Objective To evaluate the effects of inhaled iloprost on pulmonary hypertension after cardiopulmonary bypass in patients with congenital heart disease undergoing surgical correction of anomaly. Methods Fifty-eight patients with congenital heart disease aged 14-60 yr undergoing surgical correction of anomaly under cardiopulmonary bypass (CPB) were enrolled in this study. Radial artery was cannulated before induction of anesthesia. A 6-lumen pulmonary catheter was placed via right internal jugular vein after tracheal intubation. Their mean pulmonary arterial pressure was still > 25 mm Hg after operation. ECG, HR, BP, CO, PAP and SpO_2 were continuously monitored. Aerosolized iloprost 10 fig was inhaled via nebulizer after CPB. Hemodynamics were measured before iloprost inhalation (baseline) and at 0, 5, 15, 30 and 60 min after the end of iloprost inhalation. Results There were 28 patients with pulmonary hypertension after CPB among the 58 patients with congenital heart disease. Inhalation of iloprost 10μg significantly decreased mPAP, pulmonary vascular resistance and intrapulmonary shunt as compared with the baseline. Iloprost inhalation could also improve significantly CO and the mixed venous oxygen saturation (SvO_2 ). Conclusion Iloprost inhaled after CPB can effectively reduce pulmonary arterial pressure and pulmonary vascular resistance in patients with congenital heart disease undergoing surgical correction of anomaly and help them wean from CPB.

Objective To investigate the correlation between ICRU reference point dose and dosevolume parameters of organs at risk (OARs) under different bladder and rectal filling status in threedimensional conformal brachytherapy for locally advanced cervical cancer.Methods A total of 31 patients who received magnetic resonance imaging-guided three-dimensional conformal brachytherapy for cervical cancer in 96 fractions were enrolled.The ICRU rectal and bladder reference points were determined in the treatment planning system,and the doses at these points were recorded and compared with the dose-volume parameters of the rectum and bladder.The paired t-test was used to analyze the differences between them.Results Bladder DICRU was lower than bladder D0.1cm3 and D1 cm3 (P=0.000 and 0.000),higher than bladder D5 cm3 and D10cm3 (P=0.000 and 0.000),and similar to bladder D2 cm3 (P=0.345).Under the bladder filling status,bladder DICRU was lower than D2cm3.Rectal DICRU was lower than rectal D0.1 cm3 and D1cm3 (P =0.000 and 0.002),higher than rectal D5 cm3 and D 10 cm3 (P =0.000 and 0.000),and similar to rectal D2cm3 (P=0.058).The ICRU bladder and rectal reference point doses were positively correlated with corresponding D2 cm3.In the case of bladder volume ≥ 200 cm3,the ICRU bladder reference point dose underestimated bladder D2 cm3.In the case of rectal volume ≥ 37 cm3,the ICRU rectal reference point dose overestimated rectal D2 cm3.Conclusions In three-dimensional conformal brachytherapy,it is generally safe to use D2 cm3 as an index to evaluate OARs,but when the bladder or rectum is in an empty status,the ICRU bladder or rectal reference point doses should be considered.

Objective To investigate the dosimetric differences between Utrecht applicator and ring applicator in three-dimensional (3D) conformal brachytherapy for locally advanced cervical cancer.Methods Twenty-five patients with locally advanced cervical cancer were treated with magnetic resonance imaging-guided 3D conformal brachytherapy.Utrecht applicator and ring applicator were used interchangeably for 96 cycles.Patients were divided into two groups according to the type of applicator.Each group received 48 cycles of treatment, in which ring applicator was first applied for 26 cycles and Utrecht applicator was first applied for 22 cycles.High-risk clinical target volume ( HR-CTV) , width, thickness, and D90 at the point A level, D2 cm3 of organs at risk (OARs), V7 Gy , W7 Gy,A, V7 Gy ,A, and W/T7 Gy were evaluated and analyzed using paired t-test.Results There were no significant differences in HR-CTV and the width, thickness, and D90 at the point A level between the Utrecht group and the ring group ( P=0.487;P=0.340;P=0.857;P=0.921);there were no significant differences in D2 cm3 values of bladder, rectum, sigmoid, and bowel between the two groups ( P=0.136;P=0.802;P=0.985;P=0.458);there were no significant differences in V7 Gy and T7 Gy,A between the two groups ( P=0.076;P=0.435) .The Utrecht group had a significantly larger W/T7 Gy,A than the ring group ( P=0.002 ) .Conclusions Utrecht applicator is appropriate for patients with relatively large width and width/thickness ratio of HR-CTV at the point A level.

