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Diarrhea-predominant irritable bowel syndrome （IBS-D） is a chronic functional bowel disorder characterized by abdominal pain and diarrhea， with visceral hypersensitivity and abnormal gastrointestinal dynamics as the pathophysiological basis. The brain-gut interaction plays a role in pain-related functional gastrointestinal disorders， especially IBS-D. 5-Hydroxytryptamine （5-HT）， as an important brain-gut peptide regulating gastrointestinal function， affects brain activity， gastrointestinal motility， pain perception， mucosal inflammation， and immune response through brain-gut interaction and is associated with the occurrence and development of IBS-D. In recent years， traditional Chinese medicine （TCM） has shown great potential to mitigate gastrointestinal symptoms and improve the quality of life with its holistic view and treatment based on syndrome differentiation. Studies have shown that TCM treats IBS-D by regulating the 5-HT signaling pathway. With a focus on syndrome differentiation in TCM， this paper systematically describes the efficacy and mechanism of TCM in treating different TCM syndromes of IBS-D via the 5-HT signaling pathway， aiming to provide a scientific basis for TCM treatment of this disease.
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Objective:To discuss the surgical strategies of atlantoaxial dislocation in children with mucopolysaccharidosis IVA.Methods:8 cases of atlantoaxial dislocation in children with mucopolysaccharidosis IVA treated with posterior atlantoaxial reduction, decompression, bone graft and internal fixation from April, 2019 to October, 2020 were retrospectively analyzed, including 6 males and 2 females, aged 6.2±3.1 years (range, 2-10 years). All the 8 children had lower limb weakness and walking instability, and some of them could not even stand and walk, and all of them had odontoid hypoplasia, atlantoaxial dislocation and systemic skeletal dysplasia. Measures, including American Spinal injury Association (ASIA) grade, modified atlanto-dental interval (mADI) and reduction rate, screw placement type and fusion of bone graft, were recorded and analyzed.Results:The follow-up time was 17.8±7.4 months (range, 8-27 months). The total operation time was 144.0±43.1 mins (range, 90-220 min) and the blood loss during the surgery was 89.1±55.1 ml (range, 15-180 ml). The ASIA grade were 3 cases of "C" level, 4 cases of "D" level and 1 case of "E" level before the operation, and 1 case of "C" level, 1 case of "D" level and 6 cases of "E" level at the latest follow-up. The mADI reduced from 7.38±2.62 mm pre-surgery to 2.50±1.60 mm ( t=5.71, P=0.001). The reduction rate of the latest follow-up mADI was 65.0%±26.3%. 31 pedicle screws were inserted, including 26 Type I screws (83.9%), 4 Type II screws (12.9%) and 1 Type III screw (3.2%), and no injury of spinal cord or blood vessels were observed associated with the Type III screw. One unilateral axial lamina screw was used in 1 case. 5 patients showed fusion (autogenous bone) 6 months after the surgery, 2 patients got fusion (allogeneic bone) 1 year after the surgery, and other patients showed bone graft resorption (allogeneic bone) at the latest follow-up. One patient developed type II respiratory failure on the night of operation and recovered after rescue. Other patients had no complications such as vascular and nerve injury, screw loosening and so on. Conclusion:The majority of children with type IVa mucopolysaccharidosis are accompanied by absence of odontoid process. If such children are complicated with atlantoaxial dislocation and cervical spinal canal stenosis resulting in cervical spinal cord injury, timely surgical intervention should be carried out. Posterior atlantoaxial fusion is a safe and effective surgical method. As children have the characteristics of multi-system involvement, multi-disciplinary cooperation may be needed to ensure perioperative safety.
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Objective:To understand the current situation of the layout of the national science and technology innovation platform in the medical field, and provides a basis for departments to improve the formulation of scientific and technological innovation policies and promote the reform of the mechanism.Methods:The report and the evaluation list of the official websites are the main reference, supplemented by the public information of each platform and the information retrieval and mining of database, select quantitative statistical indicator to analyze data.Results:Platforms rely on a rich variety of units, mainly concentrated in Beijing, Shanghai and other areas with strong research ability, including major disease areas, covering many key medical disciplines.Conclusions:The regional layout is not balanced, and the layout of the type of disease at the subdivision level needs to be further complemented and improved.
