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Objective:To provide a new morning check method for the output dose stability of the multileaf collimator (MLC) of the CyberKnife M6 (CK-M6) system.Methods:The CT images of a verification phantom with a size of 20 cm × 20 cm × 10 cm were transmitted into the Precision Treatment Plan ning System (ver. 1.1.1.1). The high-precision alignment between the accelerator output front and the fixed position of the phantom surface was achieved using the fiducial tracking method. A 10 cm × 10 cm radiation field was formed by the MLC and a DailyCheck plan with an output of 200 MU was designed. The repeatability, sensitivity, and accuracy of the DailyCheck plan were measured, and the CK-M6 system was continuously tested for one month using the artificial fixed method and the DailyCheck plan designed in this study. Results:The average and the standard deviation of 10 repeated measurements by the DailyCheck plan were 492.28 pC and 0.09, respectively, indicating good stability. There was a linear correlation between the measured values and the output dose, with a correlation coefficient of R2 > 0.999. Moreover, there was a position deviation of 2 mm between the phantom and the accelerator output front, and the result ant effect on the measured values was equivalent to a dose deviation caused by an output of 1.24 MU. The result from the continuous measurement of both the artificial fixed method and the DailyCheck plan fell within permissible limits, showing high consistency. Conclusions:The DailyCheck plan established through the fiducial tracking of a verification phantom can achieve the convenient, quick, and accurate daily detection of the output dose stability of the MLC of CK-M6. Therefore, this method can be widely applied in the clinical quality control of the CK-M6 system.
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Objective:To analyze the radiological protection situation in the workplace of medical X-ray diagnostic equipment in primary medical institutions in south Xinjiang Uygur Autonomous Region, and then put forward necessary measures and suggestions.Methods:In accordance with the national medical radiation protection monitoring program and the requirements of relevant standards for radiological health, medical X-ray diagnostic equipment in radialogical diagnosis and treatment institutions was tested selectively for workplace radiological protection, with the result statistically analyzed.Results:From 2018 to 2021, radiological protection test was conducted for 84 workplaces in 15 radiological diagnosis and treatment institutions in 4 districts of south Xinjiang, with a pass rate of 98.8%, which was consistent with the mainland including the eastern and central regions in the country.Conclusions:Based on the current situation in radiological diagnosis and treatment institutions on medical radiation protection in south Xinjiang, it is recommended to strengthen the supervision and management of radiological diagnosis and treatment equipment, improve the testing and technical capabilities of the local medical radiation monitoring technical teams and raise the level of radiological health work in the south Xinjiang.
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Objective To understand the radioactivity level of food surrounding a uranium mine in Xinjiang, to supplement the baseline database of food radionuclides in Xinjiang, to analyze the content of radionuclides and to estimate the internal exposure dose of residents caused by dietary intake. Methods The specific activity of 238U, 232Th, 226Ra, 40K and 137Cs of interest nuclides was measured, statistically analyzed by high purity germanium γ spectrometer, and the annual effective dose of these nuclides was estimated. Results No nuclide 238U was detected in food samples from 2018 to 2020. The average activity concentration and detection rate of other radionuclides were 232Th: 0.428 ± 0.038 Bq/kg (18.3%)、226Ra: 0.477 ± 0.063 Bq/kg (38%)、40K: 162 ± 7 Bq/kg (100%)、137Cs: 0.071 ± 0.011 Bq/kg (29.6%). The annual effective dose of residents due to food radionuclides was about 0.198 mSv. Conclusion The radioactivity level of food in the vicinity of a uranium mining mountain in Xinjiang is within the national standard limit, and the average annual effective dose caused by the diet of residents is consistent with the report of UNSCEAR in 2000. The content of artificial radionuclide 137Cs detected in food samples will not cause harm to the health of residents.
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Objective:To investigate the difference of heart rate variability in cardioinhibitory type vasovagal syncope(VVS-CI) children with different body mass index(BMI).Methods:Clinical data of thirty-four children with syncope or pre-syncope were retrospectively analyzed, who visited specialist clinic for syncope and diagnosed as VVS-CI at the Second Xiangya Hospital of Central South University from January 2012 to December 2019.BMI was calculated based on height and weight, and divided into lean group(BMI≤18.4 kg/m 2, n=19) and normal group(BMI 18.5-23.9 kg/m 2, n=15). Heart rate variability(HRV) of 24 h dynamic electrocardiogram was analyzed using linear analysis method.Time domain index included SDNN, SDANN, rMSSD and pNN50.Frequency domain index included total power(TP), ultra low frequency power(ULF), very low frequency power(VLF), low frequency power(LF), high frequency power(HF) and LF/HF. Results:There was no significant difference in SDNN, SDANN and rMSSD between lean and normal group( P>0.05), but pNN50 increased in lean group( P<0.05). No significant differences were found in TP, ULF, LF, HF and LF/HF between two groups( P>0.05), while VLF was lower in lean group than that in normal group( P<0.05). There was no statistical difference in time domain index and frequency domain index between different gender between lean and normal group( P>0.05). SDNN, SDANN and LF were higher in<12 years old than those in≥12 years old in lean group( P<0.05). There was no statistical difference in rMSSD, pNN50, TP, ULF, VLF, HF and LF/HF( P>0.05). ULF increased and LF decreased in<12 years old compared to ≥12 years old in normal group( P<0.05). No statistical differences were found in SDNN, SDANN, rMSSD, pNN50, TP, VLF, HF and LF/HF( P>0.05). Conclusion:The autonomic nervous regulation function of VVS-CI children with low BMI and normal BMI is different, resulting in HRV difference.There were also differences in HRV between<12 years old and ≥12 years old with the same BMI.
