Evaluating the efficacy of surgical and conservative approaches in mild autonomous cortisol secretion: a meta-analysis.

Introduction: The management of Mild Autonomous Cortisol Secretion (MACS) remains a topic of debate among clinicians, with differing opinions on the effectiveness of surgical intervention compared to conservative treatment methods. This meta-analysis provides a comprehensive assessment of available literature to determine the most effective approach for treating this condition. Methods: On December 1, 2023, an exhaustive literature search of English databases Embase, PubMed, the Cochrane Library, Scopus, Web of Science, as well as the Chinese databases China HowNet, Wanfang Database, SinoMed Database, and Weipu Database using the keywords "Mild Autonomous Cortisol Secretion", "Subclinical Cushing's Syndrome", "Subclinical Hypercortisolism", "Mild Cortisol Autonomous Secretion", "Adrenal Incidentaloma", "Surgical Treatment" and "Adrenalectomy". The data were statistically analyzed using STATA version 15.0. Results: In this comprehensive analysis involving 629 patients with MACS, the therapeutic efficacy of adrenalectomy was evident. The meta-analysis results indicate that compared to conservative treatment, surgical intervention more effectively improves obesity indicators in patients: waist circumference (SMD=-0.62, 95% CI: -1.06 to -0.18), BMI (SMD=-0.41, 95% CI: -0.62 to -0.20), enhances glycemic control: fasting blood glucose (SMD=-0.47, 95% CI: -0.68 to -0.26), glycated hemoglobin (SMD=-0.66, 95% CI: -0.95 to -0.38), improves lipid metabolism: triglycerides (SMD=-0.45, 95% CI: -0.73 to -0.16), lowers blood pressure: systolic blood pressure (SMD=-1.04, 95% CI: -1.25 to -0.83), diastolic blood pressure (SMD=-0.89, 95% CI: -1.12 to -0.65), and ameliorates hormonal metabolic disorder: 24h urinary free cortisol (SMD=-1.10, 95% CI: -1.33 to -0.87), ACTH (SMD=2.30, 95% CI: 1.63 to 2.97). All these differences are statistically significant. Conclusion: This meta-analysis shows that, compared to conservative treatment, surgical treatment is more effective in improving obesity indicators, glycemic control, lipid metabolism, reducing blood pressure, and ameliorating hormonal metabolic disorders in patients with MACS. These statistically significant results highlight the importance of considering surgical intervention in the management of patients with MACS. Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42023492527.

Influence of disinfection methods used in hospitals on monitoring personal dose of external irradiation during COVID-19 / 中国辐射卫生

@#<b>Objective</b> To study whether the disinfection methods for thermoluminescence dosimeters used by major hospitals during the COVID-19 pandemic had an impact on monitoring personal dose of external irradiation, and to screen for the disinfection procedures suitable for use during the pandemic. <b>Methods</b> Hospitals with fever clinics during the epidemic in Shandong Province were selected from March to October 2020, we investigated the disinfection methods as well as the types and frequency of use of disinfection supplies used for thermoluminescence dosimeters during the pandemic in hospitals. Simulations were performed in experimental and control groups. <b>Results</b> The average doses measured by the disc dosimeter with different disinfection methods and the control group were 0.92-0.99 mSv and 0.98 mSv, respectively, and the deviation was ≤ 6%. The average doses measured by the glass tube dosimeter with different disinfection methods and the control group were 0.20-0.22 and 0.21, respectively, and the deviation was ≤ 5%. <b>Conclusion</b> The results showed that the commonly used disinfection methods had no influence on personal dose monitoring, but some disinfection measures were not suitable for dosimeters.

Untreated thyroid autoantibody-negative SCH increases the risk of spontaneous abortions.

