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Objective:To analyze the clinically acceptable and reproducible bladder and rectum volumes of prostate cancer patients during radiotherapy under bladder and bowel preparation, aiming to provide quantitative indicators for bowel and bladder preparation before and after radiotherapy.Methods:Clinical data of 275 prostate cancer patients with strict bladder and bowel preparation and completion of whole course radical radiotherapy at Sun Yat-sen University Cancer Center from April 2015 to December 2020 were retrospectively analyzed. Patients were scanned with cone beam CT (CBCT) before each treatment and the setup error was recorded. Sixty-six patients were selected by simple random sampling and the bladder and rectum on daily CBCT was outlined using MIM software. The relationship between the ratio of daily bladder or rectum volume to the planned bladder or rectum volume (relative value of volume) and setup error was analyzed. Quantitative data were expressed as mean±SD. Normally distributed data were analyzed by paired t-test while non-normally distributed data were assessed by Kruskal-Wallis test.Results:The bladder and rectum volume on planning CT were (370.87±110.04) ml and (59.94±25.07) ml of 275 patients. The bladder and rectum volumes on planning CT were (357.51±107.38) ml and (65.28±35.37) ml respectively of the 66 selected patients with 1611 sets of CBCT images. And the bladder and rectum volumes on daily CBCT were (258.96±120.23) ml and (59.95 ± 30.40) ml. The bladder volume of patients was decreased by 3.59 ml per day on average during the treatment and 0.37 ml for the rectum volume. According to the bladder volume on planning CT, all patients were divided into three groups: <250 ml, 250-450 ml and >450 ml groups. The relative value of volume in the 250-450 ml group during the course of radiotherapy was the smallest. And the setup error in the superior and inferior (SI) direction was (0.28±0.24) cm and (0.19±0.17) cm in the left and right (LR) direction, significantly lower than those in the other two groups (both P≤0.027). According to the rectum volume on planning CT, all patients were divided into four groups: <50 ml, 50-<80 ml, 80-120 ml and >120 ml groups. The <50 ml group had the smallest relative value of volume during radiotherapy, and the setup error in the SI direction was (0.26±0.22) cm and (0.24±0.22) cm in the anterior and posterior (AP) direction, significantly smaller than those in the other groups (both P≤0.003). The setup errors in the SI, LR, AP directions of the enrolled 66 patients were (0.30±0.25) cm, (0.20±0.18) cm and (0.28±0.27) cm, respectively. Among them, the relative value of bladder volume in the AP direction was (0.73±0.37) in the setup error <0.3 cm group, which was statistically different from those in the setup error 0.3-0.5 cm and >0.5 cm groups (both P<0.05). Conclusion:Under the bladder and bowel preparation before planning CT, the appropriate bladder and rectum volumes are in the range of 250-450 ml and <50 ml, which yields higher reproducibility and smaller setup error.
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Objective:To understand the results of blind evaluation of dissertation of three-year doctors and eight-year medical doctors, and to explore the improvement measures of eight-year program education.Methods:The data analysis method was manipulated. A total of 47 eight-year doctoral and 88 three-year doctoral dissertations submitted by the first clinical college of Huazhong University of Science and Technology in 2020 were selected as the research material. SPSS 17.0 was used to perform Chi-square test to compare the itemized evaluation opinions of the dissertation, Spearman test was used to analyze the correlation between the defense opinions, itemized evaluation opinions and the overall evaluation.Results:The gap between eight-year and three-year doctoral dissertation is mainly manifested in innovation and research value ( χ2=9.10, P=0.003), topic and review ( χ2=5.70, P=0.017), while there is no significant difference in the overall assessment and oral defense suggestion. The main influencing factor of dissertation defense suggestion for both doctors was the dissertation standardization (eight-year: r s=0.53, P<0.001; three-year: r s=0.45, P<0.001). The evaluation results of eight-year doctor dissertation were closely related to basic knowledge and scientific research ability ( r s=0.74, P<0.001). Conclusion:There is no significant difference between eight-year doctors and full-time doctors in research attitude. But there was a certain gap in scientific research and innovation ability among them. It is suggested to clarify the teaching objectives, formulate and refine the evaluation system of dissertations, and strengthen the cultivation of scientific research interest and academic belief of eight-year study program.
