AIM: To investigate the effect of Ginkgo biloba extrac (GBE) on cerebral ischemia during early stage of subarachnoid hemorrhage (SAH). METHODS: Noncraniotomy models of SAH in Wistar rats were used and animals were divided into sham-operated group, SAH group and SAH+GBE group. Dynamic change of regional cerebral blood flow (rCBF) was detected. Brain endothelin-1(ET-1) and calcium contents were also determined at different time point during 24 hours after the operation. Pathological change of neurons of hippocampus CA1 region was observed. RESULTS: In SAH group, rCBF decreased immediately and persistently after induction of SAH. Values of brain ET-1 content and calcium content at 1 hour, 6 hours and 24 hours were significantly higher than those in sham-operated group. Neurons of hippocampus CA1 region were damaged severely 3 days after onset of SAH. Above abnormal changes in SAH+GBE group were much slighter than those in SAH group. CONCLUSION: GBE may relieve cerebral ischemic damage after SAH.

Objective To evaluate the accuracy of systolic pressure variation (SPV) in monitoring blood volume in patients.Methods Twenty-two ASA Ⅱ or Ⅲ patients (17 male,5 female),aged 49-79 yr,with body height 153-173 cm,weighing 55-89 kg,scheduled for elective coronary artery bypass grafting under cardiopulmonary bypass,were studied.Stroke volume variation (SVV) was monitored based on the arterial pressure wave and SPV measured based on the invasive arterial pressure wave after changing the title.After the chest was closed,the volume load test was immediately carried out.6％ hydroxyethyl starch 130/0.4 50-80 ml/min was infused via the jugular vein until cardiac index (CI) increased by 10％.HR,mean arterial pressure (MAP),SPV,CI,SVV,stroke volume index (SVI),systemic vascular resistance index (SVRI),central venous pressure (CVP),and pulmonary capillary wedge pressure (PCWP) were recorded in supine position (T1),at 30° head-down tilt before skin incision (T1'),before (T2) and after opening the chest in supine position (T2'),before (T3) and after the volume load test in supine position after closing the chest (T3'),in supine position after skin closure (T4),and at 30° head-down tilt after skin closure (T4').The difference in SPV and SVV (△SPV and △SVV) was calculated.The receiver operator characteristic curve for △SVV and △ SPV in determining blood volume changes was plotted.Results MAP,CVP,PCWP,CI,and SVRI were significantly increased,while SVV and SPV were decreased at T1' compared with those at T1 (P ＜ 0.05).HR was significantly increased,while CVP was decreased at T2' compared with those at T2 (P ＜ 0.05).MAP,CVP,PCWP,and CI were significantly increased,while SVV and SPV were decreased at T3' compared with those at T3 (P ＜ 0.05).MAP,CVP,and PCWP were significantly increased,while SVV and SPV were decreased at T4' compared with those at T4 (P ＜ 0.05).The area under receive operator characteristic curve for △SVV and △SPV in determining blood volume changes was 0.603 and 0.616 respectively,and there was no significant difference (P ＞ 0.05).Conclusion SPV can accurately monitor the blood volume in patients.

AIM: To investigate the role of nitric oxide in the development of brain edema after subarachnoid hemorrhage(SAH), and the influence of L-arginine on them. METHODS: Noncraniotomy models of SAH in Wistar rats were used and animals were divided into sham-operated group, SAH group and SAH plus L-arginine group. Dynamic changes of regional cerebral blood flow within 24 hours were measured. Serum nitric oxide level, brain water and sodium content at different time points within 24 hours were also detected. RESULTS: Regional cerebral blood flow and serum nitric oxide level at every time point after operation in SAH group were lower than those in sham-operated group, while brain water content and sodium content in the former group were higher than those in the latter group. Above pathological alterations in SAH plus L-arginine group were not so obvious as in SAH group. CONCLUSION: Decrease in serum nitric oxide plays a role in the development of brain edema after SAH, which may be partly reversed by administration of L-arginine.

Objective To investigate the plan quality between two treatment planning systems (TPSs) for volumetric modulated arc therapy (VMAT). Methods VMAT plans based on Varian Eclipse and Philips Pinnacle TPS were designed for 10 cervical cancer patients (2, 3 Arcs) and 10 prostate cancer patients ( 1, 2 Arcs) . The delivery system of VMAT was Varian ClinaciX machine, and RapidArc was used. The treatment plan quality between the two TPSs was evaluated based on dose distribution, delivery efficiency, and parameter settings. The differences between the two TPSs were compared using paired t-test. Results For cervical cancer patients, the 2-Arc VMAT plans based on the Pinnacle was slightly better than those based on the Eclipse in terms of the conformal index ( CI) of planning target volume ( PTV) , rectum V30 and V40 , and bladder V30 and V40 , and the homogeneity index ( HI) of PTV and PTV1 as well as CI of PTV1 in the Eclips were slightly better than those in the Pinnacle( P<005) Pinnacle were slightly worse than those in the Eclipse ( P>005) . The number of monitor units with 2-Arcs and 3-Arcs plans of the Eclipse was significantly smaller than those in the Pinnacle (P<005). For prostate cancer patients, The 1-arc VMAT plans of the Pinnacle TPS were slightly superior to those of the Eclipse TPS in terms of the HI of PTV, rectumV30 and V40 , and bladderV30 and V40 , but the former was slight inferior to the latter in terms of the CI of PTV (P<005). The number of monitor units of 1-arc and 2-Arcs plans showed no significant difference between the two TPSs (P>005). Conclusions For patients with cervical cancer and prostate cancer, the VMAT plans based on Varian Eclipse and Philips Pinnacle TPS can achieve a clinically acceptable dose distribution and show a little difference in the treatment plan quality. However, we will still need more cases to further study and determine the performance characteristics of the commercial TPSs for optimizing VMAT.

To study an automatic plan(AP) method for radiotherapy after breast-conserving surgery based on TiGRT system and and compare with manual plan (MP). The dosimetry parameters of 10 patients and the evaluation of scoring table were analyzed, it was found that the targets dose of AP were better than that of MP, but there was no statistical difference except for CI, The V5, V20 and V30 of affected lungs and whole lungs in AP were lower than all that in MP, the Dmean of hearts was slightly higher than that of MP, but the difference was not statistically significant, the MU of AP was increase by 16.1% compared with MP, the score of AP evaluation was increase by 6.1% compared with MP. So the AP could be programmed and automated while ensuring the quality of the plan, and can be used to design the plans for radiotherapy after breast-conserving surgery.
Breast Neoplasms/surgery* ; Female ; Humans ; Mastectomy, Segmental ; Organs at Risk ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; Radiotherapy, Intensity-Modulated