Objective: To study a method for verifying the doses to PTV and OAR as well as the 2D dose distribution arising from IMRT through using radiochromic films and TLDs. Methods: Totally 7 medical electronic linear accelerators from Varian, Siemens and Elekta were selected. The polystyrene phantom provided by IAEA was conducted with CT scan. After irradiation with 6 MV X-rays, the TLDs and films were returned to the secondary standard dosimetry laboratory of China CDC for measurement and estimation. Results: According to the IAEA requirements, the relative deviations between TLD-measured and TPS-planned values for PTV and OAR doses were both within ±7.0%. For PTV, the measured relative deviations for 5 accelerators were in the range of -4.0% to 3.4%, consistent with the IAEA requirements, whereas the values for the other 2 accelerators were in the range of -7.0% to 10.6%, not consistent with the requirements. For OAR, the values for 4 accelerators were in the range of -5.6% to 3.3%, consistent with the IAEA requirements, whereas the values for the other 3 accelerators were in the range of -20.8% to 11.5%, not meeting the requirements. As required by the IAEA, the 2D dose distribution 3 mm/3% pass rate should be higher than 90%. The measured values for 5 accelerators were in the range of 91.8% to 98.5%, consistent with the requirements, whereas the values measured for the other 2 were 45.0% and 77.0% respectively, not meeting the requirements. Conclusions It is feasible for using TLDs and radiochromic films to verify the doses to PTV and OAR and the 2D dose distribution in IMRT. This method should be applied to not only quality verification but also hospital internal audit to the extent possible.

This study aims to observe the intervention effects of Chinese herbal medicine of supplementing Qi and activating blood circulation on chronic intermittent hypoxia(CIH) composite insulin resistance(IR) mediated atherosclerosis(AS) mice model,and to observe the mechanism of SREBP-1 c signaling molecule.IR Apo E-/-mice model was induced by high-fat diet combined with STZ injection.Then the mice were treated with hypoxic animal incubator for 8 h per day and 8 weeks to establish a CIH+IR-ApoE-/-mouse model.Model mice were randomly and averagely divided into normoxic control group(NC),model group(CIH) and SREBPs inhibitor group(betulin),atorvastatin group(WM),TCM low-dose group(TCM-L),TCM middle-dose group(TCM-M) and TCM high-dose group(TCM-H) group.Chinese herbal medicine of supplementing Qi and activating blood circulation including ginsenosides combined with ligustrazine(TMP) were used as intervention drugs.The study observed the effect of drugs on IR,serum lipid,inflammation,stress,AS and SREBP-1 c related molecules.The results showed that fasting blood glucose in TCM-H group decreased compared with other experimental groups(P<0.05).HDL-C level in betulin group,WM group,TCM-H group was higher than that in CIH group(P<0.05).LDL-C level in TCM-M group,TCM-H group is lower than that in CIH group(P<0.05).The level of CRP in CIH group was higher than that in other groups(P<0.05).The level of SOD in TCM-H group was higher than that in CIH group(P<0.05).NC group and CIH group showed obvious AS aortic plaque,while betulin group,WM group,TCM-H group showed reduction in AS plaque(P<0.05).For descending aorta,AS plaque in CIH group was multiple and large,while less and smaller in WM group and TCM-H(P<0.05).The expression of SREBP-1 c and FAS in aorta and skeletal muscle in TCM-H group was lower than that in CIH group(P<0.05).In aorta,the expression of TNF-α and CD106(VCAM-1) was lower in TCM-H group than that in CIH group(P<0.05).In aorta,skeletal muscle and liver,the level of p-IRS-1 in TCM-H group was significantly higher than that in CIH group(P<0.05).In aorta and liver,the expression of HIF-1α in TCM-H group was lower than that in CIH group(P<0.05).The study demonstrated that combination ginsenosides with TMP could improve IR and serum lipid level and inhibit inflammation and oxidative stress as well as ultimately alleviate AS to some extent.And the mechanism of its interventional effects might be related to the inhibition of CIH-induced upregulation of SREBP-1 c related molecules.
Animals ; Atherosclerosis ; drug therapy ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Ginsenosides ; pharmacology ; Hypoxia ; pathology ; Insulin Resistance ; Mice ; Mice, Knockout, ApoE ; Pyrazines ; pharmacology ; Qi ; Random Allocation

