Objective To compare the dosimetry between three -dimensional conformal radiotherapy (3DCRT)and intensity -modulated radiotherapy(IMRT)in the treatment of upper thoracic esophageal carcino-ma,and to provide references to choose radiotherapy program for clinical physician .Methods twenty-five cases with upper esophageal carcinoma (clinical stageⅠ~Ⅲstage)were treated by 3DCRT and IMRT at the concentra three-dimensional radiation treatment planning system .The different exposure doses between target area and effected organs were compared by dose volume histogram ( DVH) with the planed target volume ( PTV) ,which must reach 95% of the prescriptive doses.Results Two different radiotherapy plans of IMRT and 3DCRT:V95, (99.91 ±0.14)%,(95.73 ±4.14)% respectively,P<0.05;targeting maximum doses(Dmax)were(6658.26 ±215.29)cGy,(6 664.20 ±465.16)cGy,P>0.05;targeting minimum dose(Dmin)were(5 458.88 ±184.06) cGy,(4541.60 ±599.0)cGy,P<0.05;targeting average doses(Dmean)were(6 232.80 ±53.00)cGy and (6 105.78 ±163.34)cGy,P<0.05.CI values were (0.76 ±0.04) and(0.57 ±0.05),P<0.05;HI values were(1.07 ±0.02) and(1.12 ±0.06),P <0.05;Spinal cord maximum dose (3 889.68 ±712.69) cGy, (4 337.48 ±178.49)cGy,P<0.05;Lung V20(20.94 ±5.32)%,(21.90 ±6.94)%,P>0.05;Lung V10 (35.39 ±11.41)%,(29.0 ±8.80)%,P<0.05,Lung V5(44.95 ±15.55)%,(37.27 ±11.93)%,P<0.05. Conclusion Intensity-modulated radiotherapy is better than 3DCRT technology in showing PTV volume ,target conformal degrees and the mean index ,spinal cord protection ,However ,The risk of lung injury could be increased with the enlarged area of low -dose irradiation in lung .

Objective To explore the value of DWI (diffusion weighted imaging,DWI) in diagnosis of bladder cancer in clinical T stage by comparing DWI and CT.Methods Seventy-five patients with bladder cancer underwent MRI plain scan,enhanced diffusion-weighted imaging and CT scan,to make a diagnosis preoperative clinical T stage according to their image.Then we compared the diffusion-weighted imaging and CT results with pathological staging results to assess the value of DWI in bladder tumor staging.Results For clinical T staging bladder cancer,the diagnostic accuracy rate was 83.5％ and 72％ for DWI and CT,resectively,statistical analysis showed a significant difference (P ＜0.05).Conclusion Magnetic resonance diffusion weighted imaging can accurately diagose the clinical T stage of bladder cancer,and has a higher value than CT.

OBJECTIVE: To explore the difference of the threshold of auditory steady-state evoked responses (ASSR) in awake and sleeping. METHOD: Fifteen adults (30 ears) with normal hearing were selected to ASSR test. ASSR parameters: carrier frequency (CM)are 0.5, 1.0, 2.0, 3.0, 4.0, 6.0 kHz, modulation frequency (FM) are 46.81 Hz. The test was performed in two different status (in awake and sleeping). RESULT: In awake, the thresholds of ASSR with FM of 46 Hz are significantly lower than 81 Hz (P < 0.01); In sleeping, the thresholds of ASSR with FM of 81 Hz are lower than 46 Hz above 2 kHz CM (P < 0.05), which thresholds were close to pure tone. CONCLUSION To select low modulate (46 Hz) frequency in awake, and use high modulate (81 Hz) frequency in sleeping. When perform ASSR test, the test values are closer to the actual hearing threshold.
Acoustic Stimulation ; Adult ; Audiometry, Evoked Response ; Audiometry, Pure-Tone ; Auditory Threshold ; physiology ; Female ; Humans ; Male ; Sleep ; Wakefulness ; Young Adult

Objective To examine the levels of serum adipunectin (ADPN)in patients with end-stage renal disease (ESRD), and identify the relationship between serum ADPN and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein(hs-CRP) and renal function. Methods Sixty ESRD patients and twenty normal healthy persons were involved in this study. The patients were divided into three groups: patients with chronic renal failure (CRF, 18 cases), patients with hemodialysis (HD,22 cases) and patients with peritoneal dialysis (PD,20 cases). The levels of serum ADPN, TNF-α and hs-CRP were detected by means of ELISA. Differences in continuous variables be-tween the three groups were evaluated. Results The levels of serum ADPN, TNF-α and hs-CRP in CRF, HD and PD patients were signifi-cantly higher than those in control group ( P<0.01 ). Serum ADPN levels in ESRD patients were positive related to serum TNF-α( r≥0.478, P<0.01 ), and negative related to GFR ( r≥-0.582, P<0.01 ). Conclusion The level of serum ADPN was markedly in-creased in patients with ESRD, and correlated with serum TNF-α level and.renal function.

