Retrospective investigation and analysis of pertussis in Ninghai County， Zhejiang Province from 2018 to 2019 / 上海预防医学

ObjectiveTo characterize the incidence of laboratory confirmed pertussis cases by immunization status in Ninghai County， and to provide evidence for improving pertussis prevention and control strategy in Ninghai County. MethodsData of reported pertussis cases in Ninghai County from 2018 to 2019 were collected through the National Notifiable Infectious Disease Reporting System. The immunization history of vaccines related to pertussis was collected through the Ningbo Immunization Planning Information Management System and field investigation. Descriptive epidemiological methods were used to analyze the collected data. ResultsThe respiratory secretions collected in the 64 cases tested positive for nucleic acid of Bordetella pertussis bacilli， of which 56.25% aged 0‒1 year. They were mainly pre-school children. No adolescent or adult case was reported. All cases had whooping cough. Of the cases， 78.13% had an increase in white blood cell count， 62.5% had an increase in lymphocyte percentage， 59.38% had completed three or more doses of pertussis vaccination， 69.39% had a time interval of >1 year between the onset and last dose of pertussis vaccination， and 31.25% reported close contact with pertussis patients before the onset. The misdiagnosis rate of pertussis was as high as 92.19%. In contrast， the prevalence of anti-pertussis IgG antibody in health population was 1.05%. ConclusionFurther improvement in the laboratory testing capacity can help clarify the diagnosis of pertussis. Generally， children aged 0-1 year are mainly affected， of which vast majority have received at least one dose of pertussis vaccination. Clinical symptoms are characterized by whooping cough. Additionally， elevated white blood cells and lymphocytes should be on the alert to pertussis infection.

Study of radiotherapy dose effect of neoadjuvant chemotherapy versus concurrent chemoradiotherapy in cervical cancer / 中华放射肿瘤学杂志

Objective:To compare the effect of neoadjuvant chemotherapy vs. concurrent chemoradiotherapy on the target volume and organs at risk for locally advanced bulky (>4 cm) cervical cancer. Methods:From March 1, 2019 to June 30, 2021, 146 patients pathologically diagnosed with cervical cancer were selected and randomly divided into two groups using random number table method: the neoadjuvant chemotherapy (NACT) + concurrent chemoradiotherapy (CCRT) group ( n=73) and CCRT group ( n=73). Patients in the NACT+CCRT group received 2 cycles of paclitaxel combined with cisplatin NACT, followed by CCRT, the chemotherapy regimen was the same as NACT. In the CCRT group, CCRT was given. Statistical description of categorical data was expressed by rate. The measurement data between two groups were compared by Wilcoxon rank-sum test for comparison of two independent samples, and the rate or composition ratio of two groups was compared by χ2 test. Results:Before radiotherapy, GTV in the NACT+CCRT group was (31.95±25.96) cm 3, significantly lower than (71.54±33.59) cm 3 in the CCRT group ( P<0.01). Besides, CTV and PTV in the NACT+CCRT group were also significantly lower compared with those in the CCRT group (both P<0.05). In terms of target volume dosimetry, D 100GTV, D 95CTV, V 100GTV, V 100CTV and V 95PTV in the NACT+CCRT group were significantly higher than those in the CCRT group (all P<0.05). The complete remision (CR) rates in the NACT+CCRT and CCRT groups were 86.3% and 67.6%, with statistical significance between two groups ( P<0.01) . Regarding organs at risk, NACT+CCRT group significantly reduced the dose to the bladder, rectum, small intestine and urethra compared with CCRT group (all P<0.05). Conclusions:NACT can reduce the volume of tumors in patients with large cervical masses, increase the radiation dose to tumors, reduce the dose to organs at risk, and make the three-dimensional brachytherapy easier. Therefore, NACT combined with CCRT may be a new choice for patients with locally advanced cervical cancer with large masses.

