Objective To study the effects of using jaw tracking technique with Smart LMC algorithm on the absorbing dose of planning target volume (PTV) and organs at risk (OARs) in dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods Field fluencies of 10 cases of NPC patients were optimized using DVO algorithm on Eclipse TPS (11.0),and according to the same optimal fluence,MLC operation files were calculated using jaw tracking technique and jaw fixing technique respectively,dose distribution was calculated with AAA algorithm and jaw tracking IMRT plan (JT-IMRT) and jaw fixing IMRT plan (JF-IMRT) were generated respectively.Collimators' position at the plan implementation was observed,and the total number of plans' monitor units (MU),the dose of PTV,the absorb dose of OARs,and the actual fluence verification pass rate were compared.Results The collimators' opening gap distances in 166 control points of the JT-IMRT reduced in both X and Y directions in the field,compared to that of the JF-IMRT.Total number of the JT-IMRT's MU increased by 3.59％-11.63％.There was no statistical significant difference between the doses of the PTV.Statistical significance was found in the differences between maximum dose (Dmax) of brainstem,spinal cord,crystal,optic nerve,the mean dose (Dmean) and D50％ of parotid and their decreased values after therapy (t=5.70-8.66,P＜0.05).The actual fluence verification pass rate of the JT-IMRT was higher than that of the JF-IMRT.There was a significant difference between the results (t=5.18,P＜0.05).Conclusions The JT-IMRT plan of the smart LMC algorithm is more tolerant to the radiation leakage between inter-and intra-leaf.The dose of OARs is lower,while the dose calculation precision and the verification pass rate are higher,the actual radiation dose is more accurate and reliable.Therefore it is more suitable for clinical applications.

OBJECTIVE: To observe the changes of endothelium-dependent dilation (EDD) of patients with congestive heart failure (CHF) before and after Kanli Decoction treatment. METHODS: Thirty-five CHF patients were treated with Kanli Decoction. We used color Doppler ultrasound to monitor the flow-mediated dilation (FMD), pulsatile index (PI), resistance index (RI), baseline blood flow (BF), ejection fraction (EF) before and after the treatment. RESULTS: FMD after treatment (9.26+/-3.19) were obviously higher than that before the treatment (7.06+/-2.58) (P<0.05), but BF, PI and RI were not improved. CONCLUSION: Applying color Doppler ultrasound into observation on EDD of patients suffering from CHF and treated by the Kanli Decoction shows that the CHF could be treated by traditional Chinese medicine.

OBJECTIVEThis study measures the glutaredoxin (Grx) gene and protein expression in umbilical vein endothelial cells upon exposure to Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide (LPS). The involvement of the Akt-signaling pathway is also determined.

METHODSEA-hy926 cells were pretreated with 1,000 ng · mL⁻¹ P. gingivalis LPS for 4, 12, 18, and 24 h, and then real-time reverse transcription polymerase chain reaction was employed to detect Grx1 expression. The effect of Grx on Akt activity was investigated using Western blot for the control, LPS (1,000 ng · mL⁻¹ LPS), and carmus- tine (BCNU) groups (1,000 ng · mL⁻¹ LPS, and the EA-hy926 cells were pretreated with 25 μmol · ml⁻¹ BCNU for 30 min).

RESULTSGene expression of Grx1 significantly increased in LPS group compared with that in the control group. The Grx1 expression reached the peak level in 12 h, and the variation between the expression in 4 and 12 h was significant (P < 0.05). After 12 h, the protein levels of Grx and phosphorylated-Akt (p-Akt) significantly increased in the LPS group (P < 0.05), whereas the BCNU group showed a considerable decrease in both Grx and p-Akt expression levels (P < 0.05). Moreover, a slight difference was observed in the total Akt protein levels in the three groups (P > 0.05).

CONCLUSIONGrx expression increased upon exposure of EA-hy926 cells to the LPS. Akt activity could be inhibited by BCNU (a Grx inhibitor), which indicated that Akt might act as a downstream regulator of Grx.

Endothelial Cells ; Glutaredoxins ; genetics ; Humans ; Lipopolysaccharides ; pharmacology ; Oxidative Stress ; drug effects ; Phosphorylation ; Porphyromonas gingivalis ; pathogenicity ; Proto-Oncogene Proteins c-akt ; drug effects ; Signal Transduction ; drug effects ; Umbilical Veins

