Independent check is one of the key measures of quality control (QC) in radiotherapy and is essential for the assurance of radiotherapy accuracy.In recent years,with the application of computer-aided system,the automaticity of independent check,as well as its accuracy and efficiency,increases.Meanwhile,QC has evolved from a device-centered to a process-centered program.Therefore,independent check has been increasingly systematic and specific.This review gives a brief summary of the implementation and development of independent check.

In vivo dosimetry (IVD) is currently the most direct and effective means of quality assurance.The electronic portal imaging device (EPID) has been widely used for IVD verification owing to its favorable dosimetric properties.In recent years,an increasing number of EPID-based IVD studies have emerged around the world.The purpose of this paper is to give an overview of the present progress in EPID-based IVD studies,and to provide a reference for the subsequent application of EPID in IVD.

OBJECTIVE:To standardized declaration of preparation registration in medical institutions. METHODS:With the combination of registration review of new varieties in the preparation registration in medical institutions in Liaoning province from 2010 to 2014,the existing problems in drug registration information of preparation in medical institutions were introduced,and the solutions and suggestions were proposed. RESULTS & CONCLUSIONS:The main problems of registration information of prepara-tion in medical institutions included non-standardized preparation name,unclear topic and writing,inappropriate instructions and la-bels,and imperfect preparation process,etc. To standardize the preparation registration authenticity and integrity of registration in-formation of medical institutions,it is suggested to increase on-site verification efforts,strengthen the five years clinical using his-torical inspection,improve the level of research and development of hospital preparations declaration units,and strengthen the idea that the medical institutions should be responsible for the quality and safety of preparations to ensure the safety and effectiveness.

Objective To analyze the impact of electronic portal imagingdevice (EPID) position error on three-dimensional dose verification of volumetric modulated arc therapy (VMAT).Metbods Five Suremark SL-20 lead points were fixed on Elekta tray,and EPID images were collected in 0-360° rotation,one image per 5°.The position error relative to the accelerator was analyzed via Matlab.Then the images position error was corrected according to the analysis,and the 3D dose was reconstructed with the corrected images.The dose distributions of double arcs,clockwise arc(arc 1),and counterclockwise arc (arc 2) of 16 nasopharyngeal carcinoma patients' VMAT plan were evaluated by γ analysis,and the results of before and after position error correction were compared.Results Compared to 0° gantry angle,the error of source to the image distance (SID) was maximum (1.20 cm) when the gantry angle was 180°.On account of the SID change,the maximum error along the up-down (y) direction in the iso-center planar was 2.28 mm and the left-right (x) direction error was within ± O.5 mm.The 3D γ analyses of 16 nasopharyngeal carcinoma in VMAT plans were obviously increased after the position error along y was corrected.The double arcs,arc1 and arc 2 were increased by (4.12 ±1.67) ％ (t =-9.86,P＜ 0.05),(3.47±1.64) ％ (t=-8.46,P＜ 0.05) and (5.08±1.30) ％ (t=-15.63,P＜ 0.05) in 5％/3 mm standard,respectively.However,in 3％/3 mm standard,γ value of the double arcs,arc 1 and arc2 were increased by (7.63 ±2.24) ％ (t =-13.63,P＜ 0.05),(6.03 ±2.07) ％ (t =-11.66,P＜ 0.05),(9.17 ±2.23) ％ (t =-16.41,P＜ 0.05),respectively.Since the EPID position error along x was corrected after y,the 3D γ analysis of reconstruction dose indicated that the average of the 5％/3 mm and 3％/3 mm γ value were increased by 0.23％ and 0.24％,respectively.Conclusions EPID motion error along the gantry to table direction of the accelerator can't be ignored.When reconstruct dose based on EPID,a modification should be made for rebuilding more accurate patients' 3D dose distribution.

Objective To investigate the effects of carbachol on intestinal inflammation and mucosal blood flow after gut ischemia-repedusion(I/R) in rat. Method A jejunal sac was formed in Wistar rats. The superior mesenteric artery (SMA) was occluded for 45 mi-nutes followed by 240 minutes of reperfusion. Animals were random divided into three groups: sham operation, L/R + saline injection (I/R + NS) and I/R + carbachol injection (0.1mg/kg, I/R + Ca). Immediately after occluded of SAM blood flow, either 0.1mg/kg of carba-chol or same account of 0.9% saline was injected into the jejunal sac. The pathological injury was observed with HE staining. The activity of DAO and content of TNF-α in intestinal mucosa tissue were determined. Mucosal blood flow was measured by laser Doppler. All measure-ments were done at 0 min, 30 min, 60 min, 120 min, and 240 min after reperfusion. Result In I/R group the activity of DAO in intestinal mucosa and mucosal blood flow deceased, meanwhile the content of TNF-α gut tissue was dramatically increased than those in sham operation (P<0.01). Severe pathological changes were observed in intestinal mucosa. After injection of carbachol, the activity of DAO and mucosal blood flow increased (P<0.01), but the content of TNF-α in intestinal mucosa were dramatically decreased (P<0.01), compared with those in I/R group. Conclusion Administration of carbachol protects intestinal ischemia-reperfusion injury by attenuating intestinal mucosa inflammation and increasing gut mueosal blood flow.

OBJECTIVETo discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children.

