Analysis of induced radiation and shielding materials in proton therapy room / 中国辐射卫生

Objective To analyze the dose distribution of induced radiation in fixed proton beam therapy room and the influence of shielding materials, and to provide a basis for radiation protection and shielding material selection in proton therapy. Methods FLUKA was used to simulate the dose distribution of induced radiation in fixed proton beam therapy room, the dose over time, and the influence of different concrete materials. Results The dose of induced radiation was mainly concentrated around the target, and the dose rapidly decreased to 1/5-1/10 of the value at the time of stopping irradiation after cooling for 3-5 min. The induced radiation in concrete formed a slightly higher dose area at the end of the main beam near the inner side of the shield. The content of Fe, O, and H in concrete had significant effects on induced radiation (P < 0.01), and the dose was negatively correlated with the content of Fe. Conclusion The patients after proton therapy as well as the induced radiation in air and shielding materials are the main sources of external radiation dose for workers, and waiting for a period of time is the most effective way to protect the staff. Without considering the difficulty in construction and based on the analysis of shielding materials in protection against external irradiation and their influence on induced radiation, heavy concrete with a relatively high level of Fe is the best choice of the shielding material for proton therapy room.

Analysis of radioactive occupational hazard and protective measures in iodine-125 seed source manufacturer / 中国职业医学

Objective To analyze the occupational hazards and protective measures for personnel in an iodine-125(125I) seed source production company. Methods In 2022, a 125I seed source production enterprise in Guangdong Province was selected as the research subject. The occupational hazards in the workplace of the research subject was identified using the system engineering analysis method. The FLUAK program based on Monte Carlo method was used to simulate the blocking protection of the production of the 125I seed source, and to estimate the dose of internal and external irradiation of seed source that affected workers. Results The main occupational radiation hazards in the seed production were non-sealed radioactive materials, including external irradiation from X-ray and γ ray and internal irradiation from aerosols formed by iodine volatilization. Estimated maximum dose equivalent rate around the chest and eye lens for workers were 0.52 and 0.02 μSv/h, respectively. The expected annual effective dose for workers in each work site was 0.035 mSv, and the expected annual equivalent dose to the eye lens for all workers in various work sites was 0.001 mSv. The maximum annual equivalent dose of operator's hand was 80.620 mSv. The maximum dose of internal irradiation to the worker was 18.750 mSv, which was caused by the volatilization of nuclides. Conclusion With effective protection measures for internal and external irradiation in place, the annual exposure doses for seed production personnel and operator’s hand are below the national limits. Adequate measures should be taken on hand protection.

Association of light-intensity physical activity, sedentary time and body composition in adolescents / 中国学校卫生

Objective@#To explore the association between light intensity physical activity (LPA) and sedentary behavior (SB) with body composition, so as to provide data references for improving adolescent physical health.@*Methods@#From August 2020 to January 2021, general information of 694 students in grade one of a high school in Foshan City was collected, and the 24 hour activity behavior and body composition of the students were measured objectively by triaxial accelerometer and bioelectrical impedance tester. Dual component multivariate regression and dual compositional isotemporal substitution model were used to explore the relationship between LPA and SB and body composition.@*Results@#LPA was associated with lower fat relative dominance (FRD) (male weekends FRD=-21.44%, female weekly FRD=-17.83%, weekdays FRD=-18.27%, P <0.05), and LPA was also associated with higher muscle relative dominance (MRD) and bone relative dominance (BRD) (male weekends MRD=12.78%, BRD= 12.87 %; female weekly MRD=11.64%, BRD=9.01%; female weekdays MRD=12.02%, BRD=9.23%, P <0.05). Replacing sedentary behavior (SB) with 10 minutes of LPA could reduce fat proportion [male:weekly -0.15(-0.26--0.04), weekdays -0.12 (-0.22--0.02); female:weekly -0.18(-0.27--0.08), weekdays -0.16(-0.25--0.07)) and increase muscle proportion (male:weekly 0.14(0.03-0.24), weekdays 0.11(0.02-0.21); female:weekly 0.17(0.07-0.26), weekdays 0.15(0.07-0.24)].@*Conclusion@#Interrupting continuous SB with LPA can serve as an intervention measure to promote physical health and fitness in adolescents. School should encourage students to engage in frequent LPA during breaks and after school activities, while avoiding prolonged SB.

