Preliminary study of clinical application of respiratory navigator-guided stereotactic body radiation therapy of liver malignancies on magnetic resonance linear accelerator / 中华放射肿瘤学杂志

Objective:To investigate the workflow, feasibility and advantages of respiratory navigator-guided stereotactic body radiation therapy (SBRT) of liver malignancies on the magnetic resonance linear accelerator (MR-linac).Methods:Clinical data of 10 patients with liver cancer treated with respiratory navigator-guided SBRT on the MR-linac from September to December 2021 were analyzed retrospectively. All patients underwent CT and MR simulated localization, and plain, enhanced and 4D CT scan, and T 1 3D MR and T 2 3D MR images were collected. The expiratory 4D CT was chosen to design the reference plan. The T 2 3D navigator MR image (end-exhalation) was collected before treatment, the target position was adjusted or the target shape was modified in combination with the real-time monitoring 2D MR image and appropriate online adaptive planning process was selected. Then, the ability of CT, T 2 3D and T 2 3D navigator MR images to display the tumor was evaluated by naked eye. The changes of target volume were calculated. Dosimetric differences between the adaptive and reference plans were compared. The efficacy and adverse reactions of patients were evaluated. Results:In the free breathing state, the T 2 3D navigator MR image was significantly better than T 2 3D MR image to clearly display the tumor and its boundary. The adaptive plans of adapt-to-position (ATP) and adapt-to-shape (ATS) adopted by 10 patients was 37 times and 22 times respectively. The tumor subsided significantly in 3 patients. The average target conformal index (CI) of the adaptive plans was no different from that of the reference plans, but the gradient index (GI) was higher ( P<0.05), especially in the ATS plans. Compared to the reference plans, the normal liver V 5 Gy, V 10 Gy and D mean were almost the same, but the average MU was increased with a significant difference in the ATP adaptive plans ( P<0.05). The average of MU, segments and normal liver D mean and V 10 Gy in the ATS adaptive plans were lower than those in the reference plans, and the liver V 5 Gy was slightly increased. Seven patients were evaluated after 1 month and 3 months. The local control of lesions was promising. Toxicities were mild and no grade 3 or higher toxicities were observed. Conclusion:Respiratory navigator on MR-linac improves the visual clarity of tumors and online MR images, and shows its advantages to guide the adaptive precision radiotherapy of liver tumors, especially in SBRT.

Clinicopathological Characteristics of Patients with Intestinal Diffuse Large B-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinicopathological features of intestinal diffuse large B-cell lymphoma (DLBCL).@*METHODS@#The clinical features, pathological morphology, immunophenotype, and EBER in situ hybridization of 136 DLBCL patients diagnosed in Jinan People's Hospital Affiliated to Shandong First Medical University from January 2007 to October 2014 were analyzed retrospectively. A total of 136 DLBCL samples were obtained, the DLBCL sites were categorized as: duodenum (n=23), ileocecal region (n=63), other small intestine (n=29), rectum (n=7), and other large intestine (n=14). Survival curves for the DLBCL patients were plotted using the Kaplan-Meier method and judged by the Log-rank test.@*RESULTS@#Patients with DLBCL of the ileocecal region and other small intestine except duodenum were mainly male (P=0.042), and had a higher proportion of limited-stage tumors(P=0.015), and lower International Prognostic Index (IPI) (P=0.001). Patients with DLBCL of ileocecal region had higher incidence of lactate dehydrogenase elevation (P=0.007), and higher incidence of intestinal obstruction or perforation (P<0.001) than those with DLBCL of other regions. The 5-year overall survival and 5-year progression-free survival of patients with DLBCL in ileocecal and other small intestine sites were higher than those in other sites, but the differences were not statistically significant (P=0.135, 0.459). Fifty percent of intestinal DLBCL were germinal center B cell-like (GCB) subtypes. A low-grade B-cell lymphoma was found in 21% of 136 tumor samples. In ileocecal and other small intestinal specimens, the proportion of low-grade B-cell lymphoma was 29%, and the difference was statistically significant(P=0.025). About 16% of 136 DLBCL samples expressed follicular lymphoma while no mucosa-associated lymphoid tissue lymphoma . The Epstein-Barr virus-encoded RNA-1 (EBER1) positive rate of duodenal DLBCL was significantly higher than that of other sites (5/23, 22% vs 2/63, 3%, P=0.001).@*CONCLUSION@#The intestinal DLBCL is commonly observed in male, and ileocecal is the most primary site. Patients with DLBCL of the ileocecal region and small intestine except duodenum have low IPI, high proportion of limited-stage tumors, low level of lactate dehydrogenase, high incidence of intestinal obstruction or perforation, and low incidence of inert lymphoma. The EBER1 positive rate of DLBCL in duodenal is higher.

