Objective To evaluate the efficacy of embolization for spinal intramedullary arteriovenous malformations.Methods 25 patients with spinal intramedullary arteriovenous malformations (AVMs) were reviewed. Embolic therapy was conducted in 4 patients by introducing the tip of a catheter into the segmental arteries and injecting lyophilized dura or polyvinyl alcohol(PVA). Microcatheter were navigated into the feeding arteries and injected PVA in 9 patients, and NBCA in 7 patients. Embosphere was used after embolizing an aneurysm in the feeding artery with NBCA in one pateint. Results Spinal angiography immediately after embolization disclosed that the lesion were obliterated almost entirely in 12 cases and partially in others. The anterior or posterior spinal artery was preserved in all patients recently. The clinical follow-up period after embolization ranged from 6 to 60 months. 16 patients improved but four patients did not show any improvement.Conclusions Embolization appears to be the treatment of first choice in the management of juvenile or partial glomus AVMs which are not amenable to surgery.

Objective To evaluate the treatment of spinal cord vascular malformations by endo vascular therapy. Methods All 41 patients including 3 cases were embolized by 3 0 silk line segments, 14 cases by selective embolization of dry dura particles, 16 by PVA and 8 cases by NBCA. Results Lesions were completely embolized in 27 cases, and partialy embolized in 14 cases. Paralysis of limbs were significantly improved in 36 cases, the other 5 cases showed no improvement on account of previous resection of the lesions. During 32 months follow up period, 18 cases recovered completely but with recurrence in 5. Conclusion Endovascular therapy is effective for spinal cord vascular malformations.

90%) in 57, 70%-90% in 27 cases, 50～70% in 8 cases,

Somatosensory evoked potential(SEP) monitoring was performed intraoperatively in 28 patients with extramedullary or intramedullary tumors.Dissection of intramedullary tumor usually leads to decrease of amplitude and increase of latency in SEP. SEP reappeared at the end of operation in 2 cases of Frankel A grade extramedullary tumors whose SEP disappeared during operation with functional recovering to some degree. In 2 cases of Frankel B and C grade intramedullary tumors, the amplitude of SEP decreased by more than 40% and the latent period in SEP increased by more than 5% during operation,and the surgical procedure was paused for a while.There was slight reversible injury of nerve post operatively. In 8 of 12 cases of Frankel D and E grade intramedullary tumors, the amplitude of SEP descended nearly by 50% and elongation of latency in SEP was about 7% during surgery. SEP was reduced lightly in other 4 cases and all achieved good recovery. Intraoperative monitoring of spinal SEP and cortex SEP can reflect the change of spinal function, reduce post operative complication, and predict prognosis.

Purpose: Simulating calculation the dose distribution of the total body irradiation (TBI) with three dimension treatment planning system(3D-TPS ). Materials and Methods: For TBI, the source skin distance(SSD) is 380 cm, field size is 40 cm × 40cm, and collimator angle is 45°. The percent dose depth (PDD) and onset axis ratio (OAR) of the linac accelerator is measured with the big water phantom self-made. In the same radiation condition, the PDD and OAR of water which is simulated calculation with the 3D-TPS is compared with the measurement results to confirm whether the 3D-TPS can calculate the TBI dose distribution. The dose distribution of the human phantom is calculated with 3D-TPS, which is compared and confirmed with the film and TLD measurements. Results: The maximum error of PDD and OAR in the water phantom between the measurements and calculations of 3D-TPS are 3% and 6%. The calculation results of the 3D-TPS is according with the measurement results of the film and TLD approximately. Conclusions: 3D-TPS could simulate calculation the dose distribution for TBI accurately. It is possible to improve more uniform dose for TBI with corresponding compensator for specific patient.

Objective To compare the setup errors of the negative pressure vacuum air cushion (vacuum bag) and the Orfit body foam fixator (Orfit frame) in radiotherapy for cervical cancer.Methods A total of 40 patients receiving three-dimensional radiotherapy for cervical cancer were enrolled in this study and equally and randomly divided into vacuum bag group and Orfit frame group.And the two groups were divided into Orfit-1 group, Orfit-2 group, vacuum-1 group, and vacuum-2 group according to the treatment course.The Orfit-1 group and vacuum-1 group were the data in the first 12 treatments, while the Orfit-2 group and vacuum-2 group were the data in the following 13 treatments.A cone-beam computed tomography scan was performed before each treatment to analyze setup error and then the body position was corrected to start the treatment.Comparison of continuous data between groups was made by paired t-test, while comparison of categorical data was made by chi-square test.Results There was a significant difference in the setup error in y-axis direction between the Orfit-1 group and the Orfit-2 group (P=0.003) and the setup error in r-axis direction between the vacuum-1 group and the vacuum-2 group (P=0.013).There were no significant differences in the setup errors in four directions (x-axis, y-axis, z-axis, and r-axis) between the Orfit-1 group and the vacuum-1 group (P>0.05).There were significant differences in the setup errors in y-axis and z-axis directions between the Orfit-2 group and the vacuum-2 group (P=0.007;P=0.001).Conclusions The Orfit frame and the vacuum bag have their own advantages and disadvantages in the fixation of body position in radiotherapy for cervical cancer.The setup error can be improved by long vacuum bags, ultrasound bladder capacity scanner, image-guided radiotherapy, or sectional radiotherapy plan.

