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Objective:To compare the dosimetric differences between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) on planning target volume (PTV) and organ-at-risk (OAR) for breast cancer after modified radical mastectomy, aiming to provide evidence-based reference for clinical practice.Methods:According to strict inclusion and exclusion criteria, literature search was performed in PubMed, Cochrane Library, FMRS, CNKI, Wanfang Data and VIP full text databases from the inception of databases up to March 2020. The controlled clinical trials of dosimetric comparison between VMAT and IMRT for breast cancer following modified radical mastectomy were selected. The meta-analysis was performed using Stata14 software.Results:The meta-analysis included 281 patients from 13 observational studies. Compared with IMRT, VMAT significantly increased the PTV dose coverage D 95%( P<0.001) and significantly improved the PTV homogeneity index (HI, P<0.001) and conformity index (CI, P=0.004). Compared with IMRT, VMAT more effectively decreased the ipsilateral lung V 20Gy (WMD=1.332, P=0.027) and contralateral lung V 10Gy ( P=0.003). There were no significant differences in theD mean, V 5Gy, V 10Gy and V 30Gy of the ipsilateral lung, D mean and V 5Gy of the contralateral lung, D mean, V 10Gy and V 30Gy of the heart between VMAT and IMRT (all P>0.05). Compared with VMAT, IMRT reduced the cardiac V 5Gy ( P=0.001). However, sensitivity analysis of included literature on cardiac V 5Gy showed that the P value was reversed, indicating that the stability of the results was poor. VMAT significantly shortened the delivery time ( P<0.001) and the number of monitor units ( P<0.001) compared to IMRT. Conclusion:Compared with IMRT, VMAT can achieves superior target dose coverage, HI and CI, better protection for the ipsilateral and contralateral lung, fewer monitor units and shorter delivery time.
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Objective To provide a practical device and protocol to hold conscious rats for subsequent operations which can overcome the disadvantages of existing methods .Users can complete the experiment more efficiently , with or without prior experience .Methods Using transparent plastic film , plastic sealing machine and sponge to make a simple device for holding rats , by taking advantage of their escaping nature .To compare the performance of the new method and existing methods for holding and injecting rats .Results Compared with existing methods , the new device and method can reduce the time-consuming to hold rats by 44.7%, from 18.13 seconds to 10.03 seconds.For holding and injecting , the new method can reduce the time-consuming by 55.3%, from 139.33 seconds to 52.26 seconds .Conclusions The new device and method is good for holding and injecting rats or drawing blood from the caudal veins .It can shorten the time of operation and reduce the stress reaction in the animals .It’ s especially helpful for inexperienced experimenters such as students in teaching and research tasks .
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Objective To analyze changes in lactic acid level in patients with late-onset intracranial hematoma after craniocerebral injury and investigate their relativity.Methods Forty-eight patients with late-onset intracranial hematoma after craniocerebral injury treated in our hospital between May 2009 and December 2012 were enrolled as observation group.There were 32 males and 16 females.Moreover,50 cases checked up in our hospital during the same period were studied as health population controls,including 35 males and 15 females.Level of lactic acid was measured on admission,at the time of definite diagnosis as well as at days 7 and 14 after treatment and compared between groups.Results Level of lactic acid was (1.77 ±0.21) mmol/L in control group and (1.82 ± 0.25) mmol/L in observation group respectively on admission (t =1.070,P ＞ 0.05) ; Level of lactic acid was (3.32 ± 0.89) mmol/L in observation group at the time of definite diagnosis,which increased to (3.74 ± 1.16) mmol/L at days 7 after treatment and decreased to (1.89 ±0.75) mmol/L at days 14 after treatment.When diagnosed and treated for 7 days,level of lactic acid differed significantly between the two groups (P ＜ 0.05).Level of lactic acid related to craniocerebral injury at each time point,but higher correlation coefficient was observed at the time of definite diagnosis and 7 days after treatment with 0.986 and 0.989 respectively.Conclusion Level of lactic acid relates to late-onset intracranial hematoma after craniocerebral injury,which can be used as reference for progression of the disease.
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BACKGROUND:Studies have found that c-kit+ bone marrow mesenchymal stem cels can differentiate into myocardial cels specificaly, which may be the ideal seed cels. OBJECTIVE:To investigate the feasibility of cultivation of myocardial tissue by using c-kit+ bone marrow mesenchymal stem cels and decelularized heart matrix. METHODS:Heart tissues harvested from adult rats were decelularized for the folowing experiments. Primary rat bone marrow-derived mesenchymal stem cels were culturedin vitro. Until passage 8, bone marrow mesenchymal stem cels were enriched for c-kit and induced by 5 μmol/L 5-azacytidine for 2 weeks, and a second enrichment for the dihydropyridine receptor subunit α2δ1 was performed before analysis of cardiac differentiation or implantation into decelularized heart matrix for cultivation of myocardial tissue. Six weeks later, myocardial differentiation was identified by specific cardiac protein and action potential. Immunofluorescence staining was used to analysis neonatal myocardial tissue. RESULTS AND CONCLUSION:Six weeks after the second enrichment, 60% bone marrow mesenchymal stem cels expressed cardiac troponin T, GATA binding protein 4, and connexin 43, and these cels could be induced to yield cardiac action potential, which was identified as cardiac differentiation. And when implanted into decelularized heart matrix, these cels could form myocardial tissue arranged regularly.
