Objective:To study the effect of rotational errors on the positioning accuracy (PA) and to assess whether correcting rotation in patients with head-neck tumors in radiotherapy or not.Methods:The image information of 34 patients with head-neck tumors treated at Zhongnan Hospital of Wuhan University between August 2019 and January 2020 was collected. Mega-voltage computed tomography (MVCT) images of each patient were taken before radiotherapy, and were registered with planned kilo-voltage computed tomography (KVCT) images by two registration methods. All information was divided into control group (translation only) and intervention group (translation and rotation) according to different registration methods, there were 144 fractioned registered images for each group, respectively. The position errors of the two registration methods were recorded and compared. Data were carried out with Wilcoxon signed rank test and Spearman rank correlation.Results:Translational errors of the control group and the intervention group were 0.10 (5.35) mm and 0.00 (5.78) mm in right-left direction, and there was a statistically significant difference ( Z=-2.675, P=0.007); 0.75 (2.78) mm and 0.60 (2.68) mm in superior-inferior direction, and there was a statistically significant difference ( Z=-2.819, P=0.005); 0.10 (0.90) mm and 0.20 (1.28) mm in anterio-posterior direction, and there was a statistically significant difference ( Z=-3.984, P<0.001). Rotational errors of the intervention group were -0.20 (0.60)°, 0.35 (2.00)°, 0.00 (0.98)° in pitch, roll, yaw, respectively. The distribute of 3D vector corrected frequency for two groups was positively skewed. The corrected cumulative frequency (CCF) varied with 3D vector, 3D vector was 8.0 mm, and 19 F and 16 F fractioned treatments of the control group and the intervention group were not corrected, respectively; 3D vector was between 8.0-13.5 mm, the corrected tendency of the intervention group was slower and fractioned treatment was completed later. The analytical results of Spearman rank correlation showed that rotational errors in pitch were negatively correlated with translational errors of the control group in superior-inferior direction ( r=-0.182, P=0.029) and the intervention group in anterio-osterior direction ( r=-0.484, P<0.001); rotational errors in roll were negatively correlated with translational errors of the intervention group in right-left direction ( r=-0.334, P<0.001); rotational errors in yaw which were positively correlated with translational errors of the intervention group in right-left direction ( r=0.370, P<0.001) were negatively correlated with translational errors of the control group in superior-inferior direction ( r=-0.171, P=0.040) and the same was true for the intervention group ( r=-0.203, P=0.015); total angles were positively correlated and negatively correlated with translational errors of the control group in superior-inferior direction ( r=0.246, P=0.003) and anterio-posterior direction ( r=-0.188, P=0.024), and positively correlated with 3D vector of the control group ( r=0.198, P=0.017), total angles were positively correlated with translational errors of the intervention group in superior-inferior direction ( r=0.170, P=0.041) and with 3D vector of the intervention group ( r=0.239, P=0.004); there were no correlations between rotational errors and the other translational errors (all P>0.05). Conclusion:Although the corrected rotation increases translational errors in anterio-posterior direction and 3D vector, it improves PA for head-neck tumors in radiotherapy. When rotational errors are not corrected, rotational offsets are present with corrected translation to decrease its effect on PA.

Objective The systemic inflammatory response syndrome ( SIRS) can be caused by infection and non-infection factors, which have similar clinical features but differ in treatment and prognosis .Rapid synthesis of procalcitonin ( PCT) during infec-tion can be used as a biomarker for the early diagnosis of sepsis .The present study aims to assess the value of the serum PCT level in the etiological diagnosis and prognosis of SIRS in the surgical ICU . Methods We retrospectively analyzed the data on 166 cases of SIRS from the surgical ICU in Jinling Hospital between June 2014 and June 2015 .The data obtained were associated with the patients'demograph-ics, primary diseases, laboratory results, and clinical outcomes.We analyzed the serum PCT values , blood culture results , and clinical outcomes. Results Totally, 131 of the patients were diagnosed with sepsis, with a median value of serum PCT of 2.43 (0.81-10.51) ng/mL, of whom 109 were PCT-positive (≥0.47 ng/mL), with a positive rate of 83.2%.Among the 35 non-infection SIRS patients, the mean level of serum PCT was 0.23 (0.1 -0.39) ng/mL, with a positive rate of 17.14%(6/35).There were statistically significant differences between the two groups in both the ser-um PCT level and positive rate (P<0.05).The PCT-positive rate was significantly higher in the bacteria-infected than in the fungi-in-fected group (86.5%[83/96] vs 74.3%[26/35], P<0.05), with a median value of 4.28 (1.05-14.59) ng/mL and 0.89 (0.37-1.59) ng/mL, respectively, so was it in the survivors than in the non-survivors (94.4%[34/36] vs 78.9%[75/95], P<0.05), with a median value of 12.89 (4.76-47.73) ng/mL and 1.41 (0.54-4.00) ng/mL, respectively. Conclusion The se-rum PCT level might be used to distinguish between sepsis and non-infection SIRS, significantly higher in bacteria-infected and survival groups than in fungi-infected and non-survival groups .Serum PCT determination contributes to the etiological diagnosis and prognosis of SIRS.

