Objective To verify the wedge angle of virtual wedge and the relation between wedge factor and beam energy, field size, wedge angle and to study the difference in percent depth dose (PDD) of virtual wedge field, hard wedge field and open field.Methods Using wedge angle and wedge factor of 15?,30?,45?and 60? virtual wedge of Siemens Mevatron 6?MV and Primus 8?MV, 18?MV X rays were measured by RFA-plus 3D water phantom and RK finger chamber the PDD of the virtual wedge field, hard wedge field and open field were measured by Kodak XV-2 verifying film and FDM-300 film dosimeter. These PDDs were normalized to Dmax then compared. Results There was good conformation between virtual wedge measured by four point method and set value. The virtual wedge was almost equal to 1,with a maximal variation of 0.031 no matter what the value of beam energy, field size or wedge angle was. Generally, for certain energy and field size, the wedge factor of larger wedge angle was slightly larger than smaller wedge angle. For certain energy and wedge angle, the wedge factor of larger field was also a little larger than smaller field. The PDD of virtual wedge field was similar to that of open field. Conclusions The four point method measurement for virtual wedge angle is good for daily QA. Radiotherapy of virtual wedge field is not only simpler than hard wedge field,but also spares the beam output. The PDD comfarmation between virtual field and open field simplifies radiation treatment planning and increases the accuracy of wedge field therapy.

Inhaled nitric oxide has been identified as a potent method for curing acute respiratory distress syndrome,high brood pressure and some illnesses related to the lung,but the high cost limits its application.The present study investigates the reason of the high cost of inhaled nitric oxide in the current application,and gives some advices on solving them by using pulsed arc discharge in clean air,reducing the price of nitrogen oxides analyzer and being compatible with the present ventilators.The perspective of inhaled nitric oxide was viewed as well.

Objective To evaluate the diagnostic value of MRI and MRS in the prostatic diseases.Methods Clinical data together with MRI and MRS findings were reviewed retrospectively in 16 cases with benign prostate hyperplasia(BPH) and 6 cases with prostate carcinoma(PC) which were confirmed with pathology.MRI observation was focused on the size of the gland,the location of the lesion,the signal features and the extent of the tumor.MRS observation included the chemical shift of citrate(Cit),choline(Cho) and creatine(Cr)spectra,and the ratio of(Cho+Cr)/Cit.Results BPH appeared as irregular enlargement of the whole prostate gland.On T2WI,the central zones of the gland were marked enlargement,there were many different-size similar round low-signal or high-signal intensity nodular lesions in peripheral zones in 13 cases,some low-signal nodular with low-signal false capsules were found and the peripheral zone were compressed obviously.In 6 patients with PC,5 cases localized low-signal area in the periphery and 1 case localized low-signal area in the centre,the tumors localized within the prostate capsule in 2 cases,breakthrough the prostatic capsule in 4 cases with seminal vesicle and the neurovascular bundles involved,the lymph node in pelvis and the bone of pelvis were involved in 1 case.On MRS,Cit elevated obviously,Cho elevated slightly,(Cho+Cr)/Cit ratio was not high,average 0.60 in BPH.In PC,Cit dropped obviously,Cho elevated obviously,(Cho+Cr)/Cit ratio elevated,average 2.51.The metabolic ratios between the BPH and PC were of remarkable statistically difference(t=0.353,P

Objective To investigate the application value of spatio-temporal image correlation (STIC) combined with tomographic ultrasound imaging(TUI) in the prenatal diagnosis of conotruncal defects(CTD).Methods Two-dimensional(2D) fetal echocardiography to screen and TUI-STIC volumes from 1508 cases of fetuses of high risk with congenital heart disease.Postnatal work-up and pathological results were available for all fetuses with CTD.Results Thirty nine cases with CTD were found by TUI-STIC while thirty five cases were found by 2D echocardiography,but TUI-STIC had new findings and corrected the diagnosis in 9 cases as compared with 2D echocardiography.The sensitivity,specificity,positivity predictive value,negative predictive value and accuracy of TUI-STIC in evaluating CTD were 97.5 ％,100％,100 ％,99.9 ％ and 99 ％.The Kappa value of consistency test between 2DE and TUI-SIC was 0.244(P ＜ 0.01),McNemar test showed that the difference was statistically significant (P ＜ 0.01).Conclusions TUI-STIC allows a complete sequential analysis of fetal conotruncal defects and supplying additional information over 2D fetal echocardiography,it could improve the prenatal diagnosis rate.TUI-STIC is helpful in diagnosis of prenatal conotruncal defects.

Objective To explore the relationship between adjustment of immunosuppressant and prognosis in renal transplantation recipients with pulmonary infection. Methods The clinical data of 98 patients with pulmonary infection following renal transplantation were retrospectively analyzed.Patients were divided into two groups: conventional group (n = 45) and immunosuppressant adjustment group (n = 53). The mortality, recovery time and rejection rate in two groups were analyzed under the statement of serious infection (SOFA≥12) and slight infection (SOFA＜ 12) by sequential organ failure assessment (SOFA) score. Results When the SOFA scores ≥ 12, the mortality and recovery time in immunosuppressant adjustment group were significantly lower than in conventional group (P＜0.05), but there was no significant difference in the rejection rate between two groups (P＞0.05). When the SOFA scores ＜11, there was no significant difference in mortality and recovery time between the two groups (P＞0.05). The incidence of rejection in immunosuppressant adjustment group was significantly higher than in conventional group (P＜0.05).Conclusion Mortality could be decreased and course of anti-infection treatment could also be shortened by adjusting the immunosuppressant in renal transplantation recipients with serious pulmonary infection (SOFA≥12). Immunosuppressant agent was proposed to maintain the original treatment protocol when the infection was slight (SOFA＜12).

