Toxic epidermal necrolysis (TEN) is an acute skin inflammation,which belongs to heavy drug eruption.With the extensive and widespread use of antibiotics,nonsteroidal antipyretic analgesics and other pharmacotherapies in the treatment of critically ill patients,the trend of morbidity of TEN is gradually increased,especially in intensive care unit.In consideration of the high mortality rate of TEN and its great influence on the overall prognosis of patients with critical illness,we summarized the diagnosis and treatment experiences in the management of TEN based on retrospective analysis of one patient with severe acute pancreatitis and TEN.

Objective To measure the setup errors and organ movements of patients with esophagus carcinoma during radiotherapy and find a reasonable margin from the clinic target volume (CTV) to the planning target volume (PTV). Methods (1) Set-up veri cation: Forty-two cases of untreated esophageal cancer were enrolled into this study. The physicist firstly made the planning according to the doctor requests and ensured the best distribution at the target. Thereafter, the 0° and 90° digitally reconstructed radiograph (DRR) was transmitted to the iView GT workshop. Meanwhile, two copies of cross-cut electronic portal image (EPI) were required before radiotherapy. Two doctors confirmed the variance of the osteal mark from the EPI and DRR,and output a 3D direction (left to right, superior to inferior, anterior to posterior) of the setup errors through the iView GT software. (2)Breathing motion:Ten cases of untreated esophageal cancer were enrolled into this study.Three distinct breathing levels were deflned: FB (free breathing), EBH (expiration with breath-held) and IBH (inspiration with breath-held). We gave the treatment planning in FB, then by moving the isocenter to EBH and IBH, we recalculated the dose distribution without changing the field angle, shape and weighing (Mus). Displacements were analyzed at four points (anterior, posterior, right lateral and left lateral) and five levels of target (upper, quarter, isocenter, three-quarter and lower). Results (1) The systematic setup errors were -0.23 cm, -0.02 cm and -0.06 cm, and the random errors were 0.44 cm, 0.45 cm and 0.44 cm at the direction of left to right(LR), superior to inferior (SI), anterior to posterior(AP), respectively. (2) The organ movements were 0.3 cm, 0.6cm and 0.3cm at the LR, SI, AP, respectively. Conclusions As an alternative, the root-sum-of-squares of set-up error and organ motion are suggested by σtot=√ (σITV2+σSM2). The CTV to PTV margins are 0.8cm left to right, 0.78cm superior to inferior, 0.5cm anterior to posterior.

Objective To establish the quality standard of Buxin Ruanmai granules. Methods TLC was used to identify Ophiopogonis, Corni Fructus, Hirudo, Ginkgo Folium and Polygoni Cuspidati Rhizoma et Radix. HPLC was used to determine the content of salidroside and loganin. Results Ophiopogonis, Corni Fructus, Hirudo, Ginkgo Folium and Polygoni Cuspidati Rhizoma et Radix could be identified by TLC. The linear range of salidroside was within 0.290 2-2.902 4 μg and the average recovery (n=6) was 99.64%(RSD=2.72%). The linear range of loganin was within 0.083 1-0.831 2 μg and the average recovery (n=6) was 100.12% (RSD=2.27%). Conclusion The method is simple, accurate and reproducible, which can effectively control the quality of Buxin Ruanmai granules.

Purpose To evaluate the feasibility of using dual-energy CT scanner to differentiate two contrast media bismuth and gadolinium. Materials and Methods Two phantoms containing contrast media of different ratio were scanned on dual-energy CT. Group 1 was mixture of iodine and gadolinium solution with volume ratio of 0∶1, 1∶6, 1∶1, 6∶1 and 1∶0. Group 2 was mixture of iodine and bismuth solution with mass ratio of 0∶1, 1∶6, 1∶1, 6∶1, 1∶0. Monoenergetic image reconstruction was performed at 80 keV. Liver VNC software was used for virtual scanning and iodine concentration analysis. Results Under 80 keV reconstruction, the measured CT attenuation of Group 1 was 379-383 HU, and 170-173 HU in group 2. The iodine concentration of two groups was not signiifcantly different between the calculated and actual iodine concentration (P>0.05). The dual-energy CT can distinguish two contrast media. Iodine and gadolinium contrast media were not statistically different, while iodine and bismuth contrast media agent could be easily differentiated. Conclusion Dual-energy CT can distinguish two contrast media with different attenuation.

