The number of patients with vascular cognitive impairment(VC I)is increasing year by year,and its incidence rate is second only to that of Alzheimer's disease(AD),becoming the second leading cause of dementia.It should be noted that,VCI is a disease that can be controlled by early diagnosis and timely treatment,and It is even a disease that can achieve clinical cure.Therefore,an in-depth exploration of the pathogenesis of VCI,as well as the development of effective early diagnostic and preventive strategies,is not only of significant clinical guidance importance but also holds profound social value.The Klotho gene,an anti-aging gene,is primarily expressed in the brain's choroid plexus and kidneys.The Klotho protein it encodes not only has anti-aging and longevity-extending functions but is also closely associated with cognitive function.Current research has revealed a strong connection between Klotho protein levels and vascular cognitive impairment induced by ischemic stroke,suggesting that Klotho protein could serve as an important biomarker for predicting vascular cognitive impairment after ischemic stroke.This article aims to comprehensively summarize the latest research progresses on the Klotho gene and its polymorphisms,as well as the Klotho protein and cognitive impairment following ischemic stroke,both domestically and internationally,in the hope of providing a solid theoretical foundation and reference for further research in this field.

The number of patients with vascular cognitive impairment(VC I)is increasing year by year,and its incidence rate is second only to that of Alzheimer's disease(AD),becoming the second leading cause of dementia.It should be noted that,VCI is a disease that can be controlled by early diagnosis and timely treatment,and It is even a disease that can achieve clinical cure.Therefore,an in-depth exploration of the pathogenesis of VCI,as well as the development of effective early diagnostic and preventive strategies,is not only of significant clinical guidance importance but also holds profound social value.The Klotho gene,an anti-aging gene,is primarily expressed in the brain's choroid plexus and kidneys.The Klotho protein it encodes not only has anti-aging and longevity-extending functions but is also closely associated with cognitive function.Current research has revealed a strong connection between Klotho protein levels and vascular cognitive impairment induced by ischemic stroke,suggesting that Klotho protein could serve as an important biomarker for predicting vascular cognitive impairment after ischemic stroke.This article aims to comprehensively summarize the latest research progresses on the Klotho gene and its polymorphisms,as well as the Klotho protein and cognitive impairment following ischemic stroke,both domestically and internationally,in the hope of providing a solid theoretical foundation and reference for further research in this field.

Objective:To develop an integrated intelligent device of measurement and calibration for cardiopulmonary resuscitator,so as to improve the efficiency and reliability of measurement and calibration of cardiopulmonary resuscitators,and to ensure the safety and effectiveness of rescuing wounded.Methods:This device used modern sensor transmission technique,and adopted a systematically combined design with industrial control measurement and control module.This device could realize simultaneously automatic detection for a series of parameters included depth and frequency of pressure,single breath frequency,moisture volume and so on in the device of measurement and calibration.Results:The measurement and control of the measurement and calibration device of the integrated cardiopulmonary resuscitator are accurate,which average values of pressure depths were respectively(29.8±0.13)mm,(49.3±0.08)mm and(69.89±0.14)when standard values were respectively 30,50,70 mm.The pressure frequencies were respectively(79.30±0.08)times/min,(99.89±0.14)times/min and(119.94±0.24)times/min when standard values were respectively 80,100 and 120 times/min.The moisture volumes were respectively(347.99±2.77)mL,(546.18±1.89)mL and(746.67±2.14)mL when the standard values were respectively 350,550 and 750mL.The above results of this dive are consistent with the results of the standard device,and the errors of depth and frequency of pressure,and moisture volume were respectively±15%,±10%,±20%,which all were within the allowed range.Conclusion:The measurement and calibration device of integrated intelligence of cardiopulmonary resuscitators can complete various detection of related parameters within one pressure cycle of the cardiopulmonary resuscitator.The detection results of the device are highly consistent with those of the standard device,and the detection results are accurate and reliable.

