Current situation and influencing factors of post-traumatic stress disorder among firefighters in Chongqing City / 中国职业医学

{L-End}Objective To analyze the current status of post-traumatic stress disorder (PTSD) among firefighters in Chongqing City and explore its influencing factors. {L-End}Methods A total of 1 021 firefighters in Chongqing City were selected as the study subjects using the convenient sampling method. The PTSD Checklist Civilian Version was used to assess their PTSD symptom and characteristics. The Trait Coping Style Questionnaire and the Social Support Rating Scale were used to investigate coping styles and the level of social support. {L-End}Results The positive detection rate of PTSD among the study subjects was 4.6%(47/1 021), with positive detection rates of re-experiencing, avoidance/numbing, and hyperarousal symptoms of 7.0%, 9.2%, and 16.5%, respectively. The positive detection rates of re-experiencing, avoidance/numbing, and hyperarousal symptoms in the PTSD firefighters were higher than those in non-PTSD firefighters (83.0% vs 3.3%, 93.6% vs 5.1%, 100.0% vs 12.1%, respectively; all P<0.01). The results of the multivariate logistic regression analysis showed that being injured in the past six months and adopting a negative coping style were risk factors for PTSD ［odds ratio (OR) and 95% confidence interval (CI) were 2.65 (1.07-6.56) and 1.26 (1.19-1.33), respectively; both P<0.05］, while adopting a positive coping style and having a higher level of social support were protective factors for PTSD ［OR and 95%CI were 0.90 (0.85-0.95) and 0.95 (0.91-0.99), respectively; both P<0.05］. {L-End}Conclusion The incidence of PTSD among the firefighters in Chongqing City is relatively high, with symptoms mainly characterized by hyperarousal. Being injured in the past six months, coping styles, and the level of social support are influencing factors for PTSD.

Research advances in bioactivity of oyster peptides / 药学实践杂志

Functional peptides refer to peptides that are beneficial to life activities or have special physiological activities, also known as bioactive peptides. Oyster is rich in protein and is a good material for developing bioactive peptides, which has great potential as a functional food and great application value in pharmaceutical and medical industry. With the development of modern biotechnology and medical technology, the method innovation of oyster peptide preparation，the absorptivity and biological activity of oyster peptide have been enhanced significantly, which lead to deep recognition of the biological function of oyster peptide and offer the boarder application prospect. The researches on the diversification activities of oyster peptides were summarized in this review, which provided clues and ideas for the development of the oyster peptide applications.

Yigong Powder regulates CXCL12/CXCR4 signaling to reduce glutamate release and prevent cognitive decline in mouse model of aging / 中国中药杂志

