OBJECTIVE:To observe the curative effect of Xiaoer chiqiao qingre granule in treating child common cold fever (stagnant type).METHODS:A total of 118 cases with child common cold fever(stagnant type) were randomly assigned to receive Xiaoer chiqiao qingre granule (treatment group,n=60) or ribovirin tablet,Ertangganmao granule(control group,n=58) tid for 3 days.The antipyretic time, clinical effective rate, and improvement in clinical symptoms were compared between the two groups. RESULTS: There outcome indexes including the antipyretic time,the clinical effective rate,and the improvement in clinical symptoms in the treatment group was significnatly better than in the control group(P

Objective To investigate an X-ray total body irradiation (TBI) technique using anterior-posterior opposed fields with patients at the side-lying position,and to analyze the real-time in vivo dosimetry results.Methods The accelerator with 10 MV X-rays of Varian Trilogy was used for the TBI with the extended source to skin distance of 390 cm.The percent depth dose,off axis factors and absolute dose output were measured.The dose accuracy and homogeneity was monitored real-time using multichannel diode dosimeter for 10 patients.The monitored sites included forehead,mandible,suprasternal fossae,xiphoid,umbilicus,pelvis,middle of thigh,knee,middle of leg and ankle.The patients were irradiated at the side-lying position,with the prescription dose of 1 200 cGy/6 f during 3 days,the middle line dose rate of 5.0 cGy/min.Solid water was used for the compensation of the dose homogeneity.Results The off axis dose homogeneity was less than ± 5.0％ for the TBI geometry.The absolute dose output was 0.072 1 cGy/MU at the maximum dose point.The total body irradiation was finished smoothly for the 10 patients lying on side.The deviation of monitored total dose from the total prescription dose was within -4.9％ to 6.7％ for the 10 monitored sites.The monitored dose homogeneity was less than 5.0％.Conclusions The fractionated anterior-posterior opposed parallel TBI can be finished smoothly with patients side-lying.Accurate and homogenous dose distribution can be obtained using real-time dose monitoring and compensation with solid water.

Objective To analyze the patient-specific dosimetric verification results of 2010 intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans from different treatment sites,and provide a reference for improving the patient-specific dosimetric verification program.Methods A total of 2 010 (965 IMRT and 1 045 VMAT) patient-specific dosimetric verification results were reviewed for isocenter dose difference and percentage of pixels passing planar dose γ analysis.All plans were designed with Eclipse planning system and delivered with Trilogy linear accelerator from February 2012 to February 2016.The dosimetric verification was performed with MatriXX array together with Muhicube phantom.Point dose difference larger than ± 3％ and/or γ pass rate (3％/ 3 mm) less than 90％ was defined as plan failure.Additional analysis was conducted for trends in difference of pass rates with treatment site and delivery technique (IMRT vs.VMAT).Results The mean isocenter difference between measured and calculated doses was-0.3％ ± 2.4％ for 2 010 plans.The mean percentage of pixels passing the γ criteria was 97.9％ ± 3.4％.88.2％ and 96.7％ of plans passed the point and planar dose verification,respectively.The γ pass rate was different among the treatment sites (F =3.09,P ＜ 0.05).The pass rate of point and planar dose difference was different among the treatment sites(x2 =40.93,39.15,P ＜0.05).There was no difference between IMRT and VMAT plans for both point dose and planar dose evaluation (P ＞ 0.05).Conclusions Most of IMRT and VMAT plans passed the tolerance criteria of ±3％ and 90％ for point and planar dose verification with MatriXX together with Multicube phantom,respectively.Both point and planar dose verification results varied among treatment sites,whereas no significant difference was found between IMRT and VMAT.