Objective To explore the changes of type H vessel during the low bone mineral density caused by iron accumulation and discuss its clinical meaning.Methods Ten 8-week old male C57BL/6J mice were used for experiments,and randomly divided into two groups:control group and iron group,and 5 mice in each group.In the iron group,0.1 g/kg of iron dextran was injected intraperitoneally once a week for 8 weeks.The control group was injected with the same amount of saline.The femoral and tibial specimens were examined by microscopic CT scan and bone tissue type H vessel immunohistochemical staining.Liver tissue from the two groups were collected for the content of iron by atomic absorption spectroscopy.All experimental data were analyzed with t-test.Results The content of hepatic iron in mice was significantly higher than that in the control group,which indicating that the model was successfully established.The tibia specimens were collected for immunostaining.The vascular area of type H at metaphyseal regions is 11.24％± 1.76％ in iron group and 30.69％±2.78％ in control group,respectively.There is significant difference between the two groups (P＜0.005).The femur specimens were collected for Micro-CT scan,the value of bone mineral density (BMD),bone volume/tissue volume (BV/TV),trabecular thickness (Tb.Th),trabecular number (Tb.N) and trabecular separation (Tb.Sp) was (0.19±0.013) g/cm3,11.92％±1.199％,(35.66±2.684) μm,(2.36±0.429)/mm and (284.41±23.197) μm in iron group and (0.37±0.023) g/cm3,35.76％± 1.336％,(62.05±2.238) μm,(5.68± 1.039)/mm and (163.23± 13.203) μm in control group,respectively.The differences between the two groups were statistically significant (P＜0.05).Conclusion Iron accumulation can lead to low BMD and suppress type H vessel formation in bone,which might provide a new experimental value for mechanism research on osteoporosis caused by iron accumulation.

OBJECTIVETo investigate the relationship between hepatitis B virus (HBV) infection and risk of pancreatic cancer.

METHODSVarious English and Chinese language literature databases, including PubMed, Web of Knowledge, Embase, Cochrane Library and the Chinese National Knowledge Infrastructure, were searched for case-control studies comparing rates of HBV infection and pancreatic cancer. The RevMan meta analysis software, version 5.0, was used to perform the meta-analysis of the 6 included studies.

RESULTSCompared with the control group, the pancreatic cancer group had a significantly higher rate of positivity for hepatitis B surface antigen (HBsAg) (8.87% vs.5.86%, odds ratio (OR) =1.24, 95% confidence interval (CI):1.06 to 1.47, P =0.009) and a lower rate of patients never exposed to HBV (defined as HBsAg(-)/hepatitis B core antibody (anti-HBc)(-) (69.4% vs.77.1%, OR =0.68, 95% CI:0.51 to 0.92, P =0.01). There was no significant difference between the two groups in the rate of hepatitis B e antigen positivity (P =0.55).

CONCLUSIONHBV-infected patients with HBsAg(+) status are at greater risk of developing pancreatic cancer; however, since most of the research studies evaluated were conducted in Asians, the generalizability of this conclusion is unknown.

Hepatitis B ; epidemiology ; Hepatitis B Surface Antigens ; blood ; Hepatitis B virus ; Humans ; Pancreatic Neoplasms ; epidemiology ; virology ; Risk Factors

Objective To report a simple method for determination of dwell position offset of ring applicator using GafchromicTM EBT3 film and ImageJ software. Methods In the dummy plan, this study reconstructed the ring applicator point by point manually according to the MR line marker, the most distal reconstruction point was at the end of marker, set the offset to zero. The first, eleventh, and twenty-third dwell positions were activated with the step length of 2. 5 mm. A setup image was designed to immobilize the ring applicator. The setup image was composed of two perpendicular thin lines and a circular with a diameter of 16 mm. GafchromicTM EBT3 film was fixed behind the setup image by plastic tapes. After irradiation, a ruler was put on the bottom of the irradiated film as a plotting scale. Photos were taken with the help of a vertical camera using a tripod. The file was imported into ImageJ software and the coordinate values were obtained by semi-automatic recognition of the center of exposure area. The test was repeated five times at one week interval to evaluate the uncertainty. For every time, each dwell position was measured five times. Results The angle between the radius of the first dwell position and the x-axis was 43° in the dummy plan, and (46. 8 ± 0. 9)° for actual measurement. The offset was 0. 9 mm for the ring applicator combined with the MR according to calculation. The distances between the first,the eleventh and the twenty-third dwell positions and the center of the ring were ( 12. 9 ± 0. 1 ) mm, ( 12. 5 ± 0. 1 ) mm, (12. 4 ± 0. 1) mm, respectively. Conclusions Using GafchromicTM EBT3 film and the ImageJ software is a simplified method to validate the dwell position offset of the ring applicator.