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Objective:To explore the setup errors of vacuum pad combined with breast bracket in linear accelerator intensity-modulated radiotherapy for breast cancer.Methods:The clinical data of 72 patients who received linear accelerator intensity-modulated radiotherapy after breast conserving surgery in Hai'an Hospital of Traditional Chinese Medicine from July 2017 to March 2022 were retrospectively analyzed. According to the radiotherapy fixation schemes, they were divided into vacuum pad group (24 patients), breast bracket group (27 patients) and vacuum pad combined with breast bracket group (21 patients). Cone-beam CT was used to analyze the setup errors of the fixation, and the mean value of the overall errors and the standard deviation of the system errors were calculated. The relative factors affecting the fixed setup errors were analyzed.Results:There were statistical differences among vacuum pad group, breast bracket group and vacuum pad combined with breast bracket group in the level of forward and backward (Z) direction translation error (2.11±0.41, 2.67±0.26 and 1.79±0.21) and Z direction rotation error (1.14±0.24, 1.05±0.21 and 0.91±0.22) ( F values were 45.86 and 6.21, both P < 0.05). The level of Z direction translation error in vacuum pad group was higher than that in vacuum pad combined with breast bracket group, and the difference was statistically significant ( t = 12.37, P = 0.001). The level of Z direction rotation error in breast bracket group was higher than that in vacuum pad combined with breast bracket group, and the difference was statistically significant ( t = 3.41, P = 0.001). In the breast bracket group, the planning target volume (PTV) extension boundary values in the left and right (X), up and down (Y), and Z directions were 2.02, 2.09 and 1.97; the PTV release boundary values in X, Y and Z directions of the vacuum pad group were 1.81, 2.07 and 2.25; the external boundary values of PTV in X, Y and Z directions of the vacuum pad combined with breast bracket group were 1.13, 1.51 and 1.49. The result of multifactor analysis showed that body mass index (BMI) ( OR = 4.208, 95% CI 1.438-12.312) and breast volume ( OR = 4.023, 95% CI 1.375-11.769) were the independent influencing factors of fixed setup errors (both P < 0.05). Conclusions:The application of vacuum pad combined with breast bracket in the fixed setup of linear accelerator intensity-modulated radiotherapy of breast cancer is helpful to reduce the fixed setup errors, but at the same time, the fixed setup errors is affected by the patient's BMI, breast volume and other factors.
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Objective:To effectively express the receptor binding domain (RBD) of SARS-CoV-2 spike protein in Pichia pastoris and to evaluate its immunogenicity. Methods:The gene encoding the RBD protein was synthesized and cloned into the pPICZαA plasmid. After linearization, the plasmid was transferred and integrated into the genome of Pichia pastoris. The expressed RBD protein in culture supernatant was analyzed by Western blot and Biolayer interferometry. After screening, a single clone expressing the RBD protein was selected. The high-level expression of RBD protein was achieved by optimizing the fermentation process, including the salt concentration adjusting of the medium and induction condition optimization (pH, temperature and duration). The immunogenicity of the expressed RBD protein was evaluated in a mouse model. Results:A single clone with a high expression level of RBD protein was obtained and named RBD-X33. The expression level of RBD protein in the fermentation supernatant reached up to 240 mg/L after optimization of the induction condition (HBSM medium, pH=6.5±0.3, 22℃ and 120 h). In the mouse experiment, the recombinant RBD protein was formulated with Alum+ CpG dual adjuvant and injected into mice. The binding IgG antibody levels were up to 2.7×10 6 tested by ELISA and the neutralizing antibody levels were up to 726.8 tested by live virus neutralizing antibody assay (prototype). Conclusions:The RBD protein could be efficiently expressed in Pichia pastoris and induce stronger immune response in animals. This study suggested that the recombinant SARS-CoV-2 RBD protein expressed in Pichia pastoris could serve as a candidate antigen in the development of SARS-CoV-2 vaccine.