Effects of different bladder filling volumes on target area and organs at risk during three-dimensional brachytherapy of postoperative early cervical cancer / 中华放射医学与防护杂志

Objective:To investigate the optimal bladder filling volume in the 3D brachytherapy of postoperative cervical cancer.Methods:Totally 111 early cervical cancer patients with positive incisal margins or insufficient safety boundaries were included. The normal saline 50, 60, 70, 80, 90, and 100 ml were filled into their bladders, and accordingly six groups were determined, and 66, 69, 66, 69, 72, 56 person-times in each group, respectively. The CT-based simulation positioning was performed. According to the ICRU 89 report, high-risk clinical target volume and organs at risk such as bladder and rectum were delineated. The Oncentra planning system was used to prepare the treatment program. The high-risk clinical target volume (HR-CTV), D90, and the D2 cm 3 and D1 cm 3 of organs at risk under different volumes were recorded. Results:Compared to the 60 ml group, the volume and dosage of HR-CTV in the groups of 50, 70, 80, 90, and 100 ml had no significant difference ( P>0.05). The D2 cm 3 and D1 cm 3 of the bladder and rectum of patients in these groups significantly decreased, and the difference was statistically significant ( tbladder = 3.21, 5.83, 2.89, 12.95, 7.96, Pbladder = 0.031, 0.010, 0.041, 0.000, 0.001; trectum = 2.94, 4.66, 2.53, 5.89, 4.13, Prectum = 0.037, 0.024, 0.049, 0.005, 0.028). The pairwise comparison among these groups except for the 60 ml group showed that the volume and dosage of HR-CTV and the D2 cm 3 and D1 cm 3 of bladder and rectum had no significant difference ( P > 0.05). Moreover, the D2 cm 3 and D1 cm 3 of sigmoid colon and small intestine of these groups had no significant difference ( P > 0.05). Conclusions:In the 3D brachytherapy of postoperative early cervical cancer, a bladder filling volume of 60 ml can ensure the volume and dose of HR-CTV and can protect the bladder and rectum compared with other filling volumes.

Predictive Value of CD44v6 and EGFR Expression in Neoadjuvant Chemotherapy Sensitivity of Stage Ⅱ-Ⅲ Cervical Cancer / 肿瘤防治研究

Objective To explore the predictive value of the expression of CD44v6 and EGFR on the efficacy of neoadjuvant chemotherapy (NACT) in stageⅡ-Ⅲ cervical cancer. Methods A total of 53 patients with stageⅡ-Ⅲ cervical cancer diagnosed by pathology were selected. All patients received two cycles of paclitaxel+platinum NACT. The pathological tissue samples of cervical tumors before NACT treatment were collected. The expression of CD44v6 and EGFR were detected by the immunohistochemical SP method, and we analyzed their predictive value of NACT in stageⅡ-Ⅲ cervical cancer. Results Among the 53 patients, 38 were in the NACT effective group (CR+PR), and 15 were in the NACT ineffective group (SD+PD). The expression of CD44v6 in the ineffective group was significantly higher than that in the effective group (P < 0.05). The expression of CD44v6 was significantly different in patients with CR, PR, and SD (P < 0.05). The AUC of CD44v6 to NACT effect on stage Ⅱ-Ⅲ cervical cancer was 0.74 (P < 0.05). The patients in the high expression group of CD44v6 had worse efficacy in NACT than those in the low expression group of CD44v6 (P < 0.05). Pearson test showed that CD44v6 and EGFR expression were correlated (R=0.34, P < 0.05). Conclusion High expression of CD44v6 may reduce the efficacy of NACT in stageⅡ-Ⅲ cervical cancer, suggesting that the expression of CD44v6 has a certain predictive value and clinical significance in the efficacy of paclitaxel+platinum NACT on cervical cancer. Moreover, CD44v6 is positively correlated with EGFR expression.

