Prediction of anatomical images during radiotherapy of nasopharyngeal carcinoma with deep learning method / 中华放射肿瘤学杂志

Objective:To develop a deep learning method to predict the anatomical images of nasopharyngeal carcinoma patients during the treatment course, which could detect the anatomical variation for specific patients in advance.Methods:Imaging data including planning CT (pCT) and cone-beam CT (CBCT) for each fraction of 230 patients with T 3-T 4 staging nasopharyngeal carcinoma who treated in Cancer Hospital Chinese Academy of Medical Sciences from January 1, 2020 to December 31, 2022 were collected. The anatomical images of week k+1 were predicted using a 3D Unet model with inputs of pCT, CBCT on days 1-3, and CBCT of weeks 2- k. In this experiment, we trained four models to predict anatomical images of weeks 3-6, respectively. The nasopharynx gross tumor volume (GTV nx) and bilateral parotid glands were delineated on the predicted and real images (ground truth). The performance of models was evaluated by the consistence of the delineation between the predicted and ground truth images. Results:The proposed method could predict the anatomical images over the radiotherapy course. The contours of interest in the predicted image were consistent with those in the real image, with Dice similarity coefficient of 0.96, 0.90, 0.92, mean Hausdorff distance of 3.28, 4.18 and 3.86 mm, and mean distance to agreement of 0.37, 0.70, and 0.60 mm, for GTV nx, left parotid, and right parotid, respectively. Conclusion:This deep learning method is an accurate and feasible tool for predicting the patient's anatomical images, which contributes to predicting and preparing treatment strategy in advance and achieving individualized treatment.

ZHANG Guoliang's Experience in Treating Cough in Convalescent Period of COVID-19 / 浙江中医药大学学报

[Objective]To introduce the clinical experience of Director ZHANG Guoliang,a famous and highly-experienced traditional Chinese medicine practitioner,in treating cough in convalescent period of Corona Virus Disease 2019(COVID-19)with exterior and interior differentiation therapy.[Methods]Based on the relevant discussions on epidemic diseases and coughs by doctors of all ages and the experience of more than 300 COVID-19 patients treated by Director ZHANG himself,the understanding of Director ZHANG on the etiology and pathogenesis of cough in convalescent period of COVID-19 was expounded,and his experience in treating cough in convalescent period of COVID-19 with exterior and interior differentiation therapy was summarized,and a typical case was interpreted.[Results]Director ZHANG believes that treatment of cough in convalescent period of COVID-19 should start from the disease location.The disease is located in the nose and pharynx,and the exterior treatment method is adopted,focusing on ventilating the lung and dissolving phlegm,dispelling wind and relieving cough.In clinical practice,a combination of Banxia Houpu Decoction and Zhisou Powder is commonly used,added or subtracted according to the symptoms.The disease is located in the trachea and lungs,and the interior treatment method is adopted,and the phlegm turbidity(phlegm heat)accumulation in lung syndrome focuses on clearing the lungs and dissolving phlegm,relieving cough and asthma,added or subtracted Maxing Shigan Decoction,Qianjin Weijing Decoction combined with Tingli Dazao Xiefei Decoction are often used.Qi and Yin deficiency syndrome should clear the lungs and dissolve phlegm,invigorate Qi and nourish Yin,generally use added or subtracted Zhuye Shigao Decoction combined with Shengmai Drink.The medical case attached belonged to the phlegm and pharyngeal syndrome,Director ZHANG first treated with ventilating the lung and resolving phlegm,dispelling wind and relieving cough,then strengthening the spleen and invigorating Qi,drying dampness and resolving phlegm,and finally achieved good results.[Conclusion]Director ZHANG's unique opinion and clinical experience in the treatment of cough in convalescent period of COVID-19 with exterior and interior differentiation therapy are worth learning and promoting.