Sequential treatment with tirofiban and argatroban in acute isolated pontine infarction caused by branch atheromatous disease / 国际脑血管病杂志

Objective:To investigate the efficacy and safety of sequential treatment with tirofiban and argatroban in acute isolated pontine infarction (AIPI) caused by branch atheromatous disease (BAD).Methods:Consecutive patients with AIPI caused by BAD within 48 h of onset and admitted to Zhengzhou Central Hospital from April 2021 to April 2022 were enrolled retrospectively. The patients were divided into sequential treatment group and tirofiban group according to their therapeutic modalities. In the tirofiban group, tirofiban was pumped intravenously within 48 h after admission, and dual antiplatelet therapy with aspirin and clopidogrel was added 4 h before tirofiban was discontinued. On the basis of tirofiban treatment, the sequential treatment group was followed by argatroban for 5 days when tirofiban is discontinued. The main outcome measure was the modified Rankin Scale (mRS) score at 3 months after the onset . A score of <2 was defined as a good outcome. The secondary outcome measure was all the adverse events during the treatment and follow-up. Multivariate logistic regression analysis was used to determine the independent factors of the outcomes. Results:A total of 64 patients with AIPI caused by BAD were enrolled, including 32 in the sequential treatment group and 32 in the tirofiban group. There was no statistical difference in baseline data between the two groups, but the rate of good outcomes at 3 months after onset in the sequential treatment group was significantly higher than that in the tirofiban group (78.1% vs. 50.0%; χ2=5.497, P=0.019). Multivariate logistic regression analysis showed that after adjusting for low-density lipoprotein cholesterol, the higher baseline National Institutes of Health Stroke Scale score was independently associated with the poor outcomes (odds ratio 2.067, 95% confidence interval 1.343-3.182; P=0.001), while the sequential treatment was independently associated with the good outcomes (odds ratio 0.248, 95% confidence interval 0.064-0.957; P=0.043). Conclusion:Early application of sequential treatment with tirofiban and argatroban in AIPI caused by BAD may effectively improve the outcomes of patients, and the safety is good.

Current situation and discussion on common problems of radiation protection for dental X-ray diagnostic project in 44 dental clinics in Guangdong Province, China / 中国辐射卫生

@#<b>Objective</b> To analyze the relevant measures of radiation protection for dental X-ray diagnostic projects in 44 dental clinics in Guangdong Province, China, and discuss common problems. <b>Methods</b> Based on the three principles of radiation protection, relevant laws, regulations and standards of the state, combined with field investigations and test results of radiation protection, the situation of radiation protection and management was analyzed. <b>Results</b> The layout of 56 dental diagnostic rooms in 44 clinics was (basically) reasonable. The protective performances and quality control tests of 56 dental X-ray diagnostic machines met the standard requirements, and the dose equivalent rate around 56 dental diagnostic rooms was from the background to 1.47 μSv/h, which met the national standard. The coincidence rates of ionizing radiation warning signs, working status indicator lights and door light interlocks, automatic door closing devices, power ventilation devices, and personal protective equipment were from 85.70% to 98.20%. The compliance rates of dental radiologists and full-time (part-time) administrative staffs, occupational health monitoring, management system related to radiation protection, and radiation health files were from 79.5% to 100.0%. <b>Conclusion</b> The current situation of radiation protection and management in the dental X-ray diagnostic room is good, and relevant national regulations and standards should be promulgated or improved to standardize the cone-beam CT quality control testing, dental clinic location requirements, and radiation staff configuration.

Analysis of radiation dose at the entrance of the medical linear accelerator treatment room / 中国辐射卫生

@#<b>Objective</b> To investigate the radiation dose at the entrance of the accelerator treatment room, and to guide the radiation protection detection at the entrance of the treatment room. <b>Methods</b> The FLUKA program was used to build the model of accelerator head and treatment room. Under the simulation conditions of 10 MV and 600 cGy/min for the accelerator, the radiation dose rate inside the entrance of the treatment room was measured at different gantry angles, irradiation conditions, and labyrinths. <b>Results</b> The entrance dose rate with a water tank was significantly higher than that without a water tank under different inner labyrinth wall thicknesses and gantry angles. The entrance dose rate reached the maximum at the inner labyrinth wall thickness of 1800 mm and the gantry angle of 90°. When the inner labyrinth wall thickness was 1000 mm and the gantry angles were 0° and 180°, the entrance dose rate was significantly higher than that at other conditions. The dose rate at the entrance of the treatment room reached (82.26 ± 48.95) μSv/h to (314.09 ± 96.34) μSv/h under the following conditions: the inner labyrinth wall thickness of 1800 mm, the gantry angle of 90°, with a water tank, and the width of the inner labyrinth entrance of 1400-2200 mm. <b>Conclusion</b> The dose at the entrance of the accelerator treatment room mainly comes from the scattering and leakage radiation of the useful wire harness on the patient’s body surface, and the entrance dose rate increases with the increase in the width of the inner labyrinth entrance. In the entrance protection test, the gantry angle should be determined considering the inner labyrinth wall thickness, and the test should be performed at four angles in the uncertain case to ensure the comprehensiveness and accuracy of test results.

