Objective To study the real?time dose verification with 2D array ion chamber array in volumetric modulated arc therapy ( VMAT) with a 2D array ion chamber array. Methods The 2D ion chamber array was fixed on the panel of electronic portal imaging device (EPID). Source?detector distance (SDD) was 140 cm. 8 mm RW3 solid water was added to the 2D array to improve the signal noise ratio. Patient plans for esophageal, prostate and liver cancers were selected to be delivered on the cylindrical Cheese phantom 5 times in order to validate the reproducibility of doses. Real?time patient transit dose measurements were performed at each fraction. Dose distributions were evaluated using gamma index criteria of 3 mm DTA and 3% dose difference referred to the first time result. Results The gamma index pass rate in the Cheese phantom were about 98%;the gamma index pass rate for esophageal, prostate and liver cancer patient were about 92%, 92% and 94%, respectively. Gamma pass rate for all single fraction were more than 90%. Conclusions The 2D array is capable of monitoring the real time transit doses during VMAT delivery. It is helpful to improve the treatment accuracy.

Objective To explore the status of iodine nutrition in 8～10 years children after universal salt iodization(USI)in the iodine deficiency area.Methods Probability proportion to size method(PPS)or simple random sampling methods were used to sample children aged 8～10 years in iodine deficiency area in the vear 1995,1997,1999,2002 and 2005, respectively.Goiter were detected by palpation and B-ultrasound, iodine concentration in salt was detected by direct titration method and that in urine by the method of As3+-Ce4+catalytic spectrophotometry.Results After USI has been implemented,the median of salt and urinary iodine tended to mcreaseand the goiter rate tended to decrease year by year.In 2005,the coverage rate of iodinated salt was elevated to 97.2%,qualified iodize salt rate was 97.1%and edible qualified iodinated salt rate was 94.3%in the whole iodine deficiency areas.The median of urinary iodine Was 227.7 μg/L 89.7%(323/360)of the population had a level of the urinary iodine over 100μg/L Goiter rate of 8～10 years children Wag decreased from 22.3%(282/1267)to 4.4%(53/1200) from 1995 to 2005.Conclusion After 10-year USI,the status of iodine nutrition in ShaJldong Province has been promoted obviously and it is in a suitable iodine nutritional status.

OBJECTIVETo prepare monoclonal antibodies (mAbs) against enoyl-CoA hydratase 1 (ECH1).

METHODSNormal human liver tissues were homogenized, and the mitochondria were isolated by differential centrifugation. The total mitochondrial proteins were used to immunize BALB/c mice to prepare mAbs by routine hybridoma technique. The mAbs were characterized by ELISA, Western blotting and immunohistochemistry. The specificity of the antibody was identified by mass spectrometry (MS) following immunoprecipitation (IP) and confirmed by Uni-ZAP expression library screening.

RESULTSOne clone of the hybridoma BGB095 secreting specific mAb against ECH1 was obtained. The mAb was identified to belong to Ig subclass IgG1 and could be used in ELISA, Western blotting, immunohistochemistry, and immunoprecipitation.

CONCLUSIONA hybridoma cell line stably secreting specific mAb against ECH1 has been established. The specific mAb against ECH1 can be of great value for functional and distribution studies of ECH1.

Animals ; Antibodies, Monoclonal ; analysis ; immunology ; Antibody Specificity ; Blotting, Western ; Cell Line ; Enoyl-CoA Hydratase ; immunology ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunohistochemistry ; Liver ; cytology ; metabolism ; Mice ; Mice, Inbred BALB C ; Mitochondria ; metabolism

OBJECTIVETo investigate the etiology of 1977 patients from northern China with acute (ALF), sub-acute (SALF) or acute-on-chronic liver (ACLF) failures.

METHODThe age, gender, etiology, pathogenesis, and prognosis of the 1977 patients with liver failures were retrospectively analyzed.

RESULTSOf the 1977 cases, the three most common causes of ALF were HEV (33.96%) or HBV (13.21%) infections or those caused by medicines (9.43%). The three predominant causes of SALF were medicines (31.53%), HEV (16.22%) or HBV (9.91%) infections, but those of the ACLF were HBV (90.29%) infection, alcoholic hepatopathy (2.65%), and HBV super infected with HEV (2.26%) infections. 90.09% (1781) patients were infected by hepatotropic viruses. Of these 1781 patients, the most common cause of their liver failures was HBV infection (92.93%). In these HBV infected patients, 77.10% were from 26 to 55 years old. From 2005 to 2007, there were 39 patients with alcoholic liver failure. In the past two years, there were 23 patients with drug induced liver failure. The improvement rate of the 1977 patients after their treatments was 35.56%. The improvement rate of HEV infected liver failure was higher than drug induced liver failure (P less than 0.05); no statistical significance was found between other groups (P more than 0.05).