Retrospective study on the treatment of phalanx fractures with absorbable materials / 中国医师进修杂志

Objective:To investigate the effect of absorbable material internal fixation in the treatment of phalanx fracture and its effect on the complications related to hypersensitive C-reactive protein (hs-CRP), interleukin-10 (IL-10), adrenocorticotropic hormone (ACTH) and foreign body reaction.Methods:The clinical data of 98 patients with phalangeal fracture in Huishan District People′s Hospital of Wuxi City from January 2018 to January 2020 were divided into absorbable group (49 cases, treated with absorbable material internal fixation) and microplate group (49 cases, treated with minimally invasive plate internal fixation). The rates of excellent and good treatment, operation conditions, serum inflammatory stress response indexes levels before and 1 d and 1 week after surgery were compared, and recovery at 3 and 6 months after surgery, the incidence of complications and the degree of treatment satisfaction were counted.Results:The rates of excellent and good treatmentin the absorbable group were higher than that in the micro plate group: 95.92%(47/49) vs. 81.63%(40/49), χ2 = 5.02, P<0.05. The duration of operation in the absorbable group was longer than that in the microplate group: (43.28 ± 12.18) min vs. (31.29 ± 11.69) min; and the duration of hospital stay, fracture healing time and recovery time were shorter than those in the microplate group: (4.09 ± 1.18) d vs. (6.89 ± 2.12) d, (4.35 ± 1.05) weeks vs. (5.69 ± 1.38) weeks, (4.89 ± 1.10) d vs. (6.20 ± 2.01) d; the differences were statistically significant ( P<0.05). The levels of serum hs-CRP, IL-10 and ACTH in absorbable group were lower than those in microplate group at 1 d and 1 week after surgery ( P<0.05). At 3 and 6 months after surgery, the range of motion of metacarpophalangeal joint in the absorbable group was greater than that in the microplate group, and the loss of grip strength of the healthy side was less than that in the microplate group ( P<0.05). The incidence of complications in absorbable group was lower than that in microplate group: 6.12%(3/49) vs. 20.41%(10/49), χ2 = 4.35, P<0.05. Conclusions:The absorbable material internal fixation can achieve good results in the treatment of phalanx fracture, the postoperative recovery is fast, the incidence of complications is lower.

Effect of HMGB1/Caspase-1/GSDMD signaling axis-mediated hepatocyte pyroptosis on liver ischemia-reperfusion injury / 器官移植

Objective To evaluate the effect of high mobility group box 1 (HMGB1)/ cysteinyl aspartate specific proteinase (Caspase)-1/Gasdermin D (GSDMD) signaling axis-mediated hepatocyte pyroptosis on liver ischemia-reperfusion injury (IRI). Methods C57BL/6 mice were randomly divided into the sham operation group (Sham group), IRI 2 h group, IRI 6 h group, IRI 12 h group, glycyrrhizic acid (GA)+Sham group and GA+IRI 12 h group (n=8 in each group). AML12 cells were evenly divided into the Sham group, IRI 12 h group, GA+Sham group and GA+IRI 12 h group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), interleukin (IL)-1β and IL-6 in each group were detected by enzyme-linked immune absorbent assay(ELISA). The messenger ribonucleic acid (mRNA) levels of IL-1β and IL-6 were detected by reverse transcription polymerase chain reaction(RT-PCR). The pathological score of liver ischemia and cell apoptosis were compared among all groups. The expression level of HMGB1 in the liver tissues of each group was determined by immunohistochemistry. The expression levels of HMGB1, Caspase-1 and GSDMD proteins in the mouse liver tissues and AML12 cells were measured by Western blot. Results Compared with the Sham group, the serum levels of ALT, AST, IL-1β and IL-6 and the relative expression levels of IL-1β and IL-6 mRNA in the liver tissues were all significantly up-regulated after IRI in each group (all P < 0.05), and showed significant time-dependent pattern along with the prolongation of reperfusion time. Compared with the Sham group, the pathological score of hepatic ischemia and the apoptosis rate of hepatocytes were significantly increased after IRI in each group (all P < 0.05). Immunohistochemical results showed that the expression level of HMGB1 in the liver tissues was significantly up-regulated after IRI, which showed an increasing trend along with the prolongation within the period of 2-12 h. Western blot showed that compared with the Sham group, the relative expression levels of HMGB1, Caspase-1 and GSDMD proteins in vivo and in vitro were up-regulated in the IRI 12 h group. The relative expression level of HMGB1 protein was significantly up-regulated, whereas those of Caspase-1 and GSDMD proteins were significantly down-regulated in the GA+IRI 12 h group compared with those in the IRI 12 h group (all P < 0.05). Conclusions Hepatocytes probably activate the Caspase-1/GSDMD signaling pathway by releasing HMGB1, thereby triggering hepatocyte pyroptosis and leading to liver IRI. Inhibition of extracellular release of HMGB1 by GA may mitigate liver IRI.

