PAFR/Stat3 axis maintains the symbiotic ecosystem between tumor and stroma to facilitate tumor malignancy

Stroma surrounding the tumor cells plays crucial roles for tumor progression. However, little is known about the factors that maintain the symbiosis between stroma and tumor cells. In this study, we found that the transcriptional regulator-signal transducer and activator of transcription 3 (Stat3) was frequently activated in cancer-associated fibroblasts (CAFs), which was a potent facilitator of tumor malignancy, and formed forward feedback loop with platelet-activating factor receptor (PAFR) both in CAFs and tumor cells. Importantly, PAFR/Stat3 axis connected intercellular signaling crosstalk between CAFs and cancer cells and drove mutual transcriptional programming of these two types of cells. Two central Stat3-related cytokine signaling molecules-interleukin 6 (IL-6) and IL-11 played the critical role in the process of PAFR/Stat3 axis-mediated communication between tumor and CAFs. Pharmacological inhibition of PAFR and Stat3 activities effectively reduced tumor progression using CAFs/tumor co-culture xenograft model. Our study reveals that PAFR/Stat3 axis enhances the interaction between tumor and its associated stroma and suggests that targeting this axis can be an effective therapeutic strategy against tumor malignancy.

Application of modified ultrafiltration combined with sequential infusion of blood products in neonatal cardiovascular surgery / 中华胸心血管外科杂志

Objective:To discuss the effect of modified ultrafiltration combined with sequential infusion of blood products, such as platelets and cryoprecipitation, on perioperative coagulation function in neonates undergoing cardiovascular surgery under extracorporeal circulation.Methods:A retrospective analysis was performed on 83 neonates who underwent cardiovascular surgery from January 2017 to December 2019. They were divided into the control group (conventional ultrafiltration, 51 cases) and the treatment group (modified ultrafiltration + sequential infusion of blood products, 32 cases).Results:The age of treatment group was significantly younger than that of the control group ( P<0.05). The extracorporeal circulation time of the treatment group was significantly longer than that of the control group. Compared with the preoperative data, post-APTT, post-PT and post-INR were increased significantly in the control group, platelet count and FIB were decreased significantly ( P<0.01), while there was no significant difference in the treatment group. Compared with the treatment groups, post-APTT, post-PT and post-INR were significantly increased in the control group, and postoperative platelet count and FIB were significantly decreased ( P<0.05). The drainage of control group was significantly higher than that of the treatment group at 12 h and 24 h after surgery ( P<0.01). Conclusion:The application of modified ultrafiltration combined with sequential infusion of blood products can significantly improve perioperative coagulation and reduce mediastinal bleeding in neonatal after cardiovascular surgery.

A random forest model to predict acute kidney injury after acute myocardial infarction / 中华急诊医学杂志

Objective:Our study aims to predict acute kidney injury (AKI) in acute myocardial infarction (AMI) by establishing a random forest model.Methods:By using the clinical database from affiliated Dongyang Hospital of Wenzhou Medical University, a total of 1 363 AMI cases were included. Then, 75% of participants were analyzed as training subsets and the remaining 25% were testing subsets. The CARET package in R was used to filter variables and build random forest. The prediction ability of established model was evaluated by specificity, sensitivity, accuracy, relative operating characteristic curve (ROC curve) in testing subsets. In addition, the performance of random forest was compared with other 3 commonly used machine learning algorithms (Artificial Neural Network, Naive Bayes, and Support Vector Machine).Results:In this study, 30 variables including the demographic information, risk factors of cardiovascular disease, vital signs at admission, laboratory tests were identified and used to establish our random forest prediction model. The area under the curve of the testing subsets ROC was 0.893. The specificity and sensitivity of prediction model was 0.791 and 0.866, respectively. And the first creatinine, first blood urea nitrogen, and D-dimer after admission, age, mechanical ventilation were the top-five factors in this model. After comparing various machine learning algorithms, random forest model had a better performance.Conclusion:The random forest model would be used to predict the occurrence of AMI with AKI.

