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Objective:To evaluate the difference between conventional fractionation radiotherapy (CRT) and stereotactic body radiation therapy (SBRT) in lung cancer.Methods:A model was constructed based on convolution operation and finite element method, simulating the dose delivered to circulating lymphocytes (CL) in radiotherapy. The model was trained on a training group ( n=3) and validated in an independent validation group between SBRT ( n=10) and CRT ( n=10). The peak cumulative dose of circulating lymphocyte (PCDC) was compared between the two schemes, and the effect of different PTV volumes and treatment time on the cumulative dose was also analyzed. The correlation between PCDC and CL change value was discussed. Results:In the training group, PCDC with CRT to CL were 1.26 Gy,1.79 Gy, 2.54 Gy in PTV of 38 cm 3, 63 cm 3 and 114 cm 3, and PCDC with SBRT to CL were 0.84 Gy, 1.22 Gy, 1.55 Gy in PTV of 38 cm 3, 63 cm 3, 114 cm 3, respectively. PCDC gap of SBRT to CL was decreased by 0.42 Gy, 0.57 Gy, 0.99 Gy, respectively. In the validation group, the lymphocyte change value in SBRT and CRT were (1.10±0.64)×10 9/L and (0.42±0.48)×10 9/L, and there was significant difference ( P=0.015). PCDC in SBRT and CRT were 3.56 (2.79, 3.82) Gy and 1.24 (0.697, 1.73) Gy, and there was significant difference ( P<0.001). There was a positive correlation between lymphocyte change value and PCDC ( r=0.455, P<0.05). Conclusions:SBRT, compared to CRT, will lead to lower PCDC and CL lymphocyte change value, which may cause a greater impact on the difference of PCDC along with the enlargement of PTV. CRT and large PTV volume may cause more significant effect upon the body immune function.
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The understanding of heart embryonic development and structure can contribute to improve our leaning of the etiology, pathophysiology and classification of congenital heart disease in humans, which has become the focus of echocardiography teaching. Meanwhile the difficulties and problems formed because of its diverse and fragmented theoretical knowledge. "Hand as foot" teaching method is a kind of teaching method using intuitive body language combined with the thought of analogy, so as to make teaching content relatively simplistic and figurative. Our study has demonstrated this method can be used in a constructive way to improve course content and delivery for echocardiography teaching to assess patent foramen ovale for standardized residency training of cardiac ultrasound, and achieved a good teaching effect. The specific implementation approaches and effect of this method are described in detail. This paper also explores the potential feasibility and benefits of the application of using "Hand as foot" teaching method in echocardiography teaching.
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Objective:To evaluate the CT characteristics of ossifying foci in sinonasal inverted papilloma (IP) and to compare with the tumor root shown intraoperatively.Methods:The clinical and CT imaging data of 127 patients with IP, which were proved by histopathology, were reviewed retrospectively from Beijing Tongren Hospital, Capital Medical University, during the period from January 2012 to December 2018. The number, location, shape, density of ossifying foci in sinonasal IP and the relationship with the wall of sinus were observed. The sites of ossification on CT scans were compared with the root of the tumors described in the corresponding patient′s operative records.Results:In 127 IP patients, 51 (40.2%) patients showed the ossification in the tumor on CT. Single ossifying foci were found in 35 cases and multiple in 16 cases. The ossification affected single site of the sinonasal tract ( n=16) or distributed diffusely ( n=35). In the 50 cases, the ossifying foci extended along the long axis of the affected sinus appearing as branched ( n=19), striped ( n=16), linear ( n=7), lumpy ( n=2) or mixed type ( n=6), and 1 case was located at the edge of the maxillary sinus. Totally 66.7% (34/51) of the ossifying focis contained peripherally hyperdense bone tissue and centrally hypodense adipose tissue, which corresponded to bone cortices and fatty marrow of the trabecular bone. And 96.1% (49/51) of the ossifying focis were attached to the adjacent bone of the sinus, and the sites of attachment were concordant with the actual origin of tumor confirmed in operation . Conclusions:Ossification can be seen in some sinonasal IPs. Tracing along ossifying focus to the site of attachment with sinus might facilitate preoperative prediction of the originating site of tumor.
