Objective To perform the main application of MRI arterial spin labeling (ASL) in cerebral blood flow (CBF) on hippocampus of patients with temporal lobe epilepsy for quantitative measurement,to assess the relationship between temporal lobe epilepsy occurrence and hippocampal perfusion and to explore the critical value of hippocampal CBF predict the temporal lobe epilepsy early.Methods Forty-two subjects by video EEG (VEEG) and conventional MR sequences screend were divided into 3 groups eventually,namely group of healthy control,the group with one temporal lobe abnormal discharge,that conventional MRI in hippocampus is not abnormal and the last group with one side hippocampus sclerosis confirmed by conventional MRI in temporal lobe epilepsy patients,then for the hippocampal 3D ASL examination.We provided six same size regions of interest (ROI) in the hippocampal head,body,tail respectively with the best level display to measure and record bilateral hippocampal cerebral blood flow values (CBF values) of every subject,and to explore the relationship between the cerebral blood flow value in the hippocampus and temporal lobe epilepsy.Results Mean cerebral blood flow (CBF) value of each subject's unilateral hippocampus was calculated.The average CBF value of the hippocampus in the healthy control group was 53.82 ± 0.98ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral abnormal discharge group with the ipsilateral and contralateral were 49.12 ± 5.31ml/(100g · min) and 55.99 ± 1.65ml/(100g · min).The average CBF of the hippocampus in epileptic unilateral hippocampal sclerosis group with the ipsilateral and contralateral were 39.57 ± 2.08ml/(100g · min) and 48.06 ± 1.74ml/(100g · min).Then pairwise comparison of the unilateral hippocampal average CBF value among the 3 groups of experimenters in different groups was performed.The results showed that in the eight times,the first six times had statistically significant differences.Comparing between the healthy control group and epilepsy unilateral temporal lobe abnormal discharge group,to calculates the best critical point by the ROC curve,the cut-off value was 46.76.Conclusion Magnetic resonance arterial spin labeling (ASL) technique can evaluate the cerebral blood flow in the hippocampus of patients with temporal lobe epilepsy by quantitative measurement of hippocampal CBF value.The changes of hippocampal perfusion in patients with temporal lobe epilepsy should be preceded by the changes of imaging.ASL quantitative measurement of hippocampal CBF value is helpful for early diagnosis and treatment of temporal lobe epilepsy.

Objective To evaluate the effect of bladder volume change on the doses to normal tissues in cervical cancer patients undergoing external three-dimensional conformal radiotherapy (3DRT)plus 3D conformal brachytherapy (3DCBT).Methods The study included 56 patients with cervical cancer who were admitted to our hospital from 2012 to 2013 and received radical external 3DRT and 3DCBT.During 3DCBT,the doses to 0.1,1.0,and 2.0 cm3(D0.1 cm3,D1.0cm3,and D2.0cm3,respectively) for the rectum,small intestine,sigmoid colon,and bladder under different bladder filling status (empty,50,100,and 150 ml) were compared and analyzed by paired t-test.Results The rectum D0.1cm3 with bladder volumes of 50and 100 ml were significantly reduced compared with that with an empty bladder (P =0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the small intestine with bladder volumes of 50,100,and 150 ml were significantly reduced compared with those with an empty bladder (P =0.008,0.000,0.000 and 0.000,0.000,0.000 or 0.000,0.000,0.000).The D0.1 cm3,D1.0cm3,and D2.0cm3 for the bladder with bladder volumes of 100 and 150 ml were significantly increased compared with those with an empty bladder (P =0.000,0.000 and 0.000,0.000 or 0.000,0.000).Conclusions The doses to the bladder and small intestine are influenced by different bladder filling status,but the doses to the rectum and sigmoid colon show no significant variation.The increase in bladder volume is helpful in reducing the dose to the small intestine.Without any change in the bladder dose,the bladder volume of 50 ml is more beneficial to reduce the dose to the small intestine than those of 100 and 150 ml.

