Objective To compare the dosimetric differences between helical tomotherapy (HT) and volume-modulated arc therapy (VMAT) in the treatment of upper thoracic esophageal carcinoma (UTEC).Methods A total of 10 patients with UTEC were randomly selected.HT plan and double-arc VMAT plan were designed and optimized for each patient.The prescription dose was 50 Gy/30 fractions for gross target volume (GTV), 66 Gy/30 fractions for planned target volume (PTV).The dose distribution and conformal index (CI), homogeneity index (HI) of target volume, the D1％, D5％, Dg5％, D99％, and dose of organ at risk (OAR) were analyzed by using the dose volume histogram (DVH).The monitor units and delivery time were also evaluated.Results For GTV and PTV, the D99％ of HT plans were slightly higher than those of VMAT plans (t =4.476, 3.756, P ＜ 0.05) , but no significant differences in D1％ , D5％ , D95％ , HI and CI (P ＞ 0.05) were found.The V10, V15, V20 and mean lung dose (MLD) to the total-lung of HT plans were all significantly lower than those of VMAT plans (t =-3.369,-4.824, -4.869,-3.657, P ＜ 0.05).There were no significant differences for V5, V30 and Dmax of cord (P ＞ 0.05).The monitor units and delivery time of VMAT plans were significantly lower than those of HT plans (t =13.970, 7.982, P ＜ 0.05).Conclusions Both HT and VMAT are appropriate for esophageal cancer radiotherapy.HT significantly reduces the radiation dose of the total-lung, while VMAT has obvious advantages in efficiency.

Objective To investigate clinical significance and function of microRNA-106b (miR-106b) in retinoblastoma tissues and cells.Methods We detected miR-106b expression in 51 samples of thyroid cancer and the adjacent non-tumor tissues using qRT-PCR.The expression of miR-106b was altered by corresponding vectors in thyroid cancer cells,and then BrdU cell proliferation and flow cytometry assay were performed to examine the proliferation and apoptosis of thyroid cancer cells.Results The expression of miR-106b in thyroid cancer tissues was significantly lower than that in normal tumor-adjacent tissues (0.36±0.029 vs 0.98±0.034,P＝ 0.004).MiR-106b expression in tumor tissues was significantly associated with tumor size and tumor number.MiR-106b was obviously inhibited by miR-106b inhibitor in PTC-I cells (0.96±0.025 vs 0.29±0.032,P＝0.001),and inhibition of miR-106b resulted in significantly increased proliferation (89.33±5.67 vs 136.67±10.33,P＝0.03) and decreased apoptosis (16.33±3.20 vs 7.67±2.45,P＝0.04).On the contrast,over-expression of miR-106b using miR-106b mimics led to significantly decreased proliferation (98.00±4.65 vs 76.33±2.87,P＝0.03) and increased apoptosis (22.54±2.13 vs 32.45±4.34,P＝0.04).Conclusions Decreased expression of miR-106b is correlated with the adverse clinicopathological features of thyroid cancer.MiR-106b can inhibit cell proliferation and apoptosis of thyroid cancer cells,suggesting miR-106b plays a suppressive role in development and progression of thyroid cancer.

Objective To evaluate the dosimetric characteristics of helical tomotherapy (HT),intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) for postoperative radiotherapy of rectal cancer.Methods Ten male patients with stage Ⅱ or Ⅲ middle or low position rectal cancer were selected retrospectively.All of the 10 patients underwent Dixon surgery and CT simulation orientation.The target volumes and normal organs were drawn in the CT images and the plans for HT,IMRT and 3D-CRT were designed.The prescribed dose was given 50 Gy in 25 fractions,covering at least 95％ of the planning target volume.Results All plans met the needs of the prescribed doses.The HT and IMRT plans met the needs of dose limit to organs at risk,however,the 3D-CRT plans failed to do that.The conformity indexes of HT,IMRT and 3D-CRT plans were 0.86,0.82 and 0.62,respectively (F =206.81,P ＜ 0.001),and the homogeneity indexes were 0.001,0.157,and 0.205,respectively (x2 =15.8,P ＜ 0.001).The 3D-CRT plans had larger volumes than the HT plans and IMRT plans in the high-dose regions such as pelvic V50,bladder V40,bowel V50 and femoral head D5 (P ＜ 0.05),but the differences between the HT plans and IMRT plans were not statistically significant (P ＞0.05).The V15 value of bowel of HT plans were higher than those of the IMRT and 3D-CRT plans (71.1％ vs.63.3％ and 67.7％,respectively).However,there was no significantly difference.Conclusions All of the HT,IMRT and 3D-CRT plans are able to meet the prescription dose requirement of the target regions of rectal cancer.The HT plans show the best dose homogeneity and target conformity,followed by the IMRT plans,and then the 3D-CRT plans.The HT plans meet the needs of all OARs slightly better than the IMRT plans.3D-CRT plans are simple and practical with poor protective ability toward the OARs.

