Effect of BiPAP ventilation on respiratory physiology in patients with stable COPD / 中华健康管理学杂志

Objective:To observe the physiological effect of bi-level positive airway pressure (BiPAP) ventilation among stable chronic obstructive pulmonary disease (COPD) patients.Methods:This was a small sample size, exploratory, interventional study. A total of 10 outpatients with stable COPD were included from Department of Pulmonary and Critical Care Medicine of Zhujiang Hospital, Southern Medical University between January 2018 and December 2018. The BiPAP mode of noninvasive mechanical ventilation was adopted. The inspiratory positive airway pressure was gradually increased from 10 cmH 2O (1 cmH 2O=0.098 kPa) to 24 cmH 2O, and each time by 2 cmH 2O. The expiratory positive airway pressure remained unchanged at 4 cmH 2O. Baseline and test data were collected before and during the ventilation for comparison, including total respiratory cycle time (T tot), inspiratory time (T i), inspiratory time (T e), inspiratory tidal volume (V Ti); mouth pressure (P mo), esophageal pressure (P eso), transdiaphragmatic pressure (P di), esophageal pressure time product (PTP es), diaphragm pressure time product (PTP di), root mean square of electromyography of diaphragm (RMS), V e/RMS, inspiratory capacity (IC), the change in end-expiratory lung volume (ΔEELV) and dynamic PEEPi (PEEPi dyn). Results:All the 10 patients completed the trial. Compared to calm breathing, V Ti, V e, P mo, IC, ΔEELV score and V e/RMS increased significantly with increasing pressure levels (all P<0.05); T e only increased significantly at 20-22 cmH 2O pressure levels compared to calm breathing ( P<0.05). P di, PTP es, PTP di, RMS and RMS/RMS max decreased significantly with increasing levels (all P<0.05). PTP es and PTP di converged to 0 and no longer showed significant changes after the 18 cmH 2O pressure level. RMS and RMS/RMS max flattened out at pressure level greater than 16 cmH 2O. T i/T tot only significantly decreased at the 20 cmH 2O pressure level compared to calm breathing. PEEPi dyn showed a tendency to decrease and then increase with increasing pressure levels. Conclusion:BiPAP ventilation, at appropriate pressure levels, significantly relieves pulmonary ventilation disorders and reduces the load of respiratory muscle in patients with stable COPD.

Screening and Identification of Blood Group Alloantibody by Surface Plasmon Resonance Technique and Its Preliminary Application / 中国实验血液学杂志

OBJECTIVE@#To investigate the feasibilily of screening and identifying the red blood cell type alloantibodies by means of surface plasman resonance(SPR) technique so as to provide a new method for detecting the transfusion compatibility of red blood cells.@*METHODS@#The RBC antigens for screening the alloantibody were fixed on the SPR chip surface by means of amino coupling method; the analysis conditions of SPR chip were optimized and then the control serum with RBC blood group antibody positive was detected; the performance of SPR chip for detection of serum was analysed; the consistance of rusults detected by SPR technique and microcolum agglutination for clinieal samples of 129 thalasstmia patients with history of lone-term blood transfusion were compared; at the same time, the blood group amtibodies in 7 patients with blood group antibody positive were identified before blood transfusion by using SPR chip so as to select the RBC antigen compatible blood for transfusion; and the efficacy of RBC transfusion was followed up and evaluated.@*RESULTS@#The repeatability, sensitivity and specificity of SPR chip technique for detecting the blood group alloantibodies all were better. The SPR technique and microcolumn agglutination method were not significant different for screening blood group alloantibodies (χ2 = 0.333, P＞0.05), and the overall consistency was 97.2%; the results of SPR technique in 7 patients with positive blood group antibodies were as follows: 3 cases with anti-E, 1 case anti-M, 1 case anti-C, 1 case anti-Jka and 1 case autoantibody, which were consistent with the results of microcolumn agglutination tests, and the compatible red blood cells were selected for transfusion, of which the infusion of 6 cases was effective. In only 1 case the infusion was ineffective because of autoantibody.@*CONCLUSION@#For screening and identification of blood group alloantibodies, the performance of SPR chip technique is equivalent to the micro-column agglutination, but the procedure of SPR technique is simpler, faster and high-throughput and label-free, which can meet the basic requirements for rapid screening and identification of blood group alloantibodies before transfusion of red blood cells.