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Objective:To investigate the applicability of time series model in predicting incidence of nosocomial infection in a cancer center in Shanghai, and to provide the references for early warning and prevention.Methods:The nosocomial infection data of inpatients of a tertiary oncology hospital in Shanghai from 2013 to 2018 were collected. The autoregressive integrated moving average (ARIMA) model and the exponential smoothing model were established by SPSS 22.0 expert modeler. The fitting predictions were compared between these two time series models to select the optimal one. The nosocomial infection data from January 2019 to June 2019 were used to test the predictive effect of the model.Results:A total of 379 477 cancer inpatients were studied, 3 170 of which acquired nosocomial infection and the incidence was 0.84% from 2013 to 2018. Additive Holt-Winters method exponential smoothing model was the better model with R2of 0.82. Using this model, the predicted value fitted well with observed value from January 2019 to June 2019, and the mean relative percentage error was 15.22%. Conclusion:Additive Holt-Winters method exponential smoothing model could be used to fit and predict the tendency of nosocomial infection among cancer patients, which can provide reference for surveillance of nosocomial infection in oncology hospitals.
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Objective: To explore the mechanism of Yinao Jieyu Compound Formula in the treatment of post-stroke stressrats from the perspective of intestinal flora changes. Methods: A total of 48 male clean SD rats were randomly divided into4 groups: sham-operation group, post-stroke stress group, western medicine group and traditional Chinese medicinegroup, with 12 rats in each group. In the sham-operation group, only the free blood vessels were not inserted into thethread embolus. The rats in post-stroke stress group, the western medicine group and the Chinese medicine group weretreated as follows: after 1 week of middle cerebral artery occlusion, the rat model of PSD was prepared by using chronicrestraint stress and single cage feeding. The 7 th day from the beginning of the construction of the cerebral stroke model, the gavage treatment began to be done. The western medicine group was given Fluoxetine Hydrochloride Capsules2.33 mg/ (kg.d), and the Chinese medicine group was given 9.92 g/ (kg·D) . The rest of the rats were gavage with 10 mL/kgdistilled water, 1 time/day. The behavioral changes on the 14 th day after post-stroke were observed and the microbialcommunity structure and composition was analyzed by Illumina-MiSeq high throughput sequencing technique. Results:Compared with the sham operation group, the sucrose water preference, open field score and swimming struggle time ofthe post-stroke stress group were significantly decreased (P ＜ 0.01, P ＜ 0.01, P ＜ 0.01), and the proportions ofAllobaculum, Sutterella, Dorea and rc4-4 in the feces decreased significantly (P ＜ 0.01, P ＜ 0.01, P ＜ 0.01, P ＜ 0.05) .The proportion of Oscillospira increased significantly (P ＜ 0.01, P ＜ 0.05, P ＜ 0.01) . Compared with the post-strokestress group, the horizontal scores and swimming struggling time of the rats in the Chinese medicine group weresignificantly increased (P ＜ 0.05, P ＜ 0.05), and the proportions of the 6 species of Lactobacillus and Bacteroides weresignificantly increased in the feces. The difference between Lactobacillus and Bacteroides was the most obvious with27.91％ vs 5.96％ and 24.21％ vs 9.62％ (P ＜ 0.01, P ＜ 0.01) . The proportion of Oscillospira was significantly decreased (P ＜ 0.05) . Compared with the western medicine group, there was no significant difference in the behavioral scores of therats in the traditional Chinese medicine group (P＞ 0.05), and the proportion of Bacteroides and rc4-4 in the feces wassignificantly increased (P ＜ 0.01, P ＜ 0.05) . Conclusion: Yinao Jieyu Compound Formula can alleviate similar depressivesymptoms in post-stroke stress rats by increasing the content of Lactobacillus and Bacteroides in the intestine of rats.
