Objective To evaluate the patient dose from Hi-ART MV helical CT imaging in image-guided radiotherapy.Methods Weighted CT dose index (CTDI_W) was measured with PTW TM30009 CT ion chamber in head and body phantoms,respectively,for slice thicknesses of 2,4,6 mm with scanned range of 5 cm and 15 cm.Dose length products (DLP) were subsequently calculated.The CTDI_W and DLP were compared with XVI kV CBCT and ACQSim simulator CT for routine clinical protocols.Results An inverse relationship between CTDI and the slice thickness was found.The dose distribution was inhomogeneous owing to the attenuation of the couch.CTDI and DLP had close relationship with the slice thickness and the scanned range.Patient dose from MVCT was lower than XVI CBCT for head,but larger for body scan.Results CTDI_W can be used to assess the patient dose in MV helical CT due to its simplicity for measurement and reproducibility.Regular measurement should be performed in QA & QC program.Appropriate slice thickness and scan range should be chosen to reduce the patient dose.

easurement should be performed in QA & QC program. Optimal image parameters should be chosen to reduce the scanning range and patient dose.

Objectives:To discuss the observation of patients receiving simultaneous pancreas-kidney transplantation for insulin-dependent diabetes mellitus complicated with end-stage renal failure.　Methods:The patient received simultaneous pancreas-kidney transplantation with enteric drainage of exocrine pancreatic secretions.　Results:The important aspects were as follows: monitoring the functions of the transplanted pancreas and kidney, observing the early characteristics of rejection, especially the pancreas, preventing thrombosis of blood vessels of the transplanted pancreas, digestive tract hemorrhage，pancreatitis, and preventing duodenal fistula. 　Conclusion:By careful clinical observation, postoperative complications could be found earlier, which aided the treatment and improved the prognosis.

Data warehouse of Fuzhou General Hospital as the example, the basic conception and requirements of data warehouse are introduced in this paper. The design and construction of data warehouse are described from the aspects of subject determination, data preparation, model building, model evaluation and interpretation, and model application and consolidation. The main function of the data warehouse of Fuzhou General Hospital is also mentioned.

Objective To introduce management of control and thinking from LIS System for providing some advice on the realization of clinical laboratory informatization. Methods Combined with our practical work, the general requirements, the overall structure, the design principles, the charging and the data security management of current information systems were analyzed. Results Under this model, LIS system was stable and secure, the laboratory workflow was also reasonable and the charging system is well in order. Conclusion The reasonable design and an overall co -ordination are required by the clinical laboratory information system, which will be better for our laboratory work and contribute much to the automation of laboratory information administration.

Objective To evaluate the role of equivalent uniform dose (EUD) in planning optimization of intensity-modulated radiotherapy (IMRT) for prostate cancer.Methods Ten patients with prostate cancer were randomly selected who treated with IMRT.For these patients,the treatment plans were designed with dose-volume objectives.Based on these plans,new plans were designed through replacing the dose-volume objectives with maximum EUD for rectum,bladder and small bowel,while keeping the dosevolume objectives unchanged.Comparison was made between the new plans and the former cones by paired t-test.Results The conformity index of planning target volume was better with EUD optimization compared to dose-volume (1.00 ± 0.04 ∶ 0.94 ± 0.04,t =3.80,P =0.04).The D53,D30 and Dicm3 for rectum was better with EUD optimization compared to dose-volume (24.4 ± 2.7 ∶ 25.5 ± 2.6,t =-3.82,P =0.004,34.1 ±4.3∶39.1±2.1,t=-3.80,P=0.004 and51.4±1.0∶51.8±0.9,t=-2.42,P=0.039),with V10,V20 for bladder and V10,V20,V30,V40 for small bowel also better with EUD optimization (92.2 ±6.2∶99.4±1.1,t=-4.28,P=0.002;70.7±5.7∶78.7±6.3,t=-3.10,P=0.013 and 62.2±30.2∶74.7 ±30.0,t =-4.18,P =0.002;34.3 ±26.3∶46.5 ±30.9,t =-5.46,P =0.000;17.1 ±17.0∶25.1 ±22.6,t=-3.52,P=0.007;10.6± 11.5∶ 15.6± 16.1,t=-2.64,P=0.030).Conclusions The conformity index of planning target volume is better with EUD optimization compared to dose-volume.And the dose to rectum,bladder and small bowel can be reduced through optimization with EUD optimization compared to dose-volume.