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Objective To investigate the correlation between quantitative parameters derived from iodine overlay images and the monochromatic images of dual‐energy CT and the differentiation degree of laryngeal and hypopharyngeal squamous cell carcinoma(LHSCC). Methods Retrospective analysis of clinical and imaging data of eighty patients with different differentiation degree of LHSCC who underwent dual‐energy CT enhanced scan in the arterial and venous phase from March 2016 to January 2017 (20, 42 and 18 patients with well, moderately and poorly differentiation, respectively) was performed.Among them, twenty‐eight cases were stage T1, twenty‐four cases were stage T2, twenty cases were stage T3 and eight cases were stage T4. All patients were not treated with radiotherapy and chemotherapy before operation. Iodine overlay images and the monochromatic images of arterial and venous phases were acquired from Syngo MultiModality Workplace dual‐energy post‐processing software of Siemens, respectively. The mean iodine concentration (IC), standardized iodine concentration (SIC), and the slope of spectral curve(λ) of different differentiation degrees of LHSCC were calculated and compared. The correlation between quantitative parameters of LHSCC and its differentiation degree was performed by Spearman rank sum test. One‐way analysis of variance was used to compare the quantitative parameters of different differentiation degree of LHSCC. Receiver operating characteristic (ROC) curve was used for analyzing diagnostic efficiency. Results The IC, SIC, and λ in the arterial phase, and IC in the venous phase correlated positively with differentiation degree in LHSCC (r=0.258, 0.350, 0.262 and 0.275, respectively; P<0.05) in this group. The IC, SIC, and λ of poorly differentiated LHSCC in the arterial phase [(3.13 ± 0.54) mg/ml, (0.38±0.10), (5.40±0.92)] were higher than those of well differentiated LHSCC [(2.38±1.02) mg/ml, (0.25± 0.09) and (4.19 ± 1.18); t=2.73, 3.36 and 2.75 respectively; P<0.05] and moderately differentiated LHSCC [(2.56±0.85) mg/ml, (0.28±0.16) and (4.56±1.41); t=2.38, 3.06 and 2.21, P<0.05]. IC of poorly differentiated LHSCC in the venous phase [(2.59 ± 0.62) mg/ml] was significantly higher than that of well differentiated LHSCC [(1.96±0.56) mg/ml,t=2.45,P<0.05] and moderately differentiated [(2.02±0.93) mg/ml,t=2.56,P<0.05] LHSCC. There was no significant difference in the SIC and λ between different differentiation degrees of LHSCC (P>0.05) in the venous phase. The standardized iodine concentration in the arterial phase was the best in distinguishing poorly and moderately differentiated LHSCC, and poorly and well differentiated LHSCC with the area under the receiver operating curve 0.77 and 0.81, respectively, the sensitivity 88.2% and 70.0%, respectively, and the specificity 69.0% and 70.0%, respectively. Conclusions Quantitative parameters derived from dual‐energy CT might be useful in the evaluation of different differentiated degrees of LHSCC. In addition, the standardized iodine concentration of LHSCC in the arterial phase was the best in the estimation of different differentiated degrees of LHSCC.
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Objective To study the expression and clinical significance of ARHGAP4 in colorectal cancer Method Real?time PCR,Western blot and immunocytochemistry were used to detect the expression of ARHGAP4 in colorectal cancer tissues and cell lines ,and the correlation between its expression and clinical features of patients was analyzed Results ARHGAP4 is overexpressed in colorectal cancer tissues and cell lines and its overexpression is correlated with T stage, N stage, clinical stage, and metastasis. Conclusion ARHGAP4 may promote the progression of colorectal cancer ,and have the potential to be a novel prognosis marker.
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Objective To study the effect of multi-disciplinary teamwork (MDT) nursing mode on perioperative care to breast cancer patients. Methods One hundred and twenty breast cancer patients undergoing surgical operations were evenly randomized into the observation and control groups by random digit number table. The control group was treated with routine nursing care and the observation group with MDT nursing mode. Result The rate of complications (like subcutaneous effusion, lymphatic edema and skin flap necrosis) in the observation group was significantly lower than that of the control group and the hospital stay was significantly shorter than that of the control group as well (all P<0.05). Conclusion The MDT nursing mode can reduce the rate of complications, shorten the hospital stay and relieve patient′s depression.