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【Objective】 To analyze the causes and preventive measures of lipemic blood in voluntary blood donors. 【Methods】 Data of 12 000 voluntary blood donors donated at our blood station from January 2018 to June 2020 were retrospectively analyzed. The incidence, discarding rate and causes of lipemic blood were investigated, and preventive measures were formulated. 【Results】 384(3.20%) out of the 12 000 blood samples were lipemic blood, while mild, moderate and severe lipemic blood constituted 181, 148 and 55 cases, respectively. The incidence of lipoemia in males(4.22%) was higher than that in females(1.52%). The incidence of lipoemia in 26~45 and 36~45 age population was 4.75%, which was higher than that in 18~25 age group(0.62%). The incidence of lipoemia was the lowest in donors with mass index(kg/m2) <18.5, followed by 18.5~24.9 and >30 (P<0.05). The incidence of lipemic blood among first-time blood donors(4.38%) was higher than that in repeated donors(2.31%), higher in blood donation collected during 13: 00 to 17: 00(3.54%) than 9: 00 to 12: 00 a. m.(2.73%), also higher in group blood donors(4.01%) than street blood donors(1.56%)(P<0.05). The free Hb of red blood cells in moderate and severe group was higher than that in mild group immediate after preparation and 7 days after preparation (P<0.05). 【Conclusion】 There was a significant tendency for the incidence of lipemic blood in voluntary blood donors, which causes blood discarding. The publicity of blood donation, pre-donation consultation and advice on reasonable diet should be boosted to reduce the discarding rate of lipemic blood and improve the use of blood.
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BK polyomavirus-associated nephropathy (BKPyVAN) is a common cause of allograft failure. However, differentiation between BKPyVAN and type I T cell-mediated rejection (TCMR) is challenging when simian virus 40 (SV40) staining is negative, because of the similarities in histopathology. This study investigated whether donor-derived cell-free DNA (ddcfDNA) can be used to differentiate BKPyVAN. Target region capture sequencing was applied to detect the ddcfDNAs of 12 recipients with stable graft function, 22 with type I TCMR, 21 with proven BKPyVAN, and 5 with possible PyVAN. We found that urinary ddcfDNA levels were upregulated in recipients with graft injury, whereas plasma ddcfDNA levels were comparable for all groups. The median urinary concentrations and fractions of ddcfDNA in proven BKPyVAN recipients were significantly higher than those in type I TCMR recipients (10.4 vs. 6.1 ng/mL,
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Objective:To explore the application value of virtual reality technology in thoracoscopic anatomical segmentectomy.Methods:Eighty-four patients with early stage non-small cell lung cancer admitted to the First Hospital of Jiaxing from December 2017 to December 2018 were enrolled in the study.They were divided into observation group and control group according to the random digital table method, with 42 cases in each group.The observation group used virtual reality technology to construct a three-dimensional digital model, and performed preoperative evaluation and simulated surgical drills and intraoperative navigation on the three-dimensional digital model, based on the preoperative evaluation and simulated surgical drill results, combined with the specific actual situation during the operation, developed and implemented individualized thoracoscopic anatomical segmentectomy.Thoracoscopy anatomical segmentectomy was routinely performed in the control group.The operation time, intraoperative blood loss, intraoperative lymph node dissection number, intraoperative lymph node dissection, postoperative hospital stay, postoperative thoracic closed drainage tube, total postoperative drainage, total hospitalization, cost and incidence of postoperative complications were compared between the two groups.Results:The operation of both two groups was successfully completed, and no intraoperative thoracic surgery was performed during the operation.There was no perioperative death.The operation time, intraoperative blood loss, intraoperative lymph node dissection number, intraoperative lymph node dissection, postoperative hospital stay, postoperative thoracic closed drainage tube, total postoperative drainage, total hospitalization cost and the incidence of postoperative complications in the observation group were (100.98±26.51)min, (67.98±32.96)mL, (7.79±1.32), (11.98±4.69), (4.60±1.43)d, (2.86±0.81)d, (437.14±193.86)mL, (3.76±0.31)million, 9.52%(4/42), respectively, which in the control group were (114.88±24.26)min, (104.52±52.37)mL, (6.45±0.3), (8.31±1.94), (6.50±2.55)d, (4.00±2.25)d, (667.26±415.01)mL, (4.20±0.65)million, 26.19%(11/42), respectively, the differences between the two groups were statistically significant ( t=-2.208, -3.328, 5.916, 4.678, -4.221, -3.993, -3.265, -3.968, χ 2=3.977, all P<0.05). No local recurrence or distant metastasis was found during the follow-up period. Conclusion:Virtual reality technology can provide preoperative evaluation and simulated surgical exercises and intraoperative navigation for thoracoscopic anatomical segmentectomy, which can reduce the difficulty of surgery and improve the accuracy and safety of the operation.
