Objective To analyze the effection of improved three-dimensional conformal radiotherapy (3D-CRT) to the dose of target area of local advanced non-small-cell lung cancer (NSCLC) and observe the therapeutic efficacy and toxity.Methods 81 patients with local advanced NSCLC were collected and treated.The diameter of tumor exceed 5 cm.52 patients were squamous carcinoma.24 patients were adencarcinoma.5 patients were adenosquamous carcinoma.63 patients were onstage of Ⅲ A,18 patients were Ⅲ B.The patients were randomized into two groups,the first group was unmodified planning of 3D-CRT group (T1 group,39 patients),the second group was modified planning of 3D-CRT group (T2 group,42 patients).The 31 patients of T1 group (79.5 ％) received radiotherapy and chemotherapy.Toties quoties was 2 Gy.The fractions were 26-30.The total dose was 52-60 Gy.The 31 patients of T1 group (73.8 ％) received radiotherapy and chemotherapy.Toties quoties was 2 Gy.The fractions were 30-35.The total dose was 60-70 Gy.Results The 1-,2-,3-year overall survive rates of T1 group were 56.4 ％,33.3 ％,28.4 ％,the 1-,2-,3-year local control survive rates were 38.4 ％,28.2 ％,20.5 ％,and the median survive time was 17 months.The 1-,2-,3-year overall survive rates of T2 group were 61.9 ％,35.7 ％,28.5 ％,the 1-,2-,3-year local control survive rates were 47.6 ％,40.4 ％,30.9 ％,and the median survive time was 19 months.The significant difference was found for the local control survive rates between T1 and T2 group (P ＜ 0.05).No significant difference was found for the overall survive rates and the median survive time between T1 and T2 group (P ＞ 0.05).Conclution Improved 3D-CRT can advance local control survive rate and living quality to local advanced NSCLC.Meanwhile,it also increases survive rate of 1-year,but can not increase long-time survival rate.

Objective To analyze the differentially expressed genes in peripheral blood of human immunodeficiency(HIV)/tubercle bacilli co-infected patients and explore the biological regulatory mechanism and network of key proteins,so as to provide new evidence for early diagnosis and clinical treatment of HIV/TB co-infected patients. Methods Microarray gene chip data of HIV/TB co-infected patients were downloaded from public databases GEO and imported into the analysis software GEO,STRING,PANTHER,and GenClip. The gene expression profiles,protein interaction networks,processes of molecular biology,and gene functions were analyzed. Results The expression profiles of 15 529 genes between the two groups of patients were similar,and gene expression profiles from 44 subjects were highly correlated. The 251 differentially expressed genes had good diagnostic capabilities in the differential diagnosis of HIV/TB infection. RPLP1 might be a key gene in the diagnosis of HIV/TB infection. The differentially expressed genes and positive regulators showed certain functions such as external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological and other relevant functionalities. Meanwhile,they may also be involved in free radical-related apoptosis,inflammation,and activation pathways. Conclusions A total of 251 differentially expressed genes are found to be able to distinguish simple HIV infection from HIV/TB infection. Protein-protein interaction network of top 40 differential expression genes includes RPLP1 gene,which is possibly associated with HIV/TB co-infection and may be involved in and the positive regulation of external stimuli,signal transduction pathways in cells,migration of neutrophils,and immunological functions. These findings may provide certain evidence for the diagnosis and treatment of HIV/TB infection.

With the development of modern imaging technologies,three-dimensional (3D) reconstruction techniques based on the computed tomography (CT) or magnetic resonance imaging (MRI) data has been gradually applied in clinical diagnosis and treatment of hepatobiliary diseases.In order to study the characteristics of the 3 D model of portal branches and collateral circulation in various types of portal hypertension,the data of 64-slice spiral CT scan of5 patients with portal hypertension were collected and imported to the abdominal medical image three-dimensional visualization system (MI-3DVS) for sequence segmenting and 3D reconstruction,and then the results of 3D models were compared with operation findings.The 3D models were vividly,visually and clearly displayed the portal system and the collateral circulation,which is helpful in the diagnosis and treatment of the portal hypertension.

Objective To analyze the data of influenza A(H1N1) viruses surveillance and genetic characteristics from Taian City during 2005-2008,so a scientific basis can be provided for the prevention and treatment of influenza.Methods The specimens from Influenza-Like Illness(ILI) were collected.The viruses were isolated with MDCK cell and identified with HAI and RT-PCR.The product of PCR were sequenced.Then the sequences were analyzed through biometric software.Results A total of 121 influenza strains were obtained from 615 specimens,and 4 of them were identified as A(H1N1) subtype.There were 3 strains mutated on several sites.Compared with strains isolated in 2005,there were 5 and 8 mutations in the amino acid sequences of virus strains isolated in 2007 and 2008 respectively.And there were a total of 22 amino acid mutations compared with A/Brisbane/59/2007(H1N1).Conclusions Influenza type A(H1N1) are detected in Taian City.There are several mutations in the amino acid sequences of virus strains isolated in Taian. The antigenic drift of virus strains is due to accumulation of amino acid substitutions