Identification of RhCcEe Mixed Visual Field in Patients with Regular Blood Transfusion and Efficacy Analysis of the Matched Transfusion / 中国实验血液学杂志

OBJECTIVE@#To explore the feasibility of RhCcEe blood group antigen mixed visual field identification in patients with regular blood transfusion, to follow up and evaluate the efficacy of matched transfusion and its clinical significance.@*METHODS@#RhCcEe genotyping for 142 patients with regular transfusion in our hospital was carried out by PCR-SSP method. According to the results of genotyping, 48 patients voluntarily selected the continuous transfusion of RhCcEe matched red blood cells, 46 patients received random blood transfusion (RhCcEe mismatched transfusion), 42 patients received partial RhCcEe matched transfusion (unable to provide fully matched RhCcEe donors each time), and 6 patients' blood transfusion data were lost. After 3-6 months of the RhCcEe matched transfusion, all patients were tested by RhCcEe microcolumn gel card and compared with the results before RhCcEe matched transfusion. The positive rates of alloantibodies, DAT and the percentage of red blood cell invalid transfusion were followed up and evaluated for the above-mentsioned 3 types of regular transfusion patients in the past 5 years.@*RESULTS@#Out of the 48 patients who underwent conti-nuous RhCcEe matched transfusion, only 1 case showed stratification, the remaining 47 cases had clear gel card results without stratification, suggesting that PCR-SSP genotyping was feasible. In addition, another 42 patients who could not receive RhCcEe matched transfusion each time and 46 patients with random blood transfusion were found to have a mixed vision phenomenon again. but the results was still difficult to confirm the results. For the transfusion results in the past 5 years, follow-up analysis showed that there were 1 case alloantibody (anti-Jka) (1/48) , 1 case of DAT positive (1/48) and 2 cases of invalid transfusion (2/48) in the RhCcEe matched transfusion group; 7 cases of alloantibodies (3 anti-E, 1 anti-E+anti-c, 1 anti-C, 1 anti-M, 1 anti-Fya) (7/46), 6 case of DAT positive (6/46) and 9 case of invalid transfusion (9/46) in the random transfusion group; 6 cases of alloantibodies (1 anti-E, 1 anti-E+autoantibody, 1 anti-C, 1 anti-c, 1 anti-M and 1 other antibody) (6/42) and 7 case of DAT positive (7/42) and 8 case of invalid transfusion (8/42) in the partial RhCcEe matched transfusion group. The statistical analysis showed that the positive rate of alloantibodies and the invalid infusion rate of RBC in each group were significant differences between RhCcEe matched transfusion group and the random transfusion group as well as betwen Rhce fe matched transfusion group and the partial matched transfusion group（P＜0.05）, but there was no statistical difference between the random transfusion group and the partial matched transfusion group（P>0.05）.@*CONCLUSION@#PCR-SSP genotyping technique can be used to detect RhCcEe mixed vision in patients with regular blood transfusion. Continuous RhCcEe matched transfusion can effectively prevent the occurrence of alloimmunization, and improve the clinical transfusion efficacy and safety of the patients with regular blood transfusion, which has very important clinical significance.

Advances in postoperative delirium in elderly patients with lung cancer / 中华内分泌外科杂志

At present, more and more elderly patients with lung cancer have been treated with surgery. Postoperative delirium, as a common and serious postoperative complication in elderly patients, can increase the incidence of postoperative complications, extend the length of ICU stay time and hospitalization time, and even increase the hospitalization mortality in severe cases. This article reviewed the high-risk factors, pathogenesis, diagnosis, prevention and treatment of postoperative delirium in elderly patients with lung cancer, so as to provide reference for clinical management.