This study aims to explore the effect of preventive administration of Yigong Powder on the learning and memory abilities of the mouse model of aging induced by D-galactose and decipher the underlying mechanism, so as to provide a basis for the application of Yigong Powder in the prevention and treatment of cognitive decline. Forty KM mice were randomized into control, model, donepezil(1.5 mg·kg~(-1)), and high-dose(7.5 g·kg~(-1)) and low-dose(3.75 g·kg~(-1)) Yigong Powder groups. The mice in other groups except the control group were injected with D-galactose(200 g·kg~(-1)) at the back of the neck for the modeling of aging. At the same time, the mice were administrated with corresponding drugs by gavage for one month. Morris water maze was used to examine the learning and memory abilities of the mice. Hematoxylin-eosin staining was employed to observe the pathological and morphological changes of the hippocampus. The immunofluorescence assay was employed to detect the expression of ionized calcium-binding adapter molecule 1(IBA1), glial fibrillary acidic protein(GFAP), chemokine C-X-C-motif ligand 12(CXCL12), chemokine C-X-C-motif receptor 4(CXCR4) in the hippocampus and observe the positional relationship between IBA1, GFAP, and CXCR4. Western blot was employed to determine the protein levels of extracellular regulated kinase(ERK), p-ERK, and tumor necrosis factor receptor 1(TNFR1). Enzyme-linked immunosorbent assay was employed to measure the levels of glutamate and tumor necrosis factor(TNF-α) in the brain tissue and the level of TNF-α in the serum and spleen. Yigong Powder significantly shortened the escape latency, increased the times crossing platforms, and prolonged the cumulative time in quadrants of the aging mice. It alleviated the nerve cell disarrangement, increased intercellular space, and cell degeneration or death in the hippocampus and reduced the pathology score of the damaged nerve. Moreover, Yigong Powder reduced the positive area of IBA1 and GFAP, reduced the levels of TNF-α in the brain tissue, serum, and spleen, and decreased spleen index. Furthermore, Yigong Powder decreased the average fluorescence intensity of CXCL12 and CXCR4, reduced CXCR4-positive astrocytes and microglia, down-regulated the protein levels of p-ERK/ERK and TNFR1, and lowered the level of glutamate in the brain tissue. This study showed that the preventive administration of Yigong Powder can ameliorate the learning and memory decline of the D-galactose-induced aging mice by regulating the immune function of the spleen and the CXCL12/CXCR4 signaling in the brain to reduce glutamate release. However, the mechanism of Yigong San in preventing and treating dementia via regulating spleen and stomach function remains to be studied.

Design and practice of SPOC mixed teaching based on MOOC in general medical courses / 中华医学教育探索杂志

Taking "count down your weight—start from 'diet'" as an example, this article discusses the design and practice of SPOC (small private online course) mixed teaching based on MOOC (massive open online course) in general medical courses. By designing teaching methods and teaching content, and using formative evaluation methods, the SPOC mixed teaching was implemented for 201 students from Sichuan University in the spring of 2020. According to the teaching evaluation and preliminary teaching effect, students generally believed that teaching resources were relatively abundant and the communication effects were generally recognized, as well as, it could significantly improve students' interest in and effect of general medical courses.

Characterization and phylogenetic analysis of the complete chloroplast genome of Lycopus europaeus / 药学学报

We intend to study the structural characteristics of Lycopus europaeus Linn. chloroplast genome and compare the evolutionary relationship of species from Lamiaceae with similar medicinal effects. The total DNA of Lycopus europaeus was sequenced using the Illumina Hiseq 4000 Sequencing platform and was assembled using NOVOplasty software. And then we annotated and analyzed the genome using the CPGAVAS2 online tool. We constructed the phylogenetic tree using the Stellera chamaejasme and Potentilla chinensis as the outgroup. The whole length of Lycopus europaeus chloroplast genome was 152 085 bp. A total of 132 genes were annotated including 88 protein-coding genes, 8 rRNA genes and 36 tRNA genes. Among them, 8 protein-coding genes (ndhB, rps7, rps12, rps19, rpl2, rpl23, ycf2, ycf15), 7 tRNA coding genes (trnM-CAU, trnL CAA, trnN-GUU, trnE-UUC, trnV-GAC, trnA-UGC, trnR-ACG) and 4 rRNA coding genes (rrn16s, rrn23s, rrn4.5s, rrn5s) are located in the IR region. There are 13 protein coding genes [rps16, rps19 (×2), atpF, rpoC1, rpl2 (×2), petB, petD, rpl16, ndhB (×2), ndhA] each contains one intron, two protein-coding genes (ycf3, clpP) each contain two introns, and 8 tRNA coding genes each contain one intron. A total of 34 SSRs were detected in the chloroplast genome of Lycopus europaeus. Phylogenetic analysis revealed that two species in the Lycopus genus, four species in the Dracocephalum genus, Glechoma longituba, two species in the Mentha genus and Prunella vulgari, in total 10 species are most related. The complete genome sequence of Lycopus europaeus was obtained and analyzed, which clarified the evolutional relationship between the species of Lycopus europaeus and in the Lamiaceae family.

Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

Equity of community health resource allocation for the elderly in Shanghai / 中华健康管理学杂志

Objective:To analyze the equity of community health resource allocation available to the elderly in Shanghai to provide a reference for the optimization of their allocation and to ensure the basic medical needs of the elderly.Methods:116 community health service centers were selected as research objects. Based on the human resources and financial inputs for community health, the Gini coefficient and Theil index were used to analyze the equity of community health resource allocation in Shanghai from the service population and across geographical dimensions.Results:The Gini coefficients of in-service health technicians and total financial compensation, as based upon the dimension of serving the elderly population, were 0.116 and 0.251, respectively, while the Gini coefficients based on the geographical dimension were 0.483 and 0.329 (respectively). The results of the Theil index analysis are relatively consistent with the Gini coefficient. The equity of health human resource allocation is slightly better than that of financial investment, and the equity of health resource allocation population is better than that concerning geography. Regional differences are the main factors regarding the equity of health resource allocation of the elderly community based on geographical factors (71.47%-86.71%), intra-regional differences were the main source of equity differences in community health resources allocation based on the elderly population (52.52%-89.44%).Conclusion:The allocation structure of community health resources for the elderly in Shanghai is, on the whole, fair; but, the differences between population equity and geographical equity, and between and within regional plates, cannot be ignored.

Clinical characteristics of coronavirus disease 2019 infected with Delta variant in Guangzhou:A real-world study / 中华急诊医学杂志

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Clinical Efficacy of Sheti Zhiqiu Decoction Combined with Intradermal Needling in Treatment of Allergic Rhinitis with Deficient Cold of Lung Qi Syndrome / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Sheti Zhiqiu decoction combined with intradermal needling in treatment of allergic rhinitis （AR） of deficient cold of lung Qi syndrome and its effect on cytokines of helper T cell 17 （Th17） and regulatory T cells （Treg）. Method:A total of 105 patients with AR of deficient cold of lung Qi syndrome were randomly divided into traditional Chinese medicine （TCM） group， combination group and western medicine group， with 35 cases in each group. The TCM group was treated with Sheti Zhiqiu decoction， 1 dose a day. The combination group was treated with intradermal needling in addition to the therapy of the TCM group. The selected acupoints were Yintang， bilateral Yingxiang， Fengchi， Feishu and Zusanli. The needles were retained for 3 days before being replaced. The western medicine group was treated with mometasone furoate nasal spray， 100 μg/time at each side of the nasal cavity， <italic>qd</italic>， and desloratadine citrate tablet， 8.8 mg/time， <italic>qd</italic>. Three groups were treated for 4 weeks and followed up for 3 months. Nasal and ocular symptom scores and rhinoconjunctivitis quality of life questionnaire （RQLQ） scores of patients in three groups were observed before and after treatment. Levels of serum interleukin-17 （IL-17）， interleukin-10 （IL-10） and transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁） were measured before and after treatment. The clinical efficacy and safety were evaluated， and the disease recurrence rate was observed during the follow-up period. Result:Compared with before treatment， nasal and ocular symptom scores and total score， and RQLQ scores and total score of patients in three groups were significantly decreased after treatment （<italic>P</italic><0.01）. Compared with the TCM group and the western medicine group after treatment， except for eyes itching/foreign body sensation/red eyes score， nasal and ocular symptom scores and total score， and RQLQ scores and total score of the combination group were lower（<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with before treatment， level of serum IL-17 of patients in three groups was significantly decreased （<italic>P</italic><0.01）， while levels of IL-10 and TGF-<italic>β</italic>₁ were significantly increased after treatment （<italic>P</italic><0.01）. Compared with the TCM group and the western medicine group after treatment， level of serum IL-17 was lower， whereas levels of IL-10 and TGF-<italic>β</italic>₁ were higher in the combination group （<italic>P</italic><0.05，<italic>P</italic><0.01）. The clinical efficacy of the combination group was better than that of the TCM medicine group and the western medicine group （Z=-2.207，Z=-2.185，<italic>P</italic><0.05）. There was no significant difference in recurrence rate between combination group and the TCM group， and the recurrence rate of both groups was lower than that of the western medicine group（<italic>χ</italic>²=5.020，<italic>χ</italic>²=4.835，<italic>P</italic><0.05）. There was no significant adverse reaction during the treatment period in three groups. Conclusion:Sheti Zhiqiu decoction combined with intradermal needling is effective in treatment of patients with AR of deficient cold of lung Qi syndrome. It can significantly relieve patients' symptoms， improve patients' quality of life and reduce disease recurrence. It may play a role by regulating immune balance of Th17/Treg of patients and improving their immune function.

