Objective To measure the positioning accuracy of multi-leaf collimators (MLC) leaves by using radiochromic films,with aim to providing data in support of IAEA's methodology validation.Methods The present study focused on 8 accelerators (Varian,Elekta and Siemens machines) at 6 hospitals in Henan province with highly skilled physicists.The 25 cm × 25 cm radiochromic films were put on 30 cm × 30 cm homogeneous solid phantoms and covered with a 2.0-cm-thick homogeneous solid phantom slabs.The CT-scanned images were transmitted to TPS for plan formulation.With 6 MV X-ray,MLC created 5 strip 3 cm × 0.6 cm picket fence field,each with 3.0 cm strip separation.The SSD was 100 cm at the maximum dose point,with a 250 MU to each strip.The irradiated radiochromic films were returned to IAEA for analysis within one week and compared with the values given by IAEA.Results The difference of film-measured and TPS-planned positions of MLC leaves for each strip picket fence should be within ± 0.5 mm as required by IAEA.For 7 of 8 accelerators selected,the differences of accurately measured MLC leaf positions were all within ±0.5 mm,which were in line with the IAEA requirements,with only other one being beyond-0.5 mm,not consistent with the IAEA requirements.The differences of film-measured actual widths between each pair and all pairs of leaves were within ±0.75 mm as required by IAEA for 7 accelerators,whereas the other one was outside ± 0.75 mm,not consistent with the IAEA requirements.The standard deviation of film-measured actual width of MCL leaf between each pair and all pairs for 7 accelerators were ≤ 0.3 mm as required by IAEA,whereas the other one was 0.5 mm,not consistent with IAEA requirements.Conclusions The MLC positioning accuracy of a few of medical accelerators in Henan is not qualified.It is of great significance to carry out regular quality examination as well as third-party verification to ensure precise delivery of radiotherapy.

Objective To investigate the health status of centenarian hospitalized patients and analyze the risk factors for in-hospital death in Nanjing district.Methods All centenarians hospitalized patients who were discharged from wards of 10 upper first-class general hospitals in Nanjing district during the past five years were retrieved from their hospital information systems.Then,a retrospective study was performed on centenarians' data of general information,laboratory test results,Charlson comorbidity index (CCI),neutrophil to lymphocyte ratio (NLR) and shock index(SI),etc.were calculated and collected.Relevant risk factors for in-hospital death were analyzed by multivariate logistic regression analysis.Results A total of 156 patients aged 100 years and over,with an average age of (101.0±2.1)years,were enrolled during the past 5 years.The top 3 admitting diagnosis for the patients were pulmonary infection(30.1％,47/156 cases),coronary heart disease(10.9％,17/156 cases)and cerebrovascular disease(7.1％,11/156 cases).Fifty patients died during hospitalization,with a mortality of 32.1％ (50/156).Pneumonia was the most common admitting diagnosis(40.0％,20/50 case).Among causes of death,the combined admitting diagnosis with dementia,chronic renal insufficiency,one or more basic disease were significantly associated with death.There were statistically significant differences between bad vs.good vs.indifferent prognosis in heart rate,shock index,leukocyte count,neutrophil count,NLR,hemoglobin,albumin,albumin/globulin,fasting blood glucose,blood urea nitrogen,serum creatinine,C-reactive protein(CRP)and CCI levels.Multivariate logistic regression analysis suggested that NLR≥13.18,fasting blood glucose ≥7.56 mmol/L,blood urea nitrogen ≥20.74 mmol/L,CRP≥65 mg/L and CCI≥3 might be predictors for in-hospital death in the cohort(OR =48.91、3.43、1.22、6.55、1.55,all P＜0.05).Conclusions Pulmonary infection is the most common reason for admission and the cause of death in centenarian inpatients.Comorbidities increase the risk of death.To lower in-hospital mortality,CCI and other assessment indicators should be used to strengthen the comprehensive assessment and chronic disease management of hospitalized centenarians.Infectious diseases should be prevented beforehand.