Objective To observe the effect of Huoxue Jiedu Recipe(Herbal recipe for activating blood and removing toxins)on proliferation and cell cycle status of keratinocytes cultured in vitro in psoriasis.Methods Using the serum pharmacologic technique,the clean SD rats were adopted to make the Huoxue Jiedu Recipe medicated serum(high,moderate,low dose),Dexamethasone medicated serum,and blank serum,which were added into the keratinocytes culture system respectively.After incubated for 48 hours,the cell proliferation of keratinocytes was measured by MTT assay,and the cell cycle distribution estimated with flow cytometer(FCM).Results The different density of Huoxue Jiedu Recipe could all inhibit significantly the generation of COLO-16 keratinocyte line and change the distribution proportion of each phase in the cell division cycle.Conclusion Huoxue Jiedu Recipe treats psoriasis through inhibiting the proliferation of keratinocytes.

Objective:To study the neuroprotective effect of nobiletin on the symptoms of postoperative cognitive impairment (POCD) induced by sevoflurane inhalation.Methods:Twenty-four aged SD rats (12 female mice and 12 male mice) were divided into three groups randomly: control group ( n=8), surgery group ( n=8) and surgery + nobiletin group ( n=8), with 4 females and 4 males in each group.The rats in surgery group and surgery+ nobiletin group were given normal saline(0.1 ml/10 g, once a day) and nobiletin(100 mg/kg, once a day) intragastrically for 6 weeks.Then the rats were anesthetized by sevoflurane and treated by abdominal exploration surgery, and then continued gavage for 1 week.The rats in control group were given normal saline(0.1 ml/10 g, once a day) intragastrically for 7 weeks without anesthesia or surgery.Sevoflurane inhalation anesthesia and abbreviated laparotomy were not done for control group.Morris water maze and open field experiment were used to measure the memory and cognitive ability and the independent exploration ability respectively.The changes of α-band electroencephalogram (EEG) were recorded by multi-channel physiological signal acquisition and processing system.The concentration of S100β, a marker of neurological impairment was detected by ELISA.Western blot was used to detect the expression level of IBA-1 in microglia.SPSS 20.0 software was used to analyze the data. Results:There were no significant differences in Morris water maze, positioning cruise test and open field test among the groups before operation (all P>0.05). The differences were statistically significant among the groups 7 days after operation (all P<0.05). Compared with the control group (the escape latency, path length and cross platform times were ((20.37±1.11)s, (552.37±14.19)cm, (6.75±0.43)times respectively), the escape latency ((40.87±2.03)s) and path length ((1 258.62±19.53)cm) of rats in surgery group were significantly longer (both P<0.01), and the cross platform times ((2.12±0.33)times) significantly reduced ( P<0.01). The differences between surgery + nobiletin group ((22.37±1.11)s, (584.50±10.90)cm, (6.62±0.48)times) and control group were not significant (all P>0.05). The open field experiment showed that the movement distance, the crossed square number, and activity times in surgery group ((1.78±0.55) m, (4.75±0.50), (14.87±0.33) times) decreased significantly compared with those in control group ((3.73±0.07) m, (11.10±0.78), (51.12±0.78) times, all P<0.01). No significant difference was found between surgery + nobiletin group ((3.76±0.07)m, (10.75±0.66), (50.75±0.43)times) and control group(all P>0.05). Before anesthesia, there was no significant difference in the power ratio of α-band among the three groups ( P>0.05), but the differences during anesthesia and operation were significant ( F=72.58, 101.50, P<0.01). During anesthesia and operation, the power ratio of α-band in anesthesia and in surgery group (2.51±0.04, 2.14±0.03) were significantly lower (both P<0.01) than those in control group (3.49±0.03, 3.49±0.03), while there was no obvious changes (both P>0.05) in the surgery + nobiletin group (3.50±0.04, 3.51±0.04). There were significant differences in Bcl-2 protein expression and caspase 3/7 protein activity among the three groups ( F=5.21, 7.84, P<0.01). Compared with control group (1.00±0.02, 1 557.46±3.63), Bcl-2 of rats in the surgery group(0.40±0.05) were significantly lower and Caspase3/7 expression of surgery group (3 689.58±10.46) was significantly higher (both P<0.01), while the rats in the surgery + nobiletin group had no significant difference in both Bcl-2 level (1.03±0.06) and caspase 3/7 activities (1 805.28±6.17, both P>0.05). The difference of S100 β protein expression was significant among the three groups ( F=490.80, P<0.01). Compared with the control group ((0.18±0.01)μg/L), the concentration of S100β protein in the surgery group ((2.13±0.02)μg/L) decreased ( P<0.01), while there was no significant difference in the surgery + nobiletin group ((0.16±0.01) μg/L, P>0.05). The expression levels of IBA-1 protein ( F=10.83) and TNF-α, IL-1, IL-1β and IL-6 ( F=996.20, 221.40, 73.02, 174.13) were significantly different among the three groups (all P<0.01). The expression level of the neuroglial marker IBA-1 in the surgery group(1.36±0.02) was significantly higher than that in the control group (1.00±0.01, P<0.01), while the surgery + nobiletin group (1.03±0.01) had no significant different compared with control group ( P>0.05). The levels of inflammatory factors, including TNF-α, IL-1, IL-1β and IL-6, in the brain of rats treated with nobiletin ((49.06±3.63)pg/mg, (2.09±0.43)pg/mg, (16.27±0.80)pg/mg, (2.11±0.19)pg/mg) were significantly lower than those in the surgery group((145.10±6.46)pg/mg, (5.67±0.43)pg/mg, (27.88±3.43)pg/mg, (4.74±0.32)pg/mg, all P<0.01). Conclusion:Nobiletin can obviously alleviate POCD symptoms caused by sevoflurane inhalation anesthesia.