Application of mind mapping model in the teaching of molecular biology / 生物工程学报

Molecular biology is a biology course containing multiple core concepts and complex biological processes, which are organized in a strong logic. In order to help the medical students in college of traditional Chinese medicine (TCM) understand the content of this professional foundation course, we integrated the mind mapping model into the three sessions of teaching this course. First, putting forward teaching questions through a "nine grids analysis" model before the class teaching; second, transforming class teaching through a "six thinking hats" model; third, reviewing teaching content through a "pyramid principle" model, which helps students develop closed-loop thinking skills. The students' understandings to the course content were enhanced by connecting, merging and diverging the relevant knowledge through thinking visualization. According to the questionnaire, 91% of the students believe that the application of mind mapping model is an effective teaching method, which improves the teaching efficiency and effect. Furthermore, 76% of the students deem this method helps them improve their thinking ability and they also try to apply this method to the study process of other courses. Therefore, the application of mind mapping model in teaching plays an important role in fostering students' high-order thinking skills and provides a new approach for college curriculum teaching.

Energy Spectrum CT Intelligent Matching Combined with Adaptive Iterative Reconstruction in Budd-Chiari Syndrome / 中国医学影像学杂志

Purpose To investigate the effect of energy spectrum CT intelligent matching combined with adaptive iterative reconstruction (ASIR) on image quality and radiation dose of Budd-Chiari syndrome. Materials and Methods 120 cases of Budd-Chiari syndrome patients underwent energy spectrum CT angiography were prospectively included. They were randomly divided into research group and control group with 60 cases in each group. The research group adopted CT intelligent matching technology and 1.6 ml/kg contrast agent, with filtered back projection (FBP) and ASIR being applied respectively for reconstruction of 40-60 keV images to obtain images of group A and B; control group used conventional 120 kVp scans and 1.8 ml/kg contrast agent, with FBP being adopted for reconstruction to obtain group C images. The main portal vein, hepatic vein, contrast noise ratio (CNR) of postcavalliver and subjective scoring of the three groups' images were compared. Results At the level of 40-60 keV, the CNR of each part of group B was the highest, and the difference among the three groups was statistically significant (P<0.01). At the level of 40 keV, the subjective scoring of group C was the highest, being (3.61±0.53) points; at the level of 50-60 keV, the subjective scoring of group B was the highest, being (3.67±0.61) points and (3.91±0.66) points, respectively, the differences of which were all statistically significant (P<0.05). Conclusion The radiation dose obtained through energy spectrum CT intelligent matching is equivalent to that through conventional scans. The use of ASIR technology can reduce the amount of contrast agent while improving image quality.

The protective effect of Xuebijing on paraquat-induced HK-2 cells apoptosis and the underlying mechanisms / 中华劳动卫生职业病杂志

Objective@#To investigate the protective effect and mechanism of Xuebijing (XBJ) on paraquat (PQ) -induced apoptosis in Human kidney cell line-2 (HK-2) cells.@*Methods@#Routinely cultured HK-2 cells, (1) Cell growth inhibition experiment after PQ and XBJ intervention: PQ was divided into 0、200、400、800、1600 and 3200 μmol/L PQ groups, and the cell survival rate was detected after intervening 24、48 and 72 h. XBJ was divided into 0、5、10、20、40 mg/ml XBJ groups, and the cell survival rate was detected after intervening 24、48 and 72 h.To determine the rational drug concentration and the duration of action of XBJ and PQ. (2) PQ-induced HK-2 cell growth inhibition experiment antagonized by XBJ: The cells were divided into normal control group, PQ group (800 μmol/L) and PQ+XBJ group (The cells were pretreated with 5、10 and 20 mg/ml XBJ for 1 h, then cultured with PQ of 800 μmol/L) , After cultured 24 h、48 h and 72 h separately, the cell survival rate was detected. (3) HK-2 cells were divided into normal control group、PQ group (800 μmol/L PQ cultured for 24 h) 、PQ+XBJ group (pretreated with 10 mg/ml XBJ for 1 h, and then 800 μmol/L PQ cultured for 24 h) and XBJ group (10 mg/ml XBJ cultured 24 h). The apoptosis of cells was detected by flow cytometry. The protein expression of Bcl-2 and BAX in each group was detected by Western blotting. The expressions of caspase-3 and caspase-9 were detected by caspase-3 and caspase-9 activity kit active.@*Results@#(1) PQ could significantly reduced the survival rate of HK-2 cells and showed time and concentration dependence. The survival rate of HK-2 cells was about 55% after 800 μmol/L PQ contacted 24 h, XBJ under 20 mg/ml was no significant effect on the survival rate of HK-2 cells after cultured 72 h. (2) Compared with the PQ group, the survival rate of HK-2 cells of PQ+XBJ group was significantly increased (P<0.05). (3) Compared with the normal control group, the cell apoptosis rate of PQ group was significantly increased (P<0.05). Compared with the PQ group, the cell apoptosis rate of PQ+XBJ group was significantly decreased (P<0.05). (4) Compared with the normal control group, Bcl-2 protein expression in PQ group was significantly decreased and BAX protein expression in PQ group was significantly increased (P<0.05) ; compared with PQ group, Bcl-2 protein expression in PQ+XBJ group was significantly increased, BAX protein expression in PQ+XBJ group was significantly decreased (P<0.05). (5) Compared with the normal control group, the activities of caspase-3 and caspase-9 in PQ group were significantly increased (P<0.05). Compared with PQ group, the activities of caspase-3 and caspase-9 in PQ+XBJ group were decreased significantly (P<0.05) .@*Conclusion@#XBJ (10 mg/ml) has obvious protective effect on HK-2 cell injuried by PQ (800 μmol/L) , It can improve the survival rate of cells through reducing the apoptosis of HK-2 cells which induced by PQ.

