OBJECTIVE:To strengthen the reporting and monitoring of adverse drug reactions(ADR)in primary health care institutions.METHODS:A monitoring network for primary health care institutions was set up;the ADR monitoring system in primary health care institutions was improved and the monitoring ability of the monitoring personnel in primary health care institutions was enhanced.RESULTS:The ADR reporting and monitoring proceeded smoothly and both the quantity and the quality of ADR reporting enhanced significantly.CONCLUSION:Effective mechanism and means on ADR monitoring contribute to the improvement of ADR monitoring level in primary health care institutions.

Objective To compare the dosimetric differences of permanent prostate braehytherapy utilizing 131Cs,125 I and 103 Pd seeds.Methods Twenty-five patients with T1-T2c prostate cancer who had previously implanted with 125I seeds were randomly selected in our study.The patients were re-planned with 131 Cs,125 I and 103 Pd seeds by using the Prowess Brachytherpay 3.1 planning system to the prescription doses of 115 Gy,145 Gy and 125 Gy,respectively.The seed strengths were 1.8 U,0.5 U and 1.8 U,respeetively. The prostate,prostatic urethra and anterior wall of the rectum were contoured on trans-rectal ultrasound ima ges.PTV was outlined based on the prostate volume with no margin applied.The attempted planning goals were that V100(tbe percentage volume of the prostate receiving at least 100% of the prescription doses)= 95%,D90 (the minimum percentage dose covering 90% of the prostate volume) ≥100% ,and prostatic ure thra UD10 (the maximum percentage dose receiving by 10% of the contoured urethra)≤150%.For the plan comparison,we also computed prostate V150,prostatic urethra UV120,rectum RV100,and the number of implan ted seeds and needles.The significance of the differences was tested using one way analysis of variance. Results The average V200 in the 103pd,125 I and 131 Cs plans were 28.7% ,20.9% and 19.6% (F=42.50, P =0.000) ;the average V150 were 51.9% ,42.1% and 39.4% (F=26.15,P =0.000) ;the average UV120 were 26.9% ,29.5% and 23.8% (F = 0.37,P =0.691) ; and the average rectum RV100 were 0.31 cm3, 0.22 cm3 and 0.19 cm3(F=0.43,P=0.652).For 103 Pd,124 I and 131 Cs,the average number of implanted seeds per cm3 prostate were 2.02,2.01 and 1.87(F = 1.92 ,P =0.154) ,and the average number of needles were 33.6,32.9 and 31.6(F=0.26,P=0.772). Conclusions Comparing to 124 I and 103 pd seeds used in permanent prostate brachytherapy ,131 Cs seeds has better dose homogeneity,and possible better sparing of the urethra and rectum,with comparable or less implanted seeds and needles.

Based on a review of currently published 40 papers ( 20 published in recent 5 years, 20 published in recent 10 years) on gold nanoparticles for cancer radiotherapy, the general characteristics, theoretical studies, in vitro experiment, in vivo experiment,and the clinical prospects of targeted radiotherapy with gold nanoparticles were reviewed. Three key aspects guarantee further investigation for the full understanding of the radiosensitization effect of gold nanoparticles:the cellular localization and tissue distribution of nanoparticles and influential factors;the micro dose enhancement effect of gold nanoparticles, and the molecular biological mechanism. More cross disciplinary collaboration, research, development and translation are needed before gold nanoparticles are put into clinical trials.

Stereotactic body radiation therapy ( SBRT ) for locally advanced pancreatic cancer ( LAPC) shows good signs of efficacy as measured by local control,which can also reduce toxicity. The dose fractionation in foreign countries have changed from conventional fractionation to single fraction and finally moderate hypofractionation. It is similar to that in China, with the dose fractionation changing from conventional fractionation to moderate hypofractionation. This review introduces the latest research results of dose fractionation of SBRT for LAPC.