We summarize our clinical experience with the use of wind herbs for membranous nephropathy treatment.The pathology of membranous nephropathy is mainly based on the spleen and kidney,with wind pathogen,dampness-heat,and blood stasis as the main pathological factors.The imbalance of the spleen ascending clear and kidney-transforming qi is the fundamental pathogenesis of membranous nephropathy.Wind herbs are light and gentle in nature,and they can dispel wind,assist in raising the spleen yang,aid in kidney qi transformation,and promote the unblocking of qi and blood stasis.This corresponds to the pathogenesis of membranous nephropathy,which involves wind invasion,deficiency of the spleen and kidney,failure to ascend clear yang,and stagnation of qi and blood.In the clinical treatment of membranous nephropathy,the use of wind herbs such as ephedra,cassia twig,mulberry leaf,chrysanthemum flower,and other herbs,along with blood-activating and collateral-opening herbs such as incised notopterygium rhizome and root,rhizome ligustici,zedoray rhizome,and pangolin scales,is proposed.Chinese thorowax root,largetrifoliolious bugbane rhizome,divaricate saposhnikovia,incised notopterygium rhizome and root,and other pungent herbs combined with ginseng,membranous milkvetch root,and other sweet-tonifying herbs can tonify yang and benefit the spleen,enhancing the tonifying effect.Ephedra,cassia twig,fresh ginger,prepared common monkshood branched root,manchurian wildginger,and other pungent-warm herbs can warm the kidney,support yang,and promote qi transformation and water metabolism.In clinical treatment of membranous nephropathy,satisfactory result have been achieved by making use of the characteristics of wind herbs.

The core pathogenesis of membranous nephropathy is spleen-kidney depletion and dampness-stasis blocking collaterals， in which spleen-kidney depletion runs through the whole process of membranous nephropathy. Spleen and kidney depletion often occurs in the early stage of membranous nephropathy， accompanied by the progression of the disease and the stagnation of deficiency and qi， which leads to the obstruction of kidney collaterals by patho-logical products such as phlegm， blood stasis and water-dampness， and then the formation of stasis obstruction in kidney collaterals over time. Huangqi （Radix Astragali） as an important herb for supplementing spleen and boosting kidney can be used to fortify spleen， consolidate kidney and generate essence， and to boost qi， expel blood and unblock collaterals when treating membranous nephropathy. With combined medicinals， it can dispel and remove wind， astringe， store and consolidate essence， unblock stagnation and remove excess， strengthen efficiency and supplement deficiency， raise yang and lift the sunken. Besides， it is emphasized that caution should be taken against the drawbacks that excessive sweet may constrain the stomach， and the sweet and the warm may assist heat in the treatment of membranous nephropathy. The degree at which the spleen is supplemented and the kidney boosted should be chosen properly， and the medication contraindications should be cautioned.

Lumbar spinal stenosis is a common clinical syndrome in orthopedics,frequently oc-curring in the elderly,and can affect the physical and mental health as well as daily life of patients.Surgery is the primary treatment measure for lumbar spinal stenosis,among which laminoplasty has re-ceived widespread attention in recent years.This article reviewed the current application status and research progress of laminoplasty for lumbar spinal stenosis in the elderly,aiming to provide reference for technical research and clinical practice in this field.

Lumbar spinal stenosis is a common clinical syndrome in orthopedics,frequently oc-curring in the elderly,and can affect the physical and mental health as well as daily life of patients.Surgery is the primary treatment measure for lumbar spinal stenosis,among which laminoplasty has re-ceived widespread attention in recent years.This article reviewed the current application status and research progress of laminoplasty for lumbar spinal stenosis in the elderly,aiming to provide reference for technical research and clinical practice in this field.

Objective:To develope and analyze and optimize the performance of some kinds of environmentally friendly flexible X-ray protective materials in attempt to tackle the various environmental and high energy consumption problems in the development of traditional medical X-ray protective clothing.Methods:The Monte Carlo program was used to establish a simplified model of medical X-ray tube. The aim was to carry out numerical simulation and prediction of the shielding materials′ performance against X-ray, prepare the flexible X-ray shielding materials through experiments and test and verify the their shielding performances The development and optimization path was also obtained by comparing the result between simulation and experiment.Results:Bi was the preferred alternative to toxic Pb elements, while W was able to compensate for weak X-ray absorption zone of Bi. The shielding efficiency of the composite material doped with 25% Bi+ 25% W was able to reach 77.8% and 66.3% at 80 and 120 kV p tube voltages, respectively. Conclusions:With both the selection of elements and the optimization of functional particles, the combination of W and Bi is an economical, environmentally friendly, and efficient shielding way within the energy range of medical diagnostic X-rays. The numerical simulation helps reduce experimental costs, shorten the research period, and improve the design efficiency of X-ray shielding materials.

Chiral drugs are closely related to the safety and effectiveness of drug use.Most dihydropyridine drugs have chiral carbon atoms,which are used as racemes and produce stereoselective disposal characteristics after entering the body,and may affect the safety and effectiveness of drugs.Therefore,based on the chiral resolution and pharmacokinetic characteristics of this class of drugs,the selection rules of chiral HPLC and CE methods and in vivo analysis applications of this class of drugs in recent years were reviewed.The stereoselective pharmacokinetics of this class of drugs were listed and compared.It was found that some of these drugs had obvious differences in stereoselective pharmacokinetics,and the pharmacokinetics and toxicity in vivo were also different.

Objective?To analyze the literature about the research situation and developmental trend of swallowing dysfunction nursing in China and to provide reference for further swallowing dysfunction nursing practice. Methods?Using blibiometric method and NoteExpress 2.0 soft-ware, we searched China National Knowledge Infrastructure (CNKI) database and Wan Fang database for swallowing dysfunction nursing related publications in China (from January 2000 to December 2016). Results?A total of 1 330 publications published have been searched out. The number of articles increased every year, and 814 (61.20%) articles were published in recent 5 years. The articles were mainly clinical trial research literature, accounting for 50.83%, followed by experience introduction and case report literature, accounting for 44.28%. These articles mainly focused on rehabilitation nursing and rehabilitation training. 96 articles were cited over 10 times, accounting for 7.22%, and the highest was cited for 135 times. 35 articles (2.63%) were funded by grants. Conclusions?Swallowing dysfunction nursing related articles have been increasing yearly, however, the contents and the objects needs to be expended. There is great space for the improvement in research depth, breadth and quality.