Preparing anti-SARS-CoV-2 agent EIDD-2801 by a practical and scalable approach, and quick evaluation

EIDD-2801 is an orally bioavailable prodrug, which will be applied for emergency use authorization from the U.S. Food and Drug Administration for the treatment of COVID-19. To investigate the optimal parameters, EIDD-2801 was optimized

Clinical Comparation of Two Kinds of Chemotherapy Regimens in the Treatment of Patients with MDS-RAEB/AML-MRC / 中国实验血液学杂志

OBJECTIVE@#To investigate the influence of conventional CAG regimen and decitabine + decreased dose CAG (D+dCAG) regimen on the clinical efficacy and safety of patients with MDS-RAEB/AML-MRC.@*METHODS@#The clinical data of 67 patients with MDS-RAEB/AML-MRC hospitalized in our hospital from March 2012 to July 2017 were analyzed retrospectively. According to chemotherapecctic regimens, 76 patients were divided into 2 groups: 37 patients treated with conventional CAG regimen were enrolled in control group, 30 patients treated with decitabine + decreased dose CAG regimen were enrolled in D+dCAG group. The complete remission (CR) rate, overall remission rate (ORR), OS and PFS time and incidence of adverse reactions in 2 groups were compared.@*RESULTS@#The CR in D+dCAG group was significantly higher than that in control group (P＜0.05). ORR was not significanly different between 2 groups (P＞0.05). There was no significant difference in the cumulative OS rate between 2 groups (P＞0.05). There was no significant difference in the cumulative OS rate and PFS rate in nonimplantation between 2 groups (P＞0.05). The incidence of adverse reactions of hematological system, pulmonary infection, skin and soft tissue infection, agranulocytosic fever and mycotic infection was not significanly different between 2 groups (P＞0.05). The duration of granulocyte deficiency and platelet count less than 20×10/L were not significanly different between 2 groups (P＞0.05).@*CONCLUSION@#Compared with conventional CAG regimen, decitabine + decreased dose CAG regimen in the treatment of patients with MDS-RAEB/AML-MRC can efficiently improve the remission effects and showed the well overall safety, but can not increase the survival rate.

Role of microglial pyroptosis in hypoxic-ischemic brain damage / 中国当代儿科杂志

OBJECTIVE@#To investigate the role of microglial pyroptosis in hypoxic-ischemic brain damage.@*METHODS@#An oxygen-glucose deprivation/reoxygenation (OGD/R) model of rat microglial cells were cultured in vitro. Western blot was used to measure the expression of the pyroptosis-related proteins caspase-1, interleukin-1β (IL-1β), and N-terminal gasdermin D (GSDMD-N) at 0, 1, 3, 6, 12, and 24 hours after OGD/R. After the microglial cells were transfected with lentivirus-mediated silenced gasdermin D (GSDMD), immunofluorescence assay and Western blot were used to measure the transfection rate of GSDMD. Microglial cell lines were divided into three groups: normal control, negative control, and LV-sh_GSDMD (lentivirus-mediated GSDMD silencing). CCK-8 assay and LDH kit were used to observe the effect of GSDMD silencing on the viability and toxicity of microglial cells at 24 hours after OGD/R. Western blot was used to observe the effect of GSDMD silencing on the levels of caspase-1, GSDMD-N, and IL-1β in the microglial cells at 24 hours after OGD/R.@*RESULTS@#The expression levels of the pyroptosis-related proteins caspase-1, GSDMD-N, and IL-1β in microglial cells were upregulated since 0 hour after OGD/R and reached the peak levels at 24 hours. A microglial cell model of lentivirus-mediated GSDMD silencing was successfully constructed. At 24 hours after OGD/R, compared with the normal control group, the GSDMD silencing group had a significant increase in the cell viability and a significant reduction in the cytotoxicity (P<0.05), as well as significant reductions in the protein expression levels of caspase-1, GSDMD-N, and IL-1β in microglial cells (P<0.05).@*CONCLUSIONS@#Lentivirus silencing of the key substrate protein for pyroptosis GSDMD can alleviate hypoxic-ischemic brain damage, suggesting that microglial pyroptosis aggravates hypoxic-ischemic brain damage.