Background: Numerous studies have found that subclinical hypothyroidism (SCH) may increase adverse pregnancy outcomes; however, the benefit of levothyroxine (LT4) treatment remains controversial. The 2017 guidelines of the American Thyroid Association weakly recommended LT4 therapy for serum antithyroid peroxidase antibody (TPOAb)-negative women with thyroid-stimulating hormone (TSH) concentrations greater than the pregnancy-specific reference range and below 10.0 mU/L. Therefore, the primary goal of this study was to investigate the correlation between thyroid autoantibody-negative SCH with or without LT4 treatment and adverse pregnancy outcomes. Methods: We prospectively enrolled 1868 consecutive pregnant women. Finally, 1344 women were involved in the study according to the inclusion and exclusion criteria. Assays for TSH, free thyroxine (FT4), TPOAb, anti-thyroglobulin antibody, and laboratory indicators were performed. The participants were divided into the euthyroid (ET) group (n = 1250) and the SCH group(n = 94). The SCH group was further divided into LT4 group (n = 40) and non-LT4 group(n = 54). The laboratory indicators and pregnancy outcomes were evaluated during follow-ups. Results: Maternal age, BMI, parity, and the history of spontaneous abortion did not differ significantly between the ET group and the different SCH groups. There were no significant differences in lipid profile and homocysteine levels between ET and SCH group in the first and third trimester of pregnancy. After adjusting the confounding factors, the non-LT4 group was a risk factor for spontaneous abortion (odds ratio: 3.141, 95% CI: 1.060-9.302). Survival analysis showed that the time of abortion was different between the ET group and SCH group (log-rank P= 0.042). The spontaneous abortion in SCH, especially in non-LT4, group mainly occurred in the first trimester of pregnancy. Conclusions: Thyroid autoantibody negative-SCH seems to be associated with increased risk of spontaneous abortions during the first trimester of pregnancy. LT4 therapy in this patient population might be beneficial to reduce adverse pregnancy outcomes.

Association Between Iodine Nutritional Status and Adverse Pregnancy Outcomes in Beijing, China: a Single-Center Cohort Study.

Iodine is an essential trace element for humans and the main raw material for thyroid hormone synthesis. However, the association between iodine nutritional status and adverse pregnancy outcomes in different regions remains controversial. This single-center cohort study was focused on the association between iodine nutritional status and adverse pregnancy outcomes in Beijing, China. We enrolled 726 pregnant women who were registered at the Peking University International Hospital between February 2017 and December 2019. To analyze the association between iodine nutritional status variations and adverse pregnancy outcomes, this study cohort included 390 (53.72%) participants with iodine deficiency, 206 (28.37%) with an adequate iodine level, 103 (14.19%) with a more than adequate iodine level, and 27 (3.72%) with iodine excess, according to the urinary iodine (UI) status of pregnant women. After adjusting for age, body mass index, parity, and history of spontaneous abortion, we identified iodine deficiency as a risk factor for anti-thyroid peroxidase antibody (TPOAb) positivity [odds ratio (OR), 3.646; 95% confidence interval (95% CI), 1.658-8.017], anti-thyroglobulin antibody (TGAb) positivity (OR, 3.109; 95% CI, 1.465-6.599), and thyroid autoimmunity (OR, 2.885; 95% CI, 1.539-5.407). There was a non-linear relationship between UI and the concentrations of TPOAb and TGAb (Pnon-linear < 0.05). Iodine deficiency during the first trimester is a risk factor for thyroid autoantibody positivity. The relationship between UI and the concentrations of TPOAb and TGAb follows a nearly U-shaped curve. Thus, physicians should critically consider the iodine nutritional status of pregnant women during the first trimester. Clinical Trials.gov Identifier: NCT02966405.

