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Objective:Utilizing multi-criterion optimization (MCO) technology to improve plan design quality based on knowledge-based planning (KBP) model.Methods:Fifty-five patients with nasopharyngeal carcinoma (NPC) who had completed radiotherapy were selected, and fixed-field intensity-modulated radiotherapy (IMRT) technology was used in each case. Among them, 40 cases were randomly selected as training set 1. Then, IMRT plans in training set 1 were preprocessed by MCO technology to construct a new training set 2. With the initial training set 1 and the processed training set 2 as training samples, the traditional KBP model and the MCO-KBP model refined by MCO technology were trained, respectively. Among the remaining 15 cases, 5 cases were randomly selected as the validation set, and the remaining 10 cases were used as the test set. After verification, the test set was used to statistically analyze the plan quality of the initial manual plan and the automatic plan generated by the traditional KBP model and the MCO-KBP model.Results:The target dose (D 95%) of plans generated by the traditional KBP model and the MCO-KBP model met the clinical requirements. Conformity index (CI) and homogeneity index (HI) were almost the same ( P>0.05), and the doses of organ at risk (OAR) of the automatic plans generated by the MCO-KBP model were lower than those of the traditional KBP model. For example, compared with the traditional KBP model, the average D max of the brainstem in the automatic plans generated by the MCO-KBP model was lower by 2.13 Gy, the average D mean of the left parotid gland was lower by 1.39 Gy, the average D mean of the right parotid gland was lower by 1.59 Gy, and the average D max of the left optic nerve was lower by 1.42 Gy, the average D max of the right optic nerve was lower by 1.16 Gy, and the average D max of the pituitary gland was lower by 1.88 Gy. All of the above-mentioned dosimetry indexes were statistically significant. Conclusion:Compared with the traditional KBP model, the IMRT plans designed by the refined MCO-KBP model have obvious advantages in the protection of OAR, which proves the feasibility of utilizing MCO technology to improve the plan design quality of the KBP model.
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Objective To investigate the clinical efficacy of alprostadil in the treatment of diabetic nephropathy,and its effect on serum bone morphogenetic protein 7(BMP-7)and transforming growth factor-β1(TGF-β1)levels in patients.Methods From January 2014 to January 2016,120 cases of diabetic nephropathy in the People's Hospital of Beilun District were selected in the study.According to different treatment methods,the patients were divided into study group and control group,with 60 cases in each group.The two groups were treated with basic treatment,the study group was treated with alprostadil for 8 weeks.The clinical efficacy and serum levels of BMP-7 and TGF-β1 were compared between the two groups.Results There were no significant differences in serum BMP-7 and TGF-β1 between the two groups before treatment(P>0.05).After treatment,the serum BMP-7[(17.54 ±3.90)pg/mL]in the study group was higher than that in the control group [(15.20 ±2.96)pg/mL](t=3.607,P<0.05),the level of TGF-β1[(7786.3 ±1951.2)pg/mL]was lower than that of the control group [(10021.5 ±2109.7)pg/mL](t=6.025,P<0.05).There were no significant differences in the levels of fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG)and glycosylated hemoglobin(HbA1c)between the two groups(all P >0.05).After treatment,the levels of UAER,Hcy,Scr,BUN in the study group were(89.62 ±17.74)g/min,(23.55 ±4.17)mol/L,(64.2 ±8.5)mol/L,(6.70 ±0.96)mmol/L,which were significantly lower than those in the control group [(118.50 ± 21.18)g/min,(29.69 ±4.82)mol/L,(74.7 ±9)mol/L,(7.52 ±0.89)mmol/L](t=8.097,7.462,6.57,4.852,all P<0.05).Conclusion Alprostadil has better clinical effect on diabetic nephropathy,and can significantly improve serum BMP-7 and TGF-β1 levels.