Correlation of Early Minimal Residual Disease Level with Prognosis in AML Patients with NPM1 Mutation Positive after Chemotherapy / 中国实验血液学杂志

OBJECTIVE@#To analyze the correlation of the minimal residual disease level with the prognosis of the AML patients with NPM1 gene mutation positive after chemotherapy.@*METHODS@#The clinical data of 112 newly diagnosed adult AML patients with positive NPM1 gene were collected and retrospectively analyzed. The correlation of the transcripts of NPM1 gene mutation with prognosis of patients was analyzed.@*RESULTS@#In 112 AML patients, the median transcript level of NPM1 gene mutation accounted for 83.68% (5.86%-486.57%), FLT3-ITD mutation positive was found in 44 cases (39.29%), chromosomal abnormalities in 22 cases (19.64%) and complete remission in 96 cases (85.71%). Multivariate logistic regression analysis showed that the initial induction therapy and white blood cell count closely related with complete remission (P＜0.05). The median follow-up time was 22 (3-36) months, and the 3-year overall survival rate was 66.07% in 112 patients. Multivariate logistic regression analysis showed that both the high level of minimal residual disease at the initial complete remission and the high level of minimal residual disease after consolidation therapy were the independent risk factors for overall survival (P＜0.05).@*CONCLUSION@#In newly diagnosed adult AML patients with NPM1 mutation positive, the early high level of minimal residual disease after chemotherapy closely relates with poor prognosis.

Correlation of serum sICAM-1 and sVCAM-1 levels with severity of and prognosis of thyroid-associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the correlation between levels of serum soluble intercellular adhesion molecule-1(sICAM-1), soluble vascular cell adhesion molecule-1(sVCAM-1)and the severity of thyroid-associated ophthalmopathy(TAO). <p>METHODS: A total of 120 patients with TAO admitted to the hospital from August 2016 to March 2018 were selected and included in the study. According to the clinical activity score(CAS), the patients were divided into active stage group and inactive stage group. According to the severity, they were divided into mild group, moderate group and severe group. There were 90 healthy persons were selected as the control group at the same time. The general data, serum sICAM-1 and sVCAM-1 levels were compared among groups and the correlation of sICAM-1 and sVCAM-1 levels with the severity of TAO was analyzed. <p>RESULTS: There were no significant differences in the clinical basic data of patients in between the different clinical active stage groups and the control group, and between the different severity groups and the control group(<i>P</i>>0.05). The levels of serum sICAM-1 and sVCAM-1 in the active stage group were significantly higher than those in the inactive stage group and the control group(<i>P</i><0.01). The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups were significantly higher than those in inactive stage patients and of control groups(<i>P</i><0.01). There were no significant differences in levels of serum sICAM-1 and sVCAM-1 in inactive stage patients of different severity groups. The levels of serum sICAM-1 and sVCAM-1 in active stage patients of different severity groups increased gradually with the severity of the disease. There was no significant correlation between levels of serum sICAM-1 and sVCAM-1 in inactive stage patients and the severity of disease(<i>r</i>=0.102, 0.095, <i>P</i>=0.135, 0.167). Levels of serum sICAM-1 and sVCAM-1 in active stage patients were positively correlated to severity of disease(<i>r</i>=0.695, 0.824, <i>P</i>=0.005, 0.002).<p>CONCLUSION: The levels of serum sICAM-1 and sVCAM-1 in inactive patients will not increase with the severity of the disease. However, the levels in patients with active disease will increase with the severity of the disease, which can be used for clinical diagnosis and staging of TAO and monitoring of the prognosis.

Clinical Efficacy and Safety of R-CDOP Regimen for Treatment of Newly Treated DLBCL Patients with Adverse Prognostic Factors / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical efficacy and Safety of R-CDOP regimen for treatment of newly diagnosed DLBCL patients with adverse prognostic factors.@*METHODS@#The clinical data of 94 patients who suffered from DLBCL and received treatment with R-CDOP regimen, from October 2013 to February 2018 were collected and analyzed retrospectively. The clinical efficacy, survival benifits and safety, as well as the OS and PFS were compared according to clinical features.@*RESULTS@#After treatment of 94 cases with R-CDOP regimen, 73 cases reachived CR, 14 cases reachived PR, 2 cases were in SD and 4 cases were in PD, the ORR was 92.55% (87/94). The OS rate and PFS rate in followed-up 1 year were 94.68%（89/94） and 85.11%（80/94） separately, However, the median OS and PFS were not reached. There was no significant difference in the followed-up cumulative OS rate and PFS rate between patients with different Age, Ann-Arbor stage, IPI score, number of extranodal tumors, tumor diameter, expression of Ki-67 and LDH level and tissue involvement status（P>0.05）. There was no significant difference in the 1 years PFS rate and OS rate between patients with number of extranodal tumors for 0-1 and ≥2（P>0.05）. There was no significant difference in the 1 years PFS rate and OS rate between patients with tumor diameter for 0.05）.@*CONCLUSION@#The R-CDOP regimen in the treatment of newly diagnosed DLBCL patients with poor prognostic factors can efficiently improve the early clinical efficacy, prolong the survival time and possess good safety, but the clinical prognosis for long-term remains to be observed.