Objective This study aims to explore the application value of tuberculosis T lymphocytes enzyme-linked immune SPOT test (T-SPOT.TB) on early diagnosis of tuberculosis.Methods The TB infection in 189 inpatients suspected tuberculosis in pneumology department of Shaanxi Provincial People's Hospital was detected with T-SPOT.TB,fluorescence RQPCR,tuberculosis (TB-Ab)protein chip and PPD methods.Results The sensitivity of four methods was 91.54％ (119/130),73.85％(96/130),63.08％(82/130) and 57.69％ (75/130) respectively and the specificity of those was 89.83％ (53/59),86.44％(51/59),67.79％(40/59) and 66.10％(39/59),respectively.The sensitivity of T-SPOT.TB method was statistically higher than those of other three tests,respectively (P＜0.05).The specificity of T-SPOT.TB was significantly higher than those of TB-AB and PPD (P＜0.05),but there was no statistical difference between RQ-PCR and T-SPOT.TB (P＞0.05).The positive predictive values of T-SPOT.TB,fluorescent quantitative PCR,TB-Ab and PPD assays were 95.2％ (119/1250),92.3％ (96/104),81.2％ (82/101) and 78.9％ (75/95) respectively while the negative predictive values of those were 82.8％ (53/64),60％ (51/85),45.5％ (40/88) and 41.5％ (39/94),respectively.The false-positive rates (misdiagnosis rate) of four assays were 10.2％ (6/59),13.6％ (8/59),32.2％ (19/59) and 33.9％ (20/59) respectively and the false-negative rates (rates of missed diagnosis) of those were 8.5％ (11/130),26.2％ (34/130),36.9％ (48/130)and 42.3 ％ (55/130),respectively.The negative likelihood ratios of T SPOT.TB,fluorescent quantitative PCR,TB-Ab and PPD assays were 0.11,0.16,0.48 and 0.51 respectively,meanwhile the positive likelihood ratios of T-SPOT.TB,fluorescent quantitative PCR,TB-Ab andPPD assays were 9.0,5.4,2.0 and 1.7,respectively.What' s more,the diagnostic accordance rates of the four assays were 91.0％ (172 189),77.8％ (147 189).64.6％ (122/189) and 60.3％ (114/189),respectively.Conclusion T-SPOT.TB test is a more sensitive and specific method and of great significance to the early diagnosis of TB,which has more clinical value in different stages of tuberculosis diagnosis.

