Objective:To monitor intra-fractional set-up errors in tumor radiotherapy using a real-time intelligent capture system for precision displacement.Methods:A simulated radiotherapy environment was created in both the laboratory and the treatment room. A three-axis ( xyz) displacement platform (LD60-LM) and dial gauges were used as displacement measurement tools. Moreover, a real-time intelligent capture system for precision displacement was developed for displacement monitoring. With 23 patients treated with radiotherapy enrolled in this study, the above system was employed to monitor their intra-fractional set-up errors in fractionated radiotherapy. Descriptive analyses were conducted on the deviations between the data captured by cameras and the actual displacement, obtaining the mean values and standard deviation. Results:The monitoring calibration data from the laboratory revealed displacement differences of ≤ 0.5 mm within 20 mm and a maximum displacement difference of 1.47 mm for 50 mm. In contrast, the calibration result from the treatment room exhibited deviations of ± 0.2 mm on the y- z axes, as displayed by both the left and right cameras, and ± 0.31 mm on the x- z axes, as displayed by the middle camera. During 37 radiotherapy sessions in 23 patients, the monitoring result from the middle camera revealed five deviations exceeding the threshold of 5 mm, with the maximum deviation duration and displacement of 57.2 s and 9.24 mm, respectively. Conclusions:The real-time intelligent capture system for precision displacement based on machine vision can achieve real-time monitoring of set-up errors during tumor radiotherapy. Nevertheless, further improvements and service testing are necessary for this system.

Objective:To investigate the clinicopathological features of central nervous system (CNS) mesenchymal chondrosarcoma (MCS).Methods:Nine cases of CNS MCS were collected at the First Affiliated Hospital of Fujian Medical University from September 2010 to September 2020. The clinical,imaging,histopathological and immunohistochemical features were reviewed. NCOA2 gene rearrangement was evaluated by fluorescence in situ hybridization (FISH).Results:There were three male and six female patients, with age range of 1 to 59 years (median 31 years). Six cases were intracranial and three cases were intraspinal, and the tumors showed dural attachment. They were often diagnosed as meningioma basing on preoperative imaging. Microscopically, the tumors showed a characteristic biphasic histologic pattern composed of undifferentiated mesenchymal small cells and well-differentiated hyaline cartilage islands. The small cells area were positive for SOX9 (9/9), CD99 (8/9), and without BRG1 and INI1 deletion. The cartilaginous component expressed SOX9 (9/9) and S-100 protein (8/9). NCOA2 gene break apart signal was identified in five cases (5/5). Eight patients were followed up for 4-124 months. Three patients (3/8) had recurrences within one year and two patients died of the tumor.Conclusions:CNS MCS is an extremely rare malignant neoplasm with a propensity to dural involvement. Preoperative imaging has low diagnostic accuracy. CNS MCS should be differentiated from other CNS small round cell tumors and chondrosarcoma. FISH detection of NCOA2 gene rearrangement will assist the diagnosis of MCS.

PURPOSE: The significance of neuroendocrine differentiation (NED) in gastric carcinoma (GC) is controversial, leading to ambiguous concepts in traditional classifications. This study aimed to determine the prognostic threshold of meaningful NED in GC and clarify its unclear features in existing classifications. MATERIALS AND METHODS: Immunohistochemical staining for synaptophysin, chromogranin A, and neural cell adhesion molecule was performed for 945 GC specimens. Survival analysis was performed using the log-rank test and univariate/multivariate models with percentages of NED (PNED) and demographic and clinicopathological parameters. RESULTS: In total, 275 (29.1%) cases were immunoreactive to at least 1 neuroendocrine (NE) marker. GC-NED was more common in the upper third of the stomach. PNED, and Borrmann's classification and tumor, lymph node, metastasis stages were independent prognostic factors. The cutoff PNED was 10%, beyond which patients had significantly worse outcomes, although the risk did not increase with higher PNED. Tumors with ≥10% NED tended to manifest as Borrmann type III lesion with mixed/diffuse morphology and poorer histological differentiation; the NE components in this population mainly grew in insulae/nests, which differed from the predominant growth pattern (glandular/acinar) in GC with <10% NED. CONCLUSIONS: GC with ≥10% NED should be classified as a distinct subtype because of its worse prognosis, and more attention should be paid to the necessity of additional therapeutics for NE components.
Adenocarcinoma ; Chromogranin A ; Classification ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Neural Cell Adhesion Molecules ; Prognosis ; Stomach ; Stomach Neoplasms ; Synaptophysin

