm as positive,the Se and PPV between CT and MR were statistically different(P ＜ 0.001 and P =0.036,respectively).When taking MSAD ≥ 1.0 cm as positive,there was no statistically difference (P =0.275 and 1.000,respectively).Conclusions The incidence of normal-sized lymph node metastasis was higher in patients with bladder cancer.At this phase the MRI evaluation was superior to that of CT.When the MSAD ≥ 1.0 cm,there was no significant difference between CT and MRI.

Background There remains some controversy over whether polypoidal choroidal vasculopathy (PCV) represents a subtype of neovascular age-related macular degeneration (nAMD).Anti-vascular endothelial growth factor (VEGF) therapies are important in the treatment of PCV and nAMD.It has been identified that VEGF-A was differentially spliced from exons 8 and formed two isoforms families:the pro-angiogenic VEGFxxx family and the anti-angiogenic VEGFxxxb family.However,the role of the two VEGF families in PCV and nAMD was still unclear.Objective This study was to measure the contents of pro-angiogenic VEGFxxx family and the anti-angiogenic VEGFxxxb family in aqueous humor of nAMD and PCV patients and explore their effect on nAMD and PCV.Methods Thirty-four nAMD patients and 26 PCV patients were enrolled in Peking University People's Hospital during March to December,2013,and 16 age-related cataract patients served as controls.The aqueous humor samples 0.1 ml was collected before the introvitreous injection of anti-VEGF drug.The contents of pro-angiogenic VEGFxxx family and the anti-angiogenic VEGFxxx b family in the aqueous humor were measured by enzyme-linked immunosorbent assay(ELISA).Results The concentrations of VEGF in the aqueous humor in the nAMD group,PCV group and control group were (4 210.00±998.40),(387.00±51.31) and (377.40 ±69.97)pg/ml,respectively,showing a significant difference among the three groups (F =12.851,P =0.000).The concentrations of VEGF165 b in the aqueous humor in the nAMD group,PCV group and control group were (205.50±12.59),(159.40±16.25) and (347.90±29.18) pg/ml,with a significant difference among them (F=23.752,P=0.000).Compared with the control group,VEGF content in the aqueous humor was elevated and the VEGF165b content was declined in the nAMD group,and VEGF165b was lowed in the PCV group,with significant differences between them(all at P=0.000).However,no significant difference was seen in the change of VEGF between the PCV group and the control group (P=0.992).The VEGF content in the aqueous humor was higher in the nAMD group than that in the PCV group (P =0.001),but VEGF165b content was insignificantly different (P =0.097).Conclusions The downregulation of VEGFxxx b may be associated with nAMD and PCV.The different role of VEGFxxx b in the development of PCV and nAMD needs to be verified in further studies.

Background How to control progression of myopia is a central issue in clinical optometry.Some clinical trials showed that wearing base-in (BI) prism can slow down progression of myopia to certain degree.However,whether BI prism or base-out (BO) prism should be used is worth discussing.Objective This study was to investigate the influences of different prisms on accommodative response and microfluctuation in emmetropias.Methods This clinical trail was approved by Ethic Committee of Peking University People's Hospital.During July in 2014,twenty-two emmetropias of 22 normal volunteers aged 21-27 years were recruited from Peking University People's Hospital under the written informed consent.An open-field infrared refractometer was used to monitor and record pupil diameter and accommodative response under three conditions including non-prism,3△ BI prism,and 3△ BO prism.The accommodative response value was calculated as the difference between reading value and-3.0 D,and root mean square (RMS) of accommodative response value served as amplitude of accommodative microfluctuation.Spectrum of accommodative response was analyzed by one dimension discrete Fourier transformation.The differences of accommodative response value,amplitude of accommodative microfluctuation and pupil diameter among three conditions were compared using repeated one-way ANOVA.Results The accommodative response values were (+0.31±0.78),(+0.51±0.75) and (+0.18±0.72) D under the non-prism,3△BI prism and 3△BO prismconditions,respectively,with a significant difference among them (F =28.078,P =0.000),and compared with the non-prism condition,the accommodative lag of 3△BI prism condition was increased and that of 3△BO prism condition was reduced (P =0.000,0.012).No significant difference was found in the amplitude of accommodative microfluctuation among the three conditions (F=0.062,P =0.879).The percentages of low frequency signal power (0-0.5 Hz)/total power (0-2.5 Hz) was 97.5％,98.3％ and 91.4％ under the non-prism,3△BI prism and 3△BO prism condition,respectively.The pupil diameter was (5.37-±0.69) mm under the 3 △ BI prism condition,which was larger than (5.07±0.66) mm under the non-prism condition and (5.01 ±0.69) mm under the 3△ BO prism condition (both at P =0.000).Conclusions Compared with wearing 3△ BI prism,wearing 3△ BO prism lessens the accommodative lag,decreases the pupil diameter and reduces the power of low frequency component in accommodative response.