Objective:To measure the effect of applicator materials on absorbed dose in water from HDR afterloading 192Ir source by using three-dimensional printed holder (3DPH) and synthetic single-crystal diamond detector (SSCDD). Methods:SSCDD and plastic implants were fixed on the 3DPH in turn. The central axis of SSCDD was perpendicular to that of plastic implant needle on the same plane. The actual residence dwell position measured using source position simulator was 248 mm, which was consistent with the maximum response dwell position measured in a point by point way. The materials for measurement included 304 stainless steel, polyphenylene sulfone resins (PPSU), polymethyl methacrylate (PMMA) and 3-D printed polylactic acid (PLA), respectively. The attenuation of absorbed dose in water with different thickness or filling ratio was measured.Results:The linear fitting formula of relative dose varying with thickness (mm) for 304 stainless steel and PPSU materials were y=-0.029 7 x+ 1.000 3 and y=-0.002 3 x + 1.010 2, respectively. And the goodness-of-fits were 0.925 3 and 0.722 2, respectively. The effect on dose of PMMA materials within 10 mm was less than 1%. The linear fitting formula of relative dose varying with filling ratio (%) for PLA materials with 10 mm thickness was y=-0.000 4 x+ 1.024 6, with a goodness-of-fit of 0.854 5. Conclusions:The effect of applicator materials on the absorbed dose arising from afterloading 192Ir source should attract enough attention of both developers and clinical users, especially with regard to high-density materials like 304 stainless steel and new technology materials such as 3D printed polylactic acid.

OBJECTIVETo evaluate associations between carbon constituents of fine particulate matter (PM2.5) and atherogenic index of plasma (AIP).

METHODSWe collected subjects from two communities by a system sampling, and 112 people aged over 60 years old without cardiovascular disease were recruited. The levels of cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) of objects, and personal exposure to PM2.5 were measured on December, 2011. Total carbon (TC), organic carbon (OC) and elemental carbon (EC) of PM2.5 were detected and AIP was calculated according to its definition.

RESULTSThe value of AIP among the 112 subjects was 0.05 ± 0.26. Personal exposure concentration of PM2.5 and its carbon components (TC,OC and EC) were (164.75 ± 110.67), (53.86 ± 29.65), (44.93 ± 26.37) and (9.49 ± 5.75) µg/m(3), respectively. The Pearson analysis showed the linear relationship between TC,OC,EC and AIP, all significant positive correlations. The correlation coefficients were TC (r = 0.307, P < 0.05),OC (r = 0.287, P < 0.05) and EC (r = 0.252, P < 0.05), respectively. The multiple logistic regression analysis showed that when the AIP risk categories were selected as dependent variable and low risk group as reference group, the regression coefficient of TC,OC and EC was separately 1.03 (95%CI:1.01-1.05), 1.03 (95%CI:1.01-1.05), 1.12 (95%CI:1.02-1.22) in the high risk group; while there was no statistical significance of the regression coefficient and OR in the middle risk group.

CONCLUSIONThere was stable associations between the carbon constituents (TC,OC and EC) of fine Particulate Matter (PM2.5) and AIP. The findings suggested that carbon components of PM2.5 should be considered as risk factors of atherogenic.

Aged ; Air Pollutants ; analysis ; Air Pollution ; adverse effects ; Atherosclerosis ; diagnosis ; epidemiology ; Carbon ; analysis ; Cholesterol ; blood ; Environmental Exposure ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Particle Size ; Particulate Matter ; analysis ; Risk Assessment ; Triglycerides ; blood

OBJECTIVETo investigate the dynamic changes in angiogenesis within the tumor tissue of mice bearing S180 tumor at different day-points of oral administration with a Chinese medicine compound "Yiliuyin" (YLY) and to explore the anti-tumor mechanisms of YLY in vivo.

METHODFifty-six BALB/c mice were divided into YLY group and control group (28 mice/group) and each group was divided into four subgroups (7 mice/subgroup), randomly. After 24 hrs of inoculation with S180 tumor cells subcutaneously in the right axilla, YLY in the mice of YLY group and equal volume of cold boiled-water in the mice of control group were administered orally twice every day, 0.5 mL each time. The mice of one subgroup from the two groups apiece were killed at 10, 20, 30 th and 40 th day-point of oral administration, respectively. The tumors were isolated and were made into paraffin embedded sections. The dynamic changes of the angiogenesis (CD34 staining), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2 (VEGFR-2) and endostatin (ES) in tumor tissue were detected by immunohistochemistry staining, and the results were shown as PED (positive enzyme dot).