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Objective To observe the clinical efficacy ofErxian Decoction combined with elcatonin for the treatment of postmenopausal osteoporosis.Methods Eighty cases of female patients with postmenopausal osteoporosis were randomly divided into treatment group and control group, 40 cases in each group. The control group received intramuscular injections elcatonin treatment, and the treatment group received oralErxian Decoction on the basis of the treatment of the control group, for 12 weeks. The main clinical symptom score, VAS score and bone mineral density (BMD) of L2-L4 and in the tibia of the two groups were observed before and after treatment to assess the therapeutic effect.Results After treatment, VAS scores of the two groups were significantly lower (P<0.05). The total effective rate of the treatment group was 92.5% (37/40); the control group was 75.0 (30/40), with statistical significance (P<0.05). The treatment group was significantly better than the control group in main symptom scores, especially in improving body symptoms (P<0.05). BMD of the treatment group was significantly higher than the control group.ConclusionErxian Decoction combined with elcatonin therapy for postmenopausal women with osteoporosis can significantly improve clinical symptoms and increase BMD.
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ObjectiveTo observe the effects of ultrafiltration extract from Angelica Sinensis Radix and Hedysari Radix on PC12 cell apoptosis induced by H2O2; To discuss its mechanism of action.Methods H2O2 was used in the incubation of PC12 cells to establish the oxidative damage nerve cell apoptosis model. The experiment was divided into normal control group, model group, and three different dosages (0.375, 0.75, 1.5 g/L) of ultra-filtration extracted from Angelica Sinensis Radix and Hedysari Radix after modeling for interference. Rate of cell apoptosis was detected by flow cytometry; mitochondrial membrane potential was measured by laser scanning confocal microscopy; the protein expressions of cleaved Caspase-3, Bax and Bcl-2 were detected by Western blot.Results Compared with the model group, rates of cell apoptosis in the different dosage groups decreased significantly; membrane potential of mitochondria increased; the protein expressions of cleaved Caspase-3 and Bax decreased; the expression of Bcl-2 increased; the ratio of Bcl-2 and Bax increased (P<0.05).Conclusion The ultra-filtration extracted from Angelica Sinensis Radix and Hedysari Radix can inhibit PC12 cell apoptosis induced by H2O2.
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Circulating tumor cells (CTCs) detections have unique advantages in the real-time personalized medicine of patients with tumors.The rarity and heterogeneity of CTCs in peripheral blood pose great technical challenge for CTCs researches.Most of technologies for detecting CTCs have been developed to enrich CTCs by virtue of physical properties or specific biological features of the cells at first,then genotype or phenotype analysis are performed to count or characterize CTCs.Advances in molecular analysis of single cells enable CTCs detections to provide more accurate and comprehensive information.Biological processes during CTCs invasion and metastasis such as epithelial-mesenchymal transition and clustering should to be considered seriously to promote the clinical applications of CTCs detection.
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Objective To explore the effect of continued nursing on postpartum breastfeeding within 6 months. Methods Two hundred and twenty parturient women were randomly divided into the observation group and the control group using random digits table. The control group received breastfeeding knowledge education and nursing skills instruction. The observation group was given continued nursing and breastfeeding guidance . The two groups were compared in terms of breastfeeding rates at 1 , 2 , 3 , 4 , 5 , 6 months . Result The breastfeeding rates of the observation group were significantly higher than those of the control group at each time point ( all P < 0 . 05 ) . Conclusion According to reasons why the parturient women don′t breastfeed , they are given continued nursing and detailed solutions after discharge , to make them confident in breast feeding and improving breastfeeding rate within six months after delivery .
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Objective To investigate rats reared in social isolation as a model of behavioral symptoms of neurodevelop-mental psychiatric disorders including schizophrenia.Methods Male rat pups were housed in individual cages from post-weaning to adulthood.Locomotor activity detection, Morris water maze test and social interaction test were performed. Results Compared with controls, the social isolation-reared rats got more body mass, showed locomotor hyperactivity and increased social interaction, but significant spatial learning changes were not observed in Morris water maze test.Conclu-sion Exposing rats to social isolation can profoundly affect behavior in adulthood, which can be used to build animal mod-els of neurodevelopmental psychiatric disorders including schizophrenia.
