Objective　To study the indication, contraindication and short-term clinical effects of stereotactic radiotherapy (X-knife) in lung cancer. Methods　A total of 56 cases (Treatment group) of lung cancer were treated with X-knife composing of the modern 3-D treatment planning system and the stereotactic body frame, and SL-75 accelerator. And another 53 cases only treated with routine external radiation served as the control. In treatment group, 42 cases received 50 Gy radiation, at 2 Gy per day, 5 d per week in the upper mediastinum, hilus of lung, below the primary focus first and then underwent X-knife for the primary focuses, and other 14 recurrent and metastatic cases received irradiation of 8-12 Gy per day, 5 d by X-knife alone. Results　The actually reexamination rate for 1, 3, 6, and 12 months after X-knife treatment in 78 focuses from 56 cases was 79.5% (62/78), 89.8% (70/78), 87.2% (68/78) and 78.2% (61/78) respectively. The focuses reappeared in 3 months after the treatment and the growth rates of focus in 3, 6, and 12 month after the treatment were 2.6% (2/78), 5.1% and 9% (7/78) respectively. There were 2 focuses received a second treatment with X-knife because no change after the first one. Both the 1-and 2-year survival rates of 36 cases of the primary lung cancer in the treatment group were higher than that of control group (89.1%, 53.9% and 77.4%, 39.6%). Conclusion　The stereotactic radiotherapy is of applicable and prospective in the treatment of lung cancer. The indications include: ①As a boost dose in case when primary focus is less than 5 cm after the first external radiotherapy may reduce the exposure of lung tissue to x-ray and the occurrence of radiation pneumonia; ②Treatment for the recurrence after radiotherapy and operation; ③Radical treatment for the metastatic focus less than 5 cm. Attention must be paid to when multiple treatment is carried on the volume of the focus, the Karnofsky scores and the general condition when stereotactic radiotherapy combined with X-knife for lung cancer.

Objective Objective To investigate the clinical application of high-dose-rate(HDR)endobronchial brachytherapy for the treatment of primary lung cancer with atelectasis. Methods A total of 142 cases of lung cancer with atelectasis treated with HDR endobronchial brachytherapy and 71 cases(contr01)treated with extemal irradiation only at onr center of cancer were comparatively studied.1n the treatment group,with the aid of bmnchoscope,brachytherapy was applied 2 or 3 times at the dose of 8 Gy each time to a tissue depth of 1 to 1.5 cm.Cases in the contmlgroup,treated with external irradiation,received 60-70 Gy in total.Results Complete recruitment of atelectasis was observed in 80.28%cases of the treatment group and 64.79%in the control,T11ere Was significant difference between the two groups.Survival rates after 1,2 and 3 years in cases with complete remission of atelectasis in treatment group were 60.68%,44.44%and 23.93%,but 36.00%,28.00%and 16.00%in cases with no remission of atelectasis.Significant difference of one-year survival Was found between the two groups(P

Objective To discover the mutation of ADAR gene in a pedigree with dyschromatosis symmetrical hereditaria(DSH). Methods We investigated this family and collected blood samples of the individuals in this family. Mutation screening was carried out by PCR and direct sequencing. The allele specific primer was designed for the mutation point, and allele-specific PCR was carried out on the patients, normal family members and 40 normal individuals. Results A single nucleotide deletion (c.1642 delC) was identified in exon3 of ADAR gene in the patients of this family. This mutation was not detected in the normal family members and in any of the control individuals. Conclusion This single nucleotide deletion was responsible for the disease in the family.

