Objective To facilitate activity measurement by using the thimble ionization chamber in hospitals,to obtain air kerma scatter correction factor of medical afterloading of 192Ir source by developing an available and convenient calculation method.Methods According to International Atomic Energy Agency (IAEA) 1079 Report to calculate the scatter correction factor of 192 Ir source,to measure air kenna of 192Ir source with and without lead shield using thimble ionization chamber.Simulation measurement conditions were used to calculate scatter correction factor of 192Ir source and comparison was made between experimental results and literature records.At the same time,the different ionization chamber models were simulated at different room sizes to obtain scattering correction factor of 192 Ir source.ResultsComparison was made between the simulation scatter correction factors of 192Ir source and experiment by the shadow shield,and the relative deviation was 0.8%.The deviation of the 192 Ir activity calculated according to the simulated scatter correction factor and measured by well type ionization chamber was 2.4%.By comparison between the calculated results by using two kinds of spherical ionization chamber and those ones deduced by IAEA 1079 Report,the relative deviations ranged within 0.3%-0.4%.Five different types of thimble ionization chamber and different room sizes were simulated and calculated by MC simulation,with the relative deviation within 3%.Conclusions Monte Carlo simulation method for calculating afterloading 192 Ir source's scatter correction factor is feasible,and this method is convenient for use in the thimble chamber for brachytherapy QA work in the hospital.

Objective To explore the method for measuring and calculating both absorbed dose and effective dose received in organ and tissues of occupational workers by using TLDs for the implantation of 125Ⅰ seed sources.Methods The experiments with 60Co γ-rays were carried out for the stability.A group of TLD chips was exposed to 125Ⅰ seed sources to establish standard dose curve for air kerma.During the 125Ⅰ seed implantation, the TLD chips were pasted to 13 locations like thyroid inside and outside the lead aprons worn by occupational workers to measure average absorbed dose and calculate the absorbed doses and effectives to organs and tissues.Results For 3 cases of prostate cancers with implantation of 125Ⅰ seeds, the worker's organs and tissues received the absorbed dose 0.02 -3.80 μ Gy and effective dose 0.06- 1.81 μSv outside lead aprons and the highest absorbed dose 2.35 μ Gy and effective 0.02 μSv inside lead aprons, respectively, with more than 65.9% of rays shielded.For 3 cases of brain cancers with implantation of 125Ⅰ seeds, the workers received the absorbed dose 0.23 - 11.31 μGy and effective dose 0.88 - 4.07 μSv outside lead aprons and the highest absorbed dose 2.22 μ Gy and effective dose 0.09 μSv inside lead aprons, respectively, with more than 54.5% of rays shielded.For 3 cases of lung cancers with implantation of 125Ⅰ seeds, the workers received the absorbed dose 0.03 - 14.78 μGy and effective dose 0.35 -7.59 μSv outside lead aprons and the highest absorbed dose 4.09 μGy and effective 0.22 μSv inside lead aprons, respectively, with more than 58.4% of rays shielded.For 2 cases of mediastinum cancers with implantation of 125Ⅰseeds, the workers received the absorbed dose 0.06 - 74.91 μGy and effective dose 0.83 - 17.96 μSv outside lead aprons and the highest absorbed dose 10.29 μGy and effective 0.5 μSv inside lead aprons, respectively, with more than 85% of rays shielded.For one case of ovary cancer with implantation of 125Ⅰ seeds, the worker received the absorbed dose 0.09 - 14.29 μGy and effective dose 2.40 - 4.50 μSv outside lead aprons and the highest absorbed dose 7.77 μGy and effective 0.12 μSv inside lead aprons, respectively, with more than 34% of rays shielded.For one case of eye cancer with implantation of 125Ⅰ seeds, the workers received the absorbed dose 2.2 -39.84 μGy and effective dose 4.48 - 10.06 μSv outside aprons and the highest absorbed dose 5.19 μGy and effective 0.16 μSv inside aprons, respectively, with more than 54.6 % of rays shielded.Conclusions The method of using TLDs to measure the doses to the occupational workers in the course of the implantation of 125Ⅰ seed sources is simple and easy to operate.It would be an effective approach to protecting medical workers in the case of brachytherapy.