BACKGROUND: Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection. METHODS: Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months. RESULTS: No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88). CONCLUSIONS Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.
Aged ; Atrial Fibrillation ; diagnostic imaging ; surgery ; Contrast Media ; Cryosurgery ; methods ; Echocardiography, Three-Dimensional ; methods ; Echocardiography, Transesophageal ; methods ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Veins ; diagnostic imaging ; surgery ; Treatment Outcome

To evaluate the bone strength and structure of patients with obstructive sleep apnea(OSA)by the high-resolution peripheral quantitative computed tomography(HR-pQCT)and to explore the relationship between OSA and osteoporosis. Male patients who visited the Sleep Respiratory Center of our hospital from August 2017 to January 2019 were consecutively recruited.Clinical data including the results of Epworth sleep scale(ESS)scoring and overnight polysomnography were collected.HR-pQCT was used to compare the differences in bone geometry,density,and microstructure between OSA patients and non-OSA people;also,the radius and tibia on the non-dominant side were measured to explore the relationship between OSA and osteoporosis. A total of 83 subjects were enrolled in the study.The number of patients in the mild,moderate,and severe OSA groups and non-OSA group were 21,18,34,and 10,respectively.There was no significant difference in age,blood pressure,ESS score,sleep stage,and sleep efficiency among these four groups(>0.05).Body mass index(BMI)and neck circumference were significantly different among these groups(=4.234,=0.008;=3.100,=0.031).There was no significant difference in the radius indicators(>0.05).For tibia,there were significant differences among the four groups in the cortical area(Ct.Ar)(=3.937,=0.011).There were also significant differences in the bone microstructural indicators including trabecular thickness(Tb.Th)and cortical thickness(Ct.Th)(=6.247,=0.001;=3.746,=0.014),which were significantly lower in the three OSA groups than in the control group.Pairwise comparisons showed that the Ct.Ar in the severe OSA group was significantly higher than that in the mild OSA group(=0.019)and Tb.Th in the control group was significantly higher than those in the mild and moderate OSA groups(=0.006,=0.001).Correlation analysis showed that,within a certain range,total volumetric bone mineral density(Tt.vBMD)and Tb.Th of radius and tibia were negatively correlated with age(=-0.312,=0.004;=-0.328,=0.002;=-0.265,=0.015;=-0.280,=0.010)and positively correlated with BMI(=0.240,=0.029;=0.369,=0.004;=0.299,=0.006;=0.416,=0.010).Stepwise multiple regression analysis showed that Tb.Th of radius and tibia were mostly correlated with BMI(=0.262,=0.008,=0.243,=6.270,=0.000;=0.494,=0.000,=0.186,=7.243,=0.000)and age(=-0.216,=0.030,=0.243,=6.270,=0.000;=-0.306,=0.003,=0.186,=7.243,=0.000).Tt.vBMD of radius had a certain correlation with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA(=0.312,=0.002, =-0.249,=0.012,=0.327,=7.482,=0.000). In non-elderly male populations,OSA mainly causes a decrease in Tb.Th and Ct.Th of the tibia.The changes in bone strength and structure are mainly related with age and body size and also have certain correlations with sleep efficiency and with the decreasing nocturnal mean oxygen saturation caused by OSA.
Bone Density ; Bone and Bones ; Humans ; Male ; Polysomnography ; Sleep Apnea, Obstructive ; Tomography, X-Ray Computed

Objective:To observe the effect of long-term administration of emodin on the kidney toxicity of mice, explore its possible toxic mechanism, and provide some basis for clinical rational drug use and further research. Method:The 30 Kunming mice, half male and half female, were randomly divided into 3 groups:control group, emodin low dose group and emodin high dose groups (0.8, 1.6 g·kg^-1), 10 mice in each group. Continuous intragastric administration was given for 11 weeks. During administration, the general situation of the mice was observed and recorded. After treatment, the serum urea nitrogen (BUN), creatinine (SCr), malondialdehyde (MDA), superoxide dismutase (SOD) tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) were detected. Kidney index was calculated and glutathione peroxidase (GSH-Px) and reduced glutathione/oxidized glutathione (GSH/GSSG) ratio were measured. The kidneys were taken for histopathological examination and the protein expression levels of transforming growth factor-β₁(TGF-β₁) and cysteine aspartic acid specific protease-3 (Caspase-3) were then detected by immunohistochemistry assay. Result:As compared with control group of the same sex, the weight of mice in the administration groups was decreased significantly, renal index was decreased while BUN and SCr levels were increased significantly (P<0.05,P<0.01); activity of SOD was decreased significantly (P<0.05, P<0.01); content of TNF-α was increased significantly (P<0.05, P <0.01), while the content of GSH-Px and the ratio of GSH/GSSG were decreased significantly in high emodin group(P<0.05), and the expression of Caspase-3 was increased significantly in high emodin group (P<0.05). Renal histopathology:tubule epithelial cells swelling, tubulointerstitial protein tube type, hyperemia and lymphocytic small focal hyperplasia were observed in emodin high dose group, but the performance above was not obvious in low dose group. Conclusion:The long-term administration of emodin at a large dose would show toxicity effect on mice kidney, and the toxicity was obvious at the dose of 1.6 g·kg^-1·d^-1, but there was no significant difference between the sexes. The mechanism of its potential toxicity may be related to the disorder of oxidation system, the injury of oxidative stress, the triggering of inflammatory reaction, and the apoptosis of cells.