Objective To investigate the dosimetric effect of multi-leaf collimator (MLC)transmission on intensity-modulated radiation therapy (IMRT).Methods MLC transmission through theleaves and rounded ends were measured with ion chamber for Varian Trilogy linear accelerator with the X-ray of 6 MV and 10 MV.The intraleaf and interleaf transmission were also measured with the electronic portal imaging device of aS1000.10 tumor patients treated with IMRT were used to evaluate the MLC parameters modeling in the Eclipse treatment planning system.Results The average transmissions of Millennium MLC were 1.6％ and 1.8％ for 6 MV and 10 MV X-rays.The transmission increased with the field size and depth of measurement.The transmissions at off axis position were a little lower than those on the central axis.The intraleaf transmissions measured with aS1000 were 0.8％-1.2％ and 1.1％-1.6％,the interleaf transmission were 1.3％-1.9％ and 1.6％-2.5％ for 6 MV and 10 MV X-rays respectively.Modeling with the measured MLC parameters,the Eclipse treatment planning system could calculate the dose distribution accurately.The γ pass rate at 3％ 3 mm was above 95％,except for two patients with nasopharyngeal cancer with the pass rate of 93.6％ and 94.5％.Conclusions The transmissions through the MLC leaves and the leaf ends contribute to the dose throughout the target significantly for IMRT.MLC transmission varied with the field size,depth of measurement and off axis position.

Objective:To evaluate the six-degree setup errors of tumors of cervical vertebra, thoracic vertebra and lumbar vertebra by image guided radiotherapy. Methods:From May 2013 to June 2014, 30 patients with spinal malignant tumors(10 patients of cervical vertebra, thoracic vertebra and lumbar verte-bra respectively) were treated with Elekata Synergy accelerator(Elekta company,Sweden). Six-degree set up errors were corrected using HexaPODTM evoRT bed under image of on board cone beam computed tomography ( CBCT) guided. All the patients received kilovoltage CBCT before receiving radiotherapy and after correction. The acquired images were co-registered with planning CT with bone window. The data of 838 CT images were analyzed and the errors of translational directions X ( lateral ) , Y ( lngitudi-nal),Z(vertical)and rotational directions RX(pitch), RY(roll), RZ(yaw) were recorded. The data were compared by t-test using SPSS 13. 0. Results:The absolute translational setup errors in X, Y and Z axes of cervical vertebra before correction were (1. 71 ± 0. 10) mm, (1. 81 ± 0. 11) mm and (1. 94 ± 0. 09) mm respectively:(3. 17 ± 0. 19) mm, (4. 26 ± 0. 28) mm and (2. 18 ± 0. 12) mm for thoracic vertebra, and (2. 69 ± 0. 24) mm, (3. 33 ± 0. 26) mm and (2. 86 ± 0. 21) mm for lumbar vertebra. The residual setup errors in X, Y and Z axes of cervical vertebra were (0. 5 ± 2. 4) mm,(0. 01 ± 2. 4) mm and (2. 4 ± 1. 4) mm, respectively after correction;(1. 17 ± 0. 11) mm,(0. 26 ± 0. 30) mm and (0. 08 ± 0. 12) mm for thoracic vertebra and (1. 09 ± 0. 24) mm,(2. 03 ± 1. 26) mm and (0. 06 ± 0. 51) mm for lumbar vertebra. The t-test of paired data of set up errors before and after CBCT showed significant difference in three translational directions of cervical vertebra and thoracic vertebra, only Z (t= -3. 518,P<0. 001) for lumbar vertebra. The absolute rotational setup errors in RX,RY and RZ axes of cervical vertebra before correction were 0 . 67 ° ± 0 . 04 ° ,1 . 06 ° ± 0 . 06 ° and 0 . 78 ° ± 0 . 05 ° respec-tively. 0. 62° ± 0. 05°, 0. 75° ± 0. 06°, and 0. 84° ± 0. 06° for thoracic vertebra, 0. 59° ± 0. 06°, 0. 80° ± 0. 07°, and 0. 73° ± 0. 06°for lumbar vertebra. The rotational directions RX, RY and RZ axes of cervical vertebra were 0 . 27 ° ± 0 . 14 ° , 1 . 20 ° ± 0 . 04 ° and 0 . 28 ° ± 0 . 05 ° respectively;0 . 02 ° ± 0 . 20 ° , 0. 05° ± 0. 26°and 0. 64° ± 0. 16°for thoracic vertebra and 0. 09° ± 0. 26°, 0. 50° ± 0. 05°,and 0. 03° ± 0. 16°for lumbar vertebra. The t-test of paired data of set up errors before and after CBCT showed signifi-cant difference in three rotational directions of cervical vertebra and lumbar vertebra, only RY(t=7. 106, P<0. 001)for thoracic vertebra. All the patients acquired pain relief and there was no radiation-induced toxicity detected clinically during a median follow-up of 6 months. Conclusion:Six-degree set up errors of spine tumors were corrected effectively with HexaPODTM evoRT bed under CBCT image guided and its feasibility in day-to-day clinical practice has been demonstrated.