Objective:The aim of the current study is to understand the sleep disorders in children with autism and related factors.Methods:A case-control study method was conducted in this study which included 198 children autism who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 233 cases of gender-and age-matched normal children.Their general demographic and sleep data were collected and the children with autism were assessed with Autism Behavior Checklist,Child Behavior Checklist and Autism Spectrum Screening Questionnaire.Correlation analysis and regression analysis were performed to compare sleep quality,sleep problems and the related factors of the two groups.Results:The scores of difficulty falling asleep,sleep restlessness,taking hold or shaking,restless sleep,interrupted sleep,nightmares,sleepwalking,night terrors,sleep snoring,nocturnal enuresis,sleep apnea,mouth breathing,sweating and sleep scores were higher in the autism group compared to the normal control group before falling asleep (P ＜ 0.05),while the proportion of daytime sleep time in the autism group was lower than the normal control group (P ＜0.05).With sleep status as dependent variable,linear regression analysis was conducted with children's birth weight,walking month age,speaking month age,father age,and autism spectrum as independent variables.The multiple linear regression analysis showed the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic children were positively associated with their sleep (β =0.21,0.21,0.29,P ＜ 0.05).However,paternal age at birth in the autism group had negative associatin with the sleep of autistic children (β =-0.16,P ＜0.05).In the autism group,their total scores of Autism Behavior Checklist and the scores of language and social behavior in Autism Behavior Checklist were not associated with their sleep status score (P ＞ 0.05).Conclusion:It suggests that children with autism may have more sleep problems,and their sleep problems are related to autism symptoms including the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic and their paternal age at birth.

Objective:To investigate the association of AKT1 gene polymorphism with risperidone in the treatment of first-episode and untreated schizophrenia for 8 weeks.Methods:A total of 150 patients with Chinese schizophrenia who met DSM-Ⅳ,including 128 cases of risperidone (treatment dose 4-6 mg/d) for 8 weeks were treated with risperidone (treatment dose 4-6 mg/d).The Positive and Negative Symptom Scale (PANSS) reduction rate was used to evaluate the curative effect of drugs after 8 weeks.Using DNA sequencing,four single nucleotide polymorphisms (SNP) loci (rs1130214,rs10149779,rs1130233,rs2494732) genotype were detected in 128 Han patients with schizophrenia,and quantitative trait locus analysis (QTL) was used to explore the association between AKT1 gene polymorphisms and the efficacy of risperidone in the treatment of schizophrenia.Results:AKT1 gene rs1130233 (G ＞ A) and rs2494732(C ＞ T) were significantly associated with the increase in PANSS after 8-week risperidone treatment of schizophrenia (P ＜ 0.05).After repeated testing Bonferroni correction was still statistically significant.The correlation between rs1130214and rs10149779 in this sample was not statistically significant (P ＞0.05).Conclusion:This study suggests that polymorphisms of the AKT1 gene may be associated with the efficacy of risperidone in the treatment of schizophrenia in the Chinese Han population and is expected to provide a basis for the prediction of individual drug efficacy.

Objective The purpose is to discuss the characteristics of the TCM syndromes of the patients with advanced gastric cancer, in order to reveal the pathological characteristics of Chinese medicine. Methods By observing the symptoms and signs of 126 patients with advanced gastric cancer, the TCM syndromes was used to analyze the distribution of TCM syndromes' frequency and the scores of symptoms. Results The resut showed that the common TCM syndromes for the disease location were stomach, spleen, liver, kidney, gallbladder, large intestine, small intestine, lung, utreus, heart, brain and bladder, where the frequency of stomach, spleen were higher than other. And the common TCM syndromes for the disease pathology were Qi deficiency, blood deficiency, Qi stagnation, blood stasis, toxin, phlegm, dampness, Yin deficiency, Qi revresion, heat, food stagnation, water stagnation and Yang deficiency.Conclusions The common TCM syndromes for the disease location of advanced gastric cancer were stomach, spleen, liver, kidney; And the common TCM syndromesfor the disease pathology were Qi deficiency and blood deficiency, Qi stagnation, blood stasis, toxin, phlegm, dampness, Yin deficiency, Qi revresion, heat, food stagnation, water stagnation and Yang deficiency.

