Objective To develop measurement of reference air kerma for192Ir sources with NE 2570 electrometer,2571 ion-chamber and machining measured holder.Methods The measuring holder was placed at the distance of 1 m from the walls,the floor and ceiling,the ion-chambet was insert into the oolymethyl methacrylate(PMMA)jig of the measuring holder,lhe optimum distance is 16 cm from the source centre to ionchamber centre.The source was transmitted by the afterloding system to the plastic pipe to measure reference air kerma of the source.According to calibration factors from60Coγrays and 250 kV X rays with air exposure to calculated the air kerma calibration factor,the air kerma calibration factor of 192Ir soHree was calculated bv60Co γ rays and the effective energy of the 250 kV X ray beam.The scatter correction factor was giverl by the shadow shield experiment for the wails,the floor,the air and the measuring holder,the correction factors were given for the attenuation of primary photons in air and the electrons entering the air cavity are mainly generated in the innerwall of the chamber by 1079 report in IAEA.Results Two measuring methods were used for192Ir source undersame environment condition,the ion-chatuber and well-type chamber values are 1.584×1011Bq and 1.561×1011Bq respectively,and the relative deviation from them is within 1.4%,Conclusions The air kerma measurement of 192Ir source the ion-chamber with is not depended on the source geometry(point seurce,line source etc),the size.and the material of shell,the shape,the quality of materials and the size of the chamber.The uncertainty error of the air kerma is lessin comparison to the air exposure.

Objective To investigate the safety,efficacy of CO2 insufflations during ERCP.Methods One hundred and forty eligible patients who underwent ERCP in Fuzhou General Hospital of Nanjing Military Command from January to December 2012 were randomized according to random digits in a double blind manner to receive either CO2 insufflations or air insufflations (65 vs 75).The patient's experience of abdominal pain and distension at 1 h,2 h,6 h and 24 h post-ERCP were evaluated by visual analogue scale (VAS).The heart rates,blood pressure,SpO2,PaCO2 were recorded before,during,after ERCP,and 24 h after the examination.Plain abdominal radiographic images were collected to show abdominal distention before and after ERCP,waist circumference,operative time,recovery time,intraoperative and post-ERCP complications were also determined.Results Post-ERCP the VAS of abdominal pain at 3 h was (4.08 ± 1.36) in CO2 group,which was significantly lower than that in air group [(4.59 ± 1.66),P ＜ 0.01].The VAS of abdominal distension at 1 h,3 h,6 h after ERCP were(1.78 ± 1.90),(0.72 ± 1.15),(0.12 ±0.45),which were significantly lower than those in air group [(3.53 ± 2.71),(2.51 ± 2.04),(0.84 ± 1.24),P ＜ 0.05] ; the intraoperative SpO2 was (93.29 ± 1.40)％,which was significantly lower than that in air group [(93.52 ± 1.06) ％,P ＜ 0.01].The waist circumference at 1 h after ERCP increased by (2.48 ± 1.33)cm,which was significantly lower than that in air group [(3.56 ± 2.13) cm,P =0.00).Recovery time was (11.2 ± 2.5) rain in CO2 group,which was significantly longer than that in air group [(9.7 ± 1.7) min,P =0.00].And the difference between the two groups was statistically significant.The plain abdominal radiographic images showed the degree of bowel distension was severer in air group than that in CO2 group (P =0.04).Conclusions CO2 insufflations are safe and efficacy during ERCP.CO2 can better alleviate abdominal pain and distension than air.

The femora! arteries in 38 rabbits were transected and repaired with autogenous venous grafts with different diameters. The measurements of blood flow, patency rate and thrombosis rate, and scanning electron microscopic examination were made over a period of 14 days. The result showed that a venous graftl with a diameter 20 per cent less than that of the recipient artery was most satisfactory.

Objective To investigate the inhibitory effect of Berberine hydrochloride alone or combined with antibiotics on the formation of Staphylococcus epidermidis biofilm and the expressions of relative genes in order to explore a new way to treat the infection induced by the bacteria.Methods Biofilm of Staphylococcus epidermidis was constructed in vitro first,and then Berberine hydrochloride alone or combined with norvancomycin,ciprofloxacin or erythromycin was used to affect the biofilm formation.Then the inhibition was detected by CRA,and the expressions of icaA and agr by the way of fluorescent quantitation RT-PCR.Results The effectiveness of Berberine hydrochloride on the expressions of icaA and agr in Staphylococcus epidermidis was not as better as the other antibiotics.When different-dosed berberine hydrochloride was combined with norvancomycin,ciprofloxacin or erythromycin to affect the biofilm,the inhibition on the expressions of icaA and agr showed a negatively dose-dependent fashion.Conclusion Berberine hydrochloride can inhibit the formation of the biofilm of Staphylococcus epidermidisthrough suppressing the relative genes,though not as good as the antibiotics,such as norvancomycin,ciprofloxacin and erythromycin.It should not be combined with these antibiotics because the effectiveness is antagonism.

