Objective To investigate bladder anatomical changes and dose variation in patients with cervical cancer.Methods We analyzed 20 patients,undergoing external beam radiotherapy scanning cone beam CT(CBCT)before each fraction.Bladder was contoured on each CBCT,was projected onto the planning CT and assesses anatomical changes and dose variation.Results A total 451 CBCT images,for 20 patients were collected for analysis,show more change in bladder volume and position.In 15 cases bladder volume and V45 had no significant correlation(r=0.225 -0.473,all P>0.05),4 cases shows negative correlation(r=-0.564,P<0.05;r=-0.597,P<0.01;r=-0.942,P<0.01;r=-0.816,P<0.01),1 case shows positive correlation(r=0.662,P<0.01).Have more than the criteria(V45≤50%)number is 64/451(14.2%)in whole treatment.Conclusions For most patients by filling adequacy bladder,bladder dose variation is acceptable:CTV lager for individual patients should be closely observed its regression,implementation of the offline or online calibration.

Objective:To purify HLA-DR molecules. Methods: Anti-HLA-DR antibody L243 was purified and coupled with CNBr activated Sepharose 4B gel. Immunoaffinity column was used to purify HLA-DR molecules. Results:Twenty micrograms of HLA-DR molecules were isolated from about 5 g Epstein-Barr virus-transformed human B lymphoblastoid cell line RAJI lysates by affinity chromatography. The purified HLA-DR molecules existed in α/β heterodimers form and could bind to conformation-dependent antibody L243. These HLA-DR molecules were separated into two strands,α and β,by boiling denaturation. These results are the basis for studying MHC Ⅱ binding peptide motif and CD4＋ T cell epitopes of antigens in future.

Objective:By applying moxibustion to the eight confluent points in different periods of time,to observe the changes in thermal pain threshold latency of acupoints based on Fei Teng Ba Fa.Methods:A total of 468 healthy college student volunteers received moxibustion at the eight confluent points in three different periods of time,i.e.Chen (7:00-9:00),Wu (11:00-13:00) and Xu (19:00-21:00).The thermal pain threshold latency was adopted to measure the changes in pain threshold of the eight confluent points under different conditions (different periods of time,different genders,different acupoints and different states of the acupoints) based on Fei Teng Ba Fa.Results:Finally,thirty subjects dropped out and 438 subjects were included.The comparison of thermal pain threshold latencies of the eight confluent points in the same opening or closing state based on Fei Teng Ba Fa:latencies of the closing points and adjunct points were significantly different in different periods of time (P＜0.05);the latencies of the males were significantly longer than those of the females (P＜0.05);there was no significant difference in the latency between the left and right sides (P＞0.05);in the female group,there was a significant difference in the latency between the lower-limb points and the upper-limb points (P＜0.05).The comparison of thermal point threshold latencies of the eight confluent points in different opening or closing state:in the period of Wu (11:00-13:00),the latencies of the opening points were significantly longer than those of the closing points and adjunct points (P＜0.05);for men,their opening and closing points had significantly longer thermal pain threshold latencies than their adjunct points (P＜0.05);despite the gender,the latencies of the upper limb opening and closing points were significantly longer than the latency of the adjunct points (P＜0.05);in the female group,the latencies of the lower-limb opening points were significantly shorter than those of the lower-limb closing and adjunct points (P＜0.05).Conclusion:Based on Fei Teng Ba Fa,the pain thresholds of the eight confluent points vary in different periods of time,gender,acupoint location and opening/closing state,which can be taken as the evidence of making time-based acupuncture-moxibustion prescriptions.