CONCLUSIONDifferent types of liver failure have different predominant causes. HBV infection is the most common cause in our 1977 patients. In the past two years, the number of drug induced liver failures and alcoholic liver failures have been increasing.

Acute Disease ; Adult ; Chemical and Drug Induced Liver Injury, Chronic ; etiology ; Chronic Disease ; Female ; Hepatitis B ; complications ; Hepatitis E ; complications ; Humans ; Liver Diseases, Alcoholic ; etiology ; Liver Failure ; chemically induced ; classification ; etiology ; virology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies

ObjectiveTo look into the distribution of “iodine suitable” region in iodine-deficient areas in Shandong province and to provide a scientific basis for guiding the redesignate of iodine-deficient areas and launch scientific supply of iodine.Methods One to 3 copies of water source samples were collected in 105 existing iodine-deficient counties by village.Water iodine content was detected by arsenic-cerium catalytic spectrophotometry.The areas with water iodine content below 10 μg/L was defined as iodine-deficient areas and among 10 - 150 μg/L were “iodine suitable areas” and greater than 150 μg/L were high iodine areas.Results The research was carried out in 14 cities,105 counties,and 1337 towns.We collected 65 716 water samples.Sample recovery efficiency reached 99.8％.The median of water iodine was 5.57 μg/L.In the 1337 towns surveyed,there were 82.05％(1097/1337) of the township with water iodine median ＜ 10 μg/L,17.43％(233/1337) between 10 - 150 μg/L,and 0.52％(7/1337) ＞ 150 μg/L.Conclusions In Shandong province,the water “iodine suitable” regions are distributed scattered with considerable proportion.In iodine-deficient areas,there are areas with high water iodine,and iodine-deficient regions should be redrawn.Emphasis should be put on iodine nutritional status of residents in “high iodine and iodine suitable” regions,and iodine supplementation should be carries out scientifically.

Objective To explore the influence of integrated education of hospitalization and follow-up that impacts on the mode change of life and compliance to the treatment among the patients with metabolic syndrome.Methods 56 inpatients with metabolic syndrome (MS) were selected as the education objects.The pattents were given the systematic class education and bed-side education in hospital,and were follewed up and instructed the diet and exercise behavior after discharge.Results The satisfaction rate of total calories control per day achieved 71.4%in different stages after discharge.Compared to those before being hospitalized,there were statistical meanings in the percents of earbohydrate,fat and protein in total calories.the scores of exercise knowledge,exercise attitude and exercise compliance (P<0.05).Conclusions The integrated education of hospitalization and fellow-up makes the MS patients'total calories per day controlled into an ideal state, optimize the diet structure,and improve the exercise knowledge,exercisc attitude and exercise compliance.

OBJECTIVETo investigate the changes of auditory parameters during anesthesia and establish the assessment indicators for anesthesia monitoring in animal experiments.

METHODSBALB/c mice of 4 to 6 weeks were given a single intraperitoneal dose of urethane, and the auditory evoked potential in the surgically exposed inferior colliculus in response to pure tone stimulation was recorded during urethane metabolism. The latency and amplitude data of the waves were extracted using Matlab software to analyze their variations during urethane metabolism.

RESULTSThe latency of the auditory evoked potential showed slight variation and was well correlated to time. The latency decreased progressively during urethane metabolism, fast in the initial 2 h and tending to stabilize afterwards.

CONCLUSIONThe latency of the auditory evoked potential can be more suitable indicators than the amplitude for anesthetic effect monitoring.

Anesthetics, Intravenous ; Animals ; Drug Monitoring ; methods ; Evoked Potentials, Auditory ; drug effects ; physiology ; Female ; Inferior Colliculi ; physiology ; Male ; Mice ; Mice, Inbred BALB C ; Urethane

OBJECTIVETo observe the effects of acute normovolemic hemodilution (ANH) on coagulation function and fibrinolysis in elderly patients undergoing hepatic carcinectomy.