A comparison of the efficiency of diagnostic ultrasound and magnetic resonance imaging of cervical lymph nodes in papillary thyroid carcinoma.

OBJECTIVE: To compare and evaluate diagnostic capabilities of preoperative ultrasonography (US) and magnetic resonance imaging (MRI) in the cervical lymph nodes of patients with papillary thyroid cancer. METHODS: A retrospective dataset involving 156 patients who had undergone thyroidectomy and preoperative US and MRI was assembled. Among these, 69 had cervical lymph node metastasis and 87 did not. At least four radiologists unilaterally and spontaneously investigated the US and MRI attributes of the cervical lymph nodes. The efficiency of diagnostic imaging for cervical lymph nodes, including their true-positive rate or sensitivity, true-negative rate or specificity, positive predictive value, negative predictive value, and predictive accuracy were analysed and assessed. RESULTS: In the assessment of cervical lymph node metastases of papillary thyroid cancer, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of diagnostic US vs. MRI were 58.0% vs. 79.7%, 69.0% vs. 83.9%, 59.7% vs. 79.7%, 67.4% vs. 83.9%, and 64.1% vs. 82.1%, respectively. The accuracy consistency of the two imaging modalities was 83.5%. CONCLUSIONS: MRI is more effective than US in diagnosing and assessing cervical lymph node metastases of papillary thyroid cancer.

Breakthrough points and difficulties in traditional Chinese medicine treatment of primary liver cancer / 临床肝胆病杂志

Primary liver cancer is one of the most common malignant tumors in China, and most patients are in the advanced stage at the time of diagnosis, with a short survival time and poor prognosis. In recent years, traditional Chinese medicine has shown its unique advantages in the prevention and treatment of primary liver cancer and has achieved a marked clinical effect in improving quality of life, enhancing immunity, and prolonging the life of patients with liver cancer. This article reviews the current status of traditional Chinese medicine and Western medicine in the treatment of primary liver cancer and proposes the breakthrough points and difficulties in traditional Chinese medicine treatment based on the features of clinical treatment, in order to provide a reference for the clinical treatment of primary liver cancer.

Proton FLASH radiotherapy / 中华放射肿瘤学杂志

FLASH radiotherapy (FLASH-RT) is a treatment modality that delivers ultra-high dose rate and ultra-fast radiation for cancer treatment. Compared to conventional dose rate radiotherapy, FLASH-RT can yield similar efficacy for tumors and achieve normal tissue protection, translating to an increased therapeutic window. Due to this unique feature, FLASH-RT is attracting increasing attention from the radiotherapy community, both academia and industry. Due to its unique Bragg peak as well as intrinsic high dose rate, application of FLASH has more value and profound significance in proton therapy while achieving highly conformal dose deposition simultaneously. This article reviews research progress on FLASH-RT, relevant cell and animal studies, experimental conditions and results. Moreover, this article also investigates the potential biological mechanisms, technical challenges for implementation and potential clinical applications of FLASH-RT.

