Objective To study the correlation between dose-volummetrics and changes of pulmona- ry function tests(PFTs), and to study the ability of standard dose-volummetrics to predict these changes after radiotherapy. Methods Pulmonary function was measured in 39 patients with inoperable lung cancer one week before and 2-4 months after radiotherapy. The pulmonary function parameters were the forced vital ca- pacity(FVC), forced expiratory volume in ls (FEV 1.0) and diffusion capacity of carbon monoxide(DL- CO). Dose-volumrnetrics were V_(10), V_(15), V_(20), V_(25), V_(30), V_(35), V_(40), CTV_(100), CTV_(95), CTV_(90), CTV_(80), lung D_(mean), V_(eff) and NTCP. Pearson and line regression analysis was performed to determine whether the correlation exis- ted between the metrics and the changes of PFTs. Results No correlation was found between the dose- volummetrics and the changes in PFTs. Excluding patients(n=15) with pretreatment atelectasis, signifi- cant correlation was found between the dose-volummetrics (V_(20), V_(25), V_(30), V_(35), V_(40), GTV, V_(eff) and D_(mean)) and the PFTs changes(r=0.469-0.695, P≤0.05). Therefore, the re-expansion may have jesperdized the proper data to the present record. Multivariate analysis showed that V_(30) was the risk factor to affect the chan- ges of FEV 1.0 and DLCO(P=0.046、0.041). The pulmonary function of patients with V_(30)≥18% was worse than patients with V_(30)

BACKGROUND:Shape memory polymer is a new type of functional material. The applications of shape memory polymers in the biomedical field have increasingly been paid close attention. OBJECTIVE: To summarize the characteristics and applications of shape memory polymers. METHODS: SpringerLink and China Journal Ful text Database were searched for articles related to shape memory polymers. RESULTS AND CONCLUSION: As a new type of inteligence material, shape memory polymers have lots of advantages compared with shape memory aloy and shape memory ceramics, such as low density, light weight, low cost, high shape-recovery rate, easy to regulate the shape memory temperature, to dye, to shape and to be stimulated under expected switch temperature. Especialy for polyurethane, the structure-property relationships are extremely easy to control, the shape memory temperature can be set in a wide range from-30℃ to 70℃, and it has the biocompatibility. Due to these, shape memory polymers have great potentials in applications of biomedical engineering. But the comprehensive properties of the developed shape memory polymers are not satisfactory. For example, the polynorbornene has big recovery stress, fast recovery velocity and high recovery precision, but its relative molecular mass is very big, the molecularchain is long, and processing is difficult. Furthermore, most of shape memory polymers have smal recovery stress, slow recovery velocity, low recovery precision and unsatisfied repeat memory effect. The key problems for shape memory polymers include optimization of the function of shape memory and improvement of the comprehensive properties based on the technologies of molecular design and material modification.

Objective To study the relationship between radiation gastritis ( RG ) caused by esophageal cancer radical postoperative prophylactic IMRT and the dose of gastric. Methods A total of 49 esophageal cancer patients received postoperative adjuvant radiatherapy after esophagectomy, we analysised the dose?volume histogram of treatment plan and the the occurrence of RG, To analysis those physical indicators may be related to the occurrence of RG. The of ROC curve to analysis the physical index of the occurrence of acute radiation gastritis, Chi square test is compared between groups, Logistic method was used to multivariate analysis. Results The whole group, a total of 19 cases ( 39%) patients with symptoms of acute RG level 2 or higher. The results of ROC curve analysis showed that the physical variables associated with the occurrence of RG include stomach Max,stomach Mean,LSTT5?LSTT40 and V5?V50.According to the ROC curve,the cutoff values of the physical parameters of the patients were grouped. The incidence of acute≥2RG in the group of above boundary value patients significantly higher than below boundary value group, the physical index of the differences between groups were significant (P=0. 000?0. 022),except V5.The results of Logistic multivariate analysis showed that LSTT5 and V40 were independent predictor of≥2 RG (P=0. 026,0. 001). Conclusions According to the results of this study,We should pay attention to the protection of the stomach in develop a treatment plan for the prevention of postoperative patients with esophageal cancer,dose?volume histogram can well predict the occurrence of RG. Stomach LSTT5 and V40 were independent predictor of≥2 RG.The results of this study need to be further studied.

Aged ; Female ; Humans ; Male ; Melanosomes ; Metaplasia ; Middle Aged ; Nasopharynx ; cytology ; pathology ; Oxyphil Cells ; cytology