Objective:To explore the relationship between abnormal ECG J wave and in‐hospital prognosis in patients with acute ST -segment elevation myocardial infarction (ASTEMI) .Methods :ECG and related clinical data of 204 ASTEMI patients ,who received emergency percutaneous coronary intervention (PCI) in our hospital from Jan 2007 to Dec 2012 ,were retrospectively analyzed .According to the presence of abnormal J wave or not ,patients were di‐vided into abnormal J wave group (n= 82 ,occupied 40.2% ,82/204) and no abnormal J wave group (n= 122 , 59.8% ,122/204) .Single‐and multiple‐factor Logistic regression analysis were used to analyze risk factors of in -hospital death .Results:During hospitalization ,incidence rate of sustained ventricular tachycardia/fibrillation in pa‐tients with abnormal ECG J waves was significantly higher than those without abnormal J waves (9.8% vs .1.6% , P=0.008) , but among the 12 cases (5.9% ) of cardiac deaths ,only six cases had abnormal J waves .Logistic regres‐sion analysis indicated that abnormal ECG J wave cannot predict in‐hospital death of ASTEMI patients (OR=0.99 , 95% CI :0.34~ 2.90 , P= 0.987) ,while age can be regarded as an independent predictor factor for in‐hospital prognosis of these patients (OR = 1.08 ,95% CI :1.01 ~ 1.15 , P= 0.02) .Conclusion:For ASTEMI patients , though the incidence rate of sustained ventricular tachycardia/fibrillation in abnormal J wave group is significantly higher than those of without abnormal J waves group during hospitalization ,but abnormal ECG J waves cannot pre‐dict short-term prognosis of these patients .

Objective:To explore the predictive value of abnormal ECG J waves for arrhythmias occurred during short term in patients with acute ST elevation myocardial infarction (ASTEMI ) .Methods :ECG and echocardio‐graphic monitoring recordings of 204 ASTEMI patients who received emergency percutaneous coronary intervention (PCI) in our hospital from Jan 2007 to Dec 2012 were retrospectively analyzed .Univariate and multivariate Logistic regression analyses were performed to analyze the influencing factors of arrhythmias within one week after myocar‐dial infarction .Results:Abnormal J waves detected by ECG were found in 82 cases (40.2% ) among the 204 pa‐tients ,most of which were distributed on inferior leads of ECG .Multivariate Logistic regression analysis indicated that abnormal J waves (OR=14.05 , P=0.01 ,95% CI 1.70~116.40) ,J waves distributed across ≥ two locations (OR=13.38 ,P=0.01 ,95% CI 1.53~38.68) and J wave amplitude≥0.2 mV (OR=4.28 ,P=0.02 ,95% CI 1.82~16.72) were independent predictors for sustained ventricular tachycardia/fibrillation (VT/VF) ,but they cannot be used as predictors for occurrence of all ventricular arrhythmias ,including non‐sustained VT ,sustained VT and VF (P>0.05 all) ,nor the occurrence of atrial arrhythmias , P>0.05 all .Multivariate Logistic regression analysis indicated that diabetes mellitus was an independent predictor for occurrence of ≥30s atrial tachycardia/fibrillation in ASTEMI patients (OR=2.29 ,P=0.047 ,95% CI 1.01~5.18) .Conclusion:Abnormal ECG J wave is an inde‐pendent predictor for occurrence of sustained ventricular tachycardia/fibrillation during short term after ASTEMI .

OBJECTIVETo determine the serum level and mRNA expression of type-1/type-2 cytokines of T lymphocytes in spleens of rats after thermal injury and to investigate the effects of escharectomy during burn shock stage on IFN-gamma and IL-4.

METHODSOne hundred and sixty male Wistar rats were randomized into four groups. In group A, animals were not subjected to escharectomy. In groups B, C and D, escharectomy and skin allograft were performed at 8, 24, 96 hours postburn (PB) respectively. At 4, 12, 24, 48, 96, 120 and 168 hours PB, animals were killed and blood and spleens samples were harvested. ELISA was applied to determine the concentration of IFN-gamma and IL-4 in serum. The expression pattern of IFN-gamma and IL-4 were observed at mRNA level in T lymphocytes isolated from spleen by RT-PCR.

RESULTSThe serum level of IFN-gamma and IL-4 rose rapidly and significantly after scald injury, expression of IFN-gamma and IL-4 mRNA in rats' T lymphocyte were also up-regulated spontaneously. The serum level of IFN-gamma and its mRNA expression began to rise within 4 hours PB, peaking at 24 hours PB. Whereas IL-4 and its mRNA expression showed a persistent elevation. Thereby leading to a dominant tendency of Th2 cytokine response on 7 d PB. In group A all above parameters revealed most obvious changes compared with controls, then ranked in group D, B and C.