Impact of COVID-19 on chest CT scan frequency in a general hospital / 中国辐射卫生

@#<b>Objective</b> To explore the effect of coronavirus disease 2019 (COVID-19) on the frequency of chest CT scan. <b>Methods</b> A retrospective study was conducted to extract information on the number of outpatient, emergency, and inpatient visits and patients who had chest CT imaging examination from January 1 to December 31, 2020 and in the same period in 2019 through the hospital’s medical data platform for analysis, and the chi-square test was used to analyze whether the difference in the proportion of patients who had chest CT imaging examination between 2019 and 2020 was statistically significant. <b>Results</b> The proportion of outpatients and emergency patients with chest CT examination was significantly higher in 2020 than in 2019 (2.48% <i>vs</i> 1.47%, <i>χ</i>² = 581.7, <i>P</i> < 0.000). The proportion of inpatients who underwent chest CT examination was significantly higher in 2020 than in 2019 (35.47% <i>vs</i> 28.01%, <i>χ</i>² = 182.0, <i>P</i> < 0.000). <b>Conclusion</b> Under the COVID-19 epidemic, the proportion of chest CT examination in this hospital in 2020 shows a significant upward trend compared with the same period in 2019, which will increase the collective dose due to medical exposure, and the hospital should pay attention to the determination of the legitimacy of chest CT scan.

Discovery and discussion of 7Be and another full-energy peak in water from 3D water phantom of a proton therapy system / 中国辐射卫生

Objective To discuss 7Be and a 77.2 keV full-energy peak with short half-life found in the water sample from the 3D water phantom of a proton therapy system. Methods We measured the water sample from the 3D water phantom of a proton therapy system according to Determination of Radionuclides in Water by Gamma Spectrometry (GB/T 16140—2018). Results The activity concentration of 7Be in the water sample was 1.30 × 101 Bq·L−1 on December 24, 2018; 4.3 × 101 Bq·L−1 on March 22, 2019; and 1.41 × 101 Bq·L−1 at the time of sampling on December 19, 2018. On December 24, 2018, the net peak area of the 77.2 keV full-energy peak in the sample was 683 ± 45, and the measurement time was 26123.02 s; on March 22, 2019, the net peak area decreased to the background level of 194 ± 49, and the measurement time was 86400.00 s. Conclusion In the 3D water phantom of the proton therapy system, 7Be can be generated from the spallation reaction between high-energy neutrons and oxygen in water. In addition, we find a full-energy peak at 77.2 keV with short half-life. The activity concentration of 7Be in the water sample is lower than the exemption level, but the activity concentration at sampling may not be the maximum activity concentration in the process of quality control. The inductive radionuclide 7Be produced in the 3D water phantom should be identified and properly evaluated in the assessment of occupational radiation hazards of proton therapy system.

Measurement and analysis of dose exposure in childhood intussusception reduction / 中国辐射卫生

Objective To investigate the dose of radiation in children under going X-ray-guided air enema reduction, and to provide a basis for reducing the risk of radiation injury in pediatric patients. Methods Data were collected from children with intussusception who were treated with air enema. The experimental conditions of high, medium, and low doses of three age groups were analyzed. Phantoms were used to simulate the operation, and the radiation dose was measured using a thermoluminescence system. Results In children with intussusception, the success rate of air enema under the guidance of X-ray was 88% (including secondary intussusception), with anearly re-intussusception rate of 8%. The effective dose of treatment ranged from 0.57 to 12.33 mSv, and the tissues and organs with high absorbed dose were mainly in the chest and abdomen. Conclusion Children in different groups are exposed to significantly differentand relatively high doses. The operators are recommended to use ultrasonic guidance. With X-ray guidance, the exposure time should be minimized and protective equipment for children should be used.