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Objective To investigate the distribution and susceptibility of isolated organisms from blood of malignant tumour patients.Methods Isolates from blood culture in patients with cancer during January 2013 to December 2015 were analyzed.Results were analyzed according to the breakpoints of CLSI 2014.Results Total of 498 isolates from blood culture,gram-negative bacilli accounted for 58.0% and gram-positive cocci accounted for 42.0%.The most common pathogens were E.coli,Coagulase-negative Staphylococcus,Klebsiella spp, S.aureus and Enterococcus spp.Drug resistance of E.coli strains to piperacillin-tazobactam,amikacin and imipenem were low,and drug resistance of E.coli strains to ampicillin-sulbactam,gentamicin,ciprofloxacin,levofloxacin and compound sulfamethoxazole were high.The prevalence of ESBL-producing strains was 70.7% in E.coli and 22.8% in Klebsiella spp.The E.coli and Klebsiella spp.strains isolated from ICU showed higher resistance than the strains from surgery and medicine department.The E.faecium strains were highly susceptible to gentamicin (high level) and lower susceptible to most of the antibiotics tested.The E.faecalis strains were more susceptible than E.faecium to these agents.No vancomycin-resistant strains were found in Enterococcus spp.Conclusion Among gram-negative pathogen isolates from blood culture in cancer patients,E.coli and Klebsiella spp.are the most frequent.Staphylococcus and Enterococcus are the most frequently isolated species of gram-positive cocci.The percentage of Acinetobacter spp.strains is relatively higher in ICU.Surveillance of antimicrobial resistance can provide the basis for rational use of antibiotics.
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AIM: To investigate the effects of astragalus injection combined with puerarin injection on endo-plasmic reticulum stress through PERK pathway in diabetic nephropathy mice .METHODS: Male KKAy mice were ran-domly divided into model group ( injected with normal saline ) and treatment group ( injected with astragalus and puerarin ) . The male C57BL/6J mice served as normal group .The mice were sacrificed 4 weeks after treatments for observing morpho-logical changes under electron microscope .The renal tissues were collected to determine the expression of protein kinase R-like endoplasmic reticulum kinase ( PERK ) , eukaryotic initiation factor 2α( eIF2α) and glucose-regulated protein 78 (GRP78) at mRNA and protein levels by real-time PCR and Western blot.RESULTS: Under electron microscope, the renal tubular epithelial cells in model group and treatment group showed the swelling of the nucleus , endoplasmic reticulum and mitochondria .The results of real-time PCR and Western blot showed that the expression of PERK , eIF2αand GRP78 at mRNA and protein levels in model group was higher than that in normal group (P<0.05), while that in treatment group was lower than that in model group .CONCLUSION: Astragalus injection combined with puerarin injection reduces the mRNA and protein expression of PERK , eIF2αand GRP78, thus inhibiting the endoplasmic reticulum stress in type 2 dia-betic mice to protect the kidney function .
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Ovulatory dysfunction refers to absent ovulation or luteal insufficiency. It is commonly seen in women with irregular menstruation or menstrual cycles, especially in those with oligomenorrhea or amenorrhea. Ovulatory dysfunction is considered the single-most frequent cause of female infertility. Clinically, the two major causes of ovulatory dysfunction are polycystic ovarian syndrome (PCOS) and luteinized unruptured follicle syndrome (LUFS). Acupuncture-moxibustion improves ovulation and helps with infertility. Through a systematic review and analysis on relevant literatures in Chinese Medicine and Acupuncture-moxibustion Databankover the last decade, this paper summarized the characteristics and pattern of acupuncture-moxibustion points for improving ovulation in order to provide an optimal acupuncture-moxibustion protocol in this regard.
