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.

Cross-Sectional Studies ; Dust ; Humans ; Occupational Exposure ; adverse effects ; Pneumoconiosis ; epidemiology ; Prevalence

Atherosclerosis (As) is an important pathological basis of cardiovascular and cerebrovascular diseases. The pathogenesis studies of As have been a hot topic in the field of vascular biology research. The inflammation is known as a major participant in the development process of As. And monocyte-macrophage plays a central role in inflam-mation. In recent years, with the deepening research on inflammatory mechanisms, the As macrophage polarization is attracting researchers' attention. Under different environmental inductions, macrophages develop into M1 and M2 phenotypes. M1 macrophages (classical type), which can stimulate the secretion of pro-inflammatory cytokines, is generally considered as pro-inflammatory subtypes and can facilitate the progress of As. Whereas, M2 macrophages (alternative type), which can inhibit pro-inflammatory factor production, function as anti-inflammatory subtypes and likely to inhibit the progression of As. The mechanisms of As, macrophage polarization in As, and opportunities for herbal medicines will be summarized in this review.

Objective:To investigate the effect of six degree of freedom (6-DOF) bed combined with cone beam computed tomography (CBCT) in the on-line correction of setup errors in patients with primary rectal cancer.Methods:The clinicopathological data of 17 patients with primary rectal cancer in Department of Radiotherapy, Third Hospital of Peking University from July 2013 to January 2014 were collected. There were 14 males and 3 females, a median age of 65 years. The difference of CBCT and 6-DOF bed combined with CBCT online correction of patients with positioning error were retrospectively analyzed.Results:Before position correction, the first CBCT verification of setup errors in the three translation directions including X (left and right), Y (in and out) and Z (up and down) directions were (0.06±0.25) cm, (0.13±0.40) cm and (-0.28±0.31) cm, respectively. The setup errors of RX (rotation pitch), RY(rolling) and RZ (left and right rotation) directions were (0.62±1.15)°, (-0.19±0.99)°, and (-0.34 ± 0.84)°, respectively . After correction of IGRT combined with six freedom of bed, the setup errors of translation X, Y and Z were (0.01±0.09) cm, (-0.01±0.05) cm and (-0.03±0.08) cm, respectively, and the setup errors of rotation RX, RY and RZ directions were (-0.16±0.40)°, (0.36±0.31)°and (-0.01±0.25)°, respectively. There were significant differences in translation direction (X, Y and Z direction) and rotation direction (Rx, RY and RZ) before and after 6-DOF bed combined with CBCT correction (all P<0.05). In the translation direction, the higher frequency range of Z-direction error value was 0.20-0.79 cm. In the rotation direction, the frequency range of error in Rx direction was 0.20°-2.99°. There was no significant difference between bone mode and gray scale model registration ( P>0.05). With the progress of radiotherapy, the setup errors of X, Z, Rx, RY and RZ directions increased except Y direction. Conclusions:In radiotherapy, six freedom bed combined with CBCT is helpful to correct the setup errors of patients with primary rectal cancer. Six freedom bed may be used to correct the setup errors of patients with primary rectal cancer online. Image-guided radiation therapy (IGRT) is recommended for bone pattern registration in patients with rectal cancer.

Objective:To investigate the effect of six degree of freedom (6-DOF) bed combined with cone beam computed tomography (CBCT) in the on-line correction of setup errors in patients with primary rectal cancer.Methods:The clinicopathological data of 17 patients with primary rectal cancer in Department of Radiotherapy, Third Hospital of Peking University from July 2013 to January 2014 were collected. There were 14 males and 3 females, a median age of 65 years. The difference of CBCT and 6-DOF bed combined with CBCT online correction of patients with positioning error were retrospectively analyzed.Results:Before position correction, the first CBCT verification of setup errors in the three translation directions including X (left and right), Y (in and out) and Z (up and down) directions were (0.06±0.25) cm, (0.13±0.40) cm and (-0.28±0.31) cm, respectively. The setup errors of RX (rotation pitch), RY(rolling) and RZ (left and right rotation) directions were (0.62±1.15)°, (-0.19±0.99)°, and (-0.34 ± 0.84)°, respectively . After correction of IGRT combined with six freedom of bed, the setup errors of translation X, Y and Z were (0.01±0.09) cm, (-0.01±0.05) cm and (-0.03±0.08) cm, respectively, and the setup errors of rotation RX, RY and RZ directions were (-0.16±0.40)°, (0.36±0.31)°and (-0.01±0.25)°, respectively. There were significant differences in translation direction (X, Y and Z direction) and rotation direction (Rx, RY and RZ) before and after 6-DOF bed combined with CBCT correction (all P<0.05). In the translation direction, the higher frequency range of Z-direction error value was 0.20-0.79 cm. In the rotation direction, the frequency range of error in Rx direction was 0.20°-2.99°. There was no significant difference between bone mode and gray scale model registration ( P>0.05). With the progress of radiotherapy, the setup errors of X, Z, Rx, RY and RZ directions increased except Y direction. Conclusions:In radiotherapy, six freedom bed combined with CBCT is helpful to correct the setup errors of patients with primary rectal cancer. Six freedom bed may be used to correct the setup errors of patients with primary rectal cancer online. Image-guided radiation therapy (IGRT) is recommended for bone pattern registration in patients with rectal cancer.

