Objective:To explore the feasibility of applying an ArcCHECK detector to the dose verification for ultra-long target volumes of cervical cancer.Methods:This study retrospectively selected patients suffering from cervical cancer with ultra-long target volumes (lengths: ≥ 26 cm; 50 cases; the ultra-long target volume group) and conventional target volumes (lengths: < 26 cm; 50 cases; the conventional target volume group). Subsequently, this study designed treatment plans using the Volumetric Modulated Arc Therapy (VMAT) technique and then collected and verified doses using an ArcCHECK detector. The dose detection for the conventional target volume group was performed at the central point of the detector (marked by iso and Short-0 cm). Then, the detector was moved for 5 cm along the bed exit direction (marked by iso 1), followed by the dose verification of the ultra-long target volume group (marked by Long-5 cm) and conventional target volume group (marked by Short-5 cm). The geometric parameters (the length and volume of a target volume), mechanical parameters (machine hop count and the duration of irradiation), and gamma pass rates (GPRs) under different detection conditions of each group were analyzed.Results:The target lengths, target volumes, machine hop counts, and irradiation durations of the ultra-long target group were higher than those of the conventional target group ( t = 2.61-18.56, P < 0.05). For the conventional target group, the GPRs at iso 1 were significantly lower than those at iso ( t = 2.14-8.17, P < 0.05). Meanwhile, the GPRs at iso 1 of the ultra-long target volume group were significantly lower than those of the conventional target volume group ( t = -4.70 to -2.73, P < 0.01). The GPRs of each group met clinical requirements for criteria of both 3%/3 mm and 3%/2 mm. Conclusions:The deviation of the positioning center and the length of the target volume serve as primary factors affecting the dose verification result of cervical cancer. For ultra-long target volumes, dose verification can be performed by moving the positioning center, thus ensuring treatment accuracy for cervical cancer patients.

This article reported a case of a male patient with primary hyperparathyroidism(PHPT) caused by an ectopic parathyroid adenoma in the anterior superior mediastinal. Hospital routine examinations indicated hyperlipidemia, hyperuricemia, type 2 diabetes with nephropathy, chronic kidney disease in stage Ⅳ, elevated PTH, hypercalcemia, hypophosphatemia, clinically highly suspected hyperparathyroidism. There was no obvious abnormality of parathyroid ultrasound, while 18F-FDG systemic metabolic imaging and 99mTc-MIBI dual-phase parathyroid imaging suggested that an ectopic parathyroid gland in the anterior superior mediastinal which was hyperactive. Evaluations of anterior pituitary function, pancreas, and endocrine-related hormones showed no obvious abnormalities, and thus we ruled out the possibility of multiple endocrine adenomas, combined with the patient′s symptoms and previous medical history, and ruled out the possibility of tertiary hyperparathyroidism, the patient was diagnosed as PHPT caused by the anterior superior mediastinal ectopic parathyroid adenoma. To restore the blood calcium to normal, the patient was treated with intravenous rehydration, diuresis, calcitonin to promote urinary calcium excretion, and zoledronic acid to inhibit bone resorption. Further thoracoscopic mediastinal tumor resection was performed, and the diagnosis of parathyroid adenoma was confirmed by pathology. All the indicators were normal and no recurrence of hyperparathyroidism was found during the follow-up. Integration of the patient′s clinical manifestations, biochemical indicators, and imaging examinations are necessary to diagnose PHPT qualitatively and location-specifically. In particular, it is necessary to pay attention to whether there is the possibilities of ectopic adenoma and multiple endocrine adenomas, to reduce the rates of missed diagnosis and recurrence.

Objective To observe flash visual evoked potential (F-VEP)after hyperbaric oxygen (HBO) at different time points after traumatic optic nerve injury (TON) in adult rats,so as to explore the optimal time window for HBO therapy.Methods A total of 40 Sprague-Dawley rats were used to establish an optic nerve contusion model,with the left eye as the optic nerve injury eye and the right eye as the sham surgery control eye.In accordance with different HBO intervention time points of the optic nerve contusion model at 1,3,7 and 14 days,and the animals were divided into 5 groups,i.e.the experimental group 1,group 2,group 3,group 4 and the control group,each consisting of 8 rats.In the course of treatment,F-VEP visual changes in the 5 groups were detected at day 3,day 10 and day 20,and therapeutic effects were evaluated.Results When the detected VEP data of the optic nerve-clamped eye in all the control rats were compared with those of the sham surgical eyes,latent time was prolonged and vibration amplitude was obviously decreased,and statistical significance could be found,when comparisons were made between them (P ＜ 0.05).Compared with the F-VEP data of the control group,latent time of the optic nerve-clamped eye in the experimental group 1 at various time points was considerably shortened,and at day 10 and day 20 after treatment,vibration amplitude was significantly increased,all with statistical significance (P ＜ 0.05).However,latent time of the optic nerve-clamped eye in the experimental group 2 at day 10 and day 20 after treatment was obviously shortened,also with statistical significance (P ＜ 0.05),but no statistical significance could be noted in vibration amplitude,when comparisons were made between them (P ＞ 0.05).When compared with the F-VEP data of the control group,no statistical significance could be found in the changes of latent time and vibration amplitude for the experimental group 3 and group 4 (P ＞ 0.05).Conclusion Early HBO treatment could effectively improve F-VEP of the rats with traumatic optic nerve contusion,and after sustainment of optic nerve injury,the early the HBO intervention,the better therapeutic effects would be achieved.