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OBJECTIVE:To investigate the protective effect of Compound ginkgo leaf granules on liver function damage of acute pancreatitis. METHODS:Totally 82 patients with severe acute pancreatitis(SAP)complicated with liver function damage se-lected from our hospital during Sept. 2013-Sept. 2015 were randomized into control group and observation group according to ran-dom number table,with 41 cases in each group. Control group was given SAP related routine therapy. On the basis of the control group,observation group was additionally given Compound ginkgo leaf granules 5 g added into warm boiled water 80 mL via naso-gastric tube,tid,one week as a treatment course,for 2 courses. The remission time of abdominal pain,serum amylase recovery time,length of hospital stay and adverse drug reactions were observed in 2 groups. The levels of serum amylase,ALT,TBIL, AST,γ-GT,ALB,IL-6,TNF-α,creotoxin concentration,MDA,SOD,GSH-Px,total antioxidant capacity(TAC)and peripher-al blood PMN NF-κB levels were determined in 2 groups before and after treatment. RESULTS:In control group,3 patients with-drew from the study and 38 patients completed the study;in observation group,6 patients withdrew from the study and 35 patients completed the study. The remission time of abdominal pain,recovery time of serum amylase and the length of hospital stay in obser-vation group were significantly shorter than control group,with statistical significance (P0.05). After treatment,the levels of serum amylase,ALT,TBIL, AST,γ-GT,IL-6,TNF-α,creotoxin concentration,NF-κB and MDA in 2 groups were decreased significantly,while the levels of ALB,SOD,GSH-Px and TAC were increased significantly;the observation group was significantly lower or higher than the con-trol group,with statistically significant (P0.05). CONCLUSIONS:Compound ginkgo leaf granules can significantly decrease serum amylase,protect liver function, with good safety. The mechanismmay be inhibiting the release of inflammatory factors,improving oxidative stress reactions,reduce the concentration of creotoxin and inhibiting the activity of NF-κB.
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Objective To investigate the drug resistant mechanism and homology of three strains of carbapenem-resistant Klebsiella pneumoniae (K.pneumoniae) isolated from different sites of one patient.Methods Three strains of carbapenem-resistant K.pneumoniae were isolated from femoral vein catheter tip,wound secretions and sputum of a patient with severe burns,respectively.Their carbapenemase,metallo-β-lactamase (MBL) and drug resistance genes were detected by modified Hodge test,double-disk synergy test and combination disk diffusion and PCR,respectively,and homology and biological typing were analyzed by enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) assay and multilocus sequence typing (MLST) technology,respectively.Results The carbapenemase and MBL of three strains of carbapenem-resistant K.pneumoniae were negative and positive,respectively.The blaNDM-1 gene was identified from the three strains,but other drug resistance genes such as blanC,blaGES,blaIMP,blaSPM,blaVIM,blaGIM and blaOXA-48 were not detected.ERIC-PCR showed that three isolates belonged to the same genotype,and MLST showed that they were type ST17.Conclusion Carring blaNDM-1 gene is the main cause leading to the drug resistance of three strains of carbapenem-resistant K.pneumoniae,and they belong to the same genotype.
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Objective:To investigate relationship between AdeABC efflux pump and resistance of Acinetobacter baumannii against carbapenem.Methods:Carbapenem-resistant strains were acquired from multistep selection resistance test by meropenem in vitro.The quantitation test for sensitivities of strains before and after induction was determined by the E-test,and carbonylcyanide-m-chlorophenylhydrazone (CCCP) inhibition test was used to screen efflux pump.PCR,sequencing analysis,or real-time PCR was used to analyze the changes of regulatory genes adeR and adeS of the AdeABC efflux pump system,or expressions of adeA,adeB,adeR,and adeS in the strains before and after induction,respectively.Results:The minimal inhibitory concentrations (MICs) of meropenem were at 0.38 μg/mL and 0.25 μg/mL in parental sensitive strain S25595 and S7257,respectively,and the MICs of meropenem for both S25595 and S7257 after induction were more than 32 μg/mL.Compared with parental sensitive strains,the expression level of adeA,adeB,adeR,and adeS mRNA were elevated from 2.45 to 9.44 times,but there were no gene mutations or insertion sequences in the regulatory gene adeS and adeR.Conclusion:High expression of the AdeABC efflux pump system in Acinetobacter baumannii is closely associated with meropenem resistance,The upregulation of adeA and adeB expression is not due to gene mutations in the regulatory gene adeS and adeR and other mechanisms might account for it.