Shielding performance of six different types of concrete in proton therapy room / 中国辐射卫生

@#<b>Objective</b> To study the dose level of proton beams outside the main shield of the 230 MeV proton therapy room with six different types of concrete as the main wall, and to obtain the shielding performance of six different types of concrete. <b>Methods</b> The FLUKA program was used to build a calculation model, and different concrete compositions were introduced into the FLUKA program to simulate the change in ambient dose equivalent rate of the focus with concrete thickness under 230 MeV proton beam irradiation. The transmission curves of six different types of concrete were fitted to obtain shielding performance parameters. <b>Results</b> On the condition that the 230 MeV proton beam irradiated to the water target in 90° direction and the concrete thickness exceeded 40 cm, the proton beam was exponentially decayed for six different types of concrete, and the fitted decay curves had a <i>R</i>² of > 0.99. The linear attenuation coefficients for normal concrete, barite concrete, magnetite concrete, limonite concrete, phosphorite concrete, and ferrosilicate concrete were 0.0148 cm⁻¹, 0.0172 cm⁻¹, 0.0196 cm⁻¹, 0.0219 cm⁻¹, 0.0256 cm⁻¹, and 0.0290 cm⁻¹, respectively. <b>Conclusion</b> The composition and proportion of elements in concrete materials directly affect the shielding ability of concrete against proton beams to a large extent, and the shielding performance of six different types of concrete against proton beams varies greatly. Therefore, shielding materials for the proton therapy room should be selected by a comprehensive consideration of the material compositions and shielding performance of concrete, the difficulty of construction, and construction cost.

Correlations between striatal dopamine transporter distribution, glucose metabolism and clinical symptoms in Parkinson′s disease / 中华核医学与分子影像杂志

Objective@#To investigate the correlations among striatal dopamine transporter (DAT) distribution, glucose metabolism and Parkinson′s disease (PD) clinical symptoms.@*Methods@#Twenty-five clinically confirmed idiopathic PD patients (17 males, 8 females, age: (59.8±9.2) years) who underwent 11C-2-beta-carbomethoxy-3-beta-(4-fluorophenyl)tropane (CFT) and 18F-fluorodeoxyglucose (FDG) PET imaging from January 2015 to December 2016 were reviewed. The detailed clinical scores were systematically collected from all patients. Correlations between DAT distribution, glucose metabolism and clinical symptoms were evaluated at global and voxel levels using Pearson correlation analysis.@*Results@#There were significantly positive correlations between the PD-related pattern (PDRP) value and unified PD rating scale (UPDRS) motor scores, non-motor symptoms scale (NMSS) scores, activity of daily living scale (ADL) scores (r values: 0.580, 0.522, 0.557, all P<0.05). The CFT uptake of ipsilateral caudate nucleus, anterior putamen, and posterior putamen were negatively correlated with UPDRS motor scores (r values: -0.496, -0.492, -0.457, all P<0.05), while those had no significant correlations with NMSS scores (r values: -0.420, -0.402, -0.355, all P>0.05). The CFT uptake of ipsilateral caudate nucleus and anterior putamen were negatively correlated with ADL scores (r values: -0.502, -0.522, both P<0.05). There were no significant correlations between CFT uptake in contralateral striatal, anterior putamen, posterior putamen and PDRP values, UPDRS motor scores, NMSS scores and ADL scores(r values: from -0.466 to -0.129, all P>0.05). The presence of the significant correlations between UPDRS motor scores, ADL scores and the CFT radioactive count were confirmed in left caudate nucleus and left putamen (r values: from -0.90 to -0.47, all P<0.05). The metabolic PET imaging disclosed a set of brain regions correlating with the clinical symptoms. The presence of significant correlations between the metabolic PET imaging and CFT uptake were confirmed in bilateral caudate nucleus (r values: 0.47-0.90, both P<0.01), precentral gyrus and insula (r values: -0.90 to -0.47, all P<0.01).@*Conclusion@#The correlations between DAT distribution, glucose metabolism and PD clinical symptoms are complicated, which promote the understanding in the proper application of dopaminergic and metabolic PET imaging in PD and offer more evidences in PD pathophysiological mechanisms.