Objective: Breast augmentation by polyacrylamide hydrogel(PAHG) injection has resulted in a series of adverse events in many female patients.This article summarizes the authors' experience in the diagnosis and treatment of lactational infection after breast augmentation by PAHG injection and discusses related preventive measures.Methods: This study included 2 patients who had developed infection during lactation 5 years after breast augmentation with PAHG.We identified the exact position of the PAHG and vomica by color Doppler,computerized tomography and magnetic resonance.We made incisions in the submammary fold or mammary areola to take out the PAHG,drain the pus and place the vacuum pressure tube,followed by application of pressure bandages.Results: One of the patients healed without any complication,while the other developed latex leak in both breasts,but finally cured after milk regurgitation and repeated changing of dressings.Conclusion: Lactational infection after breast augmentation by PAHG injection is detrimental to female patients.Preventive measures should be taken as early as possible.For patients with this infection,operation should be performed to take out the PAHG and drain the pus.Sufficient draining and milk regurgitation are necessary to avoid latex leak.

Purpose To observe the effect of Rongban Tongmai Granules on thrombosis and blood viscosity of in vitro rat model of blood stasis, and to study the activating blood circulation effect of the drug.Methods To observe the effect of the Rongban Tongmai Granules on thrombosis and blood viscosity of in vitro rat model of stasis, subcutaneous inject rat with epinephrine hydrochloride, and then copy "blood stasis" model by ice water stimulation in rats.Results According to a continuous 7 days′intragastric administration of Rongban Tongmai Granules, thrombus length of blood stasis model rats in vitro reduced significantly (P<0.05-0.01),wet and dry weight of thrombus reduced significantly (P<0.05), the shear rate of the whole blood viscosity under 100 S~(-1), 30 S~(-1), 5 S~(-1) decreased significantly as well (P<0.05-0.01), and the shear rate of whole blood viscosity had decreasing tendency under 200 S~(-1).Conclusion Rongban Tongmai Granules can inhibit thrombosis and lower blood viscosity.

Objective To explore the clinical effect of the treatment for fresh achilles tendon rupture by modified double Kessler suture with S type incision .Methods Totally 21 cases of fresh achilles tendon rupture were admitted into our hospital from January 2012 to Decem-ber 2015, and they were treated by S type incision modified double Kessler suture within 7 days (averagely 4.1 days).Observed the postop-erative complications and evaluated the efficacy with Arner-Lindholm.Results All the 21 patients were followed for 6 to 24 months ( aver-agely 12 months).There was no incision infection ,necrosis, re-fracture of achilles tendon and other complications .There were 16 cases of excellent and 5 cases of good , with the excellent and good rate of 100% through the Arner-Lindholm evaluation criteria .Conclusion Modified double Kessler suture with S incision for the treatment of fresh achilles tendon rupture is conducive to early functional exercise ,and it can obtain satisfactory clinical efficacy .