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Aim To investigate whether Hcy influenced the intestinal mucosal permeability by regulating MEK-ERK-MLCK pathway. Methods SD rats were divided into 4 groups:normal group, normal+Hcy group, TN-BS/ethanol group, TNBS/ethanol+Hcy group. Experi-mental colitis model with hyperhomocystinemia was es-tablished in rats with intracolonic administration of TN-BS and subcutaneous injection of Hcy. The colonic mucosal tissue was collected for histopathological exam-ination and activity of myeloperoxidase ( MPO ) . The protein expression of MLCK, p-MLCK, MEK, ERK and p-ERK in intestinal mucosal tissues was examined by Western blot method. The mRNA expression of ML-CK was examined by RT-qPCR method. Result Com-pared with the normal group and TNBS group, the DAI and HI scores and the MPO activity were increased in TNBS/ethanol+Hcy group ( P <0. 01 ) . Western blot and RT-qPCR showed that expression of MLCK, p-ML-CK, MEK, ERK and p-ERK increased in small intes-tine in TNBS/ethanol+Hcy group. Conclusion Hcy can increase intestinal permeability in TNBS-induced colitis rats by regulating the expression of MEK-ERK-MLCK signal pathway.
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OBJECTIVE:To systematically review the efficacy and safety of nedaplatin or cisplatin combined with paclitaxel in the treatment of advanced non-small cell lung cancer(NSCLC)and esophageal cancer. METHOD:Retrieved from PubMed,CJFD and Wanfang Database,randomized controlled trials(RCT)about nedaplatin combined with paclitaxel(TN)or cisplatin combined with paclitaxel (TP) in the treatment of advanced NSCLC and esophageal cancer were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extract and quality evaluation. RESULTS:Totally 7 RCTs were included,involving 505 pa-tients. Results of Meta-analysis showed,there were no significant differences in the short-term efficacy [NSCLC:OR=1.08,95%CI (0.66,1.75),P=0.76;esophageal cancer:OR=1.44,95%CI(0.68,3.06),P=0.34],1-year survival rate [NSCLC:OR=1.21, 95%CI(0.60,2.44),P=0.59],2-year survival rate [NSCLC:OR=1.01,95%CI(0.38,2.68),P=0.99],the incidence ofⅢ/Ⅳleuko-penia [esophageal cancer:OR=1.36,95%CI(0.62,2.96),P=0.44],incidence ofⅢ/Ⅳthrombocytopenia [NSCLC:OR=1.37,95%CI(0.64,2.92),P=0.42;esophageal cancer:OR=0.97,95%CI(0.30,3.18),P=0.96] and incidence of Ⅲ/Ⅳ neutropenia [NSCLC:OR=1.38,95%CI(0.70,2.74),P=0.35]. Compared with TP,TN can significantly reduce the incidences of nausea and vomiting [NSCLC:OR=0.34,95%CI(0.20,0.60),P<0.001;esophageal cancer:OR=0.16,95%CI(0.07,0.35),P<0.001] and nephrotox-icity [esophageal cancer:OR=0.10,95%CI(0.02,0.55),P=0.009]. CONCLUSIONS:Both TN and TP show good efficacy in the treatment of NSCLC,but TN has lower incidences of astrointestinal reactions and nephrotoxicity.
