Background Ex-PRESS glaucoma drainage device implantations have been clinically applied worldwide.In China,50 type and 200 type of Ex-PRESS glaucoma drainage devices are used for different types of open angle glaucoma.However,whether the clinical outcomes are similar between 50 type and 200 type of Ex-PRESS glaucoma drainage devices are not elucidated.Objective This study was to compare the therapeutic efficacy and security of Ex-PRESS implantation between PS0 type and P200 type of Ex-PRESS glaucoma drainage devices for open angle glaucoma Methods A randomized,parallel-group trial was designed,and written informed consent was obtained from each patient prior to entering in the cohort.Eighty eyes of 69 patients with various types of open angle glaucoma were included from March 2012 to April 2013 in Wuhan General Hospital of Guangzhou Military Command.The patients were randomized into 2 groups according to randomized digital table.The P50 type Ex-PRESS glaucoma drainage device was implanted in 40 eyes of 35 patients in the P50 group,and P200 type was implanted in 40 eyes of 34 patients in the patients of the P200 group.The disease composition,best corrected visual acuity (BCVA) recovery time,theoretical hospitalization days,lowing intraocular pressure (IOP) range and postoperative complications were compared between the two groups.Results The average lowing-IOP ranges of the P50 type group and P200 type group were (21.19±11.22) and (24.35±12.27) mmHg,respectively,with an insignificant difference between them (t =-1.201,P＞0.05).The theoretical hospitalization days and BCVA recovery time in the of P50 type group were (3.65±0.92) days and (2.85±0.95)days,and those in the P200 type group were (4.90±0.81) days and (3.40± 0.96) days,showing significant decreases in the P50 type group (t =-6.444,P＜0.01 ;t =-2.584,P＜ 0.05).The incidence of postoperative complications were 6.06％ and 25.00％ in P50 type group and P200 type group,respectively,with a significant difference between the two groups (.x2 =9.800,P＜0.05).Conclusions Although P50 and P200 Ex-PRESS implantation provide a similar effect in lowing IOP,P50 type Ex-PRESS implantation can restore BCVA more rapidly and lessen complications in comparison with P200 type Ex-PRESS implantation in the early postoperative stage.

To study factors related to visual field damage in Possner- Schlossman Syndrome(PSS) .Methods 145 cases of PSS and 166 cases of promary open angle glaucoma(POAG)were followed up with tonometer and perimeter. Results①Prevalence of visual field damageamong PSS and POAG cases were 35.43% and 93.42% respectively;72.11% of the visual field damage in the PSS group was of early stage,while 78.92% of that in the POAG group was of middle or late stage.②Compared with PSS cases with no visual field damage,the damaged cases were older;their course of the disease was longer;the average IOP between crises was higher;more cases were involved binocularly;more cases demonstrated abnormal diurnal and nocturnal IOP varianle or no crossover phenomenon. ③Systematic examination was given to 26 PSS cases with visual field damage and among them, 11 cases were confirmed to be complicated with POAG. Conclusion①Although the incidence of visual field damage done by PSS is much smaller and the symptoms slighter than those done by POAG,the prognosis of PSS is by no means optimistic. ②Coses at more advanced age, with longer course, with higher IOP between crises, with binocular involvement or without IOP crossover phenomenon are at a higher risk of visual field damage. ③Serious damage can be done by PSS itself.

This paper mainly discusses the development status in quo of field stretcher and its attachment with the history of field stretcher reviewed.The development trends of field stretcher in the future are also presented.

M PU employed as control center,the nerve stimulator can produce different stimul ation modes easily.The high-quality constant-current pulse and the safety of th e patient are ensured through two-steps current stabilizer,pulse width monitor and the float to ground.Both needle electrode and surface electrode can be used to achieve supramaximal stimulation.

