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Objective:To explore the clinical value of peripheral blood lymphocyte subsets in the differential diagnosis of BK virus nephropathy (BKVN) in renal transplantation recipients.Methods:From 2014 to 2018, a total of 172 renal transplant recipients were recruited. Their peripheral blood lymphocyte subsets were detected. According to the pathological puncture results of transplanted kidney, they were divided into acute rejection group (AR, n=68), BKVN group ( n=73) and stable graft function group (STA, n=31). The proportion and absolute number of peripheral blood lymphocyte subsets in each group were measured by flow cytometry and the proportion and absolute count of peripheral blood lymphocyte subsets in each group compared. Results:The proportion and absolute number of CD19 + B cells were markedly lower in BKVN group than those in AR group ( P=0.005, 0.003; 8.5% vs 13.2%, 0.094×10 9/L vs 0.202×10 9/L) and STA group ( P=0.005, 0.003; 8.5% vs 14.8%, 0.094×10 9/L vs 0.198×10 9/L); the proportion of CD3 + CD8 + T cells was significantly higher in BKVN group than that in AR group ( P=0.013; 36.9% vs 31.2%). In addition, no obvious difference existed in the proportion and absolute number of lymphocytes, CD3 + T, CD3 + CD4 + T and CD16 + CD56 + natural killer (NK) among three groups ( P>0.05). No obvious difference existed in the proportion of CD3 + CD4 + / CD3 + CD8 + T cells among three groups ( P>0.05). Conclusions:No difference exists in T cell-related lymphocyte subsets between BKVN and acute rejection recipients. However, the number and proportion of CD19 + B cells decrease markedly in BKVN.
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Objective:To resolve the issue of poor automatic segmentation of the bowel in women with pelvic tumors, a Dense V-Network model was established, trained and evaluated to accurately and automatically delineate the bowel of female patients with pelvic tumors.Methods:Dense Net and V-Net network models were combined to develop a Dense V-Network algorithm for automatic segmentation of 3D CT images. CT data were collected from 160 patients with cervical cancer, 130 of which were randomly selected as the training set to adjust the model parameters, and the remaining 30 were used as test set to evaluate the effect of automatic segmentation.Results:Eight parameters including Dice similarity coefficient (DSC) were utilized to quantitatively evaluate the segmentation effect. The DSC value, JD, ΔV, SI, IncI, HD (cm), MDA (mm), and DC (mm) of the small intestine were 0.86±0.03, 0.25±0.04, 0.10±0.07, 0.88±0.05, 0.85±0.05, 2.98±0.61, 2.40±0.45 and 4.13±1.74, which were better than those of any other single algorithm.Conclusion:Dense V-Network algorithm proposed in this paper can deliver accurate segmentation of the bowel organs. It can be applied in clinical practice after slight revision by physicians.
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Objective To evaluate the accuracy and validate the feasibility of auto-segmentation based on self-registration and Atlas in adaptive radiotherapy for cervical cancer using MIM-Maestro software.Methods The CT scan images and delineation results of 60 cervical cancer patients were obtained to establish the Atlas template database.The planning CT (pCT) and replanning CT (rCT) images were randomly selected from 15 patients for the contouring of clinical target volume (CTV) and organs at risk (OAR) by an experienced radiation oncologist.The rCT images of 15 patients were auto-contoured using Atlas-based auto-segmentation (Atlas group),and mapping contours from the pCT to the rCT images was performed by rigid and deformable image registration (rigid group and deformable group).The time for the three methods of auto-segmentation was also recorded.The similarity of the auto-contours and reference contours was assessed using dice similarity coefficient (DSC),overlap index (OI),the average hausdorff distance (AHD) and the deviation of centroid (DC),and the results were statistically compared among three groups by using one-way analysis of variance.Results The mean time was 89.2 s,22.4 s and 42.6 s in the Atlas,rigid and deformable groups respectively.The DSC,OI and AHD for the CTV and rectum in the rigid and deformable groups significantly differed from those in the Atlas group (all P＜0.001).In the rigid and deformable groups,the OI for the intestine significantly differed from that in the Atlas group.The mean DSC for CTV was 0.89 in the rigid and deformable groups,and 0.76 in the Atlas group.The optimal delineation of the bladder,pelvis and femoral heads was obtained in the deformable group.Conclusions AIl three methods of auto-segmentation can automatically and rapidly contour the CTV and OARs.The performance in the deformable group is better than that in the rigid and Atlas groups.
