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Objective:To obtain the inter-fractional set-up errors of intensity-modulated radiotherapy (IMRT) of cervical cancer by cone-beam CT (CBCT), and to analyze the variations of the set-up errors on the cumulative dose deviation of the target volume.Methods:A total of 48 patients with cervical cancer who underwent IMRT were enrolled in this study, and the set-up errors of 696 CBCTs were obtained. The set-up errors were input into the treatment planning system, and the cumulative set-up error dose was obtained by superposing the set-up errors dose. The deviation percentage was calculated by the deviation formula and the standard planning dose.Results:The set-up errors caused the offset of isocenter distance by 0.58(0.36, 0.80) cm. Different statistical differences were noted between the cumulative set-up error dose and the standard planning dose by WilCoxon test. All the dose deviations in the target volume were reduced, and the differential dose volume histogram (DVH) appeared negatively skewed, and the peak value was declined. The DVH diagram shifted to the left with an inverse S-curve and the slope was increased. The HI deviation of the target volume from small to large were: CTV 1, CTV 2, GTV/CTV, CTV 3, CTV n, CTV all, and GTV nd; The HI deviation of the target volume were increased. Conclusions:The effect of set-up errors in IMRT of cervical cancer upon the cumulative doses of the target volume significantly differs. The cumulative dose of the target volume is reduced, and the uniformity of the target volume dose becomes worse. The uncertainty of the inter-fractional position leads to an increase or decrease in the the fractional doses of the target volume. The biological effect on tumor cells and the tumor recurrence remains to be investigated. In IMRT of cervical cancer, the CBCT position calibration is required before each treatment to ensure the dose accuracy of each structure in the target volume.
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Kidney injury and decreased chemosensitivity of tumor cells are obstacles with cisplatin (CDDP) chemotherapy. Down-regulation of the organic cation transporter 2 (OCT2) and multidrug resistance-associated protein 2 (MRP2) is a key means to alleviate CDDP-induced kidney injury and increase chemosensitivity. Astragaloside IV (AS IV) is obtained from the well-known traditional Chinese herb Astragalus membranaceus. This study explored the role of AS IV in preventing kidney injury and enhancing the antitumor effect of CDDP by suppressing OCT2 expression in kidney and MRP2 in tumors. This project was reviewed and approved by the Animal Ethics Committee of the First Hospital of Jilin University. The effects of AS IV on CDDP inhibition of tumor growth and promotion of apoptosis were assessed in Lewis lung tumor (LLC)-bearing mice by H&E and TUNEL staining. Kidney injury was assessed by serum biochemical parameters and H&E staining. We used Western blotting and immunohistochemistry assays to detect OCT2 and MRP2 expression in kidney and tumor. The concentration of CDDP in kidney and tumor was measured by HPLC-MS/MS. AS IV enhanced CDDP chemosensitivity by increasing tumor cell apoptosis and slowing tumor growth, and decreased kidney injury as evidenced by lower blood creatinine (Cr) and blood urea nitrogen (BUN). Co-administration of AS IV suppressed MRP2 overexpression induced by CDDP in tumor tissues and may be an important mechanism for enhancing CDDP chemosensitivity. Moreover, AS IV reduced CDDP-induced kidney injury in mice along with suppression of OCT2 expression in kidney. The concentration of CDDP was increased in tumor but decreased in kidney. In total, AS IV not only enhanced the antitumor effect of CDDP by suppressing MRP2 expression in tumor cells, but also decreased kidney injury induced by CDDP. The results provide new insight into the combined use of a chemotherapy drug and natural ingredients to treat cancer.
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The aim of this study was to explore the neuroprotective effect and mechanism of XingNaoJing injections (XNJ) on cerebral ischemia injury and blood-brain barrier (BBB) disruption. Middle cerebral artery occlusion (MCAO) method was applicated to establish the model of cerebral ischemia/reperfusion (I/R) injury in rats. BBB permeability after I/R injury was assessed with the leaking amount of Evans Blue and the expression of occludin and ZO-1. The expression of NOD-like receptor family, pyrin domain containing (NLRP3) was checked to explore the inhibition of inflammation by XNJ. The results showed that XNJ could significantly increase the survival percent, decrease the infarct area and ameliorate neurological deficits and brain damage after I/R injury. Leaking amount of Evans Blue was reduced by XNJ, and the expression of tight junction protein, occludin and ZO-1 was also up-regulated by XNJ, which showed a role of protection on BBB disruption. The expression of NLRP3 was inhibited after exposure of XNJ, which was associated with inhibition of the inflammatory response. In summary, XNJ could suppress NLRP3 inflammasomes and improve BBB disruption and brain damage in rats after cerebral I/R injury, which provided a beneficial insight to further explore XNJ.