Relationship of Peripheral Blood IL-37 Expression with T Lymphocytes Subsets and NK Cells in Patients with Primary Immune Thrombocytopenia / 中国实验血液学杂志

OBJECTIVE@#To study the correlation of IL-37 with T lymphocytes subsets and NK cells in ITP patients, and to explore its possible mechanisms involved in the pathogenesis of ITP.@*METHODS@#Forty-five patients with newly diagnosed ITP(newly diagnosed group), 32 patients of complete remission (remission group) and 22 healthy persons(control group) were selected. The serum level of IL-37 in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The mRNA expression of IL-37, IL-17 and IL-18 in peripheral blood mononuclear cells（PBMNC） in 3 groups was measured by real-time fluorescence quantitative polymerase chain reaction (PCR). The number of IL-18RαCD4 T cells and Tim-3NK cells in the peripheral blood in 3 groups was detected by flow cytometry (FCM).@*RESULTS@#The serum level of IL-37 in the peripheral blood of ITP patients in the newly diagnosed group was significantly higher than that in the control group and the remission group(P＜0.01) . The expression level of IL-37 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P＜0. 05). The expression level of IL-17 and IL-18 in PBMNC of the ITP patients in newly diagnosed group was higher than that in the control group and the remission group(P＜0. 01); the expression of IL-18Rα in CD4 T cells in newly diagnosed group was significantly higher than that in both the control and the remission group(P＜0.01).The expression of Tim-3 in NK cells in ITP patients was significantly lower than that in the control group (P＜0. 01). In ITP patients, the serum IL-37 level and IL-18RαCD4T cells ratio both negatively correlated with Plt count (r=-0.58, r=-0.48) moreo-ver the serum IL-37 level also negatively correlated with amount of CD4 T cells and NK cells (r=-0.29, r=-0.28), but positively correlated with amount of CD8 T cells (r=0.329).@*CONCLUSION@#The IL-37 and its receptors may play an immunoregulatory role in CD4 T cells and NK cells, the IL-37 may be a therapeutic target for ITP patients.

Value of Elasticity Contrast Index of Ultrasonography in Differentiating Benign and Malignant Cervical Lymph Nodes / 中国医学科学院学报

Objective To investigate the diagnostic value of elasticity contrast index(ECI)in the differential diagnosis between benign and malignant cervical lymph nodes.Methods Cervical lymph nodes of 48 patients were examined by traditional ultrasound and ECI in Peking University Third Hospital between December 2016 and April 2017. Patients were further divided into free-hand group and non-free-hand group according to the use of manual compression or not. With pathological or clinical follow-up results as the gold standard,we compared the diagnostic values of traditional ultrasound,ECI,and their combination in the differential diagnosis between benign and malignant lymph nodes.Results Totally 138 lymph nodes were collected from 46 patients,among which 76 were benign and 62 were malignant. The ECI value of malignant lymph nodes(1.69±0.89)were significantly higher than that of benign lymph nodes(1.32±0.87)(t=-2.46,P=0.015).The area under receiver operating characteristic(ROC)curve for traditional ultrasound in discrimination of malignant cervical lymph nodes with benign ones was 0.899,with an optimal cut-off value of 7,which had a sensitivity of 93.5% and a specificity of 84.2%. The area under ROC curve for ECI was 0.649,with an optimal cut-off value of 1.25,which had a sensitivity of 59.7% and a specificity of 60.5%. For their combination,the area under ROC curve was 0.724,with a sensitivity of 93.5% and a specificity of 51.3%. In the group without using free-hand technique,the mean ECI value was 1.77±0.94 for malignant nodes,which was significantly higher than that(1.26±0.81)for benign nodes(t=-3.09,P=0.003). In the group requiring free-hand technique,the ECI value for malignant nodes was 1.33(1.01,1.44),showing no significant difference with benign ones[1.32(0.78,2.18);z=-0.20,P=0.843].Conclusions Conventional ultrasound has higher diagnostic value than ECI and their combination in differentiating benign and malignant lymph nodes. The role of ECI in evaluating other organs requires further investigations.