Objective To use clustering analysis to help physicians detect abnormal parameters in radiotherapy treatment plans and improve the efficiency of plan verification. Methods From 2010 to 2015, 835 breast cancer treatment plans for using 4?field hybrid intensity?modulated radiotherapy from MOSAIQ were collectted. Fractional dose, beam angle, and monitor unit were used as featured parameters of a treatment plan to generate a dataset. The K?means clustering algorithm based on principal component analysis was used to perform a clustering analysis of the dataset and divide the dataset into different clusters. The outliers of clusters were automatically detected based on the distance threshold. The outlier?contained treatment plans were manually verified by physicians to determine the accuracy of clustering analysis in detection of abnormal plans. Results In the clustering analysis, the sample space composed by parameters of treatment plans for breast cancer was divided into 4 clusters, 3 of which had outliers detected. In the targeted treatment plans, 3 plans became outliers because of special target volume and the other 4 plans needed improvement. Conclusions Clustering analysis is effective to help physicians to independently verify treatment plans.

Objective To evaluate the efficacy of CT in diagnosis of pulmonary blastoma (PB).Methods 10 patients with surgically and pathologically proved PB were collected in this study,and CT findings of the tumors were retrospectively analyzed. Results Of 10 cases,1 were central form (the tumors localized under pleura) and 9 was periphery form.The tumors were localized at right lobus in 6( including upper lobus,middle and lower lobus in 1,1 and 4,respectively) and left lobus in 4(upper lobus in 3 and lower lobus in one).The lesions were more than 3 cm in diameters in all cases.Necrosis of tumors were seen in 7 cases.The lesions had obvious enhancement after intravenous injection of contrast medium.Enlarged lymph nodes were identified at hilum of the lung and mediastinum in one,bony destruction and distant metastases were seen in one and 2,respectively.Conclusion PB is not of characteristic CT features,CT-guided percutaneous needle biopsy and the immunohistochemical method are helpful to the diagnosis of pulmonary blastoma.

BACKGROUND:Cholesterol is closely linked to the occurrence and progression of atherosclerosis. Current approaches to study celular cholesterol dynamics have their own limitations.
OBJECTIVE: To measure the cholesterol efflux rate of RAW 264.7 mouse macrophages by BODIPY-Cholesterol labeling and to explore the effects of extracelular cholesterol and lipopolysaccharide on the cholesterol efflux rate.
METHODS:RAW 264.7 cels were cultured in vitro with DMEM containing 10% fetal bovine serum, and labeled with BODIPY-Cholesterol for 1, 2, 4, 8 hours. Then, the cels were rinsed with serum-free DMEM and inoculated for 6, 12, 24, 48, 96 hours to optimize the labeling time and incubation time. We measured and compared the cholesterol efflux rates after cultured cels were treated with cholesterol, lipopolysaccharide, human sera with high cholesterol or human sera with normal cholesterol.
RESULTS AND CONCLUSION: The best labeling time for BODIPY-Cholesterol was 2-8 hours. Cholesterol efflux rates were gradualy decreased after the cels that were labeled for 2 hours were incubated with increasing concentrations of cholesterol (0.1, 0.5, 2.5 mmol/L,P< 0.01). Treating cels with lipopolysaccharide also decreased the cholesterol efflux rate (P < 0.05). Furthermore, the cholesterol efflux rate was decreased after cels were treated with human sera with high cholesterol (P< 0.05). These findings indicate that BODIPY-Cholesterol can be used to measure celular cholesterol efflux rate and to study the effects of extracelular cholesterol and lipopolysaccharide on the cholesterol efflux rate.

Objective:To investigate the feasibility and accuracy of osmometer in the osmolarity measurement of pirenoxinun sodi-um eye drops. Methods:An osmometer was used to measure the osmolarity of pirenoxinun sodium eye drops, and the stability of the osmolality was studied. Results:The osmolarity of pirenoxinun sodium eye drops with different formula conformed to the requirement of ophthalmic preparations. The osmolality showed no significant change at the ambient temperature, indicating the stability of the prepa-ration. Conclusion:The method is simple, rapid and practical, which can be used as the osmolarity measurement method for pirenoxi-nun sodium eye drops.

Objective To study the method and effectiveness of interventional therapy for the stenotic or obstructive inferior vena cava(IVC) caused by hepatic cancer. Methods All together 6 patients were enroled, 4 males and 2 females, with age of 45 to 58 years, average 53 years. The main symptoms including abdominal distention, varices on abdominal walls and edema in lower extremities were caused by compression or involvement of IVC with right hepatic lobe lesion. We performed thrombolysis first and follower by balloon dilation and stent placement. Results IVC were recanalized in all 6 patients with free patent blood flow. The postal venous pressure dropped from 4.4 kPa to 2.1 kPa without major complications. Conclusions Treating the IVC stenosis and obstruction caused by primary liver cancer with interventional method is safe and effective together with improvement of life quality and prolongation of survival time. (J Intervent Radiol, 2006, 15: 537-538)