Objective To compare theγpassing rate between measurements at actual degree gantry angle and zero degree gantry angle for dose verification of intensity?modulated radiotherapy ( IMRT) in the treatment of nasopharyngeal carcinoma ( NPC) and cervical carcinoma. Methods Thirty patients with NPC and thirty patients with cervical carcinoma were randomly chosen from 87 patients with NPC and 54 patients with cervical carcinoma, respectively. Using a gamma criterion of 3 mm/3%, the γ passing rates at actual gantry angle and zero degree gantry angle were measured using ArcCHECK and compared by paired t test. Results The γ passing rate was significantly lower at actual gantry angle than at zero degree gantry angle in patients with NPC or cervical carcinoma ((93.8±3. 6)% vs. (97.8±1. 1)%, P=0. 00;(96.3±2. 1)% vs. (98.2±1. 0)%, P=0. 00). Moreover, the variation range of the γ passing rate at actual gantry angle was larger than that at zero degree gantry angle. Bothγpassing rates at actual gantry angle and zero degree gantry angle were lower in the patients with NPC than in the patients with cervical carcinoma . Conclusions Compared with that at zero degree gantry angle, theγpassing rate at actual gantry angle is closer to reality. Therefore, the actual gantry angle is recommended for dose verification. In order to meet the clinical requirement, a higher standard of γ passing rate should be proposed when zero degree gantry angle is used for dose verification.

Objective To explore the resistance and molecular mechanisms underlying the anticancer activity of daunorubicin in CD34 +acute myeloid leukemia(AML) cells. Methods CD34 +AML cell lines(KG1a and Kasu-mi-1)were used as objectives, and CD34 -AML cell line U937 was used as positive control. Western blot analysis was used to examine the protein expression of Bcl-2 and Bax in CD34 +AML and CD34 -AML cell lines incubated with/without daunorubicin to compare the sensitivity of CD34 +AML and CD34 -AML cells to daunorubicin. SiRNA against Bcl-2 was used in KG1a and Kasumi-1 cells and examined the effect on cell viability by MTT assay. Results Western blot analysis showed that Bcl-2 protein levels in CD34 +AML cells appeared to be significantly higher than in CD34 -AML cells. Western blot analysis showed that treatment with 0.4 μg/ml daunorubicin for 48 h caused down-regulation of Bcl-2 only in CD34 -AML cells,but not in CD34 +AML cells. Suppression of Bcl-2 with siRNA increased the susceptibility of KG1a and Kasumi-1 to daunorubicin. Conclusion CD34 +AML cell lines ex-press higher levels of Bcl-2 protein. Daunorubicin fails to down-regulate the high Bcl-2 protein levels in CD34 +AML cells. Suppression of Bcl-2 with siRNA increases the susceptibility of KG1a and Kasumi-1 to daunorubicin. The high Bcl-2 protein levels in CD34 +AML cells may be involved in the insensitivity to daunorubicin.

Objective: To establish a method for determination of paracetamol in Vc Yinqiao tablets (Vc, paracetamol, Flos lonicerae, Fructus Forsythies), etc. Methods: Diffuse Relectance FTIR was used to determinate paracetamol in the Vc Yinqiao tablets. Results: The content of paracetamol could be obtained directly, and the relationship between the absorbance and the concentration was linear. The average recovery of paracetamol was 98.40, and RSD was 3.18%. Conclusion: The method is simple, fast and reliable. It has been proved to be a good practice for determination of Vitamin C in the Vc Yinqiao Tablets.

Objective To study the feasibility and safety of limb remote ischemic preconditioning (RIPC) in infants and explore the protective effect on myecardium ischemia reperfusion injury for infants undergoing cardiac operation under cardiopulmonary bypass. Methods 60 infants weight less than 7 kilograms with ventricular septal defect were enrolled into the study. 30 of them (RIPC group) were ischemic preconditioned two times (24 hours and 1 hour preoperatively) by three cycles of iscbemia (5 minutes for each) and reperfusion on the left upper arm using a blood pressure cuff. Serum lactate dehydrogenase (LDH), creatine kinase (CK) and its isoenzyme (CK-MB), and tro-ponin I (TnI) ; malondialdehyde (MDA) and superoxide dismutase (SOD) was preoperatively detected. The expression of heat shock pro-tein 70 (HSP 70) in cardiomyocytes was determined by western blot analysis. The surgical outcome including limb movement and sensory function was also recorded. Results No limb disability or sensory disturbance or no other surgical complications was found in all infants. LDH, CK, TnI at the beginning of operation in RIPC group was higher than those in control group. After operation, leakage of heart enzymes were attenuated in RIPC group, and the serum concentration of enzymes were lower than those in the control group. The RIPC group had low coronary sinus venous concentration of MDA but high SOD. The expression of HSP70 was upregulated in cardiomyocytes of RIPC group. Conclusion The limb RIPC can be done easily and safety in infants, and BIPC can reduce the leakage of myocardial enzymes and upregu-late the expression of HSP, which possess protective effect on myocardial IRI.