Objective To evaluate the curative effect and optimal indications of reformed percutaneous lumbar diskectomy (RPLD) for the treatment of lumbar disc herniation.Methods One handred and thirty-three patients with lumbar disc herniation were treated by RPLD, of them, 20 cases were lumbar disc extrusion and 113 cases were lumbar disc protrusion. After the procedure, 85 patients underwent flush of intervertebral space with antibiotic saline and 48 patients underwent 10 ml(40?g/ml) medical ozone-injection inside the disc to prevent infection. All patients were followed up over the course of 3 months. The therapeutic effect was evaluated according to the MacNab criteria. Results All 133 cases underwent RPLD were successful. The total efficacy was 81.9%, There were no serious complications after operations. Conclusion RPLD is an effective method in the treatment of lumbar disc herniation. Both intradiscal ozone-injection or intradiscal antibiotic saline flush after RPLD can reduce the opportunity of infection.

Objective To investigate the treatment of urinary tract obstruction after kidney transplantation, and to introduce the novel ‘antegrade percutaneous urinary tract throughout guidance technique’ with guide wire in selected patients. Methods 43 cases of renal transplantation patients due to urinary tract obstruction (ureteral stenosis and hydronephrosis in 24 cases, urinary calculi with or not ureteral stenosis in 19 cases) received endourological treatment. Retrograde pathway was tried firstly, if failed, antegrade pathway was adopted with‘antegrade percutaneous urinary tract throughout guidance technique’, 18 Fr percutaneous tract was established if necessary, endoscopy was needed in antegrade or combine with retrograde pathway. Results Of the 43 patients, 9 (20.9 %) patients were managed directly through the retrograde ureteroscopy, 28 (65.1 %) patients were managed with anterograde percutaneous technique in 18 Fr tract, 6 (14.0 %) patients were treated with ‘antegrade percutaneous urinary tract throughout guidance technique’. Operation time was (72.0 ± 16.0) (45 ~ 95) minutes. Postoperative stone clearance rate of 89.5 % (17/19). Of 32 cases with ureteral stricture, 6 (6/32, 18.8 %) cases were cured after one time of dilation and JJ stent indwelling for 2 months, 18 (56.3%) cases with stable hydronephrosis after 2-3 times of dilation and JJ stent indwelling, 5 cases (15.6 %) needed long-term repeated stent indwelling for drainage, 3 (9.4%) cases required nephrostomy tube drainage. Conclusion Minimally invasive treatment of urinary tract obstruction after renal transplantation is effective. Antegrade percutaneous urinary tract throughout guidance technique provided a powerful guarantee for retrograde operation and avoided the bleeding risk following percutaneous renal surgery, when combined with flexible ureteroscopy, urinary calculi in patients with kidney transplantation can be effectively managed with little trauma.

Objective To investigate the preventive effect of somatostatin and nitroglycerin on post-ERCP pancreatitis (PEP) and hyperamylasemia.Methods A total of 184 patients who underwent endoscopic retrograde cholangiopancreatograph (ERCP) were enrolled,and randomly divided into three groups to receive somatostatin or nitroglycerin or normal saline according to random number table.Incidence of PEP and hyperamylasemia were observed and compared among the three groups.Results Nine patients stopped the medication and dropped out of the study after occurence of adverse reactions from receiving nitroglycerin injections.The incidence rates of hyperamylasemia were 38.7％ (24/62),51.8％ (28/54) and 37.3％ (22/59) in somatostatin,nitroglycerin and control group respectively,with no significant differences among the three groups (P ＞ 0.05).The incidence rates of PEP were 6.4％ (4/62),9.3 ％ (5/54) and 23.7％ (14/59) in somatostatin,nitroglycerin and control group,respectively.The incidence rates of PEP in somatostatin and nitroglycerin group were both significantly lower than that in control group (somatostatin group vs control group:x2 =7.13,P =0.01 ; nitroglycerin group vs control group:x2 =4.22,P =0.03).There was no significant difference between somatostatin group and nitroglycerin group (x2 =0.32,P =0.41).Conclusion Somatostatin and nitroglycerin injections after ERCP show similar efficacy on preventing PEP,but the former is safer.Both have little effects on the prophylaxis of hyperamylaemia.