Objective To systematically evaluate the clinical outcomes of patients with multivessel diseases treated by fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) or other forms of treatment .Methods Some keywords inclu-ding FFR or fractional flow reserve ,percutaneous coronary intervention or PCI ,multivessel coronary artery disease were used to search randomized control trails(RCT) ,which compared outcomes of patients with multivessel disease treated by FFR guided PCI with other forms of treatment ,in Chinese and English database including CNKI ,VIP ,Wanfang ,Pubmed ,EMBASE and the web of science .The quality of included studies was evaluated by Jadad quality score and all the data was analyzed by stata 10 .0 .Results A total of 7 english literatures accumulating 2024 cases in experimental group and 7 284 cases in control group were included in this study .Compared with other forms of treatment ,patients with multivessel diseases treated by FFR-guided PCI had significantly low-er risk of myocardial infarction (RR=0 .72 ,P=0 .008) .Although the risk of death and major adverse cardiovascular events were al-so be reduced ,there were no statistically significant difference .Conclusion FFR-guided PCI is an effective treatment for multivessel disease ,but it is still needs further verification for the application in Chinese population .

Objective To detect and analyze the expression and significance of olfactory receptor family 2 subfamily W member 3 (OR2W3) in gastric adenocarcinoma,and to explore its correlation with cell proliferation and apoptosis. Methods From January 2013 to June 2014, 61 patients with gastric adenocarcinoma diagnosed in the Affiliated Hospital of North China University of Technology and undergoing radical operation were selected as the study subjects. Neoplasm tissue were selected as the observation group, normal gastric mucosa ( 61 cases) were selected as the control group. Immunohistochemistry was used to detect the expression of or2w3 and HER-2 in the two groups. Fish was used to detect the amplification of HER-2 gene in some of the patients with uncertain expression of HER-2. Western blot was used to detect the expression of PCNA and BAX in the observation group. Results Positive rate of OR2W3 was higher in the observation group ( 50. 8%, 31／61) than that in the control group ( 8. 2%( 5／61 )), and the difference between the two groups was statistically significant(χ2＝26. 63,P＜0. 05). The difference of the positive rate of OR2W3 in the maximum diameter(≥6 cm was 68. 8%(22／32),＜6 cm was 31. 0%( 9／29)),depth of invasion(seroas and beyond was 63. 4%(26／41),less serosa was 25. 0%(5／20)),vascular and lymphatic vessel involvement ( involvement was 78. 6%( 11／14),no involvement was 42. 6%( 20／47)), lymph node metastasis(metastasis was 82. 1%(23／28),no metastasis was 24. 2%(3／33)) and TNM staging(Ⅲ+Ⅳwas 78. 1%(25／32),Ⅰ+Ⅱ was 20. 7%( 6／29)) in observation group was statistically significant ( χ2 was 8. 423,7. 937,5. 559,20. 318,20. 080,respectively,all P＜0. 05). Expression of OR2W3 was correlated with survival time(X2＝5. 31,P＜0. 05). Positive correlation was found between OR2W3 and PCNA expression(r＝0. 54,P＜0. 05) . Negative correlation were found between OR2W3 and BAX expression ( r＝－0. 59, P＜0. 05). There were 8 cases of HER-2 positive and 53 cases of HER-2 negative. The difference of OR2W3 expression in tumors with different HER-2 expression was statistically significant ( χ2＝4. 957,P＜0. 05) . Conclusion The expression of OR2W3 in gastric adenocarcinoma tissue is significantly increased,which can promote the proliferation of cancer cells and inhibit apoptosis. OR2W3 is related to HER-2 expression. Detection of OR2W3 expression may be of some value in judging prognosis.