Objective: To explore the influence of heat and noise exposure on the risk of hypertension in workers,and to provide evidence for prevention of hypertension in occupational population. Methods: Cluster sampling method was used to recruit 2 130 steel workers from four factories（north iron-making,long steel,cold steel and power department）of some steel company. A cross-sectional study was conducted to collect physical examination results,heat and noise exposure. Logistic regression models were used to analyze the effects of noise,heat and their interaction on hypertension. Results: Totally 1 971 valid questionnaires were collected,and the response rate was 92.54%. There were 654 workers suffering from hypertension,with a prevalence rate of 33.18%. There were 1 006 workers exposed to noise,accounting for 51.04%;and 853 workers exposed to heat,accounting for 43.28%. The prevalence rates of hypertension in workers exposed to noise and heat were higher than those in workers without the above exposure（P<0.05）. The prevalence rates of hypertension increased with the increase of age and working years（P<0.05）. The results of multivariate logistic regression analysis showed that noise（OR=1.711,95%CI：1.380-2.121）,heat（OR=1.721,95%CI：1.394-2.125）were risk factors for hypertension;the interaction between noise and heat on hypertension was not statistically significant（P>0.05）,while the interaction between noise and age（OR=1.086,95%CI：1.057-1.115）,between heat and age（OR=1.087,95%CI：1.059-1.115）both increased the risk of hypertension. Conclusion Occupational exposure to heat and noise are risk factors for hypertension. These two occupational hazards also interact with age,which can increase the risk of hypertension in workers.

Objective:To investigate the relationship between KRAS gene mutation, programmed death receptor ligand 1 (PD-L1) expression and prognosis of first-line concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer.Methods:The clinical data of 50 patients with locally advanced non-small cell lung cancer who were admitted to Nanping First Hospital from January 2018 to December 2021 were retrospectively analyzed. All patients were treated with first-line concurrent chemoradiotherapy. Tissue samples of patients were obtained and paraffin embedded before treatment. Real-time fluorescence quantitative polymerase chain reaction was used to detect the type of KRAS gene mutation in tissues before treatment, and the expression of PD-L1 was determined by immunohistochemistry (the percentage of positive cells in tumor cells ≥1% was positive), and the relationship between KRAS gene status, PD-L1 expression and clinical characteristics and short-term efficacy of patients was analyzed. Patients were followed up for 1 year, and progression-free survival (PFS) curves were plotted by Kaplan-Meier method, and log-rank test was used for comparison. Univariate and multivariate Cox proportional hazards models were used to analyze the influencing factors of PFS.Results:Among the 50 patients, 11 (22.00%) were KRAS mutant, and 36 (72.00%) were PD-L1 positive. Among the 11 patients with KRAS mutation, there were 2 cases of codon 13 mutation and 9 cases of codon 12 mutation in exon 2. The objective response rate (ORR) and clinical control rate (DCR) were 76.00% (38/50) and 86.00% (43/50). There were no significant differences in patients' age, pathological type, TNM stage, ORR and DCR between KRAS mutant group and KRAS wild type group (all P > 0.05). The proportions of male patients [72.73% (8/11) vs. 38.46% (15/39)], patients with smoking history [90.91% (10/11) vs. 20.51% (8/39)] and patients with PD-L1 positive expression [100.00% (11/11) vs. 64.10% (25/39)] in KRAS mutant group were higher than those in KRAS wild type group (all P < 0.05). There were no significant differences in patients' age, pathological type, gender, smoking history, TNM stage, ORR and DCR between PD-L1 positive group and PD-L1 negative group (all P > 0.05). The median PFS time of patients in KRAS mutant group and wild type group was 8.75 and 11.32 months, and the difference in PFS between the two groups was statistically significant ( P = 0.039). The median PFS time of patients with PD-L1 positive and negative was 10.19 and 11.16 months, and there was no statistical significance in PFS between the two ( P = 0.116). Multivariate Cox regression analysis showed that KRAS gene mutation was an independent risk factor for PFS in patients with locally advanced NSCLC after first-line concurrent chemoradiotherapy ( HR = 1.449, 95% CI 1.071-1.196, P = 0.017). PD-L1 expression, smoking history and gender were not independent influencing factors for PFS (all P > 0.05). Conclusions:KRAS gene status is closely related to the prognosis of patients with locally advanced non-small cell lung cancer treated with first-line concurrent chemoradiotherapy, while PD-L1 expression is not.