Objective To establish serum NGAL reference range of healthy populations in Xi'an Area.Methods 2 665 cases (aged 6 to 95 years old,male 1 370,female 1 295) of health-check people were collected from March 2014 to October 2016 in Medical Examination Center of Shaanxi Provincial People's Hospital,and 682 cases (aged 0 to 6 years old,male 356,female 326) were collected from preschool children of prevention.Serum NGAL concentration of them were analysed by immunoturbidimetry method with the Automatic Biochemical Analysis Assembly Line of Beckman-AU5800,and the detection data for statistical analysis.Then established the reference range of serum NGAL population of different age and different sex in Xi'an.Results The serum NGAL levels in healthy subjects showed a skewed distribution,which were preschool children under 6 years of age 37.66±23.12 ng/ml,6～15 years 39.25±25.34 ng/ml,16～49 years 46.68±27.06 ng/ml,and 50～ 69 years 57.82±29.13 ng/ml.Compared the first two with the latter,there was a significant difference (t=0.589,P＜ 0.05).The serum NGAL levels of over 70 years were 61.87 ± 32.64 ng/ml,and there was a significant difference between the ages of 15 and 49 and over 70 years (t=8.529,P＜0.01).At the same time,the serum NGAL was closely correlated with age (r=0.298,P＜0.01).But there was no significant difference in serum NGAL level between male and female (t=0.263～0.542,all P＞0.05).87ng/ml was the upper limit of the reference value for the age of 50 years.Conclusion The level of serum NGAL was related to age and increased with age,but not with gender.

Objective To explore the impact and protective mechanisms of head cooling on neural activity during passive hyperthermia.Methods Sixteen subjects were randomly exposed for 1 h to three different conditions: normal (25℃), hot (50℃) and head cooling (chamber:50℃,cold packs:5℃),after environment exposure, rs-fMRI were performed.Regional homogeneity(ReHo) datum at three different conditions were analyzed by REST2.0 to obtain brain areas with statistical difference.Brain voxel with statistical difference were selected as ROIs to ReHo values and were analyzed by One-Way ANOVA with SPSS18.0.Neural activity of brain areas with statistical difference were compared in any two groups by Post hoc.Results The brain regions showing differences among three groups included right orbital frontal cortex,left middle frontal gyrus,bilateral amygdala,left middle temporal gyrus,left hippocampus,bilateral parietal inferior, left precentral gyrus.Compared with normal group, ReHo increased in right orbital frontal cortex, and decreased in left precentral gyrus,left middle frontal gyrus,left parietal inferior,but no changed in bilateral amygdala,left middle temporal gyrus,left hippocampus,right parietal inferior in head cooling group.Compared with hot group,head cooling group showed increased ReHo in left middle temporal gyrus,left hippocampus,right parietal inferior,and decreased ReHo in bilateral amygdala,left parietal inferior,unchanged ReHo in right orbital frontal cortex, left precentral gyrus, left middle frontal gyrus.Conclusion The specified alterations of ReHo may reflect that the head cooling could partially eliminate the impact of passive hyperthermia, and is closely linked with emotional function.