Advances in postoperative delirium in elderly patients with lung cancer / 中华内分泌外科杂志

At present, more and more elderly patients with lung cancer have been treated with surgery. Postoperative delirium, as a common and serious postoperative complication in elderly patients, can increase the incidence of postoperative complications, extend the length of ICU stay time and hospitalization time, and even in-crease the hospitalization mortality in severe cases. This article reviewed the high-risk factors, pathogenesis, diag-nosis, prevention and treatment of postoperative delirium in elderly patients with lung cancer, so as to provide ref-erence for clinical management.

Persistent Pain after Breast Cancer Surgery and Rehabilitation(review) / 中国康复理论与实践

Persistent pain after breast cancer surgery (PPBCS) is a common complication in patients suffering breast cancer sur-gery.There are varied factors related to PPBCS,such as surgical injuries,pre-and post-operative pain,age,psychosocial factors, genetic factors, and nerve sensitization, etc. Medicine, surgery and rehabilitation could be helpful for PPBCS. Rehabilitation can mobilize the enthusiasm of patients to participate in the treatment,and improve their physical and psy-chological function,with less side-effect,that could be applied widely.

Saw palmetto fruit extract improves LUTS in type ⅢA prostatitis patients / 中华男科学杂志

Objective@#To assess the clinical efficacy of the saw palmetto fruit extract (SPFE) in the treatment of lower urinary tract symptoms (LUTS) in patients with type ⅢA prostatitis.@*METHODS@#This retrospective study included 54 cases of type ⅢA prostatitis treated in the Outpatient Department of our hospital from January to December 2015. The patients were aged 35.06 ± 5.85 years, with a mean disease course of 3.8 ± 2.1 years, and all received oral medication of SPFE Capsules at the dose of 320 mg qd for 12 weeks. We assessed the therapeutic effects by comparing the NIH-chronic prostatitis symptom indexes (NIH-CPSI), voiding diary, International Prostate Symptom Scores (IPSS), and results of urodynamic examination before and after treatment.@*RESULTS@#Compared with the baseline, both NIH-CPSI and IPSS were significantly decreased after medication (27.61 ± 3.76 vs 18.6 ± 5.34, P <0.01; 20.44 ± 4.51 vs 10.96±4.62, P <0.01), and urodynamic examination and voiding diary showed dramatic post-medication improvement in the average urinary flow rate (［8.05±1.42］ vs ［12.05±2.60］ ml/s, P <0.01 ), maximum urinary flow rate (［14.22±1.74］ vs ［21.32±4.51］ ml/s, P <0.01), residual urine volume (［46.15±16.57］ vs ［14.55±10.21］ ml, P <0.01), maximum urethral closure pressure (［76.52±3.53］ vs ［65.32±4.75］ cm H2O, P <0.01), mean urinary volume (［124.63±40.55］ vs ［285.93±58.68］ ml, P <0.01), urination frequency (16.96±4.17 vs 8.96±2.50, P <0.01), and nocturia frequency (8.94±3.23 vs 3.15±1.90, P <0.01). No apparent adverse reactions were observed in any of the patients.@*CONCLUSIONS@#SPFE Capsules can safely and effectively improve LUTS and thus the quality of life of patients with type ⅢA prostatitis.