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Objective:To evaluate the clinical application of an angle gauge in internal fixation with proximal femoral nail antirotation (PFNA) for femoral intertrochanteric fracture.Methods:A retrospective analysis was carried out in the 54 elderly patients with intertrochanteric fracture of the femur who had been treated with PFNA internal fixation from February 2016 to August 2018 at Department of Orthopedic Trauma, Central Hospital of Shengli Oilfield. In the experimental group of 25 patients whose PFNA internal fixation was assisted by an angle gauge to measure the anteversion angle, there were 9 males and 16 females with an age of 74.4 years ± 4.6 years, and 7 cases of type 31-A1, 11 cases of type 31-A2, and 7 cases of type 31-A3 by the AO classification; in the control group of 29 patients whose PFNA internal fixation was not assisted by an angle gauge, there were 9 males and 20 females with an age of 74.4 years ± 3.9 years, and 9 cases of type 31-A1, 16 cases of type 31-A2, and 4 cases of type 31-A3 by the AO classification. The 2 groups were compared in terms of operation time, corrections of anteversion angle, intraoperative X-ray exposure times and Harris hip scores at the last follow-up.Results:There were no significant differences between the 2 groups in their preoperative general data, indicating they were compatible( P>0.05). Compared with the control group, the experimental group showed significantly shorter operation time (64.0 min ± 6.5 min versus 72.7 min ± 3.9 min), significantly fewer corrections of anteversion angle (2.8±1.2 versus 4.7±1.5) and significantly fewer X-ray exposure times(7.0±1.2 versus 11.6±1.6) (all P<0.05). This cohort was followed up for 6 to 24 months (average, 11 months). By the Harris hip scores at the last follow-up, therewere 22 excellent cases, 2 good cases and one fair case in the experimental group, and 23 excellent cases, 4 good cases and one poor case in the control group, showing an insignificant difference between the 2 groups ( P>0.05). Conclusion:Application of an angle gauge to assist PFNA internal fixation can lead to shorter operation time, fewer corrections of anteversion angle and fewer X-ray exposure times in the treatment of femoral intertrochanteric fracture.
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Objective To detect the expression of miR-346 in colon cancer cells and the relationship with invasion and metastasis, so as to provide experimental basis for predicting and treating targets of colon cancer. Methods Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of microRNA-346 in colon cancer cell lines ( HCT116, COLO205, SW620) and normal colon epithelial cells ( NCM460 ) . The expression of microRNA-346 was up-regulated or down-regulated by mimic or inhibitor and transfected into HCT116 cells. The transfection efficiency was detected by qRT-PCR. The metastasis and infiltration behavior of HCT116 cells were observed by Transwell. Results The relative expression of microRNA-346 in colon cancer cell lines HCT116, COLO205 and SW620 were (0. 372±0. 068),(1. 284±0. 253),(1. 105±0. 203),respectively. The relative expression of COLO-205 and SW620 in normal colon epithelial cells (NCM460) was (0. 126±0. 004). Compared with NCM460 group, COLO-205 group and SW620 group had significant difference (t＝9. 652,P＜0. 01; t＝7. 753,P＜0. 01). The invasion and metastasis ability of HCT116 cells increased after the up-regulation of the expression of microRNA-346 (t＝2. 458,P＜0. 05; t＝2. 194,P＜0. 05),and decreased after the down-regulation of the expression of microRNA-346 (t＝2. 247,P＜0. 05; t＝2. 065,P＜0. 05) . Conclusion Mir-346 is highly expressed in colon cancer cells and regulates invasion and metastasis of colon cancer cells.
