Objective To compare the dosimetric effects of systematic MLC leaf position errors on flattening filter (FF) and flattening filter-free (FFF) IMRT for nasopharyngeal carcinoma (NPC).Methods In totaly of ten patients with NPC were enrolled in the current study.FF IMRT and FFF IMRT plans were designed for each patient, and in-house software was developed to modify the corresponding MLC files.Briefly, three kinds of systematic MLC error presented with 0.5 and 1 mm magnitudes error were simulated.The modified MLC files were re-imported into IMRT plans for dose recalculation, and differences in the dosimetry trends between FF-IMRT and FFF-IMRT plans were analyzed using a dosevolume histogram.Results Upon closed MLC, the average changes in D95％ of PTV and D of parotid glands in FFF-IMRT plans were more sensitive than in FF-IMRT plans (t =3.298-4.793, P ＜ 0.05).Otherwise, when MLC are shifted in the same direction, changes in D95％of PTV, D of PGTV, PTV as well as D of left parotid gland in FFF-IMRT plans were also more sensitive (t =2.372-6.844, P ＜ 0.05), whereas average changes in D of right parotid gland presented with less sensitivity (t =-4.049,-3.378, P ＜ 0.05).Conclusions For out-of-field or large organs, FFF-IMRT plans are more sensitive to leaf position error than FF-IMRT plans.

Objective: To examine the effects of the education with glycemic index(GI)on dietary knowledge,attitude and practice of diabetic patients,and on their blood glucose and lipid.Methods: Seventy-two subjects with type 2 diabetes were randomly assingned into two groups. The test group (group GI) mainly learned the knowledge about GI of food. The controlled group (group FEL) mainly learned the knowledge about food exchange list(FEL). Outcomes were assessed by the change of dietary knowledge, attitude and practice, fasting blood glucose (FBG), 2 h postprandial blood glucose ( 2 hPBG), glycosylated hemoglobin (HbA 1c), and blood lipids which include total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and lipid comprehensive index (LCI). The period lasted five months. Results: The percent of correct answer for GI questions was increased significantly from 0 % before education to 92.2% after education (P

Objective To compare the dosimetric verification results of Varian Portal Dosimetry and Matrixx,and to assess the reliability of the clinical application of electronic portal imaging device (EPID) verification.Methods Varian TrueBeam linear accelerator,which was equipped with a 120-leaf multileaf collimator and an amorphous silicon EPID,as well as portal dose prediction software.IBA I′mRT Matrixx ion chamber array was used.EPID algorithm configuration,dose calibration,and testing before use were performed.The sliding-window protocol was used.There were 77 patients with tumors involving the head and neck (mainly nasopharyngeal carcinoma),mediastinum,abdomen,and pelvic cavity were selected.The verification plan of the portal dose was created with a source-detector distance of 100 cm,and the gantry angle was kept the same as the treatment plan.The verification plan was carried out in the TrueBeam machine,and the data were collected at the same time by EPID.Comparison between the measured and calculated dose images was performed,and the evaluation standard was gamma index (3%/3 mm).The paired t-test was used for difference analysis.Results For the 77 patients,the Gamma passing rates of both methods were above 97%.Except for head and neck carcinoma were a significant difference between the results of dosimetric results using EPID and Matrixx in intensity-modulated radiotherapy (P=0.018) other remaining all P> 0.05.Conclusions The dosimetric verification results of EPID are consistent with those of Matrixx.EPID can be used for dosimetric verification,and Matrixx ion chamber array can be used only in case of a low Gamma passing rate.

