Objective:To study the influence of intensive magnet fields on radiation dose measurement, and to demonstrate the feasibility of measuring magnet field correction factor by a combination of medical linac with variable magnet fields in view of needing for accurate measurement of the doses from reference beam arising in MR image-guided radiotherapy.Methods:A photon radiation field and a variable field with 6 MV nominal high voltage were produced by using conventional medical electron linear accelerator equipped with a pair of electromagnets with magnetic field strength up to 1.5 T. Both PTW30013 and PTW31010 ionization chambers were used to test the responses of ionization chambers under different magnetic field strengths at four orientations in which the angles between ionization chamber axis and magnetic field direction were 0°, 180°, 90° and 270°, respectively. The magnetic factors, kB, M was calculated and compared with the reported values in literature. Results:The response of ionization chamber was proportional to the magnetic field strength before it reached to a peak around 1 T, and then fell down as the magnetic field continued to rise. When the magnetic field was 0.35 T, the magnetic factors of PTW31010 were 0.988 2±0.000 3 and 0.997 4±0.000 4 corresponding to 90° and 0° directions, the discrepancy between 0° scenario and literature was 0.05% ± 0.04%. When the magnetic field reached 1.5 T, the magnetic factor of PTW30013 was 0.958 9±0.000 5 at the situation of 90°, which was 0.60% ± 0.05% different from the literature value.Conclusions:Conventional 6 MV medical accelerator equipped with electromagnet can be used to measure the magnetic field factor of reference dosimetry for MRIgRT.

Objective:To investigate the effect of HNRNPL protein on the proliferative ability of primary hepatocellular carcinoma cells and its potential mechanism.Methods:Online public database and real-time quantitative PCR were used to analyze the difference of HNRNPL expression between cancer and adjacent tissues. The effects of HNRNPL on HCC cell MHCC97H and HepG2 proliferation and MAPK pathway were investigated by Western blot, cell counting assay, colony formation assay and nude mouse transplantation tumor experiments.Results:The level of HNRNPL mRNA was validated to be higher in HCC tissue (2.76±0.37) than in normal tissue (1.00±0.14) with statistical difference ( t=3.93, P=0.002). Colony formation assay showed that the colony numbers of two MHCC97H knockdown groups (33.3±7.7) and (43.3±2.2) were lower than their control group (84.3±6.2), and two HepG2 knockdown groups (59.0±15.5) and (41.7±4.8) were lower than their control group (200.3±6.2) with statistical difference (both P<0.01). HNRNPL knockdown decreased the proliferation ability and activation level of MAPK pathway in HCC cells. Overexpression of oncogene c-RAF partially alleviated the anti-proliferation effect of HNRNPL knockdown and rescued the tumorigenic capacity. Conclusion:HNRNPL can promote hepatocellular carcinoma cell proliferation by activating MAPK signaling pathway.

ObjectiveTo observe the effects of Internet plus continuous rehabilitation nursing on older patients after lumbar fusion. MethodsFrom January, 2018 to August, 2021, 157 older patients after transforaminal lumbar interbody fusion (TLIF) in Department of Orthopedics, Chongqing General Hospital were retrospectively studied. A total of 66 patients accepting routine continuous rehabilitation nursing care were as control group, and 91 patients accepting internet plus continuous rehabilitation nursing care were as intervention group. They were assessed with Visual Analog Scale for pain (VAS), Oswestry Disability Index (ODI), Huaxi Emotional-distress Index (HEI) and Adult Health Self-management Skill Rating Scale (AHSMSRS) before, and one and three months after intervention. The compliance and nursing satisfaction were investigated with self-made questionnaire three months after intervention, and the postoperative complications were recorded. ResultsA total of 148 patients finished follow-up of three months, including 61 patients for the control group and 87 patients for the intervention group. The VAS, ODI, HEI and AHSMSRS scores improved in both groups one and three months after intervention (F > 85.4, P < 0.001), and improved more in the intervention group than in the control group (|t| > 3.645, P < 0.001). Both the compliance and nursing satisfaction were better in the intervention group than in the control group (χ² > 5.478, P < 0.05), and no postoperative complication was observed in both groups. ConclusionInternet plus continuous rehabilitation nursing can promote the recovery of function, pain and psychological emotion, ability of self-management, compliance, and nursing satisfaction.

