Objective To compare patient organ doses and entrance surface dose conversion coefficients in conventional radiography using medical internal radiation dose (MIRD) phantom and voxel human phantom.Methods The voxel phantom was adapted to the Monte Carlo transport code to simulate the organ doses and entrance surface dose in five common projections, and thus the dose conversion coefficients between the entrance skin dose and organ dose were calculated.The results were compared with the reported mean values which were simulated using MIRD phantom.Results The dose conversion coefficients values of organs covered or partially covered by the X-ray field ranged from 0.149-0.650 in chest postero-anterior projection, 0.067-0.382 in chest left lateral projection, 0.023-0.374 in chest right lateral projection, 0.035-0.431 in abdominal antero-posterior projection, 0.083-0.432 in lumbar spine antero-posterior projection.In chest postero-anterior projection, significant differences were most obviously observed in lung, the dose conversion coefficients difference was 54.3％.In chest left lateral projection, the dose conversion coefficients difference of liver was greatest, which was 54.5％.In chest right lateral projection, the dose conversion coefficients differences of stomach wall was most obviously 63.8％.In abdominal antero-posterior projection, dose conversion coefficients discrepancy was most obviously observed in spleen, with the value of 65.0％;while in lumbar spine antero-posterior projection, the dose conversion coefficients differences of stomach wall was most obviously 43.7％.Conclusions Compared with the stylized MIRD phantoms, the anatomical realism in voxel phantom is evident.Therefore, the dose conversion coefficients calculated by voxel phantoms are more accurate and scientific in conventional radiology.

Objective To comprehensively evaluate the clinical effect of cryoballoon ablation (CBA) and radiofrequency ablation (RFA) in treating paroxysmal atrial fibrillation (PAF).Methods Computer retrieval of PubMed,EMbase,the Cochrane Library,Web of Knowledge,China national knowledge infrastructure (CNKI),Chinese Biomedical Medical Literature (CBM),China Wan Fang,China VIP,and other database to collect the randomized control trials (RCT) related to RFA and CBA treatment for PAF.The retrieval time was from the establishment of database to December 2015.The data extraction and methodological quality of the included studies were assessed by two reviewers independently.And meta-analysis was conducted by using RevMan 5.2 software.Results A total of 6 research papers (636 patients in total) were included.The results of meta-analysis showed that the incidence of phrenic nerve paralysis in CBA group was significantly higher than that in RFA group (RR=9.26,95％CI:2.17-39.63,P=0.003).No statistically significant differences in the operation time (MD=10.07,95％CI:-9.10-30.52,P=0.29),fluoroscopy time (MD=-0.18,95％CI:-8.14-7.77,P=0.96),12-month success rate (RR=0.91,95％CI:0.72-1.14,P=0.40) and the incidences of atrial tachycardia,atrial flutter,atrioventricular reentrant tachycardia existed between CBA group and RFA group (RR=0.47,95％CI:0.11-2.02,P=0.31).Conclusion For the treatment of PAF,no obvious differences in the operation time,fluoroscopy time,12-month success rate,and the incidences of atrial tachycardia,atrial flutter,atrioventricular reentrant tachycardia exist between CBA and conventional RFA,but CBA can increase the incidence of phrenic nerve paralysis.

Objective:To analyze the risk factors of first-episode hematogenous metastasis in patients with thoracic esophageal squamous cell carcinoma (ESCC) who received non-surgical treatment after radiotherapy and chemotherapy, and its impact on survival and prognosis.Methods:The clinical data of 230 ESCC patients who met the inclusion criteria and received radical radiotherapy in Tengzhou Central People′s Hospital and Affiliated Hospital of Xuzhou Medical University from January 2011 to October 2018 were retrospectively analyzed.Logistic regression analysis and survival were used to analyze the risk factors and prognosis of blood group metastasis after treatment.Results:In 230 patients with thoracic esophageal cancer, 70 cases (30.4%) developed hematogenous metastasis for the first time.Compared with patients without hematogenous metastasis, the median overall survival was 15 months and 20 months (χ 2=7.249, P=0.007), and the median progression free survival was 9 months and 13 months (95% CI was 7.2-10.8 months and 10.8-15.2 months, respectively χ 2=21.664, P<0.001). Logistic multivariate analysis showed that there was significant difference in the occurrence of hematogenous metastasis among different N stages (χ 2=30.764, P<0.001). N stage was an independent factor for judging hematogenous metastasis, and the increased N stage increased the risk of hematogenous metastasis (OR value were 6.000, 12.629 and 48.167, respectively; 95% CI were 1.712-21.025, 3.546-44.976 and 10.848-213.858, respectively; all P<0.05). The overall survival time of patients with concurrent chemoradiotherapy before hematogenous metastasis was longer than that of patients with sequential chemoradiotherapy and radiotherapy alone (χ 2=10.002, P=0.007). Stratified analysis showed that adjuvant chemotherapy after concurrent chemoradiotherapy could prolong the overall survival of patients with N2 and N3 (χ 2=11.025, P=0.001). Conclusion:N staging is an independent factor to judge the hematogenous metastasis.ESCC patients with hematogenous metastasis after chemoradiotherapy have poor prognosis.N2, N3 patients with concurrent chemoradiotherapy after adjuvant chemotherapy have clinical benefits.