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Objective To study the diagnostic value of MR coronal iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL) water imaging in the far later lumbar disc herniation(FLLDH).Methods A retrospective analysis of pre-operative routine CT axial imaging and MPR post-processing,conventional MR axial plane,sagittal plane and IDEAL imaging was performed in 10 patients with pathologically FLLDH.The above images were observed to find whether it could clearly show the spatial relationship outline of the nucleus pulposus and the nerve root,including the number of affected nerve root(1 or 2),and the compressed part(dorsal root ganglion,postganglionic nerve root or preganglionic nerve root),and the morphological changes of the compressed nerve root(distortion,thinning,enlargement),and were compared with surgical results.Results Surgery showed 2 cases with extra-intervertebral foramen herniation,2 cases with intra-intervertebral foramen herniation,6 cases with mixed herniation.Nine cases involved 1 nerve root,and 1 case involved 2 nerve roots.The conventional CT axial plane could roughly show the local relationship between nucleus pulposus and the nerve root.On conventional CT axial plane,9 cases were diagnosed correctly but 1 case of herniation of extra-intervertebral foramen shifting cephalic to the lower vertebral level was missed.Seven cases of the compressed nerve root were identified with difficulty,2 cases showed obliteration of the fat space and displacement of the nerve root.The spatial relationship of the nucleus pulposus and the nerve root was more visualized by CT MPR images than conventional CT images,but the image was less clear and it could not display the full view.Ten cases on CT MPR images were diagnosed correctly.Nine cases involved 1 nerve root,and 1 case involved 2 nerve roots,the image finding was obliteration of the fat space.Eight cases involved distortion of the compressed nerve root,3 cases involved thinning of the compressed nerve root,1 case involved thickening of the nerve root,6 cases were with no change or no confirmed diagnosis.MR regular scans could roughly show the local relationship of the nucleus pulposus and the nerve root and it is superior to the conventional CT axial scanning.On the conventional axial plane,7 cases of the compressed nerve root were identified with difficulty,3 cases showed obliteration of the fat space and displacement of the compressed nerve root.On the sagittal plane through the intervertebral foramen:5 cases of mixed herniation and 2 cases herniation of intra-intervertebral foramen showed intervertebral disc into the intervertebral foramen,with displacement or annihilation of the compressed nerve root.Two cases of extra-intervertebral foramen herniation were without positive findings.On MR coronal IDEAL water imaging,it could clearly and accurately show the spatial relationship of the nucleus pulposus and the nerve root.It is superior to the conventional CT axial image,CT MPR image and the conventional MR scanning.Ten cases were diagnosed correctly.Four cases were identified as compressed DRG,5 cases were identified as compressed postganglionic nerve root,1 case was identified with compressed L4 postganglionic nerve root and compressed L5 preganglionic nerve root.Ten cases were all identified with distortion of the compressed nerve root,6 cases were identified with the compressed thinning nerve root,and 2 cases with the compressed thickening nerve root.The other nerve roots were not compressed.Conclusion MR coronal IDEAL water imaging is a good tool to show the spatial relationship of nucleus pulposus and the nerve root in FLLDH patients,and it possesses diagnostic value.
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Objective To explore the effect of quality control circle(QCC)on reducing adverse event incidence of the instrument management.Methods QCC group of 7 nurses in the central sterile supply department was set up for QCC training and then analyze the causes of adverse events in the instrument management and finally make countermeasures to apply continuous quality improvement.Result The adverse incidents were significantly decreased from 69 before QCC to 24 after QCC.(χ2=33.694;P<0.01).Conclusion QCC is effective in the reduction of the adverse events in instrument management and improvement of surgical safety.
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Objective To summarize the key points of nursing care to pregnant women with acute cholecystitis and gallstones. Methods The clinical data of twenty three pregnant women with acute cholecystitis and gallstones during August 2007 to January 2012 were reviewed and analyzed retrospectively,including 19 cases for conservative treatment,3 cases for surgical treatment,1 case for abortion.Results All patients were cured and discharged with hospital stay for 7 to 21 days,averaged(12.7±4.7)days. Conclusion For pregnant women with acute cholecystitis and gallstones,efforts should be focused on dynamic monitoring of vital signs and fetal conditions,psychological care and diet care in order to ensure the safety of the mathers and infants.
