Prognostic value of peripheral blood CD 8+ T lymphocytes for stage Ⅲ-Ⅳ non-small cell lung cancer patients treated with chemoradiotherapy / 中华放射肿瘤学杂志

Objective:To explore the changes of CD 8+ T cells in stage Ⅲ-Ⅳ non-small cell lung cancer (NSCLC) patients before and after radiochemotherapy and evaluate its clinical value in predicting survival. Methods:A total of 795 patients with stage Ⅲ-Ⅳ NSCLC who completed CD 8+ T cell testing from January 2011 to December 2017 were recruited (249 patients completed 1-3 tests within 6 months after treatment). The survival difference of patients with different levels of CD 8+ T cells and the prognostic value of the changes in the CD 8+ T cell level were analyzed. The survival analysis was performed by Kaplan- Meier method and log-rank test or univariate analysis. The multivariate survival analysis was conducted by Cox’s regression model. Results:Before treatment, the levels of CD 8+ T cells in the peripheral blood did not significantly differ among patients with different clinical factors. The survival time of stage Ⅲ NSCLC patients with CD 8+ T cell levels of<26.44% was significantly prolonged ( P=0.043). After treatment, the levels of CD 8+ T cells were significantly higher than those before treatment. The levels were similar within 1-3 months, decreased after 4-6 months but still significantly higher than those before treatment. The median survival time of patients with CD 8+ cell levels of<43.90% after treatment was 22 months, significantly longer than 16 months of those with CD 8+ cell levels of ≥43.90%( P=0.032). Stratified analysis demonstrated no significant difference in the survival time at 1 month and 2-3 months after treatment ( P>0.05), whereas the survival time significantly differed at 4-6 months ( P=0.001). The multivariate survival analysis showed that CD 8+ cell levels of<43.90% after treatment was an independent prognostic factor ( HR=0.714, P=0.031). Conclusions:The effect of CD 8+ T cells on prognosis of patients with stage Ⅲ-Ⅳ NSCLC is limited. After treatment, CD 8+ T cell levels are increased significantly. A certain increase in the CD 8+ T cell levels can prolong the survival time. The detection of CD 8+ T cell subtypes plays a more significant role.

Effect of CD 4+ T cells and CD 4+/CD 8+ in peripheral blood on survival of patients with stage Ⅳ non-small cell lung cancer—Establishment of a Nomogram prediction model / 中华放射肿瘤学杂志

Objective:To explore the possibility of CD 4+ T cells and CD 4+ /CD 8+ ratio in peripheral blood to predict the survival of patients with stage Ⅳ non-small cell lung cancer (NSCLC), and to establish a Nomogram prediction model. Methods:The influence of CD 4+ T cells and CD 4+ /CD 8+ ratio on the clinical factors and survival of 682 patients pathologically diagnosed with stage Ⅳ NSCLC with no history of cancer treatment was retrospectively analyzed and the Nomogram prediction model was established. Combined with the changes of immune cells levels in 110 patients after treatment, the prognostic and predictive values of CD 4+ T cells and CD 4+ /CD 8+ ratio were verified. Countable data were analyzed by t-test. The survival rate was calculated by Kaplan-Meier method, log-rank test or univariate analysis. The multivariate analysis was performed by Cox regression model. Results:Univariate analysis demonstrated that CD 4+ > 43.15% before treatment significantly prolonged the survival. By multivariate analysis of Cox regression model, CD 4+ >43.15% was an independent prognostic factor to prolong survival for stage Ⅳ NSCLC. The Nomogram model was established and verified that the predicted and actual overall survivals were highly consistent. Further analysis showed that 43.15% as the critical value of CD 4+ T cell level significantly prolonged survival when CD 4+ expressed at a high-level before treatment, after treatment, before and after treatment, or combined with CD 4+ /CD 8+ >1.65. Conclusions:The baseline level of CD 4+ T cells before treatment in peripheral blood is an independent prognostic factor for stage Ⅳ NSCLC. The CD 4+ /CD 8+ ratio before treatment has limited value in predicting the prognosis.