Objective:To investigate the effects of epidermal growth factor (EGF)on cell cycle and cell cycle-related regulatory factors of human esophageal squamous cell carcinoma (ESCC) cell line Eca109.Methods: Serum starved Eca109 cells were treated with 20 ng/ml recombinant human EGF(rhEGF)for 24 h.The cell cycle phase distribution was detected by flow cytometry.The mRNA and protein expression levels of p21CIP1/WAF1(p21) and p27KIP1(p27) were detected by real-time quantitative reverse transcription polymerase chain reaction(qRT-PCR)and Western blot,respectively.Results: The proportions of G1 phase cells in EGF group and control group were ( 54.90 ±0.82 )% and ( 65.94 ±0.74 )%.The mRNA and protein expression levels of p 21 in EGF group was significantly higher ,and p27 was significantly lower than that in control group ( P<0.01 ) .Conclusion: EGF facilitates G1-S phase transition,and promotes the proliferation of Eca 109 cells,which may be associated with the up-regulation of p21 and down-regulation of p27.

Objective To investigate the site,MR signal types and morphological characteristics of ulnar nerve in cubital tunnel for healthy adults,in order to improve the awareness of ulnar nerve.Methods Unilateral elbow of forty healthy volunteers were scanned with MR,the sequences were as follows:T1-weighted-spin-echo,T2-weighted-spin-echo-fat-suppression,PD-weighted-spin-echo-fat-suppression,among 40,13 were supine,27 were prone.The site and MR signal types and morphological characteristics of ulnar nerve were observed,the long diameter and short diameter of the ulnar nerve on different axials were respectively measured.Results On axial,ulnar nerve was posterior to the medial condyle of the humerus at proximal elbow,lied between the flexor carpi ulnaris and the flexor digitorum profunds and superficialis muscles distally.The shape of the ulnar nerve was roundness or elliptic,the signal of 40 volunteers'(100％) ulnar nerve was isointensity on T1-weighted,the signal of 17 volunteers'(42.5％)ulnar nerve was isointense on T2-weighted or PD-weighted,the MRI signal of 23 volunteers' (57.5％) ulnar nerve was slight hyperintense on T2-weighted or PD-weighted,especially on the axial of medial condyle of humerus.The variation range of long diameter and short diameter of the ulnar nerve respectively were 1.4-3.8 mm,1.0-3.0 mm.Conclusion The certain location,MR signal types and morphological characteristics of normal ulnar nerve play an important role in the diagnosis of cubital tunnel syndrome.

Objective To study the association between neonatal asphyxia and blood glucose disorder. Methods A total of 134 cases of neonatal asphyxia born in the Maternal and Child Hospital of Hubei Province between January 2013 and January 2015 were included in this study. Blood glucose levels were determined within 30 min after birth and before glucose infusion. The infants were divided into the mild asphyxia group (Apgar score 4 to 7) and severe asphyxia group (Apgar score 0 to 3) according to the Apgar score at 5 min after birth. Statistical analyses were performed using the two-sample t-test and Chi-square test. Results The incidence of asphyxia was 3.2‰(134/41 875). Hypoglycemia was the main blood glucose disorder in the mild asphyxia group [12% (13/112)], and hyperglycemia was the main blood glucose disorder in the severe asphyxia group [32%(7/22)]. The average blood glucose level was higher in the severe asphyxia group than in the mild asphyxia group [(5.8±3.4) vs (5.0±2.3) mmol/L, t=21.979, P=0.001]. In the severe asphyxia group, the incidence of hypoglycemia was higher [18% (4/22) vs 12% (13/112), χ2=7.464, P=0.006] and the average blood glucose level was lower [(1.8±0.7) vs (2.1±0.4) mmol/L, t=5.247, P=0.042],and the incidence of hyperglycemia was also higher [32% (7/22) vs 9% (10/112), χ2=11.679, P=0.001] and the blood glucose level was higher [(11.6±3.8) vs (9.3±2.0) mmol/L, t=1.106, P=0.048]. Conclusion Neonatal asphyxia can lead to blood glucose disorders. The incidence and the severity of these disorders were higher in neonates with severe asphyxia.

