Objective To investigate the patients' radiation dose received in digital radiography (DR) and provide basic data for developing diagnostic reference levels.Methods The patient' s ESD was estimated using the TLDs and DAP was measured by the dose-area product meter.The E values were then calculated by the DAP using Monte Carlo data and RefDose software.Measurements were made for twelve types of examination:skull PA,skull LAT,chest PA,chest LAT,abdomen AP,pelvis AP,cervix spine PA,cervix spine LAT,thoracic spine PA,thoracic spine LAT,lumber spine PA and lumber spine LAT.Results Both kV and mAs varied in the same type of examination for ESD,DAP and E(F =33.47,24.68,43.19,P ＜ 0.05).The dose each time for lumber spine LAT was the highest,reached 4.62 mGy in ESD and 2.26 Gy·cm2 in DAP,respectively.The E of abdomen AP averaged as 0.59 mSv,higher than that of lumber spine LAT.Even for the same type of examination,the dose from each equipment was different.Conclusions DR has the potential to reduce the patients' radiation doses.The guidance levels suitable for Chinese population should be established as soon as possible.

An enrichment culture showing specific algae-lysing activity was isolated from the mixtures of different samples and Microcystis aeruginosa. The process of algal lysis was monitored by chlorophyll measurement, PCR, and denaturing gradient gel electrophoresis (DGGE). The result showed that the enrichment culture had still high algicidal activity against M. aeruginosa after 1/100000 dilution. Rubritepida sp. C1, Pseudomonas sp. C2 and Sphingomonas sp. C3, as accompanying bacteria, existed in M.aeruginosa. The bacterial community in M. aeruginosa showed significant change after adding the enrichment culture, where uncultured Flavorbacterium sp. A2, Sphingomonas sp. C3 and Hydrogenophaga sp. A3 were observed, and A2 became a dominant species. The obvious correlation can be seen between change of bacterial population and extinction of M. aeruginosa. Compared identification of pure bacterium with sequencing of DGGE band, it was inferred that uncultured bacteria were probably play an important role in controlling the growth and abundance of M. aeruginosa.

Objective To compare the single-shot fields irradiated by three focusing modes of γ-knife and explore the approaches for improving the quality of stereotactic radiosurgery.Methods GAFCHROMIC(R) EBT3 mode flushing-free film was used to measure the single-shot fields irradiated by multi-source static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode of γ-knife.Also the uniformity and penumbra of the single-shot fields were compared.Results The 2D dose distribution of the single-shot fields irradiated by three focusing modes of γ-knife was different.In the axis (x,y,z),the rang of penumbra axial length ratios of multisource static focusing modes,multi-source single-axis rotating focusing mode and single-source double-axis rotating focusing mode were 0.13-0.48,0.17-0.33 and 0.28-0.54,in the diagonal direction of the wings plane (NSD,PSD),were 0.31-0.39,0.38-0.43 and 0.54-0.72,respectively;the penumbra axial length ratio of single-source double-axis rotating focusing mode was bigger than in multi-source static focusing modes and multi-source single-axis rotating focusing mode.On the no-wings plane,the area ratios of 80％ dose curve enveloped and 50％ dose curve enveloped(A80％/A50％)were 0.40,0.47 and 0.19,on the wings plane,were 0.61,0.53 and 0.35,respectively.The field uniformity of multi-source static focusing modes and multi-source single-axis rotating focusing mode were superior to single-source doubleaxis rotating focusing mode.Conclusions Considering dose distribution of the single-shot fields,the multi-source static focusing modes devices and the multi-source single-axis rotating focusing mode devices should be preferred,when important tissues and organs are adjacent to the target areas.Compared with single-source double-axis rotating focusing mode,both multi-source static focusing modes and multi-source single-axis rotating focusing mode could make more target areas to be surrounded by high dose region.