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Objective To examine the expression of tight junction protein claudin-5 in blood-spinal cord barrier (BSCB) after spinal cord injury about rat. Methods One hundred-twenty adult male SD rats were randomly divided into blank group (60) and injured group (60). The animal model of spinal cord injury was established using modified Allen method. The expression of claudin-5 in BSCB was examined at 6 h, 12 h, 1 d, 3 d, 5 d and 7 d (five rats per time point). Western blot and RT_PCR were used to detect protein and mRNA expression levels of claudin-5, respectively. Results The success rate of spinal cord injury molding was 81.7%. In injured group, EB content increased gradually over time, reached the peak at the third day(0.9435 ± 0.0813)μg/g and then reduced gradually (P<0.05), EB content was signifi-cantly higher in injured group than in blank group. Claudin-5 mRNA expression in injured group reduced gradually over time and reached the lowest point at the third day(2.871 ± 0.527)and then increased gradually(P<0.05). Claudin-5 mRNA expression was significantly lower in injured group than in blank group(P<0.05). Claudin-5 protein expression in injured group reduced gradually over time, reached the lowest at the third day(0.072 ±0.008)and then increased gradually (P<0.05). Claudin- 5 protein expression was significantly lower in injured group than in blank group(P<0.05). Con-clusions The alteration of claudin-5 expression after SCI may lead to the permeability of BSCB, which may in turn con-tribute to the secondary spinal cord injury.
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Objective To study the effects of methylprednisolone on the permeability of blood-spinal cord barrier (BSCB) and claudin-5 expression after spinal cord injury in rats. Methods The rat model of spinal cord injury was estab?lished using modified Allen method. SD rats were randomly divided into sham-operated group, spinal cord injury group and methylprednisolone pretreatment group. The permeability of BSCB and expression of claudin–5 were assessed at 12 h, 1, 3, 5, and 7 d after the onset of spinal cord injury (five animals per each time point). RT-PCR and Western blot were used to detect the expression of claudin-5. Results The success rate of the model was 84.0%. EB content was sig?nificantly higher in spinal cord injury group than in sham-operated group at each time point (F value 27.732,P was lower in spinal cord injury group than in sham operated group at each time point (Fvalue 18.108,P<0.05). The pro?tein expression of Claudin-5 was higher in methylprednisolone pretreatment group than spinal cord injury group at each time point (F value 20.247,P<0.05). Conclusions Methylprednisolone improves permeability of BSCB after spinal cord injury probably through enhancing claudin-5 expression in rats.
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Objective To observe the influence of Ligustrazine on the hemodynamic effects and prognosis in elderly patients with early cerebral ischemia following intracranial aneurysm operation ,and explore the therapeutic value .Methods 43 elderly patients with ECI following intracranial aneurysm operation were randomly divided into the Ligustrazine group (20 cases) ,and the conven-tional treatment group(23 cases)according to the table of random numbers .The patients in the Ligustrazine group were given intra-venously Ligustrazine injection and combined with conventional therapy ,whereas ,other patients were given conventional treat-ments .Results The clinical effective rate in Ligustrazine group was significantly higher than conventional treatment group (P<0 .05) .Patients recovered well in conventional treatment group were 7 cases(30 .43% ) ,mild disability 8 cases(34 .78% ) ,severe dis-ability 4 cases(17 .39% ) ,plant survival 1 case(4 .34% ) ,3 cases died(13 .06% ) ,data peer-based in the Ligustrazine group were 12 cases(60 .00% ) ,5 cases(25 .00% ) ,2 cases(10 .00% ) ,0 case and 1 case(5 .00% ) ,which were significantly lower than that of con-ventional treatment group .The prognostic scores in Ligustrazine group were apparently higher than conventional treatment group by using Glasgow outcome scale and Chinese stroke scale(P<0 .05) .Meanwhile ,the indicators of hemodynamic effects also reflec-ted that the Ligustrazine improved the blood circulation of patients with ECI ,which was better than the conventional treatment group(P<0 .05) .Conclusion The Ligustrazine Phosphate for injection showed better curative effect and prognosis in elderly pa-tients with ECI following intracranial aneurysm operation .