Characterization of clinical progression of COVID-19 patients in Shenzhen, China

BackgroundUnderstanding clinical progression of COVID-19 is a key public health priority that informs resource allocation during an emergency. We characterized clinical progression of COVID-19 and determined important predictors for faster clinical progression to key clinical events and longer use of medical resources. Methods and FindingsThe study is a single-center, observational study with prospectively collected data from all 420 patients diagnosed with COVID-19 and hospitalized in Shenzhen between January 11th and March 10th, 2020 regardless of clinical severity. Using competing risk regressions according to the methods of Fine and Gray, we found that males had faster clinical progression than females in the older age group and the difference could not be explained by difference in baseline conditions or smoking history. We estimated the proportion of cases in each severity stage over 80 days following symptom onset using a nonparametric method built upon estimated cumulative incidence of key clinical events. Based on random survival forest models, we stratified cases into risk sets with very different clinical trajectories. Those who progressed to the severe stage (22%,93/420), developed acute respiratory distress syndrome (9%,39/420), and were admitted to the intensive care unit (5%,19/420) progressed on average 9.5 days (95%CI 8.7,10.3), 11.0 days (95%CI 9.7,12.3), and 10.5 days (95%CI 8.2,13.3), respectively, after symptom onset. We estimated that patients who were admitted to ICUs remained there for an average of 34.4 days (95%CI 24.1,43.2). The median length of hospital stay was 21.3 days (95%CI, 20.5,22.2) for cases who did not progress to the severe stage, but increased to 52.1 days (95%CI, 43.3,59.5) for those who required critical care. ConclusionsOur analyses provide insights into clinical progression of cases starting early in the course of infection. Patient characteristics near symptom onset both with and without lab parameters have tremendous potential for predicting clinical progression and informing strategic response.

ECMO application of patients with Critical Corona Virus Disease 2019 and fulminant myocarditis / 中华实验和临床病毒学杂志

Objective To evaluate the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment on two cases of infection with the critical Corona Virus Disease 2019 (COVID-19) complicated by fulminant myocarditis (FM) . Methods This study selects two COVID-19 cases comorbid with fulminant myocarditis and had been treated with ECMO in Shenzhen Third People's Hospital from January 2020 to February 2020. We compare the index of inflammation, immunization, D-dimer and lactic acid before and after ECMO treatment in 24 and 96 hours, cardiopulmonary function before and after ECMO treatment in 24, 48, 72, 96 hours,. We also analyze the complications and clinical outcomes of the two cases during the ECMO treatment. Results Both patients were elderly obese men with chronic cardiopulmonary disease. Comparing the laboratory test results and imaging data of the two patients, the acute lung injury score, oxygenation index, albumin level, hypersensitive C-reactive protein, lactate and lactate dehydrogenase levels in 2 patients after ECMO treatment were improved as compared with those before ECMO treatment. Finally, case 1 died of multiple organ failure and his cardiac function continued to deteriorate, while, case 2 successfully withdrew and his cardiac function gradually improved. Conclusions For critical COVID-19 patients with fulminant myocarditis, ECMO treatment can improve pulmonary function in the short term, provide valuable time for rescuing COVID-19 patients with fulminant myocarditis.

Walnut-shell moxibustion for dry eye symptoms: a randomized controlled trial / 中国针灸