A randomized controlled study on factors influencing the curative effect of sequential combined interferon and lamivudine therapy in children with immune-tolerant phase chronic hepatitis B / 中华肝脏病杂志

Objective@#To investigate the curative effect of antiviral therapy and related factors influencing the curative affect in children with immune-tolerant phase chronic hepatitis B.@*Methods@#From May 2014 to April 2015, 46 children with chronic hepatitis B, aged 1 to 16 years with immune-tolerant phase were enrolled as the treatment group. All cases in the treated group either received interferon alpha (3-5 MIU/m2, once daily) in lamivudine combination (if HBV DNA decreased < 2 log10) or repeatedly received interferon-alpha alone (if HBV DNA decreased >2 log10) for 12 weeks. Interferon was discontinued at 72 weeks and followed-up period was continued with lamivudine for 24 weeks. At the same time, data of 23 cases of untreated children with immune-tolerant phase chronic hepatitis B were collected as the control group. The treatment group and the control group were divided into two age groups: 1-7 years old and 7-15 years old. Data measurements were compared using t-test, analysis of variance and single factor analysis methods, and the count data were analyzed by χ 2 test. Multiple logistic regression analysis was used to analyze the effects of different factors on response.@*Results@#(1) There were 22 cases aged 1-7 years in the treatment group (47.8%) and 12 cases aged 1-7 years in the control group (52.2%). The cases of mother-to-child transmission (MTCT) in treatment and control group were 34 (73.9%) and 17 (73.9%), while children with normal baseline ALT in the treatment and control group were 18 (39.1%) and 10 (43.5%). (2) At the end of follow-up, 15 cases in the treatment group (32.6%) had HBeAg serological conversion. Among them, nine (19.6%) cases had HBsAg clearance or HB-Ag seroconversion with anti-HBs, and one (2.2%) case had HBsAg clearance, but both HBeAg and anti-HBe were positive. In the control group, one case had HBV DNA lower than the lower limit of detection level, and one case had HBeAg seroconversion without HBsAg clearance. (3) At the end of follow-up, the seroconversion rates of HBeAg in patients aged 1 to 7 years and patients aged 7 to 15 years were 45.5% and 20.8%, respectively (P = 0.078) and the clearance rates of HBsAg were 36.4% and 8.3% (P = 0.023). The serum conversion rates of normal and abnormal baseline alanine aminotransferase levels were 5.6% and 50.0% (P = 0.005), and the clearance rates of HBsAg were 5.6% and 32.1% (P = 0.077), respectively. There was no statistically significant difference in gender, mother-to-child transmission, HBV DNA genotyping and baseline HBsAg level in antiviral efficacy among children (P > 0.05). (4) HBsAg and HBeAg clearance occurred in 100% of patients at the end of follow-up who had HBsAg < 3 000 IU/ml at 24 weeks of treatment. (5) Multivariate logistic regression analysis showed that serum HBeAg conversion rate had relation with non-MTCT transmission and abnormal baseline alanine aminotransferase. Furthermore, HBsAg clearance rate was associated with the age of children.@*Conclusion@#Sequential combination of interferon and lamivudine with a prolonged course can improve the HBV DNA negative conversion rate, HBeAg seroconversion rate, HBsAg loss rate and mild ALT abnormalities at baseline in children under the age of 7 years with immune-tolerant phase chronic hepatitis B.

Study on rapid eye movement sleep behavior disorder in patients with Parkinson disease psychosis / 中华行为医学与脑科学杂志

