Objective To investigate the dosimetric performance of COMPASS system,a novel 3D quality assurance system for the verification of nasopharyngeal carcinoma volumetric modulated therapy (VMAT) treatment plan.Methods Eight VMAT treatment plans of nasopharyngeal carcinoma patients were performed with MasterPlan,a treatment planning system (TPS),and then these treatment plans were sent to the COMPASS and MOSAIQ system,a coherent control system,respectively.Comparison of the COMPASS reconstructed dose versus TPS dose was conducted by using the dose volume-based indices:dose received by 95％ volume of target ( D95％ ),mean dose ( Dmean ) and γ pass rate,dose to the 1％ of the spinal cord and brain stem volume ( D1％ ),mean dose of leaf and right parotid ( Dmean ),and the volume received 30 Gy for left and right parotid (V30).COMPASS can reconstruct dose with the real measured delivery fluence after detector commissioning.Results The average dose difference for the target volumes was within 1％,the difference for D95 was within 3％ for most treatment plans,and the γ pass rate was higher than 95％ for all target volumes.The average differences for the D1％ values of spinal cord and brain stem were ( 4.3 ± 3.0) ％ and ( 5.9± 2.9 ) ％ respectively,and the average differences for the Dmean values of spinal cord and brain stem were ( 5.3 ± 3.0 ) ％ and ( 8.0 ± 3.5 ) ％ respectively.In general the COMPASS measured doses were all smaller than the TPS calculated doses for these two organs.The average differences of the Dmean values of the left and right parotids were( 6.1± 3.1 ) ％ and ( 4.7 ± 4.4 ) ％ respectively,and the average differences of the V30 values of the left and right parotids were (9.4 ± 7.5 ) ％ and (9.4 ± 9.9)％ respectively.Conclusions An ideal tool for the VMAT verification,the patient anatomy based COMPASS 3D dose verification system can check the dose difference between the real delivery and TPS calculation directly for each individual organ,either target volumes or critical organs.

Twenty healthy subjects in each of 3 groups were fed with monounsaturated fatty-acid diet,polyunsaturated fatty-acid diet, or saturated fatty-acid diet separately for 3 days. It suggested that monounsaturated fatty-acids may ameliorate the oxidative stress and improve insulin sensitivity.

Objective To explore the efficacy and adverse reaction of nedaplatin (NDP)+gemcitabine (GEM)and cisplatin (DDP)+GEM for advanced lung squamous cell carcinoma.Methods A total of 1 01 cases advanced untreated patients from September 201 2 to December 201 3 were randomly divided into 2 groups using random number table method:69 patients in the observation group accepted NDP+GEM treatment and 32 patients in the control group received DDP +GEMtreatment.The objective response rate (RR),disease control rate (DCR ) and progression-free survival (PFS ) and adverse reaction were collected and evaluated. Results RR was 28.6%(1 8/63)in the observation group and 1 5.6%(5/32)in the control group,DCR was 81 .0%(51/63)in the observation group and 68.8%(22/32)in the control group (χ2 =1 .36,P=0.24;χ2 =1 .67,P=0.20).The median PFS was 4.52 months and 4.01 months in the observation group and control group (χ2 =0.09,P=0.73).The major adverse reaction was myelosuppression in both groups (33.3% vs.37.5%,χ2 =0.1 7,P=0.68).The incidence ofⅢ-Ⅳ grade nausea and vomiting was lower in the observation group, compared with the control group (1 4.5%vs.56.3%,χ2 =1 9.02,P=0.05).Conclusion NDP combined with GEM in advanced lung squamous cell carcinoma of the first-line treatment has equivalent efficacy to DDP+GEM, with lower incidence of adverse reaction,which is worthy of further dissemination of research.

Internal contamination of radionuclides in the event of nuclear emergencies can lead to serious harm to human health. The research and development of radionuclide chelating agents and the application of new technologies can reduce the internal damage caused by radionuclides. Compared with traditional preparations, the nano-preparations have the advantages of improving drug dissolution, targeting and positioning drug release, and easily passing through biofilm barrier. In recent years, many scholars have used different nano-preparation forms for different decorporation drugs, including nanoparticles, nano-liposomes, nano-emulsions, etc., to conduct related research in order to achieve better clinical application effects. Nanomaterials with excellent properties have the advantages of high efficiency, rapid adsorption and high biocompatibility, etc., and have been used more and more widely in radionuclide decorporation. In this paper, combined with the relevant literatures at home and abroad, the internal contamination of radionuclides is classified according to nuclide-deposited sites of tissues and organs, and the applications of related nanoformulations and nanomaterials in radionuclide decorporation are introduced in order to provide reference for further research.

