Objective To put forward reasonable and feasible recommendations against the procedure with relative high risk during the high dose rate (HDR) afterloading radiotherapy,so as to enhance its clinical application safety,through studying the human reliability in the process of carrying out the HDR afterloading radiotherapy.Methods Basic data were collected by on-site investigation and process analysis as well as expert evaluation.Failure mode,effect and criticality analysis (FMECA) employed to study the human reliability in the execution of HDR afierloading radiotherapy.Results The FMECA model of human reliability for HDR afterloading radiotherapy was established,through which 25 procedures with relative high risk index were found,accounting for 14.1％ of total 177 procedures.Conclusions FMECA method in human reliability study for HDR afterloading radiotherapy is feasible.The countermeasures are put forward to reduce the human error,so as to provide important basis for enhancing clinical application safety of HDR afterloading radiotherapy.

OBJECTIVE: To explore the characteristics of tongue color in patients with primary liver cancer (PLC). METHODS: Tongue color and its RGB value were analyzed quantitatively for PLC patients in different clinical periods and other cancer patients by analysis system for comprehensive information of tongue diagnosis. RESULTS: The rate of blue and purple tongue was higher (P<0.05) and all the values of RGB were lower (P<0.01) in PLC patients compared with other cancer patients. In different clinical periods, the rate of blue and purple tongue in stage III was the highest (P<0.05). CONCLUSION: The blue and purple tongue is one of the most important tongue characteristics of PLC patients.

OBJECTIVE: To find out some microscopically visible morphological differences in normal tongue manifestation between patients with primary liver cancer and healthy adults, and provide some beneficial evidences for microcosmic syndrome differentiation of tongue inspection. METHODS: Microcirculations of the tongue tip, which represented the macroscopical normal tongue manifestation, were observed under an optical microscope in patients with primary liver cancer and healthy adults. Exfoliated cells from tongue coating were examined by hematoxylin-eosin staining. RESULTS: The proportion of normal tongue manifestation was larger in healthy adults (38.89%) than that in patients with primary liver cancer (2.32%). The total score of microcirculation of tongue tip and the maturation index of exfoliated cells from tongue coating were both higher in patients with primary liver cancer than those in healthy adults with normal tongue manifestation (P<0.01, P<0.05). CONCLUSION: Normal tongue manifestation, which is macroscopically visible, can be observed in both patients with primary liver cancer and healthy adults, but there exists obvious difference in microcosmic view.

Objective To test our hypothesis that sensitivity to avian influenza A(H5N1)virus varies among mouse strain backgrounds, we compared the pathogenicity of H5N1 viral infection in 5 mouse strains. Methods Onehundred-fifty mice from 2 inbred strains(BALB/c and C57BL/6), and 3 outbred stocks(ICR, NIH Swiss, and KM Swiss)were used. Thirty mice of each strain were subjected to an infected group(20 mice), in which mice were inoculated with 0. 1 mL(104.875 TCID50)of A/Goose/Guangdong/NH/2003(H5N1)virus intra-nasally; ten control mice received noninfectious allantoic fluid. Clinical signs were assessed daily for 14 days post-infection. Necropsy was performed on mice that died during the experiment and those euthanized at end of study. Tissue samples were collected for viral isolation and pathological analysis. Results H5N1 virus infection can cause respiratory illness in all 5 strains with severe or minor acute respiratory distress symptoms, but with different mortality rates: 70% in BALB/c; 50% in ICR; 40% in NIH Swiss; 25% in C57BL/6; and 10% in KM Swiss mice. Necrotizing interstitial pneumonia was found in all cases of death. The virus was isolated from the lungs of all infected dead mice. Conclusion A/Goose/Guangdong/NH/2003 (H5N1)virus can infect all mouse strains used in this study, and can cause clinical symptoms and pathological changes similar to those found in humans infected with HSN1 viruses. However, the pathogenicity of H5N1 viral infection varies significantly between the different mouse strains. Thus, in future study of H5N1 virus infections the mouse strain most relevant to their particular research purpose should be selected as animal model.