Objective To explore the sleep structure characteristics and risk factors in patients with Parkinson disease psychosis (PDP).Methods Fifty-one patients with Parkinson disease were enrolled.Sixteen cases met the diagnostic criteria of Parkinson disease psychosis were included in the PDP group,while the remaining 35 cases were included in the PD group as the control group.Sleep status was monitored by polysomnography.Neuropsychological assessment of patients with Parkinson disease was performed by Parkinson quality of life questionnaire,Montreal cognitive assessment(MoCA)and Hoehn-Yahr state (H-Y) of Parkinson disease.Results There were statistically significant differences in age of onset in PD group and PDP group (64.11±8.87,57.44±10.07,t=1.242),course of disease (2 (1,4),6 (4,7),Z=-3.888),HY stage (2 (1.5,2.5),3 (2,3),Z=-2.487)(all P＜0.05).The total sleep time in the PDP group was lower than that in the PD group ((344.06±26.39)min,(361.74± 17.16)min,P＜0.05).Compared with the PD group,the proportion of slow wave sleep phase Ⅰ in the PDP group was bigger ((42.88 ± 7.99) ％,(37.14±5.21) ％,t=-3.065),and the proportion of slow wave sleep phase Ⅱ in the PDP group was smaller ((31.19±5.92) ％,(37.51±5.70) ％,t=3.634) (P＜0.05).Single factor binary logistic regression analysis showed that the course of disease,age of onset,RBD,HY stage,PDQ-39 questionnaire score,total sleep time,slow wave sleep stage Ⅰ (％) and slow wave sleep stage Ⅱ (％) were the risk factors of PDP (P＜0.05).Multivariate binary logistic regression analysis showed that the course of disease and RBD were independent risk factors for patients with PDP (P＜ 0.05).Conclusion Sleep structure changes in patients with PDP,and RBD is the independent risk factor for patients with Parkinson's psychotic disorders.

Correlations between striatal dopamine transporter distribution, glucose metabolism and clinical symptoms in Parkinson's disease / 中华核医学与分子影像杂志

Objective To investigate the correlations among striatal dopamine transporter (DAT) distribution,glucose metabolism and Parkinson's disease (PD) clinical symptoms.Methods Twenty-five clinically confirmed idiopathic PD patients (17 males,8 females,age:(59.8± 9.2) years) who underwent 11 C-2-beta-carbomethoxy-3-beta-(4-fluorophenyl) tropane (CFT) and 18 F-fluorodeoxyglucose (FDG) PET imaging from January 2015 to December 2016 were reviewed.The detailed clinical scores were systematically collected from all patients.Correlations between DAT distribution,glucose metabolism and clinical symptoms were evaluated at global and voxel levels using Pearson correlation analysis.Results There were significantly positive correlations between the PD-related pattern (PDRP) value and unified PD rating scale (UPDRS) motor scores,non-motor symptoms scale (NMSS) scores,activity of daily living scale (ADL) scores (r values:0.580,0.522,0.557,all P＜0.05).The CFT uptake of ipsilateral caudate nucleus,anterior putamen,and posterior putamen were negatively correlated with UPDRS motor scores (r values:-0.496,-0.492,-0.457,all P＜0.05),while those had no significant correlations with NMSS scores (r values:-0.420,-0.402,-0.355,all P＞0.05).The CFT uptake of ipsilateral caudate nucleus and anterior putamen were negatively correlated with ADL scores (r values:-0.502,-0.522,both P＜0.05).There were no significant correlations between CFT uptake in contralateral striatal,anterior putamen,posterior putamen and PDRP values,UPDRS motor scores,NMSS scores and ADL scores(r values:from-0.466 to-0.129,all P＞0.05).The presence of the significant correlations between UPDRS motor scores,ADL scores and the CFT radioactive count were confirmed in left caudate nucleus and left putamen (r values:from-0.90 to-0.47,all P＜0.05).The metabolic PET imaging disclosed a set of brain regions correlating with the clinical symptoms.The presence of significant correlations between the metabolic PET imaging and CFT uptake were confirmed in bilateral caudate nucleus (r values:0.47-0.90,both P＜0.01),precentral gyrus and insula (r values:-0.90 to-0.47,all P＜0.01).Conclusion The correlations between DAT distribution,glucose metabolism and PD clinical symptoms are complicated,which promote the understanding in the proper application of dopaminergic and metabolic PET imaging in PD and offer more evidences in PD pathophysiological mechanisms.

Advances in pathogenesis of cerebral small vessel disease / 国际脑血管病杂志

With the development of imaging, molecular biology, and pathology, the pathogenesis of cerebral small vessel disease (CSVD) has been deeply understood, but the exact pathogenesis is still unclear. This article reviews the pathogenesis of CSVD, including oxidative stress, inflammatory reaction, amyloid beta amyloid deposition, vascular endothelial dysfunction, and blood-brain barrier damage.