Objective: To evaluate the value of clinical application of Heart of the City type TJH-03A remote electrocardiogram recorder (remote ECG). Methods: A total of 1 014 community residents from Wuhan received ECG examination by Heart of the City type TJH-03A remote ECG recorder. Clinical and ECG data of all subjects were collected and analyzed. Results: There were 359 (35.40%) cases with normal ECG and 655 (64.60%) cases with abnormal ECG, after remote ECG examination . There were 581 cases had a variety of arrhythmia in 655 cases with abnormal ECG, so there were 828 cases times with abnormal ECG, in which there were （1）320 cases times (38.65%) with repolarization abnormality,（2）98 cases times(11.84%) with sinus bradycardia, （3）98 cases times (11.84%)with myocardial ischemia,（4）78 cases times (9.42%)with conduction block,（5）56 cases times(6.76%) with ventricular hypertrophy and high voltage,（6）43 cases times(5.19%) with atrial premature beats（7）37 cases times (4.47%)with atrial fibrillation,（8）35 cases times (4.23%)with sinus tachycardia,（9）24 cases times (2.90%)with ventricular premature beats, （10）19 cases times (2.29%)with suspected myocardial infarction according to ECG abnormality rate order. In addition, there were 5 cases times with QT interval prolongation, and abnormal ECG with abnormality rate ≤3 cases times: atrial tachycardia, atrial flutter, supraventricular tachycardia, ventricular tachycardia, Brugada wave, dextrocardia. Conclusion: Heart of the City type TJH-03A remote electrocardiogram recorder is convenient to use, it can perform remote electrocardiogram record, and find a variety of arrhythmias. It’s important for ECG diagnosis, especially for diagnosis of arrhythmias.