Objective:To study nephrotoxicity induced by long-term administration of different doses of aloe-emodin in mice, and explore its mechanism. Method:A total of 30 male and female Kunming mice were randomly divided into normal control group, and low-dose aloe-emodin group,high-dose aloe-emodin group (0.8,1.6 g·kg^-1). Every dose of group was administered intragastrically for 11 weeks,twice daily. effect of serum urea nitrogen (BUN),creatinine (SCr),superoxide dismutase (SOD),malondialdehyde (MDA),Glutathione (GSH/GSSG) and Glutathione Peroxidase (GSH-Px) levels were detected by biochemical kits according to manufacturer's instruction. Enzyme-linked immune assay was used to determine serum tumor necrosis factor (TNF)-α and interleukins(IL)-6 levels. Hematoxylin eosin (HE) staining was used to detect renal pathological changes in kidney tissues, and cysteine aspartic acid specific protease(Caspase)-3 and transforming growth factor(TGF)-β₁ proteins were determined by immunohistochemistry. Result:According to results,compared with normal control group,the levels of BUN and SCr in serum with high-dose aloe-emodin were increased. The renal tubules in low-dose group were mildly injured,while renal tubules and glomeruli of high-dose group were moderately damaged. Compared with normal control group,the level of SOD was significant decreased (P<0.05), MDA was increased (P<0.05),the levels of GSH/GSSG in kidneys of high-dose groups were decreased (P<0.05). In high-dose group,the expression of Caspase-3 protein was increased in kidneys,especially in males (P<0.05). Compared with normal control group,the levels of TNF-α and IL-6 were increased,the expression of TGF-β₁ protein in kidneys was increased in low-dose and high-dose groups (P<0.05). Conclusion:results show that 1.6 g·kg^-1 aloe-emodin was administered intragastrically for 11 weeks,which had toxic effects on kidney in mice. The mechanism may be related to oxidative stress,apoptosis and TGF-β₁ protein expression.

Objective:To observe effect of long-term administration of rhein on the kidney toxicity of mice, and explore its possible toxic mechanism, in order to provide some basis for rational clinical drug use and further research. Method:The 30 Kunming mice (half male and half female) were randomly divided into 3 groups:control group, low-dose rhein group and high-dose rhein group (0.175,0.35 g·kg^-1), with 10 mice in each group. The intragastric administration lasted for 60 days. During administration, general situations of the mice were observed and recorded. Serum urea nitrogen (BUN), creatinine (SCr), malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected after drug withdrawal. Kidney index was calculated, and glutathione peroxidase (GSH-Px) and reduced glutathione/oxidized glutathione (GSH/GSSG) ratio were measured. The kidneys were collected and histopathologically examined, and the protein expressions of transforming growth factor beta (TGF-β₁) and cysteine aspartic acid specific protease-3 (Caspase-3) were detected by immunohistochemistry. Result:Compared with the control group of the same sex, BUN and SCr of the administration group increased significantly(P<0.05,P<0.01). In the high-dose group, the activity of SOD decreased significantly(P<0.05,P<0.01), while the expressions of TNF-α and Caspase-3 increased significantly(P<0.05). In the male group, the renal index was significantly decreased(P<0.05,P<0.01), the GSH-Px content in the male high-dose group was significantly decreased(P<0.05), whereas the expression of TGF-β₁ was increased(P<0.05). The histopathological changes of kidney were observed by hematoxylin-eosin (HE) staining. In the high-dose group, protein tubules were found in renal tubule lumen, glomerular and interstitial capillary congestion, tubule epithelial cell swelling and small focal proliferation of lymphocytes, and the pathological changes were more serious in male mice. The above performances in the low-dose group was less significant than those in the high-dose group. Conclusion:The toxicity of rhein in the kidney of mice was obvious at the dose of 0.35 g·kg^-1·d^-1, and the toxicity in male organism is more obvious. The mechanism of its potential toxicity may cause the imbalance of glutathione antioxidant system, induce excessive oxidation, trigger inflammatory reaction, activate the expression of Caspase-3, and then induce apoptosis.