Objective To study inhibitory effect of serine protease activity by Ulinastatin in vitro .Methods Different chromogenic peptides were designed and synthesized.Highly sensitive fluorescence detection was performed to optimize the concentration of each serine proteases and their chromogenic substrates.Multi-point method was used for the calculation of half maximal inhibitory concentration of Ulinastatin .ResuIts Ulinastain could inhibit Polymorphonuclear leukocyte elastase ( PMNE ) and plasmin with IC50 lower than 100 U/mL.For factor Xa, and Kallikrein, the IC50 of Ulinastatin was higher than 1000U/mL.No thrombin IC50 could be calculated at the present experiments.ConcIusion Similar to Ulinastatin injection from Japan, domestic Ulinastatin shows the strongest inhibitory effects on PMNE among those serine proteases.As important references, this study gives reliable data for dose range of domestic Ulinastatin in anti-inflammation, coagulation/anti-coagulation and anti-shock therapy.

Abstract： Objective　To establish a screening-diagnosis-evaluation system of neonatal congenital heart disease (CHD) suitable for Hainan Province based on the application of percutaneous blood oxygen saturation measurement and cardiac auscultation screening, and to provide a basis for further promotion of the evaluation effect. Methods　Screening agencies (all midwifery institutions) used the "double index method" to screen newborns for congenital heart disease. Those who were screened positive for any index were transferred to diagnostic institutions (the people's hospitals of all cities and counties and some tertiary hospitals) for echocardiography examination within 1 week. Those with abnormal results were transferred to the treatment institution (two tertiary hospitals) for reconfirmation and evaluation. All data were managed online. Results　In this study, 96 913 newborns born in midwifery institutions in 19 cities and counties were screened, with a response rate of 99.44%. The ratio of male infants (50 836) to female infants (46 077) was 1.10∶1. A total of 2 284 positive patients were screened by dual index method, and ultrasound diagnosis was performed, with the rate of cardiac ultrasonography of 98.07% (2 240/2 284) and a high response rate. A total of 238 cases of congenital heart disease were diagnosed (incidence rate of 0.25%), with the top three main types were ventricular septal defect, atrial septal defect, and patent ductus arteriosus. The sensitivity (88.24%) and Youden index (0.86) of dual-indicator screening for CHD detection were significantly higher than the other separate indicators. Through Kappa consistency test analysis, the consistency of dual-indicator screening with simple heart murmur screening results was excellent, with a Kappa coefficient value of 0.835 (>0.75); the consistency of dual-indicator screening and simple POX screening results was good, with a Kappa coefficient value of 0.429 (between 0.40-0.75), and the differences were statistically significant (P<0.001). By the end of the study, 136 children had undergone open-chest/occlusion surgery, with good postoperative recovery, and the rest were followed up. Conclusions　The neonatal CHD screening-diagnosis-assessment technology system established in this study, with close connections between various blocks, high screening response rate and echocardiography examination rate, is beneficial for the early diagnosis and treatment of CHD children, and has certain application value in institutions at all levels in Hainan Province, and is worth further promotion.

ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.