Objective To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. Methods Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table. The model of ventricular fibrillation (VF) was reproduced by electrical stimulation, and mechanical chest compressions and mechanical ventilation (volume-controlled mode, tidal volume 7 mL/kg, frequency 10 times/min) were performed after 8 minutes of untreated VF. Positive end expiratory pressure (PEEP) in LP group and HP group was set to 0 cmH2O and 6 cmH2O (1 cmH2O = 0.098 kPa) respectively. Up to three times of 100 J biphasic defibrillation was delivered after 10 minutes of CPR. The ROSC of animals were observed, and the respiratory parameters, arterial and venous blood gas and hemodynamic parameters were recorded at baseline, 5 minutes and 10 minutes of CPR. Results The number of animals with ROSC in the HP group was significantly more than that in the LP group (8 vs. 3, P < 0.05). Intrathoracic pressure during chest compression relaxation was negative in the HP group, and its absolute value was significantly lower than that in LP group at the same time [intrathoracic negative pressure peak (cmH2O): -4.7±2.2 vs. -10.8±3.5 at 5 minutes, -3.9±2.8 vs. -6.5±3.4 at 10 minutes], however, there was significantly difference only at 5 minutes of CPR (P < 0.01). Intrathoracic pressure variation during CPR period in the HP group were significantly higher than those in the LP group (cmH2O: 22.5±7.9 vs. 14.2±4.4 at 5 minutes, 23.1±6.4 vs. 12.9±5.1 at 10 minutes, both P < 0.01). Compared to the LP group, arterial partial pressure of oxygen [PaO2 (mmHg, 1 mmHg = 0.133 kPa): 81.5±10.7 vs. 68.0±12.1], venous oxygen saturation (SvO2: 0.493±0.109 vs. 0.394±0.061) at 5 minutes of CPR, and PaO2 (mmHg: 77.5±13.4 vs. 63.3±10.5), arterial pH (7.28±0.09 vs 7.23±0.11), SvO2 (0.458±0.096 vs. 0.352±0.078), aortic blood pressure [AoP (mmHg): 39.7±9.5 vs. 34.0±6.9], coronary perfusion pressure [CPP (mmHg): 25.2±9.6 vs. 19.0±7.6], and carotid artery flow (mL/min:44±16 vs. 37±14) at 10 minutes of CPR in the HP group were significantly higher (all P < 0.05). Arterial partial pressure of carbon dioxide (PaCO2) in the HP group was significantly lower than that in the LP group at 10 minutes of CPR (mmHg: 60.1±9.7 vs. 67.8±8.6, P < 0.05). Conclusions Compared to low airway pressure, a certain degree of positive airway pressure can still maintain the negative intrathoracic pressure during relaxation of chest compressions of CPR, while increase the degree of intrathoracic pressure variation. Positive airway pressure can improve oxygenation and hemodynamics during CPR, and is helpful to ROSC.

Objective To study the anatomical characteristics of the medial sural vessels and the clinical effects of treatment for leg skin and soft tissue defect with free flaps.Methods 6 adult lower limbs were treated by latex perfusion and then observed the origin of the blood supply to gastrocnemius muscle,measure the number of the arteries and veins,the length and diameter of the medial sural vessels.From July 2009 to May 2013,15 clinical cases of serious skin and soft tissue defect were repaired by using free flap with medial sural vessels.The areas of wound surface were ranging from 13 cm × 7 cm-24 cm × 12 cm.10 of them were treated by anterolateral thigh flap,the other of them were treated by latissimus dorsi flap.The donor site were directly sutured or repaired by free skin graft.Results The blood supply of gastrocnemius mucle was multifocal.The medial sural arteries and lateral sural arteries were both origin from popliteal artery.The medial sural vessels include 1 artery and 2 veins.With the length 4-7 cm (average,5.4 cm),the arterial diameter of the origin 2.6-2.9 mm (average,2.7 mm) and the entry point 1.9-2.3 mm (average,2.1 mm),the vein diameter of the origin 1.8-2.2 mm (average,2.0 mm)and the entry point 2.7-3.4 mm(average,2.9 mm).Totally 15 cases flaps were survived with primary healing.The mean follow-up period was 16.5 months(range,11-21 months),The flaps had satisfactory appearance,soft texture,good elasticity and achieved protective sensation at the last followed-up.Conclusions The medial sural vessels are with constant anatomical position,deeply position,hardly damage,long pedicle.Thus,the medial sural vessels combine with free flap is an good choice for the reconstruction of leg skin and soft tissue defect.

