Objective To analyze the advantage of altered fractionation radiotherapy by calculating the accumulative effects of daily biologically effective dose (BED) to find out the difference between conventional fractionated radiotherapy and altered fractionation radiotherapy.Methods The data in the report of hyperfractionated or accelerated radiotherapy for head and neck cancer published by Cochrane Collaboration in 2010 was analyzed.Based on the radiotherapy processes mentioned in this report,the accumulative effects of daily BED were calculated and compared in different radiotherapy processes by using linear-quadratic mode.The variation of BED in different radiotherapy processes was find out.Results In total dose of unity as the premise of 70 Gy,altered fractionation especially the hyperfractionated accelerated radiotherapy could give a higher BED to the tumor during a shorter period,hyperfractionated radiotherapy could give a lower BED to normal tissues,and hyperfractionated radiotherapy with split course could give higher BED to the tumor while lower BED to normal tissues.Conclusions The variation of BED in different radiotherapy processes can be shown clearly by linear-quadratic mode.It can be simple and shortcut through mathematical models for the evaluation of different radiotherapy plan,on clinical symptomatic selection play a guiding role in tumor therapy.

Objective To investigate the clinical features of acute coronary syndrome (ACS) combined with low T3 syndrome and its prognosis.Method Eighty-seven ACS patients with low free triiodothyronine (FT3) level (low FT3 group) and additional 64 ACS patients with normal FT3 level(control group) were selected in parallel; all the patients underwent coronary angiography.The contents of FT3,N-terminal pro-brain natriuretic peptide (NT-proBNP),cardiac troponin I (cTnI) and high sensitivity-C reactive protein (hs-CRP) were recorded,and the related factors were evaluated.The number of stenotic vessels was calculated.Results The contents of NT-proBNP,cTnI and hs-CRP in low FT3 group were elevated significantly compared with those in control group [(1242.14 ± 226.32) ng/L vs.(1126.36 ±195.55) ng/L,(0.92 ± 0.23) ng/L vs.(0.84 ± 0.19) ng/L,(6.46 ± 2.25) mg/L vs.(5.71 ± 1.78) mg/L],and there were significant differences (P ＜ 0.01 or ＜ 0.05).The contents of FT3 were negatively correlated with NT-proBNP,cTnI and hs-CRP in two groups (P ＜ 0.05).There was no significant difference in the number of stenotic vessels between two groups (x2 =4.512,P =0.105).Conclusion In patients with ACS,there is a negative correlation between contents of FT3 and the prognosis,but there is no correlation between contents of FT3 and the number of stenotic vessels.

Objective To explore the MatriXX measurements the dose distributions for each beam in intensity-modulated radiotherapy (IMRT) plans were measured with 0 degree gantry angle and actual gantry position respectively.To discuss whether the two multi-angle synthetic pass rate from the two methods has statistics differences.Methods The dose distributions for each beam in IMRT plans were measured with 0 degree gantry angle and actual gantry position for twelve patients with head and neck tumor respectively.The γ pass rates (according to 3％/3 mm) for each beam under each angle condition was obtained by the comparison between the measured and the calculated dose distributions from the treatment planning system which was treated as the reference distribution.Use the t-test to analyse the actual gantry angle method and use the one factor analysis of variance to analyze the two multi-angle synthetic pass rate from the two methods.Results The γ pass rates of actual gantry angle was found generally declined seemingly compared with 0 degree gantry angle,but differentγ pass rates showed only in 80 °,120°and 240° with98.71％,93.59％(t=2.10,P=0.000),98.15％,93.17％ (t=2.10,P=0.000) and 98.94％,92.85％ (t =2.10,P =0.000) respectively.The γpass rate of multi-angle synthetic was seemingly between methods (98.27％,94.63 ％,F =0.50,P =0.134).Conclusions Two kinds of IMRT verification mode are from two position to validated the IMRT plans dose accuracy,comparatively analysing the conclusions drawn from the two methods can protect accuracy of IMRT plans more comprehensively.

Objective To investigate the diagnostic value of the early slope value of enhancement in differentiating benign from malignant musculoskeletal masses.Methods Dynamic contrast-enhanced gradient-recalled acquisition in the steady state imaging(GRASS) was performed to evaluate 36 musculoskeletal masses(18 malignant,18 benign).The difference of the early slope value of enhancement was analysed and compared between benign lesions and malignant ones.Using ROC curve plotting obtained the best decisive threshold.Spearman rank correlation analysis was used to determine the relation between slope and microvessel density of tumor tissues.Results The average early slope value of enhancement was (4.33?2.70)% per second (range 0.97%～10.50% per second)for malignant lesions,and was (1.46?0.97)% per second(range 0.37%～3.86% per second)for benign ones.There was an apparent statistical significance between benign and malignant tumors(?