Objective To compare the dosimetric difference among TomoDirect (TD) radiotherapy,Helical Tomotherapy(HT) and volumetric modulated arc therapy(VMAT) in the treatment of upper thoracic esophageal carcinoma.Methods A total of 15 patients with cT2-4 N0-1 M0 upper thoracic esophageal squamous cell carcinoma were enrolled.Three plans were generated using the same dose objective for each patient:TD,HT and VMAT.Dose-volume histogram (DVH),homogeneity index (HI),conformal index (CI),dose at organ at risk (OAR),delivery time and monitor unit (MU) were compared among different plans.Results The D2 and D values in the HT and TD plans were significantly lower than those in the VMAT plans.The D98 value in the TD was similar to that in the HT,but lower than that in the VMAT.The HI of HT was significantly better than those of TD and VMAT (F =81.603,P ＜ 0.05).For the CI,there was no significant difference among the three techniques (P ＞ 0.05).For the V15 of lung,HT was significantly higher than TD (t =-2.626,P ＜0.05) and VMAT (t=3.547,P ＜ 0.05).The V20 of lung in TD was similar to that in HT,but higher than that in VMAT (t =2.824,3.052,P ＜ 0.05).The Dmax of spinal cord showed no significant difference among the three techniques.VMAT had a significantly shorter delivery time and lower MU compared with HT and TD (t =21.617,15.693,10.018,7.802,P ＜ 0.05).Conclusions HT and TD could gain a better planning target volume (PTV) coverage and HI than VMAT in the treatment of upper thoracic esophageal carcinoma.However,VMAT achieved the lowest lung V20,the least Mus and the shortest delivery time.HT achieved a better PTV coverage compared with TD,but TD had a lower lung V15 Mus and shorter delivery time compared with HT.

Objective: To explore the influence of smoking and polycyclic aromatic hydrocarbons (PAHs) on urinary 8-hydroxydeoxyguanosine (8-OHdG) in coke oven workers and investigate their dose-dependent relationships. Methods: A total of 436 workers exposed to coke oven emissions (COEs) and 132 controls were recruited in this study. Questionnaires were completed in a personal interview. Then their urine samples were also collected and the concentrations of urinary four OH-PAHs and 8-OHdG were determined by high performance liquid chromatography (HPLC) which was used to evaluate the levels of occupational PAHs internal exposure among workers and the DNA damage. Results: The differences of concentrations of urinary 2-NAP (2-hydroxynathalene) , 2-FLU (2-hydroxyfluorene) , 9-PHE (9-hydroxyphenanthrene) , 1-OHP (1-hydroxypyrene) between exposure group and control group were statistically significant (P<0.05) . In exposure group and control group, the level of 8-OHdG in heavy smoking workers were significantly higher than that in other groups (P<0.05) . Multivariate logistic regression analysis revealed high levels of urinary 8-OHdG were associated with a significantly increased risk of having higher urinary1-hydroxypyrene levels[OR=1.43 (95%CI: 1.06-1.94) , P<0.01] and heavy smoking [OR=1.44 (95%CI: 1.08-1.91) , P<0.01], respectively. Trend test showed that linear dose response relationship between smoking, 1-OHP in urine and higher concentrations of 8-OHdG (P<0.05) . Smoking could significant modify the effects of urinary 1-hydroxypyrene, while co-exposure to both heavy smoking and high urinary 1-hydroxypyrene levels[OR=5.64 (95%CI: 2.15-14.80) , P<0.05]. Conclusion Urinary 1-hydroxypyrene is a useful biomarker for evaluating total PAHs exposure, coke oven workers with heavy smoking present more serious DNA oxditive damage.

Objective To explore the effects and mechanism of implantation of umbilical blood mesenchymal stem cells(MSCs)on rats with cerebral infarction. Methods Umbilical blood MSCs were cultured in vivo,flow cytometry was ap-plied to test cytometric immunophenotype, and model of rat cerebral infarction was made by suture method; 120 rats were randomly assigned to MSCs implantation group and control group; rats' neurological function was evaluated;western-blot was applied to test the expression of GFAP protein. Fluorescence microscope was applied to observe changes of hippocampal formation in rats as well as the distribution of MSCs in rats' brain. Results According to the test of neurological function, the score of neurological function in the experiment group was reduced, and the score in the control group was improved. The difference was statistically significant(P<0.05). Expression of GFAP in MSCs im-plantation group was increased with a peak in the 7th day,while no significant changes in the control group(P<0.05). According to the observation of immunofluorescence microscopy, the distribution of MSCs in rats' brain was good in MSCs implantation group, and the hippocampal formation showed clear layers in the experiment group. Hippocampal structures in the control group were chaotic, and synapses and organelles were dissolved and compromised. Conclu-sion MSCs are able to promote the repair of hippocampal structures after cerebral infarction in rats, strengthen neuro-plasticity and promote the recovery of neurological functions.