Objective To explore the rehabilitation needs of people with disabilities and the related factors,so as to provide a scien-tific basis for the rehabilitation policy-making for people with disabilities. Methods From June,2014 to July,2015,based on the national special survey of basic services and needs of people with disabilities in Jiangsu,China,this paper clarified the factors related with the rehabilitation needs of the disabled into the individual characteristics, economic characteristics, environmental characteristics and so on by the de-scriptive statistics method. The Logit model was established to explore the factors related with rehabilitation needs. Results In Jiangsu,43% people with disabilities aged 16 and above had rehabilitation needs.Contingency table analysis and Chi square test showed that individual characteristics,economic characteristics and environmental character-istics had significant impact on the rehabilitation needs of the disabled.Multiple regression analysis showed that all the 18 variables were the significant related factors. Conclusion In order to meet the rehabilitation needs of the disabled, the refined and precise rehabilitation program should be designed in line with the different characteristics of the disabled.Through the effective docking of sup-plies and needs,we can provide accurate rehabilitation services for the disabled.

Objective:Our study was aimed to analyze the therapeutic effect of early sequential enteral nutrition on postoperative rehabilitation in patients with gastric cancer.Methods:Patients with gastric cancer receiving surgery at our hospital from 2016 to 2017 included and the clinical information was prospective collected and analyzed.Patients were randomly divided into two groups using random number table.Patients in group A were sequentially given amino acid type,short peptide type and then whole protein type,while those in group B received whole protein formulation only.The recovery of gastrointestinal function,postoperative systemic inflammatory response,six-minutes walking test,and enteral nutrition-related complications were compared between the two groups.Results:A total of 71 patients were included in this study (Group A 36 cases,Group B 35 cases).There was no significant difference in terms of the restart anal exhaust between the two groups (P ＞ 0.05).Patients in group A had a significantly shorter postoperative hospitalization (t =4.070;P ＜ 0.01) and the earlier restoration of oral intake than that of Group B (t =3.400;P =0.001).One week after surgery,the levels of CRP (t =2.547;P =0.013) and IL-6 (t =3.172;P =0.002) were significant lower in group A when compared with group B.In addition,patients in group A had a significant higher six minutes walk steps than those in Group B [(416.1 + 36.7) m vs (358.9 ± 32.7) m;t =6.927,P ＜ 0.01].However,no significant difference in enteral nutrition-related complications was found between the two groups (P ＞ 0.05).Conclusion:In patients with gastric cancer,early sequential enteral nutrition can effectively accelerate the postoperative rehabilitation.

A sensing system based on AuNP-AuNP-UCNP triple structure for efficient detection of dual targets was constructed. In the preparation of triple structure, the gold nanoparticles (AuNPs) and upconversion nanoparticles (NaYF4: Yb, Er, Gd, UCNPs) were synthesized and surface modified. Then the two nanoparticles and their aptamers were connected to form two kinds of optical fluorescent probes. A nucleic acid sequence that matches with two aptamers was designed, rendering the probes to get close based on the principle of complementary base pairing. On the basis of this, a sensing system with a triple structure was prepared,and its connecting effect was characterized by TEM. With this system, dual targets of bisphenol A and estradiol were efficiently and conveniently detected through quantitative determination by fluorescence and UV spectrophotometer. At reaction temperature of 30℃ and pH=7.8,this method exhibited good linear range for determination of bisphenol A and estradiol from 2 ng/mL to 200 ng/mL and from 10 ng/mL to 150 ng/mL, with limits of detection of 0.2 ng/mL and 0.5 ng/mL, respectively. This sensing system with the triple structure owned better specificity to structural and functional analogues, and showed good repeatability and stability. What's more,this sensing system was applied in actual water detection,with the recoveries between 86.1% and 107. 4%, and the relative standard deviation below 6. 8%. This method showed promising applications in other environmental estrogens in water samples.