Objective Studies on IMRT technique demonstrates that the improved dose homogeneities throughout the breast as well as reduction in dose to the heart and the ipsi-and control-lateral lungs. Methods Based on the physical principle of rolling tangential technique, a treatment plan for a patient has been planned by using Pinnacle aperture-based inversion software. The rolling tangential IM-beam was pre-determined at each pre-selected gantry angle with normally angle separation of 5?, 10? or 15?. Each beam's width was so chosen that the inner-and outer-edge of the beam should be tangential to the inner chest wall and target outer surface respectively. For the starting and ending tangential beam, a pair of opposing beam was designed. The beam's orientation was suggested to be reversed to its opposite angle when the tangential beam's gantry angle reached 90? or 270?. Each beam's shape and size were adjusted on its BEV map. For each tangential beam, 7 sub-segment beams were chosen for each tangential beam. Then, planning system was allowed to do optimization according to the clinical dose prescriptions. Results The calculated dose distributions in target(CTV), left & right lungs, and heart showed that the volume received the prescribed dose 50?Gy V_ 50 was 0.95; The volume in target enclosed with 95%, 105%, 110%, 115% isodose lines V_ 95% , V_ 105% , V_ 110% , V_ 115% was 0.98, 0.84, 0.53, 0.18, respectively. The volume of V_ 10 ,V_ 20 , V_ 30 , V_ 40 V_ 50 , in the lungs and heart were significantly decreased when compared to the current IMRT techniques published in the literature(Table 1).Conclusions The rolling tangential IM-segment irradiation technique for the breast developed by the author is able to offer not only a better dose distribution and better dose conformity throughout the target, but also reduce significantly the dose to the lungs and heart, with the patient's set up and localization process being very simple. The treatment planning for individual patient is optimal in any treatment planning system with Aperture-Optimization inverse software. This technique is certainly to offer more benefit to the patient if some measures are taken to limit or to follow the movement of the chest wall during irradiation.

Objective To study the changes in activity of NADPH oxidase, the effects of signal molecules on membrane potential and ROS production of mitochondria in apoptotic murine peritoneal macrophages. Methods Laser scanning confocal microscopy, flow cytometry and fluorescence labeling were used. Results 1 The macrophages treated with dexamethasone developed apoptosis quickly and presented concomitant apoptotic changes. 2 Mitochondria membrane depolarized quickly, the activity of NADPH oxidase declined sharply, and ROS production decreased rapidly. The erasers of ROS promoted macrophage apoptosis. 3 PKC favored, and cAMP inhibited the macrophage apoptosis and the rapid drop in ROS and mitochondrial membrane depolarization. cGMP and TPK which slightly inhibited macrophage apoptosis, had no effects on ROS. Conclusion 1 The activity of NADPH oxidase declined sharply, hence the ROS decreased rapidly, which promoted apoptosis in macrophages treated with dexamethasone. 2 The signal molecules affected apoptosis by modulating ROS decline and mitochondria depolarization. The results suggested that, mitochondria variations, especially the variations of ROS and membrane potential, mainly affected macrophage apoptosis.;

In our previous work, we found that trivalent dimethylarsinous acid (DMA(III)) have high affinity binding to cysteine residue 13 of rat hemoglobin. However, it is still unknown why arsenic intermediate metabolite DMA(III) has high binding affinity for Cysl3 but not for other cysteine residues 93, 140, 111 and 125. In order to better understand the molecular mechanism of DMA(III) with rat hemoglobin, we have done current study. So, SD rats were divided into control and arsenic-treated groups randomly. Arsenic species in lysate of red blood cells were analyzed by HPLC-ICP-MS, and then determined by a hybrid quadrupole TOF MS. In addition, trivalent DMA(III) binds to different cysteine residues in rat hemoglobin alpha and beta chains were also simulated by Molecular Docking. Only Cys13 in alpha chain is able to bind to DMA(III) from the experiment results. Cys13 of alpha chain in rat hemoglobin is a specific binding site for DMA(III), and we found that amino acids compose pockets structure and surround Cys13 (but not other cysteine residues), make DMA(III) much easy to bind cysteine 13. Taken together, the DMA(III) specific binding to Cys13 is related to spatial structure of Cys13.

AIM: To explore the neuroprotective action of progesterone(PROG), which has been proved to be a "neuroactive steroid". METHODS: The model of focal cerebral ischemia was established in rats by reverserble inserting a nylon thread with a diameter of 0.2 mm into the anterior cerebral artery through the internal carotid artery. The effect of PROG was assessed by determining water,sodium, potassium, and calcium contents in striatum of rats subjected to 2 h ischemia followed by 22 h reperfusion. RESULTS: The water,sodium,and calcium contents of middle cerebral artery occlusion(MCAO) striatum were obviously higher,the potassium content was obviously lower than those of non-MCAO striatum in I/R and DMSO groups,but there was no significant difference between these two groups.Compared with the result in I/R and DMSO groups , water, sodium and calcium contents significantly decreased, but potassium(P0.05). CONCLUSION: Treatment with PROG can significantly reduce the striatal injury of rats with cerebral ischmia-reperfusion.