Objective To discuss the impact of group psychology guidance combined with conductive education on social anxiety of children with primary nephrotic syndrome. Methods A total of 60 children with primary nephrotic syndrome were selected, and divided into research group ( 30 cases ) and control group ( 30 cases ) according to the sequence of admission. The patients of two groups were given treatment of metacortandracin. The patients of control group received routine health education while the patients of research group underwent conductive education who was used social anxiety scale for children to evaluate the children anxiety level on the time of before treatment ( T1 ) , induced remission ( T2 ) , alternate-day-treated metacortandracin 1 mg/(kg.d)(T3), alternate-day-treated metacortandracin 0.5 mg/(kg.d)(T4), and the anxiety level of two groups were compared at different time point.Results There were significant differences on anxiety level of 4 time points in two groups ( P<0.01);the anxiety level of T2, T3, T4 in two group were higher than anxiety level of T1 ( P<0.05) . The anxiety level of T1, T2, T3, T4 in research group were lower than that of control group (P<0.05).Conclusions Long time used glucocorticoid can lead to the increasing of social anxiety levels in the treatment of children with nephrotic syndrome, but group psychology guidance combined with conductive education can effectively relieve the anxiety of children.

Objective:To explore the application of ArcCheck system in the validation of Helical and Direct tomotherapy plans for esophageal cancer and summarize relevant experience.Methods:The Helical and Direct tomotherapy verification plans were established for 32 patients with esophageal cancer at different positions according to the doctor′s instructions, which were verified by the ArcCHECK system to compare the passing rate of the results.The correlation between the volume of the target area and the passing rate of the planned verification was analyzed. The therapeutic verification plan with a small target volume was made. The target area was placed at the center of ArcCHECK phantom and the area of detectors to statistically compare the verification passing rates.Results:Helical plan showed a significantly higher passing rate than the Direct plan ( P<0.01). The correlation coefficients between the target volume and the passing rate of the Helical and Direct plans were -0.364 and -0.042, and the P values were 0.041 and 0.819, respectively. For the Helical plan, when the 3%/2mm criterion was adopted, there was significant difference between placing the high-dose area at the center of the phantom and the area of detectors ( P=0.005), and the passing rate of the latter was higher. There was no significant difference in the other cases (all P>0.05). Conclusions:The passing rate of the Helical plan is generally higher than that of the Direct plan, which may be related to the angular response of the ArcCHECK detector and the fact that more reference points are not included for calculation due to low-dose radiation. In addition, it may also be related to the higher requirements of Direct plan for tomotherapy dose control system. In the Helical verification plan, when the 3%/3mm criterion is adopted, the larger the target volume, the higher the possibility of lower passing rate, whereas the correlation coefficient between them is relatively low. The high-dose area can be verified by the plans at the center of the phantom or the detection point. With the comprehensive consideration, we suggest putting it at the center of the phantom.

Objective:To investigate the curative effect of the Pavlik harness and polyester material casting bandage for the early treatment of congenital knee dislocation (CDK).Methods:The clinical data of 12 patients (13 knees) with CDK treated in Provincial Hospital Affiliated to Shandong First Medical University from December 2011 and January 2019 were studied retrospectively.There were 3 males and 9 females.The median age at the initial visit was 3 days ( 1-29 days). Eleven patients had unilateral CDK, and 1 patient had bilateral CDK.There were 5 cases(5 knees) with dislocation and 7 cases(8 knees) with subluxation.Associated musculoskeletal anomalies were observed in 7 patients, which included developmental dysplasia of the hip (DDH) in 6 patients, bilateral DDH and right clubfoot in 1 patient.The Pavlik harness was applied to keep the knee in position for 1.5-2.0 months if passive flexion achieved 90°or more.If passive flexion was below 90°, the polyester material casting bandage was employed to increase knee flexion, and the bandage was changed once a week.After passive flexion reached 90°, the patient was treated with the Pavlik harness for 1.5-2.0 months.Cases with DDH who worn the Pavlik harness were evaluated by ultrasonography in the follow-up period, and cases with clubfoot were treated with Ponseti polyester material casting bandages.Results:Three children (4 knees) were directly fixed with Pavlik harness for 1.5-2.0 months, 9 children (9 knees) were fixed with Pavlik harness for 1.5-2.0 months after 1-8 times (average 2.9 times) of plaster fixation. No plaster and Pavlik harness complications were found during the treatment.Twelve patients were followed up for 29.8 months on average (12.0 to 65.0 months). Ten patients (11 knees) were rated excellent, and 2 patients (2 knees) were rated good.Conclusions:The Pavlik harness and polyester material casting bandage for early treatment of CDK is simple, effective and safe.Associated musculoskeletal anomalies can also be corrected in the treatment process.The knee joint dislocation should be treated at first.