Superselective cystic arterial perfusion embolization for the treatment of invasive bladder cancer with hemorrhage / 实用放射学杂志

Objective To investigate the efficacy of transcatheter selective cystic arterial infusion chemotherapy embolization in the treatment of invasive bladder cancer with hemorrhage.Methods 81 cases of with invasive bladder cancer and hemorrhage treated by superselective intervention in hospital were selected,as well as postoperative complications and tumor volume changes were recorded in followG up.Results The success rate of intubation and embolization was 100%,the immediate hemostasis rate was 97.53%,and the preoperative bladder tumor volume (4.08±1.66)cm was significantly larger than that of the six months after surgery (3.45±1.33)cm.Conclusion Superselective cystic arterial perfusion embolization is a safe and effective treatment for patients with invasive bladder cancer complicated with hemorrhage.

Partial splenic artery embolization for the treatment of patients with hypersplenism at high altitude region: clinical analysis / 介入放射学杂志

Objective To investigate the clinical curative effect and significance of partial splenic artery embolization (PSE) for the treatment of patients with hypersplenism at high altitude region. Methods The clinical data of 66 patients with cirrhosis complicated by portal hypertension and hypersplenism, who lived in Xining City of Qinghai Province, the high altitude region in China, and were admitted to authors' hospital during the period from March 2015 to December 2016 to receive PSE, were retrospectively analyzed. White blood cell (WBC) count, red blood cell (RBC) count and platelet (PLT) count were calculated at one day before operation as well as at one, 7, 30 and 90 days after operation. Results The technical success rate of PSE was 100％. The mean WBC count determined at one, 7, 30 and 90 days after PSE was obviously different from that determined at one day before PSE, the differences were statistically significant (P＜0. 05). Conclusion For the treatment of patients with cirrhosis complicated by portal hypertension and hypersplenism, who live at high altitude region, PSE has reliable curative effect, therefore, this therapy is worth promoting in clinical practice. (J Intervent Radiol, 2018, 27: 271-273)

Research on the influence factors of the carrying system / 中华劳动卫生职业病杂志

Objective@#To investigate surface electromyography signal (sEMG) of the major back muscle group and subjective fatigue assessment under different experimental combinations during walk with weight on both shoulders, as well as the functional status and fatigue property of human muscles.@*Methods@#From October to December, 2017, 10 college students were recruited to participate in shoulder weight-bearing work and walk under the combinations of different shoulder strap widths, weights, and hardness of waist cushion. The subjects were required to complete 12 sets of experiments, with each set lasting for 15 minutes, and the rest time between work was 30 minutes. The sEMG signals of the upper trapezius and the erector spinae were measured during the experiment, and subjective fatigue assessment was performed during rest. The time domain evaluation index (average amplitude, aEMG) , the frequency domain evaluation index (median frequency, MF) , and the data of subjective assessment were processed and analyzed.@*Results@#Weight and shoulder strap width had a significantly effect on fatigue (P<0.01) , and the change in the hardness of waist cushion had no significant effect on fatigue (P>0.05) . There was an interaction effect between weight and shoulder strap width (P<0.01) , and there was no interaction effect between weight, shoulder strap width, and hardness of waist cushion (P>0.05) . For the backpack carrying system, the combination of 10% weight and 50 mm shoulder strap width was the best one for relieving fatigue. The subjective test also showed that subjective feelings of muscle fatigue were associated with the weight and width, which was consistent with sEMG results.@*Conclusion@#The results of this experiment show that the combination of 10% weight and 50 mm shoulder strap width can help to relieve muscle fatigue during walk with weight on both shoulders, and weight-bearing walking is more likely to cause the fatigue of the erector spinae.

Associations of sedentary behavior and physical activity with dyslipidemia / 北京大学学报(医学版)