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Objective:To study the diagnostic efficacy and prognostic evaluation value of QT interval dispersion (QTd) in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).Methods:From July 2010 to January 2020, 80 children and adolescents who received their first visit or admission to the Pediatric Syncope Clinic of The Second Xiangya Hospital of Central South University and definite diagnosed of VVS-CI due to syncope or presyncope were selected as the VVS-CI group, meanwhile, 80 children and adolescents who had physical examination in the hospital were selected as the control group.QT interval were measured by 12-lead electrocardiogram at the baseline.Results:(1) Comparison between the two groups: Compared with the control group, the VVS-CI group had a significantly lower heart rate ( P<0.05) and significantly longer QT interval, such as the maximum QT interval (QTmax), minimum QT interval (QTmin), QTd, corrected maximum QT interval (QTcmax) and corrected QT interval dispersion (QTcd) ( P<0.05). After follow-up 84 (45, 127) days, compared with the responsive group, the non-responsive group had a significantly longer QT interval, such as QTmax, QTd, QTcmax, corrected minimum QT interval (QTcmin)and QTcd ( P<0.05). (2) Diagnostic efficiency: QTmax, QTmin, QTd, QTcmax and QTcd had a certain diagnostic value in children and adolescents with VVS-CI ( P<0.001). QTd had the largest area under the curve (AUC) (0.914), and had a sensitivity of 86.30% and a specificity of 84.95% at the optimal cut-off value of 28.50 ms for VVS-CI diagnosis.(3) Prognostic evaluation value: QTmax, QTd, QTcmax, QTcmin, QTcd had an estimated value for the prognosis of VVS-CI in children and adolescents ( P<0.05 or 0.01). QTd had the largest AUC (0.906) and the best cut-off value was 34.50 ms, the sensitivity to predict response to VVS-CI intervention was 90.00%, and the specificity was 82.35%. Conclusion:QTd of electrocardiogram has a good estimation value in the diagnosis and prognosis of VVS-CI in children and adolescents.
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Objective:To discuss the relationship between heart rate (HR) and heart rate differences (HRD) at different time points in head-up tilt test (HUTT) and the occurrence of postural tachycardia syndrome(POTS) in children and adolescents.Methods:A total of 217 children and adolescents diagnosed as POTS, who complained of syncope or presyncope, were chosen as POTS group (aged 6 to 16 years). During the same period, 73 healthy children and adolescents with matching gender and age were selected as control group.All subjects underwent HUTT from October 2000 to November 2019.Get HR (HR0, HR5, HR10) in baseline, HUTT 5 min and 10 min, HRD (HRD5, HRD10) of HR in HUTT 5 min and 10 min minus HR in baseline.Results:(1) HR5, HR10, HRD5, and HRD10 were higher in the POTS group than those in the control group( P<0.05). (2) Univariate Logistic regression: There was a correlation between HR5, HR10, HRD5, HRD10 and the risk of POTS( P<0.01). (3) Multivariable Logistic regression: For each additional unit of HRD5 and HRD10, the risk of POTS increased by 27% ( OR=1.27, 95% CI1.16 to 1.36) and 28% ( OR=1.28, 95% CI1.20 to 1.38). Conclusion:HR and HRD are related with the occurrence of POTS in children and adolescents, but HR and HRD at different time points of HUTT play the little role on the effect size of the occurrence of POTS.
