OBJECTIVE: To observe the effects of warming spleen and stomach for dispersing phlegm recipe (Wenzhong Xiaotan Recipe, WZXTR), a compound traditional Chinese herbal medicine, on expression of interleukin-8 (IL-8) in S(180) tumor tissue in mice, and to explore the effectiveness and its mechanism. METHODS: Fifty mice were randomly divided into five groups: untreated group, cold water-treated group, cold water and WZXTR-treated group, cold water and dispersing phlegm and eliminating stagnation recipe (Xiaotan Sanjie Recipe, XTSJR, another compound traditional Chinese herbal medicine) treated group, cold water and tegafur-treated group. Mice in the latter 4 groups were fed 0-4 degrees centigrade cold distilled water 10 ml/(kg x d) one week before tumor inoculation for 3 weeks. Mice in the 5 groups were inoculated neoplastic cells which were diluted 2 x 10(7)/ml with normal saline in the right armpit at the second week. Forty-eight hours later, the mice were given drugs intragastrically (WZXTR, XTSJR and tegafur, respectively). The mice were continually intervened by cold water in the morning and given drugs in the afternoon. Mice in the cold water-treated group were given normal saline, and nothing was given in untreated group. Morphology appearance and changes of rectal temperature were observed, and the tumor weight and volume were measured and inhibitory rate was calculated 22 days after tumor inoculation. IL-8 was detected by avidin-biotin system-enzyme-labeled immunosorbent assay (ABC-ELISA) and real-time reverse polymerase chain reaction (real-time PCR). RESULTS: The content of IL-8 in tumor tissue of the untreated group was significantly higher than that of the other groups (P<0.01), and that of the cold water-treated group was higher than that of the cold water and WZXTR-treated group (P<0.01) and the cold water and XTSJR-treated group (P<0.05), respectively. The gray scale value of cDNA amplification strap was descent more evidently in both the cold water and WZXTR-treated group and the cold water and XTSJR-treated group as compared with that of the cold water-treated group and the untreated group (P<0.05). CONCLUSION: WZXTR can restrain tumor growth, and the mechanism may be that it can degrade the expression of IL-8 in S180 tumor.

Objective To investigate the dose distribution and radiation risk of Varian thoracic cone beam computed tomography (CBCT) with default parameters with reference to Monte Carlo simulation and International Commission on Radiological Protection (ICRP) report 110.Methods EGSnrc/BEAMnrc code was used to simulate the material, thickness, and geometry of the kV CBCT source (kVS) to establish the kVS model.A benchmarked MCSIM code was applied to calculate the dose distribution in the ICRP phantom after the scan with the standard thoracic parameters (110 kV, 20 mA, and 262 mAs), and the conversion coefficient of absolute dose was obtained in a spherical phantom following the TG-61 protocol.The results of Monte Carlo simulation were validated by PDD and Profile in a water phantom and the measurement of the absolute dose in the computed tomography dose index (CTDI) phantom and Alderson phantom.The models including BEIR VⅡ were used to evaluate the radiation risks.Results With reference to the criterion of 3%/1 mm, the uncertainties of PDD and Profile were less than 2%.The difference between the measured and calculated values was<2.9% in the CTDI phantom and ≤0.05 cGy in the Alderson phantom.In the ICRP110 phantom, the doses to the left lung, right lung, left breast, right breast, heart, thyroid, trachea, cancellous bone, and cortical bone were 1.28, 1.39, 1.74, 1.80, 1.46, 0.48, 0.88, 0.85, and 1.84 cGy, respectively.The relative risks of ischemic heart disease, breast cancer, lung cancer, thyroid cancer, and tracheal cancer in a standard scan were1.001 , 1.009, 1.019, 1.000, and 1.008, respectively. Conclusions The accumulated dose and long-term risks of CBCT during image-guided thoracic radiotherapy cannot be neglected and should be effectively controlled.

Objective Knowledge?based radiotherapy ( KBRT ) can reduce the plan quality variability induced by different experiences between physicians and improve the quality of treatment plans. Methods The Varian Rapid Plan system was used to train a dose?volume histogram ( DVH) prediction model. The obtained model was preliminarily applied to semi?automatic design of the preoperative treatment plans for rectal cancer. Eighty high?quality volumetric modulated arc therapy plans were imported into the model training set of the Rapid Plan system. The structures of the plans were matched to the corresponding labels and codes as listed in the library. The training started after the verification of prescription. The residual plots,regression curves,geometric plots for organ at risk ( OAR) ,in?field DVH plots,and model training logs were examined. After removal of the mismatch, the original plans were assessed to rule out outliers and influential data points. More similar plans may be added for another round of training. Ten KBRT plans were designed using the final model and compared with the clinical plans. Results For the two major OARs,the femoral head and bladder,the average goodness of fit of the principal component were 0?999 415/1.0 and 0?999 963/1.0 for the DVH model,and 0?999 651/1.0 and 0?999 945/1.0 for geometry?based expected dose model,respectively. In all the plans, 11 had Cook ’ s distance values exceeding the tolerance and 4 had studentized residual values exceeding the tolerance. The outliers were all kept in the training set to generalize the scope of the model. The 10 KBRT plans had significantly improved homogeneity indices for PGTV and PTV than the original plans (P=0?00,0?04).The 10 KBRT plans also had significantly reduced D50% to the femoral head and bladder as well as significantly reduced mean doses to the bladder than the original plans (P=0?042,0?000,0?005). Conclusions In this study,the Rapid Plan system is used to train a KBRT model for design of preoperative radiotherapy plans for rectal cancer. The results of preliminary application meet the clinical requirements.