METHODSThirty elderly patients (aged 60-70 years) with liver cancer (American Society of Anesthesiologists physical status I-II) scheduled for hepatic carcinectomy from February 2007 to February 2008 were randomly divided into ANH group (n = 15) and control group (n = 15). After tracheal intubation, patients in ANH group and control group were infused with 6% hydroxyethyl starch (HES) (130/0.4), and basic liquid containing 6% HES and routine Ringer's solution, respectively. In all the studied patients, blood samples were drawn at five different time points: before anesthesia induction (T1), 30 minutes after ANH (T2), 1 hour after start of operation (T3), immediately after operation (T4), and 24 hours after operation (T5). Then coagulation function, soluble fibrin monomer complex (SFMC), prothrombin fragment (F1+2), and platelet membrane glycoprotein (activated GPIIb/GPIIIa and P-selectin) were measured.

RESULTSThe perioperative blood loss was not significantly different between the two groups (P > 0.05). The volume of allogeneic blood transfusion in ANH group was significantly smaller than that in control group (350.5 +/- 70.7 mL vs. 457.8 +/- 181.3 mL, P < 0.01). Compared with the data of T1, prothrombin time (PT) and activated partial thromboplastin time in both groups prolonged significantly after T3 (P < 0.05), but still within normal range. There were no significant changes in thrombin time and D-dimer between the two groups and between different time points in each group (all P > 0.05). SFMC and F1 + 2 increased in both groups, but without statistical significance. P-selectin expression on the platelet surface of ANH group was significantly lowered at T2 and T3 compared with the level at T1 (P < 0.05). Compared with control group, P-selectin was significantly lower in ANH group at T2-T5 (all P < 0.05).

CONCLUSIONSIn elderly patients undergoing resection of liver cancer, ANH may not hamper fibrinolysis and coagulation function. It could therefore be safe to largely reduce allogeneic blood transfusion.

Aged ; Blood Coagulation ; Female ; Fibrinolysis ; Hemodilution ; Humans ; Liver Neoplasms ; blood ; surgery ; Male ; Middle Aged ; P-Selectin ; blood ; Platelet Glycoprotein GPIIb-IIIa Complex ; analysis

OBJECTIVETo study the relationship between pathogenic bacteria in the nasal middle meatus and acute bacterial respiratory infection in children.

METHODSThree hundred and twenty eight children with respiratory infection (mean age 8 years) were included into the prospective cohort study. The mucosal fluid specimens from the nasal middle meatus were collected under an endoscope for bacterial culture. The patients with bacterial culture positive were defined as the Exposed group and those with bacterial culture negative as the Non-exposed group. The grouping of the patients was blinded to the patients, patients' parents and physicians. Both groups received anti-virus and symptomatic treatments, without antibiotic administration. Five days later, the patients were evaluated as to whether they had bacterial infection based on the leucocyte count and CRP results.

RESULTSOf the 328 patients, 168 had a positive nasal bacterial culture. The incidence of bacterial respiratory infection in the Exposed group [51.2% (86/168)] was significantly higher than in the Non-exposed group [13.1% (21/160)] (P < 0.01). The relative risk of bacterial respiratory infection occurrence in patients with nasal bacterial culture positive was 3.9002.

CONCLUSIONSThe children with respiratory infection who had potential pathogenic bacteria in the nasal middle meatus were more prone to develop bacterial respiratory infection.

Acute Disease ; Bacterial Infections ; etiology ; Child ; Cohort Studies ; Female ; Humans ; Male ; Nose ; microbiology ; Prospective Studies ; Respiratory Tract Infections ; etiology

OBJECTIVETo investigate the prevalence of aminoglycoside resistance and genotyping of acetyltransferase in Escherichia coli.

METHODSResistance phenotypes to 12 antibiotics of 44 Escherichia coli isolates were analyzed using agar dilution method and 3 aminoglycoside resistance genes aac(3)-I, II and aac(6')-I were determined by PCR method.

RESULTSIn 44 clinical isolates, the occurrence of ESBLs was 45.45%, resistance rates were discrepant for amikacin (18.18%), gentamicin (56.82%) and tobramycin (61.36%), the prevalence of phenotype TG (tobramycin and gentamicin) indicative of aac(3)-II production and TGA (tobramycin, gentamicin and amikacin) indicative of aac(6')-I production were 36.36% and 18.18%, respectively. The most common aminoglycoside resistance genotype of acetyltransferase was aac(3)-II (52.27%) and aac(6')-I was lower (29.55%), but no aac(3)-I was detected.

CONCLUSIONAt least 2 acetyltransferase genes exist in this area i.e. aac(3)-II and aac(6')-I.

Acyltransferases ; genetics ; Amikacin ; pharmacology ; Aminoglycosides ; pharmacology ; Drug Resistance, Bacterial ; genetics ; Escherichia coli ; enzymology ; genetics ; Genotype ; Gentamicins ; pharmacology ; Phenotype ; Tobramycin ; pharmacology