Objective:To investigate the clinical value of peripheral monocyte and neutrophil count in predicting the response of patients with metastatic non-small cell lung cancer (mNSCLC) to immunosuppressive checkpoint inhibitors (ICI).Methods:The clinical data of 34 adult mNSCLC patients who received nafulizumab or pabolizumab in Danzhou People's Hospital of Hainan Province from January 2017 to March 2019 were retrospectively analyzed. The correlation of the demographic characteristics, clinical data, hematological examination results in the first two weeks before the treatment and two weeks after ICI treatment with prognosis was recorded and observed.Results:The baseline mean monocyte count [(0.52±0.09)×10 9/L vs. (0.60±0.12)×10 9/L] and neutrophil count [(4.27±0.87)×10 9/L vs.(5.39±1.02)×10 9/L] of patients with ICI reaction were lower than those of patients without ICI reaction, and the differences were statistically different ( t = -2.572, -2.727, all P < 0.05). However, there was a negative correlation between the monocyte count of the patients who responded to ICI and the reaction time ( r = -0.507, P < 0.05). The median reaction time in patients with monocyte count >0.70×10 9/L was shorter than that in patients with monocyte count ≤0.70×10 9/L (8 weeks vs. 12 weeks, χ2=4.162, P = 0.041). There was no correlation between monocyte count and time of reaction duration, progression of free survival (PFS) and overall survival (OS) ( r = -0.214, 0.182, 0.232, all P > 0.05). The decrease rate of neutrophil count in response group was higher than that in non-response group (22% vs. 2%, P < 0.05). After the first administration, cutoff value of neutrophil count was 4.2×10 9/L; the response rate of patients with neutrophil count ≤ 4.2×10 9/L was higher than that of patients with neutrophil count > 4.2×10 9/L [86.7% (13/15) vs. 36.8% (7/19), χ2=6.657, P < 0.05]. Conclusion:Peripheral blood monocyte and neutrophil count can predict the response to ICI therapy in patients with mNSCLC.

Objective To study the method of measuring the position accuracy and the step distance accuracy of afterloading system with192Ir source by using flushing-free film.Methods The position accuracy and the step distance accuracy of a China-made afterloading system with192Ir source was measured by using GAFCHROMIC (R) EBT3 flushing-free film.The film was scanned to proper image format,required by dose analysis software,by EPSON PREFACTION V700 PHOTO scanner.Then images are analyzed by using film dose analysis software in SNC Patient 5.2.Results With focus on the center of active section of source,the position accuracy of this afterloading system with192Ir source was-0.75 mm.Using film analysis could make the step point to tell apart if the step distance was 5 mm away by the method of film analysis,but couldnot make it to tell apart if the step distance was 2.5 mm away.The 2.5 mm step distance accuracy could be judged if the distance between the 1 st point and the 3rd point was 5 mm,then the 2.5 mm step distance could be deemed to no deviation.The 5 mm step distance of this afterloading system had no deviation in continuous 9 step points measured by flushing-free film.The indirect measuring results of the 2.5 mm step distance had no deviation as well.The position accuracy of this afterloading system measured with the flushing-free film accorded with the national standards.Conclusions The method of measuring the position accuracy and the step distance accuracy of the afterloading system with192Ir source by using flushing-free film is technically feasible.

AIM: To assess the accuracy of optical quality analysis system Ⅱ(OQAS Ⅱ)in predicting postoperative visual acuity of cataract patients.

METHODS: Prospective study, patients underwent cataract surgery in Daping Hospital from June 2019 to November 2019 were recruited. According to predicted visual acuity 100%(PVA100%)and best corrected visual acuity(BCVA), patients were dichotomized into group A(PVA100% worse than BCVA, 145 eyes)and group B(PVA100% equal to or better than BCVA, 114 eyes). Visual acuity improvement was compared between the two groups 1mo after surgery.