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Objective To discuss and evaluate the dosimetric characteristics of different plans implementing stereotactic radiotherapy(SRT)for intracranial tumors using Fixed and Iris collimators of CyberKnife VSI.Methods Twenty patients with intracranial tumors were selected and divided into group A with a small target volume(≤30 cm3)and group B with a large target volume(≥30 cm3). There were 10 patients in each group,and the prescribed dose to the target was 21 Gy in 3 fractions. For each patient, two treatment plans were designed using Fixed and Iris collimators. By analyzing the dosimetric parameters such as conformity index(CI),homogeneity index(HI), gradient index(GI), gradient score index(GSI), and organs at risk (OAR),the quality and efficiency of the plans were evaluated in order to discuss the beam characteristics for two sets of collimators. The difference was analyzed with the paired t-test. Results The mean time of Iris plan for delivering was significantly less than that of Fixed plan(group A:P=0.001;group B:P=0.000). In group B,the peripheral dose(20% and 10% of the prescribed dose)volumes of Fixed plan were significantly less than those of Iris plan(P=0.001 and 0.009). For OAR,D minof the visual pathway and D meanor D minof the eyeball in group B were significantly different between Fixed and Iris plans(all P<0.05), while in group A, only D minof the optic chiasm was significantly different between the two plans(P=0.043). For the other parameters of targets,there were no significant differences between Fixed and Iris plans in both groups(all P>0.05). Conclusions Apart from less treatment time in the Iris plan, there are no significant dosimetric differences between the two collimator plans of CyberKnife VSI in treating small intracranial tumor. For the large and complex tumor,although Iris plan meets the requirement for OAR dose constraints,its low-dose volumes are larger than those of Fixed plan. Further studies of the dosimetric characteristics in CyberKnife should be done.
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Objective To investigate the dosimetric feasibility of volumetric modulated arc therapy (VMAT)with a simultaneous integrated boost(SIB-VMAT58.75 Gy)for preoperative chemoradiotherapy in patients with locally advanced rectal cancer(LARC),and to provide a basis for clinical practice.Methods Nine patients with stage Ⅱ-Ⅲ rectal cancer who underwent preoperative concurrent chemoradiotherapy were involved in the study,and two plans were performed for each patient:SIB-VMAT58.75 Gy and VMAT50.00 Gy. For the SIB-VMAT58.75 Gy plan,the prescribed dose was 58.75 Gy(2.35 Gy/fraction)for the local rectal tumor and positive lymph nodes(GTV 58.75 Gy),and 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)(PTV 50Gy).For the VMAT50.00 Gy plan,the prescribed dose was 50 Gy(2 Gy/fraction)for the regions at high risk of harboring microscopic disease(pelvic lymphatic drainage area)without a boost. The conformity index(CI),homogeneity index (HI),and dose for target areas and organs at risk(OAR)were assessed according to the dose-volume histogram. The paired t-test or nonparametric rank test was used to compare the differences between the two plans. Results Both plans met the prescription goal for PTV dose coverage. There was no significant difference in CI for the PTV between the two plans(1.0±0.0 vs. 1.0±0.0,P>0.05).The SIB-VMAT58.75 Gy plan had a worse HI than the VMAT50.00 Gy plan(0.2± 0.2 vs. 0.1± 0.0,P<0.05).There was no significant difference in V10-V50of the small intestine,bladder,femoral heads,and pelvis between the two plans(P>0.05),but D 2 cm3of the small intestine was significantly higher in the SIB-VMAT58.75 Gy plan than in the VMAT50.00 Gy plan(P=0.038). Conclusions The SIB-VMAT58.75 Gy plan for LARC achieves required target volume dose coverage and OAR dose constraints,which is safe and feasible in terms of dosimetry,and its clinical efficacy and adverse effects need further evaluation.