Biopsy ; Endopeptidase K ; Fluorescent Antibody Technique ; Glomerulonephritis, IGA ; pathology ; Glomerulonephritis, Membranous ; pathology ; Humans ; Kidney ; pathology ; Lupus Nephritis ; pathology ; Paraffin Embedding ; Staining and Labeling

Objective Evaluation the Fractionated Stereotactic Radiotherapy (FSRT) for the patients with small-cell lung cancer (SCLC) after the whole brain radiotherapy (WBRT) failure.Methods We retrospectively analyzed 35 patients with brain metastases from small-cell lung cancer treated with linear accelerator FSRT after the WBRT failure. Multivariate analysis was used to determine significant prognostic factor related to survival.ResultsThe following-up rate was 100％.The median following-up time was 11 months.The median over-all survival (OS) time was 10.3( 1 -30) months after FSRT.Controlled extra cranial disease was the only identified significant predictor of increased median OS time (χ2 =4.02,P =0.045 ).The median OS time from the diagnosis of brain metastasis was 22 (6 - 134 )months.14 patients died from brain metastasis,14 from extra-cranial progression,1 from leptomeningeal metastases,and 3 from other causes. Local control at 6 months and 12 months was 91％ and 76％,respectively.No significant late complications.New brain metastases outside of the treated area developed in 17％ of patients at a median time of 4(2 -20) months; all patients had received previous WBRT.ConclusionsFractionated stereotactic radiotherapy was safe and effective treatment for recurrent small-cell lung carcinoma brain metastases.

Objective To compare and evaluate the efficacy of three operating procedures to produce permanent rat models of cerebral ischemia, including mortality, neurological evaluation score, infarction volume of ischemia and time consumed in the operation. Methods The rats were randomly divided into three groups. Group 1: The common carotid artery (CCA) and external carotid artery (ECA) were ligated during the operation and ICA was clipped temporarily by artery clamp. Group 2: The CCA and ECA were ligated and the superior thyroid artery and pterygopalatine artery were exposed but not ligated. Silk suture was utilized to hang the internal carotid artery (ICA). Plastic suture was inserted into ICA and stepped over the initiation point of pterygopalatine artery under microscopic observation. Group 3: The CCA and ECA were ligated and ICA was hanged with a silk suture, and the pterygopalatine artery was not exposed, but during the period of inserting plastic suture, the proximal part of the suture was pressed to make the suture's round distal end elevated, and then pass the initial point of pterygopalatine artery. Mortality, neurological score, volume of ischemic infarction and operation time consumed of the three groups were compared after the operation. Results The procedure to prepare the model was most efficient in the group 3, taking only 17.5 min to complete, significantly less than that in the group 1 (50 min) and group 2 (40 min), (P<0.05), and with a lower mortality and more steady neurological evaluation score and infarction volume. Conclusion The use of the third operating method can shorten the operation time and improve the efficacy of operation. Using this method, more consistent and repetitive focal cerebral ischemia models can be produced effectively, and meet the demands of clinical trials.

Objective:To explore the clinical features, follow-up characteristics and prognosis of rheumatic disease complicated with pulmonary arterial hypertension (PAH) in children, and to provide support for its clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the data of rheumatic 24 patients complicated with PAH hospitalized in the Department of Rheumatology and Immunology, Children′s Hospital Affiliated to the Capital Institute of Pediatrics, Department of Rheumatology and Immunology, Jiangxi Children′s Hospital, Department of Pediatrics Ⅰ, the First Affiliated Hospital of Zhengzhou University and Department of Pediatrics, the Affiliated Hospital of Inner Mongolia Medical University from January 2013 to June 2022.The rheumatic patients complicated with PAH were followed up by telephone on June 30, 2022, and their clinical symptoms, treatment, follow-up, and prognosis data were collected.According to different treatment methods, the patients were divided into different clinical subgroups. The change of PAH was analyzed. The t-test was used for comparison between groups. P<0.05 was statistically significant. Results:A total of 24 cases were enrolled, with 7 males and 17 females.The average onset age of PAH was (10.97±3.79) years old.The median duration of PAH was 6.00 (32.20) months.The average pulmonary artery pressure was (51.71±17.66) mmHg(1 mmHg=0.133 kPa). There were 9 cases of systemic lupus erythematosus, 5 cases of Takayasu′s arteritis, 3 cases of juvenile dermatomyositis, 3 cases of undifferentiated connective tissue disease, 2 cases of systemic juvenile idiopathic arthritis, 1 case of Behcet′s disease, and 1 case of Kawasaki disease.Among 24 cases, the common symptoms were fever (14 cases), fatigue (10 cases) and dyspnea (7 cases). Of the 24 cases, 10 cases were complicated with hydropericardium, 9 cases with valve regurgitation, and 5 cases with decreased systolic and/or diastolic function.Lung changes were observed in 17 cases.Eleven cases were tested for B-type natriuretic peptide (BNP), and the BNP levels were all elevated in them (11 cases), with a median BNP of 3 073 (10 645) ng/L.After the first occurrence of PAH, 12 cases were treated with Methylprednisolone therapy, 10 cases received Cyclophosphamide therapy, and 2 cases who were both systemic lupus erythematosus, underwent blood purification.In the treatment of PAH, 11 cases were treated with pulmonary artery pressure reduction, and 7 of the 11 cases took PAH-targeted drugs.The mean decrease of the average pulmonary artery pressure in children receiving the targeted therapy[(44.80±24.08) mmHg] was significant higher than that in children not receiving the targeted therapy [(16.15±17.25) mmHg] ( t=2.661, P=0.016). Twenty children were reexamined and/or followed up, and the average course of PAH at the telephone follow-up was (36.29±26.67) months.The pulmonary arterial hypertension in 6 cases completely recovered, with median recovery time of 8.00 (13.47) months, but 2 of them died after the complete recovery.The pulmonary arterial hypertension improved in 11 children, 1 of whom died and the remaining children were in stable condition.The pulmonary arterial hypertension worsened in 2 children, 1 of them improved previously but aggravated recently, and the other child did not monitor pulmonary artery pressure and died during telephone follow-up. Conclusions:Rheumatic diseases complicated with PAH are rare and most often diagnosed in severe rheumatic children.It can lead to death, and is commonly accompanied by notably elevated BNP levels.The patients who have early PAH detection, intensive treatment of the primary disease, symptomatic and targeted pulmonary artery pressure reduction show a better prognosis.