RESULTS: In group A, visual acuity of 112 eyes(77.2%)improved at least 2 lines. While in group B, 93 eyes(81.6%)improved at least 2 lines. There was no significant difference in visual acuity improvement ratio between the two groups(P=0.394). The average BCVA improvement of group A was 0.3(0.2, 0.4)LogMAR, and that of group B was 0.4(0.2, 0.5)LogMAR, revealed statistically significant differences(P=0.001). No significant correlation was found between preoperative PVA100% and postoperative BCVA in both of the two groups(P=0.888,0.304). In patients combined with preoperative ocular comorbidity, 17 eyes(94.4%)in group A and 26 eyes(65.0%)in group B improved at least 2 lines with significant difference between the two groups(P=0.041). BCVA improved 0.3(0.2, 0.4)LogMAR in group A and 0.3(0.1, 0.5)LogMAR in group B, there was no significant difference between the two groups(P=0.597).

CONCLUSION: The binary classification method based on the value of preoperative PVA100% and BCVA failed to accurately predict who shall benefit more from cataract surgery. In patients diagnosed with preoperative ocular comorbidity, BCVA is likely to be significantly improved if preoperative PVA100% were worse than BCVA. More data are needed to determine the clinical value of PVA100%.

Objective To establish a two-dimensional high-performance liquid chromatography method for the determination of tigecycline in human cerebrospinal fluid, which can be used for the drug monitoring in patients with intracranial infection. Methods The quantification was carried out by an external standard method. The first-dimension column was a Aston SNX5 phenyl chromatographic column (50 mm×4.6 mm, 5 μm) with ammonium phosphate (pH was adjusted with ammonium hydroxide to 7.5)-methanol (45∶55, V/V) as the mobile phase and the flow rate was 1.2 ml/min. The second-dimension chromatographic column was Aston SC5 C₁₈ (275 mm×4.6 mm, 5 μm), with ammonium phosphate (pH was adjusted with ammonium hydroxide to 7.4)-ammonium phosphate (pH was adjusted with ammonium hydroxide to 3.0)- acetonitrile (30∶50∶20, V/V/V) as the mobile phase and the flow rate was 1.0 ml/min. The detection wavelength was 340 nm. The temperature was 40 ℃ and the injection volume was 200 μl. Results The calibration curve of tigecycline showed good linearity from 64.5 to 1 290.0 ng/ml in human cerebrospinal fluid (r=0.999 8). The RSD of intra and inter-day precision were less than 5.0% with the detection accuracy of 98.80%−106.51%. Conclusion This method is simple, quick, accurate, specific and sensitive. It meets the requirements of tigecycline determination in clinical human cerebrospinal fluid, which offers the individualized therapeutic assurance for patients with intracranial infection.

Objective    To evaluate the timing of chest tube removal after resection of lung or esophageal cancer. Methods    A prospective randomized controlled study was performed. From June 2014 to February 2016, 150 patients suspected as the cancer of lung or esophagus undergoing neoplasm resection and lymph node dissection in our single medical unit were classified into 3 groups according to the random number generated by SPSS17.0 with 50 patients in the each group. The drainage volume for chest tube removal was ≤100 mL/d in the group Ⅰ, 101–200 mL/d in the group Ⅱ, and 201–300 mL/d in the group Ⅲ. Chest radiography was performed 48 hours following chest tube removal. Results    The 127 patients (108 males and 19 females, with an average age of 59.0±8.7 years) eligible for analysis consisted of 45 patients in the group Ⅰ, 41 in the group Ⅱ, and 41 in the group Ⅲ respectively after the 23 patients were excluded from this study who were diagnosed as benign lesions through intraoperative frozen pathology (n=20) and postoperative complications (empyema in 2 patients and chylothorax in 1 patient). Age, sex, types of neoplasm, and comorbidities except procedures via video-assisted thoracic surgery (and laparoscopy) showed no significant difference among the three groups (P>0.05). No mortality was observed in this study. There were postoperative complications in 6 patients and its distribution had no statistical differences among the three groups (P>0.05). The mean postoperative duration of chest tube was 181.0±68.2 h, 111.0±63.1 h, 76.0±37.2 h, the mean drainage volume was 1 413.0±500.9 mL, 1 005.0±686.4 mL, 776.0±505.8 mL, and the mean hospital stay time following chest tube removal was 19.0±9.7 d, 14.0±8.0 d, 9.0±4.8 d in the group Ⅰ,Ⅱ and Ⅲ,  respectively; there was a significant difference among the three groups (P=0.000). The 13 patients required reintervention after chest tube removal due to pleural effusion accumulation and it had no difference among the three groups (P>0.05). Chest pain relieved essentially after chest tube removal in all patients. Conclusion    A drainage volume of ≤300 mL/d as a threshold for chest tube removal after resection of lung or esophageal cancer can shorten postoperative hospital stay and accelerate early recovery of the patients.

