Objective To compare theγpassing rate between measurements at actual degree gantry angle and zero degree gantry angle for dose verification of intensity?modulated radiotherapy ( IMRT) in the treatment of nasopharyngeal carcinoma ( NPC) and cervical carcinoma. Methods Thirty patients with NPC and thirty patients with cervical carcinoma were randomly chosen from 87 patients with NPC and 54 patients with cervical carcinoma, respectively. Using a gamma criterion of 3 mm/3%, the γ passing rates at actual gantry angle and zero degree gantry angle were measured using ArcCHECK and compared by paired t test. Results The γ passing rate was significantly lower at actual gantry angle than at zero degree gantry angle in patients with NPC or cervical carcinoma ((93.8±3. 6)% vs. (97.8±1. 1)%, P=0. 00;(96.3±2. 1)% vs. (98.2±1. 0)%, P=0. 00). Moreover, the variation range of the γ passing rate at actual gantry angle was larger than that at zero degree gantry angle. Bothγpassing rates at actual gantry angle and zero degree gantry angle were lower in the patients with NPC than in the patients with cervical carcinoma . Conclusions Compared with that at zero degree gantry angle, theγpassing rate at actual gantry angle is closer to reality. Therefore, the actual gantry angle is recommended for dose verification. In order to meet the clinical requirement, a higher standard of γ passing rate should be proposed when zero degree gantry angle is used for dose verification.

Objective To explore the coincidence rates of positive and reverse blood group of infants younger than six months in Xiamen area in recent years,and to analyze the difference of anti-A or anti-B antibody in infants of different age groups and different ABO blood groups.Methods 2 993 hospitalized infants from 0 to 6 months in five hospitals of Xiamen area were selected.EDTA-K2 anticoagulant blood samples were collected.Micro-column gel agglutination assay was used in ABO blood group.All the infants were divided into six groups,which aged from 0-7 days,8-14 days,15-31 days,1-2 months,3-4 months and 5-6 months.The coincidence rates of positive and reverse blood group of each group were compared.Results Of the 2 993 infants,303 cases were AB type.The coincidence rates of positive and reverse blood group of the other infants which aged from 0-7 days,8-14 days,15-31 days,1-2 months,3-4 months and 5-6 months were 57.0%,61.0%,63.0%,71.8%,84.9% and 91.0%,respectively.The coincidence rates of positive and reverse blood group between different blood groups had no statistically significant difference(x2=0.842,P=0.657).The coincidence rates of positive and reverse blood group had statistically significant difference among different age groups(x2=185.683,P<0.05).Conclusion The IgM antibody of ABO blood group is detected in infants younger than six months.Positive and reverse blood group is necessary in ABO blood group identification of infants to guarantee the safety clinical blood transfusion.

AIM:To study the effects of ischemic postconditioning on cerebral ischemia following middle cerebral artery occlusion in rats. METHODS: 21 rats were randomly divided into three groups: middle cerebral artery occlusion (MCAO), MCAO+transient unilateral common carotid artery occlusion (u-CCA-O), MCAO+transient bilateral common carotid artery occlusion (b-CCA-O)(n=7, respectively). u-CCA-O/b- CCA-O was generated by transient middle cerebral artery occlusion plus transient unilateral/bilateral common carotid artery (CCA) occlusion. After the suture was removed, ischemic postconditioning was performed by occluding CCA for 10s, reperfusion 10s, and then allowing for another 4 cycles of 10s of reperfusion and 10s of CCA occlusion. Rats were sacrificed 2 d later and infarct size was measured. Cerebral blood flow (CBF) was measured in different 15 time points: 0 min, 10 min, 1 h after MCA occlusion, 0 min after MCA reperfusion, 10s of CCA occlusion and 10s of CCA reperfusion in all five cycles, 30 min after MCA reperfusion. Functional neurological outcome was determined 1 h and 48 h after reperfusion. Infarct volume was measured 48 h after reperfusion. RESULTS: The infarct volumes in u-CCA-O group and b-CCA-O group diminished compared to the control group. The results of CBF demonstrated that b-CCA-O group diminished 9% compared with control and u-CCA-O group when 30 min after intervention. The rats in u-CCA-O and b-CCA-O group had better neurological performance at 1 h after reperfusion. CONCLUSION: Ischemic postconditioning reduces infarct size, improves functional neurological outcome, most plausibly by diminishing cerebral blood flow.

