The UDRS interlocking fault is a common dose interlocking of Varian high-energy linear accelerator. Due to the complexity of the system, this fault has brought challenges to the engineers for a long time. Hence, an effective solution is urgently required. In this article, the circuit and principle for UFRS interlocking fault for Varian CLINAC-IX linear accelerator were explicitly analyzed and the maintenance methods were summarized. The management methods of such rare fault were shared, aiming to provide reference for subsequent management of similar interlocking faults.

Objective The aim of our study was to describe the clinicopathological characteristics and to evaluate the prognostic factors of postoperative PNENs.Methods The clinicopathological data of 101 postoperative PNENs patients were collected and analyzed retrospectively.We analyzed the clinicopathological characteristics and prognostic factors.The survival analysis was conducted by Kaplan-Meier method and survival analysis was performed by Cox model.Results 101 patients with PNENs were enrolled,including 46.5％ male(n=47) and 53.5％ female(n=54),the median age was 51 years old (ranged 19-80).94 patients(93.1％) with neuroendocrine tumors(NETs),7 patients(6.9％) with neuroendocrine carcinomas(NECs).The mean size of tumor was 3.3 cm(ranged 0.5-15).Immunohistochemistry staining positive rates for chromogranin A (CgA) and synaptophysin (Syn) were 89.0％ and 98.0％ respectively.Patients were 66 cases (65.3％),23 cases (22.8％) and 12 cases (11.9％) in TNM stage I,II and IV respectively.34 cases(33.7％) were F-PNENs,and 67 cases(66.3％) were NF-PNENs.Our study demonstrated that there were statistically significant differences between F-PNENs and NF-PNENs in stage,grade,neural and vascular invasion,CgA positive rate(χ2=10.372,18.162,9.699,5.547,4.043,P＜0.05).Meanwhile,significant differences were found between NETs and NECs in stage,neural and vascular invasion,CgA positive rate(χ2=11.642,5.254,14.458,5.254,P＜0.05).PNENs had better prognosis,with 5-year survival rate of 84.3％.The independent prognostic factor for survival was grade.Conclusion PNENs are a family of tumors with diversity clinical presentation and prognosis.Surgery is the main treatment method,grade of PNENs is the independent prognostic factor.

Objective To evaluate the clinical diagnosis,treatment and prognostic factors of kidney clear cell renal carcinoma(KIRC)in international sample database.Methods From 1998 to 2012,consecutive patients with KIRC who diagnosed and treated in TCGA organizations were enrolled.Clinical characteristics,objective response and survival time were evaluated,and correlation analysis with lncRNA urothelial cancer associated 1 (UCA1)gene was performed.Results 512 patients with KIRC were enrolled.35.4% of patients were female,59.6% of stage Ⅰ -Ⅱ, 90.0% of white and 45.1% of grade 1 -2.Comprehensive treatment was consistent with the clinical guidelines. Significant correlation was found between UCA1 expression and 4 mRNA subtype,30 genes mRNA expression, mir -101 -1 expression and PBRM1 mutation.And patients with UCA1 overexpression could achieve poor prognosis. Conclusion Diagnosis and treatment of the international TCGA -KIRC research meets clinical guidelines.UCA1 overexpression is an important poor prognostic factor.Combined with the clinical relevance of other important driver genes,UCA1 may be significantly valuable for further study.