Evaluation of Budd-Chiari syndrome with spectral CT iodine-based materials imaging and spectral curve / 实用放射学杂志

Objective To investigate the clinical value of CT spectral imaging parameters in evaluating the liver function in patients with different types of Budd-Chiari syndrome (BCS),by comparing the normalized iodine concentration (NIC) and the slope of spectral curve in liver segment Ⅰ-Ⅷ,portal vein (PV),hepatic vein (HV),inferior vena cava (IVC) and spleen.Methods Eighty-one patients with BCS underwent spectral CT angiography.NIC,spectral decay curve and the slope of spectral curve of liver segment Ⅰ-Ⅷ in portal venous phase,PV,HV,IVC and spleen were measured and calculated.Clinical indicators of liver function including prothrombin time (PT),albumin (ALB),total bilirubin (TBIL),aspartate transaminase (AST),alanine transaminase (ALT) were recorded.Quantitative data were analyzed using One-way ANOVA.Pearson correlation analysis was used to evaluate the correlation of liver NIC and clinical liver function indexes.Results PT and TBIL were negatively correlated with liver NIC and there was a positive correlation between ALB and liver NIC (P＜0.05).The differences of NIC among the three types of BCS in liver segment Ⅱ-Ⅵ,HV,IVC and spleen were statistically significant (P＜0.05) and the difference of slopes of the spectral curves among three types of BCS in liver segment Ⅱ-V and spleen was statistically significant (P＜0.05).Conclusion Combined use of spectral CT multi-site and multi-parameter imaging may be useful in the evaluation of liver function in patients with BCS.

Spectral CT in the evaluation of hepatic function before and after treatment of Budd-Chiari syndrome / 中华肝胆外科杂志