Objective: To compare the effects of different types of strength training on upper limbs’ body composition and maximum strength and bone density of male university students, so as to provide a reference for college students to choose reasonable resistance training methods. Methods: Forty-two male university students were randomly divided into three experimental groups: maximum-strength group, MS(n=12); speed-strength group, SS(n=15); strength-endurance group, SE(n=15). All subjects were subject to resistance training for 6 weeks, twice a week. Incremental load method was used to determine the maximum strength of the subject to develop a training program. Upper limbs’ Body Composition and BMD were performed by Dual energy X-ray absorptionmetry. Results: After the continuous training for 6 weeks, maximum strength of upper limbs increased significantly with training time，SE grows faster[(51.00±4.81)(67.20±5.66)(76.87±6.21)kg]; The body fat percentage of SS group and SE group decreased significantly[(13.50±4.10)%，(12.60±2.80)%；(13.70±3.80)%，(12.70±3.10)%](t=2.35，2.30，P<0.05), while LM of upper limb increased significantly[(5.19±0.59)(5.86±0.61)；(5.27±0.72)(6.21±0.59)kg](t=-2.48，-2.94，P<0.05). There was no significant difference in the body fat percentage and LM of upper limb between MS group[(14.0±3.3)%，(13.6±2.3)%] and SE group[(5.33±0.81)(5.41±0.79)kg](t=0.31，-0.22，P>0.05); BMC and BMD of upper limbs increased in all groups, but the increase of SS group and SE group was statistically significant(t=-3.07，-2.43，P<0.05). Conclusion Strength endurance resistance training for male college students can effectively promote muscle strength growth, increase bone density and improve upper limb composition.

Objective:To assess the efficacy of the newly constructed system for screening, managing and monitoring congenital heart disease (CHD) in neonates of Hainan Province, thus providing references for a further promotion.Methods:Clinical data of neonatal CHD in Hainan Province from January 1, 2019 to December 31, 2021 were retrospectively analyzed, including screening, diagnosis and treatment, prognosis and follow-up.Relying on Hainan Women and Children′s Medical Center as the leading unit, a neonatal CHD screening, diagnosis, treatment, and monitoring system was established.A dual-indicator method was adopted, that was, screening staffs in Hainan Province performed CHD screening in living neonates by cardiac auscultation and pulse oximetry (POX) within 6-72 h after birth.Echocardiographic examinations for the screened living neonates were performed in the 31 authorized diagnosis institutions.Evaluations, interventions and treatment of living neonates with CHD were performed in 6 authorized tertiary hospitals.Data of screening, diagnosis, evaluation and treatment were filled in, uploaded and managed online through the neonatal CHD screening information management system.The research team of our hospital was responsible for the data management and monitoring.Results:From January 1 st, 2019 to December 31 st, 2021, there were 329 387 living neonates in Hainan Province, and 321 447 (97.59%) were screened for CHD, and the annual screening rate increased year by year.The positive rate of CHD screening was 2.50%(8 032/321 447). The rate of cardiac ultrasound examination within 1 week of CHD positive screening was 94.66%(7 603/8 032). The referral rate of severe CHD was 100.00%(154/154). The overall prevalence of CHD in neonates of Hainan Province was 3.419‰ (1 099/321 447). Atrial septal defect was the most common CHD lesion, with a proportion of 38.40%(422/1 099). The sensitivity of cardiac auscultation, POX and their combination for CHD detection were 69.15%, 33.49% and 91.90%, respectively, and the specificity were 98.36%, 99.43% and 97.81%, respectively.At the initial screening, the ratio of dual-positive of cardiac auscultation and POX in neonates with severe CHD (serious and critical CHD) was significantly higher than that of a single positive indicator ( χ2=36.502, 46.214, respectively; all P<0.001). All neonates with CHD were evaluated.Fifteen neonates with severe CHD died.From 2019 to 2021, the standardized mortality rate of children aged 0-1 years with CHD in Hainan province was 4.67/100 000 (15/321 447). Conclusions:Dual-indicator screening for CHD (cardiac auscultation plus POX) is reliable, non-invasive, and simple, which is conducive to be clinically promoted.Introducing and promoting an appropriate technology for screening, diagnosis, and evaluation of neonatal CHD are extremely significant since they may have contributed to the timely diagnosis and treatment of CHD, especially severe CHD, thus lowering the mortality.

Objective:To investigate the clinical characteristics and therapeutic effect of adult primary hemophagocytic syndrome (HPS).Methods:The clinical data of a patient with primary HPS in the Third Affiliated Hospital of Southern Medical University in July 2017 were retrospectively analyzed, and the related literature was reviewed.Results:The patient was a 53-year-old female without history of basic disease, presenting as repeated high fever, with mutation of STXBP2 (FHL5), and was diagnosed as HPS according to hemophagocytic lymphohistiocytosis (HLH)-2004 criteria. The patient was treated with HLH-2004 regimen, and the efficacy was good. The patient was followed up until May 2021, and the overall survival time was 45 months.Conclusions:The atypical primary HPS and delayed primary HPS are rare, with mild clinical symptoms and only manifested by repeated high fever. Therefore, the gene mutations associated with HPS should be detected as soon as possible to confirm the diagnosis and to treat the disease early.