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Objective@#To investigate the expression of nucleolar and spindle-associated protein 1 (NUSAP1) in non-small cell lung cancer (NSCLC) and analyze its relationship with the prognosis of NSCLC patients.@*Methods@#Real-time fluorescent quantitative PCR and immunohistochemical staining were performed to determine the expression of NUSAP1 in NSCLC tissues and adjacent tissues collected from hospital. The relationship between NUSAP1 expression and prognosis of NSCLC patients was analyzed by online database.@*Results@#The expression level of NUSAP1 mRNA in tumor tissues was significantly higher than that of adjacent tissues (P<0.05). The high expression rate of NUSAP1 protein in NSCLC tissues was 58.0% (29/50), significantly higher than 22.0% (11/50) of adjacent tissues (P<0.05). The high expression of NUSAP1 protein in NSCLC tissues was closely correlated with tumor size, lymph node metastasis and TNM stage (P<0.05), but was not related to age and gender. The data showed that the expression level of NUSAP1 mRNA was inversely associated with the overall survival (OS) of NSCLC patients (P<0.001). The expression of NUSAP1 mRNA was significantly correlated with the pathological grade, clinical stage, gender, chemotherapy, smoking history, and histological type of NSCLC patients (P<0.05).@*Conclusions@#The expression of NUSAP1 is up-regulated in NSCLC, which is correlated with the growth and development of NSCLC and prognosis of the patients. These results indicate that NUSAP1 can be used as a potential prognostic marker for NSCLC.
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Objective@#To analyze and summarize the method and effect of cervical esophagus perforation.@*Methods@#A total of 29 cervical esophageal perforation patients caused by foreign body were retrospectively analyzed from January 2012 to June 2018 in Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University.@*Results@#Among the 29 cervical esophageal perforation patients, 28 patients were extracted by lateral neck incision, 1 patient with carotid artery hemorrhea was rescued by repairing the fistula between carotid artery and esophage. All patients recovered and successfully discharged. There were no severe complications among all patients.@*Conclusions@#The cervical CT scan is important for diagnosing a cervical esophageal perforation. Enhancement CT scan is necessay for a patient with haematemesis. Lateral neck incision would be first choice for patients with big foreign bodies. Inflammatory reaction and finger palpation are helpful for locating foreign bodies.
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Objective To analyze the mechanical properties of bone tissue engineering scaffolds with different pore structure and porosity, and improve the mechanical properties of scaffolds by changing pore structure. Methods Square pore, spherical pore and cylindrical pore with different porosities from 55% to 75% were established by SolidWorks software, and the surface-volume ratio of different structures was calculated. The stress distribution and equivalent compression modulus of different scaffolds were obtained by ANSYS Workbench software. According to the stress distribution results, the scaffold with rectangular pore structure and cuboid element structure was improved instead of square pores. Results With the increase of porosity, the surface-volume ratio of the three structures increased. For the same porosity, the surface-volume ratio of square pores and spherical pores was larger, while that of cylindrical pores was the smallest. The modulus and porosity of the three structures were approximately linear. The modulus of the square pore and the cylindrical pore were similar. The stress analysis on the square pore and two improved structures with 60% porosity showed that for the two improve structures, the wall stress on 4 edges parallel to the direction of applied stresses could be reduced by 15%. Conclusions The surface-volume ratio and mechanical property of square pores were more advantageous than spherical pores and cylindrical pores with the same porosity, and the two improved structures could improve the mechanical properties of square pores. The two improved pores enriched the structure of tissue engineering scaffolds. The research findings provide the mechanical references for their clinical application.