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Objective: To analyze the prevalence and risk factor of co-exiting pre-hypertension and pre-diabetes condition in middle to elder adults, and to provide the theoretical basis for preventing cardiovascular disease in relevant population in Chengdu area. Methods: A total of 5240 middle to elder adults from (40-79) years of age in Chengdu area were enrolled for a stratiifed cluster sampling study. The blood pressure, glucose and other clinical information were collected by more than 30 medical professionals with uniifed training to investigate the prevalence of co-exiting pre-hypertension and pre-diabetes condition with the risk factors. Results: The overall prevalence rate of coexisting pre-hypertension and pre-diabetes condition was at 12.5% in Chengdu area and the standardized prevalence was at 11.5%. The prevalence rate in urban area was 12.4% and in rural was 13.2%, P=0.47, the prevalence in male gender was 12.7% and in female was 12.4%,P=0.81. With the increased age, the prevalence trend was elevated accordingly. Multi-regression analysis indicated that the elder age, overweight or obesity (female with abdominal obesity), sibling history of hypertension, hyper-triglyceridemia, multiple childbirth and menopause had the higher risk of coexisting pre-hypertension and pre-diabetes condition, allP Conclusion: There is a high prevalence rate of coexisting pre-hypertension and pre-diabetes condition in middle to elder population in Chengdu area and the prevalence is closely related to age. It is important to prevent such condition by elevating educational level nationwide, controlling waist and body weight, adjusting diet structure with proper exercise.
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Objective To investigate the effect of health education on the improvement of home caregivers’knowledge and skills on indwelling gastric tube feeding.Methods Fifty home caregivers of senile patients with tube feeding were recruited in the study using a self-designed questionnaire,followed by pertinent health education based on the survey results.The effects of health education were compared between pre-and post-education in terms of their knowledge on tube feeding.Results The total score on knowledge after education was significantly higher than that before education(P<0.001).There were significant improvements in tube feeding temperature,volume,time for tube disinfection and judgment of tube’s place in the stomach after education(all P<0.05). Conclusion Through health education,we could increase the skills of caregivers in caring the patients with tube feeding and thus improve the life quality of these patients.
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Objective To prospectively compare the efficacy of omeprazole and esomeprazole on H. pylori eradication related to cytochrome P450 (CYP) 2C19 polymorphism in Chinese Han poputafion. Methods A total of 240 patients with peptic ulcer were randomly assigned to receive either EAC (amoxicillin, clarithromyein and esomeprazole) treatment or OAC (amoxicillin, clarithromycin and orneprazole) treatment for one week with 120 each. Then, the patients were sustained treated with esomeprazol or omeprazole for 3 weeks. The endoscopic evaluation was performed 2 weeks after treatment. At the end of the treatment, a carbon-13 (13C) urea breath test (13C-UBT) was performed to determine H. pylori status. Polymerase chain reaction and restriction fragment length polymorphism were used to detect CYP2C19 genotypes including extensive metabolizer (EM), poor metabolizer (PM), homozygous (homEM) and hetEM. Results Two hundred and twenty five of 240 patients completed the study. H. pylori eradication was 79.2% with OAC regimen and 88.3% with EAC regimen by intention to-treat (ITT) analyses without difference (P>0.05). Whereas H. pylori eradication was 87.20/00 with OAC regimen and 91.4% with EAC regimen by per-protocol (PP) analyses without difference (P>0. 05). However, both ITT and PP analysis showed that there was significant difference in H. pylori eradication between EAC regimen (91.9% and 97.1%) and OAC regimen (71.8% and 77.8%) in patients with homEM genotype (P= 0.037 and P=0.028). Two weeks after treatment, the percentage of ulcer healing was 79.2% or 81.9% in EAC group and 69.2% or 76.1% in OAC group by ITT or PP analysis, respectively (P> 0.05). Low side effects were noted in EAC or OAC groups (3.3% vs. 7.5%,P>0.05). Conclusion The high eradication will be achieved by esomeprazole-based triple regimen which is superior to omeprazole-based triple regimen in treatment of patients with homEM genotype.
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@#The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.
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4 holding time were observed among the three groups.After repeated doses,the PMs showed a significantly higher intragastric pH value than that of the homEMs or hetEMs.Conclusion The pharmacodynamic effects of omeprazole and its pharmacokinetics depend on the CYP2C19 genotype status in Chinese volunteers.
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4 time percentage of 24 h were observed among the three different genotype groups after a single dose or repeated doses of rabeprazole. And the ratio of these pH dates between day 1 and day 8 ranged from 85% to 110%.Conclusions In Chinese healthy Han people, CYP 2C19 genetic polymorphism has not any significant influence on acid inhibitory efficacy and the metabolism of rabeprazole. Rebeprazole could rapidly achieved maximum acid inhibitory efficacy in the subjects with different CYP2 C19 genotype status.
