Animals ; Calpain ; metabolism ; Epithelial Cells ; metabolism ; Kidney ; cytology ; Kidney Tubules ; cytology ; metabolism ; Rats ; Reperfusion Injury ; metabolism

Objective To study the dosimetric peculiarity of 3D intracavitary brachytherapy in the application of endometrial carcinoma comparing with traditional 2D plans. Method 39 3D brachytherapy treatment plans of 11 patients with endometrial carcinoma were retrospectively analyzed with re?planning 2D treatment plan, the dose volume histogram ( DVH) parameters such as the target dose volume parameters V150 and D90 , the 2?cc doses to organs such as bladder, small intestine, rectum and sigmoid and the total reference air kerma TRAK were analyzed. The differences between the two groups are compared by paired samples T test. Results For target with V<60 cm3 ,there is no statistically significant difference between 2D and 3D plans,the D90 is (551?17±90?33) cGy and (574?15±117?18) cGy,respectively (P=0?390). As the increase of target volume,the D90 came to be significantly different ( P=0?001) , high dose region V150 for 3D and 2D plans is (51?05±21?61) cm3 and (53?41±11?71) cm3, respectively (P=0?482). With the target volume larger than 60 cm3 ,compare to 2D plans, the 3D plan can increase the target coverage as well as OAR dose except for small intestine ( P=0?128) . In addition, with different plan mode,the BMI did not affect the crisis organ dose such as rectum, small intestine, bladder and sigmoid, the P value is 0?239, 0?198,0?744 and 0?834,respectively. Conclusions For endometrial carcinoma,compared with traditional two?dimensional plans,the 3D brachytherapy treatment plans can significantly improve the target coverage and avoiding overdose of organs, clinical curative effect and side effect still needs further observation.

Objective To investigate the virtual wedge (VW) dosimetric parameters with the ionization chamber array Matrixxenvlution.Methods Using Matrixxenvlution and solid water to measure and calculate Siemens accelerator's VW angle and VW factors of different fields and compare the wedge field dose distribution to that of treatment planning system (TPS) by gamma analysis,summarized the measurement results of 50 times.Results The γ pass rate (3 mm/ 3％) of 15° and 30° VW in both direction were (91.47 ± 1.76)％,(92.99 ± 1.54)％ and (93.27 ± 1.24)％,(93.27 ± 1.68)％,respectively,with the increase of filed size and the VW angle,but for 20 cm ×20 cm field and VW 60°,the result was not very good.The largest angle deviation ＜ 2° except small field size and wedge angle,VW factors were approximately equal to 1,the maximum deviation was no more than 0.05,plan dose distribution and the measured dose distribution have good consistency except large field with large wedge angle.Conclusions Matrixxenvlution used in the measurement of VW dosimetric parameters which can obtain all parameters for angle calculation and dose plane analysis with only once positioning,and become more rapid,convenient,economical and practical one of quality assurance tools for VW dose verification.

Objective To study the curative effect of prostaglandin E1(PGE1)on maintaining Sa(O2) and life span in the neonates with complete transposition of the large arteries(TGA).Methods Eleven of 19 neonates complete TGA received continuous PGE1 with the dosage of 5-20 ng/(kg?min),while the other 8 cases were set as control.The body temperature,Sa(O2),heart rate and blood pressure of both groups were recorded during the trial.Results The average Sa(O2) in trial group was (82.3?3.56)%,which had significant difference compared with the control group(t=8.232 P=0.001).The life span in trial group was much longer than control group.The body temperature,heart rate and blood pressure of trial group had no significant fluctuations.Conclusion PGE1 has an compkete effect on maintaining the ope-ning of patent ductus arteriosus (PDA) in TGA patients,which can improve the Sa(O2) and prolong the life span.

OBJECTIVETo summarize the experience in performing reoperation of valve dysfunction after congenital heart disease procedure.

METHODSFrom 1994 to 2001 we reviewed the data of 13 patients with valve dysfunction after congenital heart disease operation, in which 8 patients after ventricular septal defect, 3 after atrioventricular canal and 2 after respectively tetralogy of Fallot and atrial septal defect were corrected. Before the first operation, 6 patients had presented the mild to moderate mitral regurgitation, 1 had aortic regurgitation. Other 6 patients had valves dysfunction occurring after the first operation, among them, 2 suffered from respectively residual shunt of the ventricular septal defect, 2 had anterior chordae rupture of tricuspid valve, one had an operative injured aortic valve and one had surviving of right ventricular outlet obstruction. Thirteen patients were reoperated, including mitral valve replacement in 6, tricuspid valve replacement in 2, aortic valve replacement in one, aortic valve replacement consists with mitral valve repair and tricuspid valve repair in one and tricuspid valve repair in 3. Concomitant procedures were performed.

