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Objective:To analyze the dosimetric differences of volumetric modulated arc therapy (VMAT) plans for lung cancer caused by different dose calculation algorithms and radiation field settings and thus to provide a reference for designing clinical VMAT plans for lung cancer.Methods:This study randomly selected 20 patients with lung cancer and divided them into four groups of VMAT plans, namely, a group adopting two fields and two arcs based on the AAA algorithm (2F2A_AAA), a group employing two fields and two arcs based on the AXB algorithm (2F2A_AXB), a group using two fields and two arcs based on the MC algorithm (2F2A_MC), and a group adopting one field and two arcs based on the MC algorithm (1F2A_MC). Then, this study evaluated the target coverage, high-dose control, dose homogeneity index (HI), conformity index (CI), and organs at risk (OARs) of the plans using different algorithms and radiation field settings.Results:The planning target volume (PTV) results of two fields combined with two arcs (2F2A) of three groups using different algorithms are as follows. 2F2A_MC achieved better results in both D1% and V 95% (the relative volume of the target volume surrounded by 95% of the prescribed dose) of planning gross target volume (PGTV) than 2F2A_AAA (D1%: t=-2.44, P=0.03; V95%:z=-2.04, P=0.04) and 2F2A_AXB (D1%: t=2.34, P=0.03; z=-3.21, P < 0.01). 2F2A_AXB outperformed 2F2A_AAA ( z=-3.66, P < 0.01) and was comparable to 2F2A_MC in terms of the CI of PGTV. Regarding OARs, 2F2A_AXB and 2F2A_MC decreased the V5 Gy of the whole lung by 0.68% ( z=-2.69, P=0.01) and 3.05% ( z=-3.52, P < 0.01), respectively compared to 2F2A_AAA. 2F2A_AXB achieved a whole-lung Dmean of 1776.44 cGy, which was superior to that of 2F2A_MC ( t=2.67, P=0.02) and 2F2A_AAA ( t=8.62, P < 0.01). Compared to 2F2A_AAA and 2F2A_MC, 2F2A_AXB decreased the V20 Gy of Body_5 mm by 1.45% ( z=-3.88, P < 0.01) and 2.01% ( z=-3.66, P < 0.01), respectively. The results of the two groups with different field settings showed that 1F2A_MC was superior to 2F2A_MC in both the CI of PTV1 and the HI of PTV2 (CI: t=2.61, P=0.02; HI: z=-2.20, P=0.03). Moreover, 1F2A_MC increased the Dmean of the whole lung by 26.29 cGy compared to 2F2A_MC ( t=2.28, P=0.04). Conclusions:Regarding the design of VMAT plans for lung cancer, the MC algorithm is suitable for the target priority and the AXB algorithm is suitable for the OAR priority. When only the MC algorithm is available, it is recommended to choose 1F2A in the case of target priority and select 2F2A in the case of OAR priority.
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Objective To identify the risk factors for postoperative short-term cognitive dysfunction ( STCD) in the patients undergoing carotid endarterectomy. Methods A total of 158 patients with carotid artery stenosis, aged≥18 yr, without preoperative cognitive dysfunction, undergoing carotid endarterecto-my from January 1, 2014 to May 30, 2017 in our hospital, were selected. Factors including age, sex, height, weight, education, presurgical complications ( hypertension, type Ⅱ diabetes mellitus, myocar-dial infarction and brain infarction) , degree of internal carotid artery stenosis, preoperative mean arterial pressure ( MAP ) , amount of dexmedetomidine, duration of operation, time of carotid artery occlusion, MAP during occlusion period, intraoperative volume of fluid infused ( crystalloid solution and colloid solu-tion), urine volume, blood loss, significant change in electroencephalogram (EEG) and visual analogue scale scores at 24 h after surgery were collected. Mini-Mental State Examination was used to evaluate the cognitive function at 24 h after surgery. The patients were divided into STCD group and non-STCD group ac-cording to whether or not patients developed postoperative STCD. The risk factors of which P values were less than 0. 05 would enter the bivariate logistic regression analysis to stratify the risk factors for postopera-tive STCD. Results Forty-nine patients developed postoperative STCD ( 31. 0％) . The intraoperative a-mount of colloid solution infused＜5 ml/kg, increase in MAP＜20％ of the baseline value during the occlu-sion period, and significant change in EEG during the occlusion period were independent risk factors for postoperative STCD ( P＜0. 05) . Conclusion The intraoperative amount of colloid solution infused＜5 ml/kg, increase in MAP＜20％ of the baseline value during the occlusion period, and significant change in EEG during the occlusion period are independent risk factors for postoperative STCD in the patients undergo-ing carotid endarterectomy.