Objective To study the cell immunity and eytokines responses to avian influenza A H5N1 virus infections in a BALB/c model to better understand the pathogenesis of H5N1 avian influenza disease. Methods Two hundred and twenty BALB/c mice of the infected group were inoculated with 0.1 ml (10-4.875 TCID50) of A/Goose/Guangdong/NH/2003 ( H5N1 ) virus intra-nasally. Fifty control mice received noninfectious allantoic fluid and another fifty control mice received normal sodium. Blood and spleen samples were collected from the live mice every 24 h during the 14 d post-infection. The changes of CD3 + T cells , CD4 + T cells, CD8 + T cells for cell immunity in blood circulation and spleen were detected by flow cytometry. And the cytokines and antibody responses in blood circulation were detected by ELISA. Necropsy was performed on mice that died during the experiment and those euthanized at end of study. Results Avian influenza A( H5N1) virus infections can make damages to the cell immune system transiently. The CD3 + T cells, CD4 + T cells, CDS + T cells declined at 24 days post infection in blood circulation and declined at 5-8 days in spleen, then recovered to the normal level gradually. The eytokines responses to the infections can be detected: the level of IFN-γ,TNF-α declined, IL-4, IL-18, IL-10 increased, and IL-2 changed little. The antibody increased rapidly from day 7 post infection until the end of the study (day 14 post infection). Conclusion Collectively, avian influenza A(H5N1) virus can cause cell immunity deficiency and an imbalance in the level of eytokines, which may contribute to the unusual severity of disease caused by the H5N1 avian influenza virus.

Objective To investigate the expression and clinical significance of microRNA-148a-3p(miR-148a-3p)in lung adenocarcinoma and analyze the effect and mechanism of miR-148a-3p on ra-diotherapy sensitivity of lung adenocarcinoma cells by targeting the protein core 1 β13-galactosyltrans-ferase 1(C1GALT1).Methods Seventy-six patients'tumor tissues from lung adenocarcinoma tissue microarrays and lung adenocarcinoma A549 cell line were selected for the study.The miR-148a-3p in situ hybridizations(ISH)and C1GALT1 immunohistochemical staining were performed on the tissue microarrays to analyze the correlations of miR-148a-3p expression with clinical pathology,prognosis and C1GALT1 expression in the tumor tissues of the 76 patients with lung adenocarcinoma.A549 cells were transfected with miR-148a-3p overexpression plasmid by using cell transfection technique;the clone formation assay was used to detect the sensitivity of the transfected cells for radiotherapy after re-ceiving 2 Gy radiotherapy;the protein expression level of cellular C1GALT1 was detected by western blot;the targeted regulatory relationship between miR-148a-3p and C1GALT1 was verified by dual-luciferase reporter gene experiment;the mechanism of miR-148a-3p regulating the sensitivity of A549 cells to radiotherapy was analyzed by co-transfection technique.Results Low expression of miR-148a-3p in 76 cases of lung adenocarcinoma tissues was significantly associated with lymph node metastasis(P=0.012);the prognosis of patients with high expression of miR-148a-3p was significantly better than that of patients with low expression of miR-148a-3p(P=0.005);there was a significant negative correlation between the expression of miR-148a-3p and C1GALT1 in lung adenocarcinoma tissues(P=0.023).Multivariate analysis showed that low expression of miR-148a-3p,T staging and lymph node metastasis were the independent risk factors for prognosis.Clone formation experiment showed that the number of clone formation in the miR-148a-3p overexpression group was significantly lower than that in the control group(P＜0.001);western blot result showed that overexpression of miR-148a-3p was able to significantly down-regulate the level of C1GALT1 protein in cells(P＜0.001).Dual luciferase reporter gene experiment showed that miR-148a-3p was able to regulate the expression of C1GALT1 by binding to the 3'UTR of C1GALT1.Functional rescue experiment showed that C1GALT1 could partially offset the radiosensitization effect of miR-148a-3p.Conclusion Low ex-pression of miR-148a-3p in lung adenocarcinoma is significantly associated with lymph node metasta-sis,high expression of C1GALT1 and poor prognosis,and miR-148a-3p can enhance the radiosensitiv-ity of lung adenocarcinoma cells by negatively regulating the expression of C1GALT1.