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@#Objective To compare the comprehension and input skills of Chinese characters among children with physical disability, autistic disorder and intellectual disabilities. Methods From December, 2008 to July, 2016, 125 children with disabilities aged 7-14 years were evaluated with International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) functional examination list, and then they received comprehension and input skill training of Chinese characters under CKC Input Scheme. Results There was various dysfunction in comprehension and input skills among children with different disabilities. 70% children improved in Chinese characters input after training. Conclusion It is needed to construct a stage-based, individualized and continuous training approach to promote computer-based learning.
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Objective To compare the features of activity and participation difficulty of children with cerebral palsy, intellectual disabili-ty and autism. Methods 42 children with cerebral palsy, intellectual disability, and autism aged 3-6 years were evaluated with ICF-CY Ques-tionnaire. Results There were mild barriers in the domains of learning and applying knowledge, communication, mobility, self-care, domes-tic life and major life areas, and the moderate barriers in the domains of general tasks and demands, interpersonal interactions and relations. There were more barriers in learning and applying knowledge in children with cerebral palsy and intellectual disability than those with au-tism. Conclusion There are various features in activity and participation difficulty in children with cerebral palsy, intellectual disability or autism, which required diversity of educational rehabilitation strategies.
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@#Objective To compare the features of activity and participation difficulty of children with cerebral palsy, intellectual disability and autism. Methods 42 children with cerebral palsy, intellectual disability, and autism aged 3-6 years were evaluated with ICF-CY Questionnaire. Results There were mild barriers in the domains of learning and applying knowledge, communication, mobility, self-care, domestic life and major life areas, and the moderate barriers in the domains of general tasks and demands, interpersonal interactions and relations. There were more barriers in learning and applying knowledge in children with cerebral palsy and intellectual disability than those with autism. Conclusion There are various features in activity and participation difficulty in children with cerebral palsy, intellectual disability or autism, which required diversity of educational rehabilitation strategies.
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Objective To compare the influence of propofol combined with sufentanil or remifentanil on the quality of wake-up during scoliosis surgery by wake-up test.Methods Fifty pa-tients undergoing scoliosis surgery were randomized into two groups.During the surgery,propofol combined with sufentanily 0.3-0.6 μg·kg-1·h-1 (group SF)or remifentanil 0.2-0.3 μg·kg-1·min-1 (group RF)were continuously infused to maintain anesthesia,and BIS was maintained at 40-60.In wake-up test,the infusion of sufentanyl in group SF was paused and,the infusion rate of remifentanil in group RF was adjusted to 0.05 μg·kg-1·min-1 until the patient completed the wake-up test under instruction.The time that spontaneous breathing occurred,body movement was detected and the capa-bility to follow instructions in both two groups were recorded.MAP,HR,PET CO2 were measured at the time 10 min after medication adjustment (T1 ),waking up(T2 )and 10 min after waking up (T3 ), respectively,in both two groups.Wake-up quality was also recorded.Results The time that sponta-neous breathing occurred,body movement was detected and the capability to follow instructions in group RF were significantly shorter than those in group SF (P <0.05).At T2 the incidence of agita-tion in group RF was significantly higher than that in group SF(P <0.05).And the hemodynamics of group SF were more stable than those of group RF (P <0.05).Conclusion Propofol combined with sufentanil can improve wake-up quality during scoliosis surgery,but the wake-up time is relatively lon-ger.