Measurement of 131I activity in thyroid of workers at the place of radioiodine therapy in six hospitals / 中华放射医学与防护杂志

Objective:To investigate 131I activity in thyroid of workers at the place of radioiodine therapy and its main influencing factors. Methods:In terms of the types of hospitals, six hospitals that performed radioiodine therapy procedure were selected by quota sampling in the provinces of Shandong and Shanxi. 131I activity in thyroids of 76 workers at the place of radioiodine therapy was measured directly, and their internal doses were estimated. Results:131I activity in thyroids was found to be above the detection limit for 29 subjects (38.16%) in five hospitals. The maximum value of 131I activity was 2 468.45 Bq for a doctor who was responsible for manual distribution of radioisotopes. In general 131I activities in thyroid of workers at the place of radioiodine therapy of six hospitals were not significantly different ( P>0.05). But the measurement result in the hospitals where radioiodine was distributed manually were significantly higher than that in the hospitals where radioiodine was distributed automatically ( Z=1.75, P<0.01). Thyroid measurement result of 12 workers in two hospitals where radioiodine was distributed manually were all above the detection limit, with medians of 324.59 Bq and 331.98 Bq, respectively. The medians of 131I activities in thyroid of 12 staff in the remaining 4 hospitals were all below the detection limit. The detection frequencies of 131I above dose limit were 32.61%, 25.00%, 10.00% and 0. The measurement result for the doctors who participated in distributing 131I and the relevent cleaners were significantly higher than for the doctors who did not participate in distributing 131I at the same hospital ( Z=2.44, 2.12, P<0.05). Conclusions:There was a significant difference in the internal exposure level among workers at the different places of radioiodine therapy. Using automatic loading device could reduce the internal exposure level of the workers at the place of radioiodine therapy. It is necessary to strengthen the radiological protection for workers at the control area of the place of radioiodine therapy.

Measurement and evaluation of thyroid 131I activity in iodine treatment workers / 中华放射医学与防护杂志

Objective:To understand the 131I activity in thyroid of therapy workers in nuclear medicine department, and estimate the annual committed effective dose, in order to analyze the internal exposure of them. Methods:Six hospitals were investigated and 131I activity of thyroid was measured. The detection rate and activity value of thyroid 131I activity of therapy workers in nuclear medicine department were obtained from the six hospitals, and then the intake and annual committed effective dose were calculated. Results:A total of 63 iodine therapy workers from six hospitals were measured and 131I was detected for 52 workers among them, with the detection rate of 83% and 131I activities mostly lower than 200 Bq. The estimated annual committed effective dose ranged from 0.23 to 7.78 mSv. The annual committed effective dose to 84.6% of the workers was less than 2 mSv. Conclusions:Iodine therapy workers in nuclear medicine department should receive routine internal exposure personal monitoring, and the radiation protection system in all hospitals needs to be further improved.

Effect of topical injection of cyclosporine A on saliva secretion and inflammation in the submandibular gland of non-obese diabetic mice / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of topical administration of cyclosporine A (CsA) on salivary secretion and inflammation of the submandibular glands in non-obese diabetic (NOD) mice.@*METHODS@#Female NOD mice, 21 aged 14 weeks and 18 aged 21 weeks were selected and randomly divided into low-dose group, high-dose group and control group on average. CsA was injected into submandibular glands. One week later the saliva stimulated by pilocarpine was collected and measured. The submandibular glands were collected to make paraffin sections. The lymphocyte infiltration in submandi-bular gland was observed by microscope after hematoxylin-eosin (HE) staining. The number of lymphocyte infiltration foci was counted to calculate the focus sore and the ratio of lymphocyte infiltration area to total gland area was figured up by Leica image analysis system. The expressions of inflammatory cytokines tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-4 (IL-4), IL-13, IL-17F, IL22 and IL-23a in the submandibular glands of the NOD mice were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Cell apoptosis in the submandibular gland was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). The levels of serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), alanine aminotransferase (ALT), aspertate aminotransferase (AST), alkaline phosphatase (ALP), albumin (ALB) and γ-glutamyl transferase (GGT) were measured by automatic biochemical analyzer to evaluate liver and kidney functions.@*RESULTS@#After topical injection of CsA in the submandibular gland, the stimulated salivary flow rate of the 14- and 21-week-old NOD mice significantly increased compared with the control group (P < 0.01 or P < 0.05), and the number and area of lymphocyte infiltration foci in the 14-week-old NOD mice low-dose group significantly decreased compared with the control group (P < 0.01). Low and high dose of CsA had similar effects on reducing inflammation and improving salivary secretion. The overall level of inflammatory cytokines in the submandibular gland did not decrease significantly. The number of cell apoptosis of submandibular gland in the NOD mice treated with CsA decreased compared with the control group, but there was no statistically significant difference. Topical injection of CsA had no adverse effect on liver and kidney function in the NOD mice.@*CONCLUSION@#Topical injection of CsA can reduce lymphocyte infiltration in submandibular gland of NOD mice and improve salivary secretion.