Objective To evaluate the effects of unilateral and bilateral diffusion of cement on osteoporotic vertebral compression fractures treated with percutaneous kyphoplasty (PKP). Methods A retrospective case control study was conducted on the clinical data of 127 patients with single segment osteoporosis vertebral compression fracture (OVCF) treated by unilateral puncture PKP between July 2013 and July 2015. According to whether the diffusion of bone cement crossed the median, all cases with OVCF were divided into unilateral and bilateral diffusion groups. The unilateral diffusion group (72 cases) included 29 males and 43 females, with an average age of 69.5 ± 2.6 years (range, 63-76 years). In terms of the injured segment, there were 38 cases of L1, 20 L2, 11 L3, two L4, and one L5. In the unilateral diffusion group, the preoperative visual analog score (VAS) was (7.8 ±0.9) points, the preoperative anterior vertebral height compression ratio was (32.5 ±6. 3)％, and the preoperative Cobb's angle of the injured vertebra was (9.2±1.3)°. The bilateral diffusion group (55 cases) included 22 males and 33 females, with an average age of 71.2 ±2.9 years (range, 61-80 years). In terms of the injured segment, there were 32 cases of L1, 13 L2, six L3, three L4, and one L5. In the bilateral diffusion group, the preoperative VAS was (7.6 ±0. 9)points, the preoperative anterior vertebral height compression ratio was (34.5 ±5.8)％, and the preoperative Cobb's angle of the injured vertebra (9.8± 1.5)°. The VAS, anterior vertebral height compression ratio of the injured vertebra, Cobb's angle of the injured vertebra, and injured and non-injured vertebra refracture 1 month and 1 year after operation were recorded. Results The patients were followed up for 12-16 months (mean, 14.6 ± 0.6 months) in unilateral diffusion group and for 13- 16 months (mean, 15.2 ±0.2 months) in bilateral diffusion group. The VAS score of the unilateral diffusion group was (3.0 ±0.4) points at 1 month after the operation and (2.2±0. 4) points at 1 year after the operation, respectively. The VAS score of the bilateral diffusion group was (2.1 ±0.4) points at 1 month after the operation and (1.5 ± 0.4) points at 1 year after the operation, respectively. The VAS score decreased significantly 1 year after operation compared with that before operation (P ＜0.05), and significant difference was noted between two groups (P ＜0.05). The anterior vertebral height compression ratio of the unilateral diffusion group was (15.2±3.9)％ at 1 month after the operation and (16.3 ±3.4)％ at 1 year after the operation, respectively. The anterior vertebral height compression ratio of the bilateral diffusion group was (15.6±3.5)％ at 1 month after the operation and (16.8 ±3.9)％ at 1 year after the operation, respectively. The Cobb's angle of the injured vertebra of the unilateral diffusion group was (2.9±0.7)° at 1 month after the operation and (3.0±0.6)°at 1 year after the operation, respectively. The Cobb's angle of the injured vertebra of the bilateral diffusion group was (3.0 ± 0.7) ° at 1 month after the operation and (3.2 ± 0.7) ° at 1 year after the operation, respectively. The anterior vertebral height compression ratio and Cobb's angle of the injured vertebra decreased significantly after surgery (P ＜ 0.05), but no statistically significant differences were observed between two groups (P＞0.05). The injured vertebra refracture ratio was 6.9％ in unilateral diffusion group and 0 in bilateral diffusion group. The non-injured vertebra refracture ratio was 5.6％ in unilateral diffusion group and 5.5％ in bilateral diffusion group. No nerve root injury, cerebrospinal fluid leakage, pulmonary embolism, anaphylactic shock and postoperative infection were found in the two groups. Paravertebral bone cement leakage occurred in two cases of the unilateral diffusion group and anterior vertebral bone cement leakage occurred in one case of the bilateral diffusion group. Conclusion Compared with unilateral diffusion, bilateral diffusion of bone cement has better analgesic effect and can reduce the incidence of re fracture of injured vertebra, without increasing the risk of re-fracture of the non-injured vertebrae.

