Objective To compare three kinds of double-dosimetry algorithms used in estimating interventional radiology worker's effective dose.Methods TLDs were put in the Alderson Radiation Therapy Phantom (ARTP) dressed with lead apron,lead cap and lead collar.TLDs were put on the front left chest inside the lead apron and on the left outside lead collar,respectively.Radiation scattering models,intensity-modulated radiotherapy body model at one time and CT dose detection model at another time,were put on the operating table.The ARTP was set at the major operator's position exposed to the Xray,mimicking the real interventional radiology operation.Effective doses were estimated on the basis of organ absorbed doses.Effective doses were also obtained by the use of three kinds of double-dosimetry algorithms.The later three effective doses were compared with the first one.Results Two groups of effective doses were obtained,with each including four data.For intensity-modulated radiotherapy body model,effective doses were 0.138 mSv for phantom method,0.097 mSv for NCRP algorithm,0.161 mSv for Niklason's algorithm and 0.173 mSv for Boetticher's algorithm,respectively.For CT dose detection model,effective doses were 0.018,0.013,0.019 and 0.026 mSv,respectively.The result obtained by using the Niklason's algorithm was the closest to that by using phantom method.Conclusions Niklason's algorithm is more accurate and more practical in eatimating interventional radiology worker's effective dose.

Objective To evaluate effectiveness of microvascular decompression in the treatment of trigeminal neuralgia. Methods 126 cases of trigeminal neuralgia were operated on by microvascular decompression via suboccipital retrosigmoid approach. It was found that nerves were compressed by vessels nerves in 122 cases. Cotton of Teflon was implanted between oppressive trigeminal nerve roots and vessels by minimally invasive surgery. Results 113 of 126 cases were followed up postoperatively for (1～9)years. Pain disappeared or died down in 110 cases. The total effective rate was 97.3%(110/113). Conclusions Microvascular decompression is effective treatment for trigeminal neuralgia.

A certain amount of image noise is increased in low-dese protocols, but image quality is still acceptable without problem in CT localization. The reduction of radiation dose and the radiation harm to patients are the superiority.

OBJECTIVEThe clinical diagnosis and treatment of ischemia mitral regurgitation (IMR) remained difficult because of its unclear mechanisms. This paper reviews studies on the mechanisms of IMR during the last 20 years, and discusses the relevance of the various mechanisms.

DATA SOURCESData used in this review were mainly from CNKI and Pubmed in English. The search terms were "ischemia mitral regurgitation mechanism", "myocardial infarction" AND "mitral regurgitation".

STUDY SELECTIONArticles were selected if they involved mechanisms of IMR.

RESULTSIMR is one of the common complications of coronary artery disease. But currently, the clinical diagnosis and treatment of IMR remained difficult because of its unclear mechanisms.

CONCLUSIONSFor now, dominating theory of ischemic mitral regurgitation mechanisms are left ventricular remodeling, imbalance of leaflet tethering and the closing force, left ventricular dysfunction, changes in spatial structure of the annulus and the dyssynchrony of the left ventricular electromechanical activity.

Animals ; Humans ; Mitral Valve Insufficiency ; etiology ; Myocardial Ischemia ; complications ; Papillary Muscles ; physiology ; Systole ; Ventricular Dysfunction, Left ; complications ; Ventricular Remodeling