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Objective To investigate the expressions of microRNA-145 (miR-145) and Six1 in gastric cancer tissues and gastric cancer cell lines,and to investigate the effect of miR-145 targeting Six1 on invasion of human gastric cancer cells and its molecular mechanism.Methods Sixty patients with advanced gastric cancer confirmed by gastroscopy and pathology in the Fourth Hospital of Changsha were selected,from January to November,2017.The expressions of miR-145 mRNA and Six1 in 60 cases of gastric cancer and their matched adjacent tissues were detected by real-time fluorescence quantitative PCR (qRT-PCR) and their correlations were analyzed.miR-145 mimics were transfected into MKN-45,BGC-823 and SGC-7901 gastric cancer cell lines.The relative levels of miR-145 mRNA in three gastric cancer cell lines were detected by qRT-PCR.The SGC-7901 gastric cancer cell lines with the highest expression level of miR-145 mRNA were selected for subsequent experiments.The mimic group (transfected with miR-145 mimic),NC group (transfected with miR-145 negative control) and empty carrier group (no addition of any oligonucleotides) were set up.The invasive ability of gastric cancer cells was detected by Transwell test.The ability of angiogenesis was verified by microtubule formation experiment.The expression levels of downstream proteins of the gastric cancer cell lines SGC-7901 such as Six1,E-cadherin and vimentin were detected by Western blotting method.The MirTrap system and the luciferase report test verified whether miR-145 targeted the Six1 gene.Results The expressions of miR-145 mRNA in gastric cancer tissues and in para cancerous tissues were 0.579 ± 0.086 and 1.009 ±0.121,respectively.The difference was statistically significant (t =-22.498,P ＜0.001).The expressions of Six1 were 2.516 ± 0.208 and 1.041 ± 0.227,respectively.The difference was statistically significant (t =37.119,P ＜ 0.001).The expressions of miR-145 mRNA and Six1 were negatively correlated (r =-0.728,P ＜0.001).After overexpression of miR-145,in the mimic,NC and empty carrier groups,the numbers of cells passing through the membrane were 48.550 ± 3.716,82.800 ± 3.797,87.467 ± 8.023,respectively.The difference was statistically significant (F =87.789,P ＜ 0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜0.001).In the mimic,NC and empty carrier groups,the numbers of tube formation of human umbilical vein endothelial cells were 24.333 ± 1.211,34.167 ±2.041,36.500 ±3.209,respectively.The difference was statistically significant (F =47.103,P ＜ 0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜ 0.001).In the mimic,NC and empty carrier groups,the expression levels of Six1 in gastric cancer SGC-7901 cells were 1.392 ±0.072,2.426 ±0.099,2.371 ±0.079,respectively.The difference was statistically significant (F =289.517,P ＜ 0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜0.001).In the mimic,NC and empty carrier groups,the expression levels of E-cadherin were 4.001 ±0.132,2.714 ±0.181,2.653 ±0.218,respectively.The difference was statistically significant (F =106.572,P ＜0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜ 0.001).In the mimic,NC and empty carrier groups,the expression levels of vimentin were 1.634 ± 0.132,3.349 ± 0.102,3.501 ± 0.185,respectively.The difference was statistically significant (F =389.032,P ＜0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜ 0.001).MirTrap system verified that the target Six1 mRNA levels in the mimic,NC and empty carrier groups were 1.101 ± 0.097,0.582 ± 0.037,0.573 ± 0.032,respectively.The difference was statistically significant (F =138.922,P ＜ 0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜0.001).Luciferase reporter assay showed that the double fluorescence ratios of Six1 wild type recombinant vector group were 7.324 ± 0.415,10.755 ± 0.481,10.430 ± 0.309 in the mimic,NC and empty carrier groups respectively.The difference was statistically significant (F =129.345,P ＜ 0.001).There were significant differences between the mimic and NC groups and between the mimic and empty carrier groups (both P ＜0.001).The double fluorescence ratios of Six1 mutant recombinant vector group were 10.938 ± 0.091,11.077 ±0.126,11.028 ±0.205 in the mimic,NC and empty carrier groups respectively,and the difference was not statistically significant (F =1.318,P =0.297).The MirTrap system and the luciferase report test showed that miR-145 was targeted to the Six1 gene.Conclusion The expressions of miR-145 mRNA and Six1 in gastric cancer and para cancerous tissues were different and negatively correlated.miR-145 inhibited the invasion,angiogenesis and epithelial mesenchymal transition of gastric cancer cells by targeting Six1 gene.
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Biofilms are microbial communities composed of bacteria cells and self-produced extracellular polymeric substances and lead to antibiotic resistance, forming a great threat in the fields of medicine, food industries and so on. The formation of biofilms is a multi-stage dynamic process regulated by multiple mechanisms. Recently, researchers paid much more attention to the related research areas of biofilms, especially the detection methods of biofilms. This paper introduced the characteristics and formation process of biofilms as well as the effects of quorum sensing on biofilms development. Meanwhile, we discussed the detection methods of biofilms, especially electrochemical impedance spectroscopy (EIS) in detection of biofilms in detail. Furthermore, we reviewed and predicted that microfluidic chips based EIS served as an in-situ and online monitoring method for biofilms growth.
