Objective:To calculate the relative biological effectiveness (RBE) value of the released low-energy electrons in gadolinium neutron capture therapy ( 157GdNCT) based on microdosimetry. Methods:The Monte Carlo (MC) code Geant4-DNA package was used to simulate the energy deposition distribution and microdosimetry parameters of low-energy electrons released during gadolinium neutron capture treatment in different sensitive target volumes and physical models on track structures. On this basis, RBE value was obtained based on the microdosimetry kinetic model (MKM).Results:The low-energy electron RBE value was highly variable in different sensitive target volumes and decreases with increasing sensitive target volumes. With 6-nm-diameter sensitive target as reference, RBE value was 1.77 for 6-nm diameter, 1.53 for 10 nm diameter with percentage difference 13%, and 1.40 for 15-nm diameter with percentage difference of 21%, respectively. The effect of different Geant4-DNA physical models on the RBE of low-energy electrons was small. Using the RBE value of 1.53 for physical model option2 as reference, the RBE values of option6 and option7 were 1.49 and 1.52, respectively, with the percentage differences of 2.6% and 0.6%, respectively.Conclusions:The RBE values of low energy electrons released by 157GdNCT in different sensitive target volumes and physical models were calculated by MKM to be 1.40-1.77.

Objective:To explore the difference of blood pressure compliance rate in patients with continuous ambulatory peritoneal dialysis (CAPD) in the internet of things (IoT) follow-up and conventional care.Methods:CAPD patients from 3 peritoneal dialysis centers from May 2019 to October 2019 were included in this retrospective cohort study. They were divided into IoT group and conventional care group according to the way of follow-up. The difference in blood pressure compliance rate during 1 year of follow-up between the two groups was observed. The primary outcome was defined as the proportion of patients with blood pressure compliance rate≥85%.Results:A total of 75 patients were included in this study, in during 32 patients in IoT group and 43 patients in conventional care group. The comparison of baseline data between the two groups showed that the dialysis age of patients in IoT group was shorter ( P<0.01). After a median of 9(9, 12) months follow-up, the median blood pressure compliance rate was 85.2% (65.2%, 95.1%), and 25 patients (65.6%) in IoT group had met the target of blood pressure compliance rate≥85%, which was significantly higher than that in the conventional care group (17 cases, 39.5%) ( χ2=4.996, P=0.025). The cumulative probability of the target of blood pressure compliance rate≥85% was 97%, 90%, 90% and 52%, respectively in IoT group, while 95%, 86%, 55% and 34%, respectively in conventional care group after 3, 6, 9 and 12 months of follow-up, and the different between the two groups was significant (Log-rank χ2=4.774, P=0.029). Adjusted for age, sex and dialysis age, the multivariate Cox proportional risk regression model showed that serum creatinine level(for every 1 μmol/L increase, HR=1.002, 95% CI 1.000-1.003, P=0.033), follow-up mode (IoT follow-up vs conventional care, HR=0.023, 95% CI 0.003-0.210, P=0.001), follow-up times (for each additional time, HR=0.879, 95% CI 0.823-0.939, P<0.001) and the rate of weight compliance (for each increase of 1%, HR=0.964, 95% CI 0.939-0.991, P=0.008) was the independent influencing factors for the blood pressure compliance rate<85%. The results of subgroup analysis showed that patients with shorter dialysis age (<10 months) and in the centers where the nurses finished the PD follow-up work as part-time job had better blood pressure control in IoT follow-up. Conclusions:IoT follow-up is helpful to improve CAPD patients' blood pressure compliance rate. Elevated serum creatinine level at baseline is the independent risk factor associated with poor blood pressure compliance. However, IoT follow-up, more follow-up times and the elevated rate of weight compliance are the protective factors for blood pressure compliance. IoT follow-up mode is more recommended for patients with short dialysis age and for dialysis centers where most of the nurses are part-time.