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There were some shortcomings for traditional teaching mode of nutrition and food hygiene course, such as many teaching contents and little teaching time, students much passively learning and little active learning. We explored the combination of the WeChat and the TBL teaching to conduct the flipped classroom to solve the deficiency. The teaching pattern was conducted in 60 students majoring in preventive medicine from Grade 2012. The learning task of nutrition and food hygiene was released on the WeChat before the class. Students learned knowledge in the form of discussion based on case in the class. After the class, the discussion, answer the question and test were conducted on the WeChat. The survey showed that 85% of the students were satisfied with teaching pattern,especially satisfied with its role of broadening students' knowledge and vision, improving their autonomous learning ability, teamwork ability, and their ability to analyze and solve problems.
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Objective To explore the clinical efficacy of entecavir combined with Vitamin E in treating patients with Chronic hepatitis B complicated with non-alcoholic fatty liver.Methods Retrospective analysis was done by reviewing the clinical data of 103 patients, who suffered with chronic hepatitis B complicated with non-alcoholic fatty liver and treated in our hospital from 2015 to 2016.The patients were divided into the control group with 61 cases and the observation group with 42 cases based on different therapies.The control group was treated with only entecavir while the observation group was treated with entecavir and Vitamin E, and both the courses of treatment lasted for 6 months.The negative conversion ratio of HBV-DNA, levels of ALT, TBIL, ALP, the disease state and the adverse reactions of the two groups were compared before and after treatment.Results The negative conversion ratio of HBV-DNA of the observation group was obviously higher than that of the control group, and the patients of the observation group showed significant improvement.Meanwhile, the levels of ALT, TBIL and ALP in the two groups were both lower than before treatment.Compared with the control group, those indexes in the observation group were significantly lower (P<0.05).Conclusion Entecavir combined with Vitamin E for the treatment of chronic hepatitis B complicated with non-alcoholic fatty liver could significantly decrease the viral infections so that the state of patients can be improved.
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<p><b>OBJECTIVE</b>To investigate the incidence of diabetic ketoacidosis (DKA) in children with newly diagnosed type 1 diabetes.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 224 children with newly diagnosed type 1 diabetes, and according to the presence or absence of DKA, these children were divided into DKA group and non-DKA group, with 112 children in each group. The DKA group was further divided into ≥5-year group (65 children) and <5-year group (47 children), and according to the blood gas parameters, this group was divided into mild group (26 children), moderate group (29 children), and severe group (57 children). The factors influencing the development of DKA were analyzed, as well as the clinical and laboratory features of DKA children with different ages.</p><p><b>RESULTS</b>The most common symptoms in these 224 children with type 1 diabetes were polydipsia (86.2%), polyuria (78.6%), and weight loss (57.1%). Compared with the non-DKA group, the DKA group had a significantly higher percentage of children who were aged <5 years, who had low family income, or whose parents had an educational level of senior high school or below. The DKA group had significantly higher levels of random blood glucose and HbA1C and significantly lower levels of pH, HCO3, and C-peptide than the non-DKA group (P<0.05). There was no significant difference in the percentage of children with severe DKA between the ≥5-year group and the <5-year group (P>0.05). Compared with the <5-year group, the ≥5-year group sufferred from symptoms for a significantly prolonged period, and had a significantly lower level of random blood glucose and significantly higher levels of HbA1C and C-peptide (P<0.05).</p><p><b>CONCLUSIONS</b>DKA has a high incidence rate in children with type 1 diabetes, and the development of DKA is associated with age, parents' educational level, and family income.</p>
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Adolescent , Child , Female , Humans , Male , Diabetes Mellitus, Type 1 , Diabetic Ketoacidosis , Epidemiology , Glycated Hemoglobin , Retrospective StudiesABSTRACT
Objective To compare contrast-enhanced ultrasound and conventional ultrasound in determining artery stenosis of varying degrees of accuracy. Methods Using conventional ultrasound and contrast-enhanced ultrasound renal artery stenosis was diagnosed.And the renal artery diameter stenosis were measured the extent to which digital subtraction angiography (DSA) as the standard diagnostic accuracy of two methods to determine the rate. Results 50 patients were diagnosed as renal artery stenosis with DSA,21 patients stenosis rate 30%-49%,23 patients stenosis rate 50%-75%,6 patients stenosis rate ＞75%.diagnose accordance rate 78%(38/50)with conventional color doppler and 92% (46/50) with contrast-enchanced ultrasound.The difference was statistically significant (P＜0.05＝. ConclusionUsing ultrasound imaging of the renal artery stenosis to determine the degree had higher accuracy than the conventional ultrasonic testing method,was suitable for clinical application.