METHODSA total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears). Group C included 45 patients (78 ears) with negative pressure in the middle ear without effusion and an acoustic immittance. A total of 208 patients (246 ears) with SOM and tonsil and adenoid hypertrophy were divided into control group Al, group B1, and group Cl matched with the same effusion characteristics in the middle ear and tympanic pressure. Group A and Al accepted puncture in the tympanic cavity, group B and B1 accepted tympanostomy tubes, and group C and Cl accepted puncture in the tympanic cavity after palatoplasty, adenoidectomy, and tonsillectomy. All groups were treated with antibiotics and ear drops. Cure rate and recurrence rate between the experiment group and the control group were compared.

RESULTSThe control group had a better cure rate [93.09% (229/246)] than the experiment group [77.29% (405/524)] 12 months after treatment. The experiment group had a higher recurrence rate [14.57% (59/405)] than the control group [3.93% (9/229)]. Statistical differences were observed between the two groups (P<0.05). SOM with cleft palate initially had a low cure rate, and thus it was treated repeatedly for many times.

CONCLUSIONSOM with cleft palate is different from normal otitis media in terms of clinical manifestation, treatment, outcome, and prognosis. This case should be considered a special otitis media to be treated with special examination and therapy to obtain better results. Repeated puncture in the tympanic cavity and tympanostomy tubes for six months according to effusion characteristics are better treatment options for patients with SOM and cleft palate.

Child ; Cleft Palate ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion ; therapy ; Prognosis ; Recurrence

OBJECTIVETo introduce different surgical treatment for gyncomastia at different grades.

METHODS37 cases with gynecomastia were divided into three grades as: grade I with fat as main tissue, grade II with proliferated fibro-gland as main tissue, grade III with big and ptosis breasts and sagging skin. Different surgical methods were chosen according to the different grades of gyncomastia. These include liposuction, subareolar fibroglandular tissue removing, combined technique of the two methods, and breasts resection with free transplantation of nipple-areola complex.

RESULTSAll patients were satisfied for the appearance of post-operative flat male chest. Complications, such as scar, numbness of nipple and areola were acceptable for them.

CONCLUSIONSDifferent surgical methods should be chosen for the gynecomastia at different grades. It can improve both the physical and psychological problems for patients.

Adolescent ; Gynecomastia ; classification ; surgery ; Humans ; Lipectomy ; Male ; Mammaplasty ; methods ; Nipples ; transplantation ; Retrospective Studies

Objective To study the association between functional genetic polymorphisms of IL-1B(T-31C,C-511T),IL-1RN and the susceptibility to gastric cancers. Methods A case-control study was conducted in 180 gastric cancer cases and 308 age-and sex-matched cancer-free controls.Genotypes were detected by PCR-restriction fragment length polymorphism(PCR-RFLP) assays,and association between genotypes,environmental factors and risk of gastric cancers were determined. Results IL-1B T-31C was in strong linkage disequilibrium with IL-1B C-511T(D'=0.862,R2= 0.721,P=0.000).Multivariate logistic regression analysis revealed that the variant genotypes of IL-1B T-31C and C-511T were not significantly associated with risks for gastric cancers(adjusted OR,0.95 and 95% CI,0.62-1.47 for IL-1B T-31C;and adjusted OR,0.85 and 95% CI,0.55-1.31 for IL-1B C-511T).The variant genotypes(1/2,2/2) in IL-1RN were associated with a non-significantly increased risks for gastric cancers(adjusted OR,1.32 and 95% CI,0.71-2.36) in all subjects and with a significantly increased risks for gastric cancers in subjects with H.pylori infection(adjusted OR,2.03 and 95%CI,1.02-4.80).Conclusion The functional genetic polymorphisms of IL-1RN may contribute to the risks of gastric cancers in high-risk population,particularly in those with H.pylori infection.

Lipids of Thamnidium elegans,Mortierella ramanninace,Rhizopus arrhizus,Pythium irregulare and Rhodotorulla aurantiaca were extracted by Soxhlet extraction,supercritical-CO 2 fluid extraction,acid-heating extraction and organic solvent extraction,respectively.Four extraction methods were evaluated on sample treatment,minimum sample quantity,requirements of apparatus,ability of treating sample and content of lipid.The components of fatty acids were analysed by gas chromatography.Soxhlet extraction can acquired maximum lipid content,but it took the most time.Supercritical-CO 2 fluid extraction and acid-heating extraction has a same lipid content which was lower than that of Soxhlet extraction.Acid-heating extraction was the most handy,and its ability to treat sample in a hour was the most powerful.Organic solvent extraction was less efficient.Acid-heating extraction was a simple and efficient method of fungi lipid extraction fitting to breed mutant strains that highly producting lipid and polyunsaturated fatty acids.

Objective　 To clone the differentially expressed genes in the retina of rds mouse (the animal model of congenital retinitis pigmentosa) during the disease development. Methods　 The retinal mRNA of rds mouse during the development of retinitis pigmentosa was analyzed by the mRNA differential display. The differentilly expressed mRNA fragments were cloned and sequenced. Results There was obvious difference of gene expression between rds mouse and the control during the development of retinitis pigmentosa. Five differentially expressed bands were cloned and sequenced. One of those had 86% identity (132/154) with the sequence of the human cDNA DKFZp434D1227 from adult testis in GenBank, which was submitted lately (15-Oct-1999) and without much information. The other had lower identity with the sequeces in GenBank. A highly expressed clone in the rds mouse on postnatal day 25 had the same length as another clone in the normal on postnatal day 37, which was not expressed in the rds mouse on day 37. The sequences of the two clones were identical in all but two base pairs. Conclusion　 These results indicate that there are a lot of novel differentially expressed genes in the chronic processing diseases, such as retinitis pigmentosa.