Objective To evaluate the clinical effect after laparoscopic sacral colpopexy (LSC) of combined transabdominal-transvaginal approach on stage Ⅳpelvic organs prolapse (POP). Methods The clinical data of 65 patients undergoing LSC of combined transabdominal-transvaginal approach from January 1st, 2010 to July 30th, 2017 due to POP stage Ⅳ in First Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Objective outcome was assessed by comparing preoperative and postoperative pelvic organ prolapse quantification (POP-Q) systems. Subjective effects were assessed by comparing pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire short form (PFIQ-7), pelvic organ prolapse/urinary incontinence sexual questionnaire-12 (PISQ-12) and patient global impression of improvement (PGI-I). Results All 65 patients were successfully performed without any intraoperative complications. Fifty-three patients were followed in the clinic department and 12 were followed up by telephone. The follow-up duration was 6.1-80.3 months and the median follow-up duration was 24.5 months. The bleeding loss was 20-250 ml. Postoperative urethral catheter residence day was (2.5± 1.1) days, length of postoperative stay was (6.2±1.7) days. The postoperative POP-Q scores were compared with preoperative scores which had significantly improved except pb (all P<0.01). The objective cure rates of vaginal anterior wall, apical and posterior wall prolapse stageⅣwere 90% (47/52), 100% (23/23) and 95% (20/21).About PGI-I, except for 1 patient who chose"improvement", the other 64 patients (98%, 64/65) all chose"significant improvement". Furthermore, preoperative and postoperative PFDI-20, PFIQ-7, and PISQ-12 scores were all statistically significant (all P<0.01). Subjective efficacy was significant. Three cases (5%, 3/65) of postoperative fever occurred. Two cases (4%, 2/53) had mesh exposure. Six patients (11%, 6/53) had recurrence of postoperative prolapse. Five cases had recurrence of vaginal anterior wall prolapse and no reoperation was performed; 1 case was recurrence of posterior vaginal wall prolapse who diagnosed as vaginal posterior wall prolapse stage Ⅲ; no recurrence of apical prolapse. The rate of reoperation (including exposed-mesh removal and pelvic floor reconstruction surgery) was 5% (3/65). Conclusions The LSC of combined transabdominal-transvaginal approach has a high subjective efficacy rate. The objective cure rate in the case of apical prolapse stage Ⅳ is one hundred percent.The LSC of combined transabdominal-transvaginal approach has low mesh exposure, low postoperative infection and the reoperation rate, which is one of optional pelvic floor reconstruction surgery. However, there is still a risk of recurrence in patients with POP stageⅣwith severe bladder bulging.

Objective To investigate the Th1/Th2 cytokines and chemokine CXCL 13 levels in peripheral blood and cerebrospinal fluid(CSF)of patients with neurosyphilis and their clinical significance. Methods Forty seven HIV negative patients with neurosyphilis, 36 syphilis patients without neurological involvement(syphilis group)and 23 patients without infectious intracranial diseases(control group) admitted in Hangzhou Third Hospital during July 2011 to December 2014 were enrolled in the study.CSF pressure, protein contents, white blood cell counts and IgG index were detected in patients with neurosyphilis.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of Th1 cytokines (IL-2,IL-12 and IFN-γ),Th2 cytokines(IL-6,IL-10)and CXCL13 in serum and CSF in three groups.Th1/Th2 cytokines,CXCL13 levels and CSF routine were also examined in neurosyphilis patients after treatment for 3 and 12 months.ANOVA, Kruskal-Wallis test and Spearman correlation were used for data analysis.Results The levels of IL-6 and IL-10 in serum and CSF from neurosyphilis patients were higher than those in syphilis group and control group(χ2IL-6=15.43, 15.39 and 14.44, 20.01,χ2 IL-10 =16.46, 23.86 and 15.11,24.44;P<0.05 or <0.01), while the levels of IL-2, IL-12 and IFN-γin the serum and CSF were lower than those in syphilis group and control group(χ2IL-2=14.55,17.14 and 16.14,17.97;χ2IL-12=13.65,20.50 and 18.48,21.04;χ2IFN-γ=16.95,17.53 and 16.00,15.21;P<0.05 or <0.01). CXCL13 contents in CSF of neurosyphilis patients were significantly higher than those in other two groups (χ2=52.51 and 53.76, P <0.01), and were positively correlated with leucocyte counts, protein concentrations,IgG index,IL-6 and IL-10(r=0.325,0.544,0.750,0.333 and 0.382,P<0.05 or <0.01),but were negatively correlated with IL-12 levels in neurosyphilis patients(r=-0.303,P<0.05). In neurosyphilis patients,CXCL13 and IL-6 levels were reduced after treatment for 12 months(χ2=102.00 and 22.17,P<0.05 and <0.01), while the levels of IL-2 and IL-12 were increased(χ2=18.28 and 24.10,P<0.05 and <0.01).Conclusion Chemokine CXCL13 and Th1/Th2 cytokines are involved in the immune response in neurosyphilis patients, which may be used for the diagnosis and evaluation of therapeutic efficacy in patients with neurosyphilis.