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<p><b>OBJECTIVE</b>This paper analyzed the epidemiological characteristics of rubella in Shanghai from 1990 to 2006.</p><p><b>METHODS</b>Descriptive epidemiological study was applied to analyze the cases from infectious diseases reported system on rubella during 1990-2006 in Shanghai. Excel was used for data analysis.</p><p><b>RESULTS</b>The reported rubella incidence rate in Shanghai was 0.15-451.57 per 100,000 during the period from 1990 to 2006. A rubella epidemic happened in 1993, with the number of reported cases as 58,104. The year 1998 was the low year on rubella with only 19 reported cases. In the years without rubella vaccine (RV), that was, from 1990 to 1994, the annual reported incidence rate of rubella was 93 per 100,000, and there was a distinct characteristic of seasonal difference, with peak in march through June each year. Rubella cases mostly affected children aged 5-9 and adolescent of 10-14 years old. Since the wide use of RV in Shanghai since 1995, RV and measles, mumps, rubella (MMR) had been widely accepted by parents. The vaccination rate of MMR reached up to 85 percent. The incidence of rubella was descending as year went by. The annual reported cases were less than 100 since then (with exception in the year 1995). Local outbreaks were further reduced and the age group structure had also changed since the adoption of RV. Patients with RV fallen into the age group of 0-4 were increasing quickly, accounting for 21.00% percent of all the patients and the age become older. 31.62% of the patients fell into 20 years of age and above. During 1995-2006, the incidence rates of rubella in age 25-29 and 30-34 were both much higher than that in the year without vaccine.</p><p><b>CONCLUSION</b>The trend of older age among patients wilt Rubella increased the risk on fertile woman and geting congenital rebella syndrome.</p>
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Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Young Adult , Age Distribution , China , Epidemiology , Disease Outbreaks , Incidence , Measles-Mumps-Rubella Vaccine , Rubella , Epidemiology , Rubella Vaccine , VaccinationABSTRACT
Objective To investigate the prevalence and attitude of smoking and its influencing factors among residents in Hongkou District of Shanghai,so as to provide evidence for tobacco control. Methods Nine hundred and sixty residents in Hongkou District of Shanghai aged 15 to 69 years were selected by multi-level random sampling,among whom 958 completed the investigations on smoking status. Results The smoking rate and standardized smoking rate were 20.04% and 18.73%,respectively.The smoking rate and standardized smoking rate of males were 41.05% and 30.07%,and those of females were 0.80% and 1.70%,respectively.The smoking rate of males was higher than that of females(RR=0.02,95%CI: 0.01-0.03).The smoking rates of age groups of 25 years old and over were higher than those of 15 to 24 years old,and the smoking rate of subjects with or above junior college education was lower than that of subjects with or below middle school education(RR=0.45,95%CI: 0.25-0.79).Subjects who drank alcohol smoked more than those did not(RR=2.68,95%CI: 1.76-4.09).Lower annual per capita income and higher knowledge on smoking hazard led to more tendance to object to smoking and agree with anti-smoking. Conclusion The prevalence of smoking of residents aged 15 to 69 years in Hongkou District of Shanghai was relatively lower.Age,gender,education status and alcohol drinking were influencing factors of smoking.Education on tobacco control among subjects aged more than 35 years should be strengthened,and more attention should be paid to those with lower education.Besides,education on alcohol control should be managed together with tobacco control.