The Clinical Efficacy of Small Dose CAG Program in Comparison with MA Program in Senile Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy of small dose CAG regimen and MA regimen in the senile patients with acute myeloid leukemia(AML).</p><p><b>METHODS</b>The clinical data of 83 senile patients with AML from Sep. 2012 to Sep. 2016 in our Hospital were analyzed retrospectively. According to the chemotherapy regimens, the patients were divided into CAG group and MA group; 36 patients in CAG group were treated with small dose CAG, while 47 patients in MA group were treated with MA. The curative efficiency(CR rate, PR rate,NR rate and OR rate), side effect (myelosuppression,infection,intestinal discomfort and hemorrage), serum cytokines(IL-6，IL-17，TGFβ）, and prognosis(survival rate in 2 years, MST and SST) were observed, compared and studied in these 2 group.</p><p><b>RESULTS</b>The curative efficiency, CR rate and PR rate of the CAG group were not significantly different from that of the MA group (P>0.05）. The side effect in CAG group was significantly lower than that in the MA group (P<0.05）. The levels of serum cytokines of the MA group were lower than those of the CAG group. Additionally, the prognosis was not significantly different between 2 groups(P>0.05）.</p><p><b>CONCLUSION</b>For senile patients with acute myeloid leukemia, compared with traditional MA regimen, the small dose CAG has a certain curative efficacy and survival rate, and the incidence of side effect reduced. Therefore, the small dose CAG is superior to MA for the senile patients with acute myeloid leukemia.</p>

Number and Function of Myeloid-Derived Suppressor Cells in Patients with Adult Primary Immune Thrombocytopenia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the number of myeloid-derived suppressor cells(MDSC) and the level of prostaglandin E2(PGE2) in the bone marrow of adult ITP patients, and to explore their possible mechanisms involved in the pathogenesis of this disease.</p><p><b>METHODS</b>Twenty-five patients of newly diagnosed ITP, 25 patients of complete remission group and 15 patients of control group were selected. The number of MDSC in the bone marrow between 3 groups was detect by flow cytometry (FCM). The serum level of prostaglandin E2 (PGE2) in 3 groups was determined by enzyme linked immunosorbent assay (ELISA). The relative expression of IFN-γ mRNA in bone marrow mononuclear cells was measured by real time fluorescence quantitative polymerase chain reaction (RT-qPCR) in each groups.</p><p><b>RESULTS</b>The number of MDSC in the complete remission group was significantly higher than that in the control group (P<0.05); the number of MDSC in the newly diagnosed group was higher than that in the control group; the number of MDSC in the complete remission group was higher than that in the newly diagnosed group. The serum level of PGE2 in bone marrow of ITP patients in the newly diagnosed group was higher than that of the control group（P<0.05）. The serum level of PGE2 in the bone marrow of ITP patients of the complete remission group was higher than that of the control group (P<0.05）. The level of PGE2 in bone marrow serum of ITP patients of the newly diagnosed group was lower than that in the complete remission group(P<0.05）. The relative expression level of IFN-gamma in bone marrow mononuclear cells of the ITP patients in newly diagnosed group was higher than that in the control group and the complete remission group（P<0.001）. The relative quantification (RQ) of IFN-γ in bone marrow mononuclear cells was 2.60 between the newly diagnosed group and the complete remission group.</p><p><b>CONCLUSION</b>When adult ITP disease is remitted, the number of MDSC rises and correlates with the therapeutic response and PGE2 level in the bone marrow.</p>

Adiponectin is protective against endoplasmic reticulum stress-induced apoptosis of endothelial cells in sepsis

