Objective:To study the effects of docetaxel, cisplatin and fluorouracil (TPF) regimen simultaneous intensity modulated radiotherapy (IMRT) on immune function and survival prognosis of patients with advanced esophageal cancer.Methods:A total of 93 patients with advanced esophageal cancer were screened in Hebei Veterans General Hospital from June 2015 to December 2017, and were divided into two groups using randomized envelope method. The observation group (47 cases) was given synchronous TPF regimen and IMRT, and the control group (46 cases) was given synchronous PF regimen (cisplatin combined with fluorouracil) and IMRT. Esophageal barium meal, chest and upper abdominal CT were reviewed within 1 month after treatment to assess the short-term efficacy and compare the immune function of the two groups before and after treatment. Kaplan-Meier survival curve was plotted to evaluate the long-term efficacy based on overall survival (OS). The incidence of adverse reactions in the two groups was collected to evaluate their safety.Results:After treatment, the T cell subgroup CD8 + level of the observation group was higher than that of the control group [(33.55±4.46)% vs. (29.06±3.61)%, P<0.05], while CD3 + [(51.29±5.22)% vs. (56.04±6.10)%, P<0.05], CD4 + [(28.27±3.63)% vs. (30.35±3.52)%, P<0.05] and CD4 + /CD8 + (0.84±0.25 vs. 1.04±0.08, P<0.05) levels were lower than those of the control group. The effective rate of recent treatment in the observation group was 82.98% (39/47), while the effective rate in the control group was only 63.04% (29/46), with a statistically significant difference ( χ2=4.70, P=0.030). The median OS of the observation group was 25.3 months (95% CI: 17.9-26.1), and that of the control group was 18.2 months (95% CI: 14.4-25.5), with a statistically significant difference ( χ2=3.28, P=0.038). Adverse reactions during the follow-up period of the two groups of patients were mainly nausea/vomiting, fatigue, anorexia, hematological toxicity, esophagitis and pneumonia, etc., which were mostly grade 1-2, and disappeared after symptomatic treatment or termination of treatment. Compared with the control group, the incidence of nausea/vomiting (46.81% vs. 78.26%, χ2=9.80, P=0.002), anorexia (44.86% vs. 71.74%, χ2=6.99, P=0.008), leukopenia (36.96% vs. 73.91%, χ2=13.37, P<0.001) and esophagitis (61.70% vs. 82.61%, χ2=5.05, P=0.025) adverse reactions was lower in the observation group. Conclusion:TPF combined with IMRT has high efficacy and low adverse reactions, which can be used as an effective treatment to improve the survival prognosis of patients with advanced esophageal cancer.

Tuberculous meningitis is the most common and serious type of central nervous system tuberculosis, with high mortality and disability rate, which has attracted extensive attention of global public health. The high mortality rate and disability rate of tuberculosis meningitis may be related to its lack of specific clinical and imaging characteristics, insufficient attention from clinicians, lack of early sensitive and specific diagnostic testing techniques, delay in treatment, and restricted penetration of anti-TB drugs into the blood-brain barrier or/and MDR-TB, etc. This article reviews the disease burden of TBM, chemotherapy drugs and regimens, anti-inflammatory agents, aspirin, interventional and surgical treatment to provide reference for clinical management of this disease.

Objective:To explore the advantages of the novel individualized 3D printing artificial vertebral body in spine reconstruction and to evaluate its clinical effect.Methods:From January 2017 to December 2018, the 15 patients who underwent total vertebrectomy and spine reconstruction with individualized 3D printing artificial vertebral body were analyzed retrospectively. There were 8 males and 7 females, with the mean age 39.5 years (range: 20-57), including 12 primary tumors and 3 metastatic tumors. According to tumor location and surrounding soft tissue invasion range, simple posterior or combined anterior and posterior approach were used for total vertebral resection, and the defection was reconstructed by 3D printing artificial vertebral body. The operation time, intraoperative bleeding volume, postoperative stability of artificial vertebral body and bone ingrowth of adjacent vertebral body, preoperative and postoperative neurological changes, preoperative and postoperative VAS score, local control and survival of patients were analyzed.Results:The mean operation time was 412.0 min (range: 135-740 min), and the mean blood loss was 4 140.0ml (range: 100-14 000 ml). The mean follow-up time was 23.2 months (range: 12-35 months), and no one loss to follow-up. One case had pleural rupture, one case had cerebrospinal fluid leakage and one case had L5 nerve root palsy. All patients recovered after active symptomatic treatment. Compare with the preoperative VAS score (4.7±1.1), the differences of VAS score at 7 d postoperative and last follow-up (1.6±0.6 and 1.0±0.5) were significantly reduced ( P<0.001). Three patients with Frankel grade C gradually recovered to grade D, and no change were found in grade D and Grade E patients, there was no significant improved at last follow-up. Preliminary bone growth was found between the artificial vertebral body and the adjacent vertebral body 3 months after operation. The bone growth was more obvious at 12 months post-operation, and the artificial vertebral body fused with the adjacent vertebral bodies to form bone integration. At 24 months post-operation, the integration of the artificial vertebral body was more accurate. During the follow-up period, there was no loosening or displacement of the artificial vertebral body and no failure of internal fixation. A case of hemangioendothelioma and a case of epithelioid angiosarcoma died at 33 months and 35 months postoperatively. One patient with chondrosarcoma had local recurrence at16 months post-operation. After treated with arotinib, the tumor did not progress. The other 12 patients had no tumor recurrence or distant metastasis. Conclusion:After spinal tumor resection, individualized 3D printing artificial vertebral body can be used to accurate restoration of spinal continuity, and provide nice interface matching and bone growth between artificial vertebral body and the adjacent vertebral endplates. Moreover, the immediate and long-term stability of the artificial vertebral body can meet the needs of spinal reconstruction.