CONCLUSIONEscharectomy during burn shock stage is helpful to decrease the harmful over expression of Th2-type lymphocyte after severe thermal injury.

Animals ; Burns ; metabolism ; surgery ; Enzyme-Linked Immunosorbent Assay ; Interferon-gamma ; genetics ; metabolism ; Interleukin-4 ; genetics ; metabolism ; Male ; RNA, Messenger ; metabolism ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Shock, Traumatic ; metabolism ; surgery ; Spleen ; cytology ; T-Lymphocytes ; metabolism ; Time Factors

AIM:To investigate the effects of exosomes secreted by pancreatic cancer cells on the viability and function of βcells and the possible mechanism .METHODS:ExoQuick-TC kit was used to extract exosomes in the super-natants of mouse pancreatic cancer Pan 02 and MPC-83 cells, and the extracted exosomes were identified by transmission electron microscopy.Fluorescence-labeled exosomes were incubated with mouse insulinoma MIN 6 cells for 48 h to detect whether exosomes secreted by pancreatic cancer cells were uptaken by MIN 6 cells.MTT and glucose-stimulated insulin se-cretion ( GSIS) assays were conducted to examine cell viability and insulin secretion of MIN 6 cells after incubating with ex-osomes.The expression of miR-204 and Bcl-2 mRNA in MIN6 cells was detected by qPCR .The protein expression of Bcl-2, Bax, caspase-3 and cytochrome C (Cyt-C) in MIN6 cells was determined by Western blot .RESULTS:The results of transmission electron microscopy showed that both Pan 02 cells and MPC-83 cells secreted exosomes , and Pan02 cells secre-ted more.The co-incubation results of fluorescence-labeled exosomes and MIN6 cells confirmed that MIN6 cells were able to ingest large amounts of exosomes secreted by pancreatic cancer cells .The results of MTT and GSIS assays showed that the viability and the level of high glucose-stimulated insulin secretion of MIN 6 cells in exosome treatment group significantly decreased compared with nontreatment group (P<0.01).The results of qPCR showed that the exosomes secreted by pan-creatic cancer cells were rich in miR-204, and the mRNA expression of Bcl-2 in MIN6 cells was significantly down-regula-ted by exosome incubation ( P<0.01) .The results of Western blot showed that the protein expression of Bcl-2 in the MIN6 cells treated with exosomes was significantly down-regulated (P<0.05), and the protein levels of Bax, cleaved caspase-3 and Cyt-C in exosomes treatment group were significantly up-regulated ( P<0.01 ) .CONCLUSION: Pancreatic cancer cells secrete exosomes .The exosomes secreted by pancreatic cancer cells are ingested by βcells, and reduce the viability and insulin secretion of βcells.The mechanism may be related to the increase in exosomal miR-204 in the βcells.In-creasing miR-204 may inhibit the expression of Bcl-2 and promote the activation of mitochondrial apoptosis in βcells.

Objective:To evaluate the efficacy and safety of stereotactic ablative radiotherapy (SABR) in patients with pulmonary oligometastases.Methods:Clinical data of patients with pulmonary metastases treated with SABR from 2011 to 2018 were retrospectively analyzed. The local control rate (LCR) and overall survival (OS) were calculated by Kaplan- Meier method. log-rank test was used for univariate analysis and Cox’s regression model for multivariate analysis. Results:A total of 214 lung metastases were detected in 159 patients, and the median follow-up time was 43 months. The 1-, 3-and 5-year LCR were 90.1%, 73.9% and 65.8%, respectively. The 1-, 3-and 5-year OS were 73.8%, 43.6% and 11.9%, respectively. Univariate analysis showed that biological effective dose (BED)≥100 Gy was significantly correlated with LCR ( P=0.033). Cox’s multivariate analysis showed that BED and primary tumor source were the independent prognostic factors of LCR ( P=0.023, P=0.043). No>grade 3 adverse events were observed in all patients during treatment. Conclusions:SABR is a safe and effective treatment of lung oligometastases. SABR should be actively aD ministered for pulmonary oligometastases, especially for those with lesions from lung cancer and the radiation dose should be selected as BED ≥100 Gy.