RH Factor and Clinical Transfusion Effectiveness for β-Thalassemia Children with Long-Term Blood Transfusion / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the irregular antibody production and its relationship with Rh factor genotypes and the loci of thalassemia gene mutations for the β-thalassemic children with long-term transfusion, so as provide experimental basis for clinical safe and effective transfusions for thalassemic children.</p><p><b>METHODS</b>The peripheral blood from 246 children with β-thalassemia was collected in our hospital; the extraction of genomic DNA and Rh factor (C/c, E/e) genotypes were assayed by PCR-SSP method, the irregular antibodies were screened and identified by serological method, the genotypes for thalassemia and gene mutations were analysed by PCR-RD method.</p><p><b>RESULTS</b>The genotypes of Rh factors classified by PCR- SSP in the 246 cases of β-thalassemia children were as follws: Ce/Ce (143/246, 58.1%), CE/ce (59/246, 24%), cE/cE (14/24, 5.7%), Ce/ce (12/246, 4.9%); The positive rate of irregular antibody was 7.7% (19/246), including anti-E (7/19), anti-c (5/19), anti-C (2/19), anti-E and anti-c (2/19), anti-e (1/19), anti-D (2/19); Of the 19 cases with positive irregular antibody, the genotypings of Rh factor were: Ce/Ce (11/19), CE/ce (2/19), cE/cE (2/19), Ce/ce (2/19), cE/ce (2/19); the gene mutations location of thalassemia for 19 cases with positive irregular antibody: CD41-42M (13/19), CD71-72M (2/19), IVS-II-654M (3/19), -28M (1/19).</p><p><b>CONCLUSION</b>The irregular antibody production for β-thalassemic children with long-term transfusion may have some relevance with Rh factor genotypes and thalassemia genetic mutations. This study possesses a certain significance for effective prevention of RBC alloimmune response of β-thalassemia children and improvement of efficacy and safety of clinical transfasion blood.</p>

Family investigation of a RHD 845A/1227A genotype individual / 中国实验血液学杂志

This study was aimed to investigate 1 case of rare RHD845A/1227A genotype pedigree and analyse their characters. The D antigen was determined by saline method and indirect anti-globulin test (IAT), the RHD1227A, RHD845A alleles and RHD zygosity were detected by PCR-SSP assay, the RHD coding region was analysed by gene sequencing. The results showed that the serological result of RH(D) antigen was found to be negative in one sample by saline assay, but positive by IAT. The analysis of RHD gene sequence indicated that RHD genes in the 845th and 1227th location were G/A base heterozygosis, it was speculated that the individual genotype may be RHD845A/1227A. Family investigation demonstrated the proband's father was RhD negative, his mother was RhD positive, the results of PCR-SSP assay showed that his father carried the RHD1227A alleles, whose genotype was RHD1227A/RHD(-), however, his mother carried RHD845A alleles, her genotype was RHD845A/RHD(+), which proved that the proband's genotype was RHD845A/1227A, inheriting the RHD1227A and RHD845A alleles from his father and mother respectively. It is concluded that 1 case of rare RHD845A/1227A genotype is found, further study proved that this rare heterozygosis come from the hereditary of RHD845A and RHD1227A alleles, rather than the formation of individual gene mutation.

Comparison of dosimetry in radiotherapy for craniospinal irradiation / 中华放射医学与防护杂志

Objective To explore the dosimetry of simplified intensity modulated radiotherapy (sIMRT)in the spinal component of craniospinal irradiation(CSI)compared with conventional plan(3D-CRT).Methods Five previously treated patients were adopted to generate 3D-CRT,3-and 5-field slMRT plans.The prescribed dose was 36 Gy to the planning target volume(PTV)in 20 fractions.The dose distributions of target volume and normal tissues,and homogeneity index(HI)were ananlyzed using the dose volume histogram.The total monitor units(MUs)were also analyzed to compare the delivery time indirectly.Results For 3D-CRT plans,the region of the neighbouring fields only received 70％ of the prescribed dose,and the maximum dose delivered in the normal tissues was increased to approximately 140％ of the prescribed dose.The homogeneity index(HI)of 3-and 5-field sIMRT were 0.09 ± 0.01 and 0.08 ±0.01,respectively,superior to that of 3D-CRT(0.18 ± 0.02,t=7.80,7.65,P＜0.05).The values of V10 for the heart of 3-and 5-field sIMRT were(8.4 ± 1.9)％ and(8.4 ± 2.0)％,respectively,lower than that of 3D-CRT((36.0 ± 6.0)％(t=13.3,13.0,P＜0.05).V20 for the thyroid gland were (12.4±1.5)％ and(12.4±1.6)％,respectively,lower than(69.4±5.7)％ of 3D-CRT(t=26.3,26.4,P＜0.05).V20 for the larynx were(17.2 ± 1.2)％ and(17.9 ± 1.5)％,respectively,lower than that of 3D-CRT[(89.4±7.0)％(t=25.5,26.5,P＜0.05)].V30for the NTwas(4.4±1.4)％,(4.9± 1.9)％,lower than that of 3 D-CRT[(31.9 ± 6.1)％(t=8.5,10.1,P＜0.05)].The averaged values of total MUs for 3-and 5-field sIMRT were 1100 ± 177 and 1160 ±204,respectively,higher than that of 3D-CRT(640 ± 151).Conclusions Compared with the 3D-CRT CSI technique,3-and 5-field sIMRT have better dose distribution and can improve target dose uniformity and protect the organs at risk.