Objective To build an advanced clinical case collection and teaching system for the department of radiology, and thus to facilitate the scientific research and teaching.Methods By combining several free software, we built a network version of the case collection system with simple web pages, to achieve centralized storage of case text and image data, thus to facilitate the research and teaching work.Results This case collection system quickly saved text data and image data through simple operation, supported parallel work without the need for complex configuration on the client, and had good support for wide area network.This system had stable system operation and could be customized to meet the clinical needs well.Conclusion Using free software to establish the network version of the case collection and teaching system is low cost and has no legal risk.This system is a simple but powerful tool, and can meet the needs of hospitals with different sizes, which is a more perfect case collection system.

In order to construct a novel multifunctional targeting nano-carrier based on pH-redox characteristics of tumor microenvironment,ketone bonds and disulfide bonds were bonded to the oligomeric hyaluronic acid (oHA) being sensitive to pH and the reduction environment.The chemical structure of oligomeric hyaluronic acid-8-mercaptomenthone 1,2-glycerolketal (oHMST) was characterized by 1H NMR,IR and ESI-MS.Curcuminloaded micelles were prepared by dialysis.The single factor investigation was carried out on the dosage form.Some properties,including particle size zeta potential,the morphology of micelles,and pH-sensitivity were studied.The materials were synthesized successfully.The micelles were spheric with a diameter of about 100 nm.The Zeta potential of the micelles was-(21.97 ± 1.08) mV.The in vitro test showed that oHMST carriers have good pH-sensitivity and redox-sensitivity.

Objective To observe the application value of PET glucose metabolic imaging and MR structural imaging in diagnosis of Alzheimer disease (AD) and mild cognitive impairment (MCI).Methods Totally 18 patients with AD (AD group),6 patients with MCI (MCI group) and 10 healthy volunteers (HC group) were enrolled.There were 11 cases of moderate or severe AD and 7 cases of mild AD in AD group.PET and structural MR imaging of the brain were performed.The radioactivity distribution in the brain and the hippocampal atrophy were observed through visually evaluation and quantitative analysis.Results The glucose metabolism reduced in certain regions of the brain in all AD patients (18/18,100％).Among them,11 patients with moderate or severe AD accompanied hippocampal atrophy,while 3 of 7 patients with mild AD showed hippocampal atrophy.No hippocampal atrophy was found in 5 patients with MCI (5/6,83.33 ％),but 2 of them showed decreased radioactivity in the brain.The symmetric mild diminution of radioactivity distribution without hippocampal atrophy was found in all subjects in HC group (10/10,100％).Two cases in HC group showed mild encephalanalosis.Conclusion Both of PET glucose metabolic imaging and MR structural imaging can be used to diagnose AD or MCI with different focus.Combination of these two techniques is helpful to improving diagnostic accuracy.

Objective To explore the characteristics and significance signification of changes of cerebral glucose metabolism in patients with Alzheimer's disease (AD).Methods Seventeen patients diagnosed with AD based on standard clinical diagnostic criteria (AD group),and 15 healthy volunteers as normal control group (HC group)were enrolled in this study.Positron emission tomography (PET)were performed in both groups and three-dimensional reconstruction images were obtained.The visual evaluation,regions of interesting (ROI)technology and brain function analysis software were used to analyze PET results data in of each group.Results ①In AD group,glucose metabolisam was decreased and mainly distributed in the parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,but not in occipital lobe,basal ganglia,thalamus and cerebellum nuclei basales,thalamus and opisthencephalon.Ssomatic sensation and motor functionand were not affected.②Compared with mild AD patients,glucose metabolism inof moderate and severe AD patients was decreased more significantly in parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,with a wider range of lesionsthe range also expanded,and visual area and speech centerpartly followed by the disorder of visual center and speech center may bewere involved in some patients.③The built-in brain function analysis software of PET system software carried by PET system was more objectiveprecise and accurate than visual evaluation or and ROI technology,can accurately reflected the changes in brain glucose metabolism which and iwas suitable for popularization and application.Conclusion Because the distribution of impaired glucose metabolism in cerebral cortex hads certain characteristics and regularity laws in AD patients.18 F-FDG PET imaging can maybe meaningful valuable in diagnosis,differential diagnosis and therapeutic evaluation in AD.