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Objective To clarity the role of VEGF and its receptors in laryngeal squamous cell carcinoma development and metastasis. Methods The protein and mRNA expression of VEGF and its receptors (Fit-1 and KDR) were examined by Western-blotting and semiquantitative reverse transcriptase polymerase chain reaction analysis in laryngeal squamouse cell carcinoma (20 specimens) and the adjacent non-neoplastic laryngeal tissues (18 specimens). Results The protein and mRNA expression levels of VEGF and its receptors(Fit-1 and KDR) were more abundant in laryngeal squamous cell carcinoma than that in the adjacent non-neoplastic laryngeal tissues (ordedy 4.32±2.21, 2.00±0.91. 1.20±0.55, 0.29~0.31. 2.50±1.69, 0.85±0.28. P<0.01). The expression of VEGF and its receptors(Fit-1 and KDR) in laryngeal squamous cell carcinoma was significantly higher in lymph node positive group than that in lymph node negative group (P<0.01 or P<0.05). Positive correlation was observed between VEGF and KDR in the laryngeal squamouse cell carcinoma and adjacent non-neoplastic laryngeal tissues (P<0.01). There was no correlation between VEGF and Fit-1 expression(P>0.05). Conclusion The intense expression of VEGF, Fit-1 and KDR in laryngeal squamous cell carcinoma provides strong evidence linking VEGF, Fit-1 and KDR expression to the angiogenesis associated with laryngeal squamous cell carcinoma. The positive correlation between VEGF expression and KDR expression clearly demonstrates that KDR is the main signaling receptor for VEGF in laryngeal squamouse cell carcinoma. The VEGF/KDR system plays a functional role in the progression of laryngeal squamous cell carcinoma.
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Objective To explore the effect of VEGF-C,VEGFR-3 gene in primary culture in vitro of laryngeal squamous carcinoma tissue by dexamethasone (DEX). Methods Applying the technique of Drimary tissue cuiture in vitro,twelve specimens,which were identified pathologically as laryngeal squamous cell carcinoma,were cultured.After succeeded culture of twelve specimens,the cells were divided in to two groups.One continued to cuhum,another gave 10-7 mol/L of DEX.VEGF-C and VEGFR-3 gene express in 12 cases of cell were examined by reverse transcription polymerase chain reactions(RT-PCR).Results The frequency of VEGF-C(83%) and VEGFR-3(58%) in primary culture in wtro of laryngeal squamous carcinoma tissue were higher than that of the primary culture in vitro of laryngeal squamous carcinoma tissue by dexamethasone (DEX) (25%,8%P＜0.05).Conclusion The expressions of VEGF-C and VEGFR-3 in Drimary culture in vitro of laryngeal squamous carcinoma tissue by DEX are decreased.It may provide guide to apply DEX in clinic laryngeal squamous carcinoma chemotherapy and laryngeal squamous carcinoma laryngeal obstruction.
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We investigated the inhibitory effect of autologous sera on erythroid colony forimation(CFU-E) of bone marrow cells from patients with chronic renal failure and the clinical effect of recombinant erythropoietin, Colonies formed in cultures using autologous serum(AS) decreased in 15 cases as compared with those using fetal calf serum(FCS). This inhibitory effect of autologous sera was diminished by treatment with activated charcol in all these cases. The degree of hemoglobin increase after administration of recombinant erythropoietin appeared to correlate with the intensity of inhibitory activity of AS, These data indicate the clinical significance of an inhibitor(S) of erythropoiesis in uremic sera and suggest that the clinical effects of erythropoietin in this disease are further improved if the inhibitor(s) can be effectively removed.
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The observation was carried out on the effects of "Sheng Xue Wan" (pills for promoting the production of blood ) upon the rat colony forming unit--spleen, (CFU-S), colony forming unit--diffusion chamber (CFU-D) and colony forming unit--that responds to erythropoietin(CFB-E)with the extrinsic culture of splenetic colony, the intrinsic culture in medium of a diffusion chamber and the intrinsic plasma clotting. The results of our experiments indicated that "Sheng Xue Wan" has a stimulating action on the multiplication of the rat CFU-S, CFU-D and CFU-E. Thus, we infer that the mechanism of the drug used to treat aplastic anemia might be related to the effect of "Sheng Xue Wan" upon the hematopoietic stem cell.