Objective To evaluate the clinical efficacy of recombinat human brain natriuretic peptide (rhBNP) in the treatment of acute myocardial infarction (AMI) with heart failure in aged patients. Methods Totally 63 elderly patients with AMI and heart failure were randomly divided into therapy (29 cases) and control (34 cases) groups.Besides routine treatment,the therapy group received rhBNP in continuous intravenous infusion, while control group was treated with nitroglycerin.Both drugs were administered for 3-5 days.The dyspnea remission rates after treatment were recorded.At the same time,heart rates and blood oxygen saturation,left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVDD),serum interleukin 6 (IL-6) and high sensitivity C reactive protein (hsCRP) were recorded before and after treatment. Results The total effective rate after the treatment was 79.3 ％ (23/29) in therapy group and 64.7％ (22/34) in control group(P =0.017).The dyspnea remission rate was better in therapy group than in control group (P＜0.05).The heart rate,blood oxygen saturation,LVEF,hsCPR and IL-6 in therapy group were [(120± 11) times/min,(78 ± 6) ％,(28 ± 32) ％,(25.78 ± 2.44) mg/L,(40.74 ± 5.43) μg/L]before treatment,and after treatment [ ( 89 ± 9) times/min,( 97 ± 6 ) ％,(43 ±± 20) ％,( 12.78 ± 2.54 )mg/L,(28.45±2.34) μg/L] (all P＜0.05).The above indexes in control group were [(117±8)times/min,(80±8) ％,(29±31)％,(21.44±1.33) mg/L,(41.87±5.46) μg/L] before treatment,and after treatment[(109± 10) times/min,(34±18) ％,(43±20) ％,(17.63± 1.62) mg/L,(36.56±3.02) μg/L].The heart rate and the levels of IL-6 and hsCPR were reduced,blood oxygen saturation and LVEF were increased in therapy group than those in control group. Conclusions rhBNP is efficient in the treatment of elderly AMI with heart failure.

Objective To explore the effects of application of probiotics on intestinal flora and related cytokines in infants with cholestatic liver disease.Methods (1) Eighty-four infants with cholestatic liver disease had been hospitalized from October 2010 to June 2011 in the First Hospital of Guangxi Medical University.The infants with cholestatic liver disease were randomly divided into the probiotic intervention group and the non-probiotic intervention group.Quantification of intestinal bacteria was detected by SYBR Green Ⅰ real-time fluorescent quantitative polymerase chain reaction,then the number of 3 kinds of bacteria before and after the treatment was compared.(2) The indices of liver function,blood ammonia,cholesterol were detected.The levels of serum transforming growth factor-β1,tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay.Results (1) The number of bifidobacterium,lactobacillus and bifidobacterium/escherichia coli (B/E) were significantly increased (all P ＜ 0.01),whereas the number of escherichia coli was significantly decreased in the probiotic intervention group(P ＜ 0.05),however,there were no differences in the non-probiotic intervention group(all P ＞ 0.05).(2)The indices of total billirubin,direct billirubin,γ-Glutamyltransferase,total bile acid,alanine aminotransferase,blood ammonia,alkaline phosphatase were significantly improved after therapy in 2 groups (all P ＜ 0.05).The levels of TNF-α and IL-6 were significantly decreased in the probiotic intervention group (t--7.31,P =0.00;t =-2.90,P =0.01),but there were no differences in the non-probiotic intervention group.The level of BA was significantly decreased in the probiotic intervention group than the non probiotic intervention group (t =-8.37,P =0.00).(3) The B/E value were significantly inverse correlated with level of serum IL-6 (r =-0.796,P =0.01).Conclusions It may help to restore the intestinal flora and balance the immune function in infants with cholestatic liver disease after application of probiotics.