Detection of weak D antigen by flow cytometry / 中国实验血液学杂志

Flow cytometry was previously applied for analysis of Rh(D) antigen density, therefore it was suggested that the flow cytometry may be used for routine detection of weak D positive phenotypes. This study was purposed to evaluate its practicability. Six weak D positive and 7 DEL individuals were detected by using saline, IAT and absorption/elution test from 2010 to 2011 years. By RHD genotyping, zygosity analysis and sequencing, 3 cases of weak D type 15, 3 cases of partial D type DVI-III and 7 cases of DEL carrying RHD1227A alleles were identified. Taking 2 normal Rh(D)-positive and 2 D-negative samples as controls, all the samples were tested by using flow cytometry, and the median fluorescence intensities were observed as well. The results indicated that all weak D type 15 and partial D type DVI samples were detected to be positive by flow cytometry, as compared with 2 Rh(D)-negative samples (P < 0.05). Seven 7 DEL samples were tested to be negative (P > 0.05), although one of 7 DEL was tested as "±" in IAT and strong positive in absorption/elution. The RHD zygosity analysis showed this DEL individual as RHD(+)/RHD(+) homozygote. It is concluded that the sensitivity of detecting D antigen by flow cytometry is similar to that of IAT, but lower than absorption/elution test. As for detecting weak D or partial D antigens, IAT is easier than flow cytometry; as for identifying DEL, the flow cytometry is not sensitive enough.

Correlation of Breg with CD4(+)T cells of peripheral blood in patients with CITP and its clinical significance / 中国实验血液学杂志

This study was aimed to detect the level of the peripheral blood Breg and CD4(+) T cell subgroups in patients with chronic idiopathic thrombocytopenic purpura (CITP) before and after therapy, and to analyse the charge of related cytokines and their correlation, to explore their roles in the pathogenesis of CITP. A total of 35 CITP cases were taken as the research group and 35 healthy persons were served as the control group. The peripheral blood mononuclear cells (PBMNC) were separated, the percentages of Th1, Th17, Th22 and Breg cells were detected by flow cytometry before and after treatment of glucocorticoid, and the IFN-γ, IL-17, IL-22 and IL-10 levels from PBMNC culture supernatant also were determined by ELISA. The results showed that there was significant difference as compared with the healthy controls, the proportion of peripheral blood Th1, Th17, Th22 cell subgroups all increased in CITP patients before treatment with glucocorticoid, the regulatory B cells (Breg) ratio was reduced, the differences had statistical significance (P < 0.05), but the differences were no statistically significant after treatment with glucocorticoid (P > 0.05). The levels of IFN-γ, IL-17, IL-22 from culture supernatant all increased in CITP patients before treatment, the level of IL-10 was lower than that of the healthy control, the difference was statistically significant (P < 0.05), but the there were no statistically significant differences after treatment (P > 0.05). There were positive correlation between the Breg cells and IL-10 expression in CITP patients (P < 0.05), the Breg cells and Th1, Th17, Th22 cells showed a negative correlation, IL-10 and IFN-γ, IL-17, IL-22 levels also showed a negative correlation. It is concluded that the down-regulation of regulatory B cells proportion and the IL-10 level may participate in the mechanism of CD4(+) T cell immunity disorder in CITP, which can provide new targets and ideas for the clinical immune regulation therapy.