OBJECTIVE@#To evaluate the effects of walnut-shell moxibusiton on dry eye symptoms.@*METHODS@#A total of 67 patients with dry eye symptoms were randomized into a walnut moxibustion group and a sodium hyaluronate eye drops group.@*METHODS@#In the walnut moxibustion group, the walnut moxibustion was used, once every two days, 3 times a week, for 4 weeks totally. In the sodium hyaluronate eye drops group, sodium hyaluronate eye drops were selected, 4 times a day, one drop instilled in each eye each time, for 4 weeks totally. At the baseline (before treatment) and in 4 weeks of treatment, the score of the ocular surface disease index (OSDI), the score of visual analogous scale (VAS) for eye symptoms, the tear film break-up time (BUT), the cornea fluorescent pigmentation (FL) and SchirmerⅠ(SchⅠ) were evaluated. In 1-month follow-up after treatment termination, the changes of OSDI and VAS scores were evaluated in the two groups.@*RESULTS@#In 4 weeks of treatment and the follow-up, OSDI scores were reduced as compared with those before treatment in the two groups (0.05). In 4 weeks of treatment and the follow-up, VAS scores were reduced as compared with those before treatment in the two groups (all 0.05). The differences were not significant in the above indexes between the two groups (all >0.05). There was no obvious adverse reaction in the two groups.@*CONCLUSION@#The walnut-shell moxibustion is available likely for the subjective symptoms in the patients with dry eye syndrome and contributes to the tear film stabilization. The therapeutic effects need to be further evaluated with the adequate sample size in the randomized controlled trial.

Correlation of ubiquitin expression in muscles of gastric cancer patients with their nutritional status and prognosis / 中华临床营养杂志

Objective To look into the effect of ubiquitin (Ub) in muscles of gastric cancer patients on their nutritional status and prognosis.Methods Abdominal rectus muscles of 102 patients with gastric cancer and 53 patients with benign abdominal diseases were studied.The expressions of Ub mRNA and protein were assessed through real time-PCR and Western blot.Results The relative expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients (4.10± 1.04) was significantly upregulated compared with the control group (3.17±0.32) (t =7.386,P=0.000).The expression of Ub protein in rectus abdominis muscles of patients with gastric cancer was upregulated compared with the controls (0.151 ±0.058 vs.0.084±0.046,t =7.275,P =0.000).The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was significantly associated with decreases in weight,body mass index,prognostic nutritional index,serum albumin and hemoglobin (x2 =11.780,6.557,11.849,15.742,8.360;P=0.001,0.010,0.001,0.000,0.004).The high expression of Ub mRNA in rectus abdominis muscles of gastric cancer patients was not correlated with the patients'sex,age,tumor size or Borrmann type (x2 =0.038,1.978,0.486,1.483;P=0.774,0.160,0.486,0.223),but it was related to the pathologic type,lymph node metastasis and TNM staging of gastric carcinoma (x2 =11.260,9.362,20.517;P=0.004,0.002,0.000).The survival rate of gastric cancer patients with high expression of Ub mRNA was lower than those with low expression (x2 =5.775,P =0.016).Conclusions Ub mRNA and protein were upregulated in rectus abdominis muscles of gastric cancer patients.The high expression of Ub mRNA in these patients was related to their nutritional status and prognosis,which might play an important role in the development of cachexia.

Comparison of preoperative diagnostic value between ultrasonography and magnetic resonance imaging for the extrathyroidal extension of papillary thyroid carcinoma / 中国医师进修杂志

Objective To evaluate the diagnostic value of preoperative ultrasonography(US)and magnetic resonance imaging (MRI) for the extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma(PTC).Methods The clinical data of 90 patients with PTC from January 2013 to June 2016 were analyzed retrospectively,and all patients were examined by US and MRI before operation.The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of minimal ETE, extensive ETE and ETE (minimal ETE + extensive ETS) were compared between UC and MRI.Results The diagnostic minimal ETE sensitivity of UC was significantly higher than that of MRI (81.9% vs.60.0%), and there was statistical difference (P<0.05).The diagnostic extensive ETE specificity of MRI was significantly higher than that of UC(80.9% vs.63.5%),and there was statistical difference (P<0.01).The diagnostic ETE sensitivity and NPV of UC were significantly higher than those of MRI(97.4% vs.88.3% and 80.0% vs.50.0%),and there were statistical differences (P<0.05 or <0.01).Conclusions US has a higher sensitivity, compared with MRI for diagnostic minimal ETE.MRI has a higher specificity for diagnostic extensive ETE,compared with US.And US has a higher sensitivity and NPV for diagnostic ETE,compared with MRI.