Objective To investigate the use of spectral CT in assessing the treatment effect on hepatic function in patients with Budd-Chiari syndrome (BCS) before and after treatment.Methods From Dec.2015 to Mar.2017,41 patients with BCS underwent Spectral CT before and after treatment (mean time interval from treatment 1～3 months) in the First Affiliated Hospital of Zhengzhou University.The Iodine concentration (IC) measured on the hepatic section Ⅰ-Ⅷ in the portal venous phase were normalized to the aorta (NIC).The clinical indicators of liver function were studied including Prothrombin time (PT),Albumin (Alb),Total bilirubin (TBil),Aspartate transaminase (AST),and Alanine transarminase (ALT).The paired t test was used to compare NIC and the various indices of hepatic function before and after treatment.The correlation before and after treatment between NIC and the different liver functions were analyzed by the Pearson correlation analysis.Results While both PT and TBil were negatively correlated (P ＜ 0.05),Alb was positively correlated with hepatic NIC (P ＜ 0.05).The correlation of PT,Alb and TBil in patients with Child-Pugh class A liver function were higher than those in classes B and C (r =-0.749,0.658,-0.511).The NIC in the hepatic section Ⅰ-Ⅷ after treatment were higher than those before treatment,with significant differences in hepatic section Ⅱ-Ⅷ.The differences between after and before treatment in patients with Child-Pugh class C liver function were higher than those in classes A and B.The hepatic section Ⅳ,Ⅴ,Ⅷ of class A,the hepatic section Ⅲ-Ⅷ of class B,hepatic section Ⅱ-Ⅷ of classes C were statistically significant.Compared with patients before treatment,the indices of liver function in patients after treatment showed better results (shorter PT,higher ALB,lower TBil,ALT and AST).Conclusion Normalized iodine concentration from spectral CT was helpful in evaluating liver function in patients with BCS.

Imaging findings of primary bone malignant fibrous histiocytoma in long bone / 中国医师进修杂志

Objective To investigate the imaging findings of primary bone malignant fibrous histiocytoma (PBMFH) in long bone. Methods MRI and XV ray examinations were performed in 10 patients with PBMFH in long bone confirmed by histology. CT scans were performed in 6 cases. Results Nine cases had single and 1 case had multiple lesions of single bone. Seven cases showed osteolytic bone destruction, and 3 cases showed mixed bone destruction. Only 1 case showed periosteal reaction. Gross bony ridge was seen in 3 cases on CT scan. All the patients demonstrated isointensity or hypointensity on T1WI, and slight hyperintensity signal on T2WI. Necrosis was seen in the lesion of 10 cases. Four cases showed obvious but heterogeneous enhancement after contrast medium injection. Eight cases had soft tissue mass beyond the scope of bone destruction. Conclusions Some imaging features may suggest the diagnosis of PBMFH in long bone.

Analysis and Treatment of Paclitaxel-induced Muscle Soreness / 中国药房

OBJECTIVE:To observe the occurrence of paclitaxel(PTX)-induced muscle soreness and therapeutic efficacy and safety of diclofenac sodium. METHODS:Among 84 patients with malignant tumor receiving PTX chemotherapy,56 patients suf-fered from PTX-induced muscle soreness,among which 22 female patients suffered from medium and severe muscle soreness and then were randomly divided into group A and B,with 11 cases in each group. Group A was given Diclofenac sodium sustained-re-lease tablet 75 mg orally,once a day;group B was given Paracetamol and tramadol hydrochloride tablets one tablet orally,once a day,and then given Promethazine hydrochloride injection 100 mg subcutaneously,2-3 times a day when muscle soreness could not be born. Treatment course of both groups lasted for 5 d. The distribution of muscle soreness were observed. The onset time and dura-tion of muscle soreness were also observed as well as pain relief and the occurrence of ADR in group A and B. RESULTS:Among 84 cases,the incidence of muscle soreness was 66.67%,among which mild pain accounted for 23.81%,moderate pain accounted for 13.10%,and severe pain accounted for 29.76%. Among 56 patients with muscle soreness,earliest muscle soreness occurred on the day of medication,and most of muscle soreness occurred on 1-3 days after medication,mainly manifesting as sore,activity limitation when severe,associated with fatigue. The pain relief rate of group A and B were 100%,but the incidence of adverse re-actions in group A was significantly lower than group B,with statistical significances(P<0.05).CONCLUSIONS:Diclofenac sodi-um is similar to paracetamol and tramadol hydrochloride in the treatment of PTX-induced muscle soreness,but it is better than paracetamol and tramadol hydrochloride in safety.