Objective To investigate the changes of plasma thrombomodulin (TM),tissue factor (TF),tissue factor pathway inhibitor (TFPI),P-selectin (P sel),von Willebrand factor (vWF) and D-dimer (D-D) levels in patients with hemorrhagic fever with renal syndrome (HFRS) and its clinical significance.Methods Twenty-three cases of HFRS were divided into two groups according to the severity of disease (12 cases in mild group and 11 cases in severe group),and 20 healthy individuals served as control group.Blood samples were collected at every stage of the disease.Plasma TM,TF,TFPI,P-sel and vWF were measured by enzyme-linked immunosorbent assay (ELISA); plasma D-D was detected by nanoparticles enhanced turbidimetric immunoassay; creatine kinase MB isoenzyme (CKMB) was tested by immunosuppression assay; blood clotting time was recorded for blood coagulation functions; blood urea nitrogen (BUN),creatinine (Cr),alanine aminotransferase (ALT),aspartate aminotransferase (AST),and platelets (PLT) were also routinely tested.The comparison between groups was done by analysis of variance and two sided t test.Results During the acute phase of HFRS,the plasma levels of TM,TF,P-sel,vWF and D-D were significantly increased,activated partial thromboplastin time (APTT) was prolonged,international normalized ratio (INR) was elevated,while fibrinogen (Fn) and PLT were decreased markedly as compared to control group.In febrile phase,there were significant differences between severe group and mild group in plasma TM [(1.78±1.00) μmol/L vs (1.33±0.35) μmol/L,t=2.600,P＜0.01],TF [(36.63±8.48) ng/L vs (32.93±10.61) ng/L,t=3.423,P＜0.01],vWF [(327.1±57.2) μg/L vs (260.3±63.2) μg/L,t=2.257,P＜0.01],APTT [(63.9±20.5) s vs (48.7±18.6) s,t=4.920,P＜0.01],and INRlevels(1.8±0.6 vs 1.5±0.4,t=2.276 P＜0.05).The variation curves of TM,P sel,APTT,INR and D-D were similar to those of BUN and ALT,but contrary to PLT count.Conclusions There are significantly elevated plasma levels of TM,vWF,P sel and D-D,prolonged APTT,increased INR,and much decreased plasma Fn and PLT in the acute phase of HFRS,suggesting the presence of extensive capillary injuries and activation of platelet and coagulation system,which is closely associated with kidney,liver and cardiac muscle damage.Hence,it is essential to use antiviral agents,anticoagulants and fluid resuscitation in the early stage of the disease.

Objective To investigate the attentional network in patients with temporal lobe epilepsy(TLE) and the disease-related factors. Methods Fity-four patients with TLE and 40 controls were enrolled in our hospital from January 2007 to December 2008.The computerized ANT software was used for evaluating the attentional network efficiency and the clinical date of the patients with TLE were recorded. Logistic regression was used to identify the risk factors of attentional network efficiency. Results The mean reaction time(TLE:688.2±138.1 ms;Control:625.1±100.1 ms, t=2.06, P <0.05)and executive control network efficiency (TLE:155.7±57.0 ms;Control:108.0±33.8 ms, t=4.62, P <0.01) of the TLE group were lower than the healthy control group. The efficiency of alerting network and orienting network between the two groups were no significant difference. Logistic regression analysis showed that the positive epileptiform activity was an independent risk factor of the attentional impairment(95% CI : 1.03～42.33, OR =6.603, P =0.043). Conclusions The ANT demonstrate that patients with TLE may accompany with attentional executive control network efficiency impairment. Epileptiform discharge may cause attentional executive network efficiency impairment.