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Schizophrenia, described as the worst disease affecting mankind, is a severe and disabling mental disorder. Schizophrenia is characterized by complicated symptoms and still lacks a diagnostic neuropathology, so developing schizophrenia animal models which have quantifiable measures tested in a similar fashion in both humans and animals will play a key role in new therapeutic approaches. According to the symptoms of cognitive impairment and emotional disorder, the N-methyl-d-aspartate (NMDA)-receptor antagonist MK-801 was applied to induce schizophrenia-like behavior in mice. Locomotor activity and prepulse inhibition (PPI) were selected as indices and the effect of clozapine was also investigated in this model. The results showed that compared with the normal group, MK-801-treated mice exhibited significantly increased locomotor activity and impaired PPI, and pre-exposure to clozapine could ameliorate the abnormality and make it back to normal level. These findings suggest that the model we established could be a useful tool for antipsychotic drug screening.
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ObjectiveTo investigate the CT and MRI characteristic features of neuroendocrine carcinoma in paranasal sinuses.MethodsCT and MRI findings of 10 patients with proved neuroendocrine carcinoma by pathology were retrospectively reviewed. All patients underwent plain and enhanced MRI scanning,and 9 patients also underwent CT manning.ResultsThere were 5 males and 5 females with mean age of (48 ± 9 ) years old,ranging from 27 to 57 years.The treatment time after symptoms onset ranged from 1 to 4 months,with the median of 2 months.Clinical symptoms were headache and vision loss,hyposmia and yellow nasal discharge,and exophthalmos.The lesions were located in the ethmoidal sinus ( n =6 ),maxillary sinus ( n =2),and bilateral sphenoid sinus ( n =5 ).The lesions were symmetrical in the sphenoid sinus.Pathology type included typical carcinoid tumor ( n =1 ),atypical carcinoid ( n =1 ),and neuroendocrine carcinoma not otherwise specified ( n =8 ). Immunohistochemical staining showed that neurospecific enolase,synaptophysin,cytokeratin and P53 were all positive.On CT images,lesions showed isointensity (n =1 ),iso- to hypointense (n =4 ),and iso- to hyperintense (n =4 ) with hypointense or hyperintense spots.Bone changes included bony absorption and sclerosis ( n =1 ) with a clear margin in typical carcinoid tumor,and moth-eaten bone destruction in other 8 cases( n =8).The lesions were isointense on T1-weighted images,and isointense (n =4) or mixed iso- to hyperintense on T2-weighted images (n =6).Lesions showed mild to medium heterogeneous enhancement ( n =7 ) or marked enhancement ( n =3 )on gadolinium-enhanced images.Time-signal intensity curve ( TIC ) showed plateau type in 2 cases.The aggressive nature of the tumors was demonstrated by invasion of adjacent structures,involvement of nasal cavity( n =9 ),orbits ( n =7 ),pterygopalatine fossa ( n =4 ),ethmoidalsinus and sphenoid ( n =3 ),clivus ossis occipitalis(n =2),cavernous sinus and internal carotid canal(n =2),optic canal(n =2),jugular fossa ( n =1 ),anterior fossa ( n =1 ),apex partis petrosae ossis temporalis ( n =1 ),meninges ( n =1 ),temporal fossa and infratemporal fossa ( n =1 ),pharyngonasal cavity and parapharyngeal space ( n =1 ).ConclusionsThere are different CT features in different pathological types of neuroendocrine carcinoma of the paranasal sinuses,and MRI can demonstrate the invasive extent accurately. CT combined MRI can provide more comprehensive information in the diagnosis and therapy.