Objective:To observe the analgesia effect and of low-level combined- and single-laser irradiation on Zusanli (ST 36) in rats and the relationship between mast cell degranulation and laser acupuncture analgesia.Methods: A total of 66 Sprague Dawley (SD) rats were randomly assigned into normal control,model control,sham irradiation,10.6 μm laser (220 mW,40 Hz) 650nm laser(36mW,continuous),combined laser (10.6 μm+ 650 nm) groups.Arthritis mode 1 was established by injection of Complete Freund's Adjuvant (0.05 mL) into the left ankle joint.The paw withdrawal latency (PWL) was detected with a radiant heat algesimeter.Zusanli (ST 36) was irradiated with sham,single or combined laser for 30 min.After sacrifice under anesthesia (1% embutal),tissues of Zusanli (ST 36) area were sampled,sliced (5 μm) and stained with Toluidine Blue for skin for observing the mast cell degranulation.Results:Compared with model control and sham group,the pain threshold increased significantly in 650nm and combined laser groups (P＜0.01),while remained no significant difference in 10.6 μm group.Compared with model and sham group,the degranulation ratios of mast cells in 650nm and combined laser group were significantly higher (P＜0.001),while remained no significant difference in 10.6 μm group.The linear correlation coefficient between degranulation ratios of mast cells and PWL after laser acupuncture is 0.737 (P＜0.001).Conclusion:Both 650 nm and combined laser stimulation of Zusanli (ST 36) can effectively raise pain threshold,and enhance degranulation ratio of mast cells at the stimulated acupoint.The result also suggested a linear correlation between degranulation ratio of mast cell and analgesia effect.

Objective To evaluate the setup errors for lower neck with cone beam CT (CBCT) in breast cancer patients immobilized by breast bracket,and to probe the margins from supraclavicular clinical target volume (CTV) in 3 directions.Methods A total of 14 breast cancer patients with supraclavicular lymph node radiation were enrolled.All patients were immobilized by breast bracket,and each patient would undergo CBCT at the first,tenth and twentieth treatment after positioning,respectively.Then these CBCT images were registered to the planning CT to determine setup errors in translational and rotational direction,and evaluated correlation between them.At last,CTV margins were calculated from the systenatic and random errors.Results The setup errors on x (left-ring),y (superior-inferior),z (anterior-posterior) translational directions were (2.89 ±.2.52),(3.96 ±2.97),(4.21 ±2.24) mm and on θ (pitch degree),φ (roll degree),Ψ (yaw degree) rotational direction were (2.38 ± 1.97)°,(1.60±1.63) °,(1.91 ±1.54)°,respectively.The margins from CTV were 8.08,8.13,6.30mminx,y and z direction.On y and z directions translational errors were correlated significantly with φ and Ψ degree rotational errors(Pearson =-0.515,-0.509,P ＜ 0.05).In inter-fraction only on z direction the setup changes were considered as correlative with Ψ degree (Pearson =-0.583,P ＜ 0.05).Conclusions For supraclavicular region irradiation breast cancer patients immobilized with breast bracket,the margins from CTV were recommended as not less than 8.08,8.13,6.30 mm in x,y,z directions,respectively.The position immobilized method and the positioning workflow should be further improved in order to reduce the influence of the neck rotational on setup errors.

Objective To evaluate ultrasound-guided methylene blue dyeing for radical liver segmental resection.Methods Liver segmental resection with uhrasound-guide methylene blue dyeing (UMD-SR) was performed in 16 cases, results were compared with 16 conventional liver segmental resection (CSR) retrospectively.Results All the operations under uhrasound-guided methylene blue dyeing were successfully carried out, among them, reverse dyeing was used in cases with segment Ⅳ, Ⅴ, Ⅷ resection.The blood loss in UMD-SR group was much less than CSR group(t =3.011 ,P =0.009) , at the cost of a longer operation time (t =5.423,P =0.000 07).There was no difference in the mortality and morbidity rates between two groups.Tumor recurrence rate was 6.25％ in UMD-SR group and 18.75％ in CSR group (x2 =0.133,P =0.285).Conclusions Ultrasound-guided methylene blue dyeing liver segmental resection can reduce the blood loss during operation, improve the safety of hepatectomy in case of hepatic carcinoma.

