Objective To analyze the difference of the peripherally inserted central venous catheter (PICC) and central venous catheter (CVC) in cancer chemotherapy.Methods All eligible studies on PICC and CVC were searched in China National Knowledge Infrastructure,Wanfang database and VIP database.The Jadad scale was used for quality assessment of all the included studies.All analysis were conducted in Stata 12.0.Results Thirty-six studies with a total of 4920 cases of patients were included in this meta-analysis,with 2349 cases in PICC group and 2571 cases in CVC group.PICC group had advantages in puncture success rate for the first time,the average puncture time,the average catheter time than the CVC group.PICC group had fewer complication,such as the hemopneumothorax incidence,the strayed artery incidence and catheter infection incidence; however,the phlebitis incidence was higher than the CVC group.Conclusions PICC has some advantages specific in simple operation,a long retention time,fewer complications and safety.Therefore,PICC can be widely used in cancer chemotherapy.

Objective To retrieve the research or comparison of systematic nursing intervention and routine nursing intervention on breast cancer patients with chemotherapy and cancer related fatigue.Methods We searched from the database of Wanfang Data, China National Knowledge Infrastructure and VIP database.All literature had been taken Jadad scale to evaluate evidence quality, and utilized statistical software Stata and SAS to do meta-analysis for telling the differences of systematic nursing intervention and routine nursing intervention. Results This study involved 14 researches and 1 392 patients, in which were 697 cases of systematic nursing and 695 cases of routine nursing.Systematic nursing intervention was better than routine nursing intervention to cope with fatigue caused by cancer [OR(95%CI) =3.497(2.838-4.310);P<0.01], and presented the same trend at improving quality of life (SMD>0;P<0.05).Conclusions Systematic nursing intervention is worthy to promote in clinic.

Objective To explore the effect of systematic nursing intervention on cancer-related fatigue ( CRF) in advanced non-small cell lung cancer ( NSCLC) patients undergoing chemotherapy .Methods Eighty advanced NSCLC patients undergoing chemotherapy were divided into the intervention group and the control group according to the random number table , each with 40 cases.The control group received the routine nursing according to the doctor ’ s advice for tumor patients , and the intervention group received the systematic CRF nursing intervention on the basis of the control group .The CRF and life quality of patients were evaluated by the Brief Fatigue Inventory ( BFI) and the Functional Assessment of Cancer Treatment-Lung ( V3.0) ( FACT-L) before and 15 d after the intervention between the two groups .Results Eighty questionnaires were issued and 80 questionnaires were responsive with an effective response rate of 100%.No difference was found in the degree of fatigue before the intervention between the two groups (P>0.05).The degree of CRF in the intervention group was significantly lower than that in the control group after the intervention , and the difference was statistically significant (χ2 =8.47, P=0.04).The scores of physiological status , social/family status, relationships with physicians , emotional state , functional status , additional attention and total score of scale were respectively (32.15 ±6.08), (35.31 ±5.33), (12.38 ±2.67), (28.59 ±4.53), (34.34 ±5.86), (43.80 ±7.76), (186.57 ±32.23)in the intervention group, and were (25.45 ±5.42), (28.68 ±4.16), (9.95 ±1.49), (21.87 ±3.95), (26.21 ±5.01), (36.63 ±8.24), (148.79 ±28.27) in the control group, and the differences were statistically significant (t=5.20, 6.20, 5.03, 7.07, 6.67, 4.01, 5.57, respectively; P<0.01).Conclusions The systematic nursing intervention based on routine nursing can alleviate the degree of CRF in advanced NSCLC patients with chemotherapy , and improve the life qualify of patients .

Objective:To study the effects of gantry acceleration limitations of a linear accelerator (linac) on the dosimetry of volumetric modulated arc therapy (VMAT) plans, machine efficiency, and dose verification result of VMAT plans and to explore the optimal selection of gantry motion models in the Pinnacle treatment planning system.Methods:Ten cases of nasopharyngeal carcinoma, non-small cell lung cancer, sigmoid adenocarcinoma with retroperitoneal lymph node metastasis, and invasive ductal carcinoma of the breast were each selected for this study. Then two models were set up in the Pinnacle v9.10 treatment planning system, namely the one allowing gantry acceleration and the one limiting gantry acceleration. The same field arrangement, optimized target parameters, and optimized weights of VMAT plans were adopted in the two models, in order to analyze the dosimetric variations in targets and organs at risk (OARs) and compare the differences in treatment time and gamma passing rates.Results:The treatment time of the enrolled patients under the model allowing gantry acceleration was significantly lower than that of the patients under the model limiting gantry acceleration was adopted ( t=-6.751, -0.209, -19.523, -28.999; P< 0.05) and decreased by 15.27%, 18.07%, 19.71%, and 28.75%, respectively. Meanwhile, the conformity and uniformity of target areas were affected, while there was no statistical significance in the gamma passing rates in the validation of VMAT plans ( P>0.05). For the cases of nasopharyngeal carcinoma (NPC), the maximum dose to brainstem PRV increased by 1.25%. For the cases of lung cancer, the maximum dose to the spinal cord and lung V20 increased by 1.19% and 1.21%, respectively, while lung V5 decreased by 1.21%. For the cases of sigmoid adenocarcinoma with retroperitoneal lymph node metastasis, the mean doses to bilateral kidneys, livers, small intestine, and colon all increased. For the cases of breast cancer, lung V10 on the opposite side of cancer increased by 1.