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Objective To investigate the correlation of angiotensin Ⅱ type 1 receptor (AT1R) gene polymorphism with AT1R expression levels and brain edema after hypertensive intracerebral hemorrhage .Methods 45 operative patients with hypertensive intracerebral hemorrhage in the Affiliated Yongchuan Hospital of Chongqing Medical Univercity from December 2011 to August 2012 were collected as the experimental group and 45 operative patients with refractory epilepsy weres selected as the control group .The venous blood in the two groups were collected for detecting the AT 1R gene polymorphism ;The brain tissue was taken from lesions in operation ,then AT1R mRNA concentration was determined by RT-PCR and the AT1R protein level was determined by Western blot ;Head CT was performed on postoperative 1 ,3 ,5 d;the degree of cerebral edema was reflected by CT value . Results The levels of two kinds of genotype AT1R mRNA in the experimental group had no statistically significant difference(P>0 .05);the operative area CT value of AC genotype was significantly lower than that of AA genotype with statistical difference (P<0 .05);the ATIRmRNA of various genotypes ,protein level and cerebral edema in the control group had no statistical differences . Conclusion The AT 1R gene polymorphism has no obvious correlation with the concentration expression of AT 1R mRNA in the brain tis-sue;there is correlation between AT 1R protein level and AT 1R protein level and the cerebral edema degree in the brain tissue .
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Objective To investigate the correlation between cornexin37 (Cx37) CI019T polymorphism and ischemic stroke and its outcome.Methods Restriction fragment length polymorphism analysis was used to detect the distribution of Cx37 C1019T polymorphism in a ischemic stroke group and a control group.The modified Rankin scale (mRS) was used to evaluate the neurological outcome at 3 months after onset.Results A total of 235 patients in the control group,and 232 patients in the ischemic stroke goup were recruited.In the ischemic stroke group,210 had a good outcome (mRS ＜3) and 22 had a poor outcome (mRS≥ 3).The TT genotype (12.93％ vs.6.39％ ; x2 =10.087,P =0.006) and T allele (31.25％ vs.21.49％ ; x2 =11.466,P=0.001) frequency in the ischemic stroke group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that TT genotype (odds ratio [OR] 5.794; 95％ confidence interval [CI] 1.405-23.894; P =0.015) and T allele (OR 131.016,95％ CI 6.943 -2 472.477; P =0.001)signifkantly increased the risk of ischemic stroke.Univariate analysis showed that TT genotype (OR 0.650,95％ CI 0.144 - 2,934; P =0.575),CT genotype (OR 0.622,95％ CI 0.234 - 1.655; P =0.342),and CC genotype (OR 0.654,95％ CI 0.268 - 1.595; P =0.350) had no significant correlation with the outcome of ischemic stroke.Conclusions Cx37 1019TT genotype and T allele may increase the risk of ischemic stroke.T allele is one of genetic susceptibility factors for ischemic stroke; however,its gene polymorphism is not associated with the outcome of ischemic stroke at 3 months after onset.
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Objective To investigate the association between matrix metalloproteinase (MMP) -2 C735T and MMP-9 C1562T polymorphisms and TOAST subtypes, the outcome in patients with stroke. Methods A total of 232 patients with ischemic stroke were divided into large artery atherosclerosis (LAA, n =37), cardioembolism (CE, n =31), small artery occlusion (SAO, n =65) stroke, stroke of other demonstrated etiology (SOE, n =2), and stroke of undemonstrated etiology (SUE, n =97) according to TOAST criteria. A total of 235 healthy subjects in the outpatient served as control. Genetic polymorphisms of MMP-2 C735T and MMP-9 C1562T were identified by polymerase chain reaction-restriction fragment length polymorphism.The outcome of patients was evaluated with Barthel Index (BI) at day 21 and 90 after stroke.Results The frequencies of MMp-2 735CC genotype and C allele in the ischemic stroke group (CC genotype: 63.36％ vs. 54.04％,x2 =4. 182, P=0.014; C allele: 79.31％vs. 74.04％,x2 =3. 936, P =0. 047 ) and its LAA subtype ( CC genotype: 78. 37％ vs. 54. 04％, x2 =7. 740, P =0. 005; C allele: 87. 83％ vs. 74. 04％, x2 =6. 655, P =0. 01 ) were significantly higher than those in the control group. The frequencies of MMP-9 1562CT +TT genotype and T allele in the ischemic stroke group (CT +TT genotypes: 21.98％ vs. 13. 19％,x2 =6. 233, P=0.013; T allele: 11.64％ vs. 7. 02％ ,x2 =5. 891, P =0. 015)and its LAA subtype(CT +TT genotypes: 32. 43％ vs. 13. 19％ ,x2 =8. 892, P =0. 003; T allele: 20. 27％ vs. 13.19％ ,x2 =13. 950, P =0. 000). Multivariate logistic regression analysis indicated that risk of ischemic stroke and its LAA subtype with MMP-2 735CC genotype (ischemic stroke: odds ratio [OR]1.099, 95％ confidence interval [CI] 1.038-1.260, P =0.028; LAA: OR 1.360, 95％ CI 1. 167-5. 774, P =0. 009) and with MMP-9 1562TT genotype (ischemic stroke: OR 9. 409,95％ CI 1. 154-76. 722, P =0. 036; LAA: OR 8. 962, 95％ CI 1. 380-58. 218, P =0. 022)increased significantly. There were no significant correlation between the different genotypes of MMP-2 and MMP-9 and the outcome of ischemic stroke. Conclusions Polymorphisms of MMP-2 C735T and -9 C1562Tare associated with ischemic stroke and its subtype large artery atherosclerotic stroke, but not associated with the outcome in patients with ischemic stroke