Health survey of plant workers for an occupational exposure to ammonium perchlorate / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To understand the occupational hazards of ammonium perchlorate dust on operating workers and to provide the basis preventive measures for protecting the workers' health.</p><p><b>METHODS</b>36 workers exposed to ammonium perchlorate dust and 48 unexposed workers from one factory were selected as the exposure and control groups. Investigations on the general condition, sampling of dust in the workplaces and a special medical examination were conducted for two groups, including occupational history, clinical manifestations, blood routine test, hepatic and renal functions, indexes of thyroid hormone, spirometric test and chest X-ray.</p><p><b>RESULTS</b>The total dust concentration of AP in the batch plant reached to 51.63 ± 43.27 mg/m(3), exceeding the U.S. Occupational Safety and Health Administration (OSHA) permission exposure limits. The systolic blood pressure in the exposure group was higher than that of the control group (146.14 ± 21.03 VS 134.67 ± 18.58), and the difference was statistically significant (P < 0.05). The detection rates of the cumulative total symptoms, short of breath and skin itch symptoms in the exposure group were significantly higher than those in the control group (86.11% VS 66.67%; 30.56% VS 12.50%) (P < 0.05), respectively. FT(3) level in the exposure group significantly lowered than the control group, and the difference was statistically significant (P < 0.01); The pulmonary function result showed that FEV1/FVC% in the exposure group was lower than that in the control group (106.50 ± 28.99 VS 111.70 ± 19.72), but the difference was not significant. X-ray examination revealed one case of pulmonary X-ray abnormalities in the exposure group, diagnosis of pneumoconiosis, and one case with about 1.0 × 1.0 small nodules detected on the left of lung door area in the control group.</p><p><b>CONCLUSIONS</b>The systolic blood pressure of workers in the exposure group was significantly higher, which could not exclude related to the exposure to AP dust; The T(3) levels in the exposure workers were lower than those in the control group, which may due to AP exposure, suggesting that long-term chronic exposure to AP dust may affect thyroid function.</p>

Construction of expression vector from different transcripts of RHD gene / 中国实验血液学杂志

RHD gene has different alternative transcripts. This study was aimed to construct expression vector of normal mRNA, DEL9 and DEL89 transcripts from RHD gene. Total RNA was extracted from Rh(D) positive umbilical blood cells of newborn. Intact RhD cDNA, DEL9 and DEL89 transcripts were obtained by one-step and two-step RT-PCR, respectively. The obtained products were cloned into pCR4 TOPO sequencing vector for choosing the right transcript. RHD gene was amplified again from the sequencing plasmid DNA, and then subcloned into pcDNA3.1/V5-His TOPO expression vector; DEL9 and DEL89 were cloned into the expression vector directly. Gene sequence and direction were identified by sequencing. The results showed that the sequence and direction of target genes were right, thus these 3 different expression vectors were correctly constructed. It is concluded that expression vector is constructed from different transcripts of RHD gene, which lays a foundation for further exploring the membranous protein expression of Rh(D) antigen.

Chemical constituents from rhizome of Matteuccia orientalis / 中草药

Objective: To study the chemical constituents from 60% ethanol extract of the rhizomes of Matteuccia orientalis. Methods: Chromatographic methods were used for the isolation and purification. Structures were identified on the basis of spectroscopic analysis. Results: Eleven compounds were isolated from M. orientalis and identified as (±)-thunberginol C (1), (2S)-5, 7, 3′, 5′-tetrahydroxyflavanone (2), naringenin (3), strobopinin (4), farrerol (5), leptorumol (6), cis-3, 5-dihydroxystilbene (7), dihydropinosylvin (8), paeonol (9), 3, 4-dihydroxybenzalacetone (10), and caffeic acid methyl ester (11). Conclusion: Compounds 1-11 are isolated from the plants of Matteuccia Todaro for the first time.

