The changes and significance of integrin α4β7 and L-selectin levels in critical children / 中国医师进修杂志

Objective To explore the changes ofintegrin α4β7 and L-selectin levels and the possible relationship between the changes and intestinal mucosal immune function in critical children with gastrointestinal dysfunction.Methods Forty-eight admitted critical children were divided into non-gastrointestinal dysfunction group (29 cases) and gastrointestinal dysfunction group (19 cases),and also compared with 25 healthy people (control group).The expression of integrin α 4β 7 and L-selectin was measured by flow cytometry.Results The expression of integrin α 4β 7 in gastrointestinal dysfunction group [(11.11 ± 1.15)％] was lower than that in non-gastrointestinal dysfunction group [(15.36 ± 1.26)％]and control group [(19.62 ±0.89)％] (P ＜0.05),but there was no significant difference between nongastrointestinal dysfunction group and control group(P ＞ 0.05).The expression of L-selectin in gastrointestinal dysfunction group [(60.68 ±3.72)％] was lower than that in non-gastrointestinal dysfunction group [(69.43 ± 1.52)％] and control group [(88.65 ± 2.41)％] (P ＜ 0.05),and there was significant difference between non-gastrointestinal dysfunction group and control group (P ＜ 0.05).Conclusion The expression of integrin α 4β 7 and L-selectin is decreased at the early stage of gastrointestinal dysfunction in critical childern,and integrin α 4 β 7 is decreased sharply.

Evaluation of setup errors for head-and-neck cancer localized with final isocenter marking method via cone beam CT / 中华放射医学与防护杂志

Objective To evaluate the setup errors of image guided radiation therapy (IGRT) for head-and-neck cancer using kilovoltage cone beam CT( kV CBCT).Methods 256 patients with head-and-neck cancer were treated with intensity modulated radiation therapy (IMRT) from March 2009 to October 2011.All patients were immobilized with head-and-neck mask and localized with final isocenter marking method using the Philips PQS CT or Philips Brilliance CT Big Bore scanners,which were equipped with LAP movable laser systems.The CT images were transferred to a Varian Eclipse V8.6 workstation for contouring and planning.A kV cone-beam CT scans was acquired,and registered before the treatment for every patient on a Varian iX linear accelerator via OBI system.The setup errors in the right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were recorded.Results The setup errors for the 473 datasets followed a Gaussian distribution.The systematic errors ± random errors in the RL,SI and AP were(-0.6 ± 1.3 ),(0.5 ± 1.6) and (0.9 ± 1.7 ) mm,respectively.The planning target volume (PTV) margins were calculated respectively as 2.4,2.4 and 3.4 mm according to the formula of M =2.5∑ +0.7δ The margins of 288 sets of data using the Big Bore CT scanner were calculated as 2.0,2.1 and 1.7 mm,respectively.Conclusions The setup errors using final isocenter marking method are smaller than those using reference point marking method.The result derived from this retrospective study could be used to set the margin between CTV and PTV.

The value of diagnosing gastrointestinal dysfunction in critically ill children with criteria / 中国医师进修杂志

Objective To discuss the value of diagnosing gastrointestinal dysfunction in.critically ill children.Methods Seventy-six critically ill patients were reviewed,48 cases combined with gastrointestinal dysfunction.Plasma D-lactate,intestinal fatty acid binding protein(IFABP)of serum and urine were performed in all patients,detected the sensitivity and specificity,ealculated the area under the ROC curve (AUC).Results Plasma D-Iactate level≥9.63 mg/L had a sensitivity of 85.2%,specificity of 70.9%,and AUC of 0.822 for diagnosing gastrointestinal dysfunction.Serum IFABP level≥0.129μg/L had a sensitivity of 65.2%,specificity of 63.8%,and AUC of 0.744 for diagnosing gastrointestinal dysfunction.Urine IFABP ≥0.330μg/Lhad a sensitivity of 78.3%,specificity of 72.3%,and AUC of 0.820 for diagnosing gastrointestinal dysfunction.There was no significant difference in AUC between plasma and urine IFABP(P＞0.05),there was no significant difference in AUC between serum D-lactate and serum IFABP(P＞0.05).Conclusions Plasma D-Lactgte,serum and urine WABP may be useful markers as warning gastrointestinal dysfunction of critically ill children.Plasma D-lactate and urine IFABP level may be more sensitively,but they need to be further studied.

Naturally occurring antibodies to streptococcal C5a peptidase from group B streptococcus(SCPB)in neonates / 临床儿科杂志

Objective To detect the antibodies of streptococcal C5a peptidase from group B streptococcus(SCPB)in neonates,demonstrate the existence of SCPB antibody in pregnant women after natural group B streptococcus(GBS)infection,and provide clinical evidence for prevention of GBS infection. Methods Sera were collected from 107 neonates(80 term infants and 27 premature infant)between February 2007 and December 2007. The antibodies of SCPB were detected using ELISA method,and cultures of GBS were done simultaneously. Results 21(19.6%)newborns were found to be SCPB antibody positive(including 20 term infants and 1 premature infant),the difference of positive ratio between term and premature infant was significant(25% and 3.7%,respectively). Conclusions This study indicated that pregnant women could produce SCPB antibody by immune response,and transmitted it to the infants through the placenta. Further study is needed to clarify the effect of SCPB antibody in expectant mother and newborn with GBS infection.