Objective To study the anatomical characteristics of the medial sural vessels and the clinical effects of treatment for leg skin and soft tissue defect with free flaps.Methods 6 adult lower limbs were treated by latex perfusion and then observed the origin of the blood supply to gastrocnemius muscle,measure the number of the arteries and veins,the length and diameter of the medial sural vessels.From July 2009 to May 2013,15 clinical cases of serious skin and soft tissue defect were repaired by using free flap with medial sural vessels.The areas of wound surface were ranging from 13 cm × 7 cm-24 cm × 12 cm.10 of them were treated by anterolateral thigh flap,the other of them were treated by latissimus dorsi flap.The donor site were directly sutured or repaired by free skin graft.Results The blood supply of gastrocnemius mucle was multifocal.The medial sural arteries and lateral sural arteries were both origin from popliteal artery.The medial sural vessels include 1 artery and 2 veins.With the length 4-7 cm (average,5.4 cm),the arterial diameter of the origin 2.6-2.9 mm (average,2.7 mm) and the entry point 1.9-2.3 mm (average,2.1 mm),the vein diameter of the origin 1.8-2.2 mm (average,2.0 mm)and the entry point 2.7-3.4 mm(average,2.9 mm).Totally 15 cases flaps were survived with primary healing.The mean follow-up period was 16.5 months(range,11-21 months),The flaps had satisfactory appearance,soft texture,good elasticity and achieved protective sensation at the last followed-up.Conclusions The medial sural vessels are with constant anatomical position,deeply position,hardly damage,long pedicle.Thus,the medial sural vessels combine with free flap is an good choice for the reconstruction of leg skin and soft tissue defect.

Objective To explore the characteristics and influencing factors of methamphetamine dependence adolescents’ emotional faces recognition ability. Methods Eighty-six adolescents methamphet-amine addicts and 85 healthy volunteers were tested by a self-designed questionnaire and an experiment of e-motional faces identification. Results (1)There was no significant correlation between the emotional faces recognition ability of the experimental group with their age,education level and drug time (P>0. 05). (2)The correct number of positive(32. 58 ±8. 56),neutral (32. 76±8. 06),and negative(56. 28±20. 04) emotional faces recognition in the experimental group was significantly lower than that in the control group of positive (35. 64±3. 91),neutral(35. 47±4. 00),and negative(71. 02±8. 62) emotional faces recognition(t=-3. 00,-2. 79,-6. 24,P<0. 05). Meanwhile,the response time of positive(( 401. 32± 175. 13) ms) and negative ((502. 08±194. 42)ms) emotional faces recognition in the experimental group was significantly lower than that in the control group of positive((300. 83±139. 48)ms) and negative((379. 91±197. 30)ms) emotional faces (t=4. 15,4. 08,P<0. 05). Nevertheless,there was no significant difference between the experimental group((400. 90±174. 21) ms) and the control group ((356. 67±156. 70) ms) in the recognition response time of neutral emotional faces (t=1. 75,P>0. 05). Conclusion Methamphetamine dependence impairs the ability of adolescents’ emotional faces recognition,and their positive and negative emotional recognition abili-ty has processing defects. The ability of methamphetamine dependence adolescents to emotional faces recogni- tion is not affected by their age,education level and time of drug uses.

