According to the deficiencies of the present treatment planning systems,a research of field size dosage calculation based on two-dimensional localization image is presented.The technologies are emphasized including coordinate transformation,image preprocessing,edge detection & extraction and field size dosage calculation,etc.

Objective To establish a method to detect neuromyelitis optiea (NMO)-IgG in patients serum using indirect immunofluorescence assay (IFA). Methods The normal tissues (cerebellum/ midbrain, kidney and stomach) from C57 mice were cryosectioned onto microscope slides as detective substrate. For NMO-IgG detection, isolated serum from patient with NMO, multiple sclerosis (MS), optic neuritis or myelitis was incubated with the tissue sections on the slide at 4℃ overnight and subsequently incubated with a fluorochrome-cojugated lgG specific for human. For double immunostaining with aquaporius-4 (AQP4), the slides were incubated with primary antibody of AQP4 and secondary antibody of IgG-TRITC. Detection of NMO-IgG and its co-localization with AQP4 was analyzed using fluorescence microscope. Results All 182 serum samples from patients were tested using IFA. Some samples revealed a characteristic immunohistochemical staining of NMO-IgG in mouse CNS tissues, predominately in pia and subpia, and capillaries in white and grey matter in the cerebellum, midbrain, and spinal cord. Double immunostaining with AQP4 demonstrated the co-localization of NMO-IgG with AQP4. Conclusions We established an IFA using a substrate from C57 mouse cerebellum/midbrain, kidney and stomach tissue to detect NMO-IgG in patient serum. This method is specific and efficient in detection and may be useful in diagnosis and differential diagnosis of neuromyelitis optica.

Through discussing the connotation of medical humanities spirit and the current situation of medical humanities education in our country, the authors put forward that in clinical practice, respiratory medicine interns medical ways for the cultivation of the humanistic spirit, which include: guide the trainee doctors in treating pa-tients alike, on the basis of understanding and respect for life and death;to cultivate the ability of effective commu-nication between patient and physician internship; interns cultivated the spirit of collaboration and leadership skills;the in-depth, on the basis of clinical practice, in practice the doctor to write a detailed records;construc-tion of a high level of teacher love team, set an example for the students.

105 copies/mL would develop liver-related complications, such as cirrhosis, hepatocellular carcinoma and liver failure. Available evidences indicate that control of HBV replication with antiviral drugs can decrease the incidence of these complications and mortality.

Objective To investigate three-dimensional localization for sentinel lymph node (SLN) of breast cancer,and by which we can remove the SLNs directly.Methods The ipsilateral axillary lymph nodes of 40 patients were inspected by B-ultrasound and axillary artery and subscapular artery bifurcation point and its trend with Doppler B-ultrasound in the preoperation,then located them in the surface.We found SLNs using methylene blue as the mapping agent with endoscope during the operation,determined which lymphatic group the sentinel lymph node belonged and the spatial location and the surface projection according to the anatomical location.Results We found the three-dimensional location of SLNs in the group of 39 in 40 patients with endoscope,of which 34 cases located in central group,accounting for 87.18％ ;while 4 cases located in the subscapular group,accounting for 10.26％,and their spatial location was as follows:set the root of subscapular artery in this location as a starting point,the subscapular artery as a diameter,and made a diameter of 5cm circle to the bottom,then let the latissimus dorsi as the end,and made a quasi-cylinder through the circle to the axillary central.The height of the quasi-cylinder got up to the surface of the intercostal brachial nerve.Then set the nerve as the diameter of circle of quasi-cylinder,and the centre of circle was crosspoint of subscapnlar artery's surface projection with intercostal brachial nerve.The height of quasi-cylinder varies with somatotypes of the patients,its height was less than or equal to 5cm.What's more,the fiften enlarged lymph nodes located by B-ultrasound in the preoperation were all in the quasi-cylinder,and they were SLNs.Conclusion SLN lies in quasi-cylinder consisting of spatial location of subscapular group and central group lymph nodes.If the enlarged lymph nodes found by B-ultrasound are in above mentioned quasi-cylinder,they can be considered as the SLNs.Make a 5cm-incision parallelling the intercostal brachial nerve and intersecting the surface projection of subscapular artery in the surface of quasi-cylinder,then dissect toward the origin of the subscapular artery,you can find SLNs.

Objective To compare vacuum-assisted excision with periareola incision surgery for benign breast cancer.Methods One hundred and twenty one patients with benign breast nodules treated in our hospital from October 2014 to October 2015 were enrolled in the study,including 58 cases received vacuum-assisted excision (study group) and 63 cases received periareola incision surgery (control group).There were no differences in age[(30.2 ±5.4) vs.(32.1 ±6.2) years] and tumor diameter[(1.3 ±0.4) vs.(1.5 ± 0.3) cm] between two groups.Results There were no severe complications in both groups.Compared with the control group,the operation time was shorter] (20.4 ±4.7) vs.(48.2 ± 15.4)min,t =3.165,P =0.006],intraoperative blood loss was less [(18.4 ± 5.7) vs.(17.2 ± 3.7) ml,t =-0.297,P =0.672],malformation rate was lower [5.2％ (3/58)vs.22.2％ (14/63),x2 =7.27,P =0.007],incidence of postoperative hematoma was higher [20.7％ (10/58) vs.6.3％ (4/63),x2 =3.502,P =0.041],and the cost of surgery was more expensive(5 100 ± 300) vs.(3 400 ± 1 200) Yuan,t =2.181,P =0.023].Conclusion Comparing with conventional periareolar incision surgery,the vacuum-assisted excision has its advantages and disadvantages for treatment benign breast tumors,and two surgical modalities can be chosen accordingly.

