To realize temperature real-time control in microwave heat treatment, this paper presents a new type of thermal dosimeter on hyperthermia. The sign of temperature is extracted by mini-thermal-electronic-couple transducer, amplification circuit and main magnifier. The bond of temperature controlling and thermal therapy is achieved, the experimental prototype of thermal dosimeter equipment is developed and clinical experiment scheme is designed. The whole system is simple in structure, high in efficiency and reliability.

Objective To investigate the effects of preoperative parecoxib on the levels of inter-leukin 6 (IL-6)and postoperative analgesia for breast surgery.Methods Sixty breast cancer patients undergoing mastectomy were randomly divided into two groups:parecoxib group (group P)and con-trol group (group C),n=30 in each group.All patients received sevoflurane and fentanyl anesthesia. Group P was injected parecoxib 40 mg at 10 minutes before induction of anesthesia,meanwhile group C was injected saline 5 ml.All patients received postoperative patient-controlled intravenous analgesia (PCIA)with fentanyl.VAS scores for pain were assessed at postoperative 2,4,8,12,24 hours. The serum levels of IL-6 were measured by ELISA at 10 minutes before induction,4 h,8 h,and 24 h after surgery.Results Group P had lower VAS scores than group C at 2-12 h after surgery (P <0.05).Compared with 10 minutes before induction,the levels of IL-6 increased significantly at post-operative 4,8,24 h in two groups (P<0.01),while group P had lower levels of IL-6 than group C (P <0.01).Conclusion Preoperative administration of parecoxib has a stronger analgesic effect in breast cancer patients after mastectomy,and decreases the levels of IL-6.

Objective To study the characteristics of patients with acute arsine poisoning and its possible treatments. Methods The only use of drugs,or drugs with plasma exchange(PE)were used to treat 36 patients with acute arsine poisoning.The blood haemolysis,enzymes of creatinc kinase(CK),lactate dehydrogenase(LDH),alkaline phosphatase (ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),?-hydroxybutyric dehydrogenase(HHBD), total bihrubin(TBIL),indirect bilirubin(IBIL),direct bilirubin(DBIL),blood urea nitrogen(BUN),serum creatinine (Cr)were observed.Results There was an exposure time-effect relation in clinical characteristics,and a linear correlation between the concentrations of arsenic in blood and urine(r=0.718,P=0.019),but no significant correlations were found between the concentrations of arsenic in blood or urine with CK,LDH,ALP,ALT,AST,HHBD,TBIL,IBIL, DBIL,BUN,Cr(P＞0.05).In patients with severe acute arsine poisoning,PE quickly controlled hemolysis within 24 hours,and prevented secondary damage in kidney and other organs,oliguria stage got much shorter,and CK,LDH,ALP, AST,HHBD,TBIL,IBIL,BUN significantly reduced at 24 to 72 hours after PE treatment(P＜0.05).Conclusions The only use of drug was enough for the treatment of mild acute arsine poisoning.To the patients with severe acute arsine poisoning,PE may be an effective method to control its blood hemolysis and prevent complications,which should be taken as early as possible.

OBJECTIVE: To evaluate the therapeutic effect of transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine for the treatment of limb ischemia. METHODS: Twenty-three patients with limb ischemia were treated. G-CSF was used to stimulate the bone marrow. The mononuclear cells were separated from the aspirated bone marrow fluid in the stem cell studio. The cell amount was above 1x10(9). The transplantation was performed by the way of intra-muscular multi-injection. Traditional Chinese medicine for replenishing qi to activate blood was prescribed from the first day after operation. The pain, poikilothermia, ulcer or necrosis and ankle/brachial index (ABI) of the ischemic limb were evaluated before and after the treatment. RESULTS: The pain score and poikilothermia score decreased one month after the transplantation, with distinct differences as compared with the scores before the treatment (P<0.05). The ABI increased gradually after the treatment, and one month after the treatment, it was 0.15 higher than that before the treatment. CONCLUSION: Transplantation of autologous bone marrow mononuclear cells combined with traditional Chinese medicine can decrease the symptoms and signs of severe lower limb ischemia effectively, and improve the circulation of the ischemic area.