Objective To investigate the role of nuclear factor erythroid 2-related factor 2 (Nrf2) / heme oxygenase-1 (HO-1) signaling pathway in reduction of acute kidney injury following orthotopic liver transplantation (OLT) by hydrogen-rich saline in rats.Methods Thirty-two healthy adult male SpragueDawley rats,weighing 220-250 g,were randomly assigned into 4 groups (n =8 each) using a random number table:sham operation group (S group),OLT group,hydrogen-rich saline group (HS group),and all-trans retinoic acid (ATRA) group.Laparotomy was performed,and the related blood vessels were isolated in group S.The model of orthotopic autologous liver transplantation was established in OLT,HS and ATRA groups.Normal saline and hydrogen-rich saline 6 ml/kg were injected through the inferior vena cava at 5 min before the portal vein was clamped in OLT and HS groups,respectively.In group ATRA,Nrf2 inhibitor ATRA 7 mg/kg was injected intraperitoneally once a day for 2 consecutive days,the model of orthotopic autologous liver transplantation was established at 16 h after the last injection of ATRA,and the other treatments were similar to those previously described in group HS.At 6 h of reperfusion,blood samples were collected for determination of serum blood urea nitrogen (BUN),creatinine (Cr),interleukin10 (1L-10) and tumor necrosis factor-alpha (TNF-α) concentrations.After blood sampling,the lungs were removed for determination of malondialdehyde (MDA) content,superoxide dismutase (SOD) activity,expression of HO-1,Bcl-2 and Bax mRNA (by using real-time reverse transcriptase polymerase chain reaction),and HO-1 protein expression in lung tissues (by Western blot) and for microscopic examination.The damage to the renal tubules was scored.Results Compared with group S,the serum BUN,Cr and TNF-α concentrations were significantly increased,the serum IL-10 concentrations were decreased,the MDA content and renal tubular damage score were increased,the SOD activity was decreased,and the expression of HO-1 protein and mRNA,and Bcl-2 and Bax mRNA was up-regulated in group OLT (P＜ 0.05).Compared with group OLT,the serum BUN,Cr and TNF-α concentrations were significantly decreased,the serum IL-10 concentrations were increased,the MDA content and renal tubular damage score were decreased,the SOD activity was increased,the expression of HO-1 protein and mRNA and Bcl-2 mR-NA was up-regulated,and the expression of Bax mRNA was down-regulated in group HS (P＜0.05).Compared with group HS,the serum BUN,Cr and TNF-α concentrations were significantly increased,the serum IL-10 concentrations were decreased,the MDA content and renal tubular damage score were increased,the SOD activity was decreased,the expression of HO-1 protein and mRNA and Bcl-2 mRNA was down-regulated,and the expression of Bax mRNA was up-regulated in group ATRA (P＜0.05).Conclusion The mechanism by which hydrogen-rich saline reduces acute kidney injury following OLT is probably associated with activation of Nrf2/HO-1 signaling pathway in rats.

Objective To evaluate the role of autophagy in hydrogen-induced inhibition of apoptosis in hippocampal neurons in a rat model of orthotopic liver transplantation (OLT).Methods Fifty-six pathogen-free healthy adult male Sprague-Dawley rats,aged 8-10 weeks,weighing 220-250 g,were used in the study.Thirty-two rats were selected and assigned into 4 groups (n =8 each) using a random number table:sham operation group (group S),OLT group,hydrogen-rich saline group (group HS) and chloroquine group (group CQ).The other 24 rats severed as the donors.In group S,laparotomy was performed,and the related blood vessels were isolated.The model of OLT was established in OLT,HS and CQ groups.In group OLT,normal saline 6 ml/kg was slowly injected via the inferior vena cava at 5 min before anhepatic phase.In group HS,hydrogen-rich saline 6 ml/kg was slowly injected via the inferior vena cava at 5 min before anhepatic phase.In group CQ,autophagy inhibitor chloroquine 60 mg/kg was injected intraperitoneally at 1 h before establishment of the model,and the other treatments were similar to those previously described in group HS.At 6 h of reperfusion,the rats were sacrificed and hippocampi were isolated for determination of malondialdehyde (MDA) content and superoxide dismutase (SOD) activity,for pathological examination (with light microscope),and for detection of cell apoptosis (by TUNEL staining) and expression of autophagy-and apoptosis-related proteins caspase-3,cytochrome c (Cyt c),microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p53 in hippocampal tissues (by Western blot analysis).Apoptosis index (AI) was calculated.Results Compared with group S,the MDA content and AI were significantly increased,the SOD activity was decreased,and the expression of caspase-3,Cyt c,LC3 Ⅱ,Beclin-1 and p53 was up-regulated in OLT,HS and CQ groups (P＜0.05).Compared with group OLT,the MDA content and AI were significantly decreased,the SOD activity was increased,the expression of caspase-3 and Cyt c was down-regulated,and the expression of LC3 Ⅱ,Beclin-1 and p53 was up-regulated in group HS (P＜0.05).Compared with group HS,the MDA content and AI were significantly increased,the SOD activity was decreased,and the expression of caspase-3 and Cyt c was up-regulated,and the expression of LC3 Ⅱ,Beclin-1 and p53 was down-regulated in group CQ (P＜0.05).Conclusion The mechanism by which hydrogen inhibits apoptosis in hippocampal neurons is related to promotion of autophagy in a rat model of OLT.