RESULTYLY could remarkably decrease the angiogenesis within tumor tissues. The PED of CD34 in control group at 10, 20, 30 th and 40 th day-point was 392.86+/-42.01, 481.49+/-58.34, 386.31+/-54.91 and 376.69+/-28.71, and that in YLY group was 334.46+/-33.38, 289.34+/-39.63, 257.09+/-40.00 and 246.57+/-36.78, respectively. The PED of CD34 in YLY group at each day-point was lower than that in control group (P<0.05, P<0.01, P<0.01 and P<0.01, respectively). The PED of VEGF in control group at 10, 20, 30 th and 40 th day-point was 852.63+/-81.65, 1168.40+/-96.69, 1292.60+/-147.54 and 1124.74+/-139.64, and that inYLY group was 718.40+/-94.94, 866.54+/-72.40, 859.31+/-74.02 and 753.34+/-72.95, respectively. The PED of VEGF in YLY group at each day-point was lower than that in control group (P <0.05, P <0.01, P <0.01 and P <0.01, respectively). The PED of VEGFR-2 in control group at 10th, 20th, 30th and 40th day-point was 618.63+/-59.08, 750.09+/-56.72, 684.91+/-72.86 and 644.06+/-60.25, and that in YLY group was 523.91+/-64.66, 449.03+/-46.85, 400.06+/-60.12 and 339.89+/-45.39, respectively. The PED of VEGFR-2 in YLY group at each day-point was lower than that in control group (P <0.05, P <0.01, P <0.01 and P <0.01, respectively). The PED of ES in control group at 10th, 20th, 30th and 40th day-point was 250.26+/-36.27, 298.60+/-44.41, 450.86+/-38.95 and 398.43+/-34.19, and that in YLY group was 249.57+/-40.23, 350.03+/-40.92, 499.40+/-40.29 and 497.94+/-42.76, respectively. There was no difference between the two groups at 10th day-point.The PED of ES in YLY group was higher than that in control group at 20, 30, 40 th day-point (P <0.05, P <0.01 and P <0.01, respectively) .

CONCLUSIONYLY could exert the anti- tumor role by down-regulating the expression of VEGF and VEGFR-2, up-regulating the expression of ES and inhibiting the angiogenesis within tumor tissue.

Administration, Oral ; Animals ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Endostatins ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; drug effects ; Mice ; Mice, Inbred BALB C ; Neoplasm Transplantation ; Neoplasms ; blood supply ; drug therapy ; genetics ; pathology ; Neovascularization, Pathologic ; drug therapy ; pathology ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

Objective:To explore the clinical value by analyzing the application of abdominal aortic balloon occlusion in the uterine curettage treatment for patients with cesarean scar pregnancy (CSP).Methods:Totally 42 CSP patients in the first Affiliated Hospital of Zhengzhou University were analyzed retrospectively, 21 cases in the observation group, placing the balloon catheter to the abdominal aorta under the renal artery under the digital substraction angiography(DSA), conducting curettage under hysteroscopy or uterine laparoscopy immediately, and making intermittent blockage in abdominal aorta blood flow during the surgery;21 patients in the control group, conducting uterine artery embolization (UAE) before operation, conducting curettage under hysteroscopy or uterine laparoscopy after 1-3 days. The fluoroscopy time under DSA, body surface radiation dose, intraoperative blood loss, operation time, incidence of postoperative adverse reactions, hospitalization time and follow-up menstruation were comparatively analyzed.Results:All patients operated and retained the uterus successfully. In the control group, all 21 patients had different degrees of fever, pain and other symptoms after UAE. In the observation group and control group, the fluoroscopy time and body surface radiation dose under DSA respectively were (7.4±1.4) s, (5.4±1.1) mGy and (1 142.8±315.5) s, (1 442.0±300.0) mGy (both P<0.01);the average amount of intraoperative blood loss were (22±15), (19±14) ml ( P>0.05), the time of uterine curettage were (37±20), (42±19) minutes ( P>0.05);hospitalization time were (5.0±0.9), (7.7±1.3) days ( P<0.01). The follow-up period was more than 3 months, no adverse reactions were observed in the observation group; 4 cases of menstrual reduction and 1 case of intrauterine adhesions were found in the control group. Conclusion:Abdominal aortic balloon occlusion and UAE could effectively reduce intraoperative bleeding in uterine curettage for patients with CSP; abdominal aortic balloon occlusion has significant reduction of the X-ray dose, shorter hospitalization time, and fewer adverse events comparing to UAE.