Objective To investigate the protective effect of Xinyi capsule pretreatment on myocardial ischemia reperfusion injury in rabbits and its possible mechanism. Methods Ninety-four rabbits were randomly divided into 6 groups: model group (n=16), tirofiban group (n=16), high-, medium- and low-dose Xinyi capsule groups (4.0, 2.0, 1.0 g/kg;n=16 in each group), and sham operation group (n=14). Five days after intragastric administration with drug, myocardial ischemia reperfusion was induced by ligation of the proximal left circumflex artery. The electrocardiogram (ECG) was continuously recorded. The serum levels of myeloperoxidase (MPO), lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were measured. Myocardial histopathological damage was evaluated. Results The changes of J-point amplitude on ECG in high-, medium-and low-dose Xinyi capsule groups (0.064 ± 0.049 mV, 0.069 ± 0.061 mV, 0.079 ± 0.060 mV) were significantly lower than that in the model group (0.158 ± 0.105 mV, P<0.01 or P<0.05), the serum levels of LDH (399.7 ± 202.3 U/L, 369.6 ± 229.0 U/L, 435.5 ± 152.4 U/L), CK-MB (900.8 ± 231.2 U/L, 1 268.3 ± 899.8 U/L, 1 386.7 ± 621.6 U/L), MPO (69.81 ± 5.51 U/L, 85.44 ± 10.31 U/L, 81.33 ± 16.87 U/L) were significantly lower than those in the model group (LDH:817.1 ± 401.9 U/L, CK-MB:2 071.3 ± 693.5 U/L, MPO:149.9 ± 20.11 U/L;P<0.01 or P<0.05). Histopathological examination showed that myocardial damage in high-, medium- and low-dose Xinyi capsule groups reduced compared with the model group. Conclusions Xinyi capsule pretreatment can protect against myocardial ischemia reperfusion injury in rabbits, and its mechanism may be related to inflammation inhibition.

Objective To develop a special ambulance for airfield rescue of pilots in danger or offering medical care for pilots in flight.Of course the ambulance can also be used to rescue the wounded daily or in the war.Methods The ambulance owned a cross-country motorcar chassis and bearing carriage.A luffing extension-jib was installed on top of the carriage with a telescopic nacelle.The medical carriage owned a generator,air-conditioner,launder & antisepsis facilities,telescopic medical table,Air Force medical facilities for first aid and so on.It could simultaneously treat 2 injured pilots in lying position.Oxygen outputs were equipped to sustain Persons in carriage.Result The maximal speed of the ambulance was 95 km/h.The time of simulated rescue was about 3 minutes in the maxium height.Conclusion Without new staff established,the ambulance can adapt to any road and is suitable to war field.It can arrive at the location of flight accident quickly and rescue the pilot rapidly.It meets the needs of medical support in flight,war-time medical care in airport and mobile accompanying support.

Objective To further clarify the pathogenesis of different types of Kaposi′s sarcoma (KS) by measuring the protein expressions of caspase-3 and E-cad in tumor tissues of Xinjiang Uygur patients with acqured immunodeficiency syndrome (AIDS)-Kaposi′s sarcoma (KS) and classical KS.Methods From July 2011 to October 2014, 38 patients with KS at the First Affiliated Hospital of Xinjiang Medical University and Urumqi Infectious Disease Hospital were enrolled, among whom 28 were male and 10 were female, and all of them were uygur.Immunohistochemical and Western blot methods were used to detect the expressions of caspase-3 and E-cad proteins in 22 cases of AIDS-KS patients and 16 cases of classic KS.The quantitative data of normal distribution were analyzed by t test, while count data were compared with χ2 test with R × C table.Results KS lesions in patients with classic KS were confined to the skin, without mucosal, lymph node or visceral involvement.Lesions in AIDS-KS patients were not only confined to the skin and superficial lymph nodes, but also oral mucosa involved in 12 cases and internal organs involved in 7 cases.Liver and lung involvement was more common.The CD4+T lymphocyte count in patients with AIDS-KS was (200.8±166)/μL.All 15 AIDS cases with CD4+ T cell count less than 200/μL developed opportunistic infections.CD4+ T lymphocyte count of patients with classic KS was (562.52±222.66)/μL and the 16 patients with CD4+T lymphocyte count greater than 350/μL had no opportunistic infections.The results of immunohistochemistry showed that the positive expression rate of caspase-3 protein in KS tissues in patients with AIDS-KS was 68.2%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=7.37, P=0.01).The positive expression rate of E-cad protein in KS tissues in patients with AIDS-KS was 72.7%, in patients with classic KS was 100.0%, with significant difference between two groups (χ2=5.18, P=0.03).Western blotting showed that the gray value of caspase-3 in the KS tissue of patients with AIDS-KS was 0.55±0.36, and that in patients with classic KS was 0.86±0.56, with significant difference between two groups (t=-2.070, P<0.05).The gray value of E-cad in the KS tissue of patients with AIDS-KS was 0.54±0.41, and that in patients with classic KS was 0.85±0.45, with significant difference between two groups (t=-2.060,P<0.05).Conclusions There are differences in the protein expressions of caspase-3 and E-cad in tumor tissues of patients with AIDS-KS and classical KS in Xinjiang Uygur patients with Kaposi's sarcoma, which may correlate with a faster progression and a higher mortality rate for AIDS-KS.