Objective To investigate the expression and clinical significance of microRNA-148a-3p(miR-148a-3p)in lung adenocarcinoma and analyze the effect and mechanism of miR-148a-3p on ra-diotherapy sensitivity of lung adenocarcinoma cells by targeting the protein core 1 β13-galactosyltrans-ferase 1(C1GALT1).Methods Seventy-six patients'tumor tissues from lung adenocarcinoma tissue microarrays and lung adenocarcinoma A549 cell line were selected for the study.The miR-148a-3p in situ hybridizations(ISH)and C1GALT1 immunohistochemical staining were performed on the tissue microarrays to analyze the correlations of miR-148a-3p expression with clinical pathology,prognosis and C1GALT1 expression in the tumor tissues of the 76 patients with lung adenocarcinoma.A549 cells were transfected with miR-148a-3p overexpression plasmid by using cell transfection technique;the clone formation assay was used to detect the sensitivity of the transfected cells for radiotherapy after re-ceiving 2 Gy radiotherapy;the protein expression level of cellular C1GALT1 was detected by western blot;the targeted regulatory relationship between miR-148a-3p and C1GALT1 was verified by dual-luciferase reporter gene experiment;the mechanism of miR-148a-3p regulating the sensitivity of A549 cells to radiotherapy was analyzed by co-transfection technique.Results Low expression of miR-148a-3p in 76 cases of lung adenocarcinoma tissues was significantly associated with lymph node metastasis(P=0.012);the prognosis of patients with high expression of miR-148a-3p was significantly better than that of patients with low expression of miR-148a-3p(P=0.005);there was a significant negative correlation between the expression of miR-148a-3p and C1GALT1 in lung adenocarcinoma tissues(P=0.023).Multivariate analysis showed that low expression of miR-148a-3p,T staging and lymph node metastasis were the independent risk factors for prognosis.Clone formation experiment showed that the number of clone formation in the miR-148a-3p overexpression group was significantly lower than that in the control group(P＜0.001);western blot result showed that overexpression of miR-148a-3p was able to significantly down-regulate the level of C1GALT1 protein in cells(P＜0.001).Dual luciferase reporter gene experiment showed that miR-148a-3p was able to regulate the expression of C1GALT1 by binding to the 3'UTR of C1GALT1.Functional rescue experiment showed that C1GALT1 could partially offset the radiosensitization effect of miR-148a-3p.Conclusion Low ex-pression of miR-148a-3p in lung adenocarcinoma is significantly associated with lymph node metasta-sis,high expression of C1GALT1 and poor prognosis,and miR-148a-3p can enhance the radiosensitiv-ity of lung adenocarcinoma cells by negatively regulating the expression of C1GALT1.

OBJECTIVETo explore the clinical experience of surgical treatment of primary malignant tumors of the trachea and main bronchus.

METHODSThe clinicopathological data of 18 patients with primary malignant tumors of the trachea and main bronchus surgically treated from February 1994 to August 2007 were reviewed retrospectively. The surgical management included sleeve tracheal resection in 8 cases, lower trachea and carina resection with carina reconstruction in 4 cases, local enucleation of the tumor in 4 cases, left or right carino-pneumonectomy and carina reconstruction in 2 cases, and resection of the tracheal or bronchial tumor and reconstruction of the airway under cardiopulmonary bypass in 6 cases.

RESULTSAmong the 18 cases, there were 7 adenoid cystic carcinomas, 9 squamous cell carcinomas, 1 lymphoepithelial-like carcinoma and 1 follicular non-Hodgkin lymphoma. All the cases recovered well except one who died of endotracheal bleeding and asphyxia at the 10(th) postoperative day.