Sample Retention Management and Evaluation in Drug Inspection Agencies Based on Process- oriented Adminis- tration Concept / 中国药房

OBJECTIVE：To combine with the concept of process-oriented administration ，and to provide reference for improving the process and measures of the sample retention management and evaluation in drug inspection agencies. METHODS ： From the aspects of organizational management and control measures ，the improvement measures for sample retention management system were investigated. From the aspects of warehouse-in check ，storage management and warehouse-out judgment ，warehouse management and informatization ，the improvement measures for procedures and measures about sample retention management were explored. From the aspects of evaluation content and quality control measures ，the evaluation and continuous improvement of sample retention management were investigated. RESULTS & CONCLUSIONS ：In the aspect of organizational management ，it is necessary to improve management procedures and processes ，determine sample retention objectives and plans ，improve post allocation and management ，and improve safety emergency plans. In the aspect of control measures ，it is necessary to improve the business management measures such as warehouse-in status inspection ，adjust the conditions such as warehouse space allocation ， and improve the intelligent prompt of remaining validity period of samples. The key to the three links of warehouse-in ，storage and warehouse-out are warehouse-in check ，storage space and condition control ，and warehouse-out judgement. The relevant processes and measures can be improved from these aspects. The contents of sample retention management evaluation includes management system，management measures and process ，improvement and evaluation. Plan-Do-Check-Action （PDCA）cycle is a measure to improve the efficiency and quality of sample retention management in drug inspection agencies .

Chrysin serves as a novel inhibitor of DGKα/FAK interaction to suppress the malignancy of esophageal squamous cell carcinoma (ESCC)

@#Among current novel druggable targets, protein–protein interactions (PPIs) are of considerable and growing interest. Diacylglycerol kinase α (DGKα) interacts with focal adhesion kinase (FAK) band 4.1-ezrin-radixin-moesin (FERM) domain to induce the phosphorylation of FAK Tyr397 site and promotes the malignant progression of esophageal squamous cell carcinoma (ESCC) cells. Chrysin is a multi-functional bioactive flavonoid, and possesses potential anticancer activity, whereas little is known about the anticancer activity and exact molecular mechanisms of chrysin in ESCC treatment. In this study, we found that chrysin significantly disrupted the DGKα/FAK signalosome to inhibit FAK-controlled signaling pathways and the malignant progression of ESCC cells both in vitro and in vivo, whereas produced no toxicity to the normal cells. Molecular validation specifically demonstrated that Asp435 site in the catalytic domain of DGKα contributed to chrysin-mediated inhibition of the assembly of DGKα/FAK complex. This study has illustrated DGKα/FAK complex as a target of chrysin for the first time, and provided a direction for the development of natural products-derived PPIs inhibitors in tumor treatment.

Establishment of the DRL and warning dose value for CT examinations in our hospital and its application in chest CT dose optimization / 中华放射医学与防护杂志