Objective To investigate the correlation of dynamic contrast-enhanced (DCE) MRI features with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in non-small cell lung cancer(NSCLC).Methods Conventional MR imaging and dynamic contrast-enhanced scan in thirty-three patients with NSCLC confirmed by pathologyn were performed. MVD and VEGF were stained with immuno-histochemical technique in all cases. Some parameters of DCE MRI, including maximum slope(Smax) and time to peak(TTP) were put more analysis. The relationship between the results of DCE MRI (Smax and TTP) and that of immuno-histochemistry (MVD and VEGF) was analysed.Results The Smax of adeno carcinoma was higher than that of squamous cell carcinoma,but TTP was lower. The difference was obvious difference(t=3.22,P

Objective To evaluate the risk factors for healthcare-associated infection(HAI)in senile dementia pa-tients,so as to adopt effective nursing measures to reduce the incidence of HAI.Methods Clinical data of 82 senile dementia patients aged≥60 years and hospitalized between January 2011 and June 2013 were analyzed retrospective-ly.Results Of 82 patients,28 (34.15%)developed HAI.The main infection site was lower respiratory tract(n=15,53.57%),followed by urinary tract(n=6,21 .43%).Univariate analysis revealed that risk factors for HAI in senile dementia patients were bedridden,long length of hospital stay ,dysphagia,indwelling urinary catheter,irra-tional use of antimicrobial agents,combined with tumor,and hypoproteinemia (all P <0.05 ).The main isolated bacteria were gram-negative bacilli(n=40,62.50%),the top three pathogens were Klebsiella pneumoniae (n=12, 18.75%),Escherichia coli (n =10,15.63%),and Pseudomonas aeruginosa (n =8,12.50%).Conclusion Reali-zing the risk factors and common pathogens of HAI in senile dementia patients is helpful for taking effective meas-ures to prevent and control the incidence of HAI .

Objective To observe the therapeutic efficacy of the Chinese medical herb decoction qu yin tang combined with narrow-band ultraviolet B (NB-UVB) phototherapy on psoriasis vulgaris, and to investigate its influ-ence on osteopontin (OPN) and vascular endothelial growth factor (VEGF) in serum. Methods Sixty patients with psoriasis were randomly divided into a treatment group and a control group. The treatment group was treated with qu yin tang and NB-UVB; the control group was treated with qu yin tang only. The levels of OPN and VEGF in serum were detected in both groups before and after treatment using an enzyme-linked immunosorbent assay (ELISA). Twenty healthy persons' serum samples were taken as controls. At the same time, any changes in psoriasis area and severity index (PASI) scores in the two groups were recorded and compared. Results After 8 weeks of treatment, PASI scores and levels of OPN and VEGF had been reduced significantly in both groups, and there was a significant difference between the treatment group and the control group. Conclusions Chinese medical herbs combined with NB-UVB phototherapy is a safe and effective method for the treatment of psoriasis. The results suggested that OPN and VEGF may play an important role in the pathogenesis of psoirasis vulgaris.