Objective:To detect the expression of inhibitor of DNA binding-2(ID-2) in colorectal adenocarcinoma and analyze its relationship with proliferation.Methods:A total of 67 patients with colorectal adenocarcinoma diagnosed in North China University of Science and Technology Affiliated Hospital were selected from November 2014 to September 2015, tumor tissue as the research objects.All patients underwent radical operation.The tumor tissue was taken as the observation group, and the normal colonic mucosa tissue>3 cm from the edge of the tumor was taken as the control group.Immunohistochemistry was used to detect the expression of ID-2 of the two groups and the Ki67 of cancer tissue.SW480 cell line of ID-2 overexpression was constructed.The expression of proliferating cell nuclear antigen(PCNA)was detected by Western Blot.Cell activity was detected by CCK-8 test.Correlation was analyzed between ID-2 and Ki67 by pearman correlation analysis.Prognostic value of ID-2 was analyzed by Kaplan-Meier survival analysis and Log-rank test in colorectal adenocarcinoma.Results:The positive rate of ID-2 was 49.3%(33/67) in the observation group, which was higher than 9.0%(6/67) in the control group, and the difference between the two groups was was statistically significant(χ 2=23.927, P<0.05). In the observation group, the expression of ID-2 was statistically significant in different invasion depth(serosa and extraserosa was 68.7%(22/32), serosa and extraserosa was 31.4%(11/35)), degree of differentiation(low differentiation was 80.0%(8/10), medium differentiation was 57.9%(11/19), high differentiation was 36.8%(14/38)), clinical stage(Ⅲ and Ⅳ stage were 64.3%(18/28), Ⅰ and Ⅱ stage were 38.5%(15/39)), lymph node metastasis(metastasis was 70.8%(17/24), no metastasis was 37.2%(16/43)) and tumor thrombus(yes was 75.0%(12/16), no was 41.2%(21/51)). The difference was statistically significant (χ 2 value were 6.311, 4.023, 4.349, 6.967 and 5.575, respectively, all P<0.05). Positive correlation was found between ID-2 and Ki67( r=0.65, P<0.05). Survival analysis showed that the expression of ID-2 was related to the prognosis of patients (X2=5.29, P=0.013). Compared with empty vector transfection group and blank control group, the expressions of PCNA and the activity ID-2 overexpression colon cancer cells increased( P<0.05). Conclusion:The higher expression of ID-2 is related to clinicopathological features and prognosis in colorectal adenocarcinoma.The abnormal expression of ID-2 may play a role in regulating the proliferation of colon adenocarcinoma.

Objective:To create AAPM TG 119 test plans for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in order to evaluate the accuracy of the United Imaging Healthcare′s URT treatment planning system (URT-TPS). The plans were delivered to the phantom using the United Imaging Healthcare′s URT-Linac 506C.Methods:The overall accuracy of IMRT and VMAT planning, measurement, and analysis were evaluated for four test geometries provided by American Association of Physicists in Medicine (AAPM) Task Group Report 119(TG-119) on multi-target, prostate, head and neck and C-shape (easy). The dose distributions were measured in the coronal plane. The point measurements were measured by a Farmer type ion chamber and fluence measurements were completed with film and Delta4 phantom, respectively. Measured planar dose distributions were analyzed using gamma index with criteria 3%/3 mm.Results:For IMRT and VMAT plans, the planning results matched the TG-119 planning results. Measured point doses of IMRT and VMAT were within 2.62% and 3.90% of the planned doses, respectively. Measured film dosimetry gamma values of IMRT and VMAT were> 97.50% and> 93.27%, respectively.Conclusion:Based on these analyses which were performed in line with the TG119 recommendations, it is evident that the URT treatment planning system and URT-Linac 506C have commissioned IMRT and VMAT techniques with adequate accuracy.

Objective:To analyze the intensity-modulated radiotherapy (IMRT) process based on the TG100 report, aiming to improve the quality control method and guarantee the safety and quality of IMRT.Methods:Based on the TG100 report, a risk analysis team was established. The flow chart of overall and each sub-step of IMRT was constructed. The failure mode and effect analysis method were adopted to determine all potential error modes in the process. The probability of of the error mode, the probability of being checked out and the severity of the effect of the error mode on the clinical bed were evaluated based on the pre-set scoring standard. The priority value of each error mode was calculated and ranked from high to low priority value. The top 20% is defined as the high-risk error mode, which was analyzed by error tree to improve the quality control method.Results:IMRT consisted of 11 main steps and 41 sub-steps, and 180 failure modes were detected. The priority values were ranged from 30 to 178. A total of 36 high-risk failure modes were found. The top 5 high-risk failure modes (RPN) consisted of setup error (178), electronic portal imaging device (EPID) registration (172), contouring error (166), treatment delivery error (160) and prescription dose error (156).Conclusion:TG100 report is practical and convenient to utilize, which can effectively and systematically improve IMRT process and provide safety and quality assurance of IMRT process.

Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.

Objective To detect and analyze the expression and significance of olfactory receptor family 2 subfamily W member 3 (OR2W3) in gastric adenocarcinoma,and to explore its correlation with cell proliferation and apoptosis. Methods From January 2013 to June 2014, 61 patients with gastric adenocarcinoma diagnosed in the Affiliated Hospital of North China University of Technology and undergoing radical operation were selected as the study subjects. Neoplasm tissue were selected as the observation group, normal gastric mucosa ( 61 cases) were selected as the control group. Immunohistochemistry was used to detect the expression of or2w3 and HER-2 in the two groups. Fish was used to detect the amplification of HER-2 gene in some of the patients with uncertain expression of HER-2. Western blot was used to detect the expression of PCNA and BAX in the observation group. Results Positive rate of OR2W3 was higher in the observation group ( 50. 8%, 31／61) than that in the control group ( 8. 2%( 5／61 )), and the difference between the two groups was statistically significant(χ2＝26. 63,P＜0. 05). The difference of the positive rate of OR2W3 in the maximum diameter(≥6 cm was 68. 8%(22／32),＜6 cm was 31. 0%( 9／29)),depth of invasion(seroas and beyond was 63. 4%(26／41),less serosa was 25. 0%(5／20)),vascular and lymphatic vessel involvement ( involvement was 78. 6%( 11／14),no involvement was 42. 6%( 20／47)), lymph node metastasis(metastasis was 82. 1%(23／28),no metastasis was 24. 2%(3／33)) and TNM staging(Ⅲ+Ⅳwas 78. 1%(25／32),Ⅰ+Ⅱ was 20. 7%( 6／29)) in observation group was statistically significant ( χ2 was 8. 423,7. 937,5. 559,20. 318,20. 080,respectively,all P＜0. 05). Expression of OR2W3 was correlated with survival time(X2＝5. 31,P＜0. 05). Positive correlation was found between OR2W3 and PCNA expression(r＝0. 54,P＜0. 05) . Negative correlation were found between OR2W3 and BAX expression ( r＝－0. 59, P＜0. 05). There were 8 cases of HER-2 positive and 53 cases of HER-2 negative. The difference of OR2W3 expression in tumors with different HER-2 expression was statistically significant ( χ2＝4. 957,P＜0. 05) . Conclusion The expression of OR2W3 in gastric adenocarcinoma tissue is significantly increased,which can promote the proliferation of cancer cells and inhibit apoptosis. OR2W3 is related to HER-2 expression. Detection of OR2W3 expression may be of some value in judging prognosis.

Objective To predict the presence of MVI,the general clinicopathological of HCC patients' data of the preoperative neutrophil-lymphocyte ratio (NLR),platelet-lymphocyte ratio (PLR),altplatelet ratio (APRI) were evaluated.Methods 143 cases of HCC patients who underwent radical resection and ≤ 5 cm of tumor diameter in Chifeng Clinical Medical School of Inner Mongolia Medical University from January 2011 to December 2014 were analysed retrospectively and followed up.The relationship between NLR,PLR,APRI and other clinical parameters was evaluated.Results According to ROC Curve,the NLR truncation value was 2.00,PLR to 115.00,APRI 1.6.The single factor analysis of x2 test showed that NLR (x2=6.419;P＜0.05),APRI (x2=3.975;P＜0.05),AFP (x2=33.37;P＜0.05),Degree of differentiation (x2 =9.839;P＜0.05) were significant differences between MVI positive (MVI+) and negative (MVI-) groups,and the difference was statistically significant;Logistic regression multifactor analysis showed that NLR (OR 2.678;95％ CI 1.033～6.944;P＜0.05) and AFP (OR 1.724;95％CI 1.023～2.905;P＜0.05) are independent predictors of MVI.Conclusion Preoperative NLR and AFP are convenient,economical and reliable hematological indices for predicting the presence of MVI in HCC patients.

Independent check is one of the key measures of quality control (QC) in radiotherapy and is essential for the assurance of radiotherapy accuracy.In recent years,with the application of computer-aided system,the automaticity of independent check,as well as its accuracy and efficiency,increases.Meanwhile,QC has evolved from a device-centered to a process-centered program.Therefore,independent check has been increasingly systematic and specific.This review gives a brief summary of the implementation and development of independent check.