Purpose To evaluate the diagnostic efficiency of spectral CT imaging combined with oral isotonic mannitol gastrointestinal hypotonic radiography in the diagnosis of preoperative T and N staging of rectal carcinoma. Materials and Methods Forty-seven patients with rectal cancer confirmed by surgery and pathology were included in this study, all the subjects underwent oral isotonic mannitol gastrointestinal hypotonic radiography prior to CT scan, then abdominal and pelvic plain and double-phase contrast-enhanced CT scan in the spectral imaging mode was performed, the optimal contrast-to-noise ratio imaging were got by the spectrum analysis software, then T-stage was evaluated and compared with pathological T-stage; N-stage was evaluated using both traditional method and the spectral curve method, and compared with pathological N-stage. Results ① All the 47 patients were able to successfully complete the examination and the rectal filling and lesion display were satisfactory; ② the best diagnostic accuracy of T-stage by the monochromatic images was 83.0% (39/47), which had a general correlation with pathologic results (Kappa=0.713, P<0.001); ③ the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of N-stage by the traditional method were 78.72%, 80.95%, 76.92%, 73.91% and 83.33%, respectively, which had a general correlation with pathologic results (Kappa=0.574, P<0.001); the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of N-stage by the Spectral curve method were 89.13%, 75.00%, 100.00%, 100.00% and 83.87%, respectively, which had a fair correlation with pathologic results (Kappa=0.772, P<0.001). Spectral curve method had higher Youden index for N-stage evaluation than traditional method (0.64 vs. 0.58). Conclusion Oral isotonic mannitol gastrointestinal hypotonic radiography can provide a good rectal background, and it is a safe and reliable method for rectal examination, when combined with spectrum CT imaging, it is able to display the detail of lesions and identity the homology of lymph nodes, which might help to make more accurate preoperative T, N staging of rectal carcinoma.

Objective:To compare the effect of intraoral and extraoral approach for the sugical treatment of mandibular cysts in the angle and ramus. Methods:Cysts in the mandibular angle and ramus were treated by intraoral approach in 57 cases and extraoral in 18 cases. The following data were collected: operation time, peroperative blood loss, postoperative infection, mouth opening, recurrence rate, injury of the submandibular branch of the facial nerve and sensory function of the inferior alveolar nerve. The data of the two groups were compared statistically. Results:Average operation time (min) of intraoral and extraoral appoarch was 84.65?5.16 and 122.78?10.84(P0.05). Conclusion:Intraoral approach is effective in the treatment of cyst in mandibular angle and ramus.

Objective To research the structure and principle of Helical Tomotherapy, and study the clinical application value of the equipment system. Methods As the first helical radiotherapy system in the mainland of China, its constructions, structure and principle were analyzed and discussed. Results Helical Tomotherapy is a new kind of radiotherapy equipment. The Hi-Art treatment system is a combination of a LINAC and a CT scanner capable of having the function of both systems. It was approved to achieve the best intensity modulated radiation therapy (IMRT), used for adjusting the setup position of the patient with MVCT and as the basis for dose reconstruction and other adaptive radiotherapy processes. It is the first integrated planning, delivery and verification system for IMRT. Conclusion Image-guided radiation therapy (IGRT) and IMRT have introduced a new era in radiation oncology which will better fight cancer and simultaneously improve the patients' quality of life. Having been designed from the ground up for IGRT and IMRT, the tomotherapy system is in the forefront of technical advancements for efficacy and processes to make it efficiently.

