OBJECTIVETo explore the dose-length product calibration method for pencil ionization chamber in cobalt beams.

METHODSThe PTW TM30009 ionization chamber was placed into the central hole of T40017 head phantom and irradiated 60 s in 20 cm x 20 cm cobalt beam. The charge was collected with UNIDOS electrometer. Absorbed doses were measured with TM30013 0.6 mL farmer-type chamber under the same condition. The CT chamber calibration factor was expressed in dose-length product. Dose linearity and spatial response were also investigated.

RESULTSThe calibration factor in dose-length product was derived from measured data. Dose linearity and spatial response were good in cobalt beams.

CONCLUSIONIt is feasible to calibrate the CT chamber in cobalt beams for patient dose evaluation in MVCT.

ObjectiveTo investigate the curative effect of structural bone graft in treatment of high energy injury-induced complicated distal radius fractures combined with articular surface collapse and comminuted epiphyseal bone defect.MethodsThe study involved 38 patients with distal radius fractures (AO classification, type C3) treated from January 2007 to October 2010.The patients were treated with temporary Kirschner wire fixation to recover the wrist articular surface, distal radius length and palmar tilt angle at the greatest possibility.According to the form of the bone defects, the iliac bone taken from three layers of the cortical bone was embedded in the subchondral bone to support the bone graft, and a small amount of cancellous bone graft was collected to fill the articular surface collapse as much as possible for anatomical reduction of the articular surface, and anatomical form of the distal radius was reconstructed.Modified Sarmiento Gartland and Werley evaluation systems were used to evaluate the articular function recovery.ResultsThe follow-up lasted for 1-3.2 years, which showed no complications such as plate rupture or iatrogenic nerve blood vessels injuries.The fracture healing time was 15-22 weeks (mean 18.3 weeks).The wrist articular function in some patients obtained obvious improvement through functional rehabilitation training.According to the modified Gartland and Werley function evaluation systems, the curative effects reached excellence rate of 87％.During follow-up, there were two patients with high progressive loss in the height of the distal radius and two with articular surface collapse and severe carpal joint flexion and extension dysfunction.ConclusionsThe high energy injury-induced distal radius fractures with articular surface collapse and epiphyseal bone defect need recovery of the wrist articular surface, distal radius length and palmar tilt angle.Structural bone graft can effectively support the grafted bone and maintain the flatness of the radiocarpal articular surface, restore the anatomy of the distal radius and facilitate the functional recovery of the wrist.

Objective To investigate forkhead/winged helix transcription factor (FoxP3) expression in peripheral blood and liver-infiltrating lymphocytes (LIL) of patients with hepatitis B. Methods Flow cytometry, immunohistochemistry and real-time RT-PCR were employed for Fox P3 analysis of blood or live tissue obtained from patients with acute hepatitis B (AHB), chronic hepatitis B (CHB) and chronic severe hepatitis B (CSHB), as well as health controls. Results Fox P3 mRNA and protein expressions were specifically identified in CD4+CD25+ regulatory T cells. The level of Fox P3 mRNA in CD4+ T cells was identical with that in CD4+CD25+ regulatory T cell in peripheral blood. In CSHB patients a significant increase of Fox P3 mRNA expression was found in peripheral blood. The mean relative FoxP3 mRNA levels of CD4+ T cells in CSHB patients, AHB patients, CHB patients, and healthy controls were 0.199?0.174, 0.053?0.017, 0.059?0.053, and 0.056?0.021, respectively (CSHB group vs. other groups, P all

interface screw,with significant difference(P0.05).[Conclusion]All internal fixations in this study could meet biomechanical requirement,but Rigidfix and Intrafix showed more advantages.

Objectives To assess the efifcacy of nasal bilevel positive airway pressure (nBiPAP) in preventing extuba-tion failure of neonatal respiratory distress syndrome (RDS) in premature infants. Methods Premature infants (≤32 weeks) diagnosed as RDS and treated with mechanical ventilation, admitted to the neonatal intensive care unit from January 2011 to June 2012, were enrolled in the prospective controlled trial. Fifty-six infants receiving non-invasive ventilation due to unrelieved expiratory dyspnea after the ifrst extubation were selected, and were randomly divided into nBiPAP group (n=27) and nCPAP group (n=29). Blood gas analysis before and after non-invasive ventilation, the failure rate of non-invasive venti-lation in seven days and the incidence of various complications were compared between two groups. Results The blood gas analysis for the ifrst time after extubation suggested that infants treated with nBiPAP had a higher PaO2 level ((58.7±6.3) vs. (55.1±5.9) mmHg, P<0.05) and lower PaCO2 level ((46.4±4.9) vs. (49.9±5.0) mmHg, P<0.05) than those treated with nCPAP. Infants treated with nBiPAP had lower incidence of extubation failure in seven days than infants treated with nCPAP (7.4%vs. 31.0%, P=0.042). The incidence of complications between two groups was similar. Conclusions nBiPAP is safe and fea-sible for preventing extubation failure in preterm infants≤32 weeks with RDS and is more effective than nCPAP.