OBJECTIVETo establish a systematic method for isolation and identification of aerobic and facultative anaerobic bacteria in the oral cavity.

METHODSSamples of the saliva, dental plaque and periapical granulation tissue were collected from 20 subjects with healthy oral condition and from 8 patients with different oral diseases. The bacteria in the samples were identified by morphological identification, VITEK automatic microorganism identification and 16s rRNA gene sequencing.

RESULTSVITEK automatic microorganism identification and 16s rRNA gene sequencing showed an agreement rate of 22.39% in identifying the bacteria in the samples. We identified altogether 63 bacterial genus (175 species), among which Streptococcus, Actinomyces and Staphylococcus were the most common bacterial genus, and Streptococcus anginosus, Actinomyces oris, Streptococcus mutans and Streptococcus mitis were the most common species. Streptococcus anginosus was commonly found in patients with chronic periapical periodontitis. Streptococcus intermedius and Staphylococcus aureus were common in patients with radiation caries, and in patients with rampant caries, Streptococcus mutans was found at considerably higher rate than other species.

CONCLUSIONAerobic and facultative anaerobic bacteria are commonly found in the oral cavity, and most of them are gram-positive. 16s rRNA gene sequencing is more accurate than VITEK automatic microorganism identification in identifying the bacteria.

Actinomyces ; isolation & purification ; Dental Caries ; Dental Plaque ; microbiology ; Humans ; Mouth ; microbiology ; RNA, Ribosomal, 16S ; genetics ; Saliva ; microbiology ; Staphylococcus aureus ; isolation & purification ; Streptococcus ; isolation & purification

Objective To investigate the short-and mid-term prognosis and its influencing factors of Kasai portoenterostomy for type Ⅲ biliary atresia.Methods 220 infants with type Ⅲ biliary atresia who underwent Kasai surgery at Capital Pediatric Institution from Jan 2014 to June 2017 were retrospectively reviewed.There were 88 males and 132 females,with an average age at operation (60 ±23) d.The followup time ranged from 12 to 53 months.Results The survival rate with native liver (SNL) at 1,2,and 3 years after Kasai operation were 65％,59.6％,and 57.0％,respectively.The clearance rate of jaundice within 3 months after Kasai was 50.5％;3-year SNL of infants whose jaundice disappeared or did not after operation were 86.8％ and 27.1％ (P ＜ 0.05).The overall incidence of cholangitis was 60％.The clearance rate of jaundice in children with or without cholangitis was 55.3％ and 43.2％,while the 3-year SNL were 62.4％ and 49.6％,respectively (P ＞ 0.05).Conclusion The 3-year survival rate on their native liver after Kasai operation in infants with type Ⅲ biliary atresia can reach up to 57％.The clearance of jaundice within 3 months post-operation is the main factor affecting prognosis.The age at surgery and the occurrence of cholangitis do not affect the survival rate of native liver in the short-and mid-term prognosis.