Biocompatibility of fibrin sealant and human corneal fibroblasts / 中华实验眼科杂志

Objective:To study the biocompatibility of fibrin sealant (FS) and human corneal fibroblasts (HCFs) obtained by small incision lenticule extraction (SMILE).Methods:The human corneal stromal tissues were selected from corneal stromal lens in 24 eyes of 12 patients underwent SMILE in the First Affiliated Hospital of Guangxi Medical University from March to April 2018.HCFs were isolated and cultured in vitro within 1 hour after the corneal stromal lens were extracted and the growth status of HCFs on FS surface was observed.HCFs were divided into 2-fold leaching solution group and normal control group, and the cells in the two groups were treated with 2-fold leaching solution or complete medium according to grouping, respectively.The apoptosis of HCFs in the two groups was observed by acridine orange (AO)/ethidium bromide (EB) double staining.The proliferation of HCFs in the two groups was assayed by methyl thiazolyl tetrazolium (MTT) method.HCFs in logarithmic phase were divided into 2-fold leaching solution group, normal control group, and the cells were treated with 2-fold leaching solution or complete medium according to grouping, respectively.In addition, a blank control group without HCFs was also set and treated with complete medium.The absorbance value and relative growth rate of HCFs in the three groups were compared.HCFs in logarithmic phase were divided into 1-fold leaching solution group, 2-fold leaching solution group and normal control group, and the cells were treated with 1-fold leaching solution, 2-fold leaching solution or complete medium culture according to grouping, respectively.The apoptosis of HCFs in the three groups was compared by Annexin V-FITC/PI flow cytometry, and the cytotoxicity of the three groups was graded.Written informed consent was obtained from each patient before the operation.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of the First Affiliated Hospital of Guangxi Medical University (No.2018[022]). Results:HCFs grew well on FS surface and the morphology was normal.MTT assay showed that HCFs in the 2-fold leaching solution group and the normal control group had a similar proliferation tendency, and the toxicity index of HCFs in the 2-fold leaching solution group was graded 0-1 at 0-72 hours after changing solution.After AO/EB staining, the HCFs in the 2-fold leaching solution group and the normal control group were normal, and only a small amount of early apoptotic cells were observed.Flow cytometry showed that the apoptosis rates of the normal control group, once leaching solution group and the double leaching solution group were (4.96±1.09)%, (3.66±1.35)% and (2.88±0.66)%, respectively, with no significant difference among them ( F=2.89, P=0.13). Conclusions:FS has no cytotoxicity and has good biocompatibility with HCFs in vitro.