Objective: To analyze and review the clinical efficacy of acupuncture (including electroacupuncture) alone for allergic rhinitis (AR) and to compare its efficacy with antihistamines and Chinese patent medicineBi Yan Kang Tablet. Methods: The search strategy, inclusion and exclusion criteria were made according to the principle of evidence-based medicine. We performed a systematic search on China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), Chinese Biomedical Literature Database (CBM), PubMed, Excerpta Medica Database (EMBASE), Web of Science, Cochrane Library, and Cochrane Central Register of Controlled Trials (CENTRAL) for randomized controlled trials (RCTs) of acupuncture for allergic rhinitis between January 1990 and December 2015. The quality was evaluated by Cochrane Handbook for Systematic Reviews of Interventions Version 5.1, and the meta-analysis was conducted by RevMan 5.3 version. Results: Twenty eligible RCTs were included into the meta-analysis after selection. Compared with antihistamines, the meta-analysis showed RR=1.24>1, 95%CI[1.15, 1.33],P<0.00001, indicating that acupuncture achieved a better total effective rate for AR than antihistamines; MD=–0.93<0, 95%CI[–1.22, –0.63],P<0.00001, indicating that acupuncture is better than antihistamines in decreasing the total nasal symptom score (TNSS) in AR patients; and MD=1.46>0, 95%CI[–10.84, 13.75],P=0.82, indicating that there was no statistical difference between acupuncture and antihistamines in regulating immunoglobulin E (IgE) in AR patients. Compared withBi Yan Kang Tablet, the meta-analysis has shown RR=1.50>1, 95%CI[1.30, 1.73],P<0.00001, indicating that acupuncture achieved a better total effective rate for AR than Chinese patent medicineBi Yan KangTablet. Conclusion: Acupuncture alone can achieve a better total effective rate for AR than antihistamines andBi Yan Kang Tablet. It is also better than antihistamines in improving clinical symptom scores; however, whether acupuncture is better thanBi Yan KangTablet needs further proof. As far as current data are concerned, there was no statistical difference between acupuncture and antihistamines in improving serum IgE; further study is needed in this regard. The risk of bias due to absent randomization methods or blinding implementation decreased the evidence level of the overall conclusion.

By organizing and classifying the literatures related to acupuncture-moxibustion at Jiaji (EX-B 2) points in treating intervertebral disc herniation (IDH) published before December 31, 2013, to summarize the application status and features of Jiaji (EX-B 2) points. It’s found that its most favorable indication is IDH. It also further analyzed the action mechanism of acupuncture-moxibustion at Jiaji (EX-B 2) points in treating IDH, and brought up some ideas to highlight the further study.

Objective:To observe the impact of herb-partitioned moxibustion and electroacupuncture on hyaluronic acid(HA),procollagen Ⅲ(PC Ⅲ)and collagen Ⅳ(CⅣ)of intestinal fibrosis in rats with Crohn's disease(CD),and discuss the effect and the mechanism of acupuncture on treating intestinal fibrosis of rats.Methods:SD rats were randomly divided into control group,model group,herb-partitioned moxibustion group,electroacupuncture group and medicine group.The model of CD was developed by trinitrobenzene sulfonic acid.Masson stain was used to observe the collagen fibers hyperplasia in colon and radioimmunoassay was adopted to detect the content of HA,PC Ⅲ and C Ⅳ in serum.Results:Compared with the control group,the proliferation of colonic collagen fibers,as well as the HA,PC Ⅲ and CⅣ in serum increased in the model group.Compared with the model group,the expression of collagen fibers,serum HA,PC Ⅲ and C Ⅳ decreased in the herb-partitioned moxibustion group,electroacupuncture group and medicine group.The expression of collagen fibers serum HA,PC Ⅲ and C Ⅳ in the herb-partitioned moxibustion group were lower than in the electroacupuncture group and medicine group.Conclusion:Herb-partitioned moxibustion and electroacupuncture effectively improved the pathological state of intestinal fibrosis in rats with CD and reduced the content of HA,PC Ⅲ and C Ⅳ in serum.