Objective To investigate the status of cardiopulmonary resuscitation (CPR) in patients with sudden cardiac arrest (CA) in the emergency department. Methods A multicenter prospective observational study was conducted. The patients with CA admitted to 13 hospitals from 6 provinces in four different regions, including North China, Southern China, East China, Southwest China, from July 1st, 2015 to July 31st, 2017 were enrolled. A modified Utstein template was applied to collect clinical data, including general data, CA related data and prognosis, and primary outcome indicator was the return of spontaneous circulation (ROSC) rate, and the secondary outcome indicator was 28-day survival rate. The influence factors of ROSC were screened by Logistic regression analysis. Results The data of 613 patients with CA in 13 hospitals were enrolled. The ROSC rate in Beijing and Guangdong Province was higher, but there was no significant difference in 28-day survival rate among hospitals from different provinces. ① In 613 patients with CA, there were 413 patients suffering from in-hospital cardiac arrest (IHCA, 67.4%), and 200 suffering from out-hospital cardiac arrest (OHCA, 32.6%). 208 patients had ROSC at least once (33.9%), only 20 patients survived within 28 days (3.3%). ROSC rate in IHCA patients was significantly higher than that in OHCA patients [37.3% (154/413) vs. 27.0% (54/200), P < 0.01]. There was no statistic difference in 28-day survival rate between patients with IHCA and OHCA. The patients received manual chest compression, electric defibrillation, or epinephrine ≤ 4 mg had higher ROSC rate, but 28-day survival rate showed no significant difference. Multivariate Logistic regression analysis showed that IHCA [odds ratio (OR) = 1.893, 95% confidence interval (95%CI) = 1.253-2.858, P = 0.002], manual chest compression (OR = 0.506, 95%CI = 0.348-0.736, P = 0.000), electric defibrillation (OR = 0.458, 95%CI = 0.300-0.699, P = 0.000), and total adrenalin ≤ 4 mg (OR = 0.317, 95%CI = 0.216-0.464, P = 0.000) were the protective factors of ROSC in CA patients. ② In 200 OHCA patients, there were 49 patients had ROSC (24.5%), only 5 patients survived (2.5%). The patients aging < 65 years, with witnesses of CPR, received manual chest compression, electric defibrillation, or epinephrine ≤ 4 mg had higher ROSC rate, and the ROSC rate was higher in ambulances than that at home and in public sites, but 28-day survival rate showed no significant difference. Multivariable Logistic regression analysis showed that age < 65 years old (OR = 2.749, 95%CI = 1.192-6.336, P = 0.018), manual chest compressions (OR = 0.196, 95%CI =0.072-0.535, P = 0.001), electric defibrillation (OR = 0.263, 95%CI = 0.108-0.641, P = 0.003), total adrenaline dose ≤4 mg (OR = 0.122, 95%CI = 0.049-0.303, P = 0.000) and the ambulance CA (OR = 2.441, 95%CI = 1.334-4.468, P = 0.004) were protective factors of ROSC in OHCA patients. Conclusions The survival of sudden CA in emergency department was still poor. Early electric defibrillation, manual chest compression, CA occurred in hospital or in ambulance, and witness CPR can improve the ROSC rate of CA patients. Excessive use of adrenaline is not beneficial to patients with CA. Clinical Trial Registration Clinical Trials, NCT01987245.

Objective:To retrieve, evaluate and integrate the relevant evidence of the prevention of deep venous thrombosis of the lower extremities by ankle pump exercise, so as to provide reference for the clinical practice of preventing deep venous thrombosis of the lower extremities.Methods:All the evidences of ankle pump exercise for the prevention of deep venous thrombosis of the lower extremities, including guidelines, summary of evidences, information booklet of best clinical practice, recommended practice, systematic review and original studies were searched from establishment of databases until January 3, 2021 in China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang database, VIP, Cochrane Library, PubMed, Embase, Web of Science, National Institute for Health and Clinical Excellence Guide Library, National Guideline Clearinghouse, International Practice Guideline Registry Platform (Chinese version), BMJ Best Practice, Joanna Briggs Institute Evidence-based Health Care Center Library and UpToDate. Two researchers evaluated the quality of the included literature and extracted evidence from the literature that met the quality standards.Results:A total of 11 articles were included, including 2 guidelines, 1 systematic review, 3 expert consensus, 1 evidence summary and 4 randomized controlled trial studies. Finally, a total of 10 best pieces of evidence were summarized.Conclusions:Ankle pump exercise is one of the preventive measures for deep vein thrombosis of the lower extremities. The summary of the best evidence can provide reference for improving the prevention level of deep vein thrombosis of the lower extremities of medical staff, standardize preventive behaviors and reduce the incidence of deep vein thrombosis of patients.