Objective To verify the reliability of TLD-based quality audit for radiotherapy dosimetry of medical electron accelerator in non-reference condition by monitoring the dose variations from electron beams with different field sizes and 45° wedge and the dose variations from photon beams with different field sizes and source-skin distance.Methods Both TLDs and finger ionization chambers were placed at a depth of 10 cm in water to measure the absorbed dose from photon beams,and also placed at the depth of maximum dose from electron beams under non-reference condition.TLDs were then mailed to National Institute for Radiological Protection,China CDC for further measurement.Results Among the 70 measuring points for photon beams,58 points showed the results with a relative error less than ± 7.0％ (IAEA's acceptable deviation:± 7.0％) between TLDs and finger ionization chambers measurements,and the percentage of qualified point numbers was 82.8％.After corrected by P,value,62 points were qualified and the percentage was up to 88.6％.All of the measuring points for electron beams,with the total number of 24,presented a relative error within ± 5.0％ (IAEA's acceptable deviation:± 5.0％) between TLDs and finger ioization cylindrical chambers measurements.Conclusions TLD-based quality audit is convenient for determining radiotherapy dosimetric parameters of electron beams in non-reference condition and can improve the accuracy of the measuring parameters in connection with finger chambers.For electron beams of 5 MeV ＜ E0 ＜ 10 MeV,the absorbed dose parameters measured by finger ionization chambers,combined with TLD audit,can help obtain the precise and reliable results.

Objective To develop a methodology for auditing dosimetric parameters using TLD for photon and electron beams in non-reference conditions.Methods The correction experiments have been developed for non-linear dose response,PAAM holder,energy,fading and dispersion using TLD for 60Co γ-ray,high energy X-ray and electron beams.The measuring method was set up for absorbed dose estimation by TLDs in water.3 photon beams and 2 electron beams were selected for research purposes,and 5 photon beams and 4 electron beams for reliability research.Results The research results were evaluated for60Co source,6,10,15 and 18 MV photon beams in non-reference conditions at off-axis,with the relative deviation within-0.1％-7.2％ at-off axis (IAEA's acceptable deviation:± 7.0％).The verification results were evaluated for 5 photon beams in non-reference conditions at on-axis,with the relative deviation are within 0.1％-7.0％.The verification results were evaluated for 4 electron beams in non-reference conditions,with the relative deviation within 0-4.7％ (IAEA's acceptable deviation:±5.0％).Conclusions It is convenient and accurate to use TLD method for quality audits for clinic dosimetry parameters in radiotherapy.Two kinds of IAEA TLD holders are feasible for use in TLD audits.Absorbed doses for high energy electron beam were corrected using plane parallel chambers and verified using TLD,with good results obtained.

Objective To develop the methods for using 0.015 cc pinpoint chambers, 0.007 cc miniature chambers and diode detector to measure Multi-leaf collimator (MLC) small field in IMRT.Methods MAX4000 and Unidos electrometers were connected with different types of small chambers and diode detectors.MLC shaped fields of10 cm×10 cm, 6 cm×6 cm, 4 cm×4 cm, 3 cm×3 cm, 2 cm× 2 cm were defined at 100 cm SSD.The field sizes for the Varian accelerator were defined by the tertiary MLC, while the secondary jaws were kept at 10 cm × 10 cm field, with the monitor units of 250 MU.Each field was measured three times to obtain the average value.The readings of all small fields were normalized to 10 cm × 10 cm field values for comparison of measured and published output factors.Results The relative deviations of the MLC small field output factors from the published outputs are 1.0％ , 1.7％ , 1.5％ and 2.4％, respectively, for Unidos electrometer connected with 0.015 cc pinpoint chamber;0.2％, 0.8％, 0.8％ and 1.4％, respectively, for Unidos electrometer connected with 0.007 cc miniature chamber;and 0.1％, 0.5％, 0.5％ and 0.9％, respectively, for MAX4000 electrometer connected with 0.007 cc miniature chamber.Conclusions The 0.015 cc chamber-measured MLC output factors for 3 cm × 3 cm and 2 cm × 2 cm fields are excellent.As required by IAEA, the relative deviations of the measured output factor from the published output factor are within ± 2％ for 2 cm × 2 cm fields and ± 3％ for larger fields.The results measured using 0.007 cc chamber are better than those measured using 0.015 cc chamber.The measured results using the diode detector, normalized to the 10 cm × 10 cm field, are consistent with the minimum requirements and excellent when being normalized to the 4 cm × 4 cm field.For dosimetric consideration, MLC small field output factor should be measured using small chamber and diode detector.The method is accurate and reliable, therefore, all measured output factors for MLC small fields should be input into radiation treatment plan system.