Objective To analyze the clinicaopathological features and treatment of bilateral asynchronous breast cancer.Methods The clinical and pathological data of 13 patients with bilateral asynchronous breast cancer admitted in our hospital from 2010 to 2016 ere retrospectively reviewed.Results The bilateral asynchronous breast cancer accounted for 1.7% of all breast cancer patients admitted n the same period (13/782).The median age of patients at first onset was 47.The modified radical operation was the main surgical lity (12/13 for the first cancer;8/13 for the second cancer).The clinical stage Ⅱ was predominant in all patients (10/13 of the first r;9/13 of the second cancer).Invasive ductal cancer was the most common pathologic type (in 11/13 of the first cancer;11/13 of the cond cancer).Hormone receptors were highly expressed in most of the cases (9/13 of the first cancer;7/13 of the second cancer).The disease-free interval was more than 10 years in most cases (8/13).Among 13 cases local recurrence was detected in 1 case, distant metastases in 2 cases, and 1 case died from distant metastasis.Conclusion The bilateral asynchronous breast cancer has a low incidence;however, a close follow up is necessary for early detection and treatment of the second carcinoma.

Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P ＞ 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72,3.41 ± 0. 64,3.43 ± 0. 61,3.62 ± 0. 93,3.63 ±0.71,3.93 ±0.81,3.93 ±0.81,3.43 ±0.61,3.52 ±0.92,3.84 ±0.82 respectively) (Z = -2.449 to - 2. 236, P ＜ 0. 05). Conclusion Radiation dose can be effectively reduced by using an appropriate and lower current of 340 mA.

Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.

ObjectiveTo explore an individualized abdominal scan protocol with a 64-slice CT scanner.MethodsFrom Sep.2010 to Nov.2010,one hundred consecutive patients,who underwent twice non-contrast-enhanced abdominal CT scans within 3 months,were enrolled in this study.For each patient,the tube current of 274 eff.mAs and 207 eff.mAs were applied respectively in the first and second abdominal scan.The imaging qualities of the two scans were evaluated retrospectively by 3 reviewers.All the individual variants,including height,weight,body mass index (BMI),the maximum transverse diameter,the anteroposterior diameter and the average maximum diameter of abdomen were recorded.A five-point scale was used for grading the image noise of eight organs,including abdominal aorta,portal vein,liver,spleen,gallbladder,pancreas,renal cortex and renal medulla. Diagnostic acceptability of CT images at three anatomic levels,including porta bepatis,pancreas and the upper pole of renal,was also evaluated by using a five-point scale.The noise value of abdominal aorta was defined as the standard deviation (SD) of CT values of aorta at the level of porta hepatis.Scatter diagram and Pearson correlation analysis were used for evaluating the linear relationship between the individual variants and the noise value of abdominal aorta,and multivariate linear regression analysis was used for evaluating the relevance between the individual variants and the noise value of aorta.ResultsIn this patients group,the average height was ( 164.6 ± 7.5 ) cm,the average weight was (64.3 ± 11.0) kg,the BMI was (23.7 ±3.3) kg/m2,the maximum transverse diameter of abdomen was(29.8 ± 2.3 )cm,the anteroposterior diameter of abdomen was (23.1 ± 2.9) cm,and the average maximum diameter of abdomen was ( 26.5 ± 2.5 ) cm.Pearson correlation analysis showed significant positive linear correlation between the noise value of abdominal aorta( 1 1.7 ± 3.0)and patients' weight ( r =0.744,P ＜ 0.01 ),BMI ( r =0.689,P ＜ 0.01 ),the maximum transverse diameter ( r =0.813,P ＜ 0.01 ),the anteroposterior diameter ( r =0.781,P ＜ 0.01 ),the average maximum diameter of the abdomen ( r =0.789,P ＜ 0.01 ) ; however,there was no positive linear correlation between the noise value of abdominal aorta and patients' height ( r =0.292,P ＜ 0.01 ). The maximum transverse diameter of abdomen is greatly related to the noise value of abdominal aorta (Beta =0.487,P ＜0.01 ).For the patient with the maximum transverse diameter of abdomen ranging from 27 to 32 cm,diagnostic acceptability of CT images at the anatomic level of porta hepatis showed statistical significance compared with the patient with the maximal transverse diameter of the abdomen greater than 32 cm or less than 27 cm (P ＜ 0.05 ).Conclusion The tube current of 207 eft.mAs is reasonable for abdominal CT scan for patients with the maximal transverse diameter of the abdomen ranging from 27 to 32 cm.