Objective To establish a flow cytometric method for assay of platelet aggregation induced by shear stress(SIPA) and investigate its clinical value. Methods After the whole blood was subjected to a certain shear stress by a rotational viscometer, the platelets were activated and aggregated. Then the fluorescence antibody CD61 PerCP was added to stain the platelets. The free platelets and aggregates were counted respectively by flow cytometry, thereby the ratio of platelet aggregation was calculated. Results Shear stress-induced whole blood platelet aggregation varied with the increase of shear stress and time of stress. Only a small amount of platelet aggregation was detected at relatively low shear stress of 100S -1, and it was increased at 500S -1. However, a significant increase occurred with 2 000S -1. It approached to the maximum value (58.4%?5.3%) at 3 000S -1 with exposure of 3min, which was higher than the values at 100S -1(9.4%?1.3%)and 500S -1(26.4%?3.2%). At the same time, the aggregates increased in size and became more compact with increase in the shear stress and prolongation of time. High shear stress induced platelet aggregation(H-SIPA) was significantly enhanced in patients with AMI, cerebral infarction, TIA or diabetes, all of them were susceptible to coagulopathy, compared with normal control. Conclusion The results indicated that shear stress could induce platelet aggregation directly, and the degree of SIPA had positive correlation with the stress stength and exposure time.The measurement of H-SIPA was of some clinical value in the diagnosis of arterial thrombosis.

Erythropoietin is a critical growth factor in development of erythrocyte. After binding to its receptor, eryhropoietin produces biological action through consequent activation of intracellular signal transduction systems, including JAK2-STAT5, sos-Ras-MAPK, IRS-2- PI 3-K + and Ca 2+ channel.

Objective:To study the related factors of severe acute radiation-induced lung injury (SAR) caused by IMRT and concurrent chemotherapy for non-small cell lung cancer. Methods:We retrospectively analyzed the data of 2 323 non-small cell lung cancer pa-tients who underwent IMRT radiotherapy and concurrent chemotherapy at the Department of Radiotherapy of Tianjin Medical Univer-sity Cancer Institute and Hospital from January 2010 to January 2014. We analyzed the clinical factors and parameters that affect dose by univariate and multivariate analysis. Results:A total of 2 323 patients enrolled and 1 241 cases suffering from acute radiation-in-duced lung injury with the rate of 53.4%. Only 185 cases suffered from SARP with a rate of 7.96%. Univariate analysis showed that the gender, histopathological type, total radiation dose, V5 (%), and average dose rate are not related to SARP (P>0.05). By contrast an age of>60 years, 1%predicted FEV, docetaxel+carboplatin/cisplatin chemotherapy, V20 (%), V30 (%), and mean lung dose (MLD) are sig-nificantly related to SARP (P<0.05). Multivariate analysis showed that a patient age of>60 years, docetaxel+carboplatin/cisplatin che-motherapy, V20 (%), and V30 (%) are the independent risk factors of SARP. Conclusion:Among the non-small cell lung cancer patients undergoing IMRT radiotherapy and concurrent chemotherapy, further attention should be given to elderly patients, patients receiving docetaxel and platinum chemotherapy, as well as V20 and V30 with high doses. The necessary preventive treatment should be given to reduce the incidence of SARP, improve the quality of life of patients, and reduce the incidence of respiratory failure and mortality.

Objective To discuss diagnosis,treatment and late effects of three patients with acute radiation-induced skin injury after an accident.Methods Medical history collection and physical examination were made in a manner of one or several doctors to one patient.The general health condition was evaluated through laboratory studies,including complete blood count,liver and kidney function,thyroid function and humoral immunity measurement.The genetic analysis of radiation damage was performed by using chromosomal aberrations and micronucleus assay (CB method).The psychological status of the patients was evaluated during medical follow-up.Results Among the three patients,two were diagnosed with degree Ⅲ acute radiation-induced skin injury and one with degree Ⅱ.The medical follow-up showed that two patients had syndrome of neurasthenia.The two cases with degree Ⅲ acute radiation-induced skin injury then became chronic radiation-induced skin damage.Conclusions Acute radiation-induced skin injury could be persistent and become chronic radiation skin damage.It is important for long-term medical follow-up to be taken for patients with acute radiation-induced skin injury.