Objective To study the rule of dynamic change of cognitive function in community elderly and predicting for dementia through using items of MMSE. Methods A 10 year follow up of cognitive function survey was carried out in the non dementia old people using Chinese version Mini Mental State Examination(MMSE). The elder people were divided into two groups (dementia group and non dementia group) according to the DSM Ⅲ R diagnostic criteria 10 years later. Results (1) A total of 1 192 subjects completed all data sheets by two surveys and 124 cases(10 4%)were identified in the second survey 10 years later. (2)Almost all the baseline item scores and its change of MMSE of the dementia group were higher than that of the non dementia group. (3)Orientation of time, serial subtration by seven, reading items of MMSE were effective predictors for the dementia, resding and orientation of time were significant predictors for Alzheimer's disease through logistic regression model. Conclusions The item analysis of MMSE is important information for the epidemiological research.

Objective 　To explore the relationship between psychosocial factors and risk of vascular dementia. Methods　A cohort study of people 55 years old and over were followed up 10 years after a baseline screening. 5055 older subjects in Shanghai were stratified and cluster sampled from community. Information about psychosocial factors was collected during the baseline screening with an interview in 1987. The clinical diagnosis of dementia and vascular dementia (VD) were made according to DSM-Ⅲ-R and Hachinski Ischemic Score (HIS). In 1997,the elders who were not having dementia in 1987 were surveyed; Clinical diagnosis terms of that was made in above mentioned criteria. Then we analyzed the relationship between the psychosocial factors and VD in community elderly population by means of Logistic regression and estimated the incidence of VD.Results　1203 subjects were re-surveyed in 1997 and among them 124 new cases of dementia including 36 cases of VD were identified. By calculating the relative risk (RR) of psychosocial factors to the VD, we found that several psychosocial factors were correlated with the VD including not taking group activities, unsatisfying life, negative life events and depression (RR＞1). ADL total score are also good predictive points for VD.Conclusions　Psychosocial factor may play an important role in the vascular dementia developed.

Objective To investigate the dose-response of micronuclei (MN) frequency in the lymphocytes irradiated with or without combination of α-particles and γ-rays. Methods Human lymphoblast cells HMy2.CIR were irradiated with 0 - 1 Gy of α-particles,0 - 5 Gy of γ-rays,and 0.025 -0.5 Gy of α-particles followed by different doses of γ-rays,respectively.The micronuclei (MN) in the irradiated cells were measured with the cytokinesis block technique,and the dose-responses of MN were established under different irradiation conditions.Results For γ-ray irradiation,the dose-response of MN was well-fit by the linear-quadratic model with an equation Y =c + αD + βD2.For α-particle irradiation,the MN induction increased linearly with the dose less than 0.250 Gy. But when the dose of α-particles increased continually,the dose-response curve bended and could be well fit with the BaD model Y =c + αD + σ[ 1 - exp( - δD) ] exp( - βD) where radiation-induced bystander effect (RIBE) was indicated.For the combined exposure,the dose-response of MN was similar to that of γ-irradiation when the dose of α-particles was lower than 0.1 Gy,but it was similar to that of α-irradiation when the dose of α-particles was higher.When the dose of α-particles was 0.2 and 0.5 Gy,MN induced by the mixed radiation were significantly higher than the sum of corresponding irradiation alone ( t =5.22 - 11.86,P ＜ 0.05 ).Conclusions The radiation damage of α-particles differs from that of γ-rays,where RIBE may be involved.The combination irradiation of α-particles and γ-rays has a synergistic effect on radiation damage of lymphoblast cells.