Objective:To analyze associations of sedentary behavior and physical activity with dyslipidemia among residents in Wuhai city.Methods: Data about social demographic characteristics, life style, health status and other covariate required for analysis in this study was obtained from a cross-sectional study on a total of 11 497 18-79 years old residents in Wuhai City by questionnaire, body mea-surement and laboratory examination.In this study, sedentary behavior and physical activity were evaluated using international physical activity questionnaire long version (IPAQ).IPAQ is widely used all over the world, and its reliability and validity have been tested in Chinese population.2016 Chinese Guideline for the Management of Dyslipidemia in Adults was used to define dyslipidemia in this study.Results: According to IPAQ scoring protocol, 124 participants were excluded as a result of reporting more than 960 min of physical activity per day.50.58% of 11 373 participants included in the analysis reported more than 4 hours of sedentary behavior per day in this study, thus 49.42% participants reported no more than 4 hours of sedentary behavior per day;the proportions of these 11 373 participants who reached Low level physical activity, Moderate level physical activity and high level physical activity were 23.43%, 37.29% and 39.28% respectively;and the detection ratios of new cases and prevalent cases of dyslipidemia in Wuhai City were 20.46% and 16.13% respectively.After controlling for confounders in this study, we found out that sedentary behavior increased the risk of new cases of dyslipidemia in women (OR=1.17, 95% CI: 1.00-1.36), and increased the risk of prevalent cases of dyslipidemia in both men (OR=1.21, 95% CI: 1.02-1.44) and women (OR=1.24, 95% CI: 1.04-1.48);as for association of physical activity with dyslipidemia, association was found between high level physical activity and prevalent cases of dyslipidemia in men in this study (OR=0.78, 95% CI: 0.62-0.98), suggested that high level physical activity may help to reduce the risk of prevalent cases of dyslipidemia in men.Conclusion: Our results from this cross-sectional study in Wuhai City suggested that sedentary behavior increased the risk of dyslipidemia;by contrast, physical activity may help to reduce the risk of dyslipidemia.

TACE for the treatment of primary hepatocellular carcinoma associated with portal vein tumor thrombus: recent progress in research / 介入放射学杂志

At present,the combined interventional therapy that is based on transcatheter arterial chemoembolization (TACE) technique can control the progression of primary hepatocellular carcinoma (PHC)in different degrees,at the same time the clinical objectives,such as relieving portal hypertension,eliminating portal vein occlusion,controlling refractory ascites and lowering upper gastrointestinal bleeding probability,can be reliably achieved.Thus,the quality of life of the patients can be effectively improved and the survival time will be reliably prolonged.This paper aims to make a comprehensive review about the medical articles concerning TACE combined with other interventional therapies for PHC complicated by portal vein tumor thrombus,which have been published both at home and abroad in recent years,in order to provide practical help for clinical diagnosis and treatment of PHC.

Effect of angle correction factors of MatriXX on VMAT dose verification / 中华放射肿瘤学杂志

Objective To investigate the effect of the angle correction factors of ionization chamber array Matrixx on the dosimetric verification of volumetric modulated arc therapy plan.Methods The Matrixx (IBA)was put in the middle of the MultiCube Phantom. Computed tomography scan was performed and the results were sent to the Raystation treatment planning system(TPS). All data calculated from TPS and actually measured using MatriXX were gained under the following conditions:6 MV,100 MU,28 cm×28 cm radiation field. And the directions of beam were from 0°to 180°with an interval of 5°(except an interval of 1° from 85° to 95°). The angle correction factors(CF)(θ)cor of MatriXX were calculated by the calculated dose values from TPS and the measured values using MatriXX and then mirrored to the opposite side. CF (θ)cor values were compared with CF(θ)def values that were given by manufacturer. The comparison was made by paired t-test. Results CF(θ)cor and CF(θ)def were different, and the difference was significant between 85° and 95°,with a maximum of 7.5%(P<0.05). The CF(θ)cor correction method had a higher gamma pass rate than the CF(θ)def correction method,with a maximum of 17%(P<0.05). Conclusions The ionization chamber array MatriXX has an angular dependence and the angle correction should be performed.The angle correction factors have the individual characteristics and are different in every unit ionization chamber of the MatriXX. Therefore, it is necessary to do angle correction for every unit ionization chamber of the MatriXX and the possible errors caused by various factors should be considered in order to improve the accuracy rate and gamma pass rate of the plan verification.

Comparison of McGrath-5 video-laryngoscope and McCoy laryngoscope guided double-lumen tube intubation in patients with difficult airway / 中国内镜杂志

Objective To compare the clinical efficacy of double-lumen tube intubation between McGrath-5 video-laryngoscope and McCoy laryngoscope in patients with difficult airway. Methods Sixty patients who were predicted as difficult double-lumen tube intubation were divided into two groups using random number table method:McGrath-5 video-laryngoscope group (group A, n = 30) and McCoy laryngoscope group (group B, n = 30). All patients were intubated by two laryngoscopes correspondingly after conventional induction. The success rate of the first intubation, intubation time, the ratio of right positioning, the number of SpO2 < 90% within intubation time, the number of pressing the cricoid, the incidence of intubation complications and hemodynamic parameters [The changes in systolic pressure and heart rate and BIS were recorded before induction (T0), glottic exposure upon laryngoscope insertion (T1), immediately after intubation (T2), 3 min (T3) after intubation]. Results The number of pressing the cricoid was smaller in group A than in group B (P < 0.05), whereas the intubation time in group A was significantly higher than that in group B (P < 0.05). The systolic pressure and heart rate at T3 were dramatically reduced compared with those measured at T0 in both groups (P < 0.05). The systolic pressure and heart rate at T1 and T2 in group A were considerably lower in group A than those in group B (P < 0.05). Conclusions Compared with the McCoy laryngoscope, double-lumen tube intubation by McGrath-5 video-laryngoscope can less impact on hemodynamics, less intubation complications, intubation time although prolonged but not for influence the patient's oxygen supply, for difficult airway double-lumen tube intubation provides a good choice.