Objective To explore the regulation and effect factors of arsenic expose and arsenic methylation level, then to provide a reference for study the function of arsenic metabolism in a arsenic poisoning process. Methods A meta-analysis was performed by two researchers. Twenty-five papers satisfying our priori eligibility criteria were included by searching Cochrane library, Pubmed, Springer, Embase and China National Knowledge Infrastructure. Based on the results of heterogeneity, a random or fixed effects model was chosen for the meta-analysis. Results The results showed that the following arsenic metabolites increased (all P<0.01) following arsenic exposure: inorganic arsenic [iAs; standardized mean difference (SMD): 1.07; 95% confidence interval (CI):0.61 - 1.53)], monomethyl arsenic (MMA; SMD: 1.10; 95% CI: 0.81 - 1.40), dimethyl arsenic (DMA; SMD: 2.50;95%CI:1.50-3.69), and total arsenic (TAs, SMD:3.10;95%CI:2.13-4.07). Additionally, the percentages of iAs (iAs%; SMD: 1.00; 95% CI: 0.60 - 1.40) and MMA (MMA%; SMD: 0.49; 95% CI: 0.21 - 0.77) also increased, while the percentage of DMA (DMA%; SMD: - 0.55; 95% CI: - 0.80 - - 0.31) decreased (P<0.01). The primary methylation index (PMI; SMD: - 0.57; 95% CI: - 0.94 - - 0.20), and secondary methylation index (SMI;SMD: - 0.27; 95% CI: - 0.46 - - 0.09) decreased (all P< 0.01). Compared to female, male had higher MMA%(SMD:0.44;95%CI:0.35-0.52), lower DMA%(SMD:-0.33;95%CI:-0.38--0.28) and SMI (SMD:-0.36;95%CI:-0.53--0.19). The smoker had higher MMA%(SMD: 0.22; 95%CI: 0.07 - 0.37) and lower DMA%(SMD:-0.16;95%CI: - 0.26 - - 0.05). The drinker had higher MMA% (SMD: 0.17; 95% CI: 0.07 - 0.27) and lower DMA%(SMD:-0.24;95%CI:-0.39--0.10). The older people had higher MMA%(SMD:-0.23;95%CI:-0.40--0.06). In addition, the body mass index may influence the percentages of MMA (SMD: - 0.18; 95% CI: - 0.31 - - 0.04, P < 0.01). Conclusion Arsenic exposure, smoking, drinking, and older age can reduce the capacity of arsenic methylation. Arsenic methylation is more efficient in women than in men.

Objective It is still controversial how to deal with the congenital heart disease with advanced pulmonary hypertension.The choices of treatment for these patients must depend on the character and degree of pulmonary vascular change.The pulmonary vascular change correlates well with hemodynamics and acute pulmonary vasoreactivity test.Therefore,it will play an important role to obtain accurately these evaluations.Methods This paper studies 85 cases (38 males and 46 females) with congenital heart disease complic ated with advanced pulmonary hypertension and bidirectional shunt,which are diagnosed by echocardiography.Whose age range is (22.8 ± 16.5 ) and weight range (46.4 ± 12.1 ) kg.Among those cases,42 are VSD,11 are ASD,9 are VSD with patent ductus arteriosu,7 are patent ductus arteriosu,5 are ASD with VSD,and 11 are the others.With congenital heart disease complicated with advanced pulmonary hypertension and bidirectional shunt,which are diagnosed by echocardiography.There were floating catheter retention of 4 to 13 days ( average 7.5 days).Through the right subclavian vein or jugular vein,floating catheter is inserted into pulmonary artery.Pulmonary artery pressure is recorded continuously and analyzed.Hemodynamics,acute pulmonary vasoreactivity test and drug sensitivity test are evaluated.Differences of the hemodynamics are analyzed between echocardiography and floating catheter examination.Results Compared with floating catheter examination,there are not significantly difference for the diagnosis of advanced pulmonary hypertension(98.8％ vs.100％,P ＞ 0.05),less accurately diagnosis (64.3％ vs.100％,P ＜ 0.05 ) and higher (H)false positive rate (8.4％ vs.0,P ＜ 0.05) for Eisenmenger syndrome in echocardiography examination.Floating catheter examination shows that mean systolic pulmonary artery pressure(PAP)/mean systolie body artery blood pressure (BP) and mean PAP / mean BP were equal to 1.22 ± 0.35 and 1.07 ± 0.11 respectively.The patients presented total pulmonary vascular resistance of ( 17.6 ± 8.3) Wood units.Bidirectional shunt volume is more than 30％ cardiac outputs in 7 cases.Apart from 14 cases with Eisenmenger syndrome,total pulmonary vascular resistance is ( 11.3 ± 3.7) Wood units.Acute pulmonary vasoreactivity test presents positive in 67 cases.After drug sensitivity test,14 cases with Eisenmenger syndrome underwent medical treatment and waited lung transplantation or heart-lung transplantation.Floating catheter examination happened hematoma(2/85 ) in 2 patients.71 cases underwent surgical treatment.Operative complications included right heart failure (6/71) and pulmonary infection (5/71).Operative mortality was 5.6％ (4/71).The main causes of death were right heart failure.Compared with preoperative arterial oxygen saturation,postoperative arterial oxygen saturation increased by (9.7 ± 4.1 ) ％ ( P ＜ 0.05 ).Conclusion Floating catheter examination can evaluate accurately pulmonary hypertension,hemodynamics,acute pulmonary vasoreactivity test,drug sensitivity test and bidirectional shunt volume.All the patients,who were diagnosed as advanced pulmonary hypertension with bidirectional shunt by echocardiography,should undergo floating catheterization.Floating catheter examination can provide reliable,objective theoretical basis for the choice of treatment in the congenital heart diseases with advanced pulmonary hypertension.