Objective:To optimize the scheme and process of chest CT scanning and control the dose level to the examined individuals by establishing the diagnostic reference level (DRL) and warning dose value from chest CT examinations in our hospital.Methods:The medical records for 205 511 examined individuals, who had undergone chest CT scans in the Second Affiliated Hospital of Zhejiang University Medical College from January 1, 2018 to December 31, 2019, were reviewed consecutively. For the two-year examination periods, these examined individuals were divided into two groups, one for 2018 totalling 90 507 and another for 2019 with a total of 115 004. The mean value of doses from chest CT scans in 2018 was set as the DRL for the hospital, with the 75th and 25th percentiles as the upper and lower limits of diagnostic reference range (DRR) and the 97.5th percentiles as the warning dose values. The doses above the upper limit of DRR were considered to be relatively-high whearas the ones exceeding the warning dose value to be over-high. Based on the analysis of the over high dose in 2018, the scanning scheme and inspection process of the chest CT scans were improved in 2019. The number of examinations were estimated for the 2018 period for chest plain CT scans, chest enhancement CT scans, lung cancer screening low-dose CT scans, and relatively-high and over-high dose CT scans, as well as the single scanning doses to the examined in the two groups. The number of examinations resulting in high dose to the examined due to different reasons before and after the improvement were studied. The various parameters on the examined in the two groups were compared statistically.Results:After the improvement, the average dose from chest plain CT scans decreased by 8.67 %, with the statistically significant difference as compared with before improvement ( t=55.71, P<0.05). The average dose from low-dose chest CT scans fell by 20.13% with statistically significant difference ( t=81.99, P<0.05). The fraction of the examinations with slightly-high doses arising from chest plain CT scans and low dose chest CT scans dropped by 3.66% and 17.15%, respectively. The fraction of the examinations with slightly-high dose from chest enhanced CT increased by 1.7%. The fraction of the examinations with over-high dose from chest plain CT scans, enhanced CT scans and low-dose CT scans decreased by 0.55%, 1.06% and 1.74%, respectively. After improvement, the optimized fraction of the examinations with over-high dose, dropped by 4.72%, 31.49% and 19.18% respectively. Conclusions:The establishment of the DRL and the warming dose value of for chest CT examinations in our hospital is helpful to find out the cause of high dose scanning, promote the optimization of dose, reduce the average dose to the examinedes, and avoid using excessive dose during scanning.

Application of high-resolution CT local augmentation reconstruction to improve the accurate diagnosis of small pulmonary nodule structure / 中华放射学杂志

Objective:To explore the accurate display method of the local structure of small CT nodules in lung.Methods:Close the automatic radiation dose adjustment technique. Keep the thickness of the phantom was 2 mm, the interval between the phantom layers was 2 mm, the pitch was 1, and the reconstructed convoluted nucleus was B80s. Group A controlled the scanning matrix FOV to be 500 mm×500 mm, 400 mm×400 mm, 300 mm×300 mm, 200 mm×200 mm and 100 mm×100 mm, while group B controlled the scanning matrix FOV to be 500 mm×500 mm. Use these parameters to scan the catphan 500 phantom, a routine chest CT conditioned scanning quality control model. The original data raw data were used to reconstruct the FOV to be 400 mm×400 mm, 300 mm×300 mm, 200 mm×200 mm and 100 mm×100 mm under the scanning FOV to be 500 mm×500 mm. All other conditions are consistent. Observe the high contrast resolution module of Catphan 500 phantom, and compare the line logarithms of two groups of images under different scanning FOV or different reconstruction FOV. Thirty-five patients with small pulmonary nodules from February 2018 to March 2018 of the Second Affiliated Hospital of Zhejiang University Medical College were retrospectively collected. The raw data were used to reconstruct the images. The FOV was 320 mm×320 mm in the conventional reconstruction group and 100 mm×100 mm in the local magnification reconstruction group. The subjective score data of the two groups were compared by using rank-sum test.Results:When catphan 500 phantom was used, the number of lines in group A and group B increased gradually with the decreasing of FOV. The subjective score of local magnification reconstruction group (4.77±0.35) was higher than that of conventional reconstruction group (3.86±0.50) and the difference was statistically significant ( Z=-5.763, P<0.05). Conclusion:Local magnification and reconstruction of high-resolution CT images can achieve the same image quality as local magnification, local magnification and reconstruction of image quality is significantly better than simple image magnification.

Changes of coagulation / fibrinolysis factors in patients with type A aortic dissection after operation / 中国医师杂志

