With the rapid development of intensity modulated radiation therapy (IMRT) technique,the accuracy of radiotherapy has improved,while the pretreatment dose verification has become more complex.Although the experimental measurements,a widely used way to perform dose verification,is accurate and effective,its time-consuming and labor-intensive is still a challenge for physicist.The independent dose verification method such as the depth dose-off axis ratios (OAR) empirical model,Clarkson integral model,convolution model and Monte Carlo model,could partially solve these problems effectively when the accuracy is ensured within a certain range.This approach could save physicists' time to conduct dose recalculation and plan check,and has become the hotspot in the world.This paper,therefore,mainly introduces the correction-based and the model-based independent dose verification methods,and briefly discusses the development of dose verification for IMRT plans.

Objective To investigate the pharmacodynamics characteristics of continuously infused cisatracurium besylate during total intravenous anesthesia. Methods Sixty ASA Ⅰ - Ⅱ patients undergoing elective oromaxillo-facial region surgeon were randomly divided into 4 groups. 1.0, 2.0, 3.0 μg/ (kg · min ) of cisatracurium besylate was continuously infused differently in group Ⅰ, group Ⅱ and group Ⅲ, and 0.1 mg/kg of cisatracurinm besylate was injured interruptedly into group Ⅳ after anesthesia induction. Neuromuscular function was assessed using an accelerometer with train-of-four (TOF) stimulation, the maximum depression of T1and times to T1 recovered to 25%(the clinic time), 75%, 90%(the vivo time) were noted. The recovery index (time of T1 recovery from 25% to 75%) was also calculated. Results The drug consumptions of cisatracurium besylate in group Ⅰ and group Ⅱ were diminished than those in group Ⅲ and group Ⅳ [(59.1±9.6),(116.7±11.5)μg/kg vs (174.9±23.1), (177.2±20.4) μg/kg](P<0.01), and group Ⅲ and group Ⅳ were nearly (P>0.05 ). The maximum depression of T1, the clinic time and the vivo time in group Ⅰ, Ⅱ,Ⅲ were smaller than those in group Ⅳ [ ( 18.5±3.6)%, (6.4±2.7)%, 0 vs (25.0±0.0)% ] (P < 0.01 ), but there were. No significant differences in recovery index in 4 groups. The maximum depression was diminished (P< 0.01 ) and the clinic time and the vivo time were prolonged (P<0.05) with the inerease of the dosage of cisatracurium besylate in group Ⅰ, Ⅱ, Ⅲ. Conclusions With no cumulative effect, the duration of recovery of muscle relaxation is shortened and the recovery index of continuously infused eisatracurium besylate is prolonged. It indicates that the cisatracurium besylate is suitable for the continuously infusion for surgeon patients.

[Objective]To investigate the cause precautionary measures and treatment countermeasure of impingement syndrome of the anterior ankle.[Method]From june 2000 to December 2004,18 cases of acute raumatic extravasated blood of the ankle without fracture and disbocating,20 cases of pain in front side and front inboard and front outside with dorsiflexion ache and dysfunction,all the cases were examined and treated under the arthroscope.The effect was analyzed.[Result]Follow-up lasted 6~52 months(mean 28 months).In all the 38 cases there were"excellent"outcomes in 17 cases"good"in 19 cases,"fair" in 0 case,and"poor" in 0 case in the acute traumatic extravasated blood of the ankle group.Impringement syndrome of the anterior ankle group:"excellent" in 15 cases"good" in 3 cases"fair"in 2 cases"poor"in 0 case.[Conclusion]Arthrotrauma and degranding are two reasons of the impingement syndrome of the anterior ankle,the initial stage arthroscope examination and treatment of the acute traumatic extravasated blood of the ankle without fracture and disbocating is the best active method to prevent the impingement syndrome of the anterior anlke,the clearing operation under the arthroscope is the best mininmally invasive treatment countermeasure for the impingement syndrome of the anterior ankle.

Objective To study the effect of mild hypothermia on aquaporin 4 (AQP4) expressions and cerebral edema after intracerebral hemorrhage and the mechanisms of mild hypothermia on hemorrhagic brain edema. Methods The model of intracerebral hemorrhage (ICH) was established by infusing collagenase into right globus pallidus of the rat. The temperature was regulated by ice cubes and daylight lamp, which was modulated to an appropriate distance to the animals. Immunohistochemistry staining was used to detect the cerebral AQP4 expressions. Dynamic change of brain edema was observed through wet-dry weighing method. Results The brain water content (BWC) of injured side and level of AQP4 expression in perihematom tissue in ICH rats were obviously higher than those of the sham group (all P

Objective To evaluate the value of multi-slice spiral CT (MSCT) angiography in diagnosis of thoracic vascularemergency.Methods 25 cases suspected of thoracic vascular emergency were examined with MSCT. Two dimensional and three dimensionalimaging methods were used. Results Central pulmonary embolism 10 cases, aortic dissection 12 cases,aneurysm 2 cases and takayasuarteritis with stricture of kidney artery were found by two dimensional imaging(MPVR,CPR),and the extent, size and details of lesions couldbe showed well. The space relationship and calcifation of aorta were displayed in three dimensional imaging(SSD,VR,MIP). Therelationship between intraluminal embolism and the wall of pulmonary artery, as well as intimal flap and reentry of dissection could bevealuated by CTVE.Conclusion Associated with imaging post processing,MSCT angiography is an effective method in diagnosis of thoracic vascular emergency.