Endoplasmic reticulum (ER) stress is a critical molecular mechanism involved in the pathogenesis of sepsis. Hence, strategies for alleviating this stress may be essential for preventing cardiovascular injuries under sepsis. Adiponectin is secreted by adipocytes and its levels are decreased in sepsis. The purpose of this study was to investigate the protective effects of adiponectin treatment on endothelial cells and its mechanism. Male Wistar rats underwent cecal ligation and puncture (CLP) before being treated with adiponectin (72 and 120 μg/kg). The levels of malondialdehyde (MDA) in plasma, histological structure, and apoptosis of endothelial cells were evaluated. In vitro, human umbilical vein endothelial cells (HUVECs) were treated with adiponectin at 10 and 20 μg/mL for 24 h after stimulation by lipopolysaccharide (LPS). The levels of reactive oxygen species (ROS), ultrastructure, rate of apoptosis, the expression of inositol-requiring enzyme 1α (IRE1α) protein, and its downstream molecules (78 kDa glucose-regulated protein (GRP78), C/EBP homologous protein (CHOP), and caspase-12) were detected. The results showed that the levels of MDA and ROS induced by CLP or LPS stimulation were increased. Furthermore, endothelial cell apoptosis was increased under sepsis. The IRE1α pathway was initiated, as evidenced by activated IRE1α, increased GRP78, and up-regulated CHOP and caspase-12 in HUVECs. Following treatment with adiponectin, the number of apoptotic endothelial cells was markedly decreased. These findings demonstrated that treatment with adiponectin decreased apoptosis of endothelial cells caused by sepsis by attenuating the ER stress IRE1α pathway activated by oxidative stress.

Dosimetric comparison between two brachytherapy applicators in cervical cancer treatment / 中华放射肿瘤学杂志

Objective To compare the dosimetric parameters between the use of Tandem and Ring (TR;Nucletron#090.617) or Tandem and Ovoid (TO;Nucletron#189.730) applicators during three-dimensional (3D) high-dose rate (HDR) brachytherapy (BT) for cervical cancer.Methods The records of 40 cervical cancer (ⅡB-ⅣA) patients treated with 3D-image-guided HDR-BT were reviewed.Of these 40 patients, 20 were treated with the TO applicator, and 20 with the TR applicator.The D100% and V150% of the clinical target volume (CTV) and the D2 cc of organs at risk (OAR)(the rectum, bladder, and small intestine) during 3D-HDR-BT using TO and TR were compared using the independent sample t-test.ResultsOverall metrics:CTV volume:66.04±13.86 cm3(TR) vs.65.67±15.08 cm3(TO)(P=0.052);CTV D100:3.71±0.34 Gy (TR) vs.3.37±0.49 Gy (TO)(P=0.016);CTV V150%:0.54±0.02(TR) vs.0.56±0.04(TO)(P=0.034);rectum D2 cc:3.38±0.30 Gy (TR) vs.2.95±0.80 Gy (TO)P=0.037);bladder D2 cc:4.33±0.39 Gy (TR) vs.2.93±1.27 Gy (TO)(P=0.00);and small ntestine D2 cc:3.04±1.02 Gy (TR) vs.3.41±0.57 Gy (TO)(P=0.171).Conclusions TR has better CTV coverage than TO during 3D HDR brachytherapy for cervical cancer.In addition, D2 cc of the rectum and bladder were both igher with TR than with TO, though there is no significant dosimetric difference in the small intestine between the two applicators.Therefore, tumor location, extent of invasion, and vaginal conditions should be considered when selecting the suitable pplicator for the treatment of cervical cancer.

Dosimetric influence of dwell weight standard deviation and applicator displacement in patients with cervical cancer / 中华放射肿瘤学杂志

Objective To investigate the dosimetric influence of dwell weight standard deviation (DWSD) and applicator displacement in cervical cancer patients treated with three-dimensional brachytherapy.Methods A total of 20 cervical cancer patients who had completed radical treatment were selected in this study.The Fletcher applicator (Nucletron#189.730) was used for these patients.A new plan,based on the former CT images and structures,was designed for each patient.In former and new plans,dwell weight was recorded,and DWSD was calculated.Two groups,low-DWSD (LDWSD,0.141-0.299) and high-DWSD (HDWSD,0.211-0.337),were set according to the DWSD size for the two plans.Dosimetric effects from ± 1 mm displacement of tandem applicator or ovoid applicator were simulated with Oncentra (R) Brachy V4.3 treatment planning system.D100,D90,and V150 for clinical target volume (CTV)and D0.1cc,D1cc,and D2cc for the bladder,rectum,and sigmoid were evaluated.Dosimetric comparisons were made between the LDWSD group and HDWSD group to study the dosimetric effects of DWSD and applicator displacement in cervical cancer patients.Results The dosimetric effects from applicator displacement increased with increasing DWSD.If there was a 1 mm displacement of tandem applicator or ovoid applicator,D100,D90,and V150 of CTV were 3.0％,23.8％,and 4.8％ higher or 0.5％,1.2％,and 5.2％ higher in the HDWSD group than in the LDWSD group;D0.1cc,D1cc,and D2cc of the bladder and rectum were significantly higher in the HDWSD group than in the LDWSD group,particularly for the sigmoid (up 44.0％,22.8％,and 16.8％) and (up 10.3％,14.4％,and 12.4％).Conclusions DWSD should be considered in plan evaluation for cervical cancer patients treated with three-dimensional brachytherapy.The dosimetric influence from applicator displacement can be decreased by reducing DWSD properly.