2-(Dimethylamino)ethyl methacrylate and sodium monochloroacetate were employed to synthesize [2-(Methacryloyloxy)ethyl] dimethyl ammonium acetate (CBMA) functional monomer.CBMA was grafted on the surface of silica by surface initiated atom transfer radical polymerization (SI-ATRP) to obtain silica-CBMA hydrophilic interaction stationary phase.Three silica-CBMA stationary phases with different grafted density of CBMA monomer were synthesized in SI-ATRP progress by changing the concentration of CBMA under the same conditions.The ability to separate organic acid compounds of the synthesized silica-CBMA stationary phases was evaluated under different conditions, including effects of pH value, salt concentration and content of water of mobile phase on retention of solutes.The results showed that the stationary phases could effectively separate organic acid compounds in HILIC mode, which followed a mixed mode of chromatography of ion exchange and hydrophilic interaction.The retention of solutes decreased with the increases of salt concentration of mobile phase, which consistent with the characteristics of ion exchange;the pH value of mobile phase had significant influence on ionization of the stationary phase and solutes, i.e., the retention of solutes increased as the increasing of pH value of mobile phase.However, the retention of solutes decreased with the increasing of the content of water in mobile phase, which was the typical characteristic of HILIC.The method of hydrophilic interaction chromatography combined with silica-CBMA stationary phases could conveniently determinate the content of vitamin C and rutin in rutin tablets, providing a new method for the separation and determination of strong polar samples.

Objective To understand the current prevalence of clonorchiasis in Jiangxi Province. Methods A survey was performed according to the scheme of the 3rd Principal Human Parasites of Jiangxi Province. Based on the ecological regions,a stratified cluster sampling method was applied by the economic and geographic situation. In rural areas,the investigation of C. si?nensis was carried out together with the soil?transmitted helminths investigation,and in the urban areas,the random cluster sam?pling method was applied for the C. sinensis investigation. There were 92 survey sites from 32 counties. The eggs of C. sinensis in stool were examined by Kato?Katz technique,and health knowledge was also investigated by questionnaires in some people at the same time. Results A total of 23 606 sample residents were investigated,and 138 were found infected with C. sinensis, with the infection rate of 0.58%. Light infection was found in most of them. Totally 124 C. sinensis infected persons focused in Xinfeng County,and only a few of infected people scattered in the other counties. In Xinfeng County,851 residents were investi?gated. Among them,the infected people were found in all the age groups except the 0?year age group. The highest infection rate appeared in the 70? years group(24.00%). The male infection rate was 20.29%,which was higher than that of the female (6.25%),showing a statistically significant difference(P<0.01). The infection rate was highest in the population who received high school or technical secondary school education(31.48%). For the occupation distribution,the infection rate was highest in public officers(39.39%). The questionnaire survey showed that the infection rate in the populations in Xinfeng County who had the history of eating raw fish or raw shrimp was 33.15%. Conclusions The distribution of C. sinensis infection presents a region?al aggregation in Xinfeng County,but in other areas,the distribution is sporadic. It is necessary to continue to carry out the para?sitic disease screening,and in Xinfeng County,it is necessary to strengthen the comprehensive prevention and control interven?tion.

Objective To study the effects and mechanism of different administrations of atorvastatin on myocardial ischemia/reperfusion (MI/R) in rats.Methods A total of 160 male SD rats were randomly divided into five groups:sham group,MI/R group,atorvastatin of conventional dose (MI/R + N) group,atorvastatin of preoperative signal loading dose (MI/R+SL) group,and atorvastatin of preoperative continuous loading dose (MI/ R+ML) group.MI/R model was established in the rats.Myocardial infarction size was detected by Evans blue/ TTC staining.The activity of ATPase of cardiac muscle and the levels of serum IL-6 and TNF-α were detected by ELISA.The level of LVEF％ was detected by small animal ultrasound.Results Compared with MI/R+N group,MI/R+ SL and MI/R+ ML groups had significantly smaller myocardial infarction size (P＜0.05),higher activity of ATPase (P＜0.05),lower levels of serum IL-6 andTNF-α (P＜0.05),and more advancedLVEF％ (P＜0.05).However,MI/R+SL group and MI/R+ML group did not differ significantly in the above-mentioned parameters.Conclusion Atorvastatin of loading dose might alleviate MI/R injury by improving ATP metabolism of cardiac muscle and reducing abnormal expressions of inflammation factors.Meanwhile,the administration of preoperative continuous loading dose and preoperative signal loading dose of atorvastatin may not differ in protecting against MI/R injury.