RESULTSLow cardiac output occurred in 3 cases and there were 2 early deaths, due to cerebral air-embolism, respiratory and circulatory failure respectively. Other 11 cases discharged and were followed up well.

CONCLUSIONSIt is important to safeguard and repair the valvular construction and function during the operation in congenital heart disease. Reoperation should be performed timely for obtaining recurrent and a good results.

Adult ; Cardiac Surgical Procedures ; Female ; Heart Defects, Congenital ; surgery ; Heart Valve Prosthesis Implantation ; methods ; Humans ; Male ; Reoperation ; Retrospective Studies

BACKGROUND: Although traditional plain scan and enhanced magnetic resonance imaging has been used for skeletal muscle imaging for many years, it is not enough to evaluate the microscopic changes of diseased tissue or the activity of diseased tissue. Dynamic contrast-enhanced magnetic resonance imaging can capture this information and advantages are shown in orthopedic imaging examination. OBJECTIVE: To review the progress of dynamic contrast-enhanced magnetic resonance imaging in orthopedics clinics. METHODS: The relevant documents from January 1900 to February 2020 were retrieved in the CNKI database, PubMed database, Web of Science and Wanfang database by computer. The search terms were “dynamic contrast-enhanced magnetic resonance imaging; skeletal muscle tumor; arthritis; spine; fracture” in Chinese, and “dynamic contrast enhanced magnetic resonance imaging (DCE-MRI); osteomuscular tumor; arthritis; spinal surgery; fracture” in English. RESULTS AND CONCLUSION: (1) At present, there is a general lack of consensus on the best scanning method for acquiring dynamic contrast-enhanced magnetic resonance imaging images and the ideal method for analyzing such images in clinical applications. The parameter analysis methods are mainly qualitative, semi-quantitative and quantitative analysis. (2) Dynamic contrast-enhanced magnetic resonance imaging has been widely used in non-invasive detection, qualitative and therapeutic monitoring of different diseases such as heart failure, breast cancer, prostate cancer, renal rejection and liver tumors. The clinical application in orthopedics is not mature enough, but has unlimited potential: It can be used to assess the blood flow after femoral neck fracture and to predict the viability of the femoral head, the regional perfusion of nonunion after fracture, bone perfusion of arthritis and other entities, and detection of deformed blood vessels. Compared with conventional imaging, in contrast, dynamic contrast-enhanced magnetic resonance imaging can also better assess the relationship between changes in lumbar spine perfusion, disc degeneration, and endplate perfusion at different stages.

OBJECTIVE: To detect the activation pattern of the thalamus in human by the functional magnetic resonance imaging (fMRI) with the electrical stimulation of different intensities, and to explore the mechanism of this area in pain modulation. METHODS: Ten healthy right-handed volunteers were given different electrical stimulations of 1-, 2-, and 3- times pain threshold respectively. The whole-brain was scanned simultaneously by GE 1.5T magnetic resonance imaging system. The data were postprocessed by analysis of functional neuroimages (AFNI) to establish the regional activity maps of the thalamus. RESULTS: Patterns of functional activity showed a positive linear relationship between the activation signals and stimulation intensity in bilateral thalamus, whereas the BOLD signal of bilateral medial thalamus demonstrated that the curve was similar to the exponential function. Meanwhile, the activation in the contralateral lateral thalamus (cThl), but not the contralateral medial thalamus (cThm), was prominent compared with the corresponding ipsilateral subregions, and only the lateral thalamus displayed a contralateral biased representation while the medial thalamus lacked this property. CONCLUSION Thalamus is one of the vital components in the pain modulation network, which can present spatial segregation activations with unique characteristics of stimulation intensity-response in each subregion. All the results are helpful to understand the crucial role of thalamus in processing the pain information.
Adult ; Electric Stimulation ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Pain ; physiopathology ; Pain Threshold ; Thalamus ; physiology

Objective To compare the relative dose of small fields measured by clinically common detectors and those obtained from Monte Carlo simulation in order to obtain the accurate measurement method, and to modify the inappropriate detectors.Methods The percentage depth-dose distribution curve and profile (flatness and symmetry) curves were collected at 2 cm×2 cm, 3 cm×3 cm, and 4 cm×4 cm under 6-MV X-ray of Trilogy linear accelerator by CC13, PFD, SFD, and blue phantom.The results were compared with the stimulation results from Monte Carlo method (the current gold standard).The correction factors for the detectors with large error were calculated to provide reference data for clinical practice.Results The results measured by SFD detector were most close to the results from Monte Carlo simulation.The measurement errors of CC13 and PFD detectors were large.The correction factor in the penumbra for CC13 and PFD detector was 0.664-1.499.Conclusions SFD detector is better than CC13 and PFD detector in the measurement of small fields, but CC13 and PFD detector can provide reference data for clinical practice after the corresponding correction.

