Objective:To analyze and compare the dose monitoring and control systems of two types of medical linear accelerator systematically from the view of mechanical and electrical engineering, and establish the method of the quality assurance of the dosimetry system and the solution in the routine maintenance.Methods: To systematically compare and analyze the system of dose monitoring and control for two types of linear accelerators (Precise Elekta and C-series of Varian Medical Systems) from twofold aspects that included machine physics and electric engineering of medical linear accelerators.Results:The monitoring system that took ionization chamber as center was established between connotation of machine physics and concrete realization of electromechanical engineering, and explained the difference and similarity between open type and sealed type of ionization chamber, and the theory that Precise series needn't be serviced by PFN.Conclusion: Based on the analysis of ionization chambers structure of medical linear accelerators on the principle of quality assurance system, proposed dosimetric testing and adjustment method, and provide reference for the establishment of quality assurance system and technical procedures of the maintenance engineering.

Objective:To explore the process of maintenance management for large medical equipment, and the structure design and core connotation of the maintenance management software of them.Methods: Medical linear accelerator of Precise series of Elekta company was combined to achieve the objective. From the aim of designing normal operation rate to start, the failure mode and effects analysis (FMEA) was operated to analyze the maintenance strategies and maintenance manners which were established on the basis of PDCA(Plan, Do, Check, Action) cycle and the analysis mode of SWOT (Strength, Weakness, Opportunity, Threat), and it could achieve the aim of normal operation rate.Results: Through explored the connotation of maintenance management and the preliminary framework of the software of maintenance management, the detail and process of maintenance management that based on personalized accelerator of process control were established, and the element factors of software of maintenance management of accelerator also was established at the same time.Conclusion: The effective maintenance management of large medical equipment is based on informatization process management of process control, and the element factor of management software need personalized customization. On the other hand, failure mode and degradation mechanism of equipment were the basis for personalized customization, and the creation has practical value.

Objective Toexploreinfluencingfactorsoftheulinastatin(UTI)onmyocardialprotection.Methods 120casesofa-cute myocardial infarction(AMI) patients were given UTI at the base of conventional treatment for heart failure like thrombolysis , resistance to shock .The patients were divided into group A (within 12 hours) and group B (after 12 hours) ,and than each group was divided into subdivision small dose (250 kU) ,medium dose (500 kU) ,large dose (1 000 kU) groups .The patients were re-ceived echocardiogram examination ,determination of left ventricular contraction end-diastolic diameter(LVESD ,LVEDD) testing , left ventricular ejection fraction(LVEF) testing ,each stroke output(SV) ,peak concentration of creatine kinase isoenzyme(CK-MB) after treated for one week .Results Compared with the small dose and after 12 hours groups ,large dose and within 12 hours group caused an increase of cardiac function and density loss of CK-MB peak concentration (P<0 .05) .Conclusion The same cause of myocardial injury ,dose and administration timing will affect the clinical efficacy of UTI .

Objective To evaluate the clinical application value of MR/DSA- 3D fusion software. Method Fusion imaging was made with fusion software after performing MR and DSA examinations on nine cerebrovascular diseases sufferers. Results The fusion image of six sufferers could display the exact part having pathological changes to cerebral vessel and specify the relationship between the tissue of pathological changes and cerebral vessel, offering a scientific basis for clinics and the fusion images of three sufferers were not ideal. Conclusion MRDSA-3D fusion software can provide image with high diagnostic accuracy and treatment precision.

Objective To study the clinical application of Multi-slice spiral CT angiography (MSCTA) in renal arterial stenosis. Methods 36 patients clinically suspected of renovascular hypertension were examined by 16 slice or 64 slice spiral CT angiography. After scanning , three dimensional reconstruction of the blood vessels were operated. 28 cases were detected diseases of renal vessels and perivascular, and then compared with DSA. Results In the 36 cases, MSCTA showed 19 renal areterial stenosis, 3 adrenal gland neoplasms, 2 adrenal hyperplasia, 1 polycystic kidney disease. In 19 cases with MSCTA , there were 2 double renal areterial stenosis and 2 renal areterial anatomical variants. DSA showed 21 renal areterial stenosis with various degree, the accordant rate of MSCTA and DSA exceeded 90%. Conclusion MSCTA play an important role in clinical application in diagnosis of renal arterial stenosis.

Objective To evaluate the value of Bolus chase technology for angiography of lower extremity. Methods 12 cases with diabetes foot or leg pain were examined with Bolus chase technology. Results Low extremity artery thrombosis was found in 12 cases. Conclusion Bolus chase technology is better than standard DSA in the display of lower extremity vessel.

