Objective To compare the planning systems of the simplified manual intensity modulated (SMIM) irradiation and standard tangential (ST) irradiation,in order to explore the application of SMIM technique in clinic.Methods In 64 cases of breast cancers after breast conserving surgery,each underwent both SMIM and ST planning systems.SMIM planning was designed by copying additional fields for shielding the high dose areas from internal or lateral tangential field.The high dose areas were reduced by adjusting the size of the additional field and open tangential field.To optimize the SMIM planning,3 high dose areas (＞ 103% ,＞ 105% and ＞ 107%) were shielded and 3 protocols carried out.The wedges were also optimized in ST plan.The target coverage and dose homogeneity and dose of organ at risk were compared between SMIM and ST planning systems.Results When the dose was normalized to cover the volume of 95% CTV,85% of the shielded areas in optimal SMIM planning were that of ＞ 103% high dose area,and 94% of target area was covered.The study on the volume of breast CTV showed that,in the large breast group,SMIM could not only significantly reduce the high dose areas,and the maximum dose as well as the dose of organ at risk,but also enhance the dose homogeneity index.However,no such effect was not significant in the small breast group.Conclusions The simplified manual intensity modulated technique can improve target dose homogeneity in the large breast cases instead of the standard tangential technique.

Objective:To investigate the prevalence of volatile sulfur compounds ( VSC ) in oral cavity of preschool children, and to analyze related factors, thus to provide scientific basis for the prediction and treatment of halitosis. Methods:The VSC content ( hydrogen sulfide, methyl mercaptan, dimethyl sul-fide) of 170 preschool children (4 to 6 years old) was detected by a portable gas chromatograph Oral-ChromaTM . The status of the oral health was evaluated. The living habits and other aspects were obtained through questionnaires from the children' s parents. A soft package for social statistics version 13. 0 ( SPSS 13 . 0 ) was used in which univariate analysis and multivariate analysis were utilized to analyze the related factors of halitosis in children. Results:In the study, 34. 4% of the total subjects had excessive VSC. Hydrogen sulfide (H2S) [(1. 59 ± 2. 41) ng/10 mL] and total VSC concentration [(2. 14 ± 4. 42) ng/10 mL] in the girls were significantly higher (P<0. 05) than those in the boys. The tongue coating score had a significant positive correlation with H2S [tongue coating area (1. 68 ± 2. 48) ng/10 mL,tongue coating thickness (2. 18 ± 2. 69) ng/10 mL] and total VSC concentration [ tongue coating area, (2. 26 ± 4. 31) ng/10 mL,tongue coating thickness (2. 41 ± 3. 02) ng/10 mL , P<0. 01]. The site number of DI-S≥2 had a significant positive correlation with methyl mercaptan ( CH3 SH) and dime-thyl sulfide [(CH3)2S] concentration (P<0. 01). The concentration of H2S [(1. 19 ± 1. 62) ng/10 mL] in children, whose mother had a higher degree of education, was statistically lower (P<0. 01).The children who took dessert or sweat drinks more frequently had lower H2S [(1. 04 ± 1. 55) ng/10 mL, P<0. 05] concentration, while CH3SH and (CH3)2S concentration [(0. 29 ± 1. 92) ng/10 mL, (0. 37 ± 2. 06) ng/10 mL, P<0. 05) were higher in the children with mouth -breath habit. Conclu-sion:A high prevalence of halitosis was noted in preschool children. Gender, tongue coating index, deb-ris index-simplified, status of the mother' s education, frequency of eating dessert or sweat drinks and dry mouth breath were related with halitosis of preschool children. The different related factors resulted in changes of each VSC concentration.

Objective To evaluate the setup errors of image guided radiation therapy (IGRT) for head-and-neck cancer using kilovoltage cone beam CT( kV CBCT).Methods 256 patients with head-and-neck cancer were treated with intensity modulated radiation therapy (IMRT) from March 2009 to October 2011.All patients were immobilized with head-and-neck mask and localized with final isocenter marking method using the Philips PQS CT or Philips Brilliance CT Big Bore scanners,which were equipped with LAP movable laser systems.The CT images were transferred to a Varian Eclipse V8.6 workstation for contouring and planning.A kV cone-beam CT scans was acquired,and registered before the treatment for every patient on a Varian iX linear accelerator via OBI system.The setup errors in the right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were recorded.Results The setup errors for the 473 datasets followed a Gaussian distribution.The systematic errors ± random errors in the RL,SI and AP were(-0.6 ± 1.3 ),(0.5 ± 1.6) and (0.9 ± 1.7 ) mm,respectively.The planning target volume (PTV) margins were calculated respectively as 2.4,2.4 and 3.4 mm according to the formula of M =2.5∑ +0.7δ The margins of 288 sets of data using the Big Bore CT scanner were calculated as 2.0,2.1 and 1.7 mm,respectively.Conclusions The setup errors using final isocenter marking method are smaller than those using reference point marking method.The result derived from this retrospective study could be used to set the margin between CTV and PTV.

Objective:To understand the oral health status of urban and rural residents in China,the Fourth National Oral Health Epidemiological Survey (FNOHES) was conducted in 2015.Materials and methods:Based on the principles of multi-stage,stratified,equal capacity,and random sampling,the subjects included five groups of residents aged 3-5,12-15,35-44,55-64,and 65-74 years in all 31 provinces,municipalities,and autonomous regions except Hong Kong,Macao,and Taiwan.The total sample size was 172,425.The survey covered two areas,namely oral health status and knowledge,attitude and oral health behavior.Results:Residents in China had serious caries and poor periodontal condition.The prevalence of caries was above 50％ in all age groups,subjects without periodontal disease accounted for ＜50％,and fewer than 50％ of subjects brushed their teeth twice a day.Based on the results of the FNOHES,the following suggestions were proposed for improving the oral health in China in the future:to establish and improve the comprehensive prevention and control system for oral diseases,implement a comprehensive prevention and control strategy for priority groups,strengthen the oral health education for all people to improve oral health literacy,enhance dynamic monitoring to scientifically evaluate oral health status,and coordinate multi-party resources to establish and improve the oral health service security system.Conclusion:The oral health status of Chinese residents and their oral health behavior habits need to be improved.With the support of the administrative departments of the government and unremitting efforts of the oral health staff,all sectors of society must be coordinated to strengthen oral health education for the whole population.Furthermore,comprehensive prevention and control measures must be implemented for priority groups.

Objective To determine the spectrum of mutations responsible for Phenylalanine hydroxylase (PAH) deficiency on phenylketonuria (PKU) patients of Han Chinese people in the Huaihai region of central China.Methods One hundred and one patients diagnosed with PKU were referred to Xuzhou Maternity and Child Health Care Hospital for genetic counseling/analysis from January 2003 to December 2013.Thirteen exons of PAH gene mutations,as well as their flanking introns,were identified in 202 of chromosomes using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP) and sequencing.Results (1) The spectrum was composed of 24 different mutation types,which had been submitted to the National Center for Biotechnology Information(NCBI) dbSNP databases under accession number SS#2137543837_SS#C2137543860.(2)The most commonly affected region was exon 7 and its flanking introns.The most prevalent mutations were c.728G ＞ A (p.R243Q),followed by c.721C ＞ T (p.R241C),c.1155G ＞ C(p.L385L),c.1068C ＞ A(p.Y356X),c.-71A ＞ C(-71A ＞ C) and c.60 + 62C ＞ T (IVS1 +62C ＞T),accounting for 18.317％,8.416％,4.950％,3.960％,3.465％ and 2.970％ of the mutant chromosomes,respectively.(3)Two novel mutations were identified in PAH gene in PKU patients of Han Chinese people:c.60+62C＞T(IVS1 +62C ＞T) and c.782G ＞T(p.R261L).Conclusions The vast majority of PAH mutations identified corresponded to those observed for the PKU populations in the other regions in China,whereas a few are considerably different from others.The mutational spectrum of PAH gene found in patients with PKU in the Huaihai region exhibit regional association.

Objective:To investigate the effect of miR-425-5p on glucagon-like peptide-1(GLP-1) secretion in intestinal L cells induced by lipopolysaccharide(LPS), and to explore its mechanism.Methods:GLUTag cells of intestinal L cell line were incubated with LPS to determine the levels of miR-425-5p and GLP-1. Cell viability was determined by MTT assay, and cell apoptosis was detected by flow cytometry. Quantitative real time-PCR and western blot were performed to determine the expressions of miR-425-5p, phosphatase and tensin homology(PTEN), proglucagon, and GLP-1. Activity of Wnt/β-catenin signaling pathway was determined by detecting TOP/FOP ratio. Interaction among miR-425-5p, PTEN, and β-catenin was analyzed using luciferase activity assay and chromatin immunoprecipitation(ChIP)assay.Results:In GLUTag cells, with the elevation of LPS concentration, the expression of miR-425-5p and the apoptosis rate were increased, while the level of active GLP-1 and the cell viability were decreased. MiR-425-5p was involved in the regulation of LPS on GLP-1 secretion and intestinal L cell viability. Inhibition of miR-425-5p reduced the mRNA expression of proglucagon and the TOP/FOP ratio, increased PTEN protein level, and inhibited cell viability. In LPS-treated GLUTag cells, miR-425-5p increased the level of β-catenin by targeting PTEN, and β-catenin acted as a cis-acting element to induce the transcription of proglucagon and promote the secretion of GLP-1.Conclusion:In LPS-induced intestinal L cells, miR-425-5p promotes the expression of GLP-1 by targeting PTEN to modulate β-catenin.