Regulation of high glucose to the expression of Toll-like receptor 4 in retinal ganglion cells and its significance / 中华实验眼科杂志

Background Studies show that retinal neurodegeneration may precede retinal microvascular changes in diabetes mellitus.The apoptosis of retinal ganglion cells (RGCs) is an early finding in retinal neurodegeneration.Toll-like receptor 4 (TLR4) is proved to be up-regulated in diabetic rats retina.However,the impact of TLR4 on RGCs damage in retinal neurodegeneration is poorly understood.Objective The aim of this study was to investigate the expressing change of TLR4 induced by high glucose in RGCs in order to offer a basis for the prevention diabetic retinal neurodegeneration and the study on targeting drugs.Methods RGCs were isolated and purified from the retinas of SPF SD rats aged postnatal 1-3 days by using papain digestion method and then were identified by immunofluorescence technology to detect the expression of Brn3a,a specific marker of RGCs.The cells were divided into normal control group and 10,20,30 mmol/L glucose groups.The expressions of TLR4 mRNA and protein in the ceils were detected by real-time fluorescence quantitative PCR and Western blot analysis in 24 and 48 hours after addtion of glucose.All procedures performed in studies were in accordance with the Association for National Institutes of Health (NIH) Statement for the Care and Use of Laboratory Animals recommendations.The protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University.Every effort was made to minimize animal discomfort and stress.Results The normal cells grew well with the shape of near roundness after inoculaton.The cells were gradually enlarged and clustered with obvious axons and dendrites 24 hours after purifying.Brn3a showed the positive expression in cultured cells.At 24 hours and 48 hours after glucose culture,the cell structures were gradually invisible in most cells.The expressions of TLR4 mRNA in the cells were 0.945 ±0.237,1.180±0.193 and 0.827±0.213 at 24 hours and 1.509±0.422,2.433±0.617 and 1.435±0.410 at 48 hours after culture in the 10,20 and 30 mmol/L glucose groups,respectively,which were significantly higher than 0.600±0.099 and 0.724±0.302 in the normal control group (all at P＜0.01).The expressions of TLR4 protein in the cells were 0.442±0.147,0.626±0.128 and 0.330±0.153 at 24 hours and 0.464±0.121,0.930±0.441 and 0.394±0.158 at 48 hours after culture in the 10,20 and 30 mmol/L glucose groups,respectively,which were significantly higher than 0.090±0.050 and 0.094±0.070 in the normal control group (all at P＜0.01).Conclusions A large number of RGCs die in a high-glucose environment in vitro,meanwhile,the expression of TLR4 up-regulates in the cells,indicating that TLR4 maybe participate in the damage of RGCs induced by high glucose.

Preliminary analysis of the efficacy of helical tomotherapy combined with targeted therapy for stage Ⅳ non-small cell lung cancer / 肿瘤研究与临床

Objective To explore the efficacy and security of helical tomotherapy (radical radiotherapy) combined with targeted therapy for stage Ⅳ non-small cell lung cancer (NSCLC).Methods The data of 19 patients with stage Ⅳ NSCLC were retrospectively analyzed.The efficacy and security were observed by SPSS 20.0 statistical software.Results Among 19 patients, there were 6 cases complete remission (CR), 8 cases partial remission (PR), 4 cases stable disease (SD), 2 cases progressive disease (PD).The response (CR+PR) rate was 73.7 ％ (14/19).The 1-and 2-year local control rates were 73.7 ％, 47.4 ％,respectively.The 1-year progression-free survival rate was 31.6 ％.The median survival time was 13 months, and the 1-and 2-year overall survival rates were 52.6 ％, 26.3 ％, respectively.The median survival time of females, non-smokers or targeted therapy synchronous radiotherapy was longer than that of male, smokers or targeted therapy sequential radiotherapy, respectively (21 months vs 8 months, P =0.014;21 months vs 6 months, P =0.007;18 months vs 6 months, P =0.026).There were no significant differences of age, number of metastatical organs or targeted drug categories between two groups (P ＞ 0.05).All patients could tolerate the adverse reactions without treatment-related death.Conclusion The effect of helical tomotherapy combined with targeted therapy for stage Ⅳ NSCLC is desirable.