BACKGROUND:The number of hematopoietic stem cel s in the peripheral blood is very low at normal physiological state. So it is critical to mobilize hematopoietic stem cel s from donor’s bone marrow into the peripheral blood.
OBJECTIVE:To study the combination effect of AMD3100 and dexamethasone on the mobilization of hematopoietic stem cel s in mice, thereby laying the foundation for clinical application.
METHODS:C57BL/6 mice were injected with AMD3100 and dexamethasone alone or in combination. Then, hematopoietic stem cel s in the peripheral blood and bone marrow were col ected. CD34+cel concentration in the peripheral blood and bone marrow was determined by flow cytometer and the content of leucocytes in the peripheral blood was counted by a normal method. The CFU-Mix colony formation ability of hematopoietic stem cel s was identified by cel colony forming assay.
RESULTS AND CONCLUSION:The concentration of CD34+cel s in the peripheral blood and bone marrow, the content of leukocytes in the peripheral blood and the CFU-Mix colony formation ability of hematopoietic stem cel s were al improved by both AMD3100 and dexamethasone and especial y their combined use. This indicates that both AMD3100 and dexamethasone could mobilize hematopoietic stem cel s to migrate from the bone marrow to the peripheral blood, and when used in combination, the mobilization effect is better than that of single drug.

Objective To examine the prevalence of chikungunya virus in brain tissue samples from rat?like animals in Xiamen, Shenzhen and Guangzhou, and to explore whether the rat?like animals are potential sources of human chikungunya fever infections and the host of the virus. Methods Rat?like animals were trapped in residential areas, city parks, hospitals, markets and schools in Xiamen, Shenzhen and Guangzhou (Yuexiu and Baiyun districts) between January 2013 and June 2016. Brain tissue samples of the trapped animals were collected under sterile. Chikungunya virus was detected by using reverse transcription polymerase chain reaction (RT?PCR). Results Totally 1092 rat?like animals were trapped, which belonged to 7 species, 3 genera, 2 families, 2 orders. Rattus norvegicus was the dominant species in the indoor environment, Rattus losea was dominant in wild environment, and 1092 brain tissue samples were collected. No detectable chikungunya virus was found in the brain tissue samples by RT?PCR. Conclusion There is a low possibility that rat?like animals act infectious sources of human chikungunya fever infections and the host of the virus.

Objective To study the optimal timing of preoperative injection of indocyanine green in laparoscopic liver tumor resection under indocyanine green fluorescent navigation to obtain the most satisfactory fluorescence imaging effects.Methods 60 patients with liver tumors who underwent laparoscopic hepatectomy from April 2017 to October 2018 were retrospectively studied on the intraoperative fluorescence imaging effects.A simple grading of the fluorescence imaging effects was developed.The ICG R15 and preoperative injection times of ICG were correlated with the intraoperative fluorescence imaging effects.Results Of 60 patients with liver tumors,59 patients underwent laparoscopic liver resection and one patient was converted to open surgery.The overall satisfaction rate of intraoperative fluorescence imaging was 73.4％ (44/60).In the patients with an ICG R15 rate ≤ 7％,it was easier to obtain good fluorescence imagings when the preoperative administration time was longer than 48 hours.Even when the preoperative administration time was longer than 5 days,satisfactory fluorescence imaging effect could still be obtained in these patients.In the patients with an ICG R15 rate ＞ 7％,intraoperative fluorescence imagings were unsatisfactory when the administration time was less than 6 days.Relative better imagings were obtained in these patients when the preoperative administration time was more than 6 days.Conclusions When the pre-operative ICG injection dose was not changed,the preoperative administration time should be adjusted according to the value of the ICG R15 to obtain better intraoperative fluorescence imaging effects of the liver tumors.The optimal timing needs to be further studied by a large case study.

Objective:To investigate the molecular pathogenesis of a newly discovered gene mutation in a family with hereditary coagulation factor Ⅺ(FⅪ) deficiency.Methods:The proband was admitted to the First Affiliated Hospital of Wenzhou Medical University in September 2021 due to "calculus of intrahepatic duct". The patient had no symptoms of spontaneous bleeding.The clinical data and blood samples of the proband and her family members (10 persons in 3 generations) were collected.The activated partial thromboplastin time (APTT) and FⅪ activity (FⅪ:C) were performed by the one-stage clotting assay. FⅪ antigen (FⅪ:Ag) were detected by enzyme linked immunosorbent assay (ELISA). Genomic DNA extracted from peripheral blood cells of subjects was used as template to analyze F11 gene mutation by DNA direct sequencing. Bioinformatics software was used to analyze the effects of mutations on protein structure and function. Wild-type and mutant FⅪ protein expression vectors were constructed and transient transfected into HEK293T cells. The total RNA was extracted from positive transfected cells and then reversely transcribed into cDNA. The mRNA expression level of F11 gene in transfected cells was detected by real-time fluorescence quantitative PCR (qRT-PCR). The content of FⅪ:Ag and the expression of FⅪ protein in transfected cell lysates and culture supernatant were detected by ELISA and western blot.Results:The APTT of the proband was significantly prolonged to 107.9s (reference range 29.0-43.0s), while FⅪ:C and FⅪ:Ag were significantly decreased to 2% (reference range 84%-122%) and 5% (reference range 76%-127%), respectively. Gene sequencing analysis indicated that the proband had c.536C>T (p.Thr161Met) heterozygous missense mutation and c.1556G>A (p.Trp501Ter) heterozygous nonsense mutation in exon 6 and 13 of the F11 gene, respectively. Bioinformatics analysis showed that the amino acids at site 161 of FⅪ protein were threonine (Thr) in the matrix composed of five different species, indicating that Thr161 site was highly conserved among homologous genes in different species. p.Thr161Met heterozygous mutation affected the stability of local intermolecular structure of FⅪ protein. In vitro expression experiments of p.Thr161Met mutation showed that FⅪ protein had a normal synthesis in the cells but secretion dysfunction.Conclusions:c.536C>T (p.Thr161Met) heterozygous missense mutation and c.1556G>A (p.Trp501Ter) heterozygous nonsense mutation were mainly responsible for the decrease of FⅪ in this family. p.Thr161Met mutation was first reported in the world and did not affect the normal synthesis of FⅪ protein, but caused secretion dysfunction.