The accommodative function before and after laser in situ keratomileusis (LASIK) was observed, and the effect of LASIk on accommodation was investigated. In a prospective clinical trial, 48 myopic patients (96 eyes) subject to bilateral LASIK in Refractive Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (China) from March 2006 to June 2006 were selected and studied. Refractions, accommodative range, amplitude of accommodative response and high frequency component (HFC) of accommodative microfluctuations were measured with NEDIK-730A before and one week and 30 days after operation. Dominant and non-dominant eyes were determined by hole-in-card method. It was found that all of the operative eyes showed an uncorrected visual acuity of 0.8 or better one week postoperatively, and 1.0 or better 30 days postoperatively. Compared with those preoperatively, accommodative range and HFC had no significant difference at first week and 30th day after operation in both dominant eyes and non-dominant eyes (P>0.05), but there was a significant difference in the amplitude of accommodative response/accommodative stimulus ratio (A/S) after operation (P<0.01), and no significant difference was found in accommodation between one week and 30 days postoperation. No ocular dominance's change was noted. There was no significant difference in accommodative function between dominant eyes and non-dominant eyes. It was suggested that LASIK produced no significant effect on accommodation.
Accommodation, Ocular/*physiology ; Keratomileusis, Laser In Situ/*adverse effects ; Myopia/*physiopathology ; Myopia/*surgery ; Postoperative Period ; Prospective Studies ; Young Adult

BACKGROUND:At present,there is lack of relevant biomechanical model for the T6-T7-T8 rib-vertebral fix unit.In addition,there is no support of parameters of basic studies on reasons and reasonable explanation of screw breakage,poor quality of bone fusion and adjacent segment degeneration.OBJECTIVE:To develop a three-dimensional finite element model of bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8),and to analyze the stress so as to improve it.METHODS:Spiral CT data of one male patient (172 cm,71 kg,39-year-old) with T7 vertebral tuberculosis were imported into computer to develop a three-dimensional finite element model of bone graft with vertebral debridement and posterior vertebral unit fixed system through tuberculosis of T6-8 by Mimics 13.0 and Ansys 11.0 finite element software.500 N pressure and 10 N?m torque were loaded to the vertebral body by 3 kinds of physiological loads which simulated flexion,extension and lateral bending.The stress distribution of fixation devices under different loads was compared.RESULTS AND CONCLUSION: At the positions of anteflexion and extension,the stress mainly concentrated to screw tail,and the stress of upper screw was greater than the middle and lower screws.For connecting rods,the stress of the middle was always less than the lower middle and the middle stress was zero.At lateral bending position,the stresses of upper and middle screw tail were quite,and the unilateral stress of connecting rod was also equivalent.For three different dynamics at the same point,the stress of middle connecting rod increased in the lateral bending motion,and the stress of lower screw tail was equivalent.These data suggested that it is prone to fatigue fracture at upper screw tail by bone graft with vertebral tuberculosis debridement and posterior rib-vertebral unit fixed system through tuberculosis of thoracic spine (T6-8) at the three positions of anteflexion,extension and lateral bending.The lower connecting rod at the positions of anteflexion and extension and the middle connecting rod at the position of lateral bending easily cause fatigue fracture.

Objective To summarise the clinicopathologic features and survival of gastric cancer at different tumor locations.Methods A total of 942 adult gastric cancer patients undergoing curative gastrectomy with lymphadenectomy were recruited from the First Affiliated Hospital,Sun Yat-sen University,and examined retrospectively.In all cases,patients' age,gender,pTNM stage and survival time were identified and recorded.Results There were 208 carcinoma cases at gastroesophageal junction (GEJ,22.1％),261 fundus/body cases (27.7％),445 antrum/pylorus cases (47.2％) and 28 whole stomach cases (3.0％).Compared with fundus/body and antrum/pylorus carcinoma,GEJ carcinomas were more often seen in males,among older patients,with larger tumor size and deeper infiltrated tumors,higher stage and worse 5-year disease-free survivals.Whole stomach carcinoma had predilection in female,younger patients,and at later stages and worst 5-year disease-free survival.Conclusions Gastric carcinomas differ greatly in biologic behavior and prognosis by anatomic locations.GEJ carcinoma has independent biologic features.Whole stomach carcinoma is of the highest malignancy and worst prognosis.