Measurement and analysis of induced radioactivity in medical electronic linear accelerator / 中国辐射卫生

Objective By measuring the induced radioactivity of the medical electron linear accelerator, and analyzing the measuring results and the measuring process, the cooling law of the induced radioactivity was studied, to provide basic data for evaluating additional doses to patients, medical staff and the public. Methods Five Medical Electron Linear accelerators were used to measure the induced radioactivity by using automes-6150AD6/H+6150AD-b/H x-γ radiation peripheral dose equivalent rate meter for environmental monitoring. Results The level of induced radioactivity of 5 medical electron linear accelerators is related to the factors such as measuring position and time: 10 second after the end of beam output, the maximum dose equivalent rate is 5.55 μSv/h around 5 cm on the surface of the head housing of the accelerator, and the maximum ambient dose equivalent rate at 1 m from the fixed point of the housing is 4.07 μSv/h, 5 minutes after the end of output, the maximum dose equivalent rate is 2.11 μSv/h around the 5 cm surface and 1.77 μSv/h around the 1 m fixed point. Conclusion The measured radioactivity induced by the medical electron linear accelerator gradually cools over time, the measurement valuesare maintained in a relatively fixed range, and the fluctuation range of the values is narrow.

Monitoring results and analysis of 131I in the air of workplace treated with iodine / 中华放射医学与防护杂志

Objective:To understand the activity concentration of 131I aerosol in the air of the iodine treatment workplace and estimate the internal dose of 131I inhaled by medical staff in nuclear medicine. Methods:Using CF-1001BRL portable large capacity air sampler, the 131I aerosol in the iodine treatment workplace of nuclear medicine department of 6 hospitals in Shandong province was collected by iodine box, and the HPGe-γ energy spectrometer was used to measure the samples. The 131I activity concentration in iodine treatment workplace at 6 hospitals was obtained, and the internal dose to medical staff was estimated. Results:The 131I activity concentration in the air in iodine treatment workplaces at 6 hospitals ranged from 3.64 to 2.94×10 3 Bq/m 3. The 131I activity concentration in the controlled area (ward, patient passageway, subpacking room, operation administration room) was significantly higher than that in the supervised area. The highest 131I activity concentration, 2.62×10 2 Bq/m 3, in the supervised area was found in the medical care passageway. The estimated effective dose to nuclear medicine workers was 0.07-5.68 mSv, not exceeding the national limit. Conclusions:The phenomenon of 131I aerosol contamination still exists in the iodine treatment workplaces of nuclear medicine departments in hospitals, so it is necessary to carry out internal radiation monitoring for nuclear medicine departments all around the country, and explore more reasonable protection standards and methods.

