Objective One hypothesis is that patients with uraemia showing hyporesponsiveness to rHuEPO may have enhanced levels of immune activation causing increased rdease of inflammatory cytokines. To study the effects of chronic inflammation on the hyporesponsiveness to rHuEPO and its possible mechanisms, T cell phenotypes using flow cytometry and the relationship between these changes were detected. Methods 40 patients with MHD and 20 age-matched healthy volunteers were enrolled in the study. The MHD patients were divided into two groups according to the responsiveness to rHuEPO:22 cases with good responders and 18 cases with poor responders. The percentages of T cell subsets including CD+4 ,CD+8,CD+4/CD+28,CD+8/CD+28 T cell using flow cytometry were detected. Results The percentages of CD+4 and CD+8 T cell were lower in MHD patients than that in control group. The percentages of CD4+/CD+28 and CD+8/CD+28 T cell were lower in group of poor responders than in good responders.Conclusion Chronic inflammation state is common in MIlD patients. The percentages of CD+4/CD+28 and CD+8/CD+28 T cell in poor responders were much lower than good responders. The changes of T cell phenotypes may play a role in pathogenesis of hyporespousiveness to rHuEPO.

Objective To evaluate the clinical efficacy of transthoracic two dimensional echocardiography, cardioangiography (CAG), and MRI in the diagnosis of cor triatriatum. Methods Twelve cases of cor triatriatum were confirmed by operation. Imaging examination was performed in 12 cases by transthoracic two dimensional echocardiography, 6 cases by CAG, and 8 cases by MRI. Results The diagnostic accuracy of cor triatriatum was 7 out of 12 by UCG, 4 out of 6 by CAG, and 8 out of 8 by MRI, respectively. MRI provided excellent delineation of the intraatrial membrane and the size of the membrane orifice. Conclusion MRI was of great value in the diagnosis of cor triatriatum.

Objective To research the structure and principle of Helical Tomotherapy, and study the clinical application value of the equipment system. Methods As the first helical radiotherapy system in the mainland of China, its constructions, structure and principle were analyzed and discussed. Results Helical Tomotherapy is a new kind of radiotherapy equipment. The Hi-Art treatment system is a combination of a LINAC and a CT scanner capable of having the function of both systems. It was approved to achieve the best intensity modulated radiation therapy (IMRT), used for adjusting the setup position of the patient with MVCT and as the basis for dose reconstruction and other adaptive radiotherapy processes. It is the first integrated planning, delivery and verification system for IMRT. Conclusion Image-guided radiation therapy (IGRT) and IMRT have introduced a new era in radiation oncology which will better fight cancer and simultaneously improve the patients' quality of life. Having been designed from the ground up for IGRT and IMRT, the tomotherapy system is in the forefront of technical advancements for efficacy and processes to make it efficiently.

Radiotherapy physics is a cross subject that studies and solves the scientific problem referring to medicine treatment based on physics.Ceaseless progresses of Radiotherapy equipments such as Cobait-60 treatment machine,Linear Accelerator,Gama Knife,Tomotherapy have provided comprehensive treatment measures for malignant tumor.Therapies including conformal Radiotherapy,Intensity Modulation Radiotherapy and Gama Knife are progressing and being perfected.Further research should be done on dose fraction.Boron Neutron Capture Therapy and Proton Therapy are being studied.Treatment Plan System and Target Delimitation need perfecting.

Objective To analyse the long-term effect of non-small cell lung cancer treated with either postoperative irradiation(group A) or intraoperative radiotherapy(IORT) followed by postoperative irradiation(group B).Methods 154 patients with non-small cell lung carcinoma were randomized into two groups(groups A and B) with 77 patients in each.There were 134 squamous,17 adenocarcinoma and 3 adeno-squamous carcinoma.Seventeen patients had stage Ⅰ,76 stage Ⅱ and 61 stage Ⅲ lesions.The dose of postoperative irradiation in both groups was D_T4060?Gy.In group B,the IORT dose was 15-25?Gy,delivered by 9-16 ?MeV electrons.Results The local control rate was 49% and 62% in groups A and B,respectively(P0.05).Sixteen patients died of radiotherapy-induced complication: 2 in group A and 14 in group B.Conclusions Intraoperative radiotherapy followed by postoperative irradiation can enhance the local control rate of non-small cell lung cancer but can not improve the long term survival. The high complication mortality rate of IORT(18%) in contrast to that(3%) of postoperative radiotherapy is worth noticing.