Objective To investigate the association of local factors with local recurrence (LR) and distant metastasis ( DM) in patients with esophageal squamous cell carcinoma ( ESCC) who do not experience clinical metastasis.Methods A total of 236 eligible ESCC patients were analyzed retrospectively, and the association of lesion length on esophagography, maximum tumor diameter, and tumor volume with survival and treatment failure pattern was analyzed.Kaplan-Meier test and Cox regression were used for survival analysis and to identify prognostic factors.Results The 1-, 3-, and 5-year overall survival rates, LR rates, and DM rates were 88.6%,52.4%,30.2%, 15.5%,35.6%,45.8%, and 9.0%,22.2%, 30.6%, respectively.The multivariate analysis showed that short-term treatment outcome and maximum tumor diameter were independent prognostic factors for overall survival rate ( P=0.000, 0.019); sex, maximum tumor diameter, irradiation method, and short-term treatment outcome were independent prognostic factors for LR (P=0.039,0.003,0.045,0.000);maximum tumor diameter was the independence factor for DM (P=0.035).In the patients receiving elective nodal irradiation and involved-field irradiation, the maximum tumor diameter was the prognostic factor for LR (P=0.008,0.001), and the lesion length on esophagography, maximum tumor diameter, and tumor volume were prognostic factors for DM (P=0.009, 0.023,0.014).Conclusions In ESCC patients without clinical metastasis, local factors are significantly associated with LR and DM, among which maximum tumor diameter is the most important factor.

Objective:To construct an evaluation index system for the perioperative medical service efficiency.Methods:From September to November 2023, this study conducted literature search and research group discussions to select initial indicators for evaluating the efficiency of perioperative medical services guided by value-based healthcare; 2-round Delphi methods were used to construct an evaluation index system for perioperative medical service efficiency, and the weights of the indicators were determined using the analytic hierarchy process.Results:The expert motivation for both rounds of Delphi method was 100.00%, the expert authority coefficient was 0.94, and the Kendall coordination scores were 0.56 and 0.75, respectively. The final established evaluation index system for perioperative medical service efficiency included 2 primary indexes, 9 secondary indexes, and 41 tertiary indexes. The first level indexes included medical quality and medical cost, with relative weights of 66.67% and 33.33%, respectively. Among them, medical quality included 7 secondary indexes: medical management, medical safety, service mode, information construction, patient outcomes, service efficiency, and satisfaction; Medical costs include 2 secondary indiexes: patient costs and medical institution costs.Conclusions:The evaluation index system for the efficiency of perioperative medical services reflected the connotation of value-based healthcare and could comprehensively and objectively evaluate the efficiency of perioperative medical services.

Objective To explore the effect of microRNA-613 (miR-613)/Wee1 axis on the radiosensitivity of colorectal cancer cells.Methods A total of 20 patients with radiosensitive colorectal cancer and 20 patients with radioresistance were selected from Yan'an Hospital Affiliated to Kunming Medical University from November 2016 to May 2017.Human colorectal cancer cell lines LoVo and HCT116 were selected and the radioresistant cell lines LoVo/R and HCT116/R were established for subsequent experiments.Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression of miR-613 and Wee1 in colorectal cancer tissues and cell lines.The radioresistant cells were transfected by miR-613 mimic,and non-transfected cells were used as control group.The effects of miR-613 overexpression on the proliferation,invasion and cell cycle of radiation resistance of colorectal cancer cells at different radiation doses were evaluated by CCK-8 assay,Transwell assay and Western blotting,respectively.Furthermore,dual-luciferase reporter gene assay was used to verify whether Wee1 was a target gene of miR-613.si-Wee1 was transfected into radioresistant cells of colorectal cancer,or co-transfected with si-Wee1 and miR-613 inhibitor,and non-transfected cells were used as control group.The effects of miR-613/Wee1 axis on cell proliferation,invasion and cell cycle were detected by CCK-8,Transwell and Western blotting at different radiation doses.Results The expression of miR-613 was downregulated in the radiation resistance group of patients (1.54 ± 0.25 vs.2.64 ± 0.45;t =3.140,P =0.009) and radiation resistance cell lines (LoVo/R vs.LoVo:1.03 ± 0.12 vs.3.05 ± 0.15;t =8.944,P =0.006;HCT116/R vs.HCT116:1.01 ±0.11 vs.2.85 ±0.16;t =8.050,P =0.008).Overexpression of miR-613 was significantly inhibited the proliferation (LoVo/R:t6 Gy =6.018,P =0.013;HCT116/R:t6Gy =5.634,P =0.015) and invasion (LoVo/R:45.00 ± 8.95 vs.180.15 ± 6.95,t6 Gy =11.93,P =0.003;HCT116/R:49.97 ±6.21 vs.170.20 ±7.03,t6 Gy =12.82,P =0.006) of LoVo/R and HCT116/R cells and decreased the expression levels of G2-M phase cell cycle correlated proteins (CDK1 and cyclin B).Moreover,dual-luciferase reporter gene assay confirmed that Wee1 was a target of miR-613.Mechanistically,overexpression of miR-613 promoted the radiosensitivity of LoVo/R and HCT116/R cells through inhibiting cell proliferation (compared with si-Wee1 group,co-transfected with si-Wee1 and miR-613 inhibitor,and control group,LoVo/R:F8 Gy =40.742,P =0.007;HCT116/R:F8 Gy =28.958,P =0.011),invasion (LoVo/R:F8 Gy =55.413,P =0.004;HCT116/R:F8 Gy =65.634,P =0.003) and arresting cell at G2-M phase via downregulating Wee1.Conclusion miR-613/Wee1 axis plays a certain role in regulating the radiation resistance of colorectal cancer cells,overexpression of miR-613 may reverse the radiation resistance of colorectal cancer cells.

Objective To investigate the genotype of M.tuberculosis in He'nan Province.Methods A total of 668 M.tuberculosis clinical strains collected in difference regions of He'nan Province during 2015 were genotyped by two standard methods,including classical 24-locus mycobacterium interspersed repetitive unit variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping.Results The 668 isolates were divided into 11 clusters and 35 patterns by spoligotyping.Among the 558 Beijing strains,546 were typical Beijing strains and the other 12 were atypical Beijing strains.Among the 110 non-Beijing strains,eight were new strains and the remaining 102 non-Beijing strains were divided into 10 families.There were 76 isolates belonging to T family,including 59 of T1 families,7 of T2 families,and 10 of T3 families.The 668 strains were divided into 550 gene patterns by standard 24-locus VNTR,including 508 un-clustered patterns and 160 clustered into 42 clusters.The largest cluster contained 21 strains,the other clusters contained 2-20 strains.Conclusion Beijing strain is still the most prevalent M.tuberculosis in He'nan Province.

Objective:To analyze the clinical prognosis of patients with cervical and upper thoracic esophageal squamous cell carcinoma treated with radical intensity-modulated radiotherapy (IMRT) with or without chemotherapy, and to explore the significance of elective lymph node irradiation (ENI).Methods:A retrospective analysis was performed on 309 patients with cervical and upper thoracic esophageal squamous cell carcinoma who underwent IMRT with or without chemotherapy in the Department of Radiology, the Fourth Hospital of Hebei Medical University. The prognostic factors were analyzed and patients receiving different irradiation methods were assigned into different group. The curative effect, toxicity and side effects were analyzed among different groups.Results:The 1-, 3-and 5-year overall survival (OS) and progression-free survival (PFS) were 76.7%, 37.4%, 19.3% and 59.7%, 27.4% and 14.4%, respectively, with median values of 26.8 and 15.5 months. Multivariate analysis showed that gender, cTNM staging and chemotherapy were the prognostic factors affecting the OS ( P=0.003, P<0.001, P=0.022), and gender, cTNM stage and radiation mode were the prognostic factors affecting the PFS ( P=0.016, P<0.001, P=0.008). After propensity score matching (PSM), the 1-, 3-, and 5-year OS and PFS were 77.2%, 39.3%, 20.0%, and 62.0%, 29.3%, and 15.4%, respectively, with median values of 27.1 and 18.2 months. Multivariate analysis showed that gender, cTNM staging and chemotherapy were the prognostic factors affecting the OS ( P=0.026, P<0.001, P=0.017); cTNM staging and irradiation mode were the prognostic factors affecting the PFS ( P<0.001, P=0.008). A subgroup analysis of chemotherapy showed that patients receiving 3-4 cycles of chemotherapy were preferred. The side effects of the patients were mainly grade 0 to 2, which could be tolerated. Conclusions:IMRT combined with or without chemotherapy is an efficacious treatment for patients with cervical and upper thoracic esophageal squamous cell carcinoma; ENI can improve the PFS of patients.

Objective:To investigate the influence of combining therapy of massage on sacro-2 to sacro-4 spinal cord reflexion area and anal dilatation therapy on constipation after cerebral apoplexy and promote the rehabilitation of defecation function in patients with constipation after stroke.Methods:Aandomized controlled study method was chosen, 80 patients with constipation after cerebral apoplexy treated in Guangzhou Traditional Chinese Medicine Hospital from August 2018 to July 2019 were selected as research subjects by convenience sampling. The enrolled patients were divided into 2 groups, 40 to the observation group and 40 to the control group by random number table method. On the basis of routine constipation related nursing measures, the control group was given anal dilatation therapy, while the observation group′s treatment was given massage on sacro-2 to sacro-4 spinal cord reflexion area combined with anal dilatation therapy. Before intervention and after intervention, the changes of therapeutic effect of constipation effect, constipation symptoms scores and the degree of neurological deficit were all compared between the two groups.Results:There were 22 males and 18 females in the observation group; age ranged from 40 to 75 (63.33 ± 8.49) years old; in the control group, there were 23 males and 17 females, aged 41-74 (63.03 ± 7.60) years old. Before intervention, there was no statistically significant difference in constipation symptom scores and neurological deficits between the two groups (both P>0.05). After intervention, the score of constipation symptoms was (3.80 ± 2.05) points and the score of the degree of neurological deficit was (7.58 ± 2.69) points in the observation group, both lower than (5.18 ± 3.52) points and (8.90 ± 2.73) points in the control group with statistically significant differences between the two groups ( t values were respectively -2.13 and -2.19, both P<0.05). The total efficacy of the observation group was 97.50% (39/40), which was significantly higher than 87.50% (35/40) of the control group with statistically significant differences between the two groups ( χ2 = - 2.11, P<0.05). Conclusions:Nursing intervention of massage on sacro-2 to sacro-4 spinal cord reflexion area combined with anus dilatation therapy on constipation after cerebral apoplexy can effectively reduce the symptoms of constipation and lowered the degree of neurological deficit, which is beneficial to the functional rehabilitation of patients with cerebral apoplexy.