Research in technology of preparation and the stability in polysaccharide of aloe / 国际中医中药杂志

Objective To compare the contents in polysaccharide of aloe in gel of aloe with preparation in different processing methods on fresh aloe of outer cuticle and investigate their stability. It could provide technology of preparation of polysaccharide of aloe.Methods The aloe gel had been prepared through the fresh juicing method, and alcohol sinking was applied to abstract polysaccharides of aloe in proportion of sixty, seventy, eighty and ninety percent. The colorimetric method of anthracenone - thick sulfuric acid had been taken to determine contents of polysaccharide in different proportions by alcohol sinking. The contents of polysaccharide were compared among different processing methods in fresh aloe of outer cuticle, and then the stability on condition of different temperatures, pH and the reagent of reductant-oxidant with polysaccharides of aloe were investigated. Results The content abstracted from polysaccharide of aloe was the higher when the proportion was eighty percent and its character of powder was better. And content abstracted from polysaccharide of aloe with the outer cuticle was higher than that out of the outer cuticle. The powders from the polysaccharide of aloe with the outer cuticle were gray-green, gray-brown or gray-white. The powders from polysaccharide of aloe without the outer cuticle were partial-white, more well-distributed and delicate. The stability in polysaccharide of aloe was better with the condition of low temperature, reducing agent and the solution with pH from five to seven, while the stability was lower when in high temperature, oxidizing agent and the solution with strong acid and strong alkali. Conclusions The proportion of eighty percent with alcohol sinking, decorticating the outer cuticle of fresh aloe has the higher content and the better character in the polysaccharide of aloe.

Analysis of schistosomiasis endemic status of national surveillance sites in Yunnan Province,2016 / 中国血吸虫病防治杂志

Objective To master the prevalence status of schistosomiasis in Yunnan Province in 2016,so as to provide the evidence for formulating the control strategy and intervention measures. Methods The schistosomiasis heavy-endemic villages were selected from each of 18 endemic counties as the survey sites. Then,the serological and etiological tests were carried out in the local residents and floating population,and the infection status of the livestock,field feces and Oncomelania hupensis snails were surveyed. Results The serum positive rate of schistosomiasis of local residents was 8.78％and the serum positive rate was 2.26％of floating population. No schistosome eggs were found in the stool examinations in the population. The area with snails was 80.0546 hm2 in 2016 with an increasing rate of 45.47％compared to that in 2015. The average density of living snails was 0.0317/0.1 m2. No schistosome-infected snails were found for the last four years and no new area with snails was found for the last three years. No positive livestock or feces were found. Conclusions The schistosomiasis epidemic situation is stabilized in Yunnan Province in 2016. However,the area with snails and the number of living snails are increasing,and therefore,the schis-tosomiasis epidemic risk still exists. So,the comprehensive control measures should be strengthened continuously.

Comparison of Fentanyl and Remifentanil in children underwent airway foreign body removal / 中国内镜杂志