Objective:To explore the curative effect and toxic and side effects of Xihuang Capsule in the patients with advanced esophageal cancer treated with chemoradiotherapy, and to clarify its mechanism.Methods:The patients with advanced esophagealcancer without treatment were selected.The patients treated with Xihuang Capsule combined with concurrent chemoradiotherapy were defined as combination treatment group(n=27), and then other 27 patients were randomly selected from 87 patients treated with concurrent chemoradiotherapy alone as chemoradiotherapy group.The observation time was 90 d from the begining of chemotherapy.The differences in KPS, degree of dysphagia, incidence, occurrence time and degrees of acute radiation esophagitis of the patients in two groups were compared, and local control of tumor was analyzed.Results: After treatment, the KPS scores of the pateints in two groups were decreased, and the KPS score in combined treatment group was significantly higher than that in chemoradiotherapy group (P<0.05).The grade of dysphagia of the patients in combined treatment group was lower than that in chemoradiotherapy group during the late period of treatment(P<0.05).The incidence of acute radiation esophagitis, the occurence time of acute radiation esophagitis of the patients in combination group was lower than that in chemoradiotherapy group (P<0.05);the occurrence time of acute radiation esophagitis was later than that in chemoradiotherapy group (P<0.05);but there were no significant differences in the grades of acute radiation esophagitis and tumor local control between two groups(P>0.05).Conclusion:Xihuang Capsule can improve the quality of life, reduce dysphagia degree and the incidence of acute radiation esophagitis,and delay the occurrence time;it can be used as an effective auxiliary treatment of advanced esophageal cancer.

Objective To investigate the dosimetric differences between Utrecht applicator and ring applicator in three-dimensional (3D) conformal brachytherapy for locally advanced cervical cancer.Methods Twenty-five patients with locally advanced cervical cancer were treated with magnetic resonance imaging-guided 3D conformal brachytherapy.Utrecht applicator and ring applicator were used interchangeably for 96 cycles.Patients were divided into two groups according to the type of applicator.Each group received 48 cycles of treatment, in which ring applicator was first applied for 26 cycles and Utrecht applicator was first applied for 22 cycles.High-risk clinical target volume ( HR-CTV) , width, thickness, and D90 at the point A level, D2 cm3 of organs at risk (OARs), V7 Gy , W7 Gy,A, V7 Gy ,A, and W/T7 Gy were evaluated and analyzed using paired t-test.Results There were no significant differences in HR-CTV and the width, thickness, and D90 at the point A level between the Utrecht group and the ring group ( P=0.487;P=0.340;P=0.857;P=0.921);there were no significant differences in D2 cm3 values of bladder, rectum, sigmoid, and bowel between the two groups ( P=0.136;P=0.802;P=0.985;P=0.458);there were no significant differences in V7 Gy and T7 Gy,A between the two groups ( P=0.076;P=0.435) .The Utrecht group had a significantly larger W/T7 Gy,A than the ring group ( P=0.002 ) .Conclusions Utrecht applicator is appropriate for patients with relatively large width and width/thickness ratio of HR-CTV at the point A level.

Objective To compare target volume and dosimetry between computed tomography (CT)?and magnetic resonance imaging (MRI)?guided three?dimensional (3D) conformal brachytherapy for locally advanced cervical cancer, and to provide evidence for optimization of the image?guided approach and improvement of treatment regimen. Methods Thirteen patients with locally advanced cervical cancer who were treated with radical radiotherapy in our hospital in 2014 were enrolled as subjects. All patients received MRI?guided 3D conformal intracavitary/ interstitial brachytherapy. All patients received MRI and CT scans for each brachytherapy fraction, based on which the target volume delineation, intracavitary/ interstitial regimen design, and intracavitary?only treatment regimen design were performed. Comparison of data between MRI and CT scans was performed using paired t test. Results The width and volume of the high?risk clinical target volume ( HR?CTV) were significantly smaller in the MRI simulation than in the CT simulation ((38.0±9?? 4) mm vs. (45.1±8?? 7) mm, P= 0?? 000;(34.2±15?? 3) cm3 vs. (42.9±20?? 4) cm3 , P= 0?? 002), and the width, thickness, and volume of the intermediate?risk clinical target volume (IR?CTV) were also significantly smaller in the MRI simulation than in the CT simulation ((58.8±9?? 4) mm vs. (65.4±10?? 3) mm, P= 0?? 000;(34.8±6?? 3) mm vs. (37.5±6?? 3) mm, P= 0?? 001;(90.9±28?? 5) cm3 vs. (109.0±36?? 4) cm3 , P= 0?? 000). The D90 values for HR?CTV and IR?CTV were significantly higher in the MRI simulation than in the CT simulation (87?? 6 Gy vs. 85?? 8 Gy, P= 0?? 013;67?? 7 Gy vs. 66?? 3 Gy, P= 0?? 005), while the average D2 cm3 values for the bladder and rectum were significantly lower in the MRI simulation than in the CT simulation ( 73?? 1 Gy vs . 75?? 5 Gy , P= 0?? 011 ; 61?? 0 Gy vs . 65?? 7 Gy , P= 0?? 000 ) . Conclusions Compared with the MRI simulation, the CT simulation overestimates the width of target volume. MRI has substantial advantages in dosimetry for target volume and normal tissues. The intracavitary/ interstitial treatment can make up the reduced dose for the target volume resulting from the CT simulation.