Objective:To evaluate the efficacy of Piezosurgery in split teeth extractions.Methods:A single-center,randomized,split-mouth study was performed using a consecutive serious of unrelated healthy patients attending the departing of oral and maxillofacial surgery,Peking University School and Hospital of Stomatology.40 patients were selected for extraction of maxillary molars without reservation value,splitting or nonvital teeth.They were divided into control (20 patients)and test groups (20 pa-tients)randomly.Surgical treatments for both groups were under local anesthesia.Molar teeth of control group were extracted by common equipments like dental elevators,chisels,forceps,etc.While molar teeth of experimental group were extracted by Piezosurgery,aided with the use of common equipments if needed.Then we compared the duration of surgery,frequency of the usage of chisels,expansion of post-operative bony socket surgical discomfort and postoperative pain between two groups.Results:The ave-rage of operation time was (629.5 ±171.0)s in control group and (456.0 ±337.2)s in test group.The buccal alveolar bone reduced (1.07 ±0.64)mm in control group and (1.49 ±0.61)mm in test group. There was a significant difference between the two groups (P <0.05).The duration of surgery for experi-mental group was significantly longer than that of the control group,but the change of buccal alveolar bone was lower than the control group.For visual analogue scale (VAS)value of surgical discomfort,ex-pansion of postoperative bony socket and the operative fear rate,there were no significant difference be-tween the two groups (P >0.05).Conclusion:Piezosugery can be better to preserve alveolar bone,re-duce trauma and patient’s fear.Application of the piezosugery reflect the characteristics of minimally in-vasive extraction,which has the value of promotion.The Piezosurgery technique have the advantage of re-ducing change of buccal alveolar bone during the surgery,but a longer surgical time was required when compared with the conventional technique.VAS value of surgical discomfort,expansion of postoperative bony socket and the operative fear rate,there were no significant difference.Minimally invasive tooth ex-traction technique has good clinical results and high satisfaction.Piezosurgery proved its worth as the in-strument adapted to limiting the destruction of bone tissue.

Objective:To investigate the value of quantitative CT (QCT) body component parameters before and after transcatheter arterial chemoembolization (TACE) as prognostic indicator for patients with hepatic cell carcinoma (HCC).Methods:Retrospective analysis was performed on 40 patients with advanced HCC who received TACE treatment in Anhui Provincial Hospital Affiliated to Anhui Medical University from November 2013 to May 2017, all of them received QCT scanning before and after treatment. The information were recorded, including gender, age, alpha-fetoprotein (AFP), TNM stage, liver function Child-Pugh grade, portal venous thromboembolism, cirrhosis, maximum tumor diameter, tumor type, and frequency of interventional therapy. QCT parameters were measured before and after treatment, including L1, L2 bone mineral density (BMD), L3-level paravertebral muscle area (MA), subcutaneous fat area (SFA) and visceral fat area (VFA), and the change rate of QCT parameters (ΔBMD, ΔMA, ΔSFA, ΔVFA) before and after TACE were calculated after the QCT scan interval was standardized. The cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were obtained by drawing the ROC curves. The Kaplan-Meier method was used to calculate the survival rate, the Log-rank method was used for univariate analysis, and the Cox regression analysis model was used for multivariate analysis to screen out independent factors affecting the prognosis of HCC patients after TACE.Results:ROC curve analysis showed that the cut-off values of ΔBMD, ΔMA, ΔSFA and ΔVFA to diagnose the prognosis of HCC patients after TACE were -8.64%, -6.84%, -9.84% and 5.70%, respectively. Univariate analysis showed that AFP, TNM stage, liver function Child-Pugh grade, portal venous thrombosis, tumor type and ΔMA, ΔSFA, ΔVFA had statistically significant effects on prognosis ( P<0.1). Multivariate analysis showed that ΔMA, ΔVFA and portal venous thromboembolism were independent influencing factors for the prognosis of HCC patients after TACE treatment ( P<0.05). Conclusions:ΔMA, ΔVFA and portal venous thromboembolism have reference value for prognosis assessment of TACE treatment for HCC patients, and QCT body composition analysis is helpful to evaluate the prognosis of HCC patients.

3-year practice and questionnaire of the graduates majoring in ophthalmology indicate ophthalmologic typical case image implicates very much clinical information,can satisfy ophthalmologic clinical skills test,reflect examinee's clinical knowledge and technical skill level and guide intern to cultivate clinical thinking capability.

Objective:To understand the clinical features of osteonecrosis of the jaw after bisphospho-nates use for therapy of breast cancer patients with bone metastasis.Methods:The cases diagnosed as bisphosphonates-related osteonecrosis of the jaws (BRONJ)were retrospectively analyzed from January 201 1 to August 201 5 in the Peking University School and Hospital of Stomatology,and those breast cancer patients with bone metastasis were selected.The clinical symptoms,imaging characteristics and treatment results were summarized.Results:A total of 1 4 cases of breast cancer patients with bone me-tastasis were selected,with an average age of 60.21 years.The average time of suffering from breast cancer was 9 .77 years,and the average time of bone metastasis and bisphosphonates drugs use was 5 .67 and 3 .29 years individually.There was no patient with systemic application history of hormone therapy, and no history of diabetes.There were 9 patients with tooth extractions history,and the mean time of bone necrosis symptoms was 8.58 months.There were 1 0 cases with bone necrosis occurring on mandi-ble,3 cases on maxilla,and one case with both upper and lower jaws involved.Among the 1 0 patients with surgical treatment,there were 3 cases cured,and 6 cases improved.However,the clinical symp-toms of 2 cases with conservative treatment were significantly aggravated.Conclusion:The medication time between the bisphosphonates use beginning and the occurrence of BRONJ is relatively long.The his-tory of diabetes and long-time hormone use did not exist in this group.Tooth extraction itself does not de-termine the severity of BRONJ.Mandible is the most common site involved by BRONJ.Surgical treatment can alleviate the clinical symptoms of BRONJ with breast cancer to some extent.