Objective To investigate the value of local progression-free survival (LPFS) for evaluating the local long-term outcome of peripheral lung cancer treated by cyberknife.Methods Retrospective analysis was performed on the clinical records of 81 cyberknife-treated lung cancer patients (90 foci),including 43 primary lung cancer patients (43 foci) and 38 metastatic lung cancer patients (47 foci).Of all the patients,58(63 foci) were treated at a dose of 60 Gy/3 fractions (20 Gy/fraction),and 23 (27 foci) at a dose of 54 Gy/3 fractions (18 Gy/fraction).The short-term treatment outcome and LPFS were used as the indices for observation;a logistic regression was used for analyzing the predictive value of LPFS for local long-term treatment outcome.Results After the evaluation of short-term treatment outcome,63％ of all the foci needed further evaluation.As the follow-up lasted,the number of foci which needed further evaluation decreased,most rapidly during 0.5-2 years after treatment.Re-evaluation results had predictive value for the treatment outcome in the subsequent follow-up,but the predictive value declined as the follow-up lasted.Conclusions LPFS is a recommendable index for evaluating the local outcome of primary or metastatic lung cancer treated by cyberknife,and it also has predicative value for local long-term treatment outcome.

Objective To investigate the impacts of fiducial tracking and X-sight tracking on the short-term therapeutic effect of cybernikife in the treatment of lung cancer.Methods Retrospective analysis was performed on 64 lung cancer patients (72 lesions),including 40 primary tumor patients (41 lesions) and 24 metastatic tumor patients (31 lesions),who were treated with cyberknife.Fiducial tracking was used for 45 lesions,while X-sight tracking was used for 27 lesions.The planning target volume was covered by 70％-94％ (median 80％) isodose contour.The irradiation dose was 60 Gy/3 fractions.The relationship between short-term therapeutic effect and tracking method was determined.Results Overall,the lesions undergoing fiducial tracking showed significantly higher response rate than those undergoing X-sight tracking (93％ vs.74％,x2 =6.84,P=0.033),and so was in lower lung lesions (15％ vs.7％,x2 ＝7.18,P=0.028).But the two tracking methods achieved similar effects in upper lung lesions (28％ vs.12％,x2 =2.36,P =0.310).In the lesions with treatment volumes smaller than 15 cm3,the fiducial tracking achieved significantly higher response rate than the X-sight tracking (25 ％ vs.12％,x2 =6.53,P =0.038),but the two tracking methods achieved similar effects in the lesions with treatment volumes not smaller than 15 cm3 (17％ vs 8％,x2 =1.57,P =0.460).Overall,the lesions undergoing X-sight tracking had significantly highertreatment failure rate than fiducial tracking (1 9 ％ vs.2 ％,x2 =6.33,P =0.021).Conclusions Different tracking methods may lead to different therapeutic effects of cyberknife in the treatment of lung cancer,which are related to lesion location and treatment volume.

Objective To evaluate quantitatively the extra absorbed dose generated by image guided system of the Cyberknife.Methods The exposure parameters and the average frequency of images acquisition during the treatments with G3 Cyberknife in 300 cases with various tumor locations and tracking modes were collected for analysis ;The measurements of the absorbed doses in the phantom with 5 points after single exposure generated by image guided system in various exposure parameters were performed with equipment of phantom CIRS Model 002LFC and 002 PRA with ion chamber PTW30010 included.Based on the data we collected andmeasured,the conclusion of how much extra absorbed dose generated by image guided system of Cyberknife the patients received during Cyberknife treatments was drawn.Results With an average fractions of 3.94(the median was 4),the average exposure frequency was 36.5 times for static tracking per patient per fraction,while it was 49.2 times for dynamic tracking.The experimental results with various exposure parameters,positions and tissue densities showed that the minimum absorbed dose after single exposure was 0.5 μGy,while the maximum was 385 μGy.Conclusions The image guided system of the Cyberknife can induce quite low absorbed dose in patient,while providing all three types of image guided function.