BACKGROUNDAllergic asthma is a chronic airway inflammatory disease partly characterised by high concentration of T help 2 (Th2) cytokines in bronchoalveolar lavage fluid (BALF). There is no report on the relation of peripherally circulating blood lymphocytes and asthma. We explored the balance of Th2/Th1 cytokines in asthmatic mice. Exogenous recombinant interleukin (IL) 33 acted on murine peripheral circulating blood lymphocytes, IL-5 cytokine was selected for assessing Th2 cytokines and interferon-gamma (IFN-γ) for Th1 cytokines.

METHODSFemale specific pathogen free BABL/c mice were sensitised by intraperitoneal injection of 20 µg of ovalbumin emulsified in 1 mg of aluminium hydroxide gel in a total volume of 200 µl, and challenged for 30 minutes in 7 consecutive days with an aerosol of 2 g ovalbumin in 100 ml of PBS. Then we collected BALF and isolated lymphocytes from the peripheral blood. The lymphocytes were divided into two groups: asthmatic group and normal group. Th1/Th2 cytokines was detected by enzyme-linked immunosorbent assay (ELISA) kits.

RESULTSIn the asthma group, we found numerous eosinophils and lymphocytes on the glass slides. We then confirmed that the optimal concentration of IL-33 was 10 ng/ml and time of IL-33 stimulating lymphocytes was 24 hours. In the asthma group, the production of IL-5 was significantly increased over normal group after stimulation with IL-33 (P < 0.05) and the production of IFNγ was supressed from IL-33 stimulated lymphocytes (P < 0.05).

CONCLUSIONIL-33 acts on lymphocytes of peripheral blood increasing secretion of Th2 cytokines and inhibiting secretion of Th1 cytokines.

Animals ; Asthma ; chemically induced ; immunology ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Interferon-gamma ; immunology ; metabolism ; Interleukin-33 ; Interleukin-5 ; immunology ; metabolism ; Interleukins ; immunology ; metabolism ; Lymphocytes ; immunology ; metabolism ; Mice ; Mice, Inbred BALB C

Objective To identify the electrophysiological charateristics and cause of ridge gap related reentry after MI ablation in atrial ifbrillation patients. Methods Activation and entrainment mapping was performed in 82 redo cases for OAT recurrence in whom MI was ablated during the index produre. Once ridge gap related reentry was conifrmed, detailed mapping was performed in MI and ridge region. In addition, in 36 cases undergoing MI ablation and fulfilling criterion for bidirectional block, differential pacing was repeated at the ridge to identify a ridge gap. Results Out of 82 redo cases for OAT recurrence in whom MI was ablated during the index produre, 7 (8.5%) was found to be ridge gap related reentry. TCL was (247.9±19.2) ms, and the left atrial endocardial activation time was (145.4±17.7) ms, accounting for (58.5±3.2)%of TCL. However, wide double potential was recorded along the previous ablated MI line where PPI was (34.3±6.6) ms longer than TCL, while PPI was signiifcantly shorter at the ridge[PPI-TCL (11.4±3.9) ms, P<0.001]. Tachycardia was terminated at the ridge in 6 cases and at the corresponding site in coronary sinus in 1 case. No recurrence was found during follow-up for (11.1±4.5) months. In addition, in 36 patients undergoing MI ablation in whom criterion of bi-directional block was fuliflled, conduction gap located at the ridge was found in 5 (13.9%) cases. Conclusions MI ridge gap related reentry is a distinctive OAT, in which the ridge was used as the critical isthmus, whereas the previous ablated MI line is not part of the reentry. MI pseudo-block due to the ridge gap may lead to this type of recurrent tachycardia.

Objective To evaluate 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama.Methods The 3D CT features on MIP,VR images were analyzed retrospectively in 589 pediatric cases.The normal anatomy,anatomic variations and fractures of occipital squama were observed respectively,and the differential diagnostic features including the individual location,appearance and extension were analyzed.Results Four hundred and thirty-three patients (75.2％) showed normal anatomy,including 154 patients with adult occipital anatomical features,279 patients with posterior intraoccipital synchondrosis,and 37 patients with Kerckring-supraoccipital synchondrosis.When cases with recent trauma history were excluded,113 patients (19.1％) showed anatomic variants,including unpenetrating sutures and penetrating sutures.The former could be subdivided to Mendosal sutures in 23 cases,superior median fissures in 19 cases,and midline supraoccipital fissures in 4 cases,while the latter could be subdivided to the interparietal bone variations in 54 cases,wormian bones in 23 cases,and accessory bones in 7 cases.Two or more variations coexisted in 33 cases.The occipital squama fractures were shown in 34 cases (5.6％),including linear fractures in 27 cases,comminuted fractures in 3 cases,with depression fracture in one case,separation of cranial sutures in 3 cases,and other fractures associated with variants in 3 cases.The fractures were sharp,or jagged,without limitation of the occification.Conclusion There are different 3D CT features of normal anatomy,anatomic variations and fractures of occipital squama in children,which are important for making the accurate diagnosis.