Objective To study the dosimetric characteristics of thermoluminescent dosimeter (TLD).Methods A total of 350 pieces of TLD 2000 type TLDs having the same sensitivity within ± 3.0％ were selected.The TLDs were irradiated to study the repeatability and dosage effect of TLDs by using 6 MV X-rays and 125I seeds.In order to study the dose response,the TLDs were irradiated at different dosages by using 137Cs (662 keV γ-rays),125I seeds and 6 MV X-rays.In order to study the energy response,the TLDs were exposed to the same dose,from 125I seeds,137Cs and X-rays(48,65,83,118,250 keV and 6 MV).Results The maximum deviations of the repeatability were 2.7％ and 4.0％ for 6 MV X-rays and 125I seeds,respectively,and there was no effect of dose rate observed.The dose response of TLDs to 137Cs and 125I seeds were linear.For 6 MV X-rays,the linear response was within the range of 0.74-10 Gy and non-linear range was beyond 10 Gy.The energy response to 125I seeds,48,65,83,118,250 keV and6 MV X-rays,relative to the energy response of 137Cs,were 1.70,1.25,1.08,0.99,0.91,0.96 and 1.22,respectively.Conclusions TLD 2000 has a good repeatability and linear dose response for 137Cs,125I seeds and 6 MV X-rays with no dose rate effects,but the dose response is energy dependent.

Objective To customize the optimal plans for radioactive 125I seeds volumetric implants in selected regular target volumes.Methods 125I seeds were symmetrically and uniformly implanted into 3 spherical targets with the diameters of 1,2 and 3 cm and 7 ellipsoidal targets with the 3 dimensions of 1 cm×1 cm×2 cm,1 cm×1 cm×3 cm,1 cm×2cm×2cm,1 cm×2 cm×3 cm,1 cm ×3 cm×3 cm,2 cm×2 cm×3 cm and2 cm×3 cm×3 cm.The activity and inter-space of seeds were adjusted to obtain the conformal and uniform dose distribution,with the prescribed D90 (the dose delivered to 90％ of the targets) greater than 145 Gy.The inter-space of seeds was changed from 1 cm to 0.75 cm,to improve the conformity and uniformity of dose distribution.Plan quality was assessed using homogeneity index (HI),external index (EI) and conformal index (CI).The activity and number of seeds implanted were also recorded and compared.Results For the spherical target with the diameter of 1 cm,when seeds were implanted with the inter-space of 1 cm and 0.75 cm,the HI were 40.0％ and 55.9％,the EI were 98.3％ and 95.1％,the CI were 0.44 and 0.44,respectively.For the spherical target with the diameter of 3 cm and the target with the 3 dimensions of 1 cm × 2 cm × 2 cm,the implant with the inter-space of 1 cm provided better indices of HI,EI and CI than those with the inter-space of 0.75 cm.For the other targets,the implants with the inter-space of 0.75 cm provided better indices of EI and CI than those with the inter-space of 1 cm,although they displayed a little worse homogeneity in terms of HI.The activity per seed was 17.0-27.8 MBq and 30.0-58.8 MBq in the implants with the inter-spaces of 0.75 cm and 1 cm,respectively.2-10 more seeds were needed in the implants with the inter-space of 0.75 cm.Conclusions For the studied targets except the spherical targets with the diameter of 1 cm and 3 cm and the ellipsoidal target with the dimension of 1 cm × 2 cm × 2 cm,125I seeds implanted with the inter-space of 0.75 cm could provide more conformal dose distribution.It could be the better customized plans for uniformly spaced seed implantation.

OBJECTIVE:To observe the curative effect of Xiaoer chiqiao qingre granule in treating child common cold fever (stagnant type).METHODS:A total of 118 cases with child common cold fever(stagnant type) were randomly assigned to receive Xiaoer chiqiao qingre granule (treatment group,n=60) or ribovirin tablet,Ertangganmao granule(control group,n=58) tid for 3 days.The antipyretic time, clinical effective rate, and improvement in clinical symptoms were compared between the two groups. RESULTS: There outcome indexes including the antipyretic time,the clinical effective rate,and the improvement in clinical symptoms in the treatment group was significnatly better than in the control group(P