Objective:To investigate the changes of coagulation/fibrinolysis factors in patients with type A aortic dissection (AD) at early and middle stages after ascending aorta replacement+ total arch replacement+ elephant nose stenting.Methods:According to the inclusion and exclusion criteria, patients with type A AD who underwent cardiac surgery in Xinjiang Uygur Autonomous Region People′s Hospital from August 2017 to August 2018 were selected as the study group. According to the duration of onset, patients were divided into acute AD group (course <2 weeks) and chronic AD group (course ≥2 weeks). Both groups were treated with ascending aorta replacement + total arch replacement + elephant nose stenting. Fasting venous blood was drawn from the two groups, and the blood indexes [prothrombin time (PT), activated partial thrombo plastin time (APTT), fibrinogen (Fib), bone morphogenetic proteins (BMP)] and fibrinolysis indexes [D-dimer, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI)] were detected by enzyme-linked immunosorbent assay (ELISA).Results:The ELISA result showed that changes of PT, APTT, Fib, BMP, D-dimer, and PAI in patients with acute and chronic AD at 12 months after operation were significantly lower than those before operation ( P<0.05). The changes of t-PA in patients with acute and chronic AD at 12 months after operation were significantly higher than those before operation ( P<0.05). There was no significant difference in postoperative effective rate, in-hospital mortality, length of stay, incidence of complications and early and mid-term survival rate between the two groups ( P>0.05). Conclusions:Ascending aorta replacement+ total arch replacement+ elephant nose stent is effective in the treatment type A AD, and can significantly improve the expression of coagulation/ fibrinolysis markers in early and middle period after operation.

Application of high-resolution CT local augmentation reconstruction to improve the accurate diagnosis of small pulmonary nodule structure / 中华放射学杂志

Objective@#To explore the accurate display method of the local structure of small CT nodules in lung.@*Methods@#Close the automatic radiation dose adjustment technique. Keep the thickness of the phantom was 2 mm, the interval between the phantom layers was 2 mm, the pitch was 1, and the reconstructed convoluted nucleus was B80s. Group A controlled the scanning matrix FOV to be 500 mm×500 mm, 400 mm×400 mm, 300 mm×300 mm, 200 mm×200 mm and 100 mm×100 mm, while group B controlled the scanning matrix FOV to be 500 mm×500 mm. Use these parameters to scan the catphan 500 phantom, a routine chest CT conditioned scanning quality control model. The original data raw data were used to reconstruct the FOV to be 400 mm×400 mm, 300 mm×300 mm, 200 mm×200 mm and 100 mm×100 mm under the scanning FOV to be 500 mm×500 mm. All other conditions are consistent. Observe the high contrast resolution module of Catphan 500 phantom, and compare the line logarithms of two groups of images under different scanning FOV or different reconstruction FOV. Thirty-five patients with small pulmonary nodules from February 2018 to March 2018 of the Second Affiliated Hospital of Zhejiang University Medical College were retrospectively collected. The raw data were used to reconstruct the images. The FOV was 320 mm×320 mm in the conventional reconstruction group and 100 mm×100 mm in the local magnification reconstruction group. The subjective score data of the two groups were compared by using rank-sum test.@*Results@#When catphan 500 phantom was used, the number of lines in group A and group B increased gradually with the decreasing of FOV. The subjective score of local magnification reconstruction group (4.77±0.35) was higher than that of conventional reconstruction group (3.86±0.50) and the difference was statistically significant (Z=-5.763, P<0.05).@*Conclusion@#Local magnification and reconstruction of high-resolution CT images can achieve the same image quality as local magnification, local magnification and reconstruction of image quality is significantly better than simple image magnification.

Establishment of an osimertinib-resistant human non-small cell lung cancer cell line and its subsequent sensitivity to themotherapeutic drugs / 实用医学杂志