Objective To compare the safety and effectiveness of Propofol-Fentanyl and Propofol-Remifentanil total intravenous anesthesia for airway foreign body (FB) removal in children. Method 280 children aged 1 ~ 3 years underwent rigid bronchoscopy for FB removal were randomized into two groups. The Fentanyl group (Group F, n = 140) were given Propofol 2.00~3.00 mg/kg and Fentanyl 2.00 μg/kg for induction and Propofol 200.00 ~ 500.00 μg/(kg·min) for maintenance of anesthesia. The Remifentanil group (Group R, n = 140) were given Propofol 2.00 ~ 3.00 mg/kg and Remifentanil 1.00 ~ 1.50 μg/kg for induction of anesthesia, while anesthesia was maintained with Propofol 200.00 ~ 500.00 μg/(kg·min) and Remifentanil 0.10 ~ 0.20 μg/(kg·min). All the children during the procedure were with spontaneous respiration. SpO2 before inserting rigid bronchoscope (T1), 1 min (T2) and 3 min (T3) after insertion, 3 min (T4) and 10 min (T5) after extraction were recorded. PETCO2 after endoscopy (T6) was measured. Adverse events, including body movement, cough, breath-holding, and hypoxemia,were observed. The time of induction, surgery, recovery and the total dosage of the intravenous agents were recorded. Results SpO2 of the two groups were in normal range at T1 ~ 5, which was higher in group R than group F at T2 ~ 5 (P < 0.05). PETCO2 of group R was lower than group F at T6 (P < 0.05). The rate of body movement and cough were comparable between the two groups (P > 0.05), while breath-holding and hypoxemia were more frequent in group F (P < 0.05). The time of induction and recovery were shorter in group R (P < 0.05), while surgery time and the Propofol dosage were similar (P > 0.05). The total dose of Fentanyl was significantly higher than Remifentanil (P < 0.05). Conclusion Combination of Propofol with Fentanyl or Remifentanil both produce effective anesthesia in children undergoing FB removal. But Propofol-Remifentanil provides more stable oxygen saturation, faster induction and recurrence of anesthesia, as well as less intraoperative complications.

Ratio of Primary Bone Marrow Cells after Induction Chemothrapy for Two Weeks in the Patients with PhALL and Its Influence on Complete Remission and Overall Progrosis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the influence of bone marrow blasts ratio after induction chemotherapy for 2 weeks in patients with PhALL, and it's influence on complete remission (CR) and overall prognosis.</p><p><b>METHODS</b>A total of 172 patients with PhALL in our hospital from March 2012 to February 2016 were selected. The bone marrow blast ratio was analyzed by the receiver-operating characteristic curve (ROC) in patients after induction chemotherapy for 2 weeks, at same time its influence on CR and overall prognosis of PhALL patients was evaluated.</p><p><b>RESULTS</b>The cutoff value of CR was 0.075, its area under ROC was 0.763; the comparison of area under ROC with A=0.5 showed statistically significant difference, therefore 172 patients with PhALL were grouped according to bone marrow blast ratio after induction chemotherapy for 2 weeks: 104 cases (60.5%) with bone marrow blast ratio <0.075, 68 cases (39.5%) with bone marrow blast ratio ≥0.075. The PhALL patinets with bone marrow blast ratio <0.075 who achieved CR and finally achieved CR after induction chemotherapy for 4 weeks acconnted for 89 (85.6%) and 99(95.2%) respectively, which were significantly higher than those in PhALL patients with bone marrow blast ratio≥0.075, [29(42.6%) and 52 (76.5%)](P<0.05). In addition, the influencing factor clinically reducing the OS and DFS rate of patients and enhancing the ralapse rate of patients were mainly chemotherapy, the failure of induction chemotherapy (patients did not achieve CR after induction therapy for 4 weeks), the bone marrow blast ratio≥0.075 after induction treatment for 2 weeks, and CNSL at diagnosis and so on, while the enhaced WBC count at diagnosis was poor factor affecting the DFS rate of patients.</p><p><b>CONCLUSION</b>After induction chemotherapy for 2 weeks, the elevated bone marrow blast ratio in PhALL patients will be infavourable to CR, and the overall prognosis is poor.</p>

A new oleanane-type triterpenoid glycoside from roots of Ilex asprella / 中国中药杂志

A new δ-oleanane-type triterpenoid glycoside, 3-O-(3-O-sulfo)-β-D-glucopyranosiduronic acid 3β-hydroxy-13(18)-oleanen- 28-oic acid 28-β-D-glucopyranosyl ester (1), along with ten known triterpenoid glycosides, rotundinoside A (2), oblonganoside M (3), 3-O-β-D-glucopyranosyl-(1→2)-α-L-arabinopyranosyl 3β,19α-dihydroxy-20α- urs-12-en-28-oic acid 28-O-β-D- glucopyranosyl ester (4), ilexsaponin B2 (5), ilexside Ⅱ (6), rotundinoside B (7), ilekudinoside B (8), ilexpublesnin E (9), ilekudinoside D (10) and ilexpernoside D (11), was isolated from the 75% ethanol extract of the roots of Ilex asprella by various chromatographic separation. Their structures were identified on the basis of MS, NMR spectroscopic analysis and chemical methods. In addition, 2-11 were isolated from I. asprella for the first time.