Objective To investigate the MR characteristics of ulnar nerve and muscles in cubital tunnel syndrome.Methods Twenty eight patients with cubital tunnel syndrome and 28 asymptomatic volunteers underwent MR imaging,MR neurography was performed by using an isotropic three dimensions T2 sampling perfection with application optimized contrasts using different flip angle evolutions (3D T2 SPACE)on 15 patients with cubital tunnel syndrome.To evaluate changes in T2 signal intensity of the ulnar nerve,regions of interest were placed in the center of the location of the highest apparent ulnar nerve signal intensity on the axial FS T2WI images and in normal muscle within the same image slice,and the ratio of signal intensity was calculated.The sensitivity of 3D T2 SPACE sequence in detecting cubital tunnel syndrome was determined.The standard t tests were used to assess whether ulnar nerve size and relative signal intensity in symptomatic patients were statistically different from normal volunteers.Results The cross-sectional area of ulnar nerve in 24 patients and 2 volunteers was enlarged,the signal intensity of ulnar nerve in 26 patients and 16 volunteers was increased.Increased signal and muscle atrophy adjacent to the ulnar nerve were detected in 4 patients.Cubital tunnel syndrome was detected in 14 patientson 3D T2 SPACE sequence.The mean ulnar nerve sizes in the symptomatic and normal group were (0.15±0.06)and (0.06±0.01)cm2 respectively,the mean relative signal intensities in the symptomatic and normal groups were (2.86± 1.45) and 1.57±0.39 respectively (t values were 2.220 and 4.546,P＜0.05).Conclusions Ulnar nerve size and T2 signal intensity were increased,in patients with cubital tunnel syndrome.In addition,muscles innervated by the ulnar nerve showed atrophy with increased T2 signal intensity.

Objective To explore the relationship between infant feeding practices and infants growth,especially the weight gain for length in the first 6 months of life. Methods Two-hundred healthy full-term singlet normal birth weight 5 - 6 months old infants and their main care givers were recruited in Kongjiang community health service center in Shanghai. The questionnaires included infants feeding pattern, feeding environment and care givers feeding behaviors, and were completed on-site by investigators. The birth weight was obtained. The weight and length of infants at 6 months were measured. Results There were 70/200 (35.0%) infants overweight (BMI for age Z score>+1) at 6 months. There were more overweight boys than girls (40.0% vs. 30.9%, x2 = 1.798, P = 0.180). Compared with normal weight infants, the overweight infants had same birth weight (3.30 ± 0.35 kg vs. 3.35 ± 0.32 kg, t =1.010, P = 0.314) and same length at 6 months (67.64 ± 2.10 cm vs. 67.91 ± 1.97 cm, t=- 0.896, P = 0.371). However, the overweight infants gained much more weight for length in the first six months of life. At 6 months, the weight and BMI of overweight infants was significantly higher than that of normal weight infants (9.16 ± 0.67 vs. 7.94 ±0.64, t = 12.324, P < 0.01;19.86 ± 1.24 vs. 17.41 ± 0.80, t = 14.953, P < 0.01). The rates of exclusive breastfeeding for at least four months, continued breastfeeding at six months, complementary food consistency, and complementary feeding frequency, were not significantly differenct between overweight and normal weight infants (x2 =0.723 - 2.701, P > 0.05). The grandparents played an important role in infants feeding in Shanghai. There were 39.0% infants fed only by grandparents, and 23.0% infants fed jointly by grandparents and parents (x2 = 0.175, P > 0.05).The care givers' educational level and knowledge of feeding skill were similar in overweight and normal weight infants (x2 = 0.446, t = 0.949, P > 0.05). However, the overweight infants were fed more quickly than normal weight infants (Z = 2.753, P < 0.01), and there was less language communication between care givers and overweight infants during feeding (Z = 2.932, P < 0.01). In overweight infants, the overfeeding behaviors of care givers were positively correlated with BAZ (r = 0.281, P < 0.05). Conclusions Overweight in early life is associated with some particular infants feeding behaviors of care givers in Shanghai. The long term effect of more rapid weight gain for length in the first 6 months of life on the risk of childhood obesity warranted to be further followed and researched.

CMTM family is silenced and down-regulated in several kinds of tumors.Its aberrant expression has a strong association with the development,progression and metastasis of tumors.Thus,CMTM family is potential tumor suppressor genes.Epigenetics mechanism is the essential mechanism of the aberrant expression in this gene family.The discovery of this research gives a new direction to the clinical treatment of tumor.

Objective To explore the requirement of on-site first-aid knowledge of sever hand in workers,and evaluate the corresponding training effect.Methods Through the questionnaire survey in 120 workers,making the sever hand on-site first-aid knowledge courseware,during the one-year training,we sent two teachers to give lectures,provided tools for workers to practice every week.At the end of training,we examined workers through the written and practical examination and made the statistical analysis.Results 97.5％ workers presented training needs,54.2％ workers had mastered sever hand onsite first-aid knowledge compared with that before training.Conclusions Workers have higher rates of accidents,however,there is lack of knowledge of first aid in general,and they have training requirement.We take the form of participative training and give the workers both theoretical and technique training,and this can effectively improve the awareness rate of on-site sever hand first-aid knowledge and technique.