Posterior slope angle of the tibial plateau in 60 healthy Mongolia population measured by computed tomography / 中国组织工程研究

BACKGROUND: There are more measurement data about knee joint at home and abroad, but few data about the northern China, especially Inner Mongolia region. Whether the posterior slope angle of tibial plateau in local area differs from that of Chinese or foreigners is rarely reported.OBJECTIVE: To measure the posterior slope angle of the medial tibial plateau in healthy Mongolia population, and to compare the differences of different measurement methods, so as to understand the anatomical characters of tibial plateau in Inner Mongolia region.METHODS: Sixty Mongolian volunteers were recruited, the 20 cm upper and under the knee joint were scanned bilaterally by GE64 row spiral CT, and the three-dimensional model of the knee was established on Mimics16.0 software, followed by processed through fairing, filling, separation and cutting. Afterwards, the angel between anterior cortical bone extension line of upper tibia (method A), tibia anatomical axis (method B), line perpendicular to the posterior cortical bone extension line of upper tibia (method C) and upper edge line of the tibial plateau was measured,respectively. The posterior slope angle of the medial tibial plateau (90°-measured angle) was obtained and compared.RESULTS AND CONCLUSION: (1) The posterior slope angle of the medial tibial plateau measured by methods A, B and C was (11.16±3.39)°, (8.60±3.29)° and (5.30±4.40)°, respectively, and the former two were similar with those reported by Wang Ye-hua and Luo Ji-wei (P > 0.05). (2) There were significant differences in the posterior slope angle of the left and right medial tibial plateau among methods (P 0.05). (3) There was no significant difference in the posterior slope angle of the left and right medial tibial plateau between genders (P > 0.05). (4) These results indicate that the Mongolian population show smaller posterior slope angle of the tibial plateau, but the angle exhibits great individual difference, thereafter, an individualize scheme should be developed before osteotomy.

Anatomical characters of the proximal tibial osteotomy in healthy Mongolia populations / 中国组织工程研究

BACKGROUND: Whether the proximal tibial osteotomy in Mongolia populations has difference with other populations at home and abroad remains unclear.OBJECTIVE: To analyze the anatomical characters of the proximal tibial osteotomy in Mongolia populations in the northern region of China by measuring the relevant linear parameters.METHODS: Thirty-eight healthy Mongolia populations were selected, and their bilateral knee joints were scanned by CT.The original data were exported in DICOM format. Mimics software was used to reconstruct the knee three-dimensional model. The tibial data stored in STL format were imported into 3-matic software, showing the medial surface of the tibia,and 6 mm below the medial tibial plateau maintaining 7° posterior slop was subjected to total hip arthroplasty osteotomy.Subsequently, the relevant parameters were measured.RESULTS AND CONCLUSION: (1) The left tibia transverse diameter was (79.99±3.70) mm, and the right was (80.25±4.01) mm. The left anteroposterior diameter was (52.27±3.07) mm, and the right was (51.75±2.40) mm. The anteroposterior diameter of medial tibia was (55.40±2.00) mm (left), and (56.67±2.47) mm (right); the lateral was (49.84±2.78) mm (left), and (49.58±2.80) mm (right). (2) In Mongolian populations, the linear parameters showed no significant differences between two sides of the proximal tibial osteotomy (P > 0.05). The anteroposterior diameter of medial tibia was longer than that of lateral one (P > 0.05). The linear parameters of the proximal tibial osteotomy in male were significantly larger than those in female (P < 0.05). There were differences in the linear parameters of the proximal tibial osteotomy between Mongolian populations and other populations. (3)These results indicate that there are significant differences in the anatomical morphology of the tibial plateau between western and eastern countries.Besides, the geometric parameters of the tibial plateau may be different in different ethnic groups and regions. It is necessary to use the digital orthopedic technique to investigate and analyze the large sample data of different ethnic groups in different regions.