Objective To study comparatively the clinical anaesthetic potency and adverse effects to children of 0.375% ropivacaine used for brachial plexus block in upper-limb paediatric surgery.Methods After undergoing basal anesthesia with ketamine,36 children scheduled for hand and forearm surgery were randomly allocated to receive brachial plexus block with 0.375% ropivacaine(group A) and to receive intravenous anesthesia with ketamine(group B).The effect of sensor block and motor block,the changes of vital sings,the occurrence of side effect(nausea and vomiting) and palinesthesia of children were observed.Results The patients in group A kept a steady vital signs,their blood pressure,cardiac and respiration rate were similar to the backgroud level before anesthesia,whereas in group B the blood pressure,cardiac and respiration rate of patients were increased and kept a rather higer level,fluctuated with the depth of anesthesia.Conclusion Ropivacaine used for brachial plexus block in upper-limb paediatric surgery is a simple,feasible,and safe method with anesthetized perfectly and less complication.

Granular corneal dystrophy is a rare autosomal dominant genetic disease in clinic.Due to the TGFBI mutation on the 5q31 chromosome,the TGFBIp abnormally aggregates in the Bowman layer and the matrix layer and metabolic disorders,patients' bilateral cornea arise opacity,making visual acuity Progressive impairment.At present,there are at least 66 TGFBI mutations,at least 10 of which are related to granular corneal dystrophy,due to variation in genotype and the difference between homozygous and heterozygous,the patients' phenotype shows a significant difference.Along with the improvement of people's cognition,and the application of laser scanning confocal microscope and the gene diagnosis,More and more patients get the correct diagnosis,Current treatment methods mainly include corneal transplantation and laser ablation,patients are not satisfied because of the postoperative recurrence and aggravated.Due to the establishment of granular corneal dystrophy animal model,lithium and gene therapy will show a good application prospects.

Objective To explore the dose-length product calibration method for pencil ionization chamber in cobalt beams. Methods The PTW TM30009 ionization chamber was placed into the central hole of T40017 head phantom and irradiated 60 s in 20 cm×20 cm cobalt beam. The charge was col ected with UNIDOS electrometer. Absorbed doses were measured with TM30013 0.6 mL farmer-type chamber under the same condition. The CT chamber calibration factor was expressed in dose-length product. Dose linearity and spatial response were also investigated. Results The calibration factor in dose-length product was derived from measured data. Dose linearity and spatial response were good in cobalt beams. Conclusion It is feasible to calibrate the CT chamber in cobalt beams for patient dose evaluation in MVCT.

Objective To investigate the risk of hepatitis B virus (HBV) infection in the children born to HBV‐infected parent (s) after in vitro fertilization (IVF) .Methods From January 2008 to December 2013 , in the reproductive medicine center of the Third Affiliated Hospital of Zhengzhou University ,the medical history of 221 mothers by IVF were collected .Inclusion criteria were at least one of the parents was positive for hepatitis B surface antigen (HBsAg) ,and HBV DNA<1 × 104copies/mL . Hepatitis B vaccination status and HBV infection status of children were followed by telephone .Results One hundred and seventy‐two cases were followed up successfully ,and 49cases were lost .Two hundred and twenty‐four cases of children were HBsAg negative ,but one of them showed hepatitis B virus e antibody and hepatitis B virus core antibody positive .Conclusions The vertical transmission risk of HBV infection of children born to HBV‐positive patent(s) by IVF did not increase .

Objective To explore the expression of nemo-like kinase (NLK) in primary hepatic carcino-ma (HCC) and its clinicopathological significance. Methods The expression of NLK was detected in 136 HCC samples by Immunohistochemistry. Results NLK expression was significantly up-regulated in HCC specimens compared to corresponding normal liver tissues. High expression of NLK was significantly associated with Ed-mondson-steiner grade, tumor size and number of tumor nodules (all P < 0.05). There was positive correlation between NLK and proliferation marker Ki-67 (P < 0.01). Kaplan-Meier analysis showed the high expression NLK group was significantly associated with poor overall survival and disease-free survival (all P < 0.001). Univariate analysis showed that the high expression NLK was associated with poor prognosis (P < 0.001). Multivariable Cox regression analysis suggested that the expressions of NLK and Ki-67 , Edmondson-steiner grade , metastasis , tu-mor size and number of tumor nodules were independent prognostic indicators for HCC. Conclusions NLK was markedly upregulated in HCC specimens, and it might be an independent prognostic marker for HCC. NLK might play an important role in tumorigenesis, progression and prognosis of HCC.