Objective:To evaluate the combined effect of an trajectory log field based(LBF)and two commercial dose reconstruction systems on volume-modulated arc therapy(VMAT)dose verification of lung cancer.Methods:An in-house program was developed to introduce errors in trajectory log of TrueBeam to the origin plan and recalculate the dose of the error plan in treatment planning system(TPS). A total of 18 lung cancer cases treated by two-arc VMAT were selected to perform on LINAC and measured by ArcCheck simultaneously. Then, the reconstructed doses were obtained by 3DVH. The mode of reconstruction was calculated by LFB and Compass. Five of the 18 cases were performed on LINAC two times in four hours and measured by ArcCheck to evaluate the stability of the TrueBeam performance. The 18 plans were recalculated and performed on LINAC with a solid water phantom with 5 cm build-up, 4 cm back scattering thickness and a FC65-G detector in the center. The measured dose by detector was compared with the reconstructed dose by three systems.Results:TheTruebeam performance was stable. For all of the 18 cases, the point dose measured by FC65-G and reconstructed by three systems had a deviation of less than 2% to the TPS calculated. For all of the organs reconstructed by LBF and most organs reconstructed by 3DVH and Compass, the γ pass rate between them and TPS all exceeded 90% under all criteria, as well as the ArcCheck measured results. For all the organ dose difference between reconstructed and TPS, LBF system had the smallest difference, followed by the Compass system except the lung, and the 3DVH had the highest difference.Conclusions:LBF, 3DVH and Compass can reflect the VMAT dose verification results of lung cancer from different perspectives. The combined application of three systems can demonstrate the verification results in an intuitive manner, which is beneficial for subsequent analysis.

Objective To study biological characteristics of R5 tropic human immunodeficiency virus (HIV)-1 strains in different disease stage. Methods Primary clinical viruses were isolated from fresh peripheral blood mononuclear cells (PBMC) using co-culture methods; meanwhile, viral co receptor usage and infectivity were tested using flow cytometry on GHOST (3) cell lines,which expressed CD4 receptor and CC ehemokine receptor 5 (CCR5) or CXCR4 eoreceptor; to identified CCR5 tropic viruses(R5 tropic strains). Viral replication kinetics was detected in PBMCs. Plasma viral load was measured using an HIV-1 nucleotide fluorescence quantification assay kit. Results There were 22 individuals with HIV-1 subtype B' infection, in which 11 were CD4>0. 2 × 109/L and 11 were CD4≤0. 2 × 109/L. All isolated viruses used CCR5 coreceptor and therefore were HIV-1 R5 tropic strains. The infectivity of R5 tropic strains isolated from patients with CD4≤0.2 × 109/L was (7.392 7 ± 4. 584 2) % ; while the infectivity of R5 tropic strain from patients with CD4>0. 2 × 109/L was (2. 613 6 ± 1. 610 5)%. There were significant statistical difference(t= 3. 262, P<0.05). The possibility of viral replication became strong after the day 7 post-infection. There was a significant difference of viral replication between two groups in the day 7,10, 15 post-infection(t value was 3. 771, 2. 509 and 2. 260 respectively, P<0. 05). The possibility of viral replication was higher in CD4≤0.2 ×109/L group than that of CD4>0.2 × 109/L group. The logarithm of viral load was (5. 606 8 ± 0. 815 1 ) copies/mL in CD4≤0.2 × 109/L group and (4. 729 8 ± 0. 431 6) copies/mL in CD4> 0.2 × 109/L group. There was a significant difference between two groups(t = 3. 771 ; P<0.05). Conclusion Viral infection and replication are enhanced during progression of disease, even if viral coreceptor usage do not switch from CCR5 to CXCR4.