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Critical ultrasonography(CUS) is different from the traditional diagnostic ultrasound,the examiner and interpreter of the image are critical care medicine physicians.The core content of CUS is to evaluate the pathophysiological changes of organs and systems and etiology changes.With the idea of critical care medicine as the soul,it can integrate the above information and clinical information,bedside real-time diagnosis and titration treatment,and evaluate the therapeutic effect so as to improve the outcome.CUS is a traditional technique which is applied as a new application method.The consensus of experts on critical ultrasonography in China released in 2016 put forward consensus suggestions on the concept,implementation and application of CUS.It should be further emphasized that the accurate and objective assessment and implementation of CUS requires the standardization of ultrasound image acquisition and the need to establish a CUS procedure.At the same time,the standardized training for CUS accepted by critical care medicine physicians requires the application of technical specifications,and the establishment of technical specifications is the basis for the quality control and continuous improvement of CUS.Chinese Critical Ultrasound Study Group and Critical Hemodynamic Therapy Collabration Group,based on the rich experience of clinical practice in critical care and research,combined with the essence of CUS,to learn the traditional ultrasonic essence,established the clinical application technical specifications of CUS,including in five parts:basic view and relevant indicators to obtain in CUS;basic norms for viscera organ assessment and special assessment;standardized processes and systematic inspection programs;examples of CUS applications;CUS training and the application of qualification certification.The establishment of applied technology standard is helpful for standardized training and clinical correct implementation.It is helpful for clinical evaluation and correct guidance treatment,and is also helpful for quality control and continuous improvement of CUS application.
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Objective To compare the size of target volume,amplitudes of movements in different directions,movement vector,dose to the diseased lung,whole lung volume,and setup error between free breathing fixation (method A) and four-dimensional computed tomography (4DCT)-guided abdominal balloon compression fixation (method B),and to demonstrate that the 4DCT-guided abdominal balloon compression fixation is effective in the treatment of non-small cell lung cancer (NSCLC).Methods A retrospective analysis was performed among 80 patients with NSCLC in our hospital.In those patients,40 received method A and 40 method B.The GTVfree and GTVpress were delineated on the maximum intensity projection (MIP) images of 10 respiratory phases using method A and method B,respectively.The PTVfree and PTVPress were obtained by expansion of the GTVfree and GTVpress,respectively.The paired t test was used to analyze the differences in the PTV,maximum amplitudes of movements in three dimensions,absolute value of the movement vector (|V|),and volume between method A and method B.The treatment planning system was used to compare the V5,V10,V20,and V30 of the diseased lung and the whole lung volume between method A and method B.All patients underwent cone-beam CT (CBCT) scans after positioning.Setup error was obtained by matching the CBCT images with the MIP images in the XVI system based on bone and grayscale values.Results The PTVfree and PTVpress were (283.2± 12.74) and (201.8± 12.99)cm3,respectively (P=0.002).The maximum amplitudes of movements in the right-left,superior-inferior,and anterior-posterior directions as well as thel V | value were (0.22±0.02),(1.85±0.08),(0.43±0.26),and (1.91±0.27) em,respectively,for method A,and (0.05±0.01),(0.41±0.03),(0.16±0.16),and (0.44±0.16) cm,respectively,for method B (P=0.120,0.001,0.070).The V5,V10,V20,and V30 for the diseased lung and total lung volume were (61.26± 4.27) ％,(44.52± 1.70) ％,(28.22± 3.13) ％,(18.26±5.17)％,and (3556±223.12) cm3,respectively,for method A,and (52.74±4.78)％,(38.76±4.92) ％,(23.71 ±4.03) ％,(15.54±3.43) ％,and (3376±311.65) cm3,respectively,for method B (P =0.001,0.003,0.004,0.021,0.004).There was no significant difference in setup error obtained by the XVI system between the two fixation methods (P＞0.05).Conclusions Without increasing setup error,abdominal balloon compression can effectively control the lung movement amplitude,reduce the planning target volume,and reduce the radiation dose to the lung in patients with NSCLC.