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ObjectiveTo investigate the effects of dopamine D1 receptor (D1R) tool drugs and combined acupuncture and medicine on striatal expressions of D1R and dopamine transporters (DAT) in middle cerebral artery occlusion (MCAO)-reperfusion rats.MethodForty-seven male SD rats were randomly grouped, used to make a model and given corresponding interventions. The materials were taken and fixed six hrs later. Striatal D1R and DAT expressions were detectedby an immunohistochemical method in different groups.ResultThe neurological deficit score was significantly higher in the model group than in the blank group. Electroacupuncture treatment decreased the score significantly (P0.05). DAT expression was significantly down-regulated in the other groups compared with the model group (P0.05).ConclusionCerebral ischemia-reperfusion can result in high D1R and DAT expressions in rat striatum on the ischemic side. Electroacupuncture, D1R antagonists and a combination of the two can significantly down-regulate D1R expression and have a protective effect on the brain. The effects of electroacupuncture and D1R antagonists can not be added to each other. D1R signaling pathway may be one of ways by which electroacupuncture produces a protective effecton the brain.
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Objective To investigate the clinical efficacy and mechanism of electrical pudendal nerve stimulation (EPNS) in treating female stress urinary incontinence.Methods Thirty-five female patients with stress urinary incontinence were enrolled from May 2006 to April 2008.The average age was (54.9±9.7) years,the duration of incontinence was (74.1 ±45.6) months,the maximum urethral closure pressure was (63.7± 15.9) cm H2O,functional urethral length was (2.34±0.72) cm and bladder neck mobility was (1.23±0.76) cm.Long acupuncture needles were deeply inserted into four sacral points,which were located by the two edges of the sacrum on a level with the fourth sacral foramina and bilaterally to the tip of the coccyx.The needles were electrified (continuous waves,a frequency of 2.5 Hz,an intensity of 45-55 mA and 60 min once) to stimulate the pudendal nerves.When EPNS was performed,perineal ultrasonographic B-mode movements of the pelvic floor muscles (PFM),M-mode curves indicating the PFM contractions,vaginal pressure (VP) and PFM electromyogram were recorded simultaneously.Results When EPNS was performed correctly,the patient felt strong PFM contractions.Simultaneous records showed:1)B-mode cranio-caudal PFM movements; 2) M-mode PFM movement curves (amplitude:about 1 mm,n=31 ; in the other four patients,the M-mode curves were not obvious) ; 3) a sawtooth curve of VP changes (2.61±1.29 cm H2O,n=34); 4) PFM myoelectric waves (amplitude:23.9±25.3 μV).If during the EPNS process the electric current was stopped or its intensity was reduced or the two lower needles were drawn back 1-2 cm,then the above ultrasonographic PFM movements and VP changes disappeared.In the 35 patients,the ICI-Q-SF score was 12.9±2.9 before treatment and decreased to 3.5±3.3 after 27.5± 11.9 sessions of treatment (P＜0.01).Twenty-five patients with ≥50％ symptom improvement at the end of treatment were followed up for 24-72 months (mean 50),and 19 cases had ≥ 50％ symptom improvement during the period of follow-up,including complete symptoms resolution in 10 cases.Conclusion EPNS can contract the PFMs and simulate PFM training to treat female stress incontinence.
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The purpose was to investigate the research achievements over the past two decades on moxa smoke produced in the process of moxibustion, in terms of its clinical studies, chemical compositions, safety assessment as well as the mild smoke or smoke-free moxibustion, for revealing the recent dynamic and developing orientation, and promoting its further application, succession and innovation.
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Purpose To observe the curative effect of special acupuncture techniques on female urethral syndrome and its relationship with the course of treatment.Method Four abdominal and four sacral empirical points were acupunctured with special techniques and electricity. A difference in curative effect was investigated between different numbers of treatments. Results The clinical cure rate reached 15.2% just after ≤ 10 (7.3 ± 1.3) treatments. The curative effect was significantly better after 20-40 (32.1 ± 5.8) treatments than after ≤ 10 (7.3± 1.3) treatments (χ2 = 10.086, P ＜0.05). The clinical cure rate reached 43.5% in the former. Conclusion Special acupuncture techniques have a good clinical effect on female urethral syndrome. The curative effect improves with an increase in the number of treatments.