Objective To investigate the incidence of enteric pathogens causing acute gastroenteritis (AGE) among children to measure the incidence of coinfections,and to compare the clinical characteristics of those infected with one versus multiple agents.Methods A retrospective study was conducted from January 2014 to December 2014.All patients between 1 month and 14 years of age admitted to the Pediatric department with a diagnosis of AGE were eligible for enrollment.Two stool samples for each patient were tested for gastrointestinal pathogens.We summarized the clinical severity of episodes,describing the duration of diarrhea,duration and frequency of vomiting,fever.All patients underwent medical evaluation with estimation of dehydration.Results One or more etiological agents were detected in 3595 out of 4728 patients(76.0％),while we did not detect any etiological agent in 1133 (24.0％).Rotavirus was detected in 1889 (40.0％),adenovirus in 412 (8.7 ％),norovirus in 309 (6.5 ％),verotoxigenic Escherichia coli (VTEC) in 274 (5.8 ％),Salmonella spp.in 276(5.8％),Klebsiella pneumoniae in 123 (2.6％),Shigella spp.in 78 (1.6％),Staphylococcus aureus in 70 (1.5％),C.perfringens in 126(2.7％).In 1370 children out of 4728(29.0％),we found evidence of coinfection.with rotavirus and norovirus was the most common 150 (3.2％),rotavirus and C.perfringens was also common 127(2.7％).Children with coinfection had a more severe clinical presentation.The difference has statistical significance.Conclusion Rotavirus is still the most common pathogen in children with acute diarrhea,followed by NV,adenovirus,Salmonella spp.and VTEC.Rotavirus with norovirus infection was the most common.VTEC combined with three kinds of virus infection had the highest incidence.Children with multiple viral infections were more severe than those of single virus infection in the duration of vomiting and dehydration.There was no significant difference in the duration of fever and diarrhea and the frequency of diarrhea.Children infected by viruses and bacteria had a more severe clinical presentation such as fever,vomiting and diarrhea lasting for a long time,more serious diarrhea and dehydration than those with single bacteria and single virus infection.The difference has no significant difference in degree and duration of diarrhea.

Objective: To achieve quantitative analysis of image quality parameters and establish warning and action thresholds for the on-board imaging (OBI) system of linear accelerator. Methods: The Catphan604 phantom was repeatedly scanned in the Full-Fan and Half-Fan CBCT scanning modes on a Varian EDGE linear accelerator, and the software based on Python language development in-house was utilized to analyze image quality parameters, such as CT number linearity, geometric consistency, slice thickness, spatial resolution, uniformity and low-contrast resolution. The quantitative analysis results of each image quality parameter obtained from 16 times of scanning within 16 months were normalized to the mean and the standard deviations were recorded. A run chart analysis was created to determine the warnings and action thresholds. Results: The software built in-house can quantitatively analyze the image parameters of the two scanning modes of OBI system. The low-contrast resolution of Half-Fan was better than that of Full-Fan, whereas the spatial resolution of Full-Fan was superior to that of Half-Fan. One standard deviation (1σ) was set as the warning threshold and 2 standard deviations (2σ) as the action threshold, respectively. The tolerance level of Half-Fan was smaller than that of Full-Fan. Conclusion Self-developed software enables quantitative analysis of accelerator image quality parameters, establishes warning and action tolerance of quality assurance and provides guidance for image quality assurance under image-guided radiotherapy specification.