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Objective To explore the application effect of Case-Based Learning(CBL) teaching mode based on WeChat public platform in nursing practice teaching in operating room. Methods From July 2016 to June 2018, 132 nursing students in the operating room of Shengjing Hospital of China Medical University were selected as experimental subjects. They were randomly divided into the traditional teaching group (control group, from July 2016 to June 2017) and WeChat public platform combined with CBL group (experimental group, from July 2017 to June 2018 ). On the basis of traditional teaching and based on the WeChat public platform, the experimental group were sent the content of the CBL case based on the syllabus of the courses to students one week before the internship. At the end of the teaching, a theoretical written examination and skill operative quiz were performed to assess the effects of teaching and satisfaction of the subjective learning experience. Results The scores of the theoretical and basic skills of the experimental group were (42.33 ± 8.26) and (45.17 ± 6.79) points, respectively. The control group was (37.28 ± 7.70) and (39.23 ± 5.43) points, respectively. The difference between the two groups was statistically significant (t=2.289 , 2.150, P<0.05). The overall satisfaction of the experimental group was 90.90％ (60/66), and the overall satisfaction of the control group was 57.58％ (38/66). The difference between the two groups was statistically significant (χ2=6.339, P <0.05). Conclusions The WeChat public platform assisted CBL teaching model in the operating room nursing practice improved the learning efficiency, helped to deepen understanding, and can be adopted gradually in large teaching hospitals for clinical practical teaching of operation room for nursing students.
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A novel electrochemiluminescence ( ECL) method for the determination of L-cysteine ( L-Cys) was established. water-soluble CdS quantum dots ( QDs) with Cd2+rich surface were synthesized via a controllable one-poe approach. The mercapto group in L-cysteine molecule can specifically interact with excessive Cd2+on the surface of CdS QDs, resulting in enhancement of ECL intensity of the CdS QDs, which can be used for the detection of L-Cys. Under the optimal experimental conditions, the enhancement of ECL intensity was linear with the concentration of L-Cys in the range of 5. 0×10-9-1. 0×10-5 mol/L. The limit detection of (S/N=3) was 1. 2×10-9 mol/L. In comparison with other methods for detecting L-Cys, this method is more simple and selective, and can be applied to detect L-Cys in real sample with satisfactory results.
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Objective:To determine the effects of Foxp3-overexpressing lung cancer cells on activated CD4+T lymphocyte.Methods: Stable Foxp3-overexpressing lung cancer cells NCIH-1299,NCIH-hFoxp3,was generated by transfection of NCIH-1299 cells with plasmid pcDNA3-hFoxp3 mediated by Lipofectamine 2000 and by selection with G418,and validated by quantitative PCR and Western blot.The expression levels of IL-8 and IL-10 secreted by NCIH-hFoxp3 and NCIH-control were measured by ELISA.IL-2 secrection by activated human CD4+T lymphocyte which was tested after stimulation with 20% conditioned medium of NCIH-hFoxp3 and NCIH-control cells.The proliferation of activated human CD4+ T lymphocytes was assessed by MTT after coculture with NCIH-hFoxp3 cells.The adhesive ability of activated human CD4+ T lymphocytes was probed with NCIH-hFoxp3 cells by immunocytochemistry.Results: Compared with NCIH-control cells,NCIH-hFoxp3 secreted high level of IL-10 and low level of IL-8.NCIH-hFoxp3 with Foxp3 overexpression significantly suppressed the proliferation,adhesive potential and IL-2 expression by activated CD4+ T cells.Conclusion: Suppression of immune activities of activated CD4+ T cells by Foxp3 overexpression in lung cancer cells may correlate with cytokine IL-8 and IL-10,which can contribute lung cancer progression.