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Objective:To analyze the association between the types of response to head-up tilt test (HUTT) and levels of various vitamins in children and adolescents with orthostatic intolerance.Methods:Sixty-five cases of children and adolescents 35 males and 30 females aged 5-14 (10.5±2.0) years old who complained orthostatic intolerance symptoms, including syncope, dizziness, headache, and chest tightness, in Children′s Medical Center, the Se-cond Xiangya Hospital, Central South University between November 2018 and April 2019, were enrolled.By comprehensive history, physical examination, and necessary laboratory testing, heart, cerebrovascular and other system diseases were excluded.According to HUTT result, these patients were divided into 2 groups, namely negative HUTT group and positive HUTT group.The serum levels of vitamin A 1, B 1, B 2, B 6, B 9, B 12, C, and E were compared between the 2 groups.Continuous data were analyzed by conducting t-test and categorical data were analyzed by performing χ2 test. Results:(1) There were 32 cases (18 males and 14 females) in negative HUTT group and 33 cases (17 males and 16 females) in positive HUTT groups, with 28 cases of vaso vagal syncope and 5 cases of postural tachycardia syndrome.There were no significant differences in age, gender ratio, and body mass index between the negative HUTT group and positive HUTT group.(2) The serum level of vitamin B 1 of positive HUTT group was lower than that of negative HUTT group [(77.43±16.70) nmol/L vs.(88.56±18.98) nmol/L, t=-2.513, P<0.05], while the levels of vitamin A 1, B 2, B 6, B 9, B 12, C, and E had no significant differences between the two groups (all P>0.05). Conclusions:Patients with positive responses to HUTT relatively lacked vitamin B 1, suggesting the role of vitamin B 1 in the pathophysiological process of neurally mediated syncope.
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Objective:To investigate the circadian rhythm of blood pressure and morning blood pressure surge (MBPS) in children with neurally mediated syncope (NMS).Methods:From July 2018 to June 2019, 135 cases [aged 3-16 years old (10.12±2.53) years old, with 74 males and 61 females] with unexplained syncope, presyncope, and symptoms such as headache, dizziness, chest pain, and chest tightness were collected in the Second Xiangya Hospital, Central South University for the first time.The 24 hour ambulatory blood pressure monitoring (24 h ABPM) was completed on the same day of the head-up tilt test (HUTT). Patients were divided into HUTT negative and positive groups, and dippers and non-dippers groups. MBPS (sleep-trough surge) was calculated and compared respectively.Results:(1) There were 51 patients in the HUTT positive group, including 27 patients with vasovagal syncope, 23 patients with postural orthostatic tachycardia syndrome, and 1 patient with orthostatic hypotension. In HUTT positive group, there were 22 cases (43.14%) of dippers and 29 cases of non-dippers.There were 84 patients in the HUTT negative group, there were 32 cases (38.10%) of dippers and 52 cases of non-dippers. There were no statistical significances in the dipper proportion between HUTT positive and negative group ( χ2=1.305, P>0.05). (2) Sleep-trough systolic blood pressure (SBP) surge was 1-45 mmHg [(15.97±8.03) mmHg](1 mmHg=0.133 kPa), and sleep-trough diastolic blood pressure (DBP) surge was -6-43 mmHg[(14.05±7.97) mmHg]. There were no statistical significances in sleep-trough surge between the HUTT negative and positive group (all P>0.05). (3) The age in the dipper group was higher than that in the non-dipper group [(10.72±2.20) years old vs. (9.72±2.66) years old, t=2.288, P<0.05]. The daytime average SBP [(110.20±8.33) mmHg vs.(105.54±7.51) mmHg, t=3.381, P<0.01], and morning peak SBP [(109.99±10.19) mmHg vs.(106.63±8.71) mmHg, t=2.045, P<0.05] of the dipper group were higher than those of the non-dipper group.The nighttime average SBP[(95.41±7.50) mmHg vs.(98.59±6.88) mmHg, t=2.540, P<0.01], nighttime average DBP[(48.61±4.52) mmHg vs.(52.28±4.65) mmHg, t=4.547, P<0.01], nocturnal minimum SBP[(89.62±8.18) mmHg vs.(93.60±7.38) mmHg, t=2.940, P<0.01], and nocturnal minimum DBP[(44.99±5.32) mmHg vs.(49.01±5.54) mmHg, t=4.205, P<0.01] of the dipper group were lower than that of the non-dipper group.Nocturnal SBP reduction rate [(13.42±2.68)% vs.(6.48±2.49)%, t=15.384, P<0.01], nocturnal DBP reduction rate[(19.98±4.92)% vs.(12.46±5.05)%, t=8.561, P<0.01], sleep-trough SBP surge[(20.37±8.30) mmHg vs.(13.03±6.36) mmHg, t=5.800, P<0.01], and sleep-trough DBP surge[(16.91±8.06) mmHg vs.(12.13±7.36) mmHg, t=3.554, P<0.01] of the dipper group were higher than those of the non-dipper group. Conclusions:Nocturnal blood pressure reduction and sleep-trough surge decreased in NMS children, and there is a circadian rhythm disorder of blood pressure.