Objective To explore the application effect of the multidisciplinary collaborations in control of peritoneal dialysis patients with hypertension. Methods A total of 220 cases of peritoneal dialysis patients divided into experimental group and control group (each group had 110 cases) according to the random number table. In which, the control group received routine capacity control and health education with a total of 105 patients finished the study. The experimental group received of multidisciplinary collaborations on the basis of routine capacity control and health education with a total of 107 patients finished the study. Observe changes with knowledge of drugs, medication compliance, self-management behavior and blood pressure of patients before and after the intervention respectively. Results In experimental group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.93 ± 0.49), 0.00 (0.00, 0.25), (2.69 ± 0.25) points before the intervention, 6 months after the intervention were (1.17 ± 0.54), 0.25 (0.00, 0.50), (2.86 ± 0.15) points, the difference between the groups was statistically significant (t=38.60, Z=4.34, t= 2.45, P < 0.01 or 0.05). In control group,the scores of drug knowledge, medication compliance and self-management behaviors were (0.87 ± 0.45), 0.00 (0.00, 0.25), (2.64 ± 0.27) points before the intervention, 6 months after the intervention were (0.89 ± 0.43), 0.00 (0.00, 0.38), (2.73 ± 0.27) points, there was no significant difference between drug knowledge and medication compliance (t=0.44, Z=1.83, P > 0.05), there were statistically significant differences in self-management behavior (t=6.23, P<0.01);there was no difference between the statistical significance between the 2 groups before intervention (t=1.02, Z=1.46, t=1.32, P > 0.05); there was significant difference between the 2 groups after intervention (t=4.11, Z=4.03, t=4.34, P<0.01). Patients in the experimental group with the systolic and diastolic blood pressure were (147.11 ± 14.31), (90.16 ± 13.02) mmHg (1 mmHg=0.133 kPa) respectively, before the intervention; 6 months after the intervention were (139.39 ± 17.05), (83.76 ± 12.52) mmHg respectively, the difference was statistically significant (t=3.59, 2.92, P<0.01). The control group before intervention were (149.56 ± 18.11), (93.56 ± 15.09) mmHg respectively, 6 months after the intervention were (145.14±20.50), (88.14±10.88) mmHg respectively, the difference was statistically significant (t=2.02, 2.72, P<0.05 or 0.01);there was no significant difference between the two groups before intervention (t=1.09, 1.82, P>0.05);6 months after the intervention there was significant difference between the 2 groups (t=2.22, 2.72, P < 0.05 or 0.01). Conclusions Multidisciplinary collaborations have a significant role in patients with peritoneal dialysis, especially in blood pressure control, medication compliance and self-management behavior.

Objective: To investigate the effects of two different sorbents(Carbon perfusion apparatus and Resin perfusion apparatus)in Double plasma molecular absorb syetem for liver failure treatment. Methods: A total of 152 cases with liver failure who were admitted to The Sixth People's Hospital of Zhengzhou, from June 2016 to May 2018 were selected and divided into DPMARS Carbon group (77 cases) and Resin group (75 cases). The two groups were observed in terms of liver function, prothrombin activity(PTA),Plasma albumin ,tumor necrosis factor alpha and interleukin-6 were detected and compared between the two groups before and after treatment. Results: ①The clinical symptoms improved in different degree in two groups, the recovery rate of Carbon cans Carbon perfusion apparatus group and Resin group separately were89.6% (69/77)、90.7% (68/75)(χ² = 0.048, P = 0.975), there were no statistical differences. There were no statistical differences between the two groups in untoward reactions(χ² = 0.235, P = 0.995), ②Compared with before treatment, TBil(t = 3.735, 3.728; P = 0.000, 0.000)、ALT(t = 5.117, 5.203; P = 0.000, 0.000)、TNF-α (t = 3.158, 3.094; P = 0.000, 0.002)、IL-6(t = 3.647, 3.559; P = 0.002, 0.003)decreased and ALB (t = 2.300, 3.065; P = 0.024, 0.003) increased significantly after treatment in both groups, and there were statistical differences. There were no signifiant differences in the changes in ALB(t = 0.316, 0.209; P = 0.657, 0.720) and PTA(t = 0.810, 0.843; P = 0.429, 0.516). ③After treatment, there were no signifiant differences in the changes in TBil、ALT、ALB、PTA、TNF-α、IL-6(t = 0.377、0.904、-1.133、-1.552、0.841、0.401; P = 0.952、0.283、0.826、0.094、0.154、0.457). Conclusion Double plasma molecular absorb syetem is effective in treating liver failure. Carbon perfusion apparatus or Resin perfusion apparatus can be combined with Specific bilirubin adsorption column for DPMARS in clinical treatment,and their effects are similar.

Objective To compare the efficacy and safety of intravenous chemotherapy plus operation and interventional arterial chemotherapy plus operation in treatment of patients with local-ly advanced cervical carcinoma (phases Ib2~IIb).Methods 140 patients with locally advanced cervical carcinoma (phases Ib2~IIb)were divided into experimental group (uterine artery interven-tional chemotherapy plus surgery)and control group (venous chemotherapy plus surgery)according to different initial therapeutic methods,70 cases in each group.Short-term efficacy,tumor diameter changes before and after treatment,rate of radical operation,3 and 5 years overall survival (OS), progression-free survival (PFS),complications as well as pathological risk factors (rates of para-u-terine invasion and lymph node metastasis)were observed.Results Short-term efficacy improved in both groups.The decreased tumor diameter in experimental group was significantly greater than control group,and the probability rate of patients with radical operation was significantly larger than the control group.Corresponding rates of para-uterine invasion and lymph node metastasis in the ex-perimental group were significantly lower than the control group.There were no significant differ-ences of 3 years OS and PFS between two groups,and the 5 years OS and PFS in the experimental group were higher than the control group.Conclusion For patients with locally advanced cervical carcinoma,neo-adjuvant chemotherapy with artery interventional therapy is better than intravenous chemotherapy in aspects of surgical resection rate and 5 years OS,so it is a safe and effective thera-peutic method.

