Objective To evaluate the similarities and differences between four-dimensional radiotherapy (4D-CT ) and active breathing control techniques(ABC) in respiratory management in lung radiotherapy ,and investigate the indications and feasibility of different breathing control techniques for different patients .Methods Twenty-one patients treated with lung radiotherapy received respiratory management .4D-CT technology was used in 11 patients ,while ABC technology was adopted in the rest 10 .The ratios of planning target volume(PGTV) to gross tumor volume(GTV)[(PGTV/GTV)] were calculated .The differences between these two respiratory management technologies were compared in terms of the PGTV ,positioning time ,planning time and treatment time to investigate the indications .Results 4D-CT technology had higher PGTV/GTV ratio ,and shorter positioning time and irradiation time than ABC technology(P<0 .05) ,but there was no significant difference in the planning time(P>0 .05) .In patients with ABC and 4D-CT technology ,objective response rates were 50 .0% ,45 .5% ,respectively ,and the radiation pneumonitis rates were 30 .0% ,27 .3% ,respectively .There was no significant difference in both groups (P>0 .05) .Conclusion In lung tumor radiothera-py ,ABC can reduce irradiation volume ,suitable for patients with good performance status .4D-CT is time-saving and well tolerated , suitable for patients with smaller tumors .

Objective To find a novel operative modality with sphincter preservation in the treatment of middle and low rectal carcinoma. Methods Pull through lower resection was performed on 28 rectal cancer patients. The distance between the anal verge and the lower margin of the tumor was 6～8cm(20 patients) or 8～10cm(8 patients), including 8 patients in Dukes A stage, 16 Dukes B and 4 Dukes C. The resected line from tumor distal margin was 2cm, 3cm, and 4cm, respectively. Results There was no operative death, anastomotic fistula or anastomotic stenosis in these cases. Mean follow up period was 30 months. Local recurrence was found in two cases (7.1%) 18 months after the operation, and 26 cases were cancer free till the end of the follow up. Defecation was satisfactorily controlled 8～12 weeks after the operation. Conclusions Pull through Welch procedure could meet the criterion of the radical resection of rectal carcinoma,and keep the internal and external sphincter muscles intact in the superior lower anterior resection. The normal defecationcan can maintain after the operation due to the preservation of internal and external sphincter muscles.

Pathophysiological changes, such as the vulvovaginal atrophy, reduction in the proportion of lactobacilli, unbalance of the vaginal flora and impaired vaginal immune barrier, can result in a series of symptoms, signs and diseases affecting the health and quality of life in postmenopausal women.This article reviews the change characteristics and related mechanisms of the microbial flora in postmenopausal women in terms of the type, quantity and proportion of vaginal flora, and clarifies efficacy and its mechanisms of systemic and topical estrogen therapy on the improvement of intravaginal environment and urogenital symptoms, in order to improve the quality life in postmenopausal women.

Objective To study the feasibility of Brainlab plus 6-degree-of-freedom(6D) couch in the radiotherapy of head and neck by using their setup error.Methods Twenty-four patients with head and neck neoplasms in our hospital during AugustOctober 2016 were taken as the examples.After positioning by technician,each Brainlab was carried out,the setup errors in 3 translation directions of left-to-right(X),head-to-foot(Y) and abdomen to-back(Z) and 3 pivoting directions of Rx,Ry and Rz were obtained after registration of positioned CT image.After adjustment,Brainlab re-scanning was conducted for getting corrected errors.Results The online correction by Brainlab plus 6D obviously reduced the setup errors.The setup errors in all directions approached to 0,in which the difference between Ry and Rz directions had no statistical significance(P＞0.05),while the difference among the X,Y,Z and RX directions was statistically significant(P＜0.05).Conclusion The online corrections of Brainlab combined with 6D considerably reduces the errors in translation and rotation directions in radiotherapy of head and neck neoplasms,thus reduces normal tissue received amount and increases the radiotherapeutic accuracy.

Objective To investigate the clinical efficacy of levonorgestrel- releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis and the influence of ovarian function. Methods Eighty patients with adenomyosis were followed up for 0, 1, 3, 6, 12 months after treating with LNG-IUS. The menstrual blood volume, dysmenorrheal, size of uteri, CA125 and EMAb level, hepatic function, serum glucose and serum lipids were observed and evaluated. Serum- levels of FSH and LH were tested before insertion and followed up for 6, 12 months after insertion, respectively. Results After inserting LNG-IUS,dysmenorrhea was obviously alleviated, and it was significantly decreased after 6 months. The menstrual blood volume was (200. 0 ±60)ml, (40. 0 ± 15)ml and (28 ±7)ml in 0, 6, 12 months after the insertion.Serum CA125 and positive rate of EMAb also significantly reduced [CA125: (50. 69 ± 10. 00) IU/L vs (18. 60 ±3.55)IU/L;EMAb:80. 0% vs 3. 8%, P ＜0. 05]. The volume of uterus reduced without significant changed (P ＞0. 05). There were little changes in the levels of hepatic function, serum glycosum, serum lipids, FSH and LH at 6 and 12 months after LNG-IUS(P ＞ 0. 05). Conclusions LUG-IUS is an effective and safe therapy for adenomyosis with dysmenorrheal and menorrhagia, and it has no significant effects on ovarian function.

