Preliminary exploration of 3D printed individualized applicator for 3D-image-guided intracavitary HDR-brachytherapy for nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma.Methods CT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software.The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV).Individualized cavity applicators were created by using 3D printer.The applicator was inserted into the patient's nasopharyngeal cavity through oral cavity.The source tube and false source were inserted into the preset pipe of the applicator.CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system.Mter delineating the target volume and organ at risk,treatment plan was optimized.After completing the first treatment,the applicator was removed.Before second treatment in a few days,CT scan was reviewed to confirm whether the position was correct.Results When the applicator was inserted into the nasopharyngeal cavity,it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures.Comparing the location of false source in multiple reviews of CT scan,the error was ≤ 1 mm.No significant discomfort was reported throughout the treatment.In optimized three-dimensional treatment,100％ prescription dose curve included the full rGTV,maximum dose of the brain stem and spinal cord was＜30％ prescription dose.Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week.No tumor recurrence was observed at postoperative 3 months in two cases.Conclusions The 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation,accurate location,good repeatability and good patient tolerance.The short-term outcome is effective,whereas its long-term clinical effect and adverse reactions need to be further observed.

Interaction of high glucose and lipopolysaccharide on the apoptosis of human periodontal ligament fibroblasts in vitro / 中国组织工程研究

BACKGROUND:Both high glucose and lipopolysaccharide have been proved to promote the apoptosis of human periodontal ligament fibroblasts (HPLFs), but their interactions on the HPLF apoptosis in vitro have not yet been reported. OBJECTIVE:To investigate the effect of different concentrations of lipopolysaccharide and high glucose on the proliferation, apoptosis and the expression levels of Bax and Bcl-2 in HPLFs in vitro. METHODS:The primarily cultured HPLFs were identified. The 5-8 generations of HPLFs were col ected and used in the subsequent experiment. The HPLFs were cultured in different concentrations of glucose (5.5 and 25 mmol/L) and lipopolysaccharide (0, 1 and 10 mg/L) for 24 and 48 hours, respectively. RESULTS AND CONCLUSION:Lipopolysaccharide (10 mg/L) could significantly inhibit the cel proliferation, promote the cel apoptosis, upregulate the expression levels of Bax and Bcl-2 mRNA and induce a significant decrease in Bcl-2/Bax ratio in the cel s cultured with 5.5 mmol/L glucose (P<0.05). The lipopolysaccharide-induced suppression of cel proliferation, cel apoptosis, the expressions of Bax and Bcl-2 mRNA as wel as decrease in Bcl-2/Bax ratio were significantly strengthened in the HPLFs treated with 25 mmol/L glucose (P<0.05). Analysis of variance found that high glucose and lipopolysaccharide had a significant interaction on the cel apoptosis (P<0.05). These results reveal that lipopolysaccharide-induced suppression of cel proliferation, cel apoptosis and the expressions of Bax and Bcl-2 mRNA are augmented in HPLFs cultured under high glucose condition, indicating lipopolysaccharide and high glucose interactively act in inducing cel apoptosis.

Advances in the brain metastasis from esophageal carcinoma / 中国医师杂志

Esophageal carcinoma(EC) is one of the most common malignancies,which is difficult to cure.The median overall survival is less than 1 year,and the 5-year survival rate is less than 10％.Previous reports cited the incidence of brain metastasis (BM) from esophageal cancer to be approximately 0.4％ ～ 5.1％,and most of the reports come from America and Japan.The incidence of BM from EC is increased.However,because of the rarity of BM from EC,there are no established treatment guidelines.This report provides a comprehensive view of the clinical characteristics,treatment and prognosis of brain metastasis from esophageal carcinoma.