Objective To summarize the clinical experienee in surgical treatment for hepatocellular carcinoma (HCC). Methods The clinical data of 7566 HCC patients who had been admitted to Research Institute of Liver Cancer of Fudan University from January 1988 to Deeember 2007 were retrospectively analyzed. The overall survival and recurrence free survival (RFS) rates were eaeulated with Kaplan-Meier survival curve. All the data were analyzed using Log-rank test and Cox regression model. Results The 3-, 5-, 10-year overall survival and RFS rates of 7164 patients with HCC resection were 56.29%, 41.76%, 26.70%, and 63.92%, 56.12%, 42.97%, respectively, and the perioperative mortality was 1.54%. The 5- and 10-year overall survival rates of patients with small HCC (diameter<5 era) were 58.20% and 38.47%, which were significantly higher than 31.42% and 20.43% of patients with large HCC (diameter >5 cm) (X2 =535. 568, P <0.01). The 5-year overall survival rotes of HCC patients with resection after down-staging (n = 110), re-resection after recurrence (n = 515), and tumor thrombus in portal vein (n = 168) were 51.26%, 67.28% and 26.81%, respectively; nd the 5-year DFS rotes were 77.44%, 13.01% (calculated from the first operation) and 34.90%, respectively. The 3- and 5-year overall survival and DFS rates of 402 patients who had undergone liver transplantation were 60.81%, 55.63% and 64.47%, 58.52%. The independent prognostic factors influencing the overall survival and DFS rates were the size, number and differentiation of HCC and intrahepatic vessel invasion (X2 = 200.539, 27. 536, 96.964,216. 156, P <0.01). Conclusions Early screening, improved safety of surgery, combined therapy and breakthrough in the reseaeh of preventing HCC metastasis and reeurrenee will significantly improve the treatment outcome of HCC.

Objective: To elucidate the role of A39S mutation of DJ-1 in the onset of Parkinson’s disease (PD) and identify genes for which expressions are abnormally regulated by A39S DJ-1 mutation. Methods: We established HEK293 cell lines which stably expressed empty vector, wild-type DJ-1 and A39S mutated DJ-1 respectively. DNA microarrays were used to identify genes for which expressions change in wild-type DJ-1 cells and A39S DJ-1 mutant cells. Results: Compared with the cell line expression empty vector, we identified 42 differentially regulated genes (including 14 up-regulated genes and 28 down-regulated genes) in the wild-type DJ-1 cells and 8 differentially regulated genes (including 6 up-regulated genes and 2 down-regulated genes) in the A39S DJ-1 mutant cells. Compared with the wild-type DJ-1 cells, only the expression of UGT2B7 gene was down-regulated in A39S DJ-1 mutant cells. hTese differentially regulated genes were mainly related to signal transduction, regulation of transcription, apoptosis and metabolism. Conclusion: A39S mutated DJ-1 may disturb the transcriptional activities of DJ-l and involve in the pathogenesis of PD.

Objective To research the validity of PET/CT in clinic for detecting lung cancer. Method There were 20 subjects who may have lung cancer according to the result form other detecting way, including 15 males and 5 females with an average age from 54 to 86. Results Malignant lesions were found in 15 cases and benign lesions in 5 cases. Discussion The examination of chest with PET/CT is suit for early diagnosis of lung cancer. The number of patient of false postive and false negative is decreased by controlling some factor.

Objective To investigate clinical and genetic characteristics of Chinese patients with hereditary spastic paraplegia (HSP).Methods To perform retrospective analyses of clinical data from 179 HSP Han Chinese patients from Xiangya Hospital and National Laboratory of Medical Genetics of China.Results The 179 patients comprised of 114 familial cases (from 41 families with AD inheritance and 37 families with AR inheritance ) and 65 sporadic cases.Genetic anticipation was not found, and nonpenetrance was observed in some HSP families.Male to female ratio was 1.84 to 1.The mean age of onset was ( 18.1 ± 14.0) years, and the mcan duration of disease was ( 12.3 ± 11.5) years.AD-HSP patients had an older age of onset ( ( 19.7 ± 14.0) years) and a longer duration ( ( 17.9 ± 14.4) years) than ARHSP patients (t =2.196 and 4.404, P value were less than 0.05 and 0.01 respectively).Most AD patients manifested as "pure" form, while "complicated" form occurred more frequently in AR patients (F =19.322, P ＜ 0.01 ).Leg stiffness and clumsiness were often the early symptoms at the beginning of the disease, and the most common leg signs were hypertonia, hyperreflexia and pathological reflexes.Other signs included ankle clonus (46.9% ), weakness (42.5% ) and deformities (30.7% ).Ataxia, dysarthria,mental retardation, and foot deformity were more frequently seen in AR-HSP patients than AD-HSP patients,but the frequency of urinary symptoms was higher in AD-HSP patients.Among 65 patients with MRI examination of the head, 13 cases and 9 cases showed corpus callosal dysplasia and cerebellar atrophy,respectively.In addition, spinal cord atrophy was found in 7 of 45 patients undergone MRI examination of the spine.Conclusions Adolescent onset of HSP is common, and more males than females are affected.When compared with AR-HSP, AD-HSP patients have an older age of onset, a longer duration, and more marked urinary symptoms.Most AD-HSP cases are of "pure" form, while most AR-HSP cases manifest as "complicated" form with ataxia, dysarthria, and mental retardation.Dysplasia of corpus callosum is commonly seen in AR-HSP individuals than AD-HSP.HSP manifest gender-related clinical heterogeneity,illustrating the phenomenon of "female protection".