Objective To investigate the mode and effects of clinical pharmacists participating in clinical treatment and providing pharmaceutical care. Methods The clinical pharmacists participated in the treatment of the case of thymoma complicated with pulmonary infection in respiratory intensive care unit (RICU),associated with the myasthenia gravis (MG), pure red cell aplasia (PRCA) and lower extremity deep vein thrombolysis (LEDVT),through adjustment of drug regimen, observation of curative effect,monitoring blood drug concentration and adverse reaction and interaction monitoring,which could give full play to the professional expertise of pharmacy,and contribute to the clinical rational drug use. Results For patients with impaired immune function complicated with pulmonary infection,the opportunistic infections require special attention,during the initial anti-infective therapy.When the patient was unable to tolerate high doses of sulfamethoxazole and trimethoprim (SMZ-TMP),the clinical pharmacist recommended to use caspofungin for the combined treatment of pneumocystis pneumonia.When voriconazole and cyclosporine A (CsA) were used at the same time,the blood drug concentration of CsA would be increased,due to drug interactions probably.To solve the problem,clinical pharmacists recommended a temporary reduction in CsA dose. Conclusion Clinical pharmacists use pharmaceutical expertise to help optimize clinical treatment regimens,can improve the safety and effectiveness of drug treatment.

Objective: To explore the approaches and ideas of clinical pharmacists participating in drug therapy of patients with brucellosis. Methods: Clinical pharmacists participated in the clinical consultation for one patient with brucellosis. Clinical pharmacists analyzed comprehensively by asking medical history, occupation and contact history in details, adjusting the treatment scheme and performing medical education etc. Results: The consultation comments and suggestions proposed by clinical pharmacists were recognized by clinics, which played an important role in assisting doctors in the rational drug use and significantly improved the medical treatment. Conclusion: Clinical pharmacists should participate in the individualized medication and help clinicians optimize drug therapy, which can improve the safety and efficacy of medication.

OBJECTIVETo describe the distribution of zinc (Zn) and copper (Cu) in urine samples of generalpopulation in eight provinces of China, to analyze their characteristics of distribution between different region, gender and age-cohorts, and to provide the baseline of themetabolites in the general population.

METHODSFrom 2009 to 2010, 18 120 subjects from the general population aged from 6 to 60 years old were recruited from 24 areas among 8 provinces of China mainland by random sampling. The environmental and physical condition characteristics were collected from questionnaires, and urine samples were collected at the mean time. The levels of Zn and Cu in urine were measured using ICP-MS. Data were analyzed by statistical methods to compare the distribution characteristics of Zn and Cu among populations with different ages and genders.

RESULTSTotally, the median of Cu and Zn in urine were 9.28 and 115.47 µg/L respectively; and the inter-quartile range of Cu and Zn were 2.66-16.09 and 35.32-265.15 µg/L respectively. The median of Cu in male and female were 9.90 and 8.60 µg/L (Z=-5.63, P<0.001), and Zn in male and female were 140.44 and 95.27 µg/L (Z=-14.79, P<0.001). The median of Cu among the groups aged 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were 9.30, 10.14, 9.67, 9.33, 8.38 and 8.74 µg/L (χ2=70.94, P<0.001), respectively, and the median of Zn 130.83, 132.07, 139.34, 109.3, 78.74 and 109.51 µg/L ((χ2=146.00, P<0.001), respectively.There was statistically significant differences in urinary Cu and Zn levels between male and female, and among the different age groups.

CONCLUSIONThe Cu and Zn levels and distribution in urine among general population between 2009 and 2010 in China were reported in this article. These basic data in China will provide scientific and reliable reference for further scientific research.

Adolescent ; Adult ; Age Factors ; Child ; China ; Copper ; urine ; Environment ; Female ; Humans ; Male ; Middle Aged ; Sex Factors ; Surveys and Questionnaires ; Zinc ; urine

Objective To investigate the changes in the surface-associated protein expression of streptococcus rnutans (Sm) isolated from clinical samples at pH7.0 and pH5.0. Methods The proteins were extracted from cells at pH7.0 and pH5.0 by Homer method. The proteins were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and two-dimensional gel electrophoresis followed by image analysis. Proteins were identified by matrix-assisted la?ser desorption ionization time of flight mass spectrometry and computer-assisted protein sequence analysis. Results Image analysis revealed that four high expression levels of protein loci and two specific protein loci were existed in two strains at pH7.0. Two high expression levels of protein loci and two specific protein loci were existed in two strains at pH 5.0. Three high expression levels of protein loci and six specific protein loci were existed in Sm593 at pH5.0. Two-component system histidine kinases Lyts and glyceraldehyde-3-phosphate dehydrogenase were highly modulated, and NADH oxidase were modulated specifically. Conclusion The two clinical isolations in acid have high expression of some special proteins, which are presumed to be the resemblance of acid reaction.The difference of protein expression of two clinical isolations in acid may represent their distinct acid resistance.

