Objective To select the optimal registration method for on-line kilovoltage cone-beam CT (KVCBCT) guided lung cancer radiation and evaluate the reproducibility of the selected method. MethodsSixteen patients with non-small cell lung cancer were enrolled into this study.A total of 96 pre treatment KVCBCT images from the 16 patients were available for the analysis.Image registration methods were bone-based automatic registration,gray-based automatic registration,manual registration and semi-auto matic registration.All registrations were accomplished by one physician.Another physician blindly evaluated the results of each registration,then selected the optimal registration method and evaluated its reproducibili ty.Results The average score of the bone-based automatic registration,gray-based automatic registration, manual registration and semi-automatic registration methods was 2.4,2.7,3.0 and 3.7,respectively.The score of the four different groups had statistics significant difference (F = 42.20,P < 0.001).Using the semi-automatic registration method,the probability of the difference between two registration results more than 3 ram in the left-right,superior-inferior,and anterior-posterior directions was 0,3% and 6% by the same physician,0,14% and 0 by different physicians,and 8%,14% and 8% by physician and radiation therapist.Conclusions Semi-automatic registration method,possessing the highest score and accepted re producibility,is appropriate for KVCBCT guided lung cancer radiation.

As a pilot program of teaching reform,some excellent undergraduates majoring in nursing were selected to take specialized courses in ICU in order to cultivate the intensive care specialized nurses.The teaching team of specialized courses in ICU was established to guarantee the teaching quality.The team was in charge of the ICU specialized curriculum building,textbooks selection and teaching content examination.The high leveled teaching team of specialized courses in ICU was organized by taking teaching and researching section as a unit to improve theoretical teaching level,using clinical department as training base to enhance practice skill and participating in special subject classes and in-service study to promote specialized quality.

Objective To assess the rotational set-up errors in patients with thoracic neoplasms. Methods 224 kilovohage cone-beam computed tomography (KVCBCT) scans from 20 thoracic tumor pa-tients were evaluated retrospectively. All these patients were involved in the research of " Evaluation of the residual set-up error for online kilovohage cone-beam CT guided thoracic tumor radiation". Rotational set-up errors, including pitch, roll and yaw, were calculated by 'aligning the KVCBCT with the planning CT, using the semi-automatic alignment method. Results The average rotational set-up errors were -0.28°±1.52°, 0.21°± 0.91° and 0.27°± 0. 78° in the left-fight, superior-inferior and anterior-posterior axis, respective-ly. The maximal rotational errors of pitch, roll and yaw were 3.5°, 2.7° and 2.2°, respectively. After cor-rection for translational set-up errors, no statistically significant changes in rotational error were observed. Conclusions The rotational set-up errors in patients with thoracic neoplasms were all small in magnitude. Rotational errors may not change after the correction for translational set-up errors alone, which should be e-valuated in a larger sample future.