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Objective To perform a preclinical test of a delineation software based on atlas-based auto-segmentation (ABAS),to evaluate its accuracy in the delineation of organs at risk (OARs) in radiotherapy planning for nasopharyngeal carcinoma (NPC),and to provide a basis for its clinical application.Methods Using OARs manually contoured by physicians on planning-CT images of 22 patients with NPC as the standard,the automatic delineation using two different algorithms (general and head/neck) of the ABAS software were applied to the following tests:(1) to evaluate the restoration of the atlas by the software,automatic delineation was performed on copied images from each patient using the contours of OARs manually delineated on the original images as atlases;(2) to evaluate the accuracy of automatic delineation on images from various patients using a single atlas,the contours manually delineated on images from one patients were used as atlases for automatic delineation of OARs on images from other patients.Dice similarity coefficient (DSC),volume difference (Vdiff),correlation between the DSC and the volume of OARs,and efficiency difference between manual delineation and automatic delineation plus manual modification were used as indices for evaluation.Wilcoxon signed rank test and Spearman correlation analysis were used.Results The head/neck algorithm had superior restoration of the atlas over the general algorithm.The DSC was positively correlated with the volume of OARs and was higher than 0.8 for OARs larger than 1 cc in volume in the restoration test.For automatic delineation with the head/neck algorithm using a single atlas,the mean DSC and Vdiff were 0.81-0.90 and 2.73％-16.02％,respectively,for the brain stem,temporal lobes,parotids,and mandible,while the mean DSC was 0.45-0.49 for the temporomandibular joint and optic chiasm.Compared with manual delineation,automatic delineation plus manual modification saved 68％ of the time.Conclusions A preclinical test is able to determine the accuracy and conditions of the ABAS software in specific clinical application.The tested software can help to improve the efficiency of OAR delineation in radiotherapy planning for NPC.However,it is not suitable for delineation of OAR with a relatively small volume.
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Objective:To determine the effects of enforced expression of Foxp3 in lung cancer cell with regards to proliferation and tumorgeneity. Methods: A stable subline NCIH-hFoxp3 was established by liopfectamin-mediated pcDNA plasmid transfection carrying exogenous hFoxp3. The growth curve and secrection of IL-8 and IL-10 of NCIH-hFoxp3 were evaluated using MTT and ELISA, respectively. The in vivo tumorigeneity was assessed as well by inoculation of NCIH-hFoxp3 subcutaneously in nude mice. Results:Lung cancer cell NCIH-hFoxp3 with enforced expression of Foxp3 proliferated slowly but exihited increased in vivo tumorgeneity compared with corresponding control subline. In addition,increased expression of hFoxp3 in NCIH-hFoxp3 augmented secretion and at-tenuated secretion of IL-8 and IL-10,respectively. Conclusion:Increased expression of Foxp3 may promote progression of lung cancer cell by change of cellular microenvironment and evasion of immune surveillance.
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Objective To define the nuclear agrresome formation is determinated by which part of the UL76 of HCMV. Full-length, conserved N terminal and unconserved C terminal of pUL76 were constructed to eukaryotic ex-pression plasmid pEGFP-N1 . Methods Primers were designed to amplify full-length and different part of pUL76 according to standard sequence of HCMV AD169 which had been submitted to GenBank(FJ527563. 1). These frag-ments were constructed to eukaryotic expression plasmid pEGFP-N1 . The recombinant plasmids were designated pEGFP-UL76,pEGFP-UL76N, pEGFP-UL76C respectively. Double digestion and sequencing were performed to verify the accuracy of recombinant plasmids construction. Empty vector and three recombinant plasmids were transi-ent transfected to HELF and HepG-2 cells respectively. Reverse transcriptation PCR and Western blot were per-formed to detect the RNA and protein expression level respectively. Different nuclear aggresome formations were visualized with an Olympus fluorescence microscopy. Results pEGFP-N1 and pEGFP-UL76N were unable to in-duce nuclear aggresome formation, whereas pEGFP-UL76 and pEGFP-UL76C were able to elicit nuclear aggresome formation. Conclusion The unconserved C terminal of pUL76 is sufficient to induce nuclear aggresome formation.