Bonemorphogeneticproteins-2/Osterix signaling pathway regulates the differentiation of preosteoblasts / 中国组织工程研究

BACKGROUND:Bone formation and development are reported to be regulated by bone morphogenetic protein2(BMP2)-induced Osterix expression. OBJECTIVE:To investigate the regulatory effect of BMP2/Osterix signaling pathway on differentiation of preosteoblasts in mice. METHODS:mRNA and protein expression of Osterix wasdetermined by real-time RT-PCR and western blot assay, respectively at various time points after mouse preosteoblasts were treated with BMP2. pcDNA3.1/myc-Osterix eukaryotic expression vector was constructed and transducted into preosteoblasts, and then mRNA expression of alkaline phosphatase, bone sialoprotein, and matrix extracelular phosphoglycoprotein wasdetected by real-time RT-PCR after transduction and BMP2 treatment. RESULTSANDCONCLUSION:Osterix mRNA expression was up-regulated when treated with BMP2 in mouse preosteoblasts, and reached the peak at 24 hours. In addition, the protein expression of Osterix was increased after BMP2 treatment. Alkaline phosphatase, bone sialoprotein, and matrix extracelular phosphoglycoprotein mRNA expression wasup-regulated after transfection of mouse preosteoblasts with pcDNA3.1/myc-Osterix eukaryotic expression vector and BMP2 treatment. Our results indicate that BMP2 regulates the synthesis of genetic markers of osteogenesis,such asalkaline phosphatase,matrix extracelular phosphoglycoproteinviaup-regulating Osterix expression in mouse preosteoblasts, suggesting BMP2/Osterix signaling pathway plays a critical role in bone development.

The coagulation factor VII gene polymorphisms in patients with myocardial infarction in Ningxia Hui and Han populations / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the characteristics for activated coagulation factor VII(F VIIa) and the R353Q, -323 0/10 bp, HVR4 polymorphisms in the gene in patients with coronary heart disease (CHD) and myocardial infarction from Ningxia Hui and Han populations.</p><p><b>METHODS</b>Four hundred and twenty angiographically proven CHD patients in the Hui population, and 508 healthy blood donors were tested for their plasma levels of coagulation factor VII using recombinant tissue factor method. The coagulation factor VII gene R353Q, -323 0/10 bp and HVR4 genotypes were identified by polymerase chain reaction. In addition, 600 Han patients with CHD and 604 healthy Han control subjects were also investigated.</p><p><b>RESULTS</b>(1) The plasma F VIIa levels was significantly higher in patients with CHD and myocardial infarction than that in healthy control subjects and angor pectoris (P<0.01) in both Hui and Han populations. (2) There were significant differences in the distribution of genotypes and allelic frequencies of the R353Q between myocardial infarction and angor pectoris disease in the Hui population (P<0.05). So was the -323 0/10 bp locus in both the Hui and Han population. (3) The F VIIa level was significantly higher in individuals with RR genotype than those of Q allele carriers in the Hui population.</p><p><b>CONCLUSION</b>There are polymorphisms of the F VII gene R353Q, -323 0/10 bp and HVR4 in the Hui and Han populations. The Q allele might be a protective factor against myocardial infarction in the Hui, and the plasma F VIIa level may be influenced by the R353Q polymorphism of the F VII gene. The 10 allele may be a protective factor against myocardial infarction in both the Hui and Han populations.</p>

Cleaning Method Optimization and Effect Analysis of Uterine Cavity Aspiration Tube / 中华医院感染学杂志

OBJECTIVE To optimize the cleaning method of uterine cavity aspiration tube,compare with traditional method,in order to search the best way to improve the cleaning quality. METHODS Two groups A and B were set up according to the cleaning method and procedure. Group A (scrubbing group) was washed by optimized method,namely multi-enzyme soaking,scrubbing the lumen with special brush,rinsing with high pressure spray gun,and ultrasonic multi-enzyme cleaning. Group B (no scrubbing group) was used by traditional cleaning method;the cleaning procedure of Group B was almost the same with group A but had no lumen scrubbing. Both eyeballing and bacterial detection methods were used to compare cleaning quality of the two groups.RESULTS After cleaning procedure,the cleanliness pass rate of groups A and B was 99.52% and 56.25%,respectively (P

Microbiology and management of gaseous gangrene:the Sichuan experience of 20 earthquake cases / 中华内科杂志

Wound secretion from 20 patients with gaseous gangrene was collected for Gram staining,bacterial culture and drug sensitivity tests.The results indicated that gaseous gangrene was caused by the co-infection of both aerobic and anaerobic bacteria.Gram-negative bacilli were slishtly more common than other aerobic bacteria in gageous gangrene wound,which was different from the findings of ordinary gaseous gangrene.