Objective To investigate the influence of respiratory motion on target dose distribution in three-dimensional conformal radiation therapy(3DCRT) and intensity modulated radiation therapy(IM-RT). Methods A 2D air vented ionization chamber array MatriXX system,a platform which can mimic the clip motion of lung tumor, and a home-made solid water(RW3) phantom were used to measure the 2D dose distribution of static and moving targets irradiated by 3DCRT and IMRT beams using multiple gantry an-gles. The period of the moving platform was set to 3.5 s and the amplitude was ± 1 cm. Then the differences of dose distribution between the static phantom and moving phantom were compared and analyzed with the MatriXX system software. Results Compared with the static phantom in 3DCRT, the penumbra of dose distribution of the periodic moving phantom along the moving directions was increased by 6-9 mm, the high dose area was shrinked by about 5 ram,and the low dose area was extended by 5 mm,but the area of 50% i-sodose and the dose center area changed very little. When a single segment beam of IMRT was delivered and measured and the maximum dose of measuring plane was normalized to 100% ,the average difference of dose distribution between the static and dynamic phantoms was ±27% (from -56.4% to 56.1%) ;When all of the segment beams of IMRT were dehvered and the integrated dose distribution was measured ,the dose differ-ences were less than ±3% ,and the maximum difference of dose distribution was about ±15% which mainly appeared at the field margin and were similar to 3DCRT. Conclusions The dose distribution of most cen-ter areas of the periodic moving target using multi-fraction 3DCRT/IMRT beams is similar to that of the static target, while the high dose area of the former is shrinked and the low dose area is extended.

BACKGROUND:In recent years, stem cel therapy for early osteonecrosis of the femoral head has become an alternative method, but the quality of stem cels is a key to the therapeutic outcomes. OBJECTIVE:To evaluate the proliferative ability and directional differentiation ability of autologous bone marrow mesenchymal stem cels in a rat model of steroid-induced femoral head necrosis. METHODS:Twenty Sprague-Dawley rats were randomly divided into control and observation groups with ten in each group. An animal model of steroid-induced femoral head necrosis was built in the observation group, and then bone marrow mesenchymal stem cels from rats in both two groups were isolated and cultured. Cel counting kit-8 was used to detect proliferation of passage 3 cels. Bone marrow mesenchymal stem cels at passage 3 were selected in the two groups for osteogenic and adipogenic induction. Alkaline phosphatase staining and alizarin red staining were adopted at 7 and 14 days of osteogenic induction, and oil red O staining as performed at 21 days of adipogenic induction. RESULTS AND CONCLUSION:The absorbance values of bone marrow mesenchymal stem cels were lower in the observation group than the control group at 1, 3, 5 days of culture, but there was no significant difference between two groups (P > 0.05). Until the 7th day of culture, the absorbance value and alkaline phosphatase activity in the observation group were significantly lower than that in the control group (P < 0.05). Additionaly, there were fewer calcium nodules and lipid droplets in the observation group compared with the control group. These findings suggest that the proliferative ability and directional differentiation ability of autologous bone marrow mesenchymal stem cels from a rat model of steroid-induced femoral head necrosis are both decreased.

Objective To find a method for calculating the scatter dose of irregular fields. Methods The original Day function was improved to vary with radiation depth, and the improved Day function was used for irregular fields to calculate scatter dose. Results The accuracy was greatly improved by making Day function depend on radiation depth, and the error was within 1.5%. Conclusion This method can be used to calculate the scatter dose of irregular fields as well as rectangular fields.