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Objective To analyze the distribution of various genotypes of human cytomegalovirus glycoprotein N ( HCMV gN) in patients with HIV infection; to investigate the effects of HCMV-HIV co-in-fection on disease progression and the relationships between HCMV gN genotypes and disease progression. Methods Patients with active HCMV infection were screened out from 359 patients with HIV infection by using the pp65 antigenemia assay.The genes encoding HCMV gN ( UL73 ) were amplified by nested PCR ( nPCR) .The amplicons were digested by restriction enzymes including MboⅠ, ScaⅠ and SalⅠ.Then, the restricted fragment length polymorphisms were further analyzed on 4%agarose gel.The relationships be-tween HCMV genotypes and the morbidity and mortality of acquired immune deficiency syndrome ( AIDS ) were investigated via a prospective study.Results Among the 359 patients with HIV infection, 28 subjects were positive for the HCMV pp65 antigenemia assay.The HCMV gN genotypes in 20 patients with active HCMV infection were distributed as: gN-3a (4/20, 20%), gN-1 (4/20, 20%), gN-4d (1/20, 5%), gN-4b (1/20, 5%) and mixed infection (10/20, 50%).Patients with HCMV-HIV co-infection were more likely to develop AIDS during the follow-up period (RR=9.78).Patients harboring HCMV gN-1 and gN-4 genotypes would seem likely to have 4.6 times of chance leading to AIDS-associated death than those harbo-ring other HCMV gN genotypes.Conclusion HCMV infection ( especially gN-1 and gN-4 genotypes) might accelerate the progression of HIV infection.
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Objective To explore the effects of extracellular regulated protein kinase 1/2 (ERK1/2) signal pathway on cardiomyocyte apoptosis and tumor necrosis factor-α (TNF-α) expression at different glucose-lowing rates,and the influence of glucose-lowing rate on cardiomyocyte injury and inflammatory secretion function,as well as its mechanism.Methods Cardiomyocytes of Wistar neonate rat were maintained in medium supplemented with 25 mmol/L glucose for 72 h.Then the medium was changed to different concentrations of glucose and all cells were divided into five groups.Group A was control group whose medium supplemented with 25 mmol/L glucose.Medium of group B,C,D,E was supplemented with 20,15,10,5 mmol/L glucose (glucose-lowing rate was 5,10,15,20 mmol/L) respectively.Survival rate of cardiomyocyte was measured by CCK8 kit.Cardiomyocyte apoptosis was measured by flow cytometry instrument and laser confocal microscope after Annexin V-PI.TNF-α was measured by ELISA.ERK1/2 protein and phosphorylation were measured by Western blot.Cardiomyocyte apoptosis and TNF-α levels were measured again after U0126 was added.Results At the same time point,along with the glucose-lowing rate increased,survival rate of cardiomyocyte in group A was increased and those in group C,D,E were decreased (P＜ 0.05).TNF-α concentration was increased in group B,C,D and decreased in group E.After 24 h,apoptosis rate decreased in group B and increased in group C,D,E (P＜0.05).ERK1/2 phosphorylation level increased in group B,D,and E(P＜0.05).The ERK1/2 phosphorylation level in group B was the lowest.After U0126 was added,survival rates of cardiomyocyte in all groups were increased (P＜0.01) while TNF-α concentrations were decreased (P＜0.05).In every group,survival rate of eardiomyocyte after 48 h was lower than that after 3 h and 24 h,while TNF-α concentration was higher (P＜0.05).Conclusion Influence of glucose-lowering rate for cardiomyocyte apoptosis and TNF-o is caused by ERK1/2 pathway.In the glucose-lowering course,ERK1/2 pathway promotes cardiomyocytes apoptosis and TNF-α secretion is related with not only osmotic pressure,but also ERK1/2 signal pathway activation as well.
