ABSTRACT
Objective:To discuss the effect of remnant cholesterol (RC) levels on carotid intima thickness (CIT) in patients with type 2 diabetes mellitus (T2DM) by ultra-high frequency ultrasound.Methods:A total of 60 patients with T2DM who received treatment in Henan Provincial People′s Hospital from May 2021 to July 2022 were prospectively recruited, and they were divided into a higher RC group (31 cases) and a lower RC group (29 cases) according to the RC levels. Thirty-one age, sex and body mass index(BMI)-matched healthy volunteers were selected as control group. Carotid CIT, carotid media thickness(CMT) and intima-media thickness(CIMT) were measured by 24 MHz ultra-high frequency ultrasound probe. The difference of general clinical data, laboratory indicators and CIMT, CIT, CMT among the three groups were compared, and the influencing factors of CIT in T2DM patients were explored by multivariate regression analysis.Results:①There were no statistical significances in gender, age, BMI, high-density lipoprotein cholesterol (HDL-C) and CMT among the three groups (all P>0.05). There were no statistical significances in duration of diabetes, fasting blood-glucose and glycated haemoglobin between the two subgroups of T2DM (all P>0.05). ②Compared with the control group, CIMT and CIT were thicker in the T2DM group (both P<0.05). ③CIT was thicker in the higher RC group than in the lower RC group ( P<0.05), while the difference of CIMT was not statistically significant the two groups ( P>0.05). ④Multivariate regression analysis showed that RC was the influence factor of CIT in patients with T2DM(β=0.610, P=0.005). Conclusions:CIT is significantly thicker in T2DM patients with higher RC than in those with lower RC, and RC is the influence factor of CIT, which suggests that more attention should be paid to the detection of RC in T2DM patients.
ABSTRACT
Objective:To explore the vascularity index of joints synovial quantitatively evaluate activity degree of rheumatoid arthritis(RA).Methods:From January to April 2022, 102 cases of RA patients in Henan Provincial People′s Hospital were conducted ultrasound examination of 28 joints including the bilateral metacarpophalangeal joints (1-5), 1st interphalangeal and proximal interphalangeal joints (2-5), wrist joints, elbow joints, shoulder joints and knee joints. Superb microvascular imaging (SMI) was used to visualize and calculate the vascularity index (VI) in the hyperplastic synovium. Summary Vascularity index (VIsum) was calculated by adding the VI of 28 joints. Standard vascularity index (VIstand) was obtained by dividing VIsum by the number of positive joints. The mean vascular index (VImean) was obtained by dividing the VIsum by 28, which is the number of joints examined. The disease activity score in 28 joints (DAS28) was calculated, including DAS28-CRP and DAS28-ESR. Serological results related to RA were collected. The correlation between VIsum, VIstand, VImean and the above data were analyzed respectively. DAS28-ESR and DAS28-CRP stages were used as the criteria, receiver operating curve (ROC) was used, to evaluate the diagnostic efficacy, sensitivity and specificity of VI parameters in assessing RA activity.Results:VIsum, VIstand and VImean were positively correlated with DAS28-ESR, DAS28-CRP, ESR and CRP. The r values of VIsum and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.703, 0.728, 0.467 and 0.529, respectively. The r values of VIstand and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.665, 0.705, 0.538 and 0.605, respectively. The r values of VImean and DAS28-ESR, DAS28-CRP, ESR and CRP were 0.677, 0.690, 0.441 and 0.501, respectively (all P<0.01). Using DAS28-ESR as grouping standard, the area of ROC curve(AUC) of VIsum, VIstand, and VImean were 0.815, 0.816 and 0.814, respectively. With the cut-off value of VIstand being 12.83, the specificity and sensitivity of VIstand diagnosis were 0.882 and 0.676, respectively. Using DAS28-CRP as grouping standard, the AUC of VIsum, VIstand, and VImean were 0.812, 0.878 and 0.811, respectively. With the cut-off value of VIstand being 13.97, the specificity and sensitivity of VIstand diagnosis were 0.997 and 0.710, respectively. Conclusions:Synovitis VI can objectively evaluate the degree of synovitis activity in patients with rheumatoid arthritis. Synovial VI has high diagnostic efficacy for the activity of RA patients.