Objective To evaluate the treatment of malignant submandibular gland tumors with surgery combined with 125I radioactive implantation.Methods Thirty-two patients with malignant submandibular gland tumors were treated with surgery combined with 125I seed implantation from December 2005 to December 2012.All of the 32 patients with primary disease were treated by excision of the submandibular gland and neoplasm.None of the patients received wide excision or neck dissection without the evidence of the neck metastases.The planning targets was based on computerized tomography (CT)images,tumors site,extent and pathologic type.The matched peripheral dose (mPD) was 90-110 Gy.Recurrence-free survival (RFS),overall survival (OS) rates and side effects were retrospectively reviewed.Results Totally 32 patients received 1394 radioactive seeds implantation,radioactive seeds and dose distributed were well in all patients.All patients were followed for 15-126 months (mean of 64 months),with 5 recurrence,5 distant metastases,and 4 patients who died of disease.The 3-and 5-year RFS were 93.1％ and 87.9％,and OS rates were 93.3％ and 84.5％,respectively.No severe complications were observed during follow-up.Conclusions The excision of the neoplasm and the submandibular gland,combined with 125I seed implantation brachytherapy was an effective modality for the treatment of malignant submandibular gland tumors.

Objective: To investigate clinical features of distant metastases from malignant salivary gland carcinomas after treated by 125I internal brachy therapy alone.Methods: Between 2002 and 2010, 43 patients with locally advanced unresectable or recurrent malignant salivary gland carcinomas were treated by 125I internal brachy therapy alone at Peking University School and Hospital of Stomatology.All of them had been follow-up at least 2 years.The primary sites of malignant salivary gland carcinomas were the parotid for 12 patients, infratemporal fossa for 9 patients, tongue for 7 patients, maxilla for 6 patients, parapharyngeal for 4 patients, floor of months for 3 patients, submandibular gland for 1 patient, and lip for 1 patient.The overall survival rate, local control rate, and distant metastases were retrospectively reviewed.Results: Distant metastases occurred in 23 of the 43 patients (53.5%).Distant metastases developed from 5 to 96 months, with an average interval of (27.0±23.7) months from the time of initial diagnosis, the mean interval was 21 months.The commonest site of distant metastases overall was the lung 69.6%(16/23).The most common pathological types of distant metastases were adenoid cystic carcinoma (14/23, 60.9%) and nonspecific adenocarcinoma (7/23, 30.4%).At the time of the last follow-up, 26 patients died, and 18 of them due to distant metastases (69.2%, 18/26).In the study, 27 patients got complete remission(CR), 12 got partial remission(PR) more than 50%, 2 less than 50%, and 2 patients were invalid.The effective rate (CR+ PR) was 90.7%.The 3 year loco-regional control rate and survival rate were 60.1%, 82.6%, respectively, and the 5 year's 53.4% and 56.0%.Conclusion: The 125I brachy therapy is a feasible and effective modality for the treatment of locally advanced unresectable or recurrent malignant salivary gland carcinomas.However, further studies are needed with larger numbers of patients and for a longer follow-up assessment.Distant metastasis was the main cause of treatment failure, and the lung was the most common site of distant metastases.

Objective To evaluate the efficacy of 125Ⅰ brachytherapy alone for the treatment of recurrent parotid gland carcinoma.Methods Recurrent parotid gland carcinoma patients (n =24) treated by 125Ⅰ brachytherapy alone between 2006 and 2013 at Peking University Hospital of Stomatology were enrolled in this retrospective study.All patients underwent surgery or radiotherapy.The local control rate,survival rate,and side effects were evaluated.Results The median follow-up time was 21 months (range,4-59 months).Among the 24 patients,6 had local failure and 10 died during the follow-up period.The 1-and 3-year overall survival rates,progression-free survival rates,local control rates were 74.8％ and 39.3％,74.8％ and 31.5％,82.0％ and 69.4％,respectively.No grade 3 or over radiation injury was found.Conclusions 125Ⅰ seed brachytherapy alone could provide an ahernative treatment method for inoperable recurrent parotid gland carcinoma patients.