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BACKGROUND: A new method, i.e., heparin slow-release stent implantation combined with myocardium drilling, is discovered for myocardial revasculadzation, which remarkably improves myocardial perfusion. OBJECTIVE: To investigate the effect of heparin slow-release stent implantation combined with myocardium drilling on myocardial regeneration of pigs with acute myocardial infarction.METHODS: Anterior descending coronary of pig was ligated to induce myocardial infarction model, which was randomly divided into control and implantation groups, with 6 pigs for each group. Self-made borer was used in the implantation group to drill two transmural channels (3.5 mm diameter) on epicardium. A heparin slow-release stent was fixed in the transmural channel. Following intravenous injection, BrdU was used to label DNA duplication so as to observe stromal cell-derived factor-1 (SDF-1) mRNA expression, myocardial perfusion, newborn yocardium, and heart function prior to and following implantation. RESULTS AND CONCLUSION: As compared with control group, SDF-1 expression was enhanced in the implantation group at 6 weeks after stent implantation (P < 0.001), perfusion mass defect percentage was significantly decreased (P < 0.001), ejection fraction of left ventricle was increased (P < 0.05), newborn myocardium was increased (P< 0.001), and survival myocardium in the ischemic region was increased (P < 0.001). The results demonstrated that heparin slow-release stent implantation combined with myocardium drilling could repair damaged myocardial cells and improve heart function through increasing SDF-1 expression and myocardial perfusion.
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@#Objective To investigate the needs of rehabilitation in people with physical disability in Beijing.Methods 2390 Beijing physical disabled persons surveyed in the Second China National Sample Survey on Disability were involved,their rehabilitation condition and requisition were evaluated.Results 54.85% of them needed rehabilitation in institute,38.20% need rehabilitation in community and family,6.95% need extend service.41.06% need medicine service,30.70% need rehabilitation training,28.24% need assistance articles and utensils.Conclusion There are huge rehabilitation requisitions of physical disability in Beijing,which must be met with various approaches.
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Objective: To observe the clinical therapeutic effect of medium frequency electro-stimulant for dysphagia in acute cerebral arterial thrombosis. Methods: 80 patients with dysphagia after cerebral arterial thrombosis were randomly divided into therapy group and control group. The clinical medication of two groups was identical. The ice-stimulation was used in control group and medium frequency electric stimulation in therapy group respectively. The amelioration of dysphagia was observed after one month. Results: The cure rate of therapy group was 35% and the total effective rate was 90%. Compared with the control, the difference was significant. Conclusion: Medium frequency electric stimulation is a available, convenient and safe method for therapy the dysphagia in cerebral arterial thrombosis, which can be recommended in clinical.
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Objective:To observe the effect of Schisandra Chinensis Baill distilled by ethanol on energy metabolism in brain of repeated cerebral ischemia-reperfusion model mice.Method:The mice were randomly divided into six groups,respectively irrigating the groups of Nimodipine suspension,ginkgo leaf suspension,and large and small doses of Schisandra Chinensis Baill distilled by ethanol,sham group(blank) and the model group for the same volume of saline,once a day,15 days for delivery.Model mice of cerebral ischemia-reperfusion injury was established by bilateral common carotid artery blocking.48 hours after operation,the rats were decapitated,weight half of the brain and put 9 times saline into it,then the level of LD,vitality of LDH,AchE and ATP were measured.Results:Compared with model group,small doses of Schisandra Chinensis Baill distilled by ethanol could markedly reduce the content of LD of mice of repeated cerebral ischemia-reperfusion,large doses of Schisandra Chinensis Baill distilled by ethanol could notably improve the vitality of LDH;large and small doses of Schisandra Chinensis Baill distilled by ethanol could both notably improve the vitality of AchE,large doses of Schisandra Chinensis Baill distilled by ethanol could notably improve the vitality of Na+-K+-ATP、Ca2+-ATP.Conclusion:Schisandra Chinensis Baill distilled by ethanol could markedly improve the energy metabolism of the model of repeated cerebral ischemia-reperfusion of mice.