Effectiveness of vertebroplasty for osteoporotic vertebral compression fractures in the elderly aged 90 years and over / 中华老年医学杂志

Objective:To investigate the clinical effectiveness of vertebroplasty for osteoporotic vertebral compression fractures in the elderly aged 90 years and over.Methods:Clinical data of 64 elderly patients aged 90 years and over who had undergone percutaneous vertebroplasty for vertebral compression fractures between January 2015 and January 2021 were retrospectively analyzed.Changes in preoperative and postoperative pain, intraoperative bone cement leakage, postoperative pneumonia, bedsores, urinary tract infections, lower extremity venous thrombosis and changes in preoperative and postoperative physical mobility were evaluated.Pain scores, physical mobility scores, bone cement extravasation and complications such as re-fractures of the vertebral body, postoperative pneumonia, bedsores, urinary tract infections and thrombosis were recorded before surgery, 3 and 30 days after surgery.Results:The visual analogue scale(VAS)scores of 64 patients before surgery, 3 and 30 days after the procedure were 8.34±1.12, 2.17±1.45 and 1.83±1.15, retrospectively( F=540.876, P<0.01). The physical mobility scores before surgery, 3 and 30 days after the procedure were 2.83±0.94, 1.59±0.70 and 1.39±0.60, retrospectively( F=65.492, P<0.01). There were 18 cases(28.13%)of bone cement leakage during surgery, 4 cases(6.25%)of pneumonia within 30 days after surgery, 9 cases(14.06%)of urinary tract infections, 3 cases(4.69%)of lower extremity venous thrombosis, 1 case(1.56%)of bedsores, and 2 cases(3.13%)of vertebral re-fractures after surgery.No patient died during the 30-day follow-up. Conclusions:Percutaneous vertebroplasty can reduce pain and improve physical mobility and is an effective and safe minimally invasive treatment for elderly patients with spinal compression fractures aged 90 years and over.

Risk prediction model of gestational diabetes mellitus based on nomogram in a Chinese population cohort study.

To build a risk prediction model of gestational diabetes mellitus using nomogram to provide a simple-to-use clinical basis for the early prediction of gestational diabetes mellitus (GDM). This study is a prospective cohort study including 1385 pregnant women. (1) It is showed that the risk of GDM in women aged ≥ 35 years was 5.5 times higher than that in women aged < 25 years (95% CI: 1.27-23.73, p < 0.05). In the first trimester, the risk of GDM in women with abnormal triglyceride who were in their first trimester was 2.1 times higher than that of lipid normal women (95% CI: 1.12-3.91, p < 0.05). The area under the ROC curve of the nomogram of was 0.728 (95% CI: 0.683-0.772), the sensitivity and specificity of the model were 0.716 and 0.652, respectively. This study provides a simple and economic nomogram for the early prediction of GDM risk in the first trimester, and it has certain accuracy.

Simulated experimental measurement of exposure dose to patients from endoscopic retrograde cholangiopancreatography operation / 中华放射医学与防护杂志

Objective@#To estimate the doses to patients from ERCP operation through experimental measurements.@*Methods@#A retrospective analysis was made of 56 ERCP operations in three hospitals, and meanwhile, the tube voltage and current, fluoroscopy time, accumulated doses, DAPs (dose-area product) and photographic frames were also recorded for statistical analysis. Three cases of RECP operation that had led to high, medium and low DAP values were selected, respectively, as high, medium and low dose groups based on anthropomorphic phatom (AP). ERCP operation was simulated on AP on the basis of putting TLDs in it. The absorbed doses of organs were measured while effective doses while calculated.@*Results@#The effective doses for high, medium and low groups were 2.69, 11.52 and 39.27 mSv, respectively. The effective dose was 14 times higher in high dose group than that in low group. The highest organ doses for three groups were all concentrated in the irradiation fields.@*Conclusions@#Organ doses from ERCP phantom experiments vary largely in different groups. Compared with phantom experiments of other interventional types, ERCP can be regarded as one of interventional means leading to high-dose. It is advisable to reasonably and safely use intervention diagnosis and therapy and in order optimize radiation doses to patients.