Objective: To explore risk factors including prostate-specific antigen (PSA) kinetics for the prediction of castration-resistant prostate cancer (CRPC), and to build a practical model for predicting the progression to CRPC after androgen deprivation therapy(ADT) so as to facilitate clinicians in decision-making for prostate cancer patients receiving ADT.Methods: A total of 185 patients with prostate cancer who had received ADT as the primary therapy in Department of Urology of Peking University First Hospital from 2003 to 2014 were enrolled retrospectively.All the patients were diagnosed with prostate cancer via prostate biopsy and followed up every four weeks from the initiation of ADT.All the patients received ADT with luteinizing hormone-releasing hormone agonists (LHRH-A) or surgical castration accompanied with an antiandrogen (bicalutamide or flutamide, combined androgen blockade).The clinical information of the patients were collected including age, clinical TNM stage, Gleason score (GS), risk groups of prostate cancer, PSA at the initiation of ADT, PSA nadir after ADT, PSA decline velocity, and the time to PSA nadir.The end point of this study was the diagnosis of CRPC, which was based on the European Association of Urology (EAU) Guideline 2016.Cox proportional hazards regression models were established to analyze and estimate their effects on the time of progression to CRPC.Results: In this study, 185 patients with prostate cancer who had received ADT as the primary therapy were included.The mean age was (71.02±8.67) years.The median time to progression to CRPC in this cohort was 38 months (ranging from 4 to 158 months).On univariate analysis, we found clinical T stage, N stage, the metastasis state before ADT, risk groups of prostate cancer, PSA decline velocity, and PSA nadir were all related to the time to CRPC progression, P<0.01 for all the above variables.And on multivariate analysis, the presence of distant metastasis before ADT (HR=6.030, 95% CI: 3.229-11.263, P=0.001), higher PSA nadir (HR=1.185, 95% CI: 1.080-1.301, P=0.001), higher PSA decline velocity>11 μg/(L·month) (HR=2.124, 95% CI: 1.195-3.750, P=0.001), and time to PSA nadir ≤ 9 months (HR=3.623, 95% CI: 1.640-4.817, P=0.004) were found to be significantly associated with an increased risk of progression to CRPC.Conclusion: Patients with rapid decreasing of PSA in the initial ADT were more likely to progress to CRPC.

Objective To investigate the features of 2-D air vented ionization chamber array MatriXX system to use the QA procedures of radiotherapy. Methods Some important QA procedure of clinical radiotherapy practice were investigated by using a MatriXX system and a phantom made in house, mainly including the calibration of MatriXX, the off-axis rate (OAR) of virtual wedge fields, the connection between two half-fields or two asymmetry-fields, the skillful adjustment of the clinac flat filter, the 2-D dose distribution verification of radiotherapy planning, the influence of scatter screen to a large area electron beam field, the effect and best thickness and shielding position of block for a large area electron beam fields with scatter screen. Results The OAR of any virtual wedge field can be measured by a MatriXX system in a single irradiation. The conjunction accuracy of two half-fields or two asymmetry-fields may be less than 1 ram. The difference between the calculated and measured dose of any point or any isodose or any OAR of a field can be determined by using a MatriXX system. After the adjustment of the elinae flat filter with the help of MatriXX system, the flatness and symmetry of the field are 1. 85 % and 0.98 %, respectively. The dose characteristic of a large area electron beam field may be distinctively influenced by a scatter screen, and under this condition, the block faraway from the shielded target can hardly protect the organ at risk, and directe block which is put on or near the organ at risk is perfect. Conclusion Compared with conventional ionization chamber (Farmer type) or film dose measuring, the MatriXX combined with the OmniPre I'mRT software is much more convenient and effective in QA practice of clinical radiotherapy, and it's a perfect tool for the QA procedure of radiation therapy.

Objective To study the effects of using 25 kDa linear and branched PEI to transfer plasmid DNA pEGFP -C1 (pDNA ,encoding the enhanced green fluorescent protein reporter gene ) to the basilar membrane of the C57BL/6 mice cochlea in vitro .Methods L -PEI/pDNA and B -PEI/pDNA polyplexes were generated in 0 .1M phosphate buffer solution (PBS) or 5% glucose solution .Polyplexes were characterized by transmission electron mi-croscopy .Agarose gel retardation assay was used to determine the plasmid binding ability of L -PEI and B -PEI . The toxicity was investigated by MTT assay .The transfection was firstly evaluated in 293T cell line ,and then the appropriate amount of PEI and plasmid were applied for cochlear explant transfection of P4 mice pups .Results Un-der the same condition ,B -PEI had better transfection efficiency than L -PEI ,but its toxicity was also higher . When generated in PBS ,the polyplexes had lower toxicity than in glucose solution .L -PEI-pDNA nanoparticles could transfect the spiral limbus fibrocytes ,some spiral ganglion neurons and supporting cells ,but the efficiency was low .Conclusion L -PEI could be used as the non -viral vector for the transfection of the cultured basilar mem-brane of P4 mice pups ,but it should be modified to reach higher efficiency .