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Objective:To compare the effects between carvedilol and atenolol in treating congestive heart failure of rat models,and to discuss the mechanism of carvedilol.Methods:8 weeks after partial ligating abdominal aorta,30 rats were randomly divided into 3 groups:heart failure group(n=10),carvedilol group(n=10) and atenolol group(n=10).Sham-operated group(n=10) were selected randomly as control.After 4 weeks of medical therapy,hemodynamic parameters and ventricular mass index were studied.Results:Compared with sham-operated group,all the hemodynamic parameters in heart failure group were deteriorated.In carvedilol and atenolol groups,heart rate(HR) and mean blood pressure(MBP) were decreased(P
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Objective:To establish rat model of ventricular hypertrophy and heart failure by partially banding abdominal aorta for different time limits.Methods:60 Wistar rats were randomly divided into three groups:A group which were ligated for 4 weeks;B group being ligated for 8 weeks;and sham-operated group (each containing 20 Wistar rats).Left and right ventricular mass index,hemodynamic parameters,cardiac morphological changes and the time of achieving heart failure model were investigated in different groups.Results:There were 16.67% heart failure rats in A group,while 73.68% in B group.The death of models occurred in the first week after experimental procedure.MBP and LVSP were increased greatly in A group,and HR,MBP,LVSP and ?dp/dt were decreased while LVEDP increased in B group compared with A and sham-operated groups( P
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Objective:To investigate the influence of oxygen stress on the level of cardiac apoptosis index(AI) in chronic congestive heart failure rats,and to intervene with the third-generation blocker-carvedilol to elucidate its mechanism.Methods:8 weeks after partially banding abdominal aortic artery,20 Wister rats were randomly assigned into two groups:①heart failure group( n =10);②carvedilol group( n =10).Meanwhile,sham-operated rats( n =10) were established as a control group.After 4 weeks of remedy,hemodynamic parameters,ventricular mass index(LVMI and RVMI),oxygen stress including superoxide dismutase (SOD) and malondialdehyde (MDA),and myocardiac apoptosis were studied.Results:①Compared with sham-operated rats,all the hemodynamics were deteriorated,and LVMI and RVMI were increased significantly ( P
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AIM: To investigate the effects of melatonin (MT) on the immunological function in colon of rats immunological colitis. METHODS: The rats colitis was produced by enema with trinitrobenzene sulfonic acid and ethanol. The experiment groups included normal group, model group, 5-aminosalicylic acid (5-ASA) group (100 mg?kg~(-1)), MT groups (2.5,5.0,10.0 mg?kg~(-1)), and treated intracolon with saline, saline, 5-ASA and MT respectively (once per day, from the d7 after the establishment of colitis model to the end of the experiment). The content of interleukin (IL-1, IL-2) and tumour necrosis factor (TNF)-? in rats colon were detected; The inflammatory colon were homogenatized and incubated with lipopolysaccharides (LPS), and designed as control group, model group, 5-ASA group (100?mol/L), MT groups(0.01, 0.1, 1.0 mmol/L). The content of IL-1, IL-2, TNF-?, nitric oxide (NO), lactic dehydrogenase (LDH), myeloperoxidase (MPO) and malondiadehyde (MDA) in the supernant were detected. RESULTS: In model group, the contents of IL-1, IL-2 and TNF-? in colon elevated remarkably and MT depressed this effectively. In the inflammatory colon homogenates of rats colitis, the content of IL-1, IL-2, TNF-?, NO, LDH, MPO and MDA elevated remarkably, Pretreation with MT depressed the content of IL-1, TNF-?, LDH, MPO and MDA effectively. MT (1.0mmol/L) also reduced the production of NO obviously. CONCLUSION: The abnormal immunological function is shown obviously in rats colitis. MT normalizes this change in vivo and in vitro and attenuates the mucosal damage.