Hospital Infection in Surgery Intensive Care Unit:Investigation and Countermeasure of Correlation Factors / 中华医院感染学杂志

OBJECTIVE To investigate the incidence of hospital infection in surgery intensive care unit(SICU) and to provide evidence for controlling hospital infection.METHODS Managers of hospital infection entered SICU from Jan to Jun in 2007 and monitored items of inpatients who stayed more than two days,such as incidence of hospital infection,infective sites,underlying diseases,invasive operation and time in hospital.Patients had been followed up for 2 days after moving out of SICU.RESULTS In 341 cases,the total incidence of hospital infection was 19.64%(67/341).Constituent ratio:respiratory tract infection was 68.65%(46/67),and urinary tract infection was 19.4%(13/67).Incidence of hospital infection in patients older than 60 years was 48.24%(41/85)and in patients younger than 60 years was 10.16%(26/256).There was significant difference between these two groups(?2= 58.60,P

Resistant Bacteria Infection in Earthquake Casualty:Clinical Analysis and Countermeasure / 中华医院感染学杂志

OBJECTIVE To understand the resistant bacteria infection condition of earthquake casualty and provide evidence for reducing their transmission in hospital.METHODS The staff members of Department of Hospital Infection Management monitored the bacteria cultures and report 38 resistant bacteria infective wounded every day.Set up the system measures to manage resistant bacteria infection of earthquake casualty and monitored,guided and checked the implement countermeasures.RESULTS Among 419 samples,there were 70 resistant bacteria and 97.1% were G-bacteria,the main pathogens were Acinetobacter baumannii,Pseudomonas aeruginosa,Enterobacter cloacae,Klebsiella pneumoniae,and Escherichia coli.The main infective sites were respiratory tract and wounds.The resistant bacteria had the high drug resistance to the third and fourth cephalosporins,aminoglycosides and sulfonamides.The sensitive rate to amikacin,gentamicin,imipenem,piperacillin/tazobactam,sulfamethoxazole/trimethoprim compound,tobramycin and nitrofurantoin.CONCLUSIONS Real-time monitoring the earthquake casualty with resistant bacteria infection can find the infective wounds in time and make effective intervention measures.It is the important method to prevent and control the hospital infection.

Pathological and molecular genetic studies on oculopharyngeal muscular dystrophy / 中华神经科杂志

Objective To study the pathologic and molecular genetic characteristics of Chinese patients with oculopharyngeal muscular dystrophy(OPMD).Methods The ultrastructural muscle biopsies in 6 patients were carried out by using transmission electron microscopy.The DNA was obtained through blood samples from patients(n=11) and the at-risk individuals(n=16).Amplification of the PABPN1 gene mutation region was performed by polymerase chain reaction(PCR).The sequences were obtained and compared with the genomic sequence of the human PABPN1 gene.Results Intranuclear inclusions(INIs) were found by electron microscopy in 4 patients,and the rate of appearance was 18%,20%,34% and 40%.Sequence analysis of exon 1 of PABPN1 gene showed abnormal expansions of the GCG-repeat—(GCG)_8 and(GCG)_(10) in 9 patients.Conclusions INIs might be found by electron microscopy in muscle biopsies of OPMD patients.The rate of appearance of INIs should have positive relationship with the amount of the GCG-repeat.PABPN1 gene mutations might be present among Chinese patients with OPMD,and should have a negative relationship with the age of onset.

Analysis on clinical distribution and antimicrobial resistance of common gram-positive cocci / 中国实用内科杂志