ObjectiveTo observe the effects of Jianpi Bushen Huoxue prescription （JPBSHX） on rat brain microvascular endothelial cells （RBMECs） based on hypoxia-inducible factor-1α （HIF-1α）/vascular endothelial growth factor （VEGF） signaling pathway， aiming to provide a theoretical basis for the treatment of ischemic stroke. MethodTwelve 8-week-old male SPF-grade SD rats were selected. Eight of them were randomly chosen and given 3.25 g·mL^-1 JPBSHX solution by gavage at a dose of 10 mL·kg^-1 for 5 consecutive days to prepare the medicated serum， which was then preserved for later use. The remaining four rats were given the same volume of normal saline. Follow-up operations were the same as those of the above eight rats. Normal rat serum was collected and stored for later use. RBMECs were revived， cultured， passaged， and randomly divided into five groups： normal group （20% normal rat serum+80% high glucose DMEM）， model group （hypoxia-reoxygenation injury） （20% normal rat serum+80% glucose-free DMEM）， medicated serum group （20% JPBSHX-medicated serum+80% glucose-free DMEM）， medicated serum+HIF-1α inhibitor group （20% JPBSHX-medicated serum+HIF-1α inhibitor 1 mg +80% glucose-free DMEM）， and medicated serum+VEGF inhibitor group （20% JPBSHX-medicated serum +VEGF inhibitor 1 mg+80% glucose-free DMEM）. The relative protein expression levels of Claudin-1 and Claudin-5 in RBMECs， the expression levels of HIF-1α and VEGF in RBMEC culture supernatants， the repair ability of RBMECs， and the number of nodes， microvessels， and their lengths after 72 h of culture were observed in each group. ResultAfter 24 h of reoxygenation， the scratch healing rate in the model group was significantly lower than in the normal group （P<0.01）. Compared with the result in the model group， the scratch healing rates significantly improved in the medicated serum group， medicated serum+HIF-1α inhibitor group， and medicated serum+VEGF inhibitor group （P<0.05）. However， the healing rates in the medicated serum+HIF-1α inhibitor group and medicated serum+VEGF inhibitor group were significantly lower than that in the medicated serum group （P<0.05）. The number of nodes， microvessels， and total length of microvessels in the model group were significantly lower than those in the normal group （P<0.01）. These indicators significantly improved in the medicated serum group， medicated serum+HIF-1α inhibitor group， and medicated serum+VEGF inhibitor group compared with those in the model group （P<0.05）， but were significantly lower in the medicated serum+HIF-1α inhibitor group and medicated serum+VEGF inhibitor group compared with those in medicated serum group （P<0.05）. The relative expression levels of Claudin-1 and Claudin-5 proteins were significantly lower in the model group than in the normal group （P<0.01）. These levels were significantly higher in medicated serum group， medicated serum+HIF-1α inhibitor group， and medicated serum+VEGF inhibitor group than those in the model group （P<0.05）， but were significantly lower in the medicated serum+HIF-1α inhibitor group and medicated serum+VEGF inhibitor group than those in the medicated serum group （P<0.05）. The expression levels of HIF-1α and VEGF in the RBMEC culture supernatants were significantly lower in the model group than those in the normal group （P<0.01）. These levels were significantly higher in the medicated serum group， medicated serum+HIF-1α inhibitor group， and medicated serum+VEGF inhibitor group than those in the model group （P<0.05）， but were significantly lower in the medicated serum+HIF-1α inhibitor group and medicated serum+VEGF inhibitor group than those in the medicated serum group （P<0.05）. ConclusionJPBSHX can promote the proliferation， migration， and angiogenesis， such as tubule formation， of RBMECs damaged by hypoxia-reoxygenation injury， and this effect may be achieved through the regulation of the HIF-1α/VEGF signaling pathway.

At present, it has been regarded that oral disease was one of the most prevalent problems for people's general health around the world. Oral disease burden study focuses on the pressure and effect of oral diseases to the whole social economy and people's health. Oral disease burden, as a public health problem, needs to be attached importance in China and foreign countries. By means of retrieving the literature, this review article summarizes the progress of domestic and oversea studies on oral disease burden, analyses the epidemiological burden through the indicators such as the prevalence rate, decayed missing and filled teeth, disability adjusted life years, disability weights, and illustrates the economic burden of oral diseases by using part of the data. Results shows that the oral disease burden is obvious in most countries and regions both in China and foreign countries. The study of oral disease burden in China has not been well developed. Giving priority to dental caries, periodontal disease and tooth loss, the prevalence of oral diseases in China is high. The rate of seeking dental treatments is low and the proportion of self-supporting treatments is high. In general, the epidemiological and economic burden of oral diseases is heavier in China than that in the rest of the world.

President Xi presented an important address in the National Health and Wellness Conference and the high strategic priority for promoting people's health in China was emphasized. Thereafter, a number of documents of state policy on health and wellness were issued successively. These documents covered important contents on oral health, which had great significance as a milestone. This article reviewed the documentation process and analyzed the key points on oral health. The release of these series of government documents had provided policy support for integrating oral health into significant health policies, building the first barrier for oral health, preventing and treating oral diseases based on strategies for common risk factors, adopting strategies to combine both the whole population and high-risk groups, and developing health-centered oral massive health industry, etc.