Effect of early scream sound stress on learning and memory in female rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the effect of early scream sound stress on the ability of spatial learning and memory, the levels of norepinephrine (NE) and corticosterone (CORT) in serum, and the morphology of adrenal gland.
@*METHODS@#Female Sprague-Dawley (SD) rats were treated daily with scream sound from postnatal day 1(P1) for 21 d. Morris water maze was used to measure the spatial learning and memory ability. The levels of serum NE and CORT were determined by radioimmunoassay. Adrenal gland of SD rats was collected and fixed in formalin, and then embedded with paraffin. The morphology of adrenal gland was observed by HE staining.
@*RESULTS@#Exposure to early scream sound decreased latency of escape and increased times to cross the platform in Morris water maze test (P<0.05). The levels of serum NE was significantly elevated, with an obvious tendency in the increase of CORT level (P<0.05). The morphology of adrenal gland was also influenced. 
@*CONCLUSION@#Newborn female rats subjected to scream sound stress can enhance spatial learning and memory ability in adulthood, which is related to activation of the hypothalamo-pituitary-adrenal axis and sympathetic nervous system.

Application of empowerment theory-based health education for the major caregivers of patient with leukemia / 现代临床护理

Objective To evaluate the effect of the empowerment theory-based health education on anxiety, depression and self-efficacy in the major caregivers for patient with leukemia. Methods Eighty patients with leukemia and their caregivers were enrolled during November 2013 to November 2014 and were divided into the intervention group (n=40) and the control group (n=40). The caregivers of the intervention group received empowerment theory-based education , while those of the control group received general health education. The two groups were compared in terms of anxiety, depression and self-efficacy. Results Before intervention, there were no significant differences in the three items between the groups (P>0.05). After intervention, the level of self efficacy in the intervention group was better than that in the control group (P<0.05) and the scores in the intervention group were significantly lower than those of the control group. Conclusion The empowerment theory-based education can relieve anxiety and depression and improve the self efficacy of the caregivers of patients with leukemia.

Construction of pcDNA3-HERG-G572R expression vector and establishment of a cell line stably expressing HKE-HERG-G572R / 南方医科大学学报

<p><b>OBJECTIVE</b>To construct the pcDNA3-HERG-G572R expression vector and establish a cell line stably expressing HKE-HERG-G572R.</p><p><b>METHODS</b>HERG-G572R mutant fragment was constructed by over-lap extension PCR and validated by DNA sequencing. The HKE-HERG-G572R expression vector was constructed and transfected into HEK293 cells to obtain a cell line stably expressing HKE-HERG-G572R.</p><p><b>RESULTS</b>The pcDNA3-HERG-G572R expression vector was successfully constructed and the cell line stably expressing HKE-HERG-G572R was established. Real-time PCR and Western blotting revealed a 632-fold HKE-HERG-G572R overexpression in the transfected HEK293 cells as compared with that in control HEK293 cells transfected with pcDNA3 (P<0.01).</p><p><b>CONCLUSION</b>The protocol can be used to construct the cell line stably expressing HKE-HERG-G572R to provide a cell model for studying individualized therapy.</p>

Application of automatic tube voltage selection for abdominal CT in various patient sizes / 实用放射学杂志

Objective The purpose of this study was to evaluate the effect of patient’s body mass index on applications of auto-matic tube voltage selection (ATVS)for contrast-enhanced abdominal CT.Methods 1 60 patients underwent contrast-enhanced ab-dominal CT scan were assigned into the study group (ATVS technique)and the control group (120 kVp)with equal size (both n =80)according to the scanning mode.The two groups were both divided into four subgroups according to BMI (A:BMI <18.5 kg/m2 ;B:BMI 18.5~23.9 kg/m2 ;C:BMI 24~28.9 kg/m2 ;D:BMI ≥29 kg/m2 ).Image quality were assessed and compared with Rank-sum test.Analysis of variance was used to compare differences in mean contrast-to-noise ratio (CNR)and image noise a-mong the two groups.Two sample t tests were used to compare the radiation dose.Results In the study group,tube voltage of 100 kVp were selected highest(78.75%)and distributed from subgroups A to D,accounting for 60%,80%,90% and 60% respectively, with average BMI of (23.71±3.1 9)kg/m2 .Compared to control group,the effective dose of study group from subgroups A to C re-duced by 35.09%,27.61% and 1 9.08% respectively(t=3.829,4.389,2.238,P =0.005,<0.001,0.025).Despite the higher image noise in study group,the overall image quality was acceptable.Conclusion The contrast-enhanced abdominal CT with AVTS technique can reduce radiation dose in patients with BMI smaller than 28.9 kg/m2 .