ABSTRACT
Objective:To evaluate the carotid artery elasticity in the first-degree relatives of patients with type 2 diabetes mellitus.Methods:Ninety first-degree relatives of patients with type 2 diabetes who received treatment in the Department of Endocrinology of Henan Provincial People′s Hospital from October 2020 to June 2021 were randomly selected and designated as having a positive family history. Depending on the parental history of diabetes they were divided into three groups: 31 cases of family history positive in father (F), 31 cases of family history positive in mother (M) and 28 cases of family history positive in both father and mother (B). Thirty cases with matched age, height and weight without any history of diabetes, hypertension, hyperlipidemia and coronary atherosclerotic heart disease in their parents designated as control group were taken for comparison. Real-time intima-media thickness (RIMT) and R-VQS were employed to evaluate common carotid intima-media thickness (IMT), distance (Dist), diameter (Diam), hardness coefficient (HC) and pulse wave velocity (PWV). The differences among the groups were compared.Results:①There was no statistical significance in Diam among the four groups ( P>0.05). ②Compared with the control group, the IMT, PWV and HC in subjects with positive family history were increased, while Dist was decreased ( P<0.05). ③Paired comparison of the subjects with positive family history: the IMT, PWV and HC in B group were higher than in F and M group, and Dist was lower than in F and M group ( P<0.05). The PWV and HC in M group were higher than in F group, and Dist was lower than in F group ( P<0.05). There was no statistical significance in IMT between the F and M groups ( P>0.05). Conclusions:Carotid artery stiffness in the cases with positive family history is significantly higher than the control group. The decrease of carotid elasticity in B group is the most serious, M group takes the second place, while the F group is the least.
ABSTRACT
Under the background of the innovative medical association, the company took the lead in promoting the senior nurses to the community hospitals in Anhui, and opened community nursing clinics to better implement the graded diagnosis and treatment system and meet the needs of residents' integrated health services. From the background of a new round of medical reform, this paper analyzes the new occupational orientation of senior nurses in the innovative medical association model, and introduces and analyzes the problems that arise in the exploration stage of the sinking community, and puts forward suggestions based on the actual situation.
ABSTRACT
Under the background of the innovative medical association, the company took the lead in promoting the senior nurses to the community hospitals in Anhui, and opened community nursing clinics to better implement the graded diagnosis and treatment system and meet the needs of residents' integrated health services. From the background of a new round of medical reform, this paper analyzes the new occupational orientation of senior nurses in the innovative medical association model, and introduces and analyzes the problems that arise in the exploration stage of the sinking community, and puts forward suggestions based on the actual situation.
ABSTRACT
Objective To investigate whether quality assurance and quality control using multimodal image guidance and radiation dosimetry optimization could ensure and improve the targeting of 125I seeds brachytherapy.Methods A total of 287 patients (184 males,103 females,average age 61.9 years) with non-small-cell lung cancer (NSCLC) and 122 patients (average age 65.5 years) with prostate cancer who were diagnosed by pathology or imaging methods (coincidence imaging,CT,flexible fiberoptic bronchoscopy,ultrasonography) from October 2002 to October 2016 were retrospectively enrolled.All imaging methods were used to locate the target area.Optimization of radiation dosimetry was made according to treatment planning system (TPS) and evaluated by dose-volume histogram (DVH).125I seeds implantation was performed under the imaging guidance,followed by real-time location verification,dosimetric verification.Therapeutic efficacy was evaluated.Paired t test was used to analyze the data.Results The prescribed dose (PD) of planning target volume (PTV) was above 140 Gy.Immediate dosimetric verification was performed in 59 patients with NSCLC and 31 patients with pulmonary metastases.The radiation dose before and after the implantation was coincident in 93.2％ (55/59) of NSCLC and 93.5％ (29/31) of pulmonary metastases.The coincident rate of patients with dose delivered to 90％ GTV (D90)＞matched peripheral dose (MPD) was 93.2％ (55/59) and 87.1％ (27/31) respectively in NSCLC and pulmonary metastases.There was no significant difference in MPD,D90 and conformity index (CI) before and after implantation (t values:2.11-9.71,all P＞0.05).The average dose of the risk organs was significantly lower than the tolerance dose of the normal tissue.The incidence of radiation pneumonitis was 1.05％ (3/287).No other serious complications were found.Conclusion Targeted diagnosis and therapy of multimodal image guidance could be optimized to improve the effect of targeting and therapeutic gain ratio of 125I seeds brachytherapy.
ABSTRACT
This paper, on top of its introduction of the concept of medical ethics counseling, analyzed the necessity of establishing a medical ethics consultation system in China.By reviewing the development of the medical ethics counseling system in other countries, the authors, in view of China′s medical practice, put forward specific recommendations on establishing a medical ethics counseling system in China.Issues on the construction of organ donation ethics counseling system in China were also discussed in focus.