Effects of proanthocyanidins on cerebral edema and secondary brain injury inflammation following intracerebral hemorrhage / 重庆医学

Objective To investigate the effect of procyanidins on cerebral edema and inflammation of secondary brain injury after intracerebral hemorrhage.Methods Forty-eight C57BL6 mice were randomly divided into 4 groups:sham-operation+ saline group,sham-operation + procyanidins (100 mg/kg) group,intracerebral hemorrhage (ICH) + saline group and ICH + procyanidins (100 mg/kg) group.The Bederson method was used to detect postoperative nerve function score in mice.The brain tissue water content was measured by wet-dry weight method.The variety of morphological in brain tissue was observed by hematoxylin-eosin (HE) staining.The expression of glial fibrillary acidic protein (GFAP) and ionized calcium-binding adapter molecule 1(Iba-1) in mouse brain tissue were observed by western blot.The apoptosis of brain tissue was observed by TUNEL and western blot method.Results Compared with the ICH+saline group after 12h,the nerve function score in the ICH + proanthocyanidins group was significantly decreased (P＜0.05),and the water content of brain tissue was also significantly decreased (P＜0.05).The HE staining results showed that procyanidins decreased the number of neurocytes lesions in cerebral hemorrhage mice and reduced the amount of brain tissue hemorrhage.Western blot results showed that procyanidins promoted the expression of Bcl-2,decreased the expression of Bax,Caspase3,GFAP and Iba-1 in cerebral hemorrhage mice.The TUNEL results showed that procyanidins could inhibit the apoptosis of brain tissue neurons in mouse with intracerebral hemorrhage.Conclusion Procyanidins inhibits the production of neurotoxic substances possibly by reducing the expression of GFAP and Iba-1,and prevents and treats secondary brain injury after intracerebral hemorrhage.

Interaction between the stimulator of interferon genes signaling pathway and HBV / 临床肝胆病杂志

Stimulator of interferon genes (STING) is a newly discovered adaptor protein in the innate immune system and plays an important role in innate immune response mediated by cytoplasmic DNA. Double-stranded DNA recognition receptors in cells are mediated by STING protein to produce type I interferon and other cytokines. Inadequate innate immune response and anti-hepatitis B virus (HBV) specific immune response are important causes of chronic HBV infection. This article introduces the discovery of STING and the latest research advances in its structure, briefly elaborates on the mechanism of activation of the STING signaling pathway, summarizes the research advances in the interaction between the STING signaling pathway and HBV, and points out the potential value of STING in clinical treatment.

Effect of α7nAchR gene 713T>C mutation on cognitive function and Aβ expression in AD mice / 重庆医学

Objective To investigate the effect of α7nAchR gene 713T>C mutation on the cognitive function and Aβ expression in Alzheimer′s disease(AD)mice.Methods Twenty APPSwe transgenic APPa7KO mice(6 months old,α7nAchR gene knockout)were divided into the mutation type group and wild type group according to the random number table method,10 cases in each group.The mutation type and wild type of AVV-α7nAchR cDNA were respectively injected by lateral ventricle,once per month,for 6 times.The change of cognitive function in mice was examined by Morris water maze.The ELISA method was used to detect Aβ 40 and Aβ 42 expression levels.The Aβ plaque deposit situation was detected by the immunochemical method.Results Compared with the mice in the wild type group,the escape latency and the time of first time to find the platform of the mice in the mutation type group were significantly extended,while Hippocampal Aβ40 and Aβ42 expression levels were significantly increased,the difference was statistically significant(P＜0.05).Conclusion α7nAchR gene 713T>C mutation aggravates the cognitive function impairments in AD mice and hippocampal neuron Aβ expression level.

Establishment and application of networked drug-cognitive behavioral sequential management model in patients with chronic insomnia / 中华护理杂志

Objective To construct the sequential management model of networked drug-cognitive behavior in patients with chronic insomnia,and to explore the effects of this model on treatment and management of patients with chronic insomnia. Methods A total of 160 patients with chronic insomnia treated from January 2014 to June 2015 were randomly divided into the experimental group and the control group. The experimental group was treated with networked drug-cognitive behavior sequential therapy and management. Through the establishment of patient management files in the network management system,the disease was assessed,treatment programs were developed, remote implementation of 8 weeks of drug-cognitive behavior sequential treatment was conducted,12 months of net-work remote dynamic management and efficacy evaluation was performed. The control group received 8 weeks of traditional medical care with face-to-face drug-cognitive behavior sequential treatment and 12 months outpatient fol-low-up management. Results Comparison of management core indicators:there were significant differences between two groups in number of visiting hospital,exit status,treatment completion and documentation,sleep diary comple-tion,sleep scale completion and patient satisfaction. Comparison of sleep quality:after 2 months of treatment,there was no difference in quality of sleep between two groups; after 12 months of treatment,there were significant dif-ferences in sleep latency,awakening time after sleep,total sleep time and sleep efficiency between two groups. Scale score:after 12 months of treatment,there were significant differences in Pittsburgh sleep quality index,sleep personal beliefs and attitude scale score between two groups. Conclusion Network-based management improves the compliance of patients with chronic insomnia,reduces the loss of follow-up rate,improves sleep cognition,increases sleep quality,saves patients' time and cost,increases patient satisfaction,which is worth promoting in clinical application.