Objective To monitor and compare the breathing mechanics on PC,VC and PRVC during pneumoperitoneum,and to discuss the significance of the clinic use of PRVC.Method Ninety laparoscopic cholecystectomy patients were equally divided into 3 groups (PC,VC,PRVC).Levels of PES,PAWM,PAP,PaCO2,ETCO2,TV MAP and HR were detected before pneumoperitoneum,and at 5,10,15 and 20 minutes postpneumoperitoneum.Results Pneumoperitoneum made three respiratory patterns with different levels of PAWM,PAP,and PES.PES post-pneumoperitoneum in the VC model was obviously higher than that in the PC and PRVC group.At 10 min post-pneumoperitoneum,levels of PaCO2 and ETCO2 increased obviously in the PC and VC group(P ＜ 0.05).Levels of PaCO2 and ETCO2 were increased in the PC group,but TV level post-pneumoperitoneum was significantly lower than that in the other two groups (P ＜ 0.05).Level of PaCO2 and ETCO2 were increased in the PC and VC group post-pneumoperitoneum,along with increases of MAP and HR (P ＜ 0.05).Levels of MAP and HR in the PRVC group post-pneumoperitoneum were significantly lower than those in the PC and VC group (P ＜ 0.05).Conclusion PRVC mode can effectively reduce the increases of pneumoperitoneum-induced PAWM,PAP,PES,without the unusual increase of PaCO2 and ETCO2 during surgeries,contributing to the stability of vital signs of perioperative patients.

Objective To evaluate the clinical efficacy of Qilinxintongshu pill for treatment of critical patients with unstable angina pectoris (UAP) accompanied by upper alimentary tract damage.Methods A prospective randomized controlled trial was conducted. A total of 60 critical outpatients or inpatients with confirmed diagnosis of UAP accompanied by upper alimentary tract damage in Cardiology Department of Hospital of Traditional Chinese Medicine of Qionghai City from November 2011 to January 2015 were enrolled in the study, and they were assigned to a therapy group (30 cases) and a control group (30 cases) by table of random number. The conventional medical basic therapy was given to both groups, in addition, the patients in therapy group took Qilinxintongshu pill (made of notoginseng, dragon's blood, fruit of immature citron, etc.) 5 g once, three times a day, and the patients in control group orally administered clopidogrel 75 mg once a day, the therapeutic course being consecutive 30 days. After treatment, the rates of main cardiovascular events [including death, a newly-happened myocardial infarction (MI), and obstinate ischemia] and events of alimentary damage were compared between the two groups, and adverse effects were observed.Results There was no statistically significant difference in incidence of cardiovascular events between the therapy group and control group [6.7% (2/30) vs. 16.7% (5/30),P > 0.05]. The incidence of massive hemorrhage of gastrointestinal tract was significantly lower in therapy group than that in control group [10.0% (3/30) vs. 36.7% (11/30),P < 0.05]. In the treatment process, there was no significant untoward side effect, and no abnormalities in routine blood and urine tests, liver and renal functions were found.Conclusion Qilinxintongshu pill for treatment of critical patients with UAP accompanied by upper alimentary damage is safe and effective, and does not enhance the incidence of massive hemorrhage of gastrointestinal tract.

Objective:To standardize the naming of organ at risk (OAR) and target area during cervical cancer radiotherapy based on AAPM TG-263.Methods:After self-programming of Matlab software to implement the reading and resolution of radiotherapy structure files, the naming of each substructure was automatically output, recorded and restored. After naming all substructures, the structure names were classified by keywords. According to TG-263, a standard naming conversion table of OAR and target area was developed, and the classified structure names were standardized through procedures. Finally, the standardized named radiotherapy structure files were output and imported into the treatment planning system (TPS).Results:The radiation structure of 144 patients with cervical cancer was successfully transformed and displayed correctly in TPS. Before the transformation, the naming of OAR and target area lacked of uniform norms and standards, and the naming of the same structure significantly differed. After the transformation, 43 naming methods of OAR and 74 naming methods of the target area were unified into 20 and 8 naming methods, which were more convenient for staff understanding and communication.Conclusion:The standardization of cervical cancer radiotherapy structure naming can reduce the inconsistency of naming and provide reference for the standardized naming of pelvic tumors.

Objective:To investigate the clinical feasibility of the Unity radiotherapy system guided by magnetic resonance imaging.Methods:Twenty-four patients were enrolled and received a total of 384 fractions of treatment at Unity system. According to the treatment site, all patients were divided into head-neck, abdomen-thorax, pelvic, spine and limb groups. The patients were set-up without external laser. And then, the time required at different stages in online treatment process and the registration error of each fraction were separately calculated. The geometric deformations of MR images were weekly measured by using MR geometric deformation phantom. At last, the Arccheck was used to perform the dose verification of reference plan, online plan and offline plan.Results:The mean duration of radiotherapy in the five groups were 29.1, 27.6, 26.6, 25.6 and 32.0 min, respectively. The set-up errors in the left-right, superior-inferior and anterior-posterior direction in the five groups were: head-neck group (0.08±0.06 cm, 0.16±0.13 cm, 0.08±0.05 cm), abdomen-thorax group (0.23±0.18 cm, 0.50±0.47 cm, 0.12±0.1 cm), pelvic group (0.25±0.19 cm, 0.32±0.25 cm, 0.11±0.09 cm), spine group (0.46±0.38 cm, 0.26±0.26 cm, 0.13±0.07 cm) and limb group (0.33±0.30 cm, 0.34±0.23 cm, 0.08±0.06 cm), respectively. In the central region, the geometric deformation of MR was less than 0.3 mm, and that of the sphere with a diameter of 500 mm was less than 2.1 mm. The meanγ pass rate of the reference plan, online plan and offline plan were 97.92%, 97.84% and 94.58%, respectively.Conclusions:MR-guided radiotherapy has great potential for clinical application, whereas the process of Unity system is relatively complex. The synergy of different departments has a great impact on the treatment, which needs further optimization.