Independent check is one of the key measures of quality control (QC) in radiotherapy and is essential for the assurance of radiotherapy accuracy.In recent years,with the application of computer-aided system,the automaticity of independent check,as well as its accuracy and efficiency,increases.Meanwhile,QC has evolved from a device-centered to a process-centered program.Therefore,independent check has been increasingly systematic and specific.This review gives a brief summary of the implementation and development of independent check.

In vivo dosimetry (IVD) is currently the most direct and effective means of quality assurance.The electronic portal imaging device (EPID) has been widely used for IVD verification owing to its favorable dosimetric properties.In recent years,an increasing number of EPID-based IVD studies have emerged around the world.The purpose of this paper is to give an overview of the present progress in EPID-based IVD studies,and to provide a reference for the subsequent application of EPID in IVD.

Objective To evaluate the effect of local arterial infusion (LAI) of medicine on the treatment of servere acute pancreatitis(SAP). Methods The clinical data of 85 cases of SAP were retrospectively analyzed, and divided into three groups according to the admitted time:Group A. 42 cases admitted from February 1982 to December 1993,treated mainly by operation. Group B. 23 cases, admitted January 1994 to Auguest 1996, treated mainly by non operation. Group C. 20 cases, from September 1996 to Auguest 2000. treated mainly by LAI. Results The secondary infection rate in group A, B and C were 47%(20/42),26%(6/23) and 10%(2/20) respectively. The mortality in group A ,B and C were 36%(15/42),22%(5/23) and 5%(1/20),respectively. The difference in the secondary infection rate and mortality between group A , B and group C showed obvious significance (P

Objective To study the correlation between high resolution computed tomography manifestations and expression of transforming growth factor beta,tumor necrosis factor alpha in radiationinduced lung injury of rats,and to investigate the vslues of cytokine detection and HRCT scanning for the prediction and early diagnosis of radiation-induced lung injury.Methods Forty-eight Sprague-Dawley (SD)rats were randomly divided into eight groups,group A was normal control group.and group BH were irradiated with a single dose of 15 Gy to the lungs.HRCT scanning Wag performed before and 1 week,2,4,8,12,16,24 weeks after radiation in group A-H respectively.The expression of TGF-beta and TNF-alpha were detected with ELISA. All the rats were killed to observe pathological changes of their lungs.HRCT signs,levels of cytokine were simultaneously compared and analyzed.The t-test and Spenrman rank correlation were used for the statistics.Results Four HRCT signs were observed during the 24 weeks after radiation,including ground-glass opacity(1 case),patchy consolidation(8 cases),massive consolidation(7 cases)and fibrosis(3 cases).The average levels of TGF-beta in group B-H[(3.33±0.47),(3.20±0.65),(3.12±0.45),(3.54±0.80),(3.30±1.13),(2.49±0.67),(4.19±0.22)μg/L,respectively]were hisher than the control group[(0.45±0.14)μg/L.P＜0.05].At 24 weeks the average level increased to the highest peak[(4.19 4-0.22)μg/L,P＜0.05].At 1 week and 2,4,8,12 weeks after radiation,the average level of TNF-alpha in radiation group[(236.52±29.01),(214.91±34.53),(270.97±42.12),(208.83±86.51),(208.83±82.23)ng/L]was hisher than the control group[(31.78±0.92)ng/L,P＜0.05].The average level increased to the highest peak [(270.97±42.12)ng/L,P＜0.05]at 4 weeks.The average level at 16 and 24 weeks[(60.63±38.49),(32.07±1.05)ng/L]dropped to the level similar to the control group(P＞0.05).There were no rank correlations between HRCT manifestations and expression of TGF-beta and TNF-alpha(rs=0.5570 and 0.1013.P＞0.05).HRCT signs were correlated with pathological changes.Conciusions The monitoring of TGF-beta and TNF.alpha in the serum after irradiation can predict the development of radiation-induced lung injury.There are no rank correlations between HRCT manifestations and expression of TGF-beta and TNF-alpha.

BACKGROUND: The survival rate of articular chondrocytes is low after traditional cryopreservation,and great differences existed in chondrocytes from surface layer and deep layer,which easily result in graft degeneration and lead to surgery failure.OBJECTIVE: To establish rabbit allograft models of graded frozen articular cartilages with holes made before cryopreservation and to observe the effect of holed cryopreservation on the rabbit articular cartilages.METHODS: Osteochondral plugs taken aseptically from 2 months old rabbits were randomly divided into 3 groups: the experimental group,making holes(3 mm× 3 mm)in articular cartilages and graded freezing; non-hole graded freezing group,non-making holes and graded freezing; cryopreservation group: non-making holes and rapid freezing.The grafts were thawed and transplanted into the relevant articular cartilage defects of recipient rabbits.The grafts differences were observed by gross observation,histochemistry and immunohistochemistry staining.RESULTS AND CONCLUSION: The gross observation,histochemistry and immunohistochemistry staining of the experimental group were superior to the cryopreservation group.Though there were no significant differences between the non-hole graded freezing group and the experimental group,however,the experimental group enhanced the protective effect on cartilage tissue in the middle layer.The graded cryopreservation of articular cartilage gets an advantage over rapid cryopreservation.And the articular cartilage with holes could be preserved successfully in graded cryopreservation,which assures the survival and function of chondrocytes and slows down degrading process of the articular cartilage tissue after thawed and transplanted.