Objective Establishment of an osimertinib-resistant PC-9/ZDOR cell line of human non-small cell lung cancer (NSCLC) , and exploration of its drug resistance mechanisms and the sensitivity of themotherapeutic drugs. Methods An osimertinib-resistant PC-9/ZDOR cell line was induced by increasing doses of osimertinib to gefitinib-resistant cells PC-9/ZD. Mutation analysis of EGFR genes was performed by NGS. Cell growth was measured by CCK-8 assay and the sensitivity of chemotherapy was determined via analysis of resistance index (RI).The expression of EGFR and its signal transduction protein was determined by western blot. Results (1) An osimertinib-resistant human NSCLC cell line PC-9/ZDOR was successfully established with resistance index of 44. (2) The evidence from NGS data showed the mutation and amplification of EGFR was eliminated in PC-9/ZDOR cells. (3) The data from Western blot showed that the expression of EGFR and its phosphorylated form protein such as P-AKT and P-ERK was significantly decreased in PC-9/ZDOR cells when compared with those in PC-9/ZD cells (P <0.05). (4) The sensitivity of PC-9/ZDOR cell lines to docetaxel, gemcitabine and paclitaxel was significantly higher than that of PC-9/ZD cell lines (P < 0.05) , while the sensitivity of PC-9/ZDOR cell lines to cisplatin and pemetrexed was similar to the one of PC-9/ZD cell lines (P> 0.05). Conclusions The PC-9/ZDOR cell lines is an osimertinibresistant human NSCLC cell line. Elimination of EGFR gene mutation and/or the decrease of protein expressions of EGFR, p-EGFR, p-ERK and p-AKT maybe serve as the mechanisms of acquired resistance to osimertinib. This osimertinib-resistant cell line, PC-9/ZDOR, showed a elevated level of sensitivity to taxanes and gemcitabine.

Chinese medicine synthesis rehabilitation in treatment of neurogenic bladder urinary retention after incomplete spinal cord injury:A multicenter randomized controlled clinical trial / 吉林大学学报(医学版)

Objective:To discuss the curative effect of Chinese medicine synthesis rehabilitation in the treatment of neurogenic bladder dysfunction after incomplete spinal cord injury, and to provide the clinical evidences for its application.Methods:A total of 184patients meeting the inclusion criteria were randonly divided into trial group (n=89) and control group (n=95) with central area group method.The patients in two groups were given the intermittent catheterization and the urinary functional training.The patients in trial group were treated by the electricity needle (20min/time, one time a day, 6dper week) and the massage (20min/time, one time a day, 6d per week) .All patients in two groups were treated for 4courses (2 weeks for a course) .The residual urine volumes, the bladder securiey capacities, and the intravesical pressures of the patients in two groups were measured before and after treatment, and the curative effects were evaluated.Results:Compared with before treatment the residual urine volume of the patients in trial group was reduced significantly after treatment (P＜0.01) , the bladder security capacity was significantly increased (P＜0.01) , and there was no significant change in intravesical pressure (P＞0.05) ;the residual urine volume of the patients in control group was reduced significantly after treatment (P＜0.01) , there were no significant changes in the bladder security capacity and intravesical pressure (P＞0.05) .After treatment, the residual urine volume of the patients in trial group was significantly lower than that in control group (P＜0.01) , while there were no significant differences in the bladder security capacities and intravesical pressures between two groups (P＞0.05) .Conclusion:Chinese medicine synthesis rehabilitation may reduce the residual urine volume of the patients with neurogenic bladder urinary retention after incomplete spinal cord injury, and its curative effect is superior to modern rehabilitation of intermittent catheterization and urinary bladder function training.

The study on behaviour of protective equipment utilization of workers exposed to benzene and factors based on Planned Behavior Theory / 中华劳动卫生职业病杂志

Objective@#To investigate and predict the behavioral intention and mode of the protective equipment utilization selection of the workers who used Benzene, the Theory of Planned Behavior (TPB) was applied to establish the behavioral model to enhance the theoretical foundation for long-term intervention.@*Methods@#Questionnaires were used to survey the 707 workers, and all the behaviors of using protective equipment were investigated. Evaluate the relationships between each variable and obtain the influence affects by structural equation model.@*Results@#The investigation showed that 38.47% of the total workers (272 cases) used whole body protection, 13.58% used partially, and 16.69% didn't use any body protection. There were significant difference between the varying degrees in the four dimensions (behavioral attitude, perceived behavior control, subjective norm, and behavioral intention) (P<0.01) . The results of structural equation model revealed that perceived behavior control was the most important influencing factor, subjective norm, positive attitude, negative attitude were the other three respects in sequence. The path co-efficient were 0.600、0.215、0.141 and 0.046 respectively.@*Conclusion@#The study show that the theory of planned behavior can effectively explain the behavioral intention and behavior of protective equipment utilization. Therefore, combining the subjective initiative of individuals with the supervision of enterprises, In order to effectively enhance the protective equipment utilization of benzene workers.