Objective To study the efficacy and toxicity of the cyberknife in the treatment of medically inoperable patients with early stage lung cancer. Methods From September 2006 to July 2007,17 patients with clinical stage Ⅰ a- Ⅰ b lung cancer were treated with cyberknife at Tianjin Cancer Hospital. Of the 11 patients receiving CT guided biopsy, 3 were squamous cell cancer and 8 were adenocarcinoma. Six patients refused intrusive operation and were diagnosed by PET-CT scan. All patients were medically inoperable evaluated by a thoracic surgeon. The PTV = GTV + 3 ～ 5 mm, and the median volume of PTV was 36 cm3 (6-82 cm3 ). The median total prescription dose was 50 Gy(45-60 Gy) at 3-5 fractions. Results The median follow-up time was 7 months (3-11 months). All the patients finished the treatment and were alive by the last follow-up. Slight fatigue was the most common complain. Evaluated by CT scan, 13 were complete response and 4 were partial response. No recurrence, progression or distant metastasis occured. There were 3 patients with grade Ⅰ granulocytopenia,3 grade Ⅰ pneumonitis and 1 grade Ⅱ pneumonitis. Conclusions The cyberknife radiosurgery treatment in early stage lung cancer shows a high rate of local control and minimal toxicity. Long time follow-up is necessary to evaluate the survival data and late toxicity.

Objective To find a proper number of implanted fiducials in order to reconcile both more accurate image tacking and less pain for the patients.Methods The phantom was made of two parts of different materials.The inner part was a ball-cube phantom developed by Accuray Corporation, which could be regarded as a rigid body, with 5 fiducials inside using as the reference to align the whole phantom in the experiment.The outer part was made of additional silicone rubber with two components to simulate soft tissue as a non-rigid body, which was implanted with 8 fiducials inside.All combinations of different number of fiducials were tracked to aquire the target location information, which were then compared with the reference position that was set by the inner 5 fiducials to obtain the deviations of the translation and the rotation parameters.Thus the impact of the number of fiducials on image target localization accuracy could be analyzed easily.Results When 4 fiducials are used for tracking, the decline of translation and rotation errors for every fiducial is largest (0.086 mm and 0.033°).The translation error was decreased by 0.343 mm from 1 to 4 fiducials, while by only 0.077 mm from 4 to 8 fiducials;the same decline was observed for rotation errors (0.131° for 3 to 4 fiducials , and 0.09° for 4 to 8 fiducials , respectively) .Conclusions When 4 fiducials are used for tracking, the decline of errors for every fiducial is maximum.When one more fiducial is adding, the image target localization accuracy can be enhanced obviously from 1 to 4 fiducials, but not as obvious for more than 4 fiducials.

In this paper are reported the model establishment and numerical simulation of specific absorption rate(SAR) and the unsteady temperature distribution for the non-invasive tumor RF thermotherapy. The model can correctly reflect the attenuation of electromagnetic wave in the biotissue, the variation of perfusion with temperature and lower perfusion of the tumor tissue are fully considered in the simulation. These measures made simulation results more close to the clinical results. Also presented in the paper are detailed analyses and discussions on the characteristics of SAR of electromagnetic energy and the temperature profiles, the effects of the frequency and the perfusion on the depth for effective treatment. The simulation results are of great significance for directing the clinical application of tumor RF thermotherapy.
Electromagnetic Fields ; Humans ; Hyperthermia, Induced ; Models, Biological ; Neoplasms ; therapy ; Temperature ; Thermal Conductivity