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BACKGROUND: Calcium sulfate/poly amino acid compound materials carrying triple anti-tuberculosis drugs have been proved to have excellent slow release performance based on our preliminary studies on the physical and chemical properties and the release properties of the compound materials.OBJECTIVE: To observe the slow release performance of the calcium sulfate/poly(amino acid) compound material carrying triple anti-tuberculosis drugs in a rabbit model of spinal tuberculosis.METHODS: Twenty-four New Zealand white rabbits were used to make L4-5 spinal tuberculosis models and divided into two groups in a random way following removal of tuberculosis lesions. Calcium sulfate/poly amino acid compound material carrying isoniazide, rifampicin, pyrazinamide or calcium sulfate/poly(amino acid)compound material with no drugs was implanted into the defect in the experimental or control group,respectively. At 2, 4, 6 and 8 weeks after implantation, the concentrations of isoniazid, rifampicin and pyrazinamide in the defect region, including the bone tissue, adjacent psoas major and inferior vena cava,were measured.RESULTS AND CONCLUSION: In the experimental group, the isoniazid levels in the damaged bone tissue and psoas major were kept in minimum bactericidal concentration (MBC) at 8 weeks after implantation and in the minimum inhibitory concentration (MIC) at the end of 12 weeks after implantation, while its level in the vein was kept in MBC at 2 weeks and in MIC at 8 weeks. The rifampicin levels in the bone tissue and psoas major were kept in MBC at 4 weeks after implantation and in the MIC at 8 weeks after implantation, while its level in the vein was kept MIC at 4 weeks.The pyrazinamide levels in the damaged bone tissue and psoas major were kept in MBC at 8 weeks after implantation and in the MIC until 8 weeks after implantation, while its level in the vein was kept MIC at 8 weeks. In the control group,there were no levels of isoniazid, rifampicin and pyrazinamide in the damaged bone tissue, adjacent psoas major and inferior vena cava in comparison with the baseline. These results show that isoniazid, rifampicin and pyrazinamide in the defect region can achieve sustained slow release in the rabbit model of spinal tuberculosis after implantation of the calcium sulfate/poly(amino acid) compound material carrying triple anti-tuberculosis drugs. In addition, the local drug concentration and duration in the defect region are better than those in the blood.
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Objective To investigate the distribution and changes of microorganisms on the skin of submariners under a chronically closed environment , and provide reference for targeted medical support .Methods One hundred and twenty-two samples were collected using swab.After culture and isolation, the microbes were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF-MS) .Results A total of 52 types of 229 bacteria and 2 types of fungi were isolated . Major opportunistic pathogens included Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter cloacae, while major dwelling bacteria included Micrococcus luteus, Oslo Mora bacteria, Acinetobacter, Staphylococcus epidermidis, and Serratia marcescens.Compared with the early period of the task, major opportunistic pathogens and dwelling bacteria were significantly increased in the middle and late period of the task .Conclusion The skin microbes of the submariners are investigated , targeted drugs need to be prepared for daily medical support and war trauma .
ABSTRACT
Objective To compare the errors of double-center and single-center setup, and to study the role of both on reducing the rotational setup errors for the patients with esophageal carcinoma depend on rigid registration errors between online kV-cone-beam computed tomography (kV-CBCT) images and plans for CT images. Methods 20 patients with middle esophageal carcinoma received image scanning before treatment every week by using double-center setup and CBCT, and single-center setup images of 20 patients were taken from the X volume image (XVI) system. Then the images of both setup types, registration errors of CT image and rotational setup errors were compared respectively. Every patient received kV-CBCT scanning analysis before treatment every week, and 6 times in total. 240 group of kV-CBCT images from all of the patients were off-line matched with plans for CT images to calculate the errors of X-axis, Y-axis, Z-axis. Then the data of linear errors and rotational setup errors from patients were collected, aiming at putting the error data into the patients treatment program and analyzing the significances. Results The standard registration of double-center setup was as follows: T (X) (0.28 ±0.19) cm, T (Y) (0.27 ±0.19) cm, T (Z) (0.33 ±0.12) cm, R (X) (0.40 ±0.19)° , R (Y) (0.30 ±0.18)° , R (Z) (0.30 ±0.19)° . The standard registration of single-center setup was as follows:T(X) (0.32±0.20) cm, T(Y) (0.29±0.25)cm, T(Z) (0.31±0.16) cm, R(X) (2.2±0.68)°, R(Y) (0.5±0.32)°, R(Z) (2.10±0.60)°. There were statistical differences between linear errors in T(X) and rotational setup errors in R(X), R(Y) or R(Z) (P< 0.05). Conclusion Double-center position can reduce the rotational setup errors, especially in X-axis, Y-axis errors, and may provide more help for the radiation oncology departments without on-board CBCT.