ABSTRACT
Objective To explore the association of T cell immunoglobulin- and mucin-domain-containing molecule-3 (TIM-3) gene polymorphism and IFN-γ levels with the incidence of primary nephrotic syndrome (PNS) in children. Methods A case-control study was conducted and 21 Han patients with PNS were selected and included in case group. Meanwhile, 20 each from Mongolian and Han were selected and assigned into control group and at least three generations of their family members were from the same nationality. PCR-restriction fragment polymorphism analysis was used to detect and analyze single nucleotide polymorphisms of exon -574A/C in TIM-3 gene in PNS children and controls. Also the genotype and allele frequencies between the two groups were compared. Enzyme linked immunosorbent assay (ELISA) was used to detect the level of serum IFN-γ and its changes was analyzed. Results There was no significant difference in the distribution of genotypes (AA, AC, CC) of exon -574A/C in TIM-3 gene between the Han and Mongolian subgroups in control group (P=0.741). Neither did the allele frequency between the two groups (P=0.655). Compared with control group (Han and Mongolian), the frequencies of AA, AC and CC genotypes were 9.52%, 28.57% and 61.90% respectively in -574A/C loci of the Han nationality children with PNS. There was significant difference in genotypes distribution between the two groups (P=0.017). The frequency of C allele in PNS children of Han nationality was 76.2% which was higher than that in normal control group (50%), and the difference was statistically significant (P=0.005). Compared with A allele carriers, the risk of PNS in C allele carriers increased by 3.20 times (95%CI: 1.39～7.37). There were no significant differences in serum IFN-γ among the Han nationality with PNS, Han and Mongolian normal control groups (P>0.05). Conclusion The single nucleotide polymorphism of the exon -574A/C of TIM-3 gene may be related to the pathogenesis of PNS in children. In addition, IFN-γ is not associated with the incidence of primary nephrotic syndrome in children.
ABSTRACT
Professional personality is characterized by stability and plasticity,and it should make the entry point of the cultivation of medical students' professional personality on the training of doctor-patient communication skills.Meanwhile,doctor-patient communication skill is an important factor of the medical professional personality.This paper discussed the cultivation of doctor-patient communication skills among medical students from the perspective of analysis of doctor-patient communication obstacles.It should improve the doctor-patient communication skills of medical students and shape healthy medical professional personality,taking the education of cognition,emotion,will,and behavior as pathways.
ABSTRACT
Objective To research the functional polymer liposome-trapped gold nanoparticles as molecular probes used as CT contrast agents.Methods Gold nanoparticles were entrapped by ultrasonic micro-emulsion method using self-developed linoleic acid-modified dextran polymer liposome.Under the same concentrations,clinical imaging was performed with Iohexol as control for the analysis of CT value differences.Then,the particle suspensions at appropriate concentration(6 mg/mL)were intravenously injected into Balb/c nude mice for real-time observation of CT imaging.ResultsIn vitro results showed that nanoparticles at greater than 4 mg/mL could present much higher CT value than Iohexol at the same conditions,while in vivo studies indicated nanoparticles could clearly show different organ contrast with prolonged circulation time.Conclusion Compared to clinical contrast agent Iohexol,functional polymer liposome entrapped gold nanoparticles could possess a great application prospect to be used as a new type of molecular probes for CT enhanced imaging.
ABSTRACT
Objective To investigate the feasibility of reducing CT scanning dose in the process of 125I radioactive seed implantation.Methods GEMS phantom and 062 M phantom were scanned using GE Lightspeed RT large hole CT with 120 kV,100 kV and 80 kV separately,and 150-10 mA (20 mA decreased progressively).The scanning dose,CT value and noise of the region of interest were recorded and the image quality was evaluated.Image signal-to-noise ratio (SNR) and contrast to noise ratio (CNR) values were calculated.Results With the decreasing of tube voltage and current,the SNR values were reduced accorgingly.The values had significant difference with those of standard images except the images acquired with 120 kV,150-70 mA and 100 kV,150-90 mA (t =-9.294-3.717,P ＜0.05).With the decreasing of the tube voltage and current,the CNR decreased significantly.The image quality was too low to evaluate while CNR lower than 2.The high contrast resolution of the CT images were not affected obviously with the tube voltage and current lowering.Conclusions In the process of 125I radioactive seed implantation,it is feasible to choose lower tube voltage and tube current(100 kV,70 mA) to scan the same area repeatedly except for the first scan with standard chest scanning parameters.The patient radiation dose has fallen dramatically.