Objective To evaluate the dosimetric characteristics of helical tomotherapy (HT),intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiotherapy of rectal cancer.Methods Ten male patients with stage Ⅱ or Ⅲ middle or low position rectal cancer were selected retrospectively.All of the 10 patients underwent Dixon surgery and CT simulation orientation.The target volumes and normal organs were drawn in the CT images and the plans for HT,IMRT and 3D-CRT were designed.The prescribed dose was given 50 Gy in 25 fractions,covering at least 95％ of the planning target volume.Results All plans met the needs of the prescribed doses.The HT and IMRT plans met the needs of dose limit to organs at risk,however,the 3D-CRT plans failed to do that.The conformity indexes of HT,IMRT and 3D-CRT plans were 0.86,0.82 and 0.62,respectively (F =206.81,P ＜ 0.001),and the homogeneity indexes were 0.001,0.157,and 0.205,respectively (x2 =15.8,P ＜ 0.001).The 3D-CRT plans had larger volumes than the HT plans and IMRT plans in the high-dose regions such as pelvic V50,bladder V40,bowel V50 and femoral head D5 (P ＜ 0.05),but the differences between the HT plans and IMRT plans were not statistically significant (P ＞0.05).The V15 value of bowel of HT plans were higher than those of the IMRT and 3D-CRT plans (71.1％ vs.63.3％ and 67.7％,respectively).However,there was no significantly difference.Conclusions All of the HT,IMRT and 3D-CRT plans are able to meet the prescription dose requirement of the target regions of rectal cancer.The HT plans show the best dose homogeneity and target conformity,followed by the IMRT plans,and then the 3D-CRT plans.The HT plans meet the needs of all OARs slightly better than the IMRT plans.3D-CRT plans are simple and practical with poor protective ability toward the OARs.

The aim of this study is to synthesize the ordered mesoporous silica (OMS) as drug carrier to improve release property of insoluble drug and investigate the dissolution profile of insoluble drug from the porous carrier. The OMS was obtained by using cetyltrimethyl ammonium bromide as the template and resveratrol was selected as the model drug. The resveratrol-loaded OMS (Res-OMS) were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), N2 adsorption-desorption, X-ray diffraction (XRD) and FT-IR spectroscopy. In vitro drug release behavior was also investigated. It was found that the synthesized OMS showed a large surface area, a narrow pore size distribution and an important mesoporosity associated to hexagonally organized channels. Compared with physical mixture and crystalline powder, resveratrol was in amorphous or molecular form after loading into OMS. The release rate ofresveratrol from drug-loaded OMS was significantly increased suggesting the great potential application of OMS for the formulation of poorly soluble drugs.

Objective: To evaluate the targeting activity in the animal model with human hepatoma, the 131I-human antiHBsAg Fab radioimmunoimaging was explored. Methods: Radioimmunoimagings were taken on different intervals after injection of 131 I-human anti-HBsAg Fab to the nude mice and tissue distribution was measured. The human anti-HBsAg Fab was compared with the murine monoclonal antibodies. Results: The experimental group developed tumor positive images after 3 days of radio-labeled monoclonal antibodies injection, and the peak accumulation of radio-activity on the 5th day.Statistics indicated the tumor/liver ratio of the human anti-HBsAg Fab, murine monoclonal antibodies and the control groups were 5.4,4.0 and 0.9 respectively on the 7th day. Conclusions: Our results suggest that the 131 I-human anti-HB-sAg Fab has a considerable targeting activity, and provide an evidence that it can be used as a novel humanized carrer for targeting therapy of hepatoma.