Isolation and Identification of Secondary Metabolites from Cordyceps cardinalis / 中国药房

OBJECTIVE: To isolate and identify the secondary metabolites of Cordyceps cardinalis for providing reference for the further exploration of the active substance of C. cardinalis and the natural product library of Cordyceps. METHODS: The compounds from C. cardinalis fermentation broth were isolated by silica gel column chromatography, C18 reverse phase silica gel chromatography, Sephadex LH-20 gel column chromatography, TLC and so on. The structures of isolated compound were identified by 1H-NMR, 13C-NMR and MS spectra. RESULTS: Six compounds were isolated from the ethyl acetate extract of C. cardinalis fermentation broth as 5-methyl-1, 3-benzenediol (compound 1), 4-hydroxy-17R-methylincisterol (compound 2), 5α, 8 α-epidioxy-(22E,24R)-ergosta-6,22-dien-3β-ol (compound 3),3β,5α,6β-trihydroxy-(22E,24R)-ergosta-7,22-dien (compound 4), uridine (compound 5), oosporein (compound 6). CONCLUSIONS: Six compounds are isolated from C. cardinalis strain, among which compound 1 and compound 2 are isolated from the genus Cordyceps for the first time.

Teaching experience of cardiac surgery rotation for standardized training residents not majoring in cardiac surgery / 中华医学教育探索杂志

Cardiac surgery is the latest and fastest growing subject in surgery, which is character-ized by complex diseases and strong specialization.The standardized training of non cardiac surgery is short of time for the residents in cardiac surgery, and the teaching has certain complexity and particularity. The department of cardiac surgery of the Xinjiang Uygur Autonomous Region people's Hospital has analyzed the subject characteristics of the major, and explored the reform of cardiac surgery teaching. We adopted a variety of teaching forms to enhance clinical thinking ability and clinical practice ability as the focus of training, and strengthen clinical operation skills according to individual differences among residents. We improved the enthusiasm and initiative of the non-cardiac surgery residents to learn, training residents standardized,standardized diagnosis and treatment behavior,improve the quality of training.

Analysis of CT- related sites and effective dose in children / 中华放射医学与防护杂志

Objective To analyze the sites of CT scan and radiation dose to children, and to compare the dose difference between children and others aged above 14 years with the dose-monitoring software in a single scan. Methods A total of 125147 cases undergoing CT scans were selected from Jan 1 to Dec 31, 2016, including 542 in children group and 124605 in patients group aged above 14 years. Based on the self-designed CT dose of real-time detection and management software, the scan sites and the composition of the scanning dose were recorded and compared between children and patients aged above 14 years in a single scan. Results Head (39. 67%) and extremities (36. 90%) were the primary CT scan sites in children. Abdominal (20. 77%) and limbs (48. 87%) constituted the main part of effective dose to children. In children group, the average single DLP gradually increased with age ( Z =21. 42, P <0. 05). The mean DLP was (567. 38 ± 433. 03) mGy·cm and average effective dose (5. 58 ± 5. 45) mSv in children group, significantly lower than that in patients aged above[14 years (737. 75 ± 172. 40) mGy· cm and (11. 07 ± 2. 59) mSv, Z= -3. 74,-4. 12, P<0. 05]. DLPs in patients aged above 14 years were higher than or equal to those in children group, with a few exceptions of neck and limbs with higher values(Z= -2. 04、 -3. 97, P<0. 05). Effective doses in children were higher than or equal to those in the group aged above 14 years(Z= -3. 03, -3. 11, -4. 12,P<0. 05), with an exception of chest with higher value. Conclusions Although the parameters of CT scan and dose control were optimized to some extent in children, radiation protection on children still needs to be paid attention for due to the radiosensitivity of children. CT scanning on children should be more careful.