The research and analysis of wireless digital information technology for postoperative analgesia management / 中国医师杂志

Objective To compare the clinical efficacy,adverse reactions,and management effect of postoperative intravenous analgesia for patients with postoperative intravenous analgesia with digital information technology and electronic analgesia pump system.Methods Totally 100 patients with postoperative intravenous analgesia (PCIA) were selected from April 2015 to September 2015 with postoperative intravenous analgesia and randomly divided into Wireless analgesic pump system Group (A group) and electronic analgesia pump group (group B),n =50 each group.Pain score (NRS),sedation score (OAA/S),comfort score (BCS),the total number of times and the number of effective press were pressed in patients were observed and compared between two groups after postoperative analgesia 1 hour (T0),4 hour (T1),10 hour (T2),16 hour (T3),and 24 hour (T4).Patients with early adverse reactions,patients and ward medical staff satisfaction,pain pump failure found in the medical staff and effective treatment of adverse events were also observed and compared in two groups.Results There were no significant difference of patients with NRS,OAA/S and BCS in two groups (P ＞ 0.05).Adverse reactions after postoperative analgesia,total number of times and the number of effective press had also no significant difference in two groups (P ＞ 0.05).Two groups of patients with air blockage,incomplete analgesia rate of adverse events was not significantly different (P ＞ 0.05).Medical workers in time [(1.0 ± 0.5) min vs (3.0 ± 2.1) min,P ＜ 0.05],effective processing time [(4.0-± 2.1) min vs (8.0 ± 5.1) min,P ＜ 0.05] in group A was significantly shorter than group B.The patient satisfaction in group A was significantly higher than group B(12.0 ± 4.2 vs 9.0 ± 3.1,P ＜ 0.05).The satisfaction degree of medical staff in group A was also significantly higher than group B(13.0 ±3.1 vs 10.0 ±2.1,P ＜0.05).Conclusions The digital information technology of wireless analgesic pump is applied to postoperative analgesia for medical workers to standardize management,improve the work efficiency,and increase the satisfaction of patients and medical staffs.

Comparison of different front plastic angle with reinforced plastic endotracheal tube guidance by McGrath -5 video laryngoscope for orotracheal intubation in obesity / 中国基层医药

Objective To compare the different front plastic angle with reinforced plastic endotracheal tube guidance by McGrath -5 video laryngoscope for orotracheal intubation in obesity.Methods 1 20 cases with obesity undergoing general anesthesia,ASA gradeⅠ -Ⅲ who planned intubation guidance by McGrath -5 video laryngo-scope,were randomly divided into three group according to different front plastic angle for endotracheal tube:group A (catheter 60°),group B(catheter 75°),C group(catheter 90°),40 cases in each group.General information and air-way evaluation indexes such as Mallampati classification,the degree of open mouth,neck circumference,thyromental distance,atlanto -occipital joint stretch degree preoperatively were recorded.C /L classification with laryngoscopic exposure,the successful rate of first intubation,time of first intubation,cases of second intubation,the incidence of blood stained catheter and postoperative sore throat and hoarseness were recorded also.Results There were no signif-icant differences of patients with general information and airway evaluating indexes such as Mallampati classification, the degree of open mouth,neck circumference,thyromental distance,atlanto -occipital joint stretch degree among three groups(P >0.05).The successful rate of catheter alignment glottal was 97.5% in group B,which was signifi-cantly higher than that of group A(80.0%)and group C(85.0%)(χ2 =8.36,P 0.05).Conclusion McGrath -5 video laryngoscope which guided endotracheal tube with front plastic angle at 75°degree has highest success rate of intubation,shortest intubation time,least compli-cation and is suitable for the application of tracheal intubation in obese patients.