Objective To explore the dosimetric advantages of computed tomography-based and ultrasound-guided three-dimensional image-quided brachytherapy (3D-IGBT) combined with intracavitary/interstitial (IC/IS) brachytherapy for locally advanced cervical cancer.Methods A total of 45 patients with FIGO (2009) stage ⅠB2-ⅣA locally advanced cervical cancer who received radical external beam radiotherapy and 3D-IGBT combined with IC/IS brachytherapy in our hospital from 2013 to 2014 were analyzed.After the treatment with 192Ir-based IC/IS brachytherapy,patients had needles removed from the original images and received treatment only from IC radiation sources.Dosimetric differences in the planning D90 for high-risk clinical target volume (HR-CTV),D90 for intermediate-risk CTV (IR-CTV),and D2 cm3 for the bladder,rectum,sigmoid colon,and small intestines were determined and analyzed by paired t-test.Results A total of 260 after-loading treatment plans,including IC/IS treatment plans for 130 patients and IC treatment plans for 130 patients,were made.The D90 for HR-CTV and D90 for IR-CTV in the IC/IS brachytherapy group were significantly higher than those in the IC brachytherapy group (P =0.000;P =0.000).Moreover,the average D2cm3 values for the bladder and rectum were significantly reduced in the IC/IS brachytherapy group compared with those in the IC brachytherapy group (P =0.000;P =0.006).Conclusions The 3D-IGBT combined with IC/IS brachytherapy not only achieves a higher dose for the target volume,but also reduces the radiation dose to the bladder and rectum in the treatment of locally advanced cervical cancer.

Objective To investigate the clinical application of Utrecht applicator in three-dimensional image-guided brachytherapy (3D-IGBT) for locally advanced cervical cancer,as well as its application discipline in intracavitary/interstitial (IC/IS) therapy.Methods A retrospective analysis was performed for the clinical data of 45 patients with locally advanced cervical cancer who received radical radiotherapy,and the patients received external beam radiotherapy followed by 3D-IGBT.A total of 130 times (n =45) of IC/IS therapy were performed,and the patients who received such therapy were all enrolled.The patients who met the target dose fractionation defined in the plan were enrolled as group A (n=37,86 times),and the other patients were enrolled as group B (n=22,44 times).Two groups difference was analyzed with Group t-test.Results The frequencies of use of 15-,20-,and 25-mm ovoids by the applicator were 50.0％,20.0％,and 30.0％,respectively,and the 30-mm ovoid was not used.A total of 499 needles were used,and the frequencies of use of 6,7,10,and 11 insertion holes were 23.1％,21.2％,21.2％,and 24.1 ％,respectively.Group A had a significantly lower mean number of the needles than group B (3.7 vs.4.2,P=0.008).Compared with group B,group A had a significantly lower mean high-risk clinical target volume (CTV)(40.71±18.43 cm3 vs.51.81±14.74 cm3,P=0.001),as well significantly lower width and height of high-risk CTV (P=0.011 and 0.006),but the thickness of high-risk CTV was similar between the two groups (P=0.595).The difference between height and insertion depth (DH) was similar between the two groups (P=0.366).Group A had a smaller difference between width and pinhole distance Dw than group B (P=0.007).Conclusions When IC/IS therapy is performed for locally advanced cervical cancer,the 15-,20-,and 25-mm ovoids of Utrecht applicator and 6,7,10,and 11 insertion holes are frequently used.When the number of needles is no less than 4 and the depth is no less than 3 cm,width is the major factor which affects the planned dose.