Objective To analyze the efficacy,dose and complications of total body irradiation(TBI) for patients to receive hematopoietic stem cell transplantation(HSCT) in the treatment of leukemia and malignant lymphoma.Methods From May 2002 to February 2007,78 cases with leukemia or malignant lymphoma received the TBI before HSCT in our department.All the patients were irradiated with linear accelerator in 2 consecutive days at a total dose of 7 to 11 Gy,dose rate of 4.5 to 5.0 cGy/min,once per day.Among them,55 cases received traditional high-dose chemotherapy before radiotherapy,and the other 23 cases got TBI first followed by high-dose chemotherapy.Results All the cases used TBI prior to transplantation was successful,and no serious complication such as radiation pneumonitis was observed.Conclusion Our TBI regime is a safe and effective pretreatment for HSCT.TBI used before the large doses of the chemotherapy is recommended because it is proved to be effective,without affecting the survival rate,and of lesser TBI reaction and of lesser preparation work for irradiation to radiotherapist.More attention should be paid when the linear accelerator is employed for TBI.

Objective To investigate the level and proportional relationship of free fluorine and soluble fluoride in different brands of toothpaste,and analyze possible risk factors.Methods A total of 54 samples of commercially available toothpastes of domestic,joint venture and imported in Guiyang City were collected,and the levels of free fluoride and soluble fluorine were determined,respectively,using fluorideion selective electrode.method (GB 8372-2008).Results The number of the toothpaste was 32,12,10,respectively,in domestic,joint venture and imported.The levels of free fluorine ranged from 0.98 to 1 603.50 mg/kg,3.22 to 617.50 mg/kg and 306.80 to 1 590.80 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard free fluorine was 3,0 and 1,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard free fluorine was 9.4％,0.0％ and 10.0％,respectively,in toothpastes of domestic,joint venture and imported.The levels of soluble fluorine ranged from 3.06 to 4 302.50 mg/kg,9.02 to 1 667.30 mg/kg and 9.18 to 4 013.20 mg/kg,respectively,in toothpastes of domestic,joint venture and imported; the number of exceeding the standard soluble fluorine was 9,2 and 3,respectively,in toothpastes of domestic,joint venture and imported; the rate of exceeding the standard soluble fluorine was 34.4％,16.7％ and 30.0％,respectively,in toothpastes of domestic,joint venture and imported.The proportion of free fluorine and soluble fluoride was:domestic 1.0 ∶ 2.7,joint venture 1.0 ∶ 2.7,imported 1.0 ∶ 2.5,respectively.The confidence limit (R/d) was 0.98.Conclusion The fluoride level in different brands of toothpaste has exceeded the standard,the content and proportion of soluble fluoride are obviously higher than those of free fluoride,and there is a risk on tooth damage from fluoride,and factories should strengthen quality control in adding fluoride.

BACKGROUND:Diameter and length of mini-implant have effects on its stability, which has been reported mostly in I and II osteoid, but less in IV osteoid. OBJECTIVE:To optimize the design of mini-implant diameter and length in IV osteoid by a three-dimensional finite element analysis. METHODS:Implant-mandible solid model was established. A 2 N orthodontic force that was perpendicular to the long axis of the implant and at a 30° angle with the distal central axis was applied onto the top of the implant. The implant was designed for different diameters (1.2-2.0 mm) and lengths (6-10 mm). Peak stress and peak displacement of the mandible were mechanicaly assessed, and stress sensitivity variables were analyzed. RESULTS AND CONCLUSION:The stress and displacement of the implant were mainly concentrated in the neck of the implant. The stress of implant-bone interface mainly focused on the contact area of the implant-cortical bone interface, and the stress of the cancelous bone was relatively smal, but the stress of the cortical bone was weakened faster. When the implant length was constant, the implant diameter had a great effect on stress changes, and the stress of bone tissue was reduced with the increase of implant diameter. When the implant diameter was constant, the implant length had no significant effect on the stress of bone tissue. To sum up, the stress of bone tissue and displacement were sensitive to the change of implant diameter rather than the change of implant length. These findings indicate that implant diameter has a greater effect on stress distribution of bone tissue than the implant length, and the implants with > 1.5 mm in diameter are suitable for IV osteoid.

Objective To study the change and relationship among thrombopoietin (TPO), platelet parameter and megakaryocyte in immune vasculitis of weanling rabbits. The role of platelet parameter, megakaryocyte, thrombopoietin (TPO) in kawasaki disease (KD) was accessed. Methods An experimental model of weanling rabbits for KD was reproduced by bovine serum. The blood platelet counts (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet hematocrit (PCT), megakaryocyte and TPO were determined ev-ery four days. Pathological analysis of coronary artery, liver, spleen, kidney, brain was also done. Results PLT, PCT, PDW and the per-centage of total number of megakaryocyte and middle board megakaryocyte in the experimental group had obviously changes at the 12th, 16th, 20th, 24th, 28th day (P <0.05). MPV in the experimental group had obviously changes in the 12th, 24th, 28th day(P <0.05). TPO in the experimental group was higher than that in control group (P < 0.05). TPO in both groups was positively correlated with PLT, PCT, the percentage of total number of megakaryocyte and middle board megakaryocyte (P < 0.05). In experimental group, small arteries showed obvious inflammatory injury at the 17th day, medium-sized arteries showed obvious inflammatory injury at the 28th day, but the aortas showed mild changes. Conclusion Platelet, megakaryocyte and TPO took part in the pathogenesis of KD, and they had interaction and co-ordination in the course of regulation, which suggested that they could be used to monitor the changes in the KD and guide the treatment.

10.3969/j.issn.1000-8179.2013.12.003