PURPOSE: Breast cancer is the most commonly occurring cancer among women worldwide, and therefore, improved approaches for its early detection are urgently needed. As microRNAs (miRNAs) are increasingly recognized as critical regulators in tumorigenesis and possess excellent stability in plasma, this study focused on using miRNAs to develop a method for identifying noninvasive biomarkers. METHODS: To discover critical candidates, differential expression analysis was performed on tissue-originated miRNA profiles of 409 early breast cancer patients and 87 healthy controls from The Cancer Genome Atlas database. We selected candidates from the differentially expressed miRNAs and then evaluated every possible molecular signature formed by the candidates. The best signature was validated in independent serum samples from 113 early breast cancer patients and 47 healthy controls using reverse transcription quantitative real-time polymerase chain reaction. RESULTS: The miRNA candidates in our method were revealed to be associated with breast cancer according to previous studies and showed potential as useful biomarkers. When validated in independent serum samples, the area under curve of the final miRNA signature (miR-21-3p, miR-21-5p, and miR-99a-5p) was 0.895. Diagnostic sensitivity and specificity were 97.9% and 73.5%, respectively. CONCLUSION: The present study established a novel and effective method to identify biomarkers for early breast cancer. And the method, is also suitable for other cancer types. Furthermore, a combination of three miRNAs was identified as a prospective biomarker for breast cancer early detection.
Area Under Curve ; Biomarkers ; Biomarkers, Tumor ; Breast Neoplasms* ; Breast* ; Carcinogenesis ; Data Mining ; Early Detection of Cancer ; Female ; Genome ; Humans ; Methods ; MicroRNAs* ; Plasma ; Prospective Studies ; Real-Time Polymerase Chain Reaction ; Reverse Transcription ; Sensitivity and Specificity

Objective To explore the effect of evidence-based nursing intervention in senile patients with long-term nasal feeding.Methods Totals of 180 senile patients with long-term nasal feeding who were hospitalized from January, 2013 to June, 2015 were selected as the research objects and were randomly divided into observation group and control group according to the order of admission. Patients in the observation group were given nursing intervention and patients in the control group were given routine care. Complications of nasal feeding, amount of nasal feeding in single time and interval time of nasal feeding were compared between the two groups.Results There was no significant difference in the complications of nasal feeding between the two groups (P>0.05). But compared with the control group, the workload of the nasal feeding in the observation group was significantly reduced and the resting time of the digestive system of patients was prolonged obviously. Conclusions Application of evidence-based nursing intervention in senile patients with long-term nasal feeding can effectively reduce the workload of clinical nurses and reduce hungry sensation of patients.

Objective To evaluatate the impact of different anastomotic location and preventive ileostomy on postoperative anastomotic fistula in rectal cancer patients.Methods The clinical data of 316 cases of rectal cancer patients after total mesorectal excision from January 2015 to January 2016 were analyzed retrospectively.Patients were divided into anterior resection (AR) group,low anterior resection (LAR) group,uhra-low anterior resection (ULAR) group according to the anastomotic location.There were 33 cases of anastomotic fistula with preventive ileostomy or without and anastomotic leakage varied from mild to severe as grade A,B,C.Results There was no statistically significant difference in the incidence of anastomotic fistula between the different anastomotic location (x2 =3.829,P =0.147).In anterior resection group and low anterior resection group,there was no statistically significant difference in the incidence of anastomotic fistula whether or not a preventive ileostomy was performed (x2 =0.606,1.096,P =0.436,0.326).While in uhralow anterior resection group,preventive ileostomy helped dicrease the incidence of anastomotic fistula (x2 =11.667,P =0.001),and once happened the severity of the anastomotic fistula tended to be less severe.Conclusion The incidence of anastomotic fistula does not vary with anastomotic level in our study.Preventive ileostomy reduces the incidence of anastomotic fistula in patients with ultralow anterior resection.