Objective To investigate the clinical distribution and antimicrobial resistance of common gram-positive cocci in author's hospital.Methods Identification of these bacteria were done with API analysis system,disc diffusion tests were employed to study the antimicrobial resistance.Results A total of 25 052 clinical isolates were collected in 8 years,of gram-positive cocci accounted for 7907(31.9%).Staphylococcus aureus(3549 strains,44.9%),enterococcus(1760 strains,22.3%)and coagulase-negative staphylococcus(1558 strains,19.7%)were the most common isolates.The prevalence of MRSA increased from 59.6% in 2001 to 76.3% in 2008,and MRSCoN increased from 64.2% to 77.0%.The resistant rate of MRSA to gentamicin,clindamycin,erythromycin and levofloxacin were over 90%,to trimethoprim/sulfamethoxazole and chloramphenicol were less than 20%.The resistant rate of MSSA to gentamicin,levofloxacin,trimethoprim/sulfamethoxazole and chloramphenicol were low 20%,and to beta-lactamase antibacterial agents except penicillin were 0.The resistant rates of MRSCoN to all antimicrobial agents were lower than MRSA,but to trimethoprim/sulfamethoxazole(71.2%)was higher than MRSA(21.2%).No staphylococcus strains were resistant to vancomycin,teicoplanin and linezolid.2.1% enterococcus feacium and 4.4% other enterococcus were resistant to vancomycin.No strains of enterococcus were found resistant to teicoplanin and linezolid.Conclusion The resistant rate of gram-positive cocci were increasing obviously,the prevalence of MRS was high.Vancomycin,teicoplanin and linezolid were the most active agents against severe infection induced by multidrug-resistant gram-positive cocci.

Distribution and Drug Resistance of Clinically Common Non-fermentative Gram-negative Bacilli / 中华医院感染学杂志

OBJECTIVE To explore the characteristics of the clinical distribution and drug resistance of non-fermentative Gram-negative bacilli in nosocomial infection.METHODS The bacteria were identified by API 20NE.Antibiotic susceptibility test was performed by K-B disk diffusion method.RESULTS The rate of non-fermentatives in Gram-negative bacilli was 17.6%.The dominant strains were Pseudomonas aeruginosa(43.8%),Acinetobacter spp(39.9%),Stenotrophomonas maltophilia(6.7%),and Burkholderia cepacia(2.7%).The resistant rates of P.aeruginosa to cefoperaxone/sulbactam,amikacin,cefepime and meropenem were less than 20%.The resistant rates of Acinetobacter spp to imipenem,meropenem,cefoperaxone/sulbactam and minocycline were less than 20%.The resistant rates of S.maltophilia to minocycline,cefoperaxone/sulbactam,piperacillin/tazobactam and levofloxacin were less than 20%.The resistant rates of B.cepacia to minocycline,piperacillin/tazobactam and cefoperaxone/sulbactam were less than 20%.CONCLUSIONS The sensitivities of non-fermentative Gram-negative bacilli to cefoperaxone/sulbactam,piperacillin/tazobactam,minocycline,imipenem and meropenem were the highest.These antibiotics may be chosen first for the clinical treatment.

Studies on the Red Cell--membrane Protection Actionof Modified Qingdan Tuihuang ( Bile--clearing andAnti--Juandice ) Decoction / 中医杂志

The Decoction showed marked effect on manykinds of Icterus Neonatorum,Estimation on the activi-ty of superoxide dimutase,lipoperoxide,enzymes ofRBC,were made through histochemical staining andresistance of RBC membrane.Results revealed thatthe remedy has distinctive protective action on cellmembrane of RBC.

The clinical,image and pathological features of cerebral gliomatosis / 临床神经病学杂志

Objective To study the clinical,image and pathological features of cerebral gliomatosis.Methods 2 cases with cerebral gliomatosis underwent routine MRI scan, contrast enhance MRI scan and pathologic examination of the lesions. Their clinical manifestations were observed during the past 2 years.Results Main clinic features of the 2 patients were headache, dizziness, nausea, vomit, diplopia, hemiplegia, hemianesthesia and ataxia. Cranial MRI scan showed long T 2 signals in the bitemporal lobes, biparietal lobes, corpus collosum, thalamus, caudate nucleus and putamen. Brain stem and cerebellum were also involved in 1 patient. The borders of the lesions were unclear and no mass-effect phenomenons were found. Contrast enhancement occurred only in 1 patient after Gd-DTPA injection. The biopsies in the 2 patients showed diffuse infiltrative growth of most astroglioma cells. The shape of nucleus was round or ellipse and the staining of nucleus was comparatively deep. Cleavage of nucleus was seldom. The 2 patients died in 4 to 6 months after the onset of the disease.Conclusions MRI scan and pathologic examination are essential diagnostic methods for cerebral gliomatosis. The prognosis of cerebral gliomatosis is poor.