ObjectiveTo observe and evaluate the role of cervical cytological examination in 1946 cases in gestation, and at 2 months and 6 months after delivery, and treatment for abnormal cases.MethodsThe thinprep cytologic test samples of 1946 cases from external cervical orifice and cervical cavity were collected. The cytological diagnosis was performed according to TBS-diagnosis and classification system.ResultsIn 1946 samples, there were 160 inflammatory samples (8.2%), including bacterial vaginitis 51 cases (2.6%), trichomonal vaginitis 49 cases (25.%), candidal vaginitis 58 cases (3.0%); typical epithelial cells 105 cases (5.4%), including atypical squamous cells (ASUCS) 70 cases (3.6%), low-grade squamous intraepithelial lesions (LSIL) 29 cases (1.5%), high-grade squamous intraepithelial lesions (HSIL) 5cases (0.2%), the carcinoma in situ 1 case (0.05%); human papilloma virus (HPV) 32 cases (1.6%), including HPV combined with atypical squamous cells 21 cases (1.1%), HPV combined with LSIL 10 cases (0.5%). Large mass of cases with a abnormally result of cervical cytological examination had a normal childbearing, the cases that re-examination after birth showed carcinoma in situ and HSIL treated by conization, and others treated with physical treatment.ConclusionCervical cytology examination has positive effect on prevention and treatment of precancerous changes and carcinoma in gestational women. Cervical lesions less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy performed when necessary. Re-examination at two and six months after birth is necessary for determining treatment method.

Objective To evaluate the feasibility and dosimetric features of a volume modulated arc therapy (VMAT)-configured model in knowledge-based optimization of fixed-field dynamic intensitymodulated radiotherapy (IMRT) plans based on the Varian RapidPlan system.Methods ① A dose-volume histogram prediction model was trained with 81 qualified preoperative VMAT plans for rectal cancer and then statistically verified.② For clinically approved 10 IMRT plans with the same dose prescription,the above model was used to automatically generate new optimization parameters and dynamic muhileaf collimator (MLC) sequences with field geometry and beam energy unchanged.③ In order to rule out the disparities between different versions,a single algorithm was used to calculate the absolute doses of the original and new plans.④ Statistical analyses were performed on dosimetric parameters after comparable target dose coverage was achieved in the two plans by appropriate normalization.Results On the basis of similar target dose homogeneity and coverage,RapidPlan significantly reduced the doses to the urinary bladder (D50％ by 9.01 Gy,P =0.000;Dmean by 8.08 Gy,P =0.005) and the femoral head (D50％ by 4.20 Gy,P =0.000;Dmean by 3.84 Gy,P=0.005) but significantly elevated the mean total number of monitor units (1211±99 vs.771±79,P=0.000) and the number of fields with multiple MLC carriage groups.The knowledge-based semi-automated optimization caused a significantly larger number of high-dose hotspots but a similar D2％ (52.54 vs.52.71 Gy,P=0.239).Conclusions The VMAT model can be used for the knowledge-based semi-automated optimization of IMRT plans to enhance the efficiency and OAR protection.However,the resulting high-dose hotspots need further manual intervention.

Objective:To solve the problems in intensity-modulated radiation therapy (IMRT) planning, such as large labor cost and high dependence on the experience of physicists and great inconsistency in the quality of plan, and to discuss an unsupervised automatic treatment planning procedure of IMRT.Methods:The eclipse scripting application programming interface (ESAPI) within the Eclipse treatment planning system (TPS) 15.6 and optimization parameters tree search algorithm (OPTSA) were used to emulate and realize the whole planning process. Interacted with the TPS through ESAPI, relevant dosimetric parameters were input and output. The OPTSA evaluated the plan qualities based on dosimetric parameters of the targets and organs at risk (OARs) and iteratively adjusted the optimization objective parameters to achieve a progressively improving IMRT plan. In order to verify the effectiveness of the automatic planning, twenty historical rectum cancer cases were selected from the clinical database, and the dose distribution and specific dosimetric parameters were compared between the plans generated by the OPTSA and the manual plans under the same constraints.Results:All the auto plans have met clinical requirements. Furthermore, 90% and 10% of the auto plans were deemed as clinically improved and equally compared with the manual plans, respectively. The average CI for the PTV was 0.88 and 0.80 for the auto and manual plans respectively. Compared with the manual plans, the mean doses of all the OARs in the auto plans were reduced by 11% in average. The average elapsed time of automatic planning and manual planning was (28.15±3.61) and (36.7±4.6) min, respectively.Conclusions:The plans created by the proposed algorithm have been shown to be at least as good as the manual plans. In addition, this method can shorten the labor time in plan designing while ensuring the plan quality and consistency of the plan.