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Objective To investigate the effects of human cytomegalovirus ( HCMV) persistent in-fection on the central nervous system of BALB/c mice.Methods Thirty specific-pathogen-free mice of 6-8 weeks old were randomly divided into three groups including HCMV infected group , inactivated HCMV group and human embryo fibroblast ( HF) control group .Each mouse in the three groups was intraperitoneally inoc-ulated with 1.8 ×107 PFU of HCMV, 1.8 ×107 PFU inactivated HCMV and 1 ×105 HF cells, respectively. All mice were housed in microisolator cages for three months and their behavior and body weight were ob -served.Then three tests including autonomic activities test , Morris Water Maze and step-down passive avoid-ance task were performed on all mice to evaluate the changes of their behavior .Cerebral cortex tissues were collected from all mice to detect HCMV and to conduct polymerase chain reaction (PCR) analysis.Brain tis-sues were stained by HE method to evaluate the pathological damages .Transmission electron microscope was used to observe the ultrastructure of neuron cells and the existence of virus particles .Results (1) The body weight of mice showed no significant differences among the three groups ( P>0 .05 ) .( 2 ) The frequency of autonomic activities were decreases in HCMV infected group in comparison with other two groups , but there was no significant differences among the three groups (P>0.05).(3)The place navigation test demonstra-ted that the escape latency of mice from HCMV infected group as well as HF group showed significant differ -ence after training for different periods of time (P0.05).Compared with the mice in two control groups , the mice in HCMV infected group showed a lower frequency of crossing the quadrant where the platform had been located on pre -vious trials in the probe trial test (P<0.05).Moreover, the time of first crossings was also longer than that of mice from two control groups (P<0.05).(4)In the learning phase the mice from HCMV infected group showed a high frequency of mistakes in comparison with that from two control groups in step -down passive avoidance task (P<0.05).After 24 hours, the frequency of mistakes was decreased in each group , and the differences were significant (P<0.05).The latency was very shorter in mice from HCMV infected group than that observed in two control groups (P<0.05).(5)The HCMV infection was identified in six mice from HCMV infected group .And the positive HCMV UL83 gene could be only detected in HCMV infected group as indicated by PCR analysis .(6)The pathological changes including cell swelling , loosen cytoplasm, decreased cell layers and vacuolization were observed in the cerebral cortex and hippocampus of mice from HCMV infected group .HCMV-specific intracytoplasmic inclusion bodies and herpes virus like particles were detected by using transmission electron microscope .No obvious abnormalities were observed in two control groups.Conclusion HCMV persistent infection could damage the central nervous system of mice .The au-tonomic activities of mice with HCMV persistent infection were not affected , but the learning and memory ca-pability of them were damaged at some extent .
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Objective To systematically evaluate the clinical outcomes of patients with multivessel diseases treated by fractional flow reserve (FFR) guided percutaneous coronary intervention (PCI) or other forms of treatment .Methods Some keywords inclu-ding FFR or fractional flow reserve ,percutaneous coronary intervention or PCI ,multivessel coronary artery disease were used to search randomized control trails(RCT) ,which compared outcomes of patients with multivessel disease treated by FFR guided PCI with other forms of treatment ,in Chinese and English database including CNKI ,VIP ,Wanfang ,Pubmed ,EMBASE and the web of science .The quality of included studies was evaluated by Jadad quality score and all the data was analyzed by stata 10 .0 .Results A total of 7 english literatures accumulating 2024 cases in experimental group and 7 284 cases in control group were included in this study .Compared with other forms of treatment ,patients with multivessel diseases treated by FFR-guided PCI had significantly low-er risk of myocardial infarction (RR=0 .72 ,P=0 .008) .Although the risk of death and major adverse cardiovascular events were al-so be reduced ,there were no statistically significant difference .Conclusion FFR-guided PCI is an effective treatment for multivessel disease ,but it is still needs further verification for the application in Chinese population .
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Objective:To explore the regulatory effect of Hsf 1 on PLC/PRF5 hepatoma cells proliferation.Methods: By shRNA gene silencing technology ,constructed PLC/PRF5 hepatoma cell line of Hsf 1 gene silencing.To detect the expression of Hsf 1, p53 and Rb proteins in PLC/PRF5 hepatoma cells by Western blot.The proliferation of PLC/PRF5 cell line was observed by methylthiazolyl tetrazolium assay ( MTT ) , plate clone formation assay ( PCFA ) and cell cycle assay.Results: shRNA-Hsf1 could significantly inhibit the expression of Hsf 1 in PLC/PRF5 cells.It could induce PLC/PRF5 cells stopping at G1 phase of cell cycle , inhibit cell proliferation and colonal formation;silencing Hsf1 caused up-regulation of p53 and Rb proteins expression in PLC/PRF5 cells.Conclusion: Silencing Hsf1 is involved in up-regulation of p53 and Rb proteins expression , which results in inhibiting proliferation of PLC/PRF5 hepatoma cells.