The analysis of modified hamstring post surgery for the treatment of spastic cerebral palsy with knee flexion deformity / 中华骨科杂志

Objective To explore the curative effect of knee flexion deformity on spastic cerebral palsy treatment method.Methods All of 30 patients with spastic cerebral and knee flexion deformity were randomly divided into two groups:traditional operation group and modified operation group,using the commonly used operation (In 15 cases,with traditional hamstring post surgery) and) modified operation (In 15 cases,with modified hamstring post surgery),two groups of patients were treated with Ilizarov external fixation drafting device in the correction of knee flexion deformity after soft tissue release.Adjustment began 7 days after the soft tissue release operation of external fixation,and stretched approximately 0.2 degrees each time,3 times/d,until knee flexion deformity was corrected to hyperextension for 10 degree and maintained for 3 weeks,and the flexion contracture degree of knee joint was measured every 2 weeks;then the Ilizarov external fixation drafting device was removed.Then wear a walking straight leg brace for more than 3 months,until the knee walking function is good.Clinical evaluation included the joint pain index,walking function index,knee flexion deformity degree and range of joint motion score of Dimeglio standard.Results Flexion contracture deformity of knee joint in 30 cases (60 knees) was corrected when Ilizarov external fixator was removed,knee extension to 0 degrees-5 degrees.The two groups of patients had the knee flexion angle range of-1.2 degrees to 13.3 degrees,with an average of (7.32°±3.41°) after removed of the walking straight leg brace,in which 4 cases (8 joints) got recurrent deformity of 10°-15° at the time of removing of the walking straight leg brace.Knee activity significantly was improved at the end of treatment.60 cases of knee joint activity were close to normal,with flexion of 100 degrees to 135 degrees,extension of 0 degrees to 10 degrees.Two groups of patients were statistically significantly improved before and after surgery.Curative effect comparison:The walking function index of the modified operation group was obviously superior to that of the traditional operation group,there was significant statistical difference.There were no statistically significant differences in pain index,knee flexion,and range of joint motion.Conclusion For the treatment of flexion deformity of the knee joint in spastic cerebral palsy,traditional surgery using the semitendinosus and gracilis,post and semimembranosus lysis,combined with the Ilizarov draft external fixation could improve the walking function of the patients,simplify the surgical incision and reduce trauma.As a result,modified hamstring post surgery is an ideal,effective treatment method.

Influence of interferon-α therapy on height and weight of chronic hepatitis B children / 中华传染病杂志

Objective Retrospectively study of the effects of interferon-α therapy on height and weight of children with chronic hepatitis B (CHB).Methods Total of 116 hospitalized cases of CHB children in Adolescent Liver Centre, 302 Military Hospital of China from January 2010 to December 2011 were respectively studied.Heights and weights of all the subjects at baseline, 24 weeks, 48 weeks, 72 weeks and 96 weeks of treatment, and 24 weeks, 48 weeks and 96 weeks of follow-up were measured.The weight Z score (WAZ), height Z score (HAZ) and body mass index (BMI) Z score of subjects with hepatic fibrosis (S) 0.05).At 48 weeks of treatment, the median HAZ was 0.50, and the median WAZ was 0.20;after a follow-up period of 24 weeks, the median HAZ was-0.32, and the median WAZ was-0.18;after a follow-up period of 48 weeks, the median HAZ was 0.09 and the median WAZ was 0.06.All the above median values of HAZ and WAZ were significantly different from those at baseline (all P<0.05).The difference of HAZ at baseline and 96 weeks of treatment in group aged 6-16 years was significantly different from that in group aged 1-6 years (-0.74±0.69 vs-0.53±0.35, t=1.85, P<0.05).Also, the difference of WAZ at baseline and 96 weeks of treatment in group aged 6-16 years was significantly different from that in group aged 1-6 years (-0.69±0.41 vs-0.17±0.75, t=3.74, P<0.05).The difference of HAZ at baseline and 96 weeks after treatment in group aged 6-16 years was significantly different from that in groups aged 1-6 years (-1.12±0.81 vs-0.05±0.69, t=2.06, P=0.022).Conclusions Interferon-α treatment for children with chronic hepatitis B does have influence on their height and weight, which restores to some degree after the treatment finished.Physicians should pay more attention to the influence of interferon-α treatment on height and weight in children aged 6-16 years.