Objective To investigate the clinical value of color Doppler flow imaging (CDFI) for evaluating transplant renal artery stenosis (TRAS).Methods Clinical and ultrasonographic data of 216 kidney transplant recipients were collected by follow-up monitoring from September 2015 to July 2016.CDFI indexes included the peak systolic velocity (PSV) in the renal artery and resistant index (RI).Renal artery PSV and RI were measured.All suspected TRAS patients accepted transplant renal artery angiography (DSA).Results Fourteen patients with suspected TRAS accepted DSA,of which 12 patients were confirmed.The diagnostic accuracy of CDFI was 85.7％.When the POST-PSV ratio＞ 1 0,the sensitivity and specificity of diagnosis of TRAS were 91 ％ and 95 ％,respectively.CDFI indexes remarkably changed after the TRAS patients had undergone renal artery dilatation or stent implantation.PSV of the main renal artery and the POST-PSV ratio decreased significantly,and the PSV of interlobar arteries increased.Conclusions CDFI is a reliable first choice for screening transplant renal artery stenosis.The POST-PSV ratio has relatively higher sensitivity and specificity in the diagnosis of TRAS.

The feasibility and the clinical value of the enzyme-multiplied immunoassay technique (EMIT) monitoring of blood concentrations of cyclosporine A (CsA) in patients treated with CsA were investigated after kidney transplantation.The validation method was performed to the EMIT determination of CsA blood concentration,the CsA whole blood trough concentrations (Co) of patients in different time periods after renal transplantation were monitored,and combined with the clinical complications,the statistical results were analyzed and compared.EMIT was precise,accurate and stable,also with a high quality control.The mean postoperative blood concentration of CsA was as follows:＜1 month,(281.4± 57.9)ng/mL; 2 - 3 months,(264.5 ± 41.2)ng/mL; 4 - 5 months,(236.4 ± 38.9)ng/mL; 6 - 12 months,(206.5 ± 32.6)ng/mL; ＞12 months,(185.6 ± 28.1)ng/mL.The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1％,significantly lower than that of the none-recommended dose group (37.2％) (P＜0.05); the transplantation rejection rate was 4.4％,significantly lower than that of the nonerecommended dose group (22.5％) (P＜0.05).Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible,and is able to reduce the CsA toxicity and rejection significantly,leading to achieving the desired therapeutic effect.

Objective To investigate the expression and significance of caveolin-1 in breast carcinoma.Methods Using immunohistochemical method the protein expression of caveolin-1 were analyzed in 105 cases of breast carcinoma and 50 cases of non-cancerous breast tissues.The relationship between caveolin-1 expression and CK5/6,EGFR,and E-cadherin expression was investigated.Clinical data of 105 cases of breast carcinoma were retrospectively analyzed.Results Among 105 cases of breast carcinoma,there were 20 cases of basal-like subtype,22 cases of luminal subtype A,23 cases of luminal subtype B,23 cases of HER2 over-expressing subtype,17 cases of normal breast-like subtype.Positive rate of caveolin-1 was significantly lower in breast carcinoma than in non-cancerous breast tissues (24.8％ vs.88.0％,P ＜ 0.05).Positive rate of caveolin-1 (75.0％) was higher in breast carcinoma than in luminal subtype A ( 4.8％ ),luminal subtype B ( 17.4％ ),HER2 over-expressing subtype ( 17.4％ ) or normal breast-like subtype( 11.8％ ),all P ＜0.05.Caveolin-1 expression was associated with expression of CK5/6 and EGFR(P ＜0.01 ).In univariate analysis,positive caveolin-1 was associated with higher lymph node metastasis rate (18/26,69.2％ )than negative (37/79,46.8％ ),P =0.047,and shorter 5-year-disease-free survival (38.46％ vs.74.68％,P =0.0004 ),but in multivariate analysis caveolin-1 was not an independent predictor of 5-year- disease-free survival (P ＞ 0.05).Conclusions Caveolin-1 can be seen as a screening mark of basal-like breast carcinoma,it may promote the invasiveness of breast cancer cells,but it is not an independent prognostic predictor of breast cancer patients.

The feasibility and the clinical value of the enzyme-multiplied immunoassay technique （EMIT） monitoring of blood concentrations of cyclosporine A （CsA） in patients treated with CsA were investigated after kidney transplantation. The validation method was performed to the EMIT determination of CsA blood concentration, the CsA whole blood trough concentrations （Co） of patients in different time periods after renal transplantation were monitored, and combined with the clinical complications, the statistical results were analyzed and compared. EMIT was precise, accurate and stable, also with a high quality control. The mean postoperative blood concentration of CsA was as follows： 〈1 month, （281.4± 57.9）ng/mL; 2 - 3 months, （264.5 ± 41.2） ng/mL; 4 - 5 months, （236.4 ± 38.9） ng/mL; 6 - 12 months, （206.5± 32.6）ng/mL; 〉12 months, （185.6± 28.1）ng/mL. The toxic reaction rate of CsA blood concentration within the recommended therapeutic concentration was 14.1%, significantly lower than that of the none-recommended dose group （37.2%） （P〈0.05）; the transplantation rejection rate was 4.4%, significantly lower than that of the none- recommended dose group （22.5%） （P〈0.05）. Using EMIT to monitor the blood concentration of CsA as the routine laboratory method is feasible, and is able to reduce the CsA toxicity and rejection significantly, leading to achieving the desired therapeutic effect.