Objective To develop a rapid,reliable and convenient approach for diagnosing the homozygous deletion of SMN1 gene.Methods SMN1 gene was amplified specifically with double allele-specific PCR(AS-PCR).Meanwhile,one inrelevant gene was amplified as internal control by PAGE and agarose gel electrophoresis analysis to determine whether the sick children were with homozygous deletion of SMN1 genes.Results The homozygous deletion of exon7 in SMN1 gene was identified by agarose gel electrophoresis or PAGE accurately.Conclusion Compared to PCR-RFLP and DHPLC used in the past,this approach can diagnose homozygous deletion of SMA much more accurate,easier and more convenient without completed following analyses.

ObjectiveTo evaluate the efficacy and safety profiles of enteeavir (ETV) in patients with advanced schistosomiasis and hepatitis B virus (HBV) co-infection.Methods Totally sixty patients with advanced schistosomiasis and HBV co-infection were enrolled in this study.The patients were divided into ETV treatment group (n=30) and rhubarb treatment group who refused to receive antiviral treatment (n=30).The patients were treated with ETV or rhubarb thelepus ball on the basis of routine supportive therapy for 52 weeks.The hepatic fibrosis markers (e.g.hyaluronic acid,type Ⅲ procollagen,type Ⅳ collagen,laminin and fibronectin),alanine transaminase (ALT),HBV DNA,Child-Pugh score between two groups were compared.Intention to treat (ITT) population was used for analysis.The measurement data and the enumeration data were analyzed by t test and x2 test,respectively.ResultsAfter 52-week treatment,the hepatic fibrosis markers (hyaluronic acid,type Ⅲ procollagen,type Ⅳ collagen,laminin and fibronectin) were significantly improved in ETV treatment group compared to the rhubarb treatment group (t =3.952,3.765,3.857,3.122 and 3.735,respectively; all P＜0.05),and the fibrosis of liver tissue in ETV treatment group was significantly improved compared with rhubarb treatment group (x2 =11.207,P＜0.05).The ALT level,HBV DNA,Child-Pugh score after 52-weeks treatment in ETV treatment group were statistically reduced compared with rhubarb treatment group (t =3.287,4.382 and 3.872,respectively; all P＜0.05),meanwhile,the ALT normalization rate and HBV DNA undetectable rate were significantly increased in ETV treatment group (x2 =17.376 and 39.095,respectively; both P＜0.05).In addition,no obvious adverse reaction was observed during ETV treatment.Conclusion Entecavir is safe and effective in patients with advanced schistosomiasis and HBV co-infection.

Objective: To observe the characteristics of serum homocysteine (Hcy) distribution and the epidemiological characteristics of high serum level of Hcy (HHcy) in Kazakh population.
Methods: The stratiifed cluster random sampling method was used to investigate 1003 kazakh individuals in Xinyuan county of Xinjiang including 433 male and 570 female, and they were individuals into 5 age groups:①(25-34) years, n=333,②(35-44) years, n=306, ③(45-54) years, n=230, ④(55-65) years, n=90, ⑤>65 years, n=44. The questionnaire survey, physical check-up and blood biochemical examination were performed and compared among different groups.
Results: ① The geometrical mean of Hcy was 13.3μmol/L, and the male was higher than female as 16.0μmol/L vs 11.6μmol/L. ②By age stratiifcation, the serum levels of Hcy elevated with the increased age accordingly. Except for those with the age>65 years, the serum levels of Hcy were all higher in male than female in other 4 age groups. ③The average rate of HHcy prevalence was 31.5%, and the male was higher than female as 49.9%vs 17.5%.④The average rate of H type hypertension prevalence was 35.1%, and the male was higher than female as 44.3%vs 28.1%. There were 87.6%of H type hypertensive patients with H type hypertension, and the male was higher than female as 95.0%vs 80.0%, all P<0.001.
Conclusion: The serum levels of Hcy were different from gender and age; the prevalences of HHcy and H type hypertension were higher in Kazakh population at Xinyuan county of Xinjiang. Community intervention should be conducted to improve the public health condition in Kazakh population.