Correlation between white matter hyperintensities and the outcomes after reperfusion therapy in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the correlation between white matter hyperintensities (WMHs) and the outcomes after reperfusion therapy in patients with acute ischemic stroke (AIS).Methods:Patients with AIS treated with reperfusion therapy (intravenous thrombolysis, endovascular mechanical thrombectomy or bridging therapy) in the Stroke Center of Zhongshan Hospital of traditional Chinese Medicine from January 2014 to December 2019 were retrospectively enrolled. The clinical baseline data of the patients were collected. The Fazekas scale was used to evaluate the severity of WMHs according to the MRI images. At 90 d after discharge, the modified Rankin Scale was used to evaluate the outcomes. A score of ≤ 2 was defined as good outcome, and a score of >2 was defined as poor outcome. Binary multivariate logistic regression analysis was used to determine the independent risk factors for hemorrhagic transformation (HT), symptomatic intracranial hemorrhage (sICH), and poor outcomes. Results:A total of 676 patients with AIS treated with reperfusion therapy were enrolled. Among them, 506 patients (74.9%) were complicated with WMHs, and 80 (11.8%) had severe WMHs. One hundred and thirty-two patients (19.5%) had HT, 34 (5.0%) had sICH, and 306 (45.3%) had a poor outcome. Multivariate logistic regression analysis showed that severe WMHs was an independent risk factor for the occurrence of HT (odds ratio [ OR] 1.890, 95% confidence interval [ CI] 1.047-3.413; P=0.035) and poor outcomes ( OR 3.366, 95% CI 1.567-7.232; P=0.002) after reperfusion treatment in patients with AIS, but there was no independent correlation with sICH ( OR 8.403, 95% CI 0.891-79.294; P=0.063). Conclusion:Severe WMHs is an independent risk factor for the occurrence of HT and poor outcomes in patients with AIS after reperfusion treatment, but it has no independent correlation with sICH.

Reperfusion therapy and post-stroke seizures and post-stroke epilepsy / 国际脑血管病杂志

Reperfusion therapy has become a standard treatment for acute ischemic stroke, which can effectively improve the outcomes of patients and reduce the mortality. Some studies have found that reperfusion therapy may increase the incidence of post-stroke seizures and post-stroke epilepsy, but this view is still controversial. This article reviews the recent studies on reperfusion therapy and post-stroke seizures and post-stroke epilepsy.

Clinical significance of renaming nonalcoholic fatty liver disease / 临床肝胆病杂志

The terms nonalcoholic steatohepatitis and nonalcoholic fatty liver disease (NAFLD) were first used in the 1980s to describe a condition of similar liver histological changes to alcoholic liver disease, without excessive drinking nor other factors for liver injury. In-depth research on NAFLD has achieved rapid progress over the past 40 years; however, the unchanged nomenclature of the disease has become an obstacle for routine clinical practice and clinical trials. To overcome the shortcomings of the old term, the international consensus panel proposes to use the term metabolic associated fatty liver disease (MAFLD) to replace NAFLD and further puts forward the comprehensive and simple definition of MAFLD for clinical diagnosis, which makes MAFLD different from other liver diseases. Meanwhile, the panel suggests that MAFLD assessment and severity stratification should be extended beyond the simple dichotomous classification used at present. The new name MAFLD will become an important measure for optimizing clinical practice and improving clinical research and may bring benefits to physicians and patients.

Research progress on ultrasound image-guided brachytherapy for cervical cancer / 中华放射肿瘤学杂志

Brachytherapy is an integral part of radiotherapy treatment for cervical cancer. With the rapid development of medical imaging technology, three-dimensional (3D) imaging modality has been applied in the brachytherapy for cervical cancer. After computed tomography (CT) and magnetic resonance imaging (MRI), 3D ultrasound has been gradually applied to guide the brachytherapy for cervical cancer due to its superior soft tissue imaging characteristics, economy, high efficiency and convenience. In this article, the research progress on the application of ultrasonography in brachytherapy was summarized according to literature review, aiming to provide reference for subsequent research.