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Objective:To investigate the relationship between body mass index (BMI) and response time of cardioinhibitory type vasovagal syncope (VVS-CI) in children.Methods:The clinical data of 56 children with syncope or pre-syncope were retrospectively analyzed and they visited specialist clinic for syncope and were diagnosed as VVS-CI in the Second Xiangya Hospital, Central South University from December 2012 to September 2019.Based on height and weight, BMI was calculated, and divided into low BMI group (35 cases) and normal BMI group (21 cases). Between the 2 groups, baseline heart rate, head-up tilt test (HUTT) positive response heart rate, baseline head-up tilt test (BHUT) positive response time, and sublingual nitroglycerin-provocated HUTT (SNHUT) positive response time were compared.The correlation between BMI and positive response time was analyzed.SPSS 22.0 software was applied for statistical analysis.Results:There were no significant differences in age, sex, duration of disease and number of syncope between the 2 groups (all P>0.05). No significant differences were found in baseline heart rate and positive response heart rate between the 2 groups [(78.5±15.3) times/min vs.(72.8±8.7) times/min, t=1.223, P=0.230; (44.0±13.9) times/min vs.(47.0±10.0) times/min, t=-0.664, P=0.511]. Compared with normal BMI group, BHUT positive patients/SNHUT positive patients were higher in low BMI group (27/8 cases vs.9/12 cases, χ2=4.839, P=0.027), and the positive response time of BHUT was shorter [(13.1±4.6) min vs.(23.7±9.5) min, t=-2.691, P=0.023]. There were no significant differences in SNHUT positive response time between the 2 groups ( P>0.05). Low BMI was correlated with BHUT positive response time ( r=0.750, P=0.005). Normal BMI was not associated with BHUT positive response time ( r=0.316, P=0.217). There was no correlation between low BMI and normal BMI and SNHUT positive response time ( r=0.177, P=0.431; r=0.021, P=0.940). Conclusions:Low BMI is positively correlated with BHUT positive response time of children with VVS-CI.The time it takes for syncope occurrence was shorter in children with low BMI than that in normal BMI.
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Objective:To investigate the value of rate-pressure product (RPP) in predicating the prognosis of postural tachycardia syndrome (POTS) in children.Methods:Fifty-three children (26 males and 27 females) aged 5 to 15 who had syncope of unknown reasons or presyncope and were diagnosed with POTS by head-up tilt test (HUTT) at the Children′s Syncope Specialist Clinic, the Second Xiangya Hospital, Central South University from April 2012 to May 2019 were selected as the POTS group.Thirty-eight children aged 5 to 16 (19 males and 19 females) who underwent medical examinations at the Children′s Health Specialist Clinic of the Second Xiangya Hospital, Central South University over the same period were enrolled as controls (control group). POTS children were followed up after intervention and they were divided into the response group ( n=40) and the non-response group ( n=13) according to the follow-up results.The products (RPP0, RPP5, RPP10) of the heart rate (HR0, HR5, HR10) and systolic blood pressure (SBP0, SBP5, SBP10) at baseline (HUTT 0 min), HUTT 5 min and HUTT 10 min were calculated.Statistical analysis was performed using SPSS 22.0 software and EmpowerStats software. Results:(1) There was no statistical difference in age and gender between the POTS group and the control group (all P> 0.05). (2) HR5 [(115.45±14.50) times/min vs.(95.79±13.89) times/min], HR10 [(120.57±16.13) times/min vs.(96.05±12.43) times/min], RPP5 (12 814.55±2 304.56 vs.10 371.42±1 910.20), and RPP10 (13 449.17±2 360.40 vs.10 523.18±1 771.48) in the POTS group were significantly higher than those in the control group( t=0.799, 7.842, 5.747, 6.446, all P<0.01). No statistical difference of HR0 and RPP0 was observed between the 2 groups (all P>0.05). (3) In the POTS group: HR5 [(98.73±12.43) times/min vs.(113.77±17.65) times/min], HR10 [(96.90±13.96) times/min vs.(119.08±13.52) times/min], RPP5 (11 125.45±1 952.35 vs.12 914.69±3 192.12) and RPP10 (10 819.58± 2 144.26 vs.13 375.46±2 807.01) in the response group were significantly lower than those in the non-response group( t=3.406, 5.012, 2.432, 3.455, all P<0.01). HR0 and RPP0 were no significantly different between the 2 groups(all P>0.05). (4) When SBP10<114 mmHg(1 mmHg= 0.133 kPa), the probability of response after POTS intervention increased by 10% with every 1 mmHg increase in SBP10, and there was a non-linear relationship between the 2 group ( P<0.05). (5) The receiver operating characteristic curve suggested that when RPP5 was 11 548.50, the sensitivity and specificity to predict the response after POTS intervention were 81.82% and 61.70%, respectively.When RPP10 was 10 988.00, the sensitivity and specificity were 77.78% and 86.21%, respectively. Conclusions:RPP is closely related to the intervention effect of POTS in children.RPP5 and RPP10 can predict the prognosis of POTS in children.There is a non-linear relationship between SBP10 and the intervention effect of POTS in children.
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Objective To explore the effect of decreased air pollutants concentrations on the incidence of Type 2 Diabetes Mellitus (T2DM). Methods A prospective cohort was designed in Tianjin where the air quality gradually improved from 2014 to 2018. A total of 5 077 community residents (18-90 years old) were recruited as the baseline population from 2013 to 2014. From 2014 to 2018 follow-up was carried out year by year to observe the new incidence of T2DM in the cohort. The HR and 95%CI (95% confidence interval) were calculated with the multiple Cox proportional hazard regression model to evaluate the effect of the decrease in the concentrations of SO2, NO2, and particulate matters with diameters 10, PM2.5) on the incidence of T2DM. Results The cohort was followed up year by year from 2014 to 2018, with a cumulative follow-up of 25 385 person-years over the 5 years. At the same time, the air quality of Tianjin was significantly improved. Statistical analysis results after covariate adjustment revealed that the risk of T2DM in the population decreased by 0.172, 0.124, and 0.210 times, for a decrease of 10 μg/m3 in the annual average concentrations of SO2, PM10, and PM2.5 each, respectively (SO2：HR=0.828，95%CI=0.757-0.907；PM10：HR=0.876，95%CI=0.816-0.941；PM2.5：HR=0.790，95%CI=0.694-0.899). Conclusion The implementation of environmental protection measures to improve air pollution could reduce the risk of T2DM in the population and control the increasing prevalence.
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Objective@#To investigate the changes in ventricular late potentials (VLP) in children and adolescents with postural tachycardia syndrome (POTS).@*Methods@#One hundred and forty-four children and adolescents diagnosed as POTS by using the head-up tilt test (HUTT) in Second Xiangya Hospital of Central South University from January 2012 to March 2019 were selected as POTS group, their age ranged 4 to 16 years old[(11.03±2.34)years old], there were 65 boys and 79 girls.Ninety-one healthy children and adolescents matched by age and gender[aged 4-16 (11.22±1.68) years old, there were 50 boys and 41 girls]were selected as the healthy control group.VLP was measured by SR-1000A ECG automatic analyzer (Boai, Guangdong, China).@*Results@#Compared with the healthy control group, the prevalence of positive VLP in the POTS group increased [ 11.1%(16/144 cases)vs.1.1%(1/91cases)], and the difference was statistically significant(χ2= 6.904, P<0.01); the heart rate in the POTS group increased compared with that in the healthy control group[82.0 (74.0-95.0) times/min vs.78.0 (71.0-86.0) times/min], and the difference was statistically significant(Z=-2.265, P<0.05); the low-amplitude signal(LAS40) in the POTS group prolonged compared with that in the healthy control group[23.0 (17.0-31.0) μV vs.19.0 (13.0-25.0) μV], and the difference was statistically significant(Z=-4.114, P<0.01); root mean square amplitude(RMS40) increased compared with that in the healthy control group[61.3 (34.4-79.1) ms vs.52.0 (38.8-64.5) ms], and the difference was statistically significant (Z=-2.469, P<0.05). There was no statistically significant difference in total QRS time (TQRS) between 2 groups [86.0 (76.0-97.5) ms vs.87.0 (81.0-94.0) ms, Z=-0.007, P>0.05].@*Conclusions@#The positive rate of VLP is increased of children and adolescents with POTS.It suggests that there is an abnormal cardiac electrical activity in children and adolescents with POTS.
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Objective To determine the water absorption coefficient of single-flavor root and rhizome Chinese herbal medicine pieces at room temperature, and guide the water addition in the decoction process of decocting machine of Chinese herbal.Methods The water absorption coefficient of 222-flavor root and rhizome Chinese herbal medicine pieces were studied, the simulated prescriptions were decocted according to the recommended formula of the decocting machine manufacturer and the water absorption coefficient, and the amount of liquid were obtained by the two methods which were compared with the amount of liquid required.Results The water absorption coefficients of roots and rhizomes with different textures were quite different.The amount of liquid obtained according to the manufacturer′s recommended formula was quite different from the amount of liquid required and there was no rule to follow.The error of the amount of liquid obtained according to the water absorption coefficient and the amount of liquid required was small and regular.Conclusion The experimental determination of the water absorption coefficient of traditional Chinese medicine decoction pieces could guide the amount of water added to the decoction machine.
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Objective To investigate the changes in ventricular late potentials (VLP) in children and adolescents with postural tachycardia syndrome (POTS).Methods One hundred and forty-four children and adolescents diagnosed as POTS by using the head-up tilt test (HUTT) in Second Xiangya Hospital of Central South University from January 2012 to March 2019 were selected as POTS group,their age ranged 4 to 16 years old [(11.03 ± 2.34) years old],there were 65 boys and 79 girls.Ninety-one healthy children and adolescents matched by age and gender [aged 4-16 (11.22 ± 1.68) years old,there were 50 boys and 41 girls] were selected as the healthy control group.VLP was measured by SR-1000A ECG automatic analyzer (Boai,Guangdong,China).Results Compared with the healthy control group,the prevalence of positive VLP in the POTS group increased [11.1％ (16/144 cases)vs.1.1％ (1/91 cases)],and the difference was statistically significant(x2=6.904,P ＜ 0.01);the heart rate in the POTS group increased compared with that in the healthy control group [82.0 (74.0-95.0) times/min vs.78.0 (71.0-86.0) times/min],and the difference was statistically significant (Z =-2.265,P ＜ 0.05);the low-amplitude signal (LAS40) in the POTS group prolonged compared with that in the healthy control group[23.0 (17.0-31.0) μV vs.19.0 (13.0-25.0) μV],and the difference was statistically significant (Z =-4.114,P ＜ 0.01);root mean square amplitude(RMS40) increased compared with that in the healthy control group [61.3 (34.4-79.1) ms vs.52.0 (38.8-64.5) ms],and the difference was statistically significant (Z =-2.469,P ＜ 0.05).There was no statistically significant difference in total QRS time (TQRS) between 2 groups [86.0 (76.0-97.5) ms vs.87.0 (81.0-94.0) ms,Z =-0.007,P ＞ 0.05].Conclusions The positive rate of VLP is increased of children and adolescents with POTS.It suggests that there is an abnormal cardiac electrical activity in children and adolescents with POTS.
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Objective@#To investigate the clinical significance of NS1-BP expression in patients with esophageal squamous cell carcinoma (ESCC), and to study the roles of NS1-BP in proliferation and apoptosis of ESCC cells.@*Methods@#A total of 98 tumor tissues and 30 adjacent normal tissues from 98 ESCC patients were used as study group and control group, and these samples were collected in Sun Yat-Sen University Cancer Center between 2002 and 2008. In addition, 46 ESCC tissues which were collected in Cancer Institute and Hospital of Tianjin Medical University were used as validation group. Expression of mucosal NS1-BP was detected by immunohistochemistry. Kaplan-Meier curve and log-rank test were used to analyze the survival rate. Multivariate Cox proportional hazard model was used to analyze the prognostic factors. Furthermore, NS1-BP was over expressed or knocked down in ESCC cells by transient transfection. Protein levels of c-Myc were detected by western blot. Cell viability and apoptosis was analyzed by MTT assay and flow cytometry.@*Results@#Among all of tested samples, NS1-BP were down-regulated in 9 out of 30 non-tumorous normal esophageal tissues (30.0%) and 85 out of 144 ESCC tissues (59.0%), respectively, showing a statistically significant difference (P=0.012). In the study group, three-year disease-free survival rate of NS1-BP high expression group (53.2%) was significantly higher than that of NS1-BP low expression group (27.6%; P=0.009). In the validation group, the three-year disease-free survival rates were 57.8% and 25.5% in NS1-BP high and low levels groups, respectively, showing a similar results (P=0.016). Importantly, multivariate analyses showed that low expression of NS1-BP was an independent predictor for chemoradiotherapy sensitivity and shorter disease-free survival time in ESCC patients(P<0.05 for all). Furthermore, overexpressed NS1-BP in TE-1 cells repressed c-Myc expression, inhibited cell proliferation and promoted apoptosis. In contrast, knockdown NS1-BP in KYSE510 cells induced c-Myc expression, increased cell proliferation and repressed apoptosis.@*Conclusions@#NS1-BP is an independent favorable prognostic factor in ESCC. It inhibits cell proliferation and enhances cell apoptosis via repressing c-Myc. Targeting NS1-BP may be a new therapeutic strategy for ESCC patients.
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Objective To investigate the changes of amplitude of T wave and ST segment between the supine and orthostatic electrocardiogram in children and adolescents with postural tachycardia syndrome (POTS). Methods A total of 74 children and adolescents diagnosed as POTS by head-up tilt test (HUTT),who complained of unexplained dizziness,headache,syncope or other symptoms,were chosen as POTS group. A total of 64 children and adolescents who did the health check in our child health clinic were selected as control group by age and sex in the same period. All the cases in this study came from the syncope specialized clinic or inpatient department of the Second Xiangya Hospital,Central South University,from August 2013 to January 2016. The heart rate and the 12-lead T-wave and ST-segment amplitude of the supine and orthostatic electrocardiogram were measured by software and manual intervention. Results (1) Com-pared with supine electrocardiogram,the heart rate of orthostatic electrocardiogram of POTS group increased [(105. 2 ± 16. 3) times/ min vs. (83. 8 ± 18. 0) times/ min,t = - 7. 598,P < 0. 01],the T-wave amplitude decreased in lead Ⅰ[(0. 28 ± 0. 14) mV vs. (0. 33 ± 0. 11) mV,t = 2. 598,P < 0. 05],Ⅱ[(0. 28 ± 0. 12) mV vs. (0. 39 ± 0. 13) mV,t = 5. 340,P < 0. 01],Ⅲ[(0. 00 ± 0. 19) mV vs. (0. 07 ± 0. 11) mV,t = 3. 041, P < 0. 01],aVF[(0. 14 ± 0. 13) mV vs. (0. 23 ± 0. 11) mV,t = 4. 505,P < 0. 01],V4 [(0. 33 ± 0. 21) mV vs. (0. 51 ± 0. 23) mV,t = 4. 938,P < 0. 01],V5 [(0. 37 ± 0. 10) mV vs. (0. 50 ± 0. 15) mV,t = 7. 764,P <0. 01] and V6 [(0. 25 ± 0. 10) mV vs. (0. 37 ± 0. 10) mV,t = 7. 538,P < 0. 01],the T-wave amplitude in-creased in lead aVR[( - 0. 27 ± 0. 11) mV vs. ( - 0. 36 ± 0. 10) mV,t = - 5. 023,P < 0. 01],and the ST-segment amplitude increased in lead V 5 [(0. 07 ± 0. 04) mV vs. (0. 06 ± 0. 04) mV,t = - 2. 309,P < 0. 05]. (2) Compared with control group,the difference of heart rate of POTS group increased [( - 21. 4 ± 14. 0) times/ min vs. ( - 10. 7 ± 11. 4)times/ min,t = 4. 875,P < 0. 01],and the difference of T-wave amplitude in-creased in lead Ⅰ[(0. 05 ± 0. 10) mV vs. ( - 0. 01 ± 0. 15) mV,t = - 3. 161,P < 0. 01],Ⅱ[(0. 11 ± 0. 12) mV vs. (0. 07 ± 0. 12) mV,t = - 2. 243,P < 0. 05],V4 [(0. 18 ± 0. 18) mV vs. (0. 07 ± 0. 20) mV,t =- 3. 282,P < 0. 01],V5 [(0. 18 ± 0. 11) mV vs. (0. 14 ± 0. 13) mV,t = - 2. 013,P < 0. 05] and V6 [(0. 13 ± 0. 08) mV vs. (0. 08 ± 0. 10) mV,t = - 3. 364,P < 0. 01],and the difference of T-wave amplitude in-creased significant in lead aVR[( - 0. 09 ± 0. 08) mV vs. ( - 0. 03 ± 0. 08) mV,t = 4. 109,P < 0. 01]. (3) Logistic regression analysis:the difference of heart rate and T-wave amplitude in lead V5 and V6 on supine and orthostatic electrocardiogram was statistically valuable for the diagnosis of POTS (P < 0. 05). (4) Diag-nostic test evaluation:when the difference of heart rate ≥15 times/ min,of T-wave amplitude in lead V5 and lead V 6≥ 0. 10 mV separately,on supine and orthostatic electrocardiogram at the same time,the sensitivity of the diagnosis of POTS was 37. 8％ and the specificity was 81. 3％ . (5)The follow-up of children and adoles-cents with POTS showed no significant difference of T-wave amplitude and ST-segment amplitude on ortho-static and supine ECG comparing to the initial diagnosis,regardless of the type of HUTT reaction remained or turned negative (P >0. 05). Conclusion The difference of heart rate and of T-wave amplitude in lead V5 and V6 are valuable for the diagnosis of POTS in children and adolescents.
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Objective To investigate the diagnostic value of Enzymes linked immunosorbent assay(ELISA)detection of anti phospholipase A2 receptor antibody(anti-PLA2R)in idiopathic membranous nephropathy patients.Methods All articles published from January 2012 to April 2017 about ELISA test on anti phospholipase A2 recepeor antibody as a maker for IMN were collected, and the quality of the studies was evaluated by using the guidelines of the updated Quality Assessment of Diagnostic Accuracy Stud-ies(QUADAS-2)tool.According to the inclusion criteria and exclusion criteria,the research objects were selected and the data were extracted,and the analysis was carried out by Meta-Disc1.4 software.The results are summarized on the basis of sensitivity,speci-ficity,and summary receiver operating characteristic curve(ROC curve).Results Ten articles were selected according to inclusion criteria and 1517 cases were included in the study.The combined sensitivity was 0.68[95% CI(0.64,0.70)];the merge specificity was 0.92[95% CI(0.90,0.95)],and the subjects'working curve showed AUC 0.807 4.Conclusion The detection of anti-PLA2R by ELISA is effective in the diagnosis of idiopathic membranous nephropathy,which can be used as an effective supplement for the diagnosis of idiopathic membranous nephropathy.
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Objective To explore the relationship between the level of plasma ADAMTS4 and the vulnerability of carotid atherosclerotic plaque in patients with carotid artery stenosis and the clinical value of evaluating the vulnerability of the carotid atherosclerotic plaque.Methods 60 patients with carotid artery stenosis were divided into stable plaque group and vulnerable plaque group according to the histopathological typing after carotid endarterectomy (CEA).30 patients who had atherosclerosis but no carotid plaque formation served as control.Using ELISA to measure the level of plasma ADAMTS4.Results The level of plasma ADAMTS4 was significantly higher in the vulnerable-plaque group (112.74 ± 17.47) ng/ml compared with the stable plaque group (56.67 ± 22.14)ng/ml and the control group (56.67 ± 22.14)ng/ ml,P ＜ 0.001.Logistic analysis showed that high level of plasma ADAMTS4 was risk factor for vulnerability of carotid atherosclerotic plaque (P ＜ 0.05,OR =8.240,95 ％ CI:1.512-22.915).ROC curve showed that ADAMTS4 =100.935 ng/ml could accurately predict significant vulnerability with accuracy of 94.3％.Conclusion ADAMTS4 is an effective,sensitive and non-invasive biomarker to evaluate the vulnerability of carotid atherosclerotic plaque.
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Objective To investigate the clinical and imaging features of pseudo subarachnoid hemorrhage(pseudo-SAH) in order to provide a theoretical basis for correct diagnosis and reducing misdiagnosis.Methods The clinical and imaging data of 5 patients with pseudo-SAH were retrospectively analyzed and summarized.Results Five pseudo-SAH patients had a history of unconsciousness,respiratory disorder,mechanical ventilation,hypoxemia and acidosis.Cranial CT showed diffuse cerebral edema and high density of cerebral fissure and cerebral ventricle,and there was no bloody cerebrospinal fluid via lumbar puncture.In the five patients,one improved,three died,and one gave up treating because of invalid treatment.Conclusions All patients have a history of hypoxic-ischemic encephalopathy before onset of pseudo-SAH.The clinical manifestation of pseudoSAH includes encephalopathy symptom such as unconsciousness,headache,seizure,etc.Cranial CT shows diffuse cerebral edema,high density of cerebral fissure and cerebral ventricle,and there is no bloody cerebrospinal fluid via lumbar puncture.Prognosis of pseudo-SAH is often bad.And most patients show critically illness and high mortality.
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Objective To investigate the effects of different metastatic sites on the prognosis of extensive?stage small cell lung cancer ( SCLC ) . Methods A retrospective analysis was performed among 322 patients pathologically or cytologically diagnosed with extensive?stage SCLC ( stage ⅠV defined by the seventh edition of the American Joint Committee on Cancer) who were admitted to our hospital from 2011 to 2015. In those patients, 246 had primary lesions with distant metastasis and 76 primary lesions with non?regional lymph node metastasis;261 had single?organ metastasis and 61 multi?organ metastases. Survival rates were calculated using the Kaplan?Meier method. Between?group comparison of the survival was made by the log?rank test. A multivariate prognostic analysis was made by the Cox proportional hazard model. Results In all the patients, the median survival time ( MST) was 11. 7 months;1?and 2?year overall survival ( OS) rates were 47. 9% and 19. 5%, respectively. The patients with single?organ metastasis had significantly longer MST and significantly higher 1?and 2?year OS rates than the patients with multi?organ metastases ( 12. 4 vs. 8. 9 months;52. 5% vs. 30. 5%;21. 9% vs. 11. 2%;P=0. 014) . In the patients with single?organ metastasis, those with liver metastasis had the worst prognosis with a MST of 8. 5 months, while those with non?regional lymph node metastasis had the best prognosis with a MST of 14. 5 months ( P= 0. 001 );there was no significant difference in the prognosis between patients with metastasis to different organs other than the liver ( P=0. 139) . In the patients with multi?organ metastases, those with liver metastasis and bone metastasis had the worst prognosis ( P=0. 016,0. 006);there was no significant relationship between brain metastasis and the prognosis of extensive?stage SCLC with multi?organ metastases ( P=0. 995) . There was no significantdifference in the prognosis between those with liver metastasis only and multi?organ metastases ( P=0. 862) . Conclusions Liver metastasis predicts the worst prognosis in patients initially diagnosed with extensive?stage SCLC and single?organ metastasis. Liver metastasis and bone metastasis predict the worst prognosis in patients with multi?organ metastases. Brain metastasis has no significant effect on the prognosis. There is no significant difference in the prognosis of extensive?stage SCLC between patients with single?and multi?organ metastases once liver metastasis occurs.