The application of endoscopic sphincterotomy combined with endoscopic papillary large balloon dilation in the treatment of choledocholithiasis / 天津医药

Objective To investigate the effect of endoscopic sphincterotomy(EST) combined with endoscopic papillary large balloon dilation(EPLBD) in the treatment of common bile duct stones. Methods A total of 128 patients treated with EST combined with EPLBD for common bile duct stones were divided into 0 min group, 1 min group, 3 min group and 5 min group, according to the different balloon expansion times. The balloon was extended to the required diameter and was maintained to the corresponding time, and then decreased the pressure to remove the balloon. Patients were given routine monitoring and treatment after operation. All patients were observed more than 48 h to determine whether there were early complications such as pancreatitis and bleeding. The effectiveness of EPLBD was evaluated by the stone diameter, expansion balloon diameter, ERCP operation time and use of stone breaker. The safety was evaluated by the occurrence of complications including postoperative pancreatitis, bleeding and perforation. Results All patients were successfully removed stones. There were no significant differences in the maximum diameter of stone, the diameter of bile duct dilatation and the diameter of balloon dilatation between groups. No bleeding, perforation, biliary tract infection and acute pancreatitis were found in patients. There were no significant differences in the utilization rates of stone breaker between groups. ERCP operation times showed a trend of decreased first and then increased in 0, 1 and 3 min groups (P<0.05). There was no significant difference in ERCP operation time between 3 min group and 0 min group. There were no significant differences in incidence rates of high amylase between groups. Conclusion EST combined with EPLBD is a safe and effective treatment for early stage of larger common bile duct stones, of which 1 minute group shows better effect.

Utility of 18 F-FDG PET/CT in early detection of radiation-induced heart disease in Beagle dogs / 中华核医学与分子影像杂志

Objective To establish radiation-induced heart disease ( RIHD) Beagle models, in-vestigate the efficacy of 18 F-FDG PET/CT in the detection of RIHD and observe the pathological changes. Methods The ventricular anterior wall of 12 Beagle dogs were X-ray irradiated locally with a single dose of 20 Gy. 18 F-FDG PET/CT and echocardiography were performed at baseline and 3 months after radiation. ROI was drawn on the irradiation field and the non-irradiation field ( the posterior wall of left ventricle) to obtain the SUVmax . Then the SUVmax ratio of the irradiation field to the non-irradiation field ( INR) was cal-culated. The left ventricular function parameters before and after radiation were obtained by echocardio-graphy. Within 1 week after the imaging examinations were finished, the dogs were sacrificed, and hearts were taken out to perform pathological observation. Paired t test was used to analyze the data. Results High 18 F-FDG uptake in the irradiation field was shown 3 months after radiation. The average INRs before and after radiation were 0.99±0.15 and 2.54±0.43 respectively (t=7.021, P=0.001). No significant difference was ob-served on cardiac function parameters between baseline and 3 months after radiation( t values:from-1.253 to-0.786, all P>0.05) . The pathological results showed a few degenerated myocytes, increased thickness of myocardial vascular walls in irradiated myocardium. Conclusions 18 F-FDG PET/CT can detect early RIHD before abnormal cardiac function. Increased 18 F-FDG uptake in irradiated field may be related to myocardial ischemia which results from microvascular damage by radiation.