BACKGROUND: Some studies in vitro have reported that there are CD30 positive T cells in immunological response of allogenic transplantation.OBJECTIVE: To detect the relationship between the level of serum CD30 (sCD30) and clinical rejection in the patients with or without kidney transplantation, and analyze the importance of sCD30 in the estimation of immune state, monitor of acute rejection, and judgment of prognosis. DESIGN, TIME AND SETTING: Clinical case analysis study was performed at Jiangsu People's Hospital between April 2004 and March 2007. PARTICIPANTS: 153 kidney transplantation cases comprising 103 males and 50 females, averagely aged 37 years. METHODS: 3 mL peripheral blood was obtained from recipients before transplantation (without immunosuppressive agent) and at 0, 1, 3, 5, 7, 14, 21, and 28 days. Serum was isolated from obtained blood and placed at -20 ℃. Soluble CD30 levels were detected using CD30 cytokine ELISA kit supplied by BenderMedSystems. MAIN OUTCOME MEASURE: The relation between the soluble CD30 levels and rejection prior to and following transplantation.RESULTS: There was a significant relation in the sCD30 level between the patients with (n=17) and without acute rejection (n=136). The CD30 levels were 113.2 U/mL in the rejection group and 83.2 U/mL in the non-injection group (P < 0.01). No significant difference was determined between both groups in 5 days following surgery (P > 0.05). Significant difference were detected between both groups from 5 days following surgery (P < 0.01). There was no relation between the soluble CD30 level and the time of rejection and release after kidney transplantation (P > 0.05). Receiver operating characteristic (ROC) curve demonstrated that soluble CD30 levels on day 5 post-transplantation could predict acute rejection (area under ROC curve: 0.850). Meanwhile, 100 U/mL was the optimal operational cut-off level to predict rejection (specificity: 85.0%; sensitivity: 83.6%). The patients with positive of soluble CD30 level showed a lower survival rate than those with negative CD30 level (P < 0.01). CONCLUSION: The soluble CD30 levels contributed to predictive the acute rejection and prognosis of kidney transplantation.

Objective To explore the measurement method of the treatment dose of the patient with Diode for photon beam in radiotherapy,and to validate the treatment dose by comparing with the treatment planning system (TPS).Methods Experiments of the reproducibility,dose rate dependence,non-linearity dose response,and calibration factor in 60Co γ and 6 MV X beams were carried out with Diode on the surface of solid phantom and in water phantom.According to the needs of clinic treatment,different conditions were chosen to observe the dose changes with the angle of incidence,energy response,distance of source to skin,field size,wedge angle,block and tray using ionization chamber and water phantom.The Diode was placed on the surface of the solid phantom to obtain the correction factors.The doses of the chest,abdomen,and head and neek were verified with the Alderson phantom and Diode.Diode doses of the pelvis,head and neck at 14 points on the patient were measured.Results The Diode was irradiated at the points of the Alderson phantom,such as AP,RL and LL of the pelvis,with and without wedges,RL and LL junction of the neck and chin,with and without mask,the maximum relative deviation of doses was within ± 3% between Diode and TPS.The Diode was placed in different locations on the patient,including chest,abdomen and head and neck.The relative maximum deviation of doses was within ±5% between Diode and TPS.Conclusions The Diode method is reliable for measuring the exposure doses of the patient in radiotherapy.

Objective:To compare the dosimetric difference between knowledge-based planning (KBP) volumetric modulated arc therapy (VMAT) and intensity-modulated radiotherapy (IMRT) models for predicting the dose distribution during IMRT, aiming to investigate the feasibility of VMAT model to predict the IMRT plans.Methods:Fifty prostate cancer patients who had completed radiotherapy were selected. Manual planning was performed on each selected patient to generate the corresponding IMRT and VMAT plans. The IMRT and VMAT manual plans of the 40 randomly-selected patients were adopted to generate the KBP VMAT and IMRT models. The remaining 10 patients were utilized to predict IMRT plans. VMAT library-derived IMRT model (V-IMRT) and IMRT library-derived IMRT model (I-IMRT) were generated. Dosimetric parameters related to organ-at-risks (OARs) and planning target volume (PTV) were statistically compared among the manual IMRT (mIMRT), V-IMRT and I-IMRT plans.Results:Compared with the mIMRT plan, I-IMRT could significantly better control D max of the PTV ( P=0.039), whereas V-IMRT and I-IMRT plans could better protect the bladder and bilateral femoral heads (both P<0.05). V-IMRT plan could better protect the D max of bilateral femoral heads and the D 15% of the right femoral head (both P<0.05), whereas no significant difference was observed in other OARs and PTV (all P>0.05). Conclusions:Compared with the manual plans, KBP IMRT plan has significant advantages in protecting the OARs. KBP VMAT and IMRT models are both feasible in clinical practice, which yield equivalent accuracy for predicting IMRT plan.