Study on the optimized scanning conditions of cerebral CT angiography based on the angiographic CT head phantom / 中华放射学杂志

Objective To study the impacts of different tube voltage and different noise index(NI) guided automatic tube current modulation on the image quality and radiation dose in cerebrovascular imaging and determine the optimal scanning condition. Methods PH3 angiographic CT head phantom was used for head CTA examination. Scanning protocols: all the scanning objectives were divided into three groups according to the different tube voltages of 80, 100 and 120 kV. Each group applied certain tube current(300,400 mA)and automatic tube current modulation technique with NI from 3 to 10 to perform head CTA. There were 30 scanning proposals with different parameter combinations of tube voltage and tube current. The radiation dose [ CT dose index volume (CTDIvol), dose length product (DLP) and effective dose (ED)], objective indicators of images(CT value of the blood vessels and its noise, CT value of brain tissue and its noise, signal-to-noise ratio , contrast-to-noise ratio) and the subjective scores of the five cerebrovascular segments were recorded. Differences of CT value of the blood vessels and its noise, CT value of brain tissue and its noise, signal-to-noise ratio and contrast-to-noise ratio between different tube voltages and tube currents were analyzed by One-Way ANOVA. Results When the tube voltage was certain, the CTDIvol, DLP and ED were all dropped while NI was increased from 3 to 10. Compared with group(120 kV, 300 mA), CTDIvol of group with 100 kV, 300 mA decreased 35.32%(12.22/34.59), CTDIvol of group(100 kV, NI=6) decreased 46.72%(16.16/34.59). Compared with group(100 kV, 300 mA), CTDIvol of group (100 kV, NI=6) decreased 17.61%(3.94/22.37). When the tube voltage was certain and the tube current and NI were not certain, there is no statistical difference (P>0.05) between CT values of blood vessel and brain, while blood vessel noise, noise of brain, SNR and CNR showed statistical difference (P<0.05). When tube current and NI were certain while tube voltage was varied, all objective indicators discussed above all exhibited statistical difference (P<0.05). SNR and CNR of group(100 kV, NI=6) were higher than group(120 kV, 300 mA) with 6.31%(2.69/42.66)and 7.18%(2.64/36.78), respectively. The tube voltage, NI and tube current had no effect on the subjective scores of first and second grade vessel but greater impact on the fourth and fifth grade vessel. Conclusion In the head CTA scanning, combined the use of NI 6 guided automatic adjustment tube current and low tube voltage(100 kV)technique not only can get better image quality but also significantly decreased the radiation dose.

Study on the optimized scanning conditions of cerebral CT angiography based on the angiographic CT head phantom / 中华放射学杂志

Objective To study the impacts of different tube voltage and different noise index(NI) guided automatic tube current modulation on the image quality and radiation dose in cerebrovascular imaging and determine the optimal scanning condition. Methods PH3 angiographic CT head phantom was used for head CTA examination. Scanning protocols: all the scanning objectives were divided into three groups according to the different tube voltages of 80, 100 and 120 kV. Each group applied certain tube current(300,400 mA)and automatic tube current modulation technique with NI from 3 to 10 to perform head CTA. There were 30 scanning proposals with different parameter combinations of tube voltage and tube current. The radiation dose [ CT dose index volume (CTDIvol), dose length product (DLP) and effective dose (ED)], objective indicators of images(CT value of the blood vessels and its noise, CT value of brain tissue and its noise, signal-to-noise ratio , contrast-to-noise ratio) and the subjective scores of the five cerebrovascular segments were recorded. Differences of CT value of the blood vessels and its noise, CT value of brain tissue and its noise, signal-to-noise ratio and contrast-to-noise ratio between different tube voltages and tube currents were analyzed by One-Way ANOVA. Results When the tube voltage was certain, the CTDIvol, DLP and ED were all dropped while NI was increased from 3 to 10. Compared with group(120 kV, 300 mA), CTDIvol of group with 100 kV, 300 mA decreased 35.32%(12.22/34.59), CTDIvol of group(100 kV, NI=6) decreased 46.72%(16.16/34.59). Compared with group(100 kV, 300 mA), CTDIvol of group (100 kV, NI=6) decreased 17.61%(3.94/22.37). When the tube voltage was certain and the tube current and NI were not certain, there is no statistical difference (P>0.05) between CT values of blood vessel and brain, while blood vessel noise, noise of brain, SNR and CNR showed statistical difference (P<0.05). When tube current and NI were certain while tube voltage was varied, all objective indicators discussed above all exhibited statistical difference (P<0.05). SNR and CNR of group(100 kV, NI=6) were higher than group(120 kV, 300 mA) with 6.31%(2.69/42.66)and 7.18%(2.64/36.78), respectively. The tube voltage, NI and tube current had no effect on the subjective scores of first and second grade vessel but greater impact on the fourth and fifth grade vessel. Conclusion In the head CTA scanning, combined the use of NI 6 guided automatic adjustment tube current and low tube voltage(100 kV)technique not only can get better image quality but also significantly decreased the radiation dose.