BACKGROUND: Limb ischemia reperfusion (LIR) as a stressor leads to gastric mucosal injury, and then results in the occurrence of stress ulcer.OBJECTIVE: To observe the effects of LIR on gastric mucosal injury, investigate part of the mechanism, and the role of several transient limb ischemia in the occurrence of gastric mucosal injury.DESIGN: A randomized grouping design and controlled animal experiment.SETTING: Department of Pathophysiology of North China Coal Medical College.MATERIALS: The experiment was carried out in the pathophysiological laboratory of North China Coal Medical College from January to June 2002. Fifty-four healthy adult male Wistar rats were randomly divided into three groups with 18 rats in each group. Ischemia reperfusion (I/R) group: The rats were duplicated into models according to the Rosenthal method that under superficial anesthesia with ether, the roots of both hindlimbs were ligated by wrapping with rubber strap, blood flow was blocked for 4 hours and then recovered to perfusion for 4 hours, and finally killed by bleeding from abdominal aorta. Ischemic preconditioning group: Before model establishment, blood flow of both hindlimbs was blocked for 5 minutes, and then recovered to perfusion for 5 minutes, which was repeated for four times, and the following operations were the same as those in the I/R group. Control group: The operations were the same as those in the I/R group,but both hindlimbs were ligated at relaxation without blocking the blood flow.METHODS: Sections of gastric mucosa were prepared, and then observed under light microscope and electron microscope, and the index of gastric mucosal injury was determined according to the Guth standard. The colorimetric assay was performed with 721 spectrophotometer at 650 nm, and the amount of gastric combining mucus was calculated.Meanwhile, the blood flow of gastric mucosa, contents of phospholipid and hexosamine in gastric mucus, content of nitric oxide in plasma and gastric tissue and activity of nitric oxide synthase (NOS) in gastric mucosa were determined.MAIN OUTCOME MEASURES: Index of gastric mucosal injury, amount of gastric combining mucus, blood flow of gastric mucosa, contents of phospholipid and hexosamine in gastric mucus, contents of nitric oxide in plasma and gastric tissue and NOS activity in gastric mucosa.RESULTS: All the 54 rats were involved in the analysis of results. ① In the I/R group, gastric mucosal injury was serious, edema, hyperemia, erosion and disintegration of gland of mucosal glands were observed, infiltration of inflammatory cells (formation of ulcer) was observed in basal and inferior mucosa. In the ischemic preconditioning group, the gastric mucosa was complete, and the damaged severity was milder than that in the I/R group; Under electron microscope, the organell structures of gastric parietal and chief cells were incomplete and destroyed. The cell injuries in the ischemic preconditioning group were milder than those in the I/R group (index of injury: 18.00±10.71, 34.00±15.01, P＜ 0.01). ② The blood flow and combining mucosal amount of gastric mucosa, contents of phospholipid and hexosamine in gastric mucus in the ischemic preconditioning group and I/R group were all obviously lower than those in the control group [(2.12±0.56), (10.84±2.56), (25.52±2.97) mL/(kg·h); (2.01±0.91), (2.79±0.73), (3.99±0.87) mg;(7.68±1.95), (9.74±1.04), (11.98±1.98) mg/g; (3.83±1.18), (5.42±0.47), (5.76±1.21) mg/g, P ＜ 0.05, 0.01], those the above indexes were all higher in the ischemic preconditioning group than in the I/R group. ③ The contents of nitric oxide in plasma and gastric tissue and NOS activity in gastric mucosa in the ischemic preconditioning group and I/R group were significantly lower than those in the control group [(250.0±5.6), (270.0±11.3), (210.0±7.4) μmol/L; (9.34±0.67), (11.34±1.00), (7.50±0.67) μ kat/g, P ＜ 0.01], those were also signficantly higher in the ischemic preconditioning group than in the I/R group.CONCLUSION: As a stressor, LIR can lead to gastric mucosal injury, and cause stress ulcer.Ischemic preconditioning can alleviate the gastric mucosal injury following LIR

Objective To investigate the feasibility of dose verification of intensity modulated (IM) planning of helical tomotherapy (HT) using two-dimensional ion chamber array (2DICA),and develop an efficient way to validate the dose delivered under the parameters mirroring those during the treatment. Meth-ods A 2DICA,I'mRT MatriXX and MULTICube equivalent solid water phantom from IBA company were used to verify the dose distribution of 10 IM planning. The combined phantom was set up to measure the dose distributions on coronal and sagittal surface. The precise setup of phantom was guided by HTMVCT images. After the irradiation, the measured dose distributions on the coronal and sngittal plane were compared with those calculated by the IM planning system for verification. The results were evaluated and the feasibility of the different measuring methods was studied. Results The dose distribution measured by the MatriXX 2DICA was well consistent with that calculated by the treatment planning system. The errors between the measured dose and predicted dose in the selected points were within ±3%. In the comparison of the pixel-segmented ionization chamber versus treatment planning system using the 3 mm/3% γ criteria, the passing ratio of pixels with γ parameter ≤1 was 97.76% and 96.83%, respectively. Conclusions MatriXX is a-ble to measure the absolute and relative dose distributions simultaneously,which can be used for dose verifi-cation of IM planning.