An analysis of RHD zygosity of Rh(D)-positive Chinese Han population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the RHD zygosity of Rh(D)-positive Chinese Hans in order to study the mother-fetus Rh isoimmunization prophylaxis.</p><p><b>METHODS</b>Rh(D) blood group of 31 115 donors were serotyped, and the RHD zygosities were analyzed, or determined through a PCR method for 3628 donors of Rh(D)-positive individuals.</p><p><b>RESULTS</b>Among the 31 115 donors, 99 were tested Rh(D)-negative by indirect antiglobulin test (IAT) (0.318%). The d frequency was 0.056 41, D was 0.943 59, and Dd heterozygosity was 0.106 45 (10.6%). However the rate was 0.090 32 (about 9.0%) after excluding DEL (IAT-negative). For the 3628 PCR tested donors, 3383 were DD (93.2%), 245 were Dd (6.8%). After excluding nonfunctional RHD alleles, 7.4% of the donors were carrying one functional RHD. It showed that an Rh(D)-negative Chinese Han woman gives an Rh(D)-negative child at a rate of 3.7%-4.5% when her husband is Rh(D)-positive.</p><p><b>CONCLUSION</b>Fetus Rh(D) genotyping may be unnecessary for Chinese Hans if invasive operation was needed for prenatal diagnosis. The Rh prophylaxis could be chosen assuming an Rh(D)-positive fetus.</p>

Clinical application of Delta4 / 中华放射肿瘤学杂志

Objective To compare two verification tools for intensity modulated radiotherapy (IM-RT) and to investigate the feasibility of a new three dimensitional verification tool. Methods Five patients receiving IMRT were randomly chosen for the quality assurance plans with MapCHECK Model 1175 (SunNu-clear, Melbourne, FL,USA) and Delta4(ScandiDos, Sweden) by using Philips Pinnacle 8.0D treatment planning system. Dose verification was measured with the Varian Clinical 23EX LA. Results The overall average percentages of pass points in DD2% DTA2 mm, DD3% DTA3 mm and DD4% DTA4 mm were 84.7%, 97. 1% and 99.3% with MapCHECK Model 1175, 86.2%, 98.2% and 99.6% with Delta4 re-spectively. The differences were statisticically significant (t = 3.94, P = 0.003 ; t = 3.17, P = 0.011 ; t = 3.05 ,P =0.014,respectively). The gantry angle was changed to zero degree with MapCHECK, but not with Delta. The effects were embodied with Delta, such as the gravity on leaf position accuracy of MLC, the treat-ment table on dose distribution and the earth magnetism on dose system. Conclusion Delta4 is an ideal verification tool for intensity modulated radiotherapy.

The characteristics of the results of coronary artery CT angiography and coronary artery angiography in 36 patients with probable positive results of treadmill exercise test / 中国医师进修杂志

Objective To investigate the clinical characteristics of the results of coronary artery CT angiography and coronary artery angiography in 36 patients with probable positive results of treadmill exercise test(TET).Methods Thirty-six patients due to chest pain received 1ET and coronary artery CT angiography and coronary artery angiography in 2 weeks after admission.The coronary plaques were categorized as noncalcified and calcified plaque on CTA images.Results In 36 patients with probable positive results of TET.23 patients were confirmed as coronary artery disease by coronary artery angiography,and the other 13patients had normal coronary artery.Of 23 coronary artery disease patients,9 patients were presented as onevessel disease,5 patients were presented as two-vessel disease,and 9 patients were presented as three-vessel disease,29 non-calcified plaques and 23 calcified plaques were demeted On CTA.Conclusion TET was useful in confirming the diagnosis of coronary artery disease.The characteristics of the coronary artery plaque is correlated with probable positive results of TET.

Postoperative pituitary hormonal disturbances and hormone replacement therapy time and dosage in children with craniopharyngiomas / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The proliferative activity and penetration into the hypothalamic structures in children craniopharyngiomas (CP) often make radical resection difficult. Therefore, complete resection of CP often results in permanent multiple pituitary hormone deficiency (MPHD). This study aimed to elucidate the postoperative pituitary hormonal disturbances, and hormone replacement therapy (HRT) time and dosage in children with CP.</p><p><b>METHODS</b>Twenty patients with growth retardation and CP after resection, comprising 14 boys and 6 girls, with a mean age of (10.63 +/- 3.18) years (Group A) and 10 male patients of group A aged > 10 years (Group B) were entolled. Thirty age-, sex- and Tanner stage-matched normal children (control Group A), and 44 male older children > 10 years (control Group B) served as controls. The serum concentrations of insulin-like growth factor-1 (IGF-1), growth hormone (GH), free thyroxine (FT4), thyroid-stimulating hormone (TSH), adrenocorticortropic hormone (ACTH), cortisol (COR), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T) and estradiol (E2) were measured in the CP patients after resection and in controls. The appropriate time and dosage of HRT were investigated. Linear correlation analysis was made between levothyroxine (L-T4) dosage and primary FT4 in CP patients after resection.</p><p><b>RESULTS</b>All cases had MPHD. The serum peak GH, IGF-1, FT4 and COR levels of Group A were significantly lower than that of the control Group A. The serum IGF-1 concentration increased to the normal level after 3 months of rhGH therapy; the serum FSH, LH, and T levels were significantly decreased (P < 0.001); however, E2 and PRL were significantly increased (P < 0.001) in Group B compared with the control Group B; 18 cases were found to have central diabetes insipidus (DI) by water deprivation test and MRI. There was a significant negative linear regression (r = -0.8, P < 0.001) between L-T4 and primary FT4 in Group A patients with CP after resection, giving a regression equation of L-T4 dosage (microg.kg(-1).d(-1)) = 3.5-0.2 x FT4 (microg.kg(-1).d(-1)). The time and corresponding dosage of HRT for CP after resection were: rhGH started 1 year after resection and no recurrence of CP on MRI, when IGF-1 reached the normal range, the rhGH dosage was (0.13 +/- 0.04) U.kg(-1).d(-1); hydrocortisone (H-C) was started as soon as possible, and was kept in the lower normal range, at a dosage of (12.6 +/- 4.8) mg/m2; levothyroxine started after H-C or at the same time to maintain FT4 in the higher normal range, at a dosage of (1.65 +/- 0.70) microg.kg(-1).d(-1); Minirin (DDAVP) was started as soon as possible, elicited no symptoms, and maintained normal electrolyte levels; the dosage was (0.16 +/- 0.04) mg/m2.</p><p><b>CONCLUSION</b>Patients with CP after resection often displayed MPHD, and needed total HRT at appropriate time and dosage to improve the quality of life and normal growth.</p>

Effect of platelet CD42a modification by mPEG-SPA with different molecular masses / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect platelet antigen modification by mPEG-SPA with different molecular masses.</p><p><b>METHODS</b>Platelet CD42a was modified by 5 kD and 20 kD mPEG-SPA, respectively, and the fluorescence intensity of CD42a was detect by flow cytometry and the three-dimensional structure of CD42a simulated to analyze the distribution of lysine in CD42a molecule.</p><p><b>RESULTS</b>After platelet CD42a modification by 5 kD and 20 kD mPEG-SPA, the fluorescence intensity of CD42a decreased sharply by 85.54% and 88.65%, respectively, and multiple lysine regions were identified on the surface of CD42a molecule.</p><p><b>CONCLUSION</b>Both 5 kD and 20 kD mPEG-SPA allow useful modification of platelet CD42a, but 20 kD mPEG-SPA is more advantageous than 5 kD mPEG-SPA.</p>