Objective To investigate the effect of α7 nicotinic acetylcholine receptor(α7nAChR) agonist agent PNU282987 on bone cement particles stimulated secretion of inflammatory cytokines in peripheral blood monocytes and its molecular mechanism.Methods Mouse peripheral blood monocytes were isolated and the inflammatory response were induced by PMMA particles.TNF-α, IL-1β and IL-6 concentration in culture supernatant were measured by ELISA.TNF-α, IL-1β and IL-6 mRNA expression were measured by RT-PCR.p-p65, p65, p-JAK2, JAK2, p-STAT3, STAT3, and β-actin expression were detected by Western blot.NF-κB DNA binding activity were measured by ELISA.ResultsAfter stimulation of PMMA particles, TNF-α, IL-1β and IL-6 concentration in culture supernatant was significantly increased(P<0.05), TNF-α, IL-1β and IL-6 mRNA expression was significantly increased (P<0.05), p-p65, p-JAK2 and p-STAT3 expression and NF-κB DNA binding activity was also increased significantly (P<0.05).However, after PNU282987 treatment, TNF-α, IL-1β and IL-6 concentration in culture supernatant decreased(P<0.05), TNF-α, IL-1β and IL-6 mRNA expression decreased in a concentration gradient way(P<0.05), p-p65, p-JAK2 and p-STAT3expression and NF-κB p65 DNA binding activity was also decreased(P<0.05).Conclusions α7nAChR agonist PNU282987 significantly inhibites PMMA bone cement particles induced secretion of inflammatory cytokines in peripheral blood monocytes of mice.

Objective To investigate the effect of acupuncture on gap junction protein Cx43 expression in the hippocampal region in ischemia/reperfusion rats.Methods Wistar rats were randomized into normal, model, non-point acupuncture and acupuncture groups. A rat model of focal cerebral ischemia/reperfusion was made by modified middle cerebral artery thread occlusion. The model, non-point acupuncture and acupuncture groups were separately divide into four subgroups: 30, 60, 180 and 360 min ischemia/reperfusion, 10 rats each. The middle and lateral lines of vertex were given electroacupuncture in the acupuncture group of rats. A subcostal fixed point 10 mm above the iliac crest on the affect side was selected as an acupuncture point in the non-point acupuncture group. The model group was not treated. Cx43 protein expression was determined by an immunohistochemical method.Results There was a statistically significant difference in the behavior disorder (Bederson’s) score between the acupuncture group and the non-point acupuncture or model group after different times of cerebral ischemia/ reperfusion (P<0.05). There was a statistically significant difference in hippocampal Cx43 content between model, acupuncture or non-point acupuncture group and the normal group and between the acupuncture group and the model or non-point acupuncture group after different times of cerebral ischemia/reperfusion (P<0.05).Conclusions Acupuncture can inhibit the overexpression of Cx43, intervene in cerebral ischemia-reperfusion injury and produce a neuroprotective effect in ischemic brain injury.

To observe the progess of pharmacological and clinical researches on Xiangsha-Liujunzi decoction by literature reviews recently. Pharmacological study found that the Xiangsha-Liujunzi decoction can protect the gastric mucosa, regulate gastrointestinal endocrine function, promote apoptosis of hyperplasia epithelial cell lying the gastric mucosa, and promote antidepressant effect. Thus, Xiangsha-Liujunzi decoction could be used for gastrointestinal diseases and tumor postoperative gastrointestinal dysfunction caused by radiation and chemotherapy.

PurposeTo investigate the clinical value of inverted X-ray plain film and MRI examination in the diagnosis of congenital anorectal malformation (CARM). Materials and Methods Thirty-eight cases with operatively proved anorectal malformation were reviewed; inverted X-ray plain film and MRI examination were performed in all patients before surgery. The relationship between the rectum blind side and pubococcygeal line (PC line), and the type of anal atresia was determined, to compare the diagnostic accuracy of inverted plain film with MRI for CARM typing. Results Of all the 38 cases, 19 cases were with low imperforate anus, 8 cases with median imperforate anus, and 11 cases with high imperforate anus. The accuracy rate of inverted X-ray plain film and MRI examination for the diagnosis of CARM typing was 92.1% (35/38) and 97.4% (37/38) respectively, and the difference between them was not statistically significant (χ2=1.37, P>0.05). 7 cases of fistula, 5 cases of spinal cord malformations and 1 case of right kidney agenesis can be clearly demonstrated on MRI. Conclusion Both inverted X-ray plain film and MRI can diagnose the typing of CARM accurately, but MRI is also able to diagnose the fistula, visceral, spinal cord lesion and other abnormalities accompanied with CARM, while reducing the dose of X-ray radiation and damage in children, thus has higher clinical application value compared with inverted X-ray plain film.