Comparison of short-and medium-term efficacy of arthroscopic surgery versus intra-articular injections for rotator cuff tears with concomitant shoulder stiffness in elderly patients / 中华老年医学杂志

Objective:To compare the short and medium-term effects of arthroscopic surgery versus intra-articular injections for rotator cuff tears with concomitant shoulder stiffness in elderly patients.Methods:We performed a retrospectively study that included 116 patients with rotator cuff tears combined with shoulder stiffness between January 2015 and June 2017, with 56 patients receiving arthroscopic surgery (the surgery group)and 60 patients given intra-articular injections (the control group). The visual analogue scale (VAS)score, range of motion (ROM), American Shoulder and Elbow Surgeons (ASES)score, University of California Los Angeles (UCLA)score were recorded before treatment and 3, 6 and 12 months after treatment.Results:Compared with pre-treatment, VAS scores were lower and ROM, ASES and UCLA scores were higher in both groups after treatment ( P<0.05). At 3 months after treatment, VAS scores were higher and ASES and UCLA scores were lower in the surgery group than in the control group ( P<0.05), while there was no significant difference in ROM between the two groups ( P>0.05). At 6 and 12 months after treatment, VAS scores were lower, ROM was larger, and ASES and UCLA scores were higher in the surgery group than in the control group ( P<0.05). Conclusions:In patients with rotator cuff tears combined with shoulder stiffness, both arthroscopic surgery and intra-articular injections can alleviate pain and improve ROM and shoulder joint function.After 6 months of treatment, greater improvement is achieved in patients undergoing arthroscopic surgery than in patients receiving intra-articular injections.

Simulated experimental measurement of exposure dose to patients from endoscopic retrograde cholangiopancreatography operation / 中华放射医学与防护杂志

Objective To estimate the doses to patients from ERCP operation through experimental measurements.Methods A retrospective analysis was made of 56 ERCP operations in three hospitals,and meanwhile,the tube voltage and current,fluoroscopy time,accumulated doses,DAPs (dose-area product) and photographic frames were also recorded for statistical analysis.Three cases of RECP operation that had led to high,medium and low DAP values were selected,respectively,as high,medium and low dose groups based on anthropomorphic phatom (AP).ERCP operation was simulated on AP on the basis of putting TLDs in it.The absorbed doses of organs were measured while effective doses while calculated.Results The effective doses for high,medium and low groups were 2.69,11.52 and 39.27 mSv,respectively.The effective dose was 14 times higher in high dose group than that in low group.The highest organ doses for three groups were all concentrated in the irradiation fields.Conclusions Organ doses from ERCP phantom experiments vary largely in different groups.Compared with phantom experiments of other interventional types,ERCP can be regarded as one of interventional means leading to high-dose.It is advisable to reasonably and safely use intervention diagnosis and therapy and in order optimize radiation doses to patients.

Rotundic acid induces Cas3-MCF-7 cell apoptosis through the p53 pathway.

In the present study, the functions and mechanisms of rotundic acid (RA) underlying its induction of apoptosis in caspase-3-transfected MCF-7 human breast cancer cells (Cas3-MCF-7 cells) were investigated. RA induced apoptosis in Cas3-MCF-7 cells more efficiently compared with that in MCF-7 cells transfected with control plasmid. The results from an MTT assay demonstrated that RA effectively inhibited Cas3-MCF-7 cell viability in a dose-dependent manner and induced cell apoptosis via caspase-3 activity within 12 to 48 h. Western blotting and fluorescence-activated cell sorting demonstrated that RA initiated Cas3-MCF-7 cell apoptosis via p53 activation. The silencing of the p53 gene in the Cas3-MCF-7 cell line led to decreased RA-induced Cas3-MCF-7 cell caspase-3 activity and cell apoptosis. Collectively, the results of the present study indicate that caspase-3 serves a critical function in rotundic acid-induced apoptosis, and suggest that caspase-3 deficiency may contribute to the chemotherapy-resistance of breast cancer. Reconstitution of caspase-3 sensitizes MCF-7 breast cancer cells to chemotherapy. RA has the potential for development as a novel drug combined with reconstitution of caspase-3 gene therapy for the treatment of human breast cancer with caspase-3 deficiency.