Objective To investigate the radiation dose and image quality of spectral and conventional CT scan in neck.Methods Sixty patients with enhanced neck CT scan were analyzed retrospectively.The 30 patients with spectral CT scan were included in spectral CT group,and the 30 patients with conventional CT scan were included in conventional CT group.The tube voltage,tube current and rotation speed of the spectral CT group were fast switching with 80 and 140 kVp,630 mA and 0.5 s,respectively.The scanning parameters of conventional CT group were 120 kVp,auto tube current (100 to 600 mA),and 0.6 s,respectively.The objective evaluation [noise and (contrast to noise ratio) CNR] and subjective scores in the upper,middle and lower neck were evaluated.The radiation dose was also evaluated in the two groups.The independent-samples t test was used in comparison of the radiation dose.The independent-samples t test and the rank sum test were used to compare the objective and subjective image quality.Results The CT dose index of spectral and conventional scan in the neck were 17.77 mGy and (17.26±2.18) mGy,respectively without significant difference (t=-1.26,P=0.218).The noises of 65 keV images in upper,middle and lower neck were (4.5 ± 0.8),(4.5 ± 0.9),(5.2 ± 1.0) HU,and the noises of conventional CT images in above-mentioned regions were (4.5± 1.1),(4.1± 1.0),(5.0± 1.7) HU.There was no significant differences (t=0.102,-1.362,-0.621;P＞0.05).The subjective scores of 65 keV images in upper,middle and lower neck were (4.1 ± 0.3),(4.7 ± 0.5),(3.8 ± 0.7),while the subjective scores of conventional CT images in associated region were (4.1±0.4),(4.6 ±0.5),(3.5 ±0.6),wihtout significant differences (Z=-0.286,-0.531,-1.568;P＞0.05).The noises of 55 keV images in upper,middle and lower neck were (5.4±0.9),(5.6± 1.1),(6.6± 1.6) HU,which were significantly higher than noise of conventional images (t=-3.614,-5.560,-3.784;P＜0.05).The subjective scores of 55 keV images in upper and middle neck were (3.7±0.5),(4.2±0.4),which were significantly lower than those of conventional images (Z=-2.541,-3.136;P＜0.05).The subjective score of 55 keV images in lower neck was (3.3±0.8),which was no significant difference in comparison with conventional image (Z=-1.318,P＞0.05).There was no significant difference between the CNR of conventional images and CNR of spectral images with 65 keV and 55 keV in upper,middle and lower neck (P＞0.05).Conclusion The radiation dose and the image quality of spectral CT scan are same to the conventional CT scan in the neck,the 65 keV monochromatic images can be used routinely.

Objective To study on imagination features of tumor thrombi in the portal vein of primary liver cancer (PLC). Methods We established a new type system of tumor thrombi, with Ⅰ 0 to Ⅳ, a total of 5 types and 8 sub-types in the portal vein of PLC based on normal intrahepatic portal vein anatomy and growing features of the tumor thrombi. The relationship between the types and the imaging diagnosis of 130 PLC cases with tumor thrombi in the portal vein was studied. Results 85%(110/130) cases of PLC with tumor thrombi in the portal vein belongs to type Ⅱ or Ⅲ when being first diagnosed in the hospital. The resectability rates for type Ⅰ, Ⅱ, Ⅲ, Ⅳ were 62%(5/8), 16%(10/62), 10%(5/48), 0 (0/12), respectively, and chemoembolization therapy (TACE) was given in 38%(3/8), 40%(25/62), 27%(13/48), 16%(2/12), respectively. Conclusions The new types of tumor thrombi are helpful for diagnosis and treatment of PLC with tumor thrombi in the portal vein.

The technology of Magnetic Resonance Spectroscopy(MRS) is a newly-developed mean for analyzing some specific nucleus and their compounds making use of the principles of magnetic resonance and the effects of chemical shift. Currently, among MRS applications, proton magnetic resonance spectroscopy (1HMRS) is the most widely applied one developed from single voxel to three-dimensional multi-voxel scanning technique. It provides a lot of important information for clinical studies. This article mainly reviews the methods for absolute quantification measurement of brain metabolites using multi-voxel MRS.

Objective To evaluate the effect of spectral CT monochromatic imaging on the detection of hepatic tumors. Methods Forty-two patients with hepatic tumors (14 patients with hepatocellular carcinoma, 12 patients with metastatic tumor, 16 patients with hemangioma) underwent CT spectral imaging. During arterial phase, portal phase and venous phase, 140 kVp polychromatic images and 70 keV monochromatic images were obtained. Paired-sample t tests were used to compare the image quality score,liver noise and tumor-to-liver contrast-to-noise ratio (CNR) between the two image data sets. The detection rates of various tumors during each phase were compared. Results The image quality scores of various tumors during three phases were (4. 30 ± 0. 25) and (3.63 ± 0. 22) averagely for the 70 keV and 140 kVp images. The liver noises were (8. 82 ± 0. 82) and ( 10. 66 ± 1.10) , and the CNRs were 5.39 and 3. 89,respectively. The image quality score, the liver noise and the CNR of 70 keV images were significantly greater than those of 140 kVp images (P ＜0. 05 ). The detection rates of various tumors during each phase were higher with 70 keV images (78％-100％) than with 140 kVp images (65％-96％), except the hepatic metastatic tumors and the hepatic hemangiomas during the arterial phase. The detection rate was more increased for the small lesions less than 1 cm (57％-100％ vs. 14％-91％ ). Conclusion By substantially improving the image quality and increasing the tumor-to-liver conspicuity, the 70 keV monochromatic imaging of spectral CT improves the detection of hepatic tumors and is more sensitive for the detection of small lesions.