Objective To investigate the mechanism of renal damage due to rupture of atheroselerotic plaque of renal artery in apolipoprotein E (ApoE) knock-out mice. Methods The model for atherosclerotie renal artery stenosis (ARAS) was established by using ApoE knockout mice. The model mice with renal artery stenosis <50% were divided into the plaque rupture group and the non-plaque rupture group. Wild-type C57BL/6J mice were used as the control group. All the mice were raised under the same conditions. The renal arteries and kidneys were collected for the following analysis. Nuclear factor-kappa-Bp65 (NF-kBp65), intercellular adhesion molecule 1 (ICAM-1) and P-selectin (P-sel) were determined by Western blotting. The expression of interleukin 6 (IL-6) mRNA was detected by RT-PCR. Immunohistochemistry was performed by using serial sections to detect F4/80-related macrophages. Urine n-acetyl-β-d-glucosaminidase (NAG) activity was determined by direct enzyme-substrate coloration. Results In comparison with the nonplaque rupture group and the control group, the expression of NF-kBp65 protein in the blood, renal artery and kidney increased significantly in the plaque rupture group (P<0.05). The expression of F4/80, ICAM-1, P-sel, and IL-6 mRNA were increased significantly in the plaque rupture group (P<0.05), as compared with the non-plaque rupture group and the control group. The Ser and the activity of urine NAG in the plaque rupture group were higher than those in the non-plaque rapture group. The expression of NF-KBp65 protein differed insignificantly between the control group and the non-plaque rupture group (P>O.05). The group differences in the expression of F4/80, ICAM-1, P-sel, and IL-6 mRNA were similar to those in the expression of NF-KBp65 protein. The group differences in the activity of urine NAG and the Scr were similar to those in the expression of NF-kBp65 protein. Conclusion Rupture of atherosclerotic plaque of renal artery causes renal pathology change and renal function damage, which is mediated by inflammation.

Objective To evaluate the penumbra of a new multileaf collimator equipped with Elekta Synergy accelerator. Methods The penumbra were derived from beam profiles measured in air and water using PinPoint ion chamber with PTW MP3 water phantom. Variations of penumbra with X-ray beam energy, depth in water, and leaf position were investigated. Results The penumbra in air for 6 MV X-ray was 2 mm less than that at depth of maximal dose in water. The penumbra of leaf side was 1 mm less than that of the leaf end. The penumbra had close relationship with beam energy, depth in water and leaf position. Penumbra was increased with beam quality and water depth. The leaf position had great influence on the penumbra. Conclusions The penumbra of the multileaf collimator is related to its original design and radiation delivery technique. Special considerations should be taken into during treatment planning.Regular measurement should be performed to guarantee the delivery quality.

Objective To evaluate the variations of effective doges with the preset scanning parameters from linac-integrated kV cone beam CT( CBCT). Methods Weighted CT dose index(CTDIW) were measured with PTW TM30009 CT ion chamber in head phantom and body phantom, respectively, for different combinations of tube voltage, mAs, collimator and gantry rotation range. Dose length products(DLP) were derived from CTDIW and effective doses(E) were calculated by the DLP and EDLP. Results CTDIW and effective dose had the quadratical relationship with tube voltage, depending linearly on product of tube current and exposure time. Effective dose had close relationship with the collimator and the gantry rotation range. Both the DLP and ED for CBCT were lower than the reference dose level recommended for conventional CT. Conclusions Effective dose from CBCT has a close relationship with the scanning parameters. Optimal imaging parameters should be chosen according to the patient's anatomy to reduce patient dose.

Objective To investigate the learning curve of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.Methods The clinical data of 450 cases of patients who received laparoscopic inguinal hernia repair by the same group of surgeons from December 2012 to August 2016 in our hospital were sequentially divided into three groups,with 150 cases in each group.The cases of each group who received TEP inguinal hernia repair were extracted and enrolled into group A,B and C.The preoperative,intraoperative and postoperative indicators were compared among the three groups.Results Before operation,no statistically significant difference was found in age,gender,incidence rates of scrotum hernia,recurrent hernia and bilateral hernia,and types of hernia among the three groups (P＞0.05).And there was no statistically significant difference in incidence rates of postoperative urinary retention,analgesia and seromas,and hospitalization expenses among the three groups (P＞0.05).During operation,differences in conversion rate,operative time and volume of blood loss among the three groups were statistically significant (P＜0.05).Moreover,statistically significant differences in conversion rate,operative time and volume of blood loss were found between group A and group B (P＜0.05),while there was no statistically significant difference between group B and group C (P＞0.05).The regression curves were drawn based on operation time,volume of blood loss and the number of cases,which estimated the inflection point was 150.Conclusion The learning curve of TEP inguinal hernia repair include approximately 150 cases of laparoscopic inguinal hernia repair (including 16 cases of patients received TEP).The TEP inguinal hernia repair operation during the learning curve can be safety on the basis of preoperative evaluation and appropriate case selection.