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One hundred and fifty-one type 2 diabetic patients with coronary heart disease ( T2 DMC) and 142 cases of type 2 diabetes mellitus were included for analyzing the influence of different glucose-lowering rates on MB isoenzyme of creatine kinase (CKMB) and muscle hemoglobin level changes to search for the rational glucose-lowering rate.The level of CKMB in type 2 deabetes mellitus group was significantly lower( P＜0.05 ) at follow-up than that before and after intensive therapy.In type 2 diabetes mellitus group,when the fasting or postprandial glucose-lowering rate was not greater than 6 mmol· L-1 · d-1,the level of CKMB and muscle hemoglobin were significantly lower at follow-up than that before intensive therapy ( P＜0.05 ).When the fasting glucose-lowering rate is greater than 6 mmol· L-1 · d-1,the level of CKMB is significantly higher after intensive therapy than that before glucose-lowering ( P＜0.05 ).In T2DMC group,when the fasting or postprandial glucose-lowering rate was not greater than 4 mmol· L-1 · d-1,the level of CKMB and muscle hemoglobin was significantly lower at follow-up than that before intensive therapy(P＜0.05 or P＜0.01 ),buthigher at follow-up when the fasting glucose-lowering rate was greater than 4 mmol· L-1 · d-1(P＜0.05).
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Objective To compare the changes of high sensitive-C reactive protein (hs-CRP) and cardiac troponin Ⅰ ( cTn Ⅰ ) levels before and after intensive therapy in patients with type 2 diabetes,and to find out the reasonable glucose-lowering rate.Methods One hundred and thirty-two cases of type 2 diabetes( T2DM group) and 135 cases of type 2 diabetes with coronary heart disease( T2DM+CHD group) received intensive therapy.After testing hs-CRP and cTn Ⅰ levels,the variations were analyzed.Results The ranges of the change in cTn Ⅰ and hs-CRP levels were different under four glucose-lowering rates in the T2DM+CHD group( P＜0.05 ).cTn Ⅰ and hs-CRP levels were higher than those before intensive therapy in the T2DM+CHD group with glucose-lowering rate greater than 4.0mmol· L-1 · d-1.The other two subgroups with glucose-lowering rate less than 4.0 mmol· L-1 · d-1 showed decreased cTn Ⅰ and hs-CRP levels.While at the end of 3 months follow-up,cTn Ⅰ and hs-CRP levels were all significantly lower than those before intensive therapy in four subgroups ( P＜0.05 ).Conclusions The increase of cardiovascular events after intensive therapy may be due to excessively fast glucose-lowering rate.The reasonable glucose-lowering rate for patients with type 2 diabetes should depend on whether there is accompanying coronary heart disease.For type 2 diabetes with coronary heart disease,excessively fast glucose-lowering rate could lead to acute rise ofcTn Ⅰ and hs-CRP levels,which causes myocardial injury.The mechanism of myocardial injury resulted from excessively fast glucose-lowering rate may be due to activation of the inflammatory pathway.In type 2 diabetes with coronary heart disease,long-term good control of blood glucose could alleviate inflammatory response and cardiac damage resulted from excessively fast glucose-lowering rate.