OBJECTIVETo investigate the level of zinc (Zn) and copper (Cu) in whole blood among general population from 8 provinces in China, and to analyze the characteristics of distribution among different regions.

METHODSThis cross-sectional study was performed in 8 provinces from eastern, middle and western China between 2009 and 2010, including 13 110 subjects from 24 regions, and the blood and urine samples were collected. The ICP-MS was applied to test the content of ICP-MS in blood samples, and the results were used to analyze the characteristics of contents and distributions of Zn and Cu among population from different ages, genders and regions groups.

RESULTSTotally, the mean (95%CI) contents of Cu and Zn in blood were 795 (791-799)µg/L and 3 996(3 976-4 015) µg/L, respectively. The characteristics of distribution of Cu content were as followed, the content of males were lower than it of females (male:767 µg/L; female: 822 µg/L, t = -13.302, P < 0.01). The contents of blood Cu in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 860(853-868), 758(748-769), 734(728-734), 782(774-790), 811(795-827) and 820(815-826) µg/L. The differences showed statistical significance (F = 78.77, P < 0.01). The blood Cu content of people in eastern China (800µg/L) were also significantly higher than it in middle (774 µg/L)and western China (782 µg/L) (F = 10.94, P < 0.01). Distribution of blood Zn content showed characteristics as follows: the Zn content was higher in males than in females (male 4 085 µg/L and female 3 908 µg/L, t = 8.78, P < 0.01). The contents of blood Zn in groups of people aging 6-12, 13-16, 17-20, 21-30, 31-45 and 46-60 years old were separately 3 306 (3 261-3 350), 3 888 (3 839-3 937), 3 948 (3 902-3 994), 4 272(4 228-4 315), 4 231(4 180-4 281) and 4 250 (4 205-4 294)µg/L, which showed significant statistical differences (F = 233.68, P < 0.01). The blood Zn content of people in eastern China (3 938 µg/L) were significantly lower than it in middle (4 237 µg/L)and western China (4 105 µg/L) (F = 53.16, P < 0.01). In addition, the study also compared the relation between content of Cu and Zn and the frequency of eating seafood. The results found that the frequency of eating seafood could influence the content of Cu and Zn (Cu: F = 13.54, P < 0.01; Zn: F = 200.20, P < 0.01).

CONCLUSIONThe contents and distributions of Cu and Zn in blood differs among people from different groups in ages, genders and regions. The baseline data of this study provided reliable scientific evidence for further research.

Adolescent ; Adult ; Child ; China ; epidemiology ; Copper ; blood ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Zinc ; blood

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.

Objective To evaluate the value of high-frequency color Doppler ultrasound in the examination of pathological changes in the peripheral joints of patients with early rheumatoid arthritis (RA).Methods Peripheral joints of 30 consecutive patients with early rheumatoid arthritis (disease duration ＜1year) and 15 healthy volunteers were assessed with ultrasound searching for joint effusion,synovial hypertrophy,tendon lesion and bone erosions.The joints examined including bilateral elbows,wrists,knees,ankles,metacarpophalangeal joints (MCP),proximal interphalangeal joints (PIP) and metatar-sophalangeal joints (MTP).Data were analyzed with t-test and kappa test.Results Joint effusion and/or synovial hypertrophy were found in 471 joints (41.3％).Four hundred and four (35.4％) joints had joint effusion,359(31.5％) had synovial hypertrophy.Power Doppler signals were found in 128 (35.7％) joints with synovial hypertrophy.Periarticular tendon lesions were found in 90(25％) joints of all wrists,ankles and the 2nd to 5th metacarpophalangeal joints.Bone erosions were detected in 27 (2.4％) joints.The most likely involved joint in all peripheral jints was wrist which had the highest positive rate of effusion,synovial hypertrophy,bone erosion and power Doppler signals in the synovial membrane.Other joints which were easily involved with synovitis were knee,ankle,elbow,MTP,MCP and PIP.The positive rate of synovitis was highest in the MTP of all small joints exception the wrist.Synovitis present most frequently in the 2nd MCP of all MCPs,the 3rd PIP of all PIPs and the 2nd MTP of all MTPs.The kappa coefficient between clinical examination and ultrasound in the detection of peripheral joints synovitis was 0.21,showing very poor agreement.Conclusion High-frequency color Doppler ultrasound exa.mination is an effective method in assessing the pathological changes of peripheral joints of patients with early rheumatoid arthritis.It may improve the early diagnosis of RA and useful in assessing disease activity comprehensively.