BACKGROUNDSmoking is known to be a strong risk factor for premature atherosclerosis, acute myocardial infarction (AMI) and sudden cardiac death. According to a cross-sectional survey conducted in 2000 - 2001 in China, the prevalence of smoking among the Chinese men was 60.2%, the highest prevalence in the world. Up to date, the relationship between smoking and AMI in Chinese male smokers is still unclear. This study analyzed the baseline characteristics for male smokers hospitalized with AMI and investigated the effect of cigarette smoking on their clinical outcomes.

METHODSA total of 890 men aged 18 years or over with AMI were prospectively recruited from 1 January 2007 to 31 December 2009 from Shanxi Provincial People's Hospital. Patients were grouped into smokers and nonsmokers. The relationships between baseline characteristics and clinical outcomes were tested using either the chi-square test for trend for discrete variables or analysis of variance for continuous variables.

RESULTSSmokers accounted for 66.7% (594), more than twice of nonsmokers (296 (33.3%)), and were averaged 7 years younger ((56.61 ± 11.44) vs. (63.61 ± 11.62) years, P < 0.001). Smokers had the higher rate of TIMI flow grade 2 or 3 after thrombolytic therapy (42.4% vs. 24.5%, P = 0.002), 1 vessel disease (25.5% vs. 14.5%, P = 0.003) than nonsmokers. Smokers had better in-hospital outcome with lower in-hospital mortality rate than nonsmokers (6.2% vs. 10.8%, P = 0.023).

CONCLUSIONSMale smokers suffered from AMI in this study presented an average of 7 years earlier than nonsmokers and were more than twice as likely to have AMI as nonsmokers in China. Smoking appeared to result in earlier infarction, especially ST elevated myocardial infarction in otherwise healthier patients who are likely to survive.

Acute Disease ; Adult ; Aged ; China ; Hospital Mortality ; Hospitalization ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; mortality ; Smoking ; adverse effects

BACKGROUNDThe morbidity and mortality of prostate cancer have been increasing rapidly in recent China. There were few studies investigating prostate-specific antigen (PSA) values ranges in the healthy Chinese population. We performed this study to determine the distribution of serum PSA in a large healthy Chinese population.

METHODSFrom January 2001 to May 2008, 11 150 healthy Chinese men aged 30 - 79 years came to our hospital for routine health check-up. All subjects without a previous diagnosis of prostate cancer, a history of prostate surgery, or urogenital tract infection were proposed to undergo systematic serum PSA measurement and digital rectal examination (DRE). Men with normal DRE and PSA ≤ 4.0 ng/ml and those PSA > 4.0 ng/ml or abnormal DRE but without adverse findings on prostate biopsy were included (n = 9358). Age and serum PSA concentration were recorded and correlated through Logistic regression analysis.

RESULTSThe 95th percentile serum PSA concentration was 1.89 ng/ml for men aged 30 to 39 years, 2.19 ng/ml for men aged 40 to 49 years, 2.88 ng/ml for men aged 50 to 59 years, 4.42 ng/ml for men aged 60 to 69 years, and 6.52 ng/ml for men aged 70 to 79 years. The serum PSA concentration correlated with age (P < 0.0001) with an annual increase of 0.97% for men in 40 years, 1.58% for men in 50 years, 3.04% for men in 60 years, and 3.99% for men in 70 years.

CONCLUSIONSThe serum PSA level correlates directly with age in Chinese men older than 40 years, not in Chinese men younger than 40 years old. Chinese men have lower PSA level compared with white men above 60 years of age, not in those under 60 years of age.

Adult ; Age Factors ; Aged ; Asian Continental Ancestry Group ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; epidemiology