Application of equivalent uniform dose optimization in intracavitary/interstitial brachytherapy for cervical cancer / 中华放射肿瘤学杂志

Objective:To investigate the application of equivalent uniform dose (EUD) in the combination of intracavitary and interstitial brachytherapy (combined-BT) for cervical cancer.Methods:Twenty cervical cancer patients treated with combined-BT in Tianjin Medical University Cancer Institute and Hospital were recruited in this study. For each patient, treatment plans were optimized based on EUD and hybrid EUD (h-EUD). The results were statistically compared with predefined plans generated by Oncentra Brachy v4.3 using hybrid inverse planning optimization (HIPO). Furthermore, virtual uniform interstitial experiments were applied to evaluate the advantage of EUD.Results:All three plans showed consistent conformity index. Compared with the HIPO plans, the average D 2cm 3 of bladder, rectum and intestine in the EUD plans were decreased by 0.22 Gy, 0.23 Gy and 0.28 Gy, and those in the h-EUD plans were declined by 0.16 Gy, 0.22 Gy and 0.24 Gy, respectively. The average EUD of bladder, rectum and intestine in the EUD plans were decreased by 0.14 Gy, 0.20 Gy and 0.15 Gy, and those in the h-EUD plans were declined by 0.20 Gy, 0.13 Gy and 0.16 Gy, respectively (all P<0.05). The virtual interstitial experiment showed EUD could significantly improve the dose sparing for organs at risk (OARs). Conclusion:The application of EUD can significantly improve the dose sparing for normal tissues without compromising dose homogeneity and conformity during combined-BT for cervical cancer.

Research progress on ultrasound image-guided brachytherapy for cervical cancer / 中华放射肿瘤学杂志

Brachytherapy is an integral part of radiotherapy treatment for cervical cancer.With the rapid development of medical imaging technology,three-dimensional (3D) imaging modality has been applied in the brachytherapy for cervical cancer.After computed tomography (CT) and magnetic resonance imaging (MRI),3D ultrasound has been gradually applied to guide the brachytherapy for cervical cancer due to its superior soft tissue imaging characteristics,economy,high efficiency and convenience.In this article,the research progress on the application of ultrasonography in brachytherapy was summarized according to literature review,aiming to provide reference for subsequent research.

Relationship between factors of gross tumor volume and locoregional failure of radical intensity-modulated radiation therapy for esophageal carcinoma / 中华放射肿瘤学杂志

Objective Investigate the relationship between gross tumor volume (GTV)-related factors including GTV-T volume,the maximum thickness of the esophageal lesion plane and GTV-T volume/length(GTV-T volume divided by the length of the lesion calculated by the number of GTV-T layers) and the locoregional failure of radical intensity-modulated radiation therapy (IMRT) for esophageal carcinoma.Methods A total of 133 patients with esophageal cancer undergoing radical IMRT were enrolled.The factors related to GTV-T including GTV-T volume,the maximum thickness of the esophageal lesions,GTV-T volume/length were calculated.The relationship between GTV-T related factors and local recurrence of tumors was retrospectively analyzed.Results There was positively linear association between the locoregional failure rate of GTV-T and the volume of GTV-T.The volume of GTV-T tumor was 36 cm3,the maximum wall thickness was 2.5 cm,and the GTV-T volume/length was calculated as 5.3 cm2.These critical values could be utilized to predict the risk of locoregional failure of IMRT for esophageal carcinoma.Conclusions The GTV-T factors can be adopted to predict the local control and the risk of locoregional failure of radical IMRT for esophageal carcinoma to certain extent.

Feasibility Study of Intelligent Automatic Registration Ultrasound-CT/MR Fusion Imaging Based on Liver Surface / 中山大学学报(医学科学版)