Research on the change of serum immune cytokines in medical radiation workers / 中国职业医学

OBJECTIVE: To explore the changes of the serum immune cytokines in medical radiation workers exposure to low dose ionizing radiation. METHODS: Totally 244 medical professionals working with radiation(61 diagnosis radiology,51 nuclear medicine,74 radio therapeutics and 58 interventional radiology) from 7 hospitals of Guangdong Province were selected as study subjects by using the typical sampling method; 51 administration workers who did not expose to radiation were selected as control group. The radiation dose of these individuals was monitored by thermoluminescent measurement instrument for one year. Venous blood was collected and the levels of interferon γ(IFN-γ),interleukin 10(IL-10),transforming growth factor-β1(TGF-β1) in serum were examined by enzyme-linked immuno sorbent assay. RESULTS: The maximum annual average dose of radiation per person of the medical radiation workers was 0. 41 mSv/a. It was smaller than the occupational exposure limit(20. 00 mSv/a). The annual average dose of radiation per person in the group of nuclear medicine was significantly higher than those of diagnosis radiology,radio therapeutics and interventional radiology(P <0. 01). Among the male staffs,the expression of IL-10 in the diagnosis radiology group,radio therapeutics group and interventional radiology group was lower than that in the control group(P < 0. 05); the expression of IL-10 in radio therapeutics group was lower than those in nuclear medicine group and interventional radiology group(P < 0. 05); the ratio of IFN-γ/IL-10 in radio therapeutics group was higher than those in diagnosis radiology group,nuclear medicine group,interventional radiology group and control group(P < 0. 05). These individuals were divided into 3 different dose group(0. 03-,0. 06-and > 0. 15 m Sv/a) based on their average radiation dose. The expression of IL-10 in male staffs of these3 dose groups was lower than that of the male control group(P < 0. 05). CONCLUSION: Long-term low dose ionizing radiation may restrain the expression level of IL-10 in the male staffs.

Effects of amifostine on formation of abdominal aortic aneurysm in mice induced by benzo[ a] pyrene / 中国病理生理杂志

AIM:To study the role of amifostine on the formation of benzo [a]pyrene (BaP)-induced abdomi-nal aortic aneurysm ( AAA) in C57BL/6J mice and the underlying mechanism .METHODS: RAW246.7 mononuclear macrophage in vitro were divided into control group , DMSO group, BaP group, low dose (1 μmol/L) amfostine treated group, middle dose (5 μmol/L) amfostine treated group and high dose (25μmol/L) amfostine treated group .The influ-ence of BaP on the expression of matrix metalloproteinase (MMP)-9, MMP-12, TNF-α, NF-κB in the RAW246.7 mono-nuclear macrophages in vitro was determined by Western blot .Male C57BL/6J mice (8 months old) were divided into con-trol group, model group (AngII+BaP group), low dose (50 mg/kg) amfostine treated group and high dose (100 mg/kg) amfostine treated group.After 6 weeks, the abdominal aorta were isolated .The aortic tissues were subjected to HE and Masson staining.The vascular wall structure , infiltration of macrophage , the expression of MMP-9, MMP-12, TNF-α, NF-κB were evaluated by Western blot and immunochemistry staining .RESULTS:Amifostine attenuated BaP-induced expres-sion of TNF-α, MMP-9, MMP-12, NF-κB in the RAW246.7 mononuclear macrophages (P<0.05).The results of animal experiments showed that the incidence of AAA in high dose amifostine treated group were significantly lower than that in low dose amifostine treated group and model group (P<0.05).Immunohistochemistry staining observation showed that amifos-tine inhibited the aortic macrophage infiltration more obviously in high amifostine treated group compared with model group and low dose amifostine treated group (P<0.05).Compared with model group and low dose amifostine treated group , the MMP-9, MMP-12, TNF-αand NF-κB expression of abdominal aorta in high amifostine treated group was reduced signifi -cantly ( P<0.05 ) .CONCLUSION: Amifostine inhibits BaP-induced activation of macrophages , and also prevents the formation of abdominal aortic aneurysm in C 57BL/6J mice induced by BaP by inhibition of the NF-κB pathway, macro-phage infiltration and the expression of TNF-αand MMPs.