Objective To test the accuracy and reliability of Axesse accelerator for volumetric modulated arc therapy (VMAT).Methods The accuracy and reliability of Axesse accelerator for VMAT were tested in a stepwise manner, from the simple to the complex and from the part to the whole.For the parts of the system, the stability of dosimetric output and the position accuracy of multi-leaf collimator (MLC) were tested.For the process of the system, the variable VMAT dose rates and gantry speed modulation, the MLC speed and dose rate modulation, and dosimetric verification in patients were tested.Results Compared with fixed gantry irradiation, the variation in dosimetric output was below 1.0% for rotary irradiation including the slide rotary irradiation of the dynamic MLC.The MLC position error of 0.5 mm was visible using the electronic portal imaging system of Axesse, iViewGT 3.40.The MLC position accuracy was within 1 mm for fixed gantry irradiation and rotary irradiation.In the range of the dose rate applied in clinical practice, the testing results of variable VMAT dose rates and gantry speeds as well as variable dose rates and MLC speeds showed that the variation between different strip-field beam intensities was below 2.0%.Using a gamma criterion of 3 mm/3%, the pass rates in dosimetric verification of patients with cervical cancer, prostate cancer, and breast cancer were 96.52%, 95.72%, and 98.83%, respectively.Conclusions The Axesse system can precisely control MLC motion, variable dose rates, and gantry speeds in VMAT.The Axesse system is accurate and reliable for VMAT.

Objective To analyze the patient-specific dosimetric verification results of 2010 intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans from different treatment sites,and provide a reference for improving the patient-specific dosimetric verification program.Methods A total of 2 010 (965 IMRT and 1 045 VMAT) patient-specific dosimetric verification results were reviewed for isocenter dose difference and percentage of pixels passing planar dose γ analysis.All plans were designed with Eclipse planning system and delivered with Trilogy linear accelerator from February 2012 to February 2016.The dosimetric verification was performed with MatriXX array together with Muhicube phantom.Point dose difference larger than ± 3％ and/or γ pass rate (3％/ 3 mm) less than 90％ was defined as plan failure.Additional analysis was conducted for trends in difference of pass rates with treatment site and delivery technique (IMRT vs.VMAT).Results The mean isocenter difference between measured and calculated doses was-0.3％ ± 2.4％ for 2 010 plans.The mean percentage of pixels passing the γ criteria was 97.9％ ± 3.4％.88.2％ and 96.7％ of plans passed the point and planar dose verification,respectively.The γ pass rate was different among the treatment sites (F =3.09,P ＜ 0.05).The pass rate of point and planar dose difference was different among the treatment sites(x2 =40.93,39.15,P ＜0.05).There was no difference between IMRT and VMAT plans for both point dose and planar dose evaluation (P ＞ 0.05).Conclusions Most of IMRT and VMAT plans passed the tolerance criteria of ±3％ and 90％ for point and planar dose verification with MatriXX together with Multicube phantom,respectively.Both point and planar dose verification results varied among treatment sites,whereas no significant difference was found between IMRT and VMAT.

Objective To investigate an X-ray total body irradiation (TBI) technique using anterior-posterior opposed fields with patients at the side-lying position,and to analyze the real-time in vivo dosimetry results.Methods The accelerator with 10 MV X-rays of Varian Trilogy was used for the TBI with the extended source to skin distance of 390 cm.The percent depth dose,off axis factors and absolute dose output were measured.The dose accuracy and homogeneity was monitored real-time using multichannel diode dosimeter for 10 patients.The monitored sites included forehead,mandible,suprasternal fossae,xiphoid,umbilicus,pelvis,middle of thigh,knee,middle of leg and ankle.The patients were irradiated at the side-lying position,with the prescription dose of 1 200 cGy/6 f during 3 days,the middle line dose rate of 5.0 cGy/min.Solid water was used for the compensation of the dose homogeneity.Results The off axis dose homogeneity was less than ± 5.0％ for the TBI geometry.The absolute dose output was 0.072 1 cGy/MU at the maximum dose point.The total body irradiation was finished smoothly for the 10 patients lying on side.The deviation of monitored total dose from the total prescription dose was within -4.9％ to 6.7％ for the 10 monitored sites.The monitored dose homogeneity was less than 5.0％.Conclusions The fractionated anterior-posterior opposed parallel TBI can be finished smoothly with patients side-lying.Accurate and homogenous dose distribution can be obtained using real-time dose monitoring and compensation with solid water.