Relationship of myostatin with the nutritional status and outcome of gastric cancer patients / 中华临床营养杂志

Objective To investigate the expressions of myostatin (MSTN) in the gastric cancer patients' rectus abdominis and serum,and to discuss its relation with the nutritional status and outcome of the gastric cancer patients.Methods We recruited 102 patients with gastric cancer and another 53 patients with benign abdominal disease who were admitted to Zhejiang Province People's Hospital and Tongde Hospital of Zhejiang Province from February 2008 to February 2011.We tested MSTN expression in the malignant patients' rectus abdominis and serum using reverse transcription polymerase chain reaction,Western blot,and enzymelinked immunosorbent assay.Relationship between MSTN expression and nutrition status of gastric cancer patients was explored.Results The relative expression of MSTN mRNA of rectus abdominis muscle in gastric cancer group and control group was 3.43 ± 1.11 and 1.07 ± 0.31 (t =19.406,P ＜ 0.01),the relative expression level of MSTN protein in gastric cancer group and control group was 0.115±0.696 and 0.085±0.499 (t=2.856,P＜0.05) and its serum expression 8.79±4.32 and 1.21±0.55 in these two group (t =16.701,P＜0.05),showing significant difference.The high (defined as higher than median) expression of MSTN in rectus abdominis muscle of gastric cancer patients was significantly correlated with age (x2 =22.039,P =0.000),percentage of more than 10％ decline in body weight in half a year (x2 =14.365,P=0.000),body mass index (BMI) ＜22 kg/m2 (x2 =6.800,P=0.009),serum albumin (x2 =31.018,P=0.000),hemoglobin (x2=10.079,P =0.001),prognostic nutritional index (x2 =10.074,P =0.002),higher Nutritional Risk Screening 2002 Score (Z=2.628,P=-0.009),tumor stage of TNM (Z=2.550,P=0.011).The expression of the rectus abdominis muscle in patients with gastric cancer was significantly correlated with the survival rate of the patients (x2 =12.200,P＜0.01).Conclusions The expression of MSTN increases in the rectus abdominis and serum of gastric cancer patients with cachexia.The increased MSTN expression is closely related with malnutrition and TNM stage in these patients,suggesting MSTN may also play an important role in the muscle consumption of the gastric cancer patients.

Proton pump inhibitors and the pathophysiological mechanism of the risk of gastric cancer and its clinical researchs progress / 中国医师杂志

Proton pump inhibitors as a kind of acid drug are widely used in clinical.However,it is overused all over the world although generally safe and effective.Studies have shown the uncertainty of potential long-term adverse effects,especially the contact with the mechanism of gastric cancer.Clinicians should pay more attention to the potential carcinogenic risk of long-term proton pump inhibitors in treatment.The mechanism of pathophysiology and the clinical researches of proton pump inhibitor-induced gastric neuroendocrine tumors,gastric carcinoma,and gastric cardia cancers are summarized as follows.

Postoperative Analgesic Effect of Dexmedetomidine Combined with Remifentanil on Lung Cancer Resection and Its Effect on Immune Function / 中国药房

OBJECTIVE:To investigate the postoperative analgesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection and its effect on immune function. METHODS:60 lung cancer patients in lung cancer resection were randomly divided into control group(30 cases)and observation group(30 cases). All patients with endotracheal intubation re-ceived lung cancer resection under general anesthesia. After surgery,control group received Remifentanil hydrochloride 10μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml;observation group received Dexmedetomidine hydrochloride injection 0.75 μg/(kg·d)+Remifentanil hydrochloride 10 μg/(kg·d)+Ondansetron hydrochloride injection 16 mg,adding into 0.9% Sodium chloride injection co-formulated into 100 ml. Background doses in 2 groups were 2 ml/h,self-controlled amount was 2 ml,lockout time was 15 min. Visual analog pain score (VAS),IFN-γ,IL-10 level,T cell subsets(CD3+,CD4+,CD8+,CD4+/CD8+)after 6,12,24,48 h and the incidence of adverse reactions in 2 groups were observed. RESULTS:VAS scores after 6,12,24,48 h in observation group were significantly lower than control group,and VAS scores after 24,48 h in 2 groups were significantly lower than that after 6 h,with statistical significance(P0.05). CONCLUSIONS:The postoperative anal-gesic effect of Dexmedetomidine combined with Remifentanil on patients in lung cancer resection is superior to Remifentanil alone, it can improve the immune function,with good safety.