OBJECTIVETo study the relationship between the nonresponse to hepatitis B vaccine and HLA genotype/heplotype in Chinese population and provide the evidence for explaining the genetic mechanism of this nonresponse.

METHODSOur research focused on the relationship between nonresponse to Hepatitis B vaccine and HLA-DRB1, DRB3, DRB4, DRB5 and DQB1 genotype/haplotype in Chinese population, collected from a community in Guangxi Zhuang Autonomous Region. The group specific amplification was employed to characterize 107 individuals' genotype and haplotype of HLA clusters. Different models statistics such as relative risk test, correlation test and linkage disequilibrium analysis were used to analyze the data.

RESULTSThe results showed that there is a linkage disequilibrium between nonresponse to Hepatitis B vaccine and HLA haplotype DR4, 1122 (DRB1 * 0401- 22, 1122)-DR53 (DRB4 * 0101101, 0102/3)-DQB4 (DQB1 * 04).

CONCLUSIONIn Chinese population, nonresponse to hepatitis B vaccine is highly associated with special HLA haplotye.

Asian Continental Ancestry Group ; genetics ; China ; Genotype ; HLA-DQ Antigens ; classification ; genetics ; HLA-DQ beta-Chains ; HLA-DR Antigens ; classification ; genetics ; HLA-DRB1 Chains ; HLA-DRB3 Chains ; HLA-DRB4 Chains ; HLA-DRB5 Chains ; Haplotypes ; Hepatitis B ; genetics ; immunology ; prevention & control ; Hepatitis B Vaccines ; immunology ; Humans ; Linkage Disequilibrium

Objective:To compare the clinical effects of percutaneous curved vertebroplasty (PCVP) and unilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF).Methods:A retrospective cohort study was used to analyze the clinical data of 104 patients with single vertebral OVCF treated in Tianjin Hospital from September 2019 to September 2020, including 21 males and 83 females; aged 50-91 years [(70.3±7.7)years]. AO classification of the fracture was type A1 in 65 patients and type A2 in 39. The patients received PCVP (PCVP group, n=51) or unilateral PKP surgery (unilateral PKP group, n=53). The operation time, bone cement injection volume, intraoperative fluoroscopy frequency, effective dispersion times of bone cement and excellent rate of bone cement distribution were compared between the two groups. In evaluation of the therapeutic effects of the two groups, visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were measured preoperatively and at postoperative 24 hours, 3 months and 6 months; Beck index was measured preoperatively and at postoperative 24 hours and 3 months. The rate of bone cement leakage and rate of refracture of adjacent vertebral bodies were compared between the two groups. Results:All patients were followed up for 6-8 months [(6.4±0.7)months]. The operation time, bone cement injection volume and intraoperative fluoroscopy frequency in PCVP group was (12.15±1.63)minutes, (2.13±0.28)ml and (24.74±1.71)times, shorter or less than (22.09±1.62)minutes, (5.30±0.52)ml and (30.09±1.86)times in unilateral PKP group (all P<0.01). The effective dispersion times of bone cement in PCVP group was (1.42±0.04)times, higher than (1.18±0.02)times in unilateral PKP group ( P<0.01). The excellent rate of bone cement distribution in PCVP group was 94%, higher than 70% in unilateral PKP group ( P<0.01). There were no significant differences in VAS, ODI and Beck index between the two groups before operation and at 24 hours and 3 months after operation (all P>0.05). VAS and ODI in PCVP group were (1.20±0.49)points and 16.52±5.22 at 6 months after operation, lower than (1.49±0.58)points and 20.16±5.16 in unilateral PKP group (all P<0.01). VAS and ODI in the two groups were significantly improved at 24 hours, 3 months and 6 months after operation when compared with those before operation (all P<0.05). Beck index in the two groups detected at 24 hours and 3 months after operation was improved from that before operation (all P<0.05). Unilateral PKP group showed Beck index was 0.75±0.07 at 3 months after operation, significantly lower than 0.79±0.07 at 24 hours after operation ( P<0.05), but there was no significant change in PCVP group ( P>0.05). The leakage rate of bone cement in PCVP group was 16% (8/51), lower than 47% (25/53) in unilateral PKP group ( P<0.01). There was no significant difference in the incidence of refracture of adjacent vertebral bodies between the two groups during follow-up ( P>0.05). Conclusion:For OVCF, PCVP is superior to unilateral PKP in terms of operation time, amount of bone cement injection, intraoperative fluoroscopy frequency, dispersion effect of bone cement in vertebral body, pain, function improvement, maintenance of injured vertebral height and incidence of bone cement leakage.