Objective To observe the apeptosis in liver injury following limbs ischemia-reperfusion(IR) in rats and the protective effects of taurine.Methods The model of limbs ischemia-reperfusion injury was established.30 Wistar rats were randomized into 3 groups: control group,IR group and tanrine + reperfusion group (TR group) (n = 10 for each group).The levels of malondialdehyde (MDA) and xanthineoxidas (XOD), calcium and myeloper-oxidase (MPO) in the liver tissue were measured.DNA fragmentation was observed and analyzed by agarose gel e-lectrophoresis.Apoptosis was detected by TUNEL methods.The morphologic changes were observed with HE stai-ning.Results Compared with control group,the values of MDA, XOD, MPO, calcium in liver tissue were increased significantly in IR group (P<0.01), but the values of those in TR group were lower than in IR group (P<0.01).The percentage of apeptosis cell was higher in IR group than in control group(P<0.01).Compared with IR group, the percentage of apoptosis cell was lower in TR group (P<0.01).IR group presented DNA ladder pattern, while TR group showed no specific DNA ladder pattern in agarose gel electrophoresis.Conclusion Apoptosis participates in the liver injury after limb ischemia-reperfusion.Taurine can mitigate the liver injury and apoptosis after limb is-chemia-reperfusion injury in rats.

Objective To evaluate the clinical feasibility of quality assurance of helical tomotherapy intensity modulated radiation therapy (IMRT) through a series of clinical case studies. Methods Tomotherapy planning system was used to provide optimized IMRT treatment plans. To verify the dose of IMRT plans,the cylindrical Virtual Water phantom,0.056cm3 AISL, ion chamber and EDR2 film were used for getting the absolute and relative doses from tomotherapy IMRT planning. The film and ion chamber were placed into the phantom. The doses of the interesting points and isodose distribution of the axial plane were measured,then the results were compared with those from the calculation in planning system for verification. Before the irradiation,kVCT images of the phantom were registered by tomotherapy MVCT images. So the setup of phantom was guided for verifying the position. Results The isedose distribution (on the axial plane) measured by the film was well consistent with that calculated by tomotherapy planning system. The error between the measured dose and predicted dose in the measured points was less than 3%. The setup error of the phantom was able to be kept within 1 mm. There was 2 mm offset along the vertical direction of couch from the virtual isocenter to beam isocenter,which should be considered during the phantom/patient setup. Conclusions The procedures for quality assurance of tomotherapy IMRT are feasible in our experience. And helical tomotherapy IMRT QA system has been constituted.

AIM: To observe the degree of gastric mucosal injury following limb ischemia/reperfusion(LIR),and to investigate the mechanism of gastric mucosal injury and the influence of the series of brief ischemia/reperfusion of hind limbs of rats on gastric mucosal injury. METHODS: Referring to Rosenthal's method, the model rats which underwent 4 hours of ischemia and 4 hours of reperfusion in hind limbs were made. The indexes of gastric mucosal injury after LIR and ischemic preconditioning (IPC) + LIR were determined. The morphologic changes were observed with light microscope and transmission electron microscop respectively. The GMBF,histologic lesion score, gastric barrier mucus, phospholipids, hexosamine, nitric oxide and nitric oxide synthase in mucus were measured in different groups. RESULTS: Serious damage in gastric mucosa was observed under microscope and EM after LIR. But less serious damage was observed in the IPC group. After LIR, compared to the control group, the GMBF and the content of gastric barrier mucus, phospholipids and hexosamine in mucus decreased significantly. There was significant difference in most indexes between the control group and the IPC group, but compared to LIR group, the histologic lesion score decreased significantly and the GMBF and the content of gastric barrier mucus, phospholipids, hexosamine ,nitric oxide and nitric oxide synthase in mucus increased significantly. CONCLUSION: LIR caused the gastric mucosa injury. IPC alleviated the damage of gastric mucosa following ischemia/reperfusion in hind limbs.