ABSTRACT
Objective To investigate the role of sulfydral redox agent in the modulation of insulin secretion and the potential mechanism. Methods Insulin secretion was evaluated in INS-1 cells after treatment with different concentrations of glucose and sulfydral redox agents by a standard insulin radio immunoassay. Results Glucose concentration-dependently potentiates insulin secretion was observed in INS-1 cells. DTBNP and DTDP could not only significantly increase glucose-stimulated insulin secretion (GSIS), but also increase insulin secretion in nifedipine-pretreated cells, which could be abrogated by DTT. Importantly, pharmacological ablation of L-type calcium channels by nifedipine and/or ablation of K ATP channelby diazoxide both could potentiate glucose-induced insulin secretory. Conclusions Sulfydral redox agent could regulates GSIS. DTBNP and DTDP may increase insulin secretion via regulating the activities of KATP, L-type CaV channel and IP3 receptor.
ABSTRACT
Objective To investigate the influence of treatment table with C-arm and immobilization device in IMRT planning accuracy, and to explore methods to solve this problem.Methods The solid water slabs and the ionization chamber was scanned and images were transmitted to the treatment planning system (TPS).Beam parameters in the TPS were set with 6 MV beam and 100 MU exposures were used.Measurements were performed at two different sizes of 5 cm×5 cm and 10 cm×10 cm.The gantry was rotated through angles from 0° to 180° with measurements taken at 5° increments.The measure point was set at center of the ionization chamber' measure point, which was also the central point of planning.The center axis of Matrix was aligned with the center of couch and was irradiated in accordance with the same conditions.OmniPro-FmRT software was used to compare and analyze the dose distribution of the radiation field of measurement and the treatment planning system output.Using the function of add constant value to find the appropriate coefficient to improve the plan total dose.The dose distributions for each beam in IMRT plans which was increased or unincreased total dose were measured for 6 patients with pelvic tumor respectively.Results In radiation therapy, treatment couch and immobilization device may attenuate radiotherapy dose.The impact of the incident range from 65°-70° and 115°-125° were the largest.Increasing the total dose of the treatment plan by 2％ could compensate the attenuation of the treatment table and immobilization device.Conclusions In radiation therapy, the impact of the incident range from 65°-70°, 115°-125° and another side of 290°-295° and 230°-245° should be avoided.The attenuation should not be neglected in the TPS and dose should be compensated by adjusting beams' MU.
ABSTRACT
Objective To explore the MatriXX measurements the dose distributions for each beam in intensity-modulated radiotherapy (IMRT) plans were measured with 0 degree gantry angle and actual gantry position respectively.To discuss whether the two multi-angle synthetic pass rate from the two methods has statistics differences.Methods The dose distributions for each beam in IMRT plans were measured with 0 degree gantry angle and actual gantry position for twelve patients with head and neck tumor respectively.The γ pass rates (according to 3％/3 mm) for each beam under each angle condition was obtained by the comparison between the measured and the calculated dose distributions from the treatment planning system which was treated as the reference distribution.Use the t-test to analyse the actual gantry angle method and use the one factor analysis of variance to analyze the two multi-angle synthetic pass rate from the two methods.Results The γ pass rates of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle,but differentγ pass rates showed only in 80 °,120°and 240° with98.71％,93.59％(t=2.10,P=0.000),98.15％,93.17％ (t=2.10,P=0.000) and 98.94％,92.85％ (t =2.10,P =0.000) respectively.The γpass rate of multi-angle synthetic was seemingly between methods (98.27％,94.63 ％,F =0.50,P =0.134).Conclusions Two kinds of IMRT verification mode are from two position to validated the IMRT plans dose accuracy,comparatively analysing the conclusions drawn from the two methods can protect accuracy of IMRT plans more comprehensively.
ABSTRACT
Objective To study the difference in the measurement of the absorbed dose in water between the dosimetry protocols of IAEA TRS-398 and TRS-277 for high-energy electron beams.Methods The differences were compare in absorbed doses from 6 kinds of electron beams among the three methods of using cylindrical chamber,plane-parallel chamber and cross-calibrated plane-parallel chamber which was calibrated in user' s high-energy electron beam according to IAEA TRS-398 and IAEA TRS-277.Results The difference in absorbed doses measured,following the two protocols,was 0.4％-2.3％ for planeparallel chamber,0.6％-2.2％ for cylindrical chamber,and 0.5％-2.0％ for cross-calibrated chamber.The differences in measured absorbed doses between the two dosimetry protocols were slight.Conclusions The methods used to determine absorbed dose to water recommanded by IAEA TRS-398 for high-energy beams are more accurate and more suitable for clinical users to measure compared to the TRS-277.