Diagnosis,treatment,and prognostic analysis of thirty-one cases with primary bronchopulmonary carcinoid / 中国肿瘤临床

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Performance of automatic tube voltage selection and sinogram-affirmed iterative reconstruction on the image quality and radiation dose in the enhanced dual-source abdominal CT / 中华放射学杂志

Objective To investigate the impact of automatic tube voltage selection ( ATVS) and sinogram-affirmed iterative reconstruction ( SAFIRE) on image quality and radiation dose in the arterial phase (AP) and portal venous phase (PVP) abdominal dual-source CT imaging.Methods Abdomen contrast-enhanced computed tomography ( CECTs ) in 70 patients were scanned with dual-source CT.Patients were divided into study group and control group based on the scanning date.In the first 35 patients ( study group) , ATVS mode was applied; in the second 35 patients ( control group ) , the conventional fixed at 120 kVp mode was used.The imaging of the study group was reconstructed with FBP ( protocol A ) or SAFIRE ( protocol B ) respectively; the imaging of the control group was reconstructed with FBP ( protocol C).Image quality scores of the 3 protocols were assessed and compared with Rank-sum test.Analysis of variance was used to compare mean signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and image noise among the 3 protocols.Two sample t tests were used to compare the radiation dose difference.Results The effective radiation dose in the study group ( 3.9 ±0.4 ) mSv was much lower than that in the control group (4.9 ±0.4) mSv, dropped by 20.41% (t =2.315, P=0.021).The subjective rating scores in protocol A, B, C in arterial were (3.65 ±0.08), (4.41 ±0.10) and (3.79 ±0.10) point, while the subjective rating scores in venous phase were (3.57 ±0.08), (4.41 ±0.10) and (3.95 ±0.11) point.The differences were statistically significant (Z value were 27.587 and 27.436, P0.05).Conclusion Use of ATVS and SAFIRE could reduce the radiation dose and provide better quality images compared with conventional abdominal CECT and FBP .

Clinical study on irinotecan plus cetuximab in the treatment of advanced colorectal cancer in the elderly / 中华老年医学杂志

Objective To observe the efficacy and safety of cetuximab chemotherapy combined with irinotecan in the treatment of advanced colorectal in the elderly.Methods 40 irinotecanresistant patients with K-Ras wild type were randomized to cetuximab weekly combined with irinotecan group (group A) and cetuximab biweekly combined with irinotecan group (group B).In group A,cetuximab was given at an initial dose of 400 mg/m2,followed by weekly 250 mg/m2.In group B,cetuximah and irinotecan were given at 500 mg/m2 and 180 mg/m2 respectively every two weeks.Time to progression (TTP),overall survival (OS) and toxicity were compared between the two groups.Results There were no significant differences in objective response rate (RR),disease control rate (DOC),TTP and OS between goup A and group B (30.0％ vs.25.0％,60.0％ vs.55.0％,5.8 months vs.5.6 months,9.8 months vs.9.5 months,respectively,all P＞0.05).Grade 3 or more toxicities including hematological toxicity,gastrointestinal reactions and skin toxicity were found in 2 cases,2 cases and 1 case respectively in group A and 3 cases,1 case and 2 cases respectively in group B.The two groups had no significant differences in toxicities (all P＞0.05).Conclusions Cetuximab combined with irinotecan therapy is effective in the treatment of advanced colorectal cancer in elderly irinotecan resistant patients.Cetuximab biweekly regimen is more convenient but has the same efficacy and toxicity as compared with cetuximab weekly regimen.