Objective To introduce improved program for traction wire production in endoscopic submucosal dis-section assisted by oral traction. Methods A retrospective analysis was performed on 40 patients who received en-doscopy intervention. Through the use of improved traction and normal traction, they were divided into experimental group and control group. Then analyze and compare their clinical data like gender, age, traction line installed perfect time, fixed lesions after hemostatic clip off times, one-time complete resection, enbloc resection rate, bleeding and perforation and other complications and other clinical conditions. Results The improvement time was (53.30 ±12.85) s in experimental group, it was significantly shorter than that in control group (105.00 ± 11.68) s ( = 3.42, <0.05). The experimental group fixed lesions after hemostatic clamp off times were significantly less than that in con-trol group (χ2=2.37, <0.05). Conclusions Using innovative methods, adequate preoperative preparation, the op-erator's tacit understanding of nursing cooperation, close attention to the disease after surgery is the key to achieve the desired results of endoscopic surgery.

Objective To investigate the prevalence of obesity and metabolic syndrome(MS)of children and adolescents in Longquan mountainous area in Zhejiang province.Methods A representative sample involving 2 135 children and adolescence aged 10 to 15 years were randomly surveyed and a total of 2 125 had available data(male/female ratios as:1 109/1 016).Using the standard methods,we measured the weight,height,waist circumference,hip circumference,blood pressure,detected fasting plasma glucose (FPG),high density lipoprotein cholesterol (HDL -C),triglyceride(TG),total cholesterol(TC),and calculated non-high density lipoprotein cholesterol(non-HDL). The prevalence of obesity and MS among the 10 to 15 years old children and adolescence in Longquan was compared with that in six cities in China(Beijing,Tianjin,Shanghai,Zhejiang,Chongqing and Guangxi).Results The preva-lence of obesity was 4.7% in 10 -15 -year -old teenage,in which the male obesity prevalence was 6.3%(70/1 109),female obesity prevalence was 3.0%(30 /1 016).The prevalence of overweight was 9.4% and the prevalence of boys was 11.0%,while the girl was 7.6%.The prevalence of obesity and overweight was 16.4%(299/2 125).The prevalence of MS was 2%(42/2 125)in the survey,but 42.0%in the obesity.The prevalence of obesity in Longquan(4.7%)was lower than that in the national six cities(8.1%)among the children and adoles-cents from 10 to 15 years old(χ2 =31.09,P=0.000).But in the obesity students,the prevalence of MS(42.0%)in Longquan was higher than that in six cities(28.8%)(χ2 =5.43,P=0.02).Conclusion The prevalence of obesity in Longquan mountainous area was lower than that in the national six cities among the children and adolescents from 10 to 15 years old.However,the prevalence of MS among the obesity in Longquan was higher than that in six cities.

Objective To study the relationship between gastritis cystica profunda (GCP)and early gastric cancer (EGC),and to explore the diagnosis and treatment of GCP.Methods Clinical data of 17 patients,who were pathologically diagnosed as having GCP,including clinical symptoms,white light endo-scopic findings,magnifying endoscopic features,EUS outcomes and histopathological characteristics were an-alyzed.Results All 17 patients of GCP had no specific clinical symptoms or history of gastric surgery prior to the operation.Eight lesions were located at cardiac,4 at gastric body,4 at gastric antrum and 1 at gastric angle.As to the morphology,3 cases were type Ⅰ,3 type Ⅰ +Ⅱc,9 type Ⅱa +Ⅱc,1 type Ⅱc and 1 type Ⅱb +Ⅱc.The mean lesion size was 1.8 cm.Of 16 patients with preoperative EUS examination,11 patients were found to have cystic changes,with the diagnostic rate being 68.8%(11 /16).All 17 patients underwent ESD,14 (82.4%,14 /17)of which were found to have EGC.Postoperative pathology confirmed low grade intraepithelial neoplasia in 3 cases,high grade intraepithelial neoplasia in 7,intramucosal carcino-ma in 4,submucosal carcinoma in 3 patients.Conclusion EUS plays an important role in the diagnosis and treatment of GCP.And GCP is highly correlated with EGC,which should be managed in time.