Influence of EMT in Radiosensitivity of PC-9:an EGFR- mutant NSCLC cell line / 实用医学杂志

Objective To explore the influence of epithelial mesenchymal transition(EMT)in radiosensi-tivity of EGFR-mutant NSCLC cell with acquired resistance to EGFR-TKI. Methods In this study,EGFR-mutant human lung adenocarcinoma cell line PC-9 and Gefitinib acquired resistance cell line PC-9/AB were used. Western blot was used to assess EMT. Wound healing migration assay was tested. CCK8,colony formation and flow cytome-try were used to evaluate survival fraction ,as the sensitivity to irradiation. Results PC-9/AB displayed radioresis-tance(P<0.05). When EMT was reversed with CDH1,its radiosensitivity was significantly higher than PC-9/AB (P < 0.05). PC-9/TGF also displayed radioresistance (P < 0.05),as well as EMT phenotype presented. Conclusion EMT enhanced the radioresistance of EGFR-mutant NSCLC cell with acquired resistance to EGFR-TKI, possibly through TGF-βpathway.

Clinical observation of Zhang point in the subclavian vein puncture / 中国医师进修杂志

Objective To observe the clinical effect of Zhang point in subclavian vein puncture. Methods One hundred patients underwent deep vein catheterization were selected, ASA grade of Ⅱ- Ⅲ. The patients were divided into 2 groups according to puncture method with 50 cases each, the patients in group A used traditional puncturing method, and the patients in group B used Zhang point puncture method. The total success rate, success rate of the first trial and incidence of complication were recorded. All the patients received the bedside chest X-ray examination to observe the location of central venous catheter after surgery. Results The total success rate and success rate of the first trial in group B were significantly higher than those in group A:100%(50/50) vs. 88%(44/50) and 96%(48/50) vs. 76%(38/50), the incidence of complication was significantly lower than that in group A: 4% (2/50) vs. 20%(10/50), there were statistical differences (P<0.05). Conclusions Using of Zhang point is very simple in subclavian vein puncture catheterization, with a higher success rate and a less complication rate.

Role of cancer stem cells in EMT-induced acquired resistance to EGFR-TKIs in NSCLC cells / 实用医学杂志

Objective To explore the role of cancer stem cells in EMT-induced acquired resistance to EGFR-TKIs in NSCLC. Methods The EGFR del E746-A750 mutated human lung adenocarcinoma PC-9 cell line and gefitinib acquired resistance cell line PC-9/AB were used in this study. EMT was assessed by western blotting assay. The sensitivity to gefitinib was tested with CCK8. Flow cytometry for antibody analysis was used to quantify CSCs within the cell lines. Results Compared with PC-9, PC-9/AB underwent EMT and showed no-table resistance to gefitinib (P < 0.01). Compared with PC-9, the proportions of CSCs were much higher in PC-9/AB. Conclusion EMT plays an important role in the acquired resistance to EGFR-TKIs in NSCLC , possibly through the up-regulation of CSCs.