AIM: To observe the effect of PCSK9 inhibitors on blood lipid levels and common inflammatory factors in patients with coronary heart disease. METHODS: The clinical data of 201 patients with coronary heart disease who were admitted to the Department of Cardiology of Shanghai East Hospital from April 2020 to June 2021 were retrospectively analyzed. The patients were divided into PCSK9 inhibitor treatment group (101 cases: statin + PCSK9 inhibitor) and control group (100 cases: statin treatment only) according to their medication status. Blood lipids, blood routine, CRP and FIB were re-examined after 1 month of treatment. The changes of blood lipids and inflammatory factors before and after treatment were compared. RESULTS: Before treatment, there was no significant difference in blood lipids, blood routine, CRP and FIB between the two groups (P> 0.05). The levels of sdLDL and Lp(a) were significantly decreased (P< 0.05); the levels of WBC, CRP, N and FIB were significantly decreased (P< 0.05). Compared with the control group, the levels of TC, HDL, LDL-C, CRP and FIB in the PCSK9 inhibitor group were significantly changed (P< 0.05), and the results were statistically significant. CONCLUSION: PCSK9 inhibitors can not only reduce LDL-C levels, but also reduce Lp(a) levels. PCSK9 inhibitors can reduce CRP and FIB levels, suggesting that it can partially improve inflammation in peripheral blood in patients with coronary heart disease.

Objective:To explore the radiological protection measures for yttrium-90 ( 90Y)-loaded resin microsphere therapy in clinical application. Methods:The surgical operation process for 90Y-loaded resin microsphere therapy was simulated, involving measurement of ambient dose equivalent rates at various stages: preoperative preparation (dominated by drug package), drug transfer, intraoperative procedures (drug operation and injection), and postoperative care and observation within the hospital. Based on the simulation, the protection measures in clinical application were analyzed. Results:The dose equivalent rate ranged from 0.12 to 0.42 μSv/h around the active chamber and from 1.04 to 3.32 μSv/h in the fume hood. Around the digital subtraction angiography (DSA) room, the maximum dose equivalent rate was 0.78 μSv/h when 90Y and DSA were applied simultaneously and 0.36 μSv/h when 99Tc m and DSA were applied. For the first operating position in the fluoroscopy protection area, the maximum dose equivalent rate was 13.19 μSv/h at 155 cm height when only 90Y was applied, and 315.01 μSv/h at 80 cm height when 90Y and DSA were applied. For the second operating position, the maximum dose equivalent rate was 6.28 μSv/h at 155 cm height when only 90Y was applied and 291.03 μSv/h at the same height when 90Y and DSA were applied. The dose-equivalent rates ranged from 0.11 to 0.58 μSv/h around the dedicated ward for postoperative patients. Conclusions:The existing shielding measures, such as those in the nuclear medicine department and interventional room, meet the radiation protection requirements for 90Y-loaded resin microsphere therapy. However, it is still necessary to conduct a scientific assessment based on the actual situation. Additionally, radiation protection measures and surface contamination treatment should be enhanced during drug operation.

Objective:To investigate drug resistance gene in Mycoplasma pneumoniae(MP) and the distribution of 13 respiratory pathogens in bronchoalveolar lavage fluid(BALF) of children with Mycoplasma pneumoniae pneumonia(MPP).Methods:A total of 100 BALF of children with MPP in Peking University Third Hospital and Peking University First Hospital from January 2018 to January 2019 were collected.Fluorogenic quantitative PCR was used to detect nucleic acid and it′s drug resistance gene of MP and multiple PCR method was adopted to detect influenza A virus, influenza A virus-H 1N 1, influenza A virus-H 3N 2, influenza B, human parainfluenza virus, adenovirus, human bocavirus, human rhinovirus, Chlamydia pneumoniae, human metapneumovirus, MP, human coronavirus, and respi-ratory syncytial virus gene, and the results were compared by using Chi square test. Results:In 100 BALF samples, MP and drug resistance gene were detected by fluorogenic quantitative PCR.Totally, 83 cases (83.00%) were MP positive and 78 cases (93.98%) were drug resistant.All of them had the point mutations A2063G in V region of 23S rRNA domain.A total of 13 kinds of respiratory pathogens were detected by multiplex PCR method, and 89 cases (89.00%) were positive.Totally, 79 cases (79.00%) were MP positive, of which 74 cases (74.00%) detected only MP, and 5 cases (5.00%) detected MP combined with other pathogens.Other pathogens were detected in 10 cases (10.00%). The virus detection rate of 0-4 years old group was higher than that of >4-6 years old group ( P=0.042) and >6 years old group ( P=0.002), and the differences were statistically significant. Conclusions:MP can be detected in most BALF samples of MPP children, the drug resistance phenomenon is serious, and the main point mutation is A2063G.There were other respiratory pathogens and 2 or 3 pathogens were detected in a small number of BALF samples.