Objective:To observethe influence of electroacupuncture (EA) on histomorphologies of lacrimal glands, cornea and conjunctiva in experimental dry eye syndrome, and to explore the repair effects of EA on lacrimal glands and ocular surface damage. Methods:Twenty-four healthy male New Zealand rabbits were randomly divided into a normal group, a model group, an EA group and a medication group, 6 rabbits in each group. Experimental dry eye syndrome models were prepared in rabbits by using 0.1% benzalkonium chloride for eye drops. Tear secretion volume, break-up time of tear film (BUT) and corneal fluorescein staining score were observed before and after the treatment. Periodic acid Schiff (PAS) staining method was used to observe the changes of conjunctival goblet cells in rabbits. After hematoxylin eosin (HE) staining, morphological changes of rabbit cornea, conjunctiva and lacrimal gland tissues were observed under light microscope. Results: Compared with the normal group, tear secretion volume and BUT were significantly reduced (bothP<0.01), while the corneal fluorescein staining score was significantly increased (P<0.01) in the model group. Compared with the model group, tear secretion volume and BUT were significantly increased, while the corneal fluorescein staining score was significantly decreased in the EA group and the medication group (allP<0.01). Compared with the normal group, the number of conjunctival goblet cells in the model group was significantly reduced; compared with the model group, the numbers of conjunctival goblet cells were all relatively higher in the EA group and the medication group. Pathological lesions of cornea, conjunctiva and lacrimal glands all showed improvement by HE staining in the EA group and the medication group after the intervention. Conclusion:EA can improve tear secretion and tear film stability of rabbit dry eye syndrome, and repair the pathologic lesions of conjunctival goblet cells, corneal epithelia, cornea, conjunctiva and lacrimal glands.

Objective To evaluate the safety,effectiveness and clinical factors of re-intervention of transjugular intrahepatic porto-systemic shunt (TIPS).Methods A retrospective study of safety and longterm outcomes of TIPS was made in 771 patients from August 1994 to August 2010.The 625 patients had follow-up data.The patients who received TIPS once,twice,and more than twice were divided into group 1,group 2 and group 3,respectively.Clinical symptoms,survival rate and restenosis rate of each group were analyzed.Clinical influencing factors of re-intervention effect were discussed.Results The success rate of first intervention was 98.2％ (757/771),the death rate was 0.7％ (5/757) and severe complication rate was 2.5％ (19/757).The success rate of re-intervention was 98.7％ (457/463),no death and severe complications occurred.The restenosis rate in group 3 decreased significantly than group 1 ( x2 =7.908,P ＜0.05 ) in the first year of TIPS.The restenosis rates in group 2 and group 3 were lower than group 1 from 2 to 5 years of TIPS ( x2 values were 27.046,25.724,37.002 and 19.046,respectively,P ＜ 0.05 ). The survival rate in group 3 was higher than group 1 (x2 =9.114,P＜0.05)and group 2 was higher than group 1 ( x2 =4.929,P ＜ 0.05 ) in the first year of TIPS,while there was no statistical difference between group 2 and group 3 ( x2 =2.678,P ＞ 0.05).The patients in group 2 and group 3 also had higher survival rates than group 1 from 2 to 5 years of TIPS (x2 value were 41.314,26.920,13.692 and 6.713,respectively,P ＜ 0.05 ).19.4％ (79/406)of patients who received re-intervention had symptom recurrence and shunt stenosis or occlusion. 11.6％ (47/406) of patients had symptom recurrence with portal hypertension signs,62.8％ (255/406) had shunt stenosis or occlusion with portal hypertension signs.Conclusions Restenosis or occlusion of TIPS,symptom recurrence and portal hypertension signs were important factors for re-intervention.Re-intervention of TIPS was safe and effective,and could improve the survival rate of patients with TIPS.

In this article, a case for random signal interference in resolver (or encoder) of carousel on Varian VitalBeam medical linear accelerator was illustrated. This case was considered as a rare failure of the technology platform (including TrueBeam) by Chinese, European and American technical experts in Varian. In this article, the differences of the carousel in the structure and control system between VitalBeam and traditional accelerator were comparatively analyzed to enable the peers to have a deeper understanding of resolver. The logic and methods to solve the fault were summarized, providing reference experience for analyzing the problems related to carousel. It is found that the interlocking system is imperfect, which provides a factual and technological basis for Varian to optimize the system.

OBJECTIVE: To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019 (COVID-19). METHODS: Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed. RESULTS: The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%). CONCLUSIONS The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.
Betacoronavirus ; isolation & purification ; China ; Coronavirus Infections ; diagnostic imaging ; pathology ; Disease Progression ; Humans ; Pandemics ; Pneumonia, Viral ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed