ABSTRACT
Objective:To preliminarily analyze the relationship between peripheral blood CD19 +CD27 +B cells, CD4 -CD8 -double-negative T cells, related cytokines and recurrence in patients with neuromyelitis optica spectrum disorders (NMOSD). Methods:A retrospective analysis was performed on the clinical data of 72 patients with NMOSD admitted to Henan Provincial People′s Hospital between January 2019 and January 2021. According to presence or absence of recurrence within 1 year after treatment, they were divided into non-recurrence group ( n=30) and recurrence group ( n=42). The data such as gender, age and score of Extended Disability Status Scale (EDSS) at admission were collected. The levels of serum triglyceride (TG), total cholesterol (CHO), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA) 1 and apolipoprotein B (ApoB) were detected by full-automatic biochemical analyzer. The level of total protein in cerebrospinal fluid was detected by full-automatic programmed protein analyzer. The levels of immunoglobulin (Ig) G and IgM in cerebrospinal fluid were detected by immunoturbidimetry. The counts of peripheral blood CD19 +CD27 +B cells and CD4 -CD8 -double-negative T cells were detected by flow cytometry. The levels of serum interleukin (IL)-6, IL-10 and IL-2 were detected by enzyme-linked immunosorbent assay. Results:EDSS score, neutrophils, proportions of cases with positive aquaporin 4 (AQP4) antibody and autoimmune antibody in the recurrence group were significantly higher than those in the non-recurrence group (all P<0.05). There was no statistically significant difference in serum TG, HDL-C, LDH-C, ApoB, ApoA1, total protein in cerebrospinal fluid, IgG or IgM between the non-recurrence group and the recurrence group (all P>0.05). The proportions of CD19 +B cells, CD19 +CD27 +B cells and CD4 -CD8 -double-negative T cells in the recurrence group were (1.21±0.12)%, (1.61±0.17)% and (1.39±0.25)%, significantly higher than those in the non-recurrence group [(0.85±0.07)%, (1.25±0.12)%, (0.89±0.22)%, t=15.51, 3.89, 12.06, all P<0.05]. The counts of CD19 +B cells, CD19 +CD27 +B cells and CD4 -CD8 -double-negative T cells in the recurrence group were (289.50±17.64) ×10 6/L, (4.67±0.03) ×10 6/L and (64.78±6.53) ×10 6/L, significantly higher than those in the non-recurrence group [(254.56±15.34) ×10 6/L, (3.18±0.03) ×10 6/L, (47.82±4.83) ×10 6/L, t=14.27, 4.26, 12.06, all P<0.05]. The level of serum IL-10 in the recurrence group was lower than that in the non-recurrence group [(18.56±1.97) ng/ml vs (24.72±2.52) ng/ml, t=11.64, P<0.05], while levels of IL-6 and IL-2 were significantly higher than those in the non-recurrence group [(15.12±1.54) pg/ml vs (11.47±1.23) pg/ml, (28.34±2.94) pg/ml vs (22.57±2.36) pg/ml, t=10.75, 8.89, both P<0.05]. Conclusion:The levels of peripheral blood CD19 +CD27 +B cells, CD4 -CD8 -double-negative T cells and related cytokines are abnormal in NMOSD patients, which may be related to the recurrence of NMOSD.
ABSTRACT
Objective:To introduce the stereotactic cardiac radioablation (SCRA) based on the stereotactic body radiotherapy (SBRT), and comprehensively evaluate the new approach by short-term effectiveness and safety.Methods:Patients with ventricular arrhythmia (VA) were evaluated and included in this clinical trial, who were immobilized by vacuum bag and performed simulation with 4-dimensional computed tomography (4DCT). In this study, the planning target volume (PTV) was set as the target to design a SBRT plan using volumetric modulated arc therapy (VMAT), which was evaluated by dose parameters such as R 50%, homogeneity index and conformity index, etc. The results of Holter and echocardiography were monitored during the follow-up and compared with the data before treatment. Results:Three subjects with ventricular tachycardia (VT) and one with premature ventricular contraction (PVC) received the same prescription of 25 Gy in a single fraction. The average volume of PTV was 71.4 cm 3(60.3-89.4 cm 3). The average time of beam delivery was 12.0 min (4.5-21.0 min). And the short-term follow-up lasted for an average of 18 weeks (14-25 weeks), which showed significant decrease in both VT and PVC load without complications. Conclusion:This study reports the implementation method of SCRA and proves its short-term effectiveness and safety, but the effects and standards of the key radiotherapy techniques still need to be explored.
ABSTRACT
Objective:To carry out preliminarily study on the combination of high iodine flow rate (IDR) and high noise index (NI) in reducing radiation dose of CT angiography (CTA) for head and neck.Methods:A total of 120patients with lesions on head and neck who underwent head and neck CTA in the hospital were divided into high IDR combined with high NI group (high IDR+NI group, 50 cases) , middle IDR combined with middle NI group (middle IDR+NI group, 40 cases) and low IDR combined with low NI group (low IDR+NI group, 30 cases) according to the random number table method.The scanned images were reconstructed by the iterative reorganization algorithm (ASiR) 2.0.The CT values of head and neck, signal to noise ratio (SNR) , contrast noise ratio (CNR) of all images in three groups were analyzed objectively and scored subjectively.And the CT dose index (CTDI) , dose length product (DLP) , effective radiation dose (ED) of the iodine intake and radiation dose were recorded.Results:The differences of CT value of ascending aorta, upper common carotid artery or lower internal carotid artery among the three groups were no significant, respectively.The SNR and CNR in high IDR+NI group were significantly higher than those in middle IDR+NI group and low IDR+NI group (F=47.908, F=52.525, P<0.05) , respectively.And there was no significant difference in subjective scores among the three groups.The differences of CTDI, DLP and ED in high IDR+NI group were significantly lower than those in middle IDR+NI group and low IDR+NI group (F=224.861, F=199.610, F=412.443, P<0.05) , respectively.Conclusion:The combination of high IDR and high NI for patients who undergoes head and neck CT can reduce the radiation dose when ensure the image quality, and it is worthy in clinical application.
ABSTRACT
Among chemical agents in herbicides, dioxin(2,3,7,8-tetrachloro dibenzo-rho-dioxin: a chemical contaminant in herbicides sprayed during the vietnam war has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the vietnam war from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U. S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the korean veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993. This study was carried out with two major objectives: the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to october 1993. The results obtained are as follows: 1. The literature review of 107 papers revealed that: l) Dioxin is teratogenic, carcinogenic and affects almost all organs including nertous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to vietnam during the period from 1965-1970 around one year. 2) Most frequently complained symptoms in medical examination were motor weakness(32%), sensory abnormalities in extremities(23%), skin diseases(22%), and pain in extremities(20%) whereas in interview they were more frequent in order of skin problem(44%), motor weakness (38%), sensory abnormalities and pain in extremities(l7% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies; in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent. 4) when dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis(anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.