Objective To compare the efficacy and safety of intravenous chemotherapy plus operation and interventional arterial chemotherapy plus operation in treatment of patients with local-ly advanced cervical carcinoma (phases Ib2~IIb).Methods 140 patients with locally advanced cervical carcinoma (phases Ib2~IIb)were divided into experimental group (uterine artery interven-tional chemotherapy plus surgery)and control group (venous chemotherapy plus surgery)according to different initial therapeutic methods,70 cases in each group.Short-term efficacy,tumor diameter changes before and after treatment,rate of radical operation,3 and 5 years overall survival (OS), progression-free survival (PFS),complications as well as pathological risk factors (rates of para-u-terine invasion and lymph node metastasis)were observed.Results Short-term efficacy improved in both groups.The decreased tumor diameter in experimental group was significantly greater than control group,and the probability rate of patients with radical operation was significantly larger than the control group.Corresponding rates of para-uterine invasion and lymph node metastasis in the ex-perimental group were significantly lower than the control group.There were no significant differ-ences of 3 years OS and PFS between two groups,and the 5 years OS and PFS in the experimental group were higher than the control group.Conclusion For patients with locally advanced cervical carcinoma,neo-adjuvant chemotherapy with artery interventional therapy is better than intravenous chemotherapy in aspects of surgical resection rate and 5 years OS,so it is a safe and effective thera-peutic method.

Objective:To explore the clinical value of 18F-fluoromisonidazole (FMISO) PET/CT hypoxia imaging in early response to heavy ion radiotherapy in patients with non-small cell lung cancer(NSCLC). Methods:From April 2018 to January 2021, the 18F-FMISO PET/CT images of 23 NSCLC patients (19 males, 4 females; age (64.9±10.3) years) who received heavy ion radiotherapy in Shanghai Proton and Heavy Ion Center were retrospectively analyzed. The evaluation parameters included tumor volume (TV), tumor to background ratio (TBR) before and after radiotherapy. Patients were divided into hypoxia group and non-hypoxia group with the baseline TBR value≥1.4 as hypoxia threshold. Wilcoxon signed rank test was used to compare the differences of TV and TBR before and after radiotherapy in 2 groups. Results:Of 23 NSCLC patients, 17 were hypoxia and 6 were non-hypoxia. Compared with the baseline, TV after the radiotherapy (59.44(22.86, 99.43) and 33.78(8.68, 54.44) cm 3; z=-3.05, P=0.002) and TBR after the radiotherapy (2.25(2.09, 2.82) and 1.42(1.24, 1.67); z=-3.39, P=0.001) of the hypoxia group were significantly lower, while TV (16.19(6.74, 36.52) and 8.59(4.38, 25.47) cm 3; z=-1.57, P=0.120) and TBR (1.19(1.05, 1.27) and 1.10 (0.97, 1.14); z=-1.89, P=0.060) of the non-hypoxia group decreased with no significant differences. Conclusions:Hypoxic NSCLC tumors are sensitive to heavy ion radiation. Compared with non-hypoxic tumors, hypoxic tumors respond more quickly, and a significant reduction in TV can be observed early after radiotherapy. Heavy ion radiation can significantly improve tumor hypoxia.

Objective:Patients are breathing freely during adjuvant proton pencil beam radiotherapy after breast conserving surgery. Fluctuation of the thorax may affect the position of the end of the proton beam flow, which needs to be precisely evaluated on a millimeter scale.Methods:For 20 patients with breast cancer treated with proton radiotherapy after breast conserving surgery, PET-CT scan was performed approximately 10 min after the end of proton radiotherapy. The images of PET-CT were processed for ROI determination and sampling line (profile) extraction on a Raystation RV workstation to calculate the actual difference between the predicted and real radioactivity from the same spatial location as obtained by PET acquisition R50. Then, the differences in the spatial location between the actual process of proton irradiation and the planned process were obtained. Depth difference values for each pair of sampling lines were presented. Results:For 20 patients with breast cancer with a median follow-up of 22 months (range 12 - 46 months), all patients survived at the last follow-up, and no radiation pneumonitis was observed during the follow-up period. Among the verification results of 21 cases, the depth difference of evenly distributed was (-0.75±1.89) mm in the primary field and (-0.82±2.06) mm in the secondary field; The depth difference of sequential treatment was (1.81±1.87) mm in the primary field and (1.32±1.74) mm in the secondary field; The depth difference of synchronous addition in the primary field was (-1.47±1.44) mm, and the depth difference in the secondary field was (-1.48±2.11) mm.Conclusion:The results of off-line PET-CT in vivo biological verification show that the accuracy of the dose boundary cut-off was within 3 mm in breast cancer patients, which meets the clinical and physician requirement for the precision in breast cancer treatment.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.