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ObjectiveTo compare the diagnostic value of X-ray, CT, MRI, and ultrasound in primary synovial osteochondromatosis ( PSO ).Methods The imaging data of X-ray, CT, MRI, and ultrasound of 42 patients with 44 knees with PSO proved by surgery and pathology were retrospectively collected and analyzed. ResultsThe Plain X-ray demonstrated 197 calcific nodules in 28 joints, 96 ossific nodules in 24 joints, and 5 mixed type nodules in 3 joints. Compared with the data of surgery and pathology,36 joints (81.8 ％, 36/44) were diagnosed correctly by X-ray. The CT showed 8 big cartilaginous nodules in 5 joints, 255 calcific nodules in 30 joints, 146 ossific nodules in 28 joints, and 16 mixed type nodules in 7 joints.Twenty-four knees underwent volume rendering technique reconstruction which displayed the quantity, size, shape, and position of non-cartilaginous nodules clearly. Compared with the data of surgery and pathology, 40 joints (90. 9％ , 40/44)were diagnosed correctly by CT. The MRI demonstrated 8 big cartilaginous nodules in 5 joints, 70 small cartilaginous nodules in 4 joints, 248 calcific nodules in 29 joints,146 ossific nodules in 28 joints, and 16 mixed type nodules in 7 joints. All nodules displayed low signal in DWI and there was no enhancement. Compared with the data of surgery and pathology, 43 joints (97.7％,43/44) were diagnosed correctly by MRI. The ultrasound showed 8 big cartilaginous nodules in 5 joints,70 small cartilaginous nodules in 4 joints, 232 calcific nodules in 30 joints, 142 ossific nodules in 28 joints,and 16 mixed type nodules in 7 joints. Compared with the data of surgery and pathology, 43 joints (97. 7％,43/44) were diagnosed correctly by ultrasound. ConclusionsThe less common manifestations of the PSO require multimodality imaging to make the diagnosis. Multimodalities (X-ray,CT, MRI and ultrasound) are particularly useful in fully characterising PSO and to allow for appropriate clinical planning.
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Objective To investigate diagnostic value of CTA for traumatic pseudoaneurysms (TPA) in the cavernous segment of the internal carotid artery (ICA) when they rupture into the sphenoid sinus. Methods CTA of 7 patients with TPA in the cavernous segments of ICA verified by DSA were retrospectively analyzed. All the patients were performed CTA scanning. The post-processing techniques included VR,MIP,MPR, and CPR. Results All the CTA images of 7 patients showed irregular mass in the sphenoid sinus with obviously enhancement in the same phase to ICA, which communicating with ICA in wide base. The peripheral area of the mass showed no enhancement. The size varied from 3 mm × 2 mm × 1 mm to 33 mm × 30 mm × 27 mm. The adjacent lateral wall of sphenoid sinus showed fractures in all cases. TPA located at anterior-knee segments of cavernous ICA in 6 cases, and cavernous free segment in 1 case. All the disruptions were found at medial or anterior medial wall of ICA. Conclusions Cranial CTA is the effective non-invasive method for diagnosing TPA in the cavernous segment of ICA when they rupture into sphenoid sinus. Combined using of VR, MIP, MPR, and CPR can delineate the location and size of the sphenoid wall fracture and the ICA rupture, which help to clarify the anatomical relationship between them.
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ust be taken during sinonasal surgery to minimize the risk of inadvertent CNII injury.
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OBJECTIVE@#This study aimed to analyze the expression of epidermal growth factor receptor (EGFR), Ki67 and p16 in human middle ear cholesteatomas and to investigate the correlation between its expression and the ability of erosion of cholesteatoma.@*METHOD@#The specimens from the acquired middle ear cholesteatoma tissue of 30 cases and 21 external ear canal skin samples from patients and 17 external ear canal skin samples from healthful men were taken intraoperatively. Their expression was examined by immunohistochemical SP method. Then we scanned it into a computer by an image scanner and quantified the gray of them using commercial software.@*RESULT@#The percent of positive expression of EGFR, Ki67 and p16 in middle ear cholesteatoma were 70.0%, 60.0%, 46.7%. Their expression tended to the increased greatly compared with the skins of the control groups. There was not correlation between the expression of EGFR, Ki67 and p16 (P > 0.05). It showed statistically significant correlation between expression of EGFR and the ability of erosion of middle ear cholesteatoma (P 0.05). The expression of EGFR, Ki67, p16 in all epithelial layers of middle ear cholesteatoma were abundantly stained, especially in the basal and spinous layers. Only the basal layer were slightly stained in control groups.@*CONCLUSION@#The expression of EGFR, Ki67, p16 in middle ear cholesteatoma was significantly high-er compared with the skin of external auditory of cholesteatoma patients and healthful peoples. There was correlation between the expression of EGFR or Ki67 and the ability of erosion of middle ear cholesteatoma. It means that EGFR, Ki67 and p16 play a key role in the hyperproliferation middle ear cholesteatoma.