AIM: To compare the difference and consistency of corneal refractive power and astigmatism measured by CASIA2 and IOL Master 700 in patients with age-related cataract.METHODS: Retrospective study. A total of 153 patients(232 eyes)with age-related cataract admitted to Daping hospital from November to December 2021 were selected. The flat keratometry(Kf), steep keratometry(Ks), mean keratometry(Km), degree and axis of astigmatism(vector representation J0 and J45)of the anterior, posterior surfaces together with the total cornea from cataract patients were measured by CASIA2 and IOL Master 700, respectively. The difference, correlation and consistency of the two instruments were analyzed.RESULTS:There was no significant difference in J45 values of posterior corneal surface measured by CASIA2 and IOL Master 700(-0.006±0.038D vs. -0.005±0.044D, P>0.05), but there were significant differences in other parameters(all P<0.05). All parameters measured by the two instruments were significantly positive correlated(all r/rs>0.7, P<0.001); Bland-Altman analysis showed that the refractive power and astigmatism of the anterior cornea surface measured by the two facilities were in good consistency, while the refractive power of the posterior surface and the whole cornea showed poor consistency.CONCLUSION: CASIA2 and IOL Master 700 showed little differences and good consistency in the refractive power and astigmatism of the anterior, posterior and total corneal surface in cataract patients, which seems interchangeable. However, the refractive power of the posterior surface and the whole cornea has significant differences and poor consistency, which should not be interchange casually.

OBJECTIVETo study the effects of magnesium sulfate on brain mitochondrial respiratory function in rats after experimental traumatic brain injury and the possible mechanism.

METHODSThe middle degree brain injury in rats was made by BIM-III multi-function impacting machine. The brain mitochondrial respiratory function was measured with oxygen electrode and the ultra-structural changes were observed with transmission electron microscope (TEM).

RESULTS1. The brain mitochondrial respiratory stage III and respiration control rate reduced significantly in the untreated groups within 24 and 72 hours. But treated Group A showed certain degree of recovery of respiratory function; treated Group B showed further improvement. 2. Untreated Group, treated Groups A and B had different degrees of mitochondrial ultra-structural damage respectively, which could be attenuated after the treatment with magnesium sulfate.

CONCLUSIONSThe mitochondrial respiratory function decreases significantly after traumatic brain injury. But it can be apparently improved after magnesium sulfate management along with the attenuated damage of mitochondria discovered by TEM. The longer course of treatment can obtain a better improvement of mitochondrial respiratory function.

Animals ; Brain Injuries ; drug therapy ; physiopathology ; Cell Respiration ; drug effects ; physiology ; Culture Techniques ; Disease Models, Animal ; Hypoxia-Ischemia, Brain ; drug therapy ; physiopathology ; Magnesium Sulfate ; pharmacology ; Male ; Mitochondria ; drug effects ; physiology ; ultrastructure ; Oxygen Consumption ; physiology ; Random Allocation ; Rats ; Rats, Wistar ; Reference Values ; Sensitivity and Specificity