OBJECTIVETo investigate the therapeutic effects of Jiedu granules, a Chinese medicine (CM) compound, plus cinobufacini injection, which was extracted from skin of Bufo bufo gargarizans Cantor, to prevent the recurrence of hepatocellular carcinoma (HCC) after surgical resection.

METHODSIn this case-control trial, a total of 120 patients who stayed in Changhai Hospital were enrolled from December 2001 to December 2006. Sixty patients were treated with Jiedu granules plus cinobufacini injection to prevent tumor recurrence after operation (CM group) and 60 patients were treated with transcatheter arterial chemoembolization (TACE) after operation (TACE group). Progression-free survival (PFS) and overall survival (OS) rates were determined to evaluate the therapeutic effects of post-operative management of patients with HCC.

RESULTSPFS in the CM group was 18.07 months [95% confidence interval (CI): 12.49-23.65] and the 1-, 2-, 3-, 4- and 5-year PFS rates were 61%, 39%, 26%, 22% and 12%, respectively. PFS in the TACE group was 8.03 months (95% CI: 6.63-9.44) and the 1-, 2-, 3-, 4- and 5-year PFS rates were 34%, 11%, 7%, 2% and 0%, respectively. There was significant difference in survival rate between the two groups (P<0.01). The mean survival time (MST) of patients in the CM group was 49.53 months versus 39.90 months of the TACE group. The 1-, 2-, 3-, 4- and 5-year survival rates were 90%, 82%, 80%, 70% and 63%, respectively, in the CM group, and 79%, 70%, 60%, 60% and 36%, respectively, in the TACE group. There was significant difference in survival time between the two groups (P=0.045).

CONCLUSIONSJiedu granules plus cinobufacini injection, a combination that is commonly used for post-operation management of HCC, can postpone tumor recurrence and metastasis, prolong the survival time and increase the survival rate of post-surgical patients with HCC. However, these findings need to be confirmed in a prospective, randomized controlled trial.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Amphibian Venoms ; administration & dosage ; Carcinoma, Hepatocellular ; drug therapy ; mortality ; surgery ; Case-Control Studies ; Chemoembolization, Therapeutic ; methods ; Combined Modality Therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Injections, Intra-Arterial ; Liver Neoplasms ; drug therapy ; mortality ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Retrospective Studies ; Young Adult

BACKGROUNDMild hypoxic-ischemic encephalopathy (HIE) injury is becoming the major type in neonatal brain diseases. The aim of this study was to assess brain maturation in mild HIE neonatal brains using total maturation score (TMS) based on conventional magnetic resonance imaging (MRI).

METHODSTotally, 45 neonates with clinically mild HIE and 45 matched control neonates were enrolled. Gestated age, birth weight, age after birth and postmenstrual age at magnetic resonance (MR) scan were homogenous in the two groups. According to MR findings, mild HIE neonates were divided into three subgroups: Pattern I, neonates with normal MR appearance; Pattern II, preterm neonates with abnormal MR appearance; Pattern III, full-term neonates with abnormal MR appearance. TMS and its parameters, progressive myelination (M), cortical infolding (C), involution of germinal matrix tissue (G), and glial cell migration bands (B), were employed to assess brain maturation and compare difference between HIE and control groups.

RESULTSThe mean of TMS was significantly lower in mild HIE group than it in the control group (mean ± standard deviation [SD] 11.62 ± 1.53 vs. 12.36 ± 1.26, P < 0.001). In four parameters of TMS scores, the M and C scores were significantly lower in mild HIE group. Of the three patterns of mild HIE, Pattern I (10 cases) showed no significant difference of TMS compared with control neonates, while Pattern II (22 cases), III (13 cases) all had significantly decreased TMS than control neonates (mean ± SD 10.56 ± 0.93 vs. 11.48 ± 0.55, P < 0.05; 12.59 ± 1.28 vs. 13.25 ± 1.29, P < 0.05). It was M, C, and GM scores that significantly decreased in Pattern II, while for Pattern III, only C score significantly decreased.

CONCLUSIONSThe TMS system, based on conventional MRI, is an effective method to detect delayed brain maturation in clinically mild HIE. The conventional MRI can reveal the different retardations in subtle structures and development processes among the different patterns of mild HIE.

Brain ; pathology ; Female ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant, Newborn ; Magnetic Resonance Imaging ; methods ; Male