Role and mechanism of muscarinic acetylcholine receptor in the regulation of submandibular gland secretion / 北京大学学报(医学版)

Muscarinic acetylcholine receptors (mAChRs), including M1-M5 subtypes, are classic receptors in regulating water, ion, and solute transport in salivary gland. Our work focuses on the studies on the expression pattern and function of mAChR in the submandibular gland (SMG), and the underlying mechanism involved in the mAChR-regulated secretion, together with the effect of parasympathectomy on the salivary secretion. Microvascular autotransplantation of SMG into the temporal fossa provides a continuous and endogenous source of fluids, and is currently an effective method for treating severe keratoconjunctivitis sicca. By using RT-PCR, Western blotting, and immunofluorescence, our data demonstrated that the expression of M1 and M3 subtypes were decreased in latent period in rabbit SMG autotransplantation model, whereas carbachol stimulation promoted the salivary secretion, as well as M1 and M3 expressions. By contrast, mAChRs were hypersensitive in epiphora SMGs, whereas atropine gel and botulinum toxin A application significantly inhibited the hypersecretion in both animal models and patients. Furthermore, the possible intracellular signal molecules involved in the mAChR-modulated salivary secretion were explored. Activation of mAChR upregulated the expression of aquaporin 5 (AQP5), the main transporter that mediated water secretion through transcellular pathway, and led to AQP5 trafficking from lipid rafts to non-lipid microdomain. Extracellular signal-regulated kinase 1/2 (ERK1/2) was involved in the mAChR-regulated AQP5 content. mAChR activation also modulated the expression, distribution, and function of tight junction proteins, and increased paracellular permeability. ERK1/2/β-arrestin2/clathrin/ubiquitin signaling pathway was responsible for the mAChR-regulated downregulation of tight junction molecule claudin-4. Cytoskeleton filamentous actin (F-actin) was also involved in the distribution and barrier function of epithelial tight junctions. Besides, endothelial tight junctions were opened by mAChR agonist-evoked salivation in the mice. Furthermore, parasympathetic denervation increased resting salivary secretion in the long terminrats and minipigs. Taken together, our work demonstrated that mAChR regulated saliva secretion via transcellular and paracellular pathways in SMG epithelium as well as tight junction opening in SMG endothelium. Modulation of mAChR might be a promising strategy to ameliorate SMG dysfunction.

Correlation analysis between adolescent cognitive ability and health risk behaviors / 中国学校卫生

Objective@#To explore the status of adolescents’ health risk behaviors, relationship between cognitive ability and health risk behaviors, and provide an empirical reference for reducing the occurrence and early prevention of health risk behaviors among adolescents.@*Methods@#Samples were extracted by hierarchical, multi-stage, probability and scale proportional (PPS) methods. There were 112 schools randomly selected from 28 county-level regions(county, district, city), and 19 487 students were investigated by baseline survey, a follow-up study was conducted among 8 636 students during 2014-2015. Descriptive statistical methods of using 2 test and t test, and logistic multivariate regression analysis were used to analyze the relationship between cognitive abilities and healthy risk behaviors.@*Results@#The reported rate of a healthy risk behavior was 20.77%, and the incidence of more than one type of health risk behavior was 16.03%. The student’s cognitive ability standardized score was(0.33±0.82). The average score of cognitive ability of adolescents with healthy risk behavior was 0.14, which was lower than the average score of cognitive ability of adolescents without healthy risk behaviors(0.43). Boys, having rural household registeration, non-residential schools, and parents with low education levels adolescents were more likely to be involved in health behavior risks. There was a significant correlation between adolescent cognitive ability and healthy risk behavior(OR=0.67, P<0.01).@*Conclusion@#The current status of adolescent health risk behaviors is worrying. The cognitive ability has a significant impact on health risk behaviors. It is recommended to use the cognitive ability of adolescents as a starting point to prevent and reduce the occurrence of adolescent health risk behaviors.