Objective To study the hemodynamic changes and pathologic foundation of rabbit models of radiation-induced lung injury (RILI) via 64-slice CT pulmonary perfusion imaging ( CTPI),in order to seek the correlation between the alterations of the hemodynamic parameters and pathophysiology.Methods Seventy-two healthy New Zealand rabbits were randomly classified into two groups:test group ( n =36),received 25 Gy with single fraction irradiation in a whole unilateral lung; control group ( n =36),received sham-irradiation.Each group was divided into 12 subgroups respectively according to post- and pseudo-irradiation time points (1,6,12,24,48,72 h and 1,2,4,8,16,24 w).Each rabbit underwent HRCT and CTPI at every pre- and post-radiation time point.All rabbits were sacrificed,and morphology of specimens was observed using light- and electron microscope. The changing regularity of HRCT,CTPI parameters and pathology were analyzed and compared with each other in order to find the correlation among them.The CTPI parameters of the test and control groups were compared using t test.The CTPI parameters and pathological values were analyzed using linear correlation with two variables,the detection rates of RILI by CTPI and HRCT was compared using Chi-square test.Results ( 1 ) The changes of CTPI parameters from control group after irradiation was relatively stable,but in test group those parameters including rBF,rBV and rPS,at pre- and post-irradiation time points (0,72 h and 2 w),were respectively 1.01 ± 0.09,1.86 ± 0.20,1.43 ±0.12,1.03 ±0.08,1.63 ±0.19,1.56±0.14,0.96±0.12,1.54 ±0.17 and 1.83 ±0.24.The corresponding parameters before and after irradiation were significantly different ( t =2.90-6.37,P ＞ 0.05).(2)In test group,capillary endothelial cells,basement membrane and alveolar epithelial cells,as the main injury targets,showed certain alterations in pathology.There was a significant correlation between the changes of CTPI parameters ( rBF and rBV) and pathophysiology in control group ( r =0.74,0.83,P ＜0.05 ),with the dependent relationship between rPS and the amounts of RBC outside the capillary and the destruction of basement membrane( r =0.87,0.88,P ＜ 0.01 ).(3)The detection rate of RILI with CTPI (72.2％,26/36) was obviously higher than that with HRCT( 16.7％,6/36,x2 =4.37,P =0.036).Conclusions CTPI parameters is capable of revealing the rule of hemodynamic process and reflecting the pathophysiologic state of different stages of RILI.By the time of detecting RILI,the detection rate of CTPI is clearly superior to that of HRCT,which yields potential value in predicting RILL

Objective To evaluate the activation of the visual cortex in patients with primary openangle glaucoma (POAG) and to explore whether the neuronal activity corresponds with retinal nerve fiber layer (RNFL) and cup-to-disc (C/D) values.Methods Twenty-five patients and 25 gender-and agematched healthy volunteers were studied.Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) and three-dimensional brain volume imaging (3 D BRAVO) sequences were obtained using 3 T MR imaging system.A full-screen black-white shift checkerboard was used for visual stimulus during the fMRI experiment and was performed on each eye of all subjects using a visual-acoustical system.All acquired data were postprocessed and analyzed by statistical parametric mapping (SPM).After analysis,individual activated mapping,intra-group mean activated mapping,and inter-group variant mapping were observed.The voxel number,intensity,and Montreal Neurological Institute (MNI) coordinate of the activated clusters were recorded.The Xjviewer software was utilized to obtain activated voxel numbers in occipital lobe.A Pearson correlated test was performed to test the correlation between the number of activated voxels and RNFL,C/D and Hodapp-Anderson-Parrish (HAP) clinical stage.Results Intra-group mean activated mappings of both patients and volunteers showed obvious activation in bilateral occipital lobes.As compared with healthy volunteers,the POAG patients exhibited statistically significantly decreased activation in bilateral occipital lobes,left hippocampus,and left cerebellum,along with lower mean RNFL [(71.56 ±21.54) i m versus (111.88 ± 9.96) μm] and higher C/D values (0.71 ± 0.18 versus 0.36 ± 0.08 ; t value was respectively-10.901 and 11.643,P ＜ 0.05).The number of activated voxels in the occipital lobes of POAG patients did not correlate with RNFL,C/D and HAP clinical stage of the corresponding eye (r value was respectively 0.157,-0.113 and-0.242,P ＞ 0.05).Conclusions fMRI demonstrated differences in visual cortex activation in POAG patients relative to healthy volunteers,suggesting it might be a promising complementary method for diagnosing glaucoma.However,fMRI findings did not correlate with POAG extent,as measured by RNFL and C/D values.Ophthalmological examination remains to play an important role in the evaluation of open-angle glaucoma.

Objective To analyze the clinical characteristics and risk factors of nosocomial infection (NI) in elder patients with cerebral infarction Methods A retrospective study was performed.Three hundred and two patients over 60 years old with cerebral infarction were selected as our subjects,who were in a cadre ward from Jan.2011 to Jun.2013.The incidence rate of NI and the predisposing factors of NI were investigated.Results Of 302 patients with cerebral infarction,46 cases developed NI and the incidence was 15.23％.The most common site of NI was lower respiratory tract infection,counting for 60.87％ (28/46),followed by urinary tract infection(21.74％ (10/46)).The risk factors of NI included age,prolonged hospitalization,disturbance of consciousness,invasive operation and the use of antibiotics (x2 =5.720,11.517,5.185,4.218,11.931 ; P ＜ 0.05).Conclusion The clinical staff should pay close attention to the risk factors of NI in elder patients with cerebral infarction.The methods include controlling the disease as soon as possible,shortening hospital stays,reducing invasive operation and the rational use of antibiotics can reduce the incidence of NI.