Objective To investigate the correlation between expression of carcinoembryonic antigen (CEA) mRNA in preoperative peritoneal lavage fluid and prognosis of operation in patients with gastric cancer.Methods The expression levels of CEA mRNA in preoperative peritoneal lavage fluid of 68 patients with gastric cancer and 30 patients with gastric benign tumor were measured by reverse transcription polymerase chain reaction.The correlation between the expression level of CEA mRNA in preoperative peritoneal lavage fluid and clinicopathological features,prognosis of postoperative were analyzed.Results The expression level of CEA mRNA in preoperative peritoneal lavage fluid of patients with gastric cancre was 1.74 ± 0.25 and with gastric benign tumor was 0.19 ± 0.04,and there was statistical difference (P ＜ 0.05).The expression level of CEA mRNA in preoperative peritoneal lavage fluid had a correlation with the tumor infiltration depth,tumor differentiation,lymph node metastasis,distant metastasis and TNM stage (P ＜ 0.05).There was statistical difference in the recurrent / metastasis rate and survival rate 1 year after operation between low (34 cases) and higher (34 cases) expression level of CEA mRNA in preoperative peritoneal lavage fluid of gastric cancer patients:47.06％ (16/34) vs.82.35％ (28/34) and 79.41％ (27/34) vs.55.88％ (19/34),P ＜ 0.05.Conclusion The expression of CEA mRNA in preoperative peritoneal lavage fluid has close correlation with the clinicopathologic features,and the high expression of CEA mRNA indicats poor prognosis,indicating that CEA mRNA in preoperative peritoneal lavage fluid could be used as a prognostic marker in patients with gastric cancer.

OBJECTIVETo investigate the clinical value of MRI examination in congenital anorectal malformation (CARM).

METHODForty-four cases with operatively proved anorectal malformation from May 2008 to May 2012 in the authors' hospital were reviewed. Of the 44 cases, 25 were males and 19 females, their age ranged from 1 day to 2 years. MRI was performed in all patients.

RESULTOf all 44 cases, 15 cases had high imperforate anus (34%), rectum blind end were above PC line, the distance of rectum blind end and anus nest was (29.12 ± 2.35) mm; 8 cases had median imperforate anus (18%), rectum blind ends were near PC line, the distance of rectum blind end and anus nest was (18.98 ± 2.21) mm; 21 cases had low imperforate anus (48%), rectum blind ends were below PC line, the distance of rectum blind end and anus nest was (7.54 ± 1.08) mm. Twenty-five cases with fistula in 44 cases were confirmed by rectal angiography and surgery, accounting for 57%. In 13 cases with fistula, the lesion could be clearly demonstrated on MRI, in the remaining 12 cases with fistula, the lesion could not be visualized clearly or no image development occurred on MRI. Of all 44 cases, 1 case had tethered cord with filum terminale lipoma, 1 case had tethered cord, 2 cases had syringomyelia, 1 case had right kidney agenesis, 1 case had hydrocele. In 44 cases of multi-planar MRI imaging could clearly show the perianal muscles developmental situation, 36 cases had perianal muscles dysplasia, amd showed levator ani muscle, puborectalis and anal sphincter asymmetry, muscle belly slim.

CONCLUSIONMRI examination has a high clinical value in CARM diagnosis, can help accurately judge the anal atresia type, display the presence and running of most of the fistula, and diagnose perianal muscle development and other systems malformations, finally provide a reliable diagnostic basis for surgical program and prognostic assessment.

Abnormalities, Multiple ; Anal Canal ; abnormalities ; surgery ; Anus, Imperforate ; complications ; diagnosis ; surgery ; Child, Preschool ; Female ; Fistula ; epidemiology ; etiology ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Perineum ; pathology ; Rectum ; abnormalities ; surgery ; Retrospective Studies ; Urinary Fistula ; epidemiology ; etiology