Objective To detect the expressions of Matrix Metalloprotein-11 ( MMP-11 ) and Cathepsin-D(Cath-D),and investigate their relationship and prognostic significance. Methods The study included 95 cases′ clinical date and postoperative specimens of gastric adenocarcinoma ( North China University of Science and Technology Affiliated Hospital,2010. 01-2013. 12) as observation group,70 cases of normal gastric tissue(from observation group) as control group. Expressions of MMP-11 and Cath-D were detected by IHC methods in two groups. Results The positive rate of MMP-11 was 51. 6%( 49/95) in observation group,5. 7%(4/70)in control group(χ2＝38. 884,P＜0. 05). The positive rate of Cath-D was 73. 7%(70/95) in observation group,28. 6%(20/70) in control group(χ2＝33. 082,P＜0. 05). The positive rate of MMP-11 was correlated with metastasis and vascular invasion(χ2＝7. 193、15. 566,P＜0. 05). The positive rate of Cath-D was correlated with maximal diameter,lymph node metastasis,vascular invasion and proliferation index(χ2＝7.431、5.654、6.569、6.801,P＜0.05).There was positive relationship between MMP-11 and Cath-D in observation group(r＝0. 46,P＜0. 05). The expressions of MMP-11 and Cath-D were correlated with prognosis in gastric adenocarcinoma ( P＜0. 05) . Conclusion The higher expressions and synergistic effect of MMP-11 and Cath-D may promote the occurrence and development in gastric adenocarcinoma. The joint detection of MMP-11 and Cath-D may be helpful to predict the prognosis of gastric adenocarcinoma.

Objective:To learn about the application of medical ethics review in scientific research and prevention of endemic diseases.Methods:The method of retrospective analysis was used, original articles on field epidemiological investigation and clinical medicines published by Chinese Journal of Epidemiology from 2017 to 2020 were collected. Examination of medical ethics in national, provincial and municipal fund programs and nonfund projects was carried out. Statistical analysis was performed using Cochran-Armitage trend test and Cochran-Mantel-Haenszel (CMH) test.Results:A total of 638 articles were collected from 2017 - 2020, with 36 excluded and 602 remaining. The proportion of papers published after medical ethics review over the past four years was 56.85% (83/146), 62.50% (105/168), 59.87% (94/157), and 60.31% (79/131), respectively. There was no statistically significant difference in trend testing ( Z = 0.41, P > 0.05). There was no statistically significant difference in the proportion of papers produced by academic works, on-site investigations, and clinical medicine programs among different years (χ 2 = 0.01, 1.31, 1.92, P > 0.05). The proportion of papers published that supported by various fund programs that had undergone medical ethics review over the past four years was 60.55% (66/109), 62.28%(71/114), 62.38% (63/101), and 60.22% (56/93), respectively. The trend test showed no statistically significant difference( Z = - 0.03, P > 0.05). There was no statistically significant difference in the proportion of papers published that supported by national level projects, provincial and ministerial level projects, and municipal level projects among different years (χ 2 = 0.06, 0.02, 0.19, P > 0.05). The difference in the trend test of the output papers of research projects approved by the higher-level ethics committee and marked with approval numbers over the past 4 years was statistically significant ( Z = 2.85, P < 0.01); the difference was statistically significant when compared across years (χ 2 = 8.13, P < 0.01); the proportion of papers increased from 8.22% (12/146) in 2017 to 18.08% (25/131) in 2020 (χ 2 = 7.04, P = 0.008). There was no statistically significant difference ( Z = - 0.53, P > 0.05) in the proportion of papers that expressed their consent in terms of informed consent over the past 4 years; There was no statistically significant difference in comparison between different years (χ 2 = 0.28, P > 0.05). Conclusions:Medical ethics review has been taken seriously by the majority of researchers and is widely used in endemic scientific research and prevention projects.