@#【Objective】To explore the feasibility and simplicity of intelligent automatic registration ultrasound-CT/ MR fusion imaging based on liver surface in localization of focal liver lesions. 【Methods】 Thirty patients with detected focal liver lesions by contrast- enhanced CT or MR were enrolled for ultrasound- CT/MR fusion imaging using the PercuNav fusion imaging system in PHILPS EPIQ7. Both intelligent automatic registration ultrasound- CT/MR fusion imaging based on liver surface（intelligent method）and the conventional internal plane method（manual method）were used for ultrasound-CT/MR fusion imaging. The success rate of registration，the initial registration error and the times of fine-tuning were compared between these two methods.【Results】In all 30 patients，the success rates of registration were both 96.67%（29/30）using intelligent method and manual method. There was no significant difference between these two methods when compared the initial registration error and the times of fine- tuning （P>0.05）. According to the further stratified analysis，in 10 lesions in the left liver，the initial registration error of the manual method was less than that of intelligent method，the difference was statistically significant（P=0.00）. Although the times of fine-tuning of the manual method was less than that of intelligent method，there was no statistically significant difference（P=0.09）；In 20 lesions in the right liver，the initial registration error and the times of fine-tuning of the intelligent method were superior to those of the manual method. The differences were statistically significant （P<0.05）. 【Conclusion】 Intelligent automatic registration ultrasound- CT/MR fusion imaging based on liver surface is a feasible method with high success rate for ultrasound-CT/MR fusion imaging. Compared with the conventional internal plane method，the fusion imaging process is more simple and efficient for the lesions in right liver. It helps to reduce experience dependence of fusion imaging for the operators.

Systematic Evaluation and Meta-analysis of Efficacy and Safety of Different Doses of Febustrinol and Allopurinol in the Treatment of Gout / 中国药房

OBJECTIVE： To systematically evaluate the efficacy and safety of febustrin （80 mg/d and 40 mg/d） and allopurinol （300 mg/d） in the treatment of gout， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Embase， Cochrane library， CJFD， Wanfang database and CBM during from database establishment to Mar. 2019， randomized controlled trial （RCT） about efficacy and safety of febustrin 80 mg/d （trial group）， 40 mg/d （observation group） and allopurinol 300 mg/d （control group） in the treatment of gout were collected. After extracting data of clinical studies met inclusion criteria and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was conducted for blood uric acid decrease level， the compliance rate of serum uric acid concentration， incidence of liver dysfunction， incidence of renal dysfunction， incidence of digestive tract reaction and frequency of acute gout attack with Rev Man 5.1 software and Stata 13.0 software. RESULTS： A total of 17 RCTs were included， involving 1 816 patients. Meta-analysis results showed that， the serum uric acid decrease level of patients in trial group [MD＝－70.17， 95％CI （－97.41， －42.93）， P＜0.001] and the compliance rate of serum uric acid concentration [RR＝1.58， 95％CI （1.20， 2.08）， P＝0.001] were higher than observation group； the decrease of serum uric acid level [MD＝－34.68，95％（－61.35， －8.00）， P＝0.01] and the compliance rate of serum uric acid concentration [RR＝1.39，95％CI（1.04，1.85）， P＝0.03] in trial group were significantly higher than control group； the frequency of acute gout attack [RR＝1.54（1.02，2.31）， P＝0.04] in trial group was significantly higher than observation group. The incidence of liver dysfunction in observation group [RR＝0.71，95％CI（0.52，0.99），P＝0.04] was significantly lower than control group， with statistical significance. There was no statistical significance in other indexes among other indexes （P＞0.05）. CONCLUSIONS： Compared with febulostat 40 mg/d and allopurinol 300 mg/d， the efficacy of febulostat 80 mg/d is superior in reducing uric acid levels of gout patients.

Genre comparative analysis of English and Chinese medical research articles:a small corpus-based study / 中华医学教育探索杂志

In the present study,15 complete RAs were selected respectively from English and Chinese medical journals based on the principles of representativity,reputation,accessibility and timeliness.Moves and steps were determined with reference to Swales and Nwogu's models,and their distribution and frequency were recorded and genre comparative analysis was performed.The results showed that the English and Chinese RAs shared generally the similar generic structure of 11 common moves.However,obvious cultural differences were found in the frequency,sequence and length between the two corpora.The findings of the present study will provide a practical guide for Chinese medical workers to have their papers published in English medical journals.