OBJECTIVE: To study MSCT perfusion imaging of nasopharyngeal cancer and its differentiated diagnosis. METHOD: Thirty cases with nasopharyngeal cancer performed multi-detector CT perfusion examination. Among them, there were 6 cases of 25 post-radiotherapy patients performed perfusion imaging with CT scan. Nasopharynx perfusion parameters include blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS). RESULT: Compared with normal region of nasopharynx, BF, BV and PS in nasopharyngeal cancer increased significantly, while MTT has not significant difference between these two areas. CONCLUSION Nasopharynx perfusion parameters (BF, BV and PS) measured with CT were significantly altered in nasopharyngeal cancer. There was important appliance value in differentiated diagnosis of nasopharyngeal malignant neoplasms and evaluation of outcome of radiotherapy of nasopharyngeal cancer.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnostic imaging ; Perfusion ; Tomography, Spiral Computed ; methods

Objective To investigate the effect of nuclear factor erythroid-2-related factor 2(Nrf2) on the anti-hypoxia and anti-apoptotic ability of mesenchymal stem cells(MSCs). Methods Human embryonic kidney cells(293FT) were transfected with recombinant plasmid which overexpressed Nrf2 and helper plasmid. High-titer lentivirus which overexpressed Nrf2 were obtained. MSCs were transfected with lentivirus with Nrf2 overexpression and empty lentiviral vector to establish Nrf2-MSCs which stably overexpressed Nrf2 (Nrf2 overexpression group) and green fluorescent protein (GFP)-MSCs(control group). The expression of green fluorescent in 2 groups was observed by fluorescence microscope. The expression level of Nrf2 protein in 2 groups was measured by Western Blot. The anti-hypoxia ability of 2 groups was observed by light microscope. The anti-apoptotic ability of 2 groups was measured by flow cytometry. Results Nrf2-MSCs which stably overexpressed Nrf2 were successfully established. Western Blot analysis revealed that the expression level of Nrf2 protein in the Nrf2 overexpression group was significantly higher than that in the control group(P<0.01). After 15 h hypoxia treatment, the cell activity in the Nrf2 overexpression group was significantly higher than that in the control group. Flow cytometry showed that the apoptosis rate in the Nrf2 overexpression group was (30.9±1.4)%, significantly lower than (61.3±1.3)% in the control group(P<0.05). Conclusions Nrf2-MSCs which can stably overexpress Nrf2 possess certain anti-hypoxia and anti-apoptotic ability in hypoxia environment.

Objective Although aspirin resistance has been recognized to occur in patients with diabetes mellitus, the prevalence and related risk factors for aspirin resistance in elderly patients with diabetes mellitus have not been reported yet. The purpose of the present study was to evaluate the prevalence and potential risk factors for aspirin resistance in elderly patients with type 2 diabetes.Methods The 140 elderly patients [aged from 60 to 92 years, mean age (73.8±8. 0) years] with type 2 diabetes receiving daily aspirin therapy (≥ 75 mg) over one month were recruited. Platelet aggregation was measured by light transmittance aggregometry (LTA) and thrombelastograph (TEG)platelet mapping assay. Results By LTA, 6 patients (4.3%) of the diabetic patients were found to be resistant to aspirin therapy, 44 patients (31.4 %) were semi-responders. By TEG, 31 patients (22. 1%) were aspirin resistant. Among the 31 patients who were aspirin resistant by TEG, 3 were aspirin resistant by LTA. In the multivariate logistic regression analysis, female gender (OR= 5. 54,95%CI: 1.17-27.47, P=0.036) and homocysteine level (OR=1.15, 95%CI: 1.00-1.35, P=0. 043) were statistically significant risk factors for aspirin resistance by TEG. Conclusions The prevalence of aspirin resistance in elderly patients with type 2 diabetes is considerably higher in elderly female patients and in elderly patients with higher serum homocysteine level.

Objective To evaluate the clinical efficacy of application of hepatitis B surface antigen (HBsAg)-positive donor liver in adult liver transplantation. Methods Clinical efficacy of 28 recipients with liver diseases induced by virus B hepatitis (hepatitis B) undergoing liver transplantation using HBsAg-positive donor liver from July 2012 to October 2015 was retrospectively analyzed. Clinical prognosis and postoperative complications of the recipients were summarized. The changing features of serum levels of HBsAg and hepatitis B virus (HBV) DNA was investigated. Results After liver transplantation, 28 recipients were orally administered with entecavir to prevent the recurrence of hepatitis B. During perioperative period, 2 recipients died from sepsis and acute heart failure. During postoperative follow-up, 2 cases died from the recurrence of hepatocellular carcinoma (liver cancer). The remaining 24 patients were followed up for 12-26 months. Throughout the follow-up, 24 recipients were positive for serum HBsAg. After treatment, the titre of HBV DNA was significantly declined to <1×102 copies/mL at postoperative 12 months. No graft dysfunction induced by hepatitis B recurrence occurred in 24 recipients alive. Conclusions As a marginal donor liver, HBsAg-positive liver graft is safe for liver transplantation in the recipients with hepatitis B-related liver diseases. Postoperatively, anti-HBV treatment should be strengthened and intimate follow-up should be delivered.