The graft-versus-tumor (GVT) effect of T cells induced by tumor antigen-pulsed CD8α(+) dendritic cells (DCs) in vitro was investigated in this study. Immature CD8α(+) DCs were prepared from C57BL/6 (H-2(b)) bone marrow cells by using a cytokine cocktail. On the 3rd day of culture, CD8α(+) DCs were pulsed by allogeneic (Balb/c, H-2(d)) EL9611 leukemia antigen, or RM-1 syngeneic prostate cancer antigen, with the concentration series of 0, 2.5, 5.0, 10.0, 20.0 μg/mL, respectively, then antigen-loaded immature CD8α(+) DCs were co-cultured with syngeneic T cells according to the DC/T ratio of 1:1, 2:1 and 4:1. T cell proliferation was measured by MTT assay. Cytokines including interferon gamma (IFN-γ) and interleukin-10 (IL-10) in CD8α(+) DCs and T co-culture supernatant were detected by using ELISA. Cytotoxic effect of antigen-specific T cells was tested by LDH release assay. Conventional mature DCs (mDCs) induced from C57BL/6 (H-2(b)) bone marrow cells by using granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) served as a control. The results showed that the proliferative activity of T cells stimulated by CD8α(+) DCs loaded with allogeneic or syngeneic tumor antigen was augmented with the CD8α(+) DC/T ratio increased (P<0.05). When antigen concentration ≤ 5 μg/mL and CD8α(+) DC/T ratio ≤ 2:1, the ability of CD8α(+) DCs to stimulate T cell proliferation was higher than mDC control in allogeneic tumor antigen-pulsed groups (P<0.05), but not in syngeneic tumor antigen-pulsed groups (P>0.05). The level of IFN-γ and IL-10 in CD8α(+) DCs and T cell co-culture supernatant were increased in both allogeneic and syngeneic antigen-pulsed groups (P<0.05), and the cytokine level was higher in allogeneic antigen-pulsed groups than in syngeneic antigen groups when the CD8α(+) DC/T was 1:1 or 2:1 (P<0.05). There existed a negative correlation between the level of IL-10 and T cell proliferation. T cell cytotoxicity assay showed that when CD8α(+) DCs were pulsed with allogeneic tumor antigen, the maximal T cell killing efficiency could reach (100±7.7)%, whereas syngeneic tumor antigen-pulsed group had only (65.0±3.4)%. It was concluded that syngeneic and allogeneic tumor antigen-pulsed immature CD8α(+) DCs could stimulate T cells to exert the GVT effect in vitro, and the GVT effect was more obvious with allogeneic tumor antigen than with syngeneic tumor antigen. The optimal condition was low allogeneic tumor antigen pulsation (≤ 5 μg/mL) and low CD8α(+) DC/T ratio (1:1 and 2:1).

Objective To explore therapeutic effects and mechanisms of radical scavenger edaravone on experimental cerebral hemorrhage.Methods Two hundred-forty male SD rats were divided randomly into four groups:control group,cerebral hemorrhage group,edaravone treatment group before operation (A) and edaravone treatment group after operation (B).Experimental cerebral hemorrhage model was made according to the method reported by Rosenberg.Water quantity contained in brain and nervous missing sign were observed,meanwhile the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in brain tissue were measured.Results Compared with cerebral hemorrhage group,nervous missing sign and water quantity contained in brain obviously changed in edaravone treatment group (P

OBJECTIVETo establish a modified plasma protamine paracoagulation test.

METHODSPlasma protamine paracoagulation, modified plasma protamine paracoagulation and D-dimer (D-D) tests were performed for the plasma samples collected from 98 cases of disseminated intravascular coagulation (DIC) and 156 normal subjects. The sensitivity and specificity of the 3 tests were analyzed. The plasma samples from 8 cases of suspected myocardial infarction were detected using modified plasma protamine paracoagulation for diagnostic purpose.

RESULTSThe sensitivity of plasma protamine paracoagulation, modified plasma protamine paracoagulation and D-D tests was 16.33%, 88.76% and 77.56%, and the specificity was 100%, 88.46% and 97.44%, respectively. Positive results occurred earlier in modified plasma protamine paracoagulation test than in plasma protamine paracoagulation and D-D tests in 5 cases of myocardial infarction.

CONCLUSIONThe modified plasma protamine paracoagulation test has a higher sensitivity than plasma protamine paracoagulation test and a higher specificity than D-D test, and can be helpful in early diagnosis of thrombosis and fibrinolysis.

Adult ; Blood Coagulation Tests ; methods ; Female ; Humans ; Male ; Middle Aged ; Protamines ; blood ; Sensitivity and Specificity ; Thrombosis ; blood ; diagnosis