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Objective To study the value of the liver and spleen interventional therapy in primary carcinoma of the liver with hyperspleenism. Methods The treatment was given to 25 patients. Using the method of Seldinger,the 5FRH into artery hepatica propria to infuse 2/3 of the overall dose of chemotherapy medicine and embolism was inserted into the liver segment. Then 1/3 of it was infused into artery lienalis and gelatin sponge was infused into artery lienalis Rr. lienales. Combined regimens were used in chemotherapy: 5-Fu 750mg, EADM 40mg, MMC 10mmg,and 10 of the 25 added DDP 40mg. LUF and gelatin sponge were used for embolisation. Results Of the 25 patients,the WBC and PLT increased in 25 patients 4 weeks after the operation. The difference was significant. The survival rate at 6 and 12 months was 100% and 60% respectively,with 1 case of CR,8 cases of PR and 6 cases of SD. Patients had fever after the treatment but few with abnormal liver function tests. Conclusion Liver and spleen interventional therapy may relieve hyperspleenism and suggests that the treatment of primary carcinoma of the liver is effective.
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Objective To explore the influence of glucose-lowering rate on left ventricular function in patients with type 2 diabetes mellitus (T2DM). Methods One hundred and thirty-two cases of type 2 diabetes mellitus and 135 cases of type 2 diabetes mellitus with coronary heart disease (T2DM+CHD)received intensive glucose lowering therapy. Then, after measuring left ventricular ejection fraction (LVEF) and E/A ratio, the variation was analyzed. Results LVEF was significantly higher than that before intensive therapy in T2DMsubgroup with glucose-lowering rate less than 6 m mol · L-1 · d-1( P＜0.05 ). So was T2DM+CHD subgroup with glucose-lowering rate less than 4 mmol· L-1 · d-1 (P＜0.05). LVEF was significantly lower than that before intensive therapy in T2DM+CHD subgroup with glucose-lowering rate greater than 4 mmol · L-1 · d-1( P＜0. 05 ),while by the end of following up for 3 months, LVEF stepped up and no significant difference was observed between subgroups ( P ＞ 0. 05 ). The E/A ratio stepped up in both subgroups after intensive therapy ( P ＜ 0. 05 ).Conclusions For T2DM patients with coronary heart disease, excessively fast glucose-lowering rate may impair left ventricular function. Long-term good control of blood glucose restores the impaired left ventricular function causes by excessively fast glucose-lowering rate. After intensive therapy, left ventricular diastolic function finally improves in both subgroups regardless of the glucose-lowering rate and coronary heart disease.
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Objective To investigate the distribution and drug resistance of pathogens in cancer patients with nosocomial infections. Methods Pathogens isolated from cancer patients with nosocomial infections in Zhejiang Cancer Hospital from 2004 to 2008 were analyzed. Results Totally 3454 strains of pathogens were isolated, including 1900 strains of Gram-negative bacilli (55.0%), 838 strains of fungi (24.3%), and 716 strains of Gram-positive bacteria (20.7%). Pathogenic bacteria Escherichia coli and Candida albicans were isolated mainly from surgical wound, urinary tract, respiratory tract and oral cavity. The drug resistant rates for Gram-negative Escherichia coli and Gram-positive staphylococci were high, and Candida albicans was sensitive to all antifungal drugs. Conclusion Opportunistic pathogens account for most nosocomial infections in cancer patients, and some of them are of high-level resistance to antimicrobial agents.
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Objective To analyze the genotype of varicella-zoster virus (VZV) strains isolated from patients with chickenpox or zoster and to differentiate them from Oka vaccine strain by molecular analysis. Methods In the present study, single nucleotide polymorphisms(SNP) based VZV genotypes were analyzed in 19 VZV isolates using the polymerase chain reaction and restriction fragment length polymorphisms analysis of DNA fragments of the open reading frames 38, 54, 62, and the 1t5 repeat region. Results The genotypes of 19 VZV isolates including two different groups with 52.7% of Pst Ⅰ+ Bgl Ⅰ+ R5A and 47.3% of Pst Ⅰ+ Bgl Ⅰ+ R5B, which is very different from those found in North America, Europe and Japan. All the Chinese isolates are wild-type strains with ORF62 Sma Ⅰ-. No Oka vaccine strains were revealed among the isolates. Conclusion Chinese VZV strains reported in this study showed different molecular characteristics from those circulating in Europe, North America and Japan. The SNPs in ORF62 and ORF38 may be used to distinguish VZV wild-type strains and vaccine strain in clinical isolates in China.
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of MG-63 cells to cisplatin,and can inhibit the invasion and metastasis of MG-63 cell.