ABSTRACT
Objective To analyze the advantage of altered fractionation radiotherapy by calculating the accumulative effects of daily biologically effective dose (BED) to find out the difference between conventional fractionated radiotherapy and altered fractionation radiotherapy.Methods The data in the report of hyperfractionated or accelerated radiotherapy for head and neck cancer published by Cochrane Collaboration in 2010 was analyzed.Based on the radiotherapy processes mentioned in this report,the accumulative effects of daily BED were calculated and compared in different radiotherapy processes by using linear-quadratic mode.The variation of BED in different radiotherapy processes was find out.Results In total dose of unity as the premise of 70 Gy,altered fractionation especially the hyperfractionated accelerated radiotherapy could give a higher BED to the tumor during a shorter period,hyperfractionated radiotherapy could give a lower BED to normal tissues,and hyperfractionated radiotherapy with split course could give higher BED to the tumor while lower BED to normal tissues.Conclusions The variation of BED in different radiotherapy processes can be shown clearly by linear-quadratic mode.It can be simple and shortcut through mathematical models for the evaluation of different radiotherapy plan,on clinical symptomatic selection play a guiding role in tumor therapy.
ABSTRACT
ObjectiveTo investigate the age distribution of serum prostate specific antigen (PSA) and explore its correlation with fasting blood glucose(FBG)and lipid in the male elderly.MethodsThe levels of FBG,triglyceride (TG),low-density lipoprotein (LDL-C),high density lipoprotein (HDL-C) and PSA were reviewed in 2903 elderly men (aged ≥ 60 years) in our hospital.The subjects were classified into 6 groups by age,and PSA levels were compared among groups.The correlations of FBG,TG,LDL-C,HDL-C with PSA were analyzed using multiple linear regression analysis.Results The level of PSA had the trend to increase with age.Positive association of TG,LDL with serum PSA level,but negative correlation between HDL and serum PSA level were noted in the group aged 60-64 years (r=0.10,0.15,0.12,P＜0.05).In the group aged 66-69 years,there was negative relationship between FBG and serum PSA(r= 0.10,P＜0.05).No relationship could be found in other groups (P＞0.05).ConclusionsPSA level may increase with age,but without relation with FBG,TG,LDL-C and HDL-C.
ABSTRACT
Objective To investigate the feasibility of dose verification of intensity modulated (IM) planning of helical tomotherapy (HT) using two-dimensional ion chamber array (2DICA),and develop an efficient way to validate the dose delivered under the parameters mirroring those during the treatment. Meth-ods A 2DICA,I'mRT MatriXX and MULTICube equivalent solid water phantom from IBA company were used to verify the dose distribution of 10 IM planning. The combined phantom was set up to measure the dose distributions on coronal and sagittal surface. The precise setup of phantom was guided by HTMVCT images. After the irradiation, the measured dose distributions on the coronal and sngittal plane were compared with those calculated by the IM planning system for verification. The results were evaluated and the feasibility of the different measuring methods was studied. Results The dose distribution measured by the MatriXX 2DICA was well consistent with that calculated by the treatment planning system. The errors between the measured dose and predicted dose in the selected points were within ±3%. In the comparison of the pixel-segmented ionization chamber versus treatment planning system using the 3 mm/3% γ criteria, the passing ratio of pixels with γ parameter ≤1 was 97.76% and 96.83%, respectively. Conclusions MatriXX is a-ble to measure the absolute and relative dose distributions simultaneously,which can be used for dose verifi-cation of IM planning.
ABSTRACT
Objective To investigate the role of FHIT in NSCLC and the relativity between FHIT and cigarette.Methods 81 cases of NSCLC and 7 cases of the nomal lung tisses were examined for FHIT by immunochemical(S-P).Results The postive expression rates of FHIT were significantly lower than those in nomal lung tisses(P
ABSTRACT
Objective To investigate the role of FHIT,cyclinD1,CDK4 in NSCLC.Methods Immunochemical(S-P) was used to determined 81 cases of NSCLC.Results The postive expression rates of FHIT,cyclinD1,CDK4 were significantly different between in NSCLC and in nomal lung tisses(P