OBJECTIVE: To investigate the risky factors for pelvic floor functional disorder.
 METHODS: A total of 346 patients, who undergone surgery for pelvic floor reconstruction from January 2007 to December 2013 in the Third Affiliated Hospital of Zhengzhou University, were enrolled for this study and served as an experimental group. Meanwhile, 349 female healthy subjects were selected as a control group. The data including the times of gestation and parity, history of menopause, hysterectomy surgery, uterine fibroid and leucorrhea were recorded.
 RESULTS: Compared with the controls, the numbers of people with hysterectomy, menopause and clean vagina≥III degree, lack of lactobacillus as well as the times of gestation and parity in the experimental group were significantly increased (P<0.05). The history of hysterectomy, the times of gestation and parity and lack of lactobacillus in vagina were the independent risk factors of pelvic floor dysfunction.
 CONCLUSION The history of hysterectomy, the times of gestation and parity, and clean vagina may involve in the occurrence and development of pelvic floor functional disorder, and the existence of lactobacillus in the vagina might be a protective factor.
Case-Control Studies ; Female ; Humans ; Hysterectomy ; Lactobacillus ; isolation & purification ; Menopause ; Multivariate Analysis ; Parity ; Pelvic Floor ; physiopathology ; Pelvic Floor Disorders ; physiopathology ; Pregnancy ; Risk Factors ; Vagina ; microbiology

ObjectiveTo determine the therapeutic effect of Gegentang granules on a disease-syndrome mouse model combining human coronavirus 229E （hCoV-229E） pneumonia with Hanshi Yidu Xifei syndrome in vivo. MethodMice were randomly divided into normal group， infection group， cold-dampness group， model group， chloroquine phosphate group （0.18 g·kg^-1）， interferon-α2b （IFN-α2b） group （1.83×10⁶ U·kg^-1）， Gegentang granules high-dose and low-dose groups （6.6， 3.3 g·kg^-1） with 10 mice in each group. Cold-dampness environment and hCoV-229E infection were used for modeling， and the general status and lung index of mice in each group were observed. The viral load in lung tissue was detected by real-time fluorescent quantitative polymerase chain reaction （Real-time PCR）， the pathological changes in lung tissue were evaluated by hematoxylin-eosin （HE） staining， the levels of serum gastrointestinal hormones and inflammatory factors in lung tissue were detected by enzyme-linked immunosorbent assay （ELISA）， and the percentage of peripheral blood lymphocytes was detected by flow cytometry. ResultComparing with model group， Gegentang granules could significantly alleviate the physical signs of Hanshi Yidu Xifei syndrome， including listlessness， weakness of limbs， sticky stool， etc. Comparing with model group， Gegentang granules high-dose group significantly reduced lung index， histopathological score of interstitial lung and bronchus， and the level of serum motilin （P<0.05， P<0.01）， two doses of Gegentang granules could significantly increase the level of serum gastrin （P<0.05， P<0.01）， the percentage of CD4⁺， CD8⁺ T lymphocytes in peripheral blood （P<0.05， P<0.01）， and the level of tumor necrosis factor-α （TNF-α） in lung tissue was significantly decreased （P<0.01）， and the level of interleukin-6 （IL-6） showed decreasing tendency. ConclusionGegentang granules has therapeutic effect on model mice. It can improve the appearance and behavior characterization， regulate the level of gastrointestinal hormones， decrease lung index and histopathological score， and possibly play an immunomodulatory role by inhibiting the expression of inflammatory cytokines in lung tissue and restoring the percentage of peripheral blood lymphocytes.