CONCLUSIONSurgical resection is the most effective treatment for primary malignant tumors of the trachea and main bronchus. The selection of operation modes should be individualized according to patients' condition. Both complete resection and safety should be taken into consideration simultaneously.

Adult ; Aged ; Bronchial Neoplasms ; surgery ; Carcinoma, Adenoid Cystic ; surgery ; Carcinoma, Squamous Cell ; surgery ; Cardiopulmonary Bypass ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tracheal Neoplasms ; surgery ; Tracheotomy ; methods ; Young Adult

Objective: To compare the effect of galectin-3 (Gal-3), NT-proBNP and echocardiography paramerters on assessing cardiac function in patients with chronic heart failure (HF). Methods: A total of 144 patients treated in our hospital from 2016-03 to 2016-11 were enrolled. According to the NYHA classification, the patients were divided into 2 groups: HF group and Normal cardiac function group. n=72 in each group. Basic clinical information was collected, blood levels of Gal-3 and NT-proBNP were examined, echocardiography was conducted to measure left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD). Correlations between Gal-3, NT-proBNP and echocardiography parameters were studied, the abilities of Gal-3, NT-proBNP and echocardiography for estimating HF were compared. Results: Compared with Normal cardiac function group, HF group had increased blood levels of NT-proBNP [3499.5 (1431.3-9088.0) ng/L] vs [384.1 (122.1-1540.5) ng/L] and Gal-3 [3.0 (1.71-5.8) pg/ml] vs [1.9 (1.4-2.6) pg/ml], decreased LVEF [49.5% (42%-58%)] vs [62.5% (59%-67%)], enlarged LVEDD [52.0 (46.3-57.8) mm] vs [46.0 (42.0-49.0) mm] and elevated serum creatinine [113.6 (90.5-152.7) umol/L] vs 82.4 (69.1-97.4) umol/L], all P<0.05. Correlation analysis showed that NT-proBNP and Galectin-3 were positively related to LVEF and LVEDD; Gal-3 and NT-ProBNP had the strongest correlation (r=0.57, P<0.01). The AUC of ROC for Gal-3 was 0.674 (0.584-0.763), for NT-proBNP was 0.837 (0.771-0.902) and for LVEF was 0.806, (0.735-0.878) which implied that NT-proBNP was the most powerful parameter for estimating HF. Conclusion: Gal-3 had the ability to estimate HF and could be used as a biomarker, while its ability was lower than NT-proBNP in clinical practice.

OBJECTIVETo search for the best method for increasing clinical therapeutic effect on primary abnormality of sperm.

METHODSOne hundred and sixty-eight cases of infertility were randomly divided into a treatment group of 85 cases and a control group of 83 cases. The treatment group were treated with needle-picking at bilateral Shengzhi points, Dicong Shenjing points and L2 Shenjing points as main. The control group were treated with oral administration of Wuzi Yanzong Pills [symbol: see text]. Their therapeutic effects were observed in 3 hospitals.

RESULTSThe total effective rate of 83.5% and the pregnancy rate of the patient's wife of 78.8% in the treatment group, and corresponding figures were 54.2% and 43.4% in the control group, with a very significant difference between the two groups (P < 0.01); and reproductive hormones improved significantly after treatment in the two groups (P < 0.01); after treatment, superoxide dismulase (SOD) activity and Zn content in semen were elevated and cadmium level decreased significantly in the treatment group (P < 0.05).

CONCLUSIONNeedle picking therapy can significantly improve and regulate endocrine function, increase quality of semen and elevate pregnancy rate of the patient's wife for the patient of primary abnormal sperm.

Acupuncture Therapy ; Adult ; Female ; Humans ; Infertility, Male ; therapy ; Male ; Pregnancy ; Pregnancy Rate ; Sperm Count