Objective To investigate the intra-laboratory turnaround time(ILTAT) of the emergency biochemistry tests and to analyze the factors influencing ILTAT in order to adopt the corresponding improvement measures for perfecting the service quality and ensuring the patient medical safety.Methods ILTAT of the emergency biochemical specimens in our hospital from June to November 2015 was performed the retrospective statistics for comparing the determination timely rate between ILTAT≤60 min and ILTAT2 ≤120 min.ILTAT at different time periods in laboratory was emphatically analyzed.Results The determination timely rate of ILTAT ≤120min(ILTAT 1) was 98.8%(8638/8743),and which of ILTAT ≤60min(ILTAT 2) was 83.7%(7317/8743).The determination timely rate of ILTAT1 had no statistical difference among different time periods (χ2=3.36,P>0.05).The determination timely rate of ILTAT2 had statistical difference among different time periods(χ2=134.5,P<0.01).The determination timely rate of T 2(10:01-12:00) was highest (88.1%),which of T1 (8:01-10:00) was lowest(76.8%),which of T3(12:01-14:00) and T7 (6:01-8:00) was lower (79.4% and 80.2% respectively).Conclusion At present,ILTAT in our laboratory meets the requirements of the current regulations.Analyzing the ILTAT influencing factors in the emergency biochemistry,optimizing the workflow,improving the equipments and staffing allocation and improving the degree of information processing can further shorten the emergency biochemical ILTAT,and better meet the clinical and patient′s needs.

Objective To compare the performances of four commercially available LINAC daily QA instruments.Methods The dosimetric stability of a LINAC including central axis output,flatness and symmetry were verified and fine-tuned using a 3-dimensional water phantom,dosimeters and ionization chambers.The baseline of the four instruments including LINA-C,QUICK-C,BEAM-C and QA3 were set thereafter.Daily measurements of LINAC were conducted with these instruments respectively and the results were compared.Arbitrary errors (CAX and SYM) beyond TG-142 tolerances were introduced to the LINAC to test the sensibilities of each instrument in detecting these changes.Results Relative to the baseline that were measured by the 3-dimensional water phantom and dosimeters,the results monitored by the four instruments were comparable.The maximum disparities of the CAX,FLAT,and SYM were 0.5％ (LINA-C),-0.45％ (QUICK-C),and 0.5％ (BEAM-C),respectively.All checkers detected the known errors successfully.Conclusions The stabilities of all the four evaluated instruments met the requirements of daily QA for LINAC.LINA-C verifies CAX only.QUICKE-C,BEAM-C and QA3 can be used to perform all the daily QA protocols as suggested by AAPM TG 142 report.They also provide unique additional functions.The setup of baseline determines if the morning checkers could measure the LINAC dosimetric parameters correctly.When an error is alarmed by the morning checker,it is recommended to verify the performance of the instrument first rather than recalibrating the LINAC immediately.

Objective To establish gastric bypass surgery model with SD rat and analyze the influence factors and preventive measures so as to accumulate experience and skills for further developing gastric bypass surgery model on diabetic rat( GK rat) . Methods Gastric by-pass surgery was operated on 30 SD rats. Summarized modeling experience and analyzed various factors affecting modeling success. Results 17 rats weresuccessfully survived after surgery and 13 failed, with the mortality rate 43. 3%. Three rats died during operation, including two for anesthesia and one for heart failure;one died due to anastomotic bleeding two hours after surgery. Eight died in the third day after surgery, including two for infection, two for intestinal necrosis, four for anastomotic stenosis or obstruction. One died because of anastomotic leakage caused by mistaking and satiety the fifth day after surgery. There were no other complications such as wound dehiscence occurred in this group . Conclusion Establishing models of gastric bypass surgery with SD rats which is regarded as pre-experiment of building models of gas-tric bypass surgery with GK rats is economical and feasible. Anesthesia and perioperative management, surgical techniques and infection pre-vention and control are the main factors affecting modeling. The survival rate of rat model could be increased if related factors well controlled.

Bispecific antibodies have been exploited as both cancer immunodiagnostics and cancer therapeutics, which have shown promises in clinical trials in cancer imaging and therapy. To improve the anti-tumor effect, an scDb (bispecific single-chain diabody) was constructed from the variable domain genes of two scFvs (single-chain variable fragment antibodies) directed against human EGFR (epidermal growth factor receptor) and VEGFR2 (vascular endothelial growth factor receptor 2) extracellular domains. The anti-EGFR/ anti-KDR scDb was constructed into pHEN2 plasmid and expressed in Escherichia coli HB2151 host. After purification by one-step affinity chromatography of IMAC, scDb protein was characterized by Western blotting. The yield of scDb protein was 570 microg per liter medium. scDb bound to EGFR as efficiently as the parental antibody scFv-E10, while a little bit weaker than the parental antibody scFv-AK404R when bound to KDR. In conclusion, the scDb protein could bind both EGFR and KDR specifically and could be applied for further anti-tumor research.