Objective:To explore the molecular pathogenesis of hereditary protein C (PC) deficiency due to a p. Gly86Asp variant of the PROC gene through in vitro expression experiment.Methods:Wild type and Gly86Asp mutant expression plasmids of PC were constructed and respectively transfected into HEK 293FT cells. Total RNA was extracted from the transfected cells, and the expression of PROC gene was determined by quantitative real-time PCR (qRT-PCR). PC antigen (PC: Ag) in the supernatant of cell culture and cell lysate was determined by enzyme-linked immunosorbent assay (ELISA), and the level of PC protein was detected by Western blotting. Results:qRT-PCR has detected no significant difference in the transcription level of wild-type and mutant-type PC. Compared with the wild type, the level of mutant PC: Ag in the supernatant and cell lysate were 81.3%±2.6% and 110.0%±2.8%, respectively. No difference was detected in the molecular weight between the wild-type and mutant-type PC by Western blotting. The PC content of mutant type was higher than wild-type in cell lysate, while the opposite was found with the cell culture supernatant.Conclusion:The impaired secretion by mutant PC may be the molecular mechanism of PC deficiency caused by the p.

Objective:To explore the genetic basis for a patient with factor XIII (FXIII) deficiency.Methods:All exons of the F13A1 and F13B genes were amplified by PCR and sequenced directly. The sequencing was performed with a reverse primer if a variant was found. Conservation of variant site was analyzed by the ClustalX software. Four online bioinformatic software including MutationTaster, PolyPhen-2, PROVEAN and SIFT were used to predict the function of the mutation site. The Swiss-PdbViewer software was applied to analyze the changes in the protein model and intermolecular force. Results:The proband was found to harbor a novel c. 515G>C (p.Arg171Pro) variant of the F13A1 gene. The corresponding amino acid Arg171 is conserved among homologous species. Bioinformatic analysis indicated that Arg171Pro variant may affect the protein function. Protein model analysis showed that in the wild-type, there is one hydrogen bond between Arg171 and Pro27; one hydrogen bond between Arg171 and Thr28; two hydrogen bonds between Arg171 and Glu102. When Arg171 was mutated to Pro171, the three hydrogen bonds between Arg171 and Pro27, Glu102 are all disappeared and formed a new benzene ring which might affect the stability of the protein structure. No variant was found in the F13B gene. Conclusion:The Arg171Pro variant may account for the decreased FXIII level. Above finding has enriched the spectrum of F13A1 gene variants.

Objective·To evaluate the relationship between anxiety level,alexithymia degree and quality of life in patients with anxiety disorders.Methods·Anxiety disorder patients admitted to the outpatient department of Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine from October 1,2020 to March 31,2023 were selected as the research subjects,and 438 patients were ultimately included after exclusion.Among them,there were 271 patients with generalized anxiety disorder,101 patients with panic disorder,48 patients with social anxiety disorder,12 patients with agoraphobia,and 6 patients with specific phobia.Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale-17(HAMD-17),the twenty-item Toronto Alexithymia Scale(TAS-20)and World Health Organization Quality of Life Scale-Brief Form Questionnaire(WHOQOL-BREF)were used to assess the patients'anxiety level,depression level,alexithymia degree and quality of life,respectively,and the scale scores of patients with different subtypes of anxiety disorders were evaluated.Spearman correlation coefficient was used to analyze the correlation between anxiety level,depression level,alexithymia degree and quality of life in patients with anxiety disorders.Stepwise regression model was used to analyze the key variables affecting the quality of life in patients with anxiety disorders.Results·There were no significant differences in HAMA score,HAMD-17 score and TAS-20 score among patients with different subtypes of anxiety disorders,but the differences in WHOQOL-BRIEF score were statistically significant(H=10.076,P=0.039).The results of Spearman correlation analysis showed that the WHOQOL-BRIEF score of anxiety disorder patients was negatively correlated with HAMA score,HAMD-17 score and TAS-20 score(r=-0.256,P=0.000;r=-0.311,P=0.000;r=-0.342,P=0.000).The results of stepwise regression analysis showed that age,HAMA score,HAMD-17 score and TAS-20 score had significant impact on the quality of life of patients(all P<0.05).Conclusion·The quality of life in patients with different subtypes of anxiety disorders is different.The anxiety level,depression level and alexithymia degree are the key variables affecting their quality of life.