Objective To estimate the lifetime attributable risk (LAR) of lung cancer,stomach cancer,liver cancer,thyroid cancer,breast cancer and leukemia for 1-,5-and 10-year old children undergoing chest CT scan.Methods Chest CT images of children was retrieved from the picture archiving and communication system (PACS) and the average CT number and area of the region of interest (ROI) were read on the CT work station.Water equivalent diameter were calculated according to the method recommended by the American Association of Physicists in Medicine (AAPM).Furthermore,the size-specific dose estimation (SSDE) was made based on the water equivalent diameter and the volume computed tomography dose index(CTDIvol).Based on the method recommended by Caro Franck,the SSDE then was converted into average organ doses to lung,stomach,liver,thyroid,breast and blood for children at different ages and of different sex undergoing chest CT scan.On the basis of average organ dose,the cancer risk prediction model from the National Academy of Science's Biological Effects of Ionizing Radiation-Ⅶ (BEIR-Ⅶ) was used to predict the LAR for different cancers mentioned above.For lung cancer,gastric cancer,liver cancer and leukemia,the calculating sequence was from average organ dose to excess relative risk (ERR) to LAR,whereas for the thyroid cancer and breast cancer,the sequence was from ERR to average organ dose to LAR.Results The average organ dose to lung,stomach,liver,thyroid,breast and blood for children at different age and of different sex undergoing chest CT scan was obtained.The age had a statistically significant impact on the SSDE (t =24.28,P ＜ 0.05),but sex has not (P ＞ 0.05).LAR for lung cancer,gastric cancer,liver cancer,thyroid cancer,breast cancer and leukemia for 1-,5-and 10-year old children undergoing chest CT scan was obtained,among whom the LAR for thyroid cancer and breast cancer was relatively high.The LAR for women breast cancer was 10.9 per 100 000 persons for 1 year old children,30.8 per 100 000 persons for 5 years old and 34.5 per 100 000 persons for 10 years old.Conclusions With introduction of new technologies,the radiation dose due to chest CT scan is on the decline.But the induced radiation dose is still significant compared with general diagnostic radiography.The risk of cancer still deserves more attention and should be taken into consideration in the justification of diagnostic radiology.

OBJECTIVETo systematically evaluate the efficacy and safety of kidney-tonifying traditional Chinese medicine in the treatment of male infertility.

METHODSBased on the principles and methods of Cochrane systematic reviews, we searched CNKI, VIP, and Wanfang databases from inception to December 2012 for randomized controlled clinical trials addressing the treatment of male infertility with kidney-tonifying traditional Chinese medicine. According to the inclusion and exclusion criteria and retrieval strategies, we extracted the data, evaluated the quality of the included literature, and conducted meta-analysis using the RevMan 5. 2 software.

RESULTSTwenty trials involving 2,272 patients were included, and the sample size of each study was from 60 to 270 cases. All the studies were graded as of poor quality, with Jadad scores of no more than 3 points. The results of meta-analysis showed that the total effectiveness rate of traditional Chinese medicine versus Western medicine on male infertility was RR = 1.71, 95% CI 1.19-2.47, and that of Chinese-Western combined therapy versus Western medicine was RR = 1.15, 95% CI 1.01-1.30. Both traditional Chinese medicine and Chinese-Western combined therapy showed a significantly better total effectiveness than Western medicine alone in improving the pregnancy rate without serious adverse reactions.

CONCLUSIONDue to the poor methodological quality and high heterogeneity of the included studies, the evidence for the efficacy and safety of kidney-tonifying traditional Chinese drugs in the treatment of male infertility is of but limited value, and further validation is needed by more high-quality studies.

Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infertility, Male ; drug therapy ; Kidney ; Male ; Medicine, Chinese Traditional ; Pregnancy ; Randomized Controlled Trials as Topic

Objective To compare the biomechanical properties of Gamma3 and InterTan nails in the fixation of femoral intertrochanteric fractures. Methods Twelve synthetic femora of 4th generation were randomized into 4 equal groups ( n=3 ) for assessment of the 2 constructs of fracture fixation ( Gamma3 versus InterTan nails ) . Groups A and B were made into models of stable femoral intertrochanteric fracture (AO/OTA type 31-A1. 1) and groups C and D into unstable ones(AO/OTA type 31-A2. 3) . The biomechanical properties of Gamma3 and InterTan nails in the 4 models were tested and compared. Results For stable fracture models, the fracture gap movement increased with the increasing axial load and the torque increased with the increasing torsion angle. There were significant differences between groups A and B in fracture gap movement and torque ( P <0. 05 ) . There was no significant difference between groups A and B in failure load ( 5, 855. 5 ± 627. 8 N versus 5, 547. 1 ± 365. 4 N ) ( P > 0. 05 ) . For unstable fracture models, there were no significant differences between groups C and D in fracture gap movement when the axial loads were 500 N, 600 N or 700 N ( P > 0. 05 ) , but there was a significant difference between the 2 groups when the axial load was larger than 800 N ( P <0. 05 ) . With the increasing torsion angle, the torque increased in groups C and D. There was a significant difference between the 2 groups in the torque at the same torsion angle ( P <0. 05 ) . There were a significant difference between groups C and D in failure load ( 2, 781. 5 ± 600. 6 N versus 3, 150. 5 ± 633. 8 N ) ( P=0. 007 ) . Conclusions For stable femoral intertrochanteric fractures, InterTan and Gamma3 nails may exhibit similar biomechanical properties. For unstable femoral intertrochanteric fractures, InterTan nails may provide obviously better biomechanical stability than Gamma3 nails.