Objective To discuss the clinical application of different particle size of grain fat sieved by the homogenizing fat extractor.Methods A lot of 68 patients in this group were women,and the average age was 28 years.With the aid of tumescent technique,anterior and lateral thigh fat granules were extracted using liposuction needle;after the homogenizing fat extractor and sieve purification,fat particles were obtained with uniform particle size and no fibrous tissue for different sizes of 2.00 mm,0.90 mm,0.50 mm and 0.28 mm,respectively.After choosing corresponding diameter of fat transplantation needle and appropriate injection level according to fat particle size,the multiple spot and multiple track tunnels,multi-level injection for the facial soft tissue deficiency or cavity were then carried out.With long-term postoperative follow-up,evaluation of different grades were given for the complication,fat survival rate and satisfaction.Results The results were followed up for 3-12 months postoperatively;as responding,the facial appearance of graft field deformity or deficiency was significantly improved and the skin of the recipient area was soft;wrinkles was relieved,and so that they appeared young plump well-pleasing appearance.And there were no complications,such as infection,hematoma,fat liquefaction,pigmentation,induration and so on.Satisfactory results were obtained.Conclusions The treatment of facial soft tissue deficiency or deficiency,by choosing corresponding diameter of fat transplantation needle and appropriate injection level according to the differences of fat particle size sieved by the homogenizing fat extractor,can acheive a high fat survival rate,and stable long-term effect.Thus,this safe and ideal method for rejuvenation of facial treatment is worth promoting.

Objective To observe the changes of liver and kidney function in hepatitis B virus(HBV)carriers after renal transplantation. Methods A total of 116 patients with HBV infection undergoing renal transplantation and 348 counterparts without HBV infection were recruited in this clinical trial. The liver function parameters including alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels and renal function parameter including serum creatinine(Scr)level were measured before and at 1, 3, 6, 12, 18, 24, 36 and 60 months after renal transplantation. Preoperative and postoperative changes of liver and kidney function were statistical y compared between the hepatitis B surface antigen(HBsAg)(+)and HBsAg(–)groups. According to the results of preoperative HBV serology, preoperative quantitative detection of HBV DNA and preoperative liver function test, 116 HBsAg(+)patients undergoing renal transplantation were divided into(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, HBV DNA(+)and HBV DNA(–)groups, and normal and abnormal liver function groups.Preoperativeandpostoperativechangesofliverandkidneyfunctionwerestatisticalycomparedbetweendifferentsubgroups. Results(1)Preoperative ALT and AST levels in HBsAg(+)patients were significantly higher compared with those in their HBsAg(–)counterparts. In 36 months after renal transplantation, liver function parameters significantly differed between two groups(al P<0.05), whereas no statistical significance was noted at postoperative 60 months(al P>0.05). Before and in 60 months after renal transplantation, no statistical significance was observed in the Scr levels between the HBsAg(+)and HBsAg(–)groups(all P>0.05).(2)Before and in 60 months after renal transplantation, no statistical significance was observed in the liver and kidney function parameters between the(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, and HBV DNA(+)and HBV DNA(–)groups(all P>0.05).(3)The ALT levels before and at 1, 3, 6 and 12 months after renal transplantation significantly differed between the normal and abnormal liver function groups(al P<0.05), whereas no statistical significance was observed at other time points(all P>0.05). The AST levels before and at 1 month after renal transplantation significantly differed between two groups(both P<0.05), whereas did not significantly differ at alternative postoperative time points(all P>0.05). No statisticalsignificancewasobservedinthekidneyfunctionparametersbeforeandat60monthsfolowingrenaltransplantation between two groups(al P>0.05). Conclusions HBV infection cannot exert significant effect upon kidney function within 5 years after renal transplantation, whereas it can affect short-term postoperative liver function.