Objective To explore the personality features of nuclear power plant operators and the influencing factors thereof.Methods Minnesota Multiphasic Personality Inventory was used to examine the personality features of 136 nuclear power plant operators randomly selected from 2 cooperative units,all males.The results were compared with the nationwide norms and subsequently an inter-block contrast analysis was carried out.Results Obvious difierence was observed in the final scores between the nuclear power plant operators and nationwide norms.The former got higher scores on hysteria(t=3.05,P<0.05).and lower scores on hypochondriasis,depression,morbid personality,masculinity-femininity,paranoia,psychasthenia,schizophrenia,hypomania,and social introversion(t=7.47,7.47,7.3 1,2.23,15.09,16.15,19.28,7.88,11.10,P<0.05).The scores on hypochondriasis,depression,schizophrenia,and social introversion of those with the length of services over 3 years were all significantly higher than those ofwith the length of services less than 3 years(t=3.25,2.51,2.76,3.00,P<0.05).The scores on hypochondriasis,depression,psychop8thicdeviate,and social introversion of the operators aged over 30 were all significantly higher than those of the operators aged below 30(t=2.36,2.35,2.01,2.54,P<0.05).Conclusions The psychological quality of the nuclear power plant operators is superior to that of the general population.

Objective To understand the operators'psychosomatic health status in nuclear power plant;and provide the scientific basis of measures for preventing and reducing mental disorders in operators.Methods The Psychosomatic Health Battery(PSHB) was used to assess the psychosomatic health status in 109 operators who were random selected from Qinshan nuclear power plant,etc.They were tested from lie,emotional stability,liveliness,tension,apprehension,mental health,such as psychopathic deviatesuch 7 personality traits.Results Lie < 8,all inspected groups were normal.Psychopathic deviate:98.2% for normal group 0.9% for both of groups occurred possible mental health problems and confirmed mental health problems ;Mental health:80.7% (88/109) for fine mental health ones,29.4% (32/109) for those with excellent mental health,51.4% (56/109) for good mental health ones,13.8% (15/109) for general mental health ones,5.5% (6/109) for poor mental health ones.Age factor could influence the mean values of the factors of apprehension,tension,mental health and psychopathic deviate.Correlation analysis showed that there was a correlation between tension and psychopathic deviate(r = 0.664 ,P < 0.01),and the other correlation coefficient was between apprehension and mental health(r =-0.789 ,P < 0.01).Conclusions There is an excellent condition of psychosomatic health in most of the operators,however,there are still a very small percentage of psychosomatic disorders among these operators,to improve the quality of their psychosomatic health,psychological counseling should be particularly strengthened to those with problems of psychosomatic health.

Objective To investigate the direct and indirect MRI manifestations of anterior cruciate ligament(ACL)tears and discuss its mechanism and diagnostic value.Methods The study involved 40 patients with ACL tears including 37 males and three females at age range of 16-49 years(mean age of 33 years).Arthroscopy and operation confirmed 28 patients at acute phase of ACL tears,12 at chronic phase of ACL tears,35 with complete ACL tears and five with partial ACL tears.All patients were examined on 1.5T Siemens MRI scanner,with SE,TSE or Medic sequence in multiple directions.The direct and indirect MRI manifestations of ACL tears were retrospectively and statistically analyzed by employing three experienced doctors.Results Among 28 patients with acute tears,the direct MRI signs included signal interruption or non-consecutive(86%),uneven signal(64%)and swelling and thickening ligament(36%).While in 12 patients with chronic teats,the MRI signs manifested swelling ligament(92%),signal interruption or non-consecutive(75%)and uneven signal(58%).The sign of thickening ligament was mainly seen at chronic phase of ACL tears(P ＜0.01).Of 35 patients with complete ACL tears,80% occurred in the middle part of ACL,with low incidence of upper and lower parts.All five patients with partial ACL tears occurred in the anteriomedialis bundle.The indirect MRI signs of ACL tears included 7-shaped deformity of posterior cruciate ligament(PCL)(34 patients,85%),meniscus exposure(26 patients)including 16 with lateral meniscus exposure(62%),bone injury(15 patients)including segond fracture(8 patients,53%),widened joint space(9 patients)including 78% at chronic phase,and tibia antelocation(23 patients,57%).Among 40 patients,37 patients were diagnosed correctly preoperatively,with accuracy rate of 92%.While three patients with partial ACL tears were missed diagnosis preoperatively,with inaccuracy rate of 8%.Conclusion ACL tear is relatively easy to identify preoperatively according to direct and indirect MRI signs in combination with trauma history.