Objective To observe flash visual evoked potential (F-VEP)after hyperbaric oxygen (HBO) at different time points after traumatic optic nerve injury (TON) in adult rats,so as to explore the optimal time window for HBO therapy.Methods A total of 40 Sprague-Dawley rats were used to establish an optic nerve contusion model,with the left eye as the optic nerve injury eye and the right eye as the sham surgery control eye.In accordance with different HBO intervention time points of the optic nerve contusion model at 1,3,7 and 14 days,and the animals were divided into 5 groups,i.e.the experimental group 1,group 2,group 3,group 4 and the control group,each consisting of 8 rats.In the course of treatment,F-VEP visual changes in the 5 groups were detected at day 3,day 10 and day 20,and therapeutic effects were evaluated.Results When the detected VEP data of the optic nerve-clamped eye in all the control rats were compared with those of the sham surgical eyes,latent time was prolonged and vibration amplitude was obviously decreased,and statistical significance could be found,when comparisons were made between them (P ＜ 0.05).Compared with the F-VEP data of the control group,latent time of the optic nerve-clamped eye in the experimental group 1 at various time points was considerably shortened,and at day 10 and day 20 after treatment,vibration amplitude was significantly increased,all with statistical significance (P ＜ 0.05).However,latent time of the optic nerve-clamped eye in the experimental group 2 at day 10 and day 20 after treatment was obviously shortened,also with statistical significance (P ＜ 0.05),but no statistical significance could be noted in vibration amplitude,when comparisons were made between them (P ＞ 0.05).When compared with the F-VEP data of the control group,no statistical significance could be found in the changes of latent time and vibration amplitude for the experimental group 3 and group 4 (P ＞ 0.05).Conclusion Early HBO treatment could effectively improve F-VEP of the rats with traumatic optic nerve contusion,and after sustainment of optic nerve injury,the early the HBO intervention,the better therapeutic effects would be achieved.

Objective To investigate the effect and the mechanism of epithelial-mesenchymal transition (EMT) in renal tubular cells induced by uric acid.Methods Normal rat kidney tubular cell line (NRK-52E) were exposed to different concentrations of uric acid (100,200,400,600,800 μmol/L UA) for 48 hours to induce EMT.Morphological changes of the NRK-52E cells were examined under an inverted phase contrast microscope.The protein expression of E-cadherin,α-SMA,p-Akt and Akt were detected by Western blotting.The distribution of E-cadherin and α-SMA were detected by immunofluorescence.NRK-52E cells were pretreated by different concentrations of LY294002(0,2.5,5,10,15 μmol/L),the inhibitor of PI3K/p-Akt signaling pathway,and then processed by uric acid (400 μmol/L) for 48 hours.Western blotting was used to detect the protein expression of p-Akt and Akt.NRK-52E cells were then divided into four groups:normal group (N),uric acid group (UA),LY294002 group (LY),uric acid with LY294002 group (UA + LY).The protein expression of E-cadherin and α-SMA were detected by Western blotting,the distribution of E-cadherin,α-SMA and p-Akt were detected by immunofluorescence.Results There was abundant cellular expression of E-cadherin in unstimulated renal tubular cells whereas its expression was significantly decreased in uric acidstimulated cells (P ＜ 0.05).In addition,uric acid induced de novo expression of α-SMA in contrast to almost negative staining in untreated cells (P ＜ 0.05).p-Akt were obviously increased in high uric acid group (P ＜ 0.05) and Akt changed not significantly (P ＞ 0.05).NRK-52E cells transformed into elongated fibroblast-like cells from cuboidal clustered epithelial cells.These indicated that uric acid has induced EMT and activated PI3K/p-Akt signaling pathway in NRK-52E cells.However,the above effects of uric acid were abolished when p-Akt was blocked by the PI3K inhibitor (10,15 μmol/L LY294002),indicated that LY294002 has reversed the trend of EMT.Conclusions High uric acid induces phenotypic transition of renal tubular cells probably via activating PI3K/Akt signaling pathway.

Objective To assess the impact of physical training on physiological function of adult renal transplant recipients by meta-analysis and to provide theoretical guidance for clinical practice.Methods Randomized controlled trials of physical training for the treatment of renal transplant recipients until October 2017 were searched in the database of Cochrane library,PubMed,Embase,Web of Science,Wanfang Data and CNKI.Data extracted from the literatures were analyzed with RevMan software (version 5.3).Results A total of 10 studies in 10 manuscripts met the inclusion criteria,and 557 cases were included.Meta-analysis results were as follows.Compared with the control group (routine drug therapy),the level of peak exercise oxygen uptake (peak VO2) was significantly increased in physical training group (routine drug therapy and physical training) (MD=2.40,95％ CI 0.15-4.64,P=0.04).However,there was no statistically significant difference in the change of blood lipid,blood pressure,hemoglobin and serum creatinine between the two groups (all P ＞0.05).Conclusions Physical training can improve cardio respiratory fitness of renal transplant recipients in the early stage,but it has no obvious effect on blood pressure,blood lipid,hemoglobin and blood creatinine.

Objective To explore the correlation between the moving angle of elbow joint and surface electromyogram signal(sEMG)activities of biceps and triceps.Methods The eigenvalue of sEMG during elbow joint moving under constant load were calculated with means of root mean square(RMS)and integrated electromyogram(iEMG)in time domain.Results The experimental results showed that both the chavacteristics of RMS and iEMG for biceps differed from those of triceps.The sEMG activities of biceps increased with the increment of elbow joint angle,while those from triceps reached to the maximum values when elbow joint angle was 90?.Furthermore,the sEMG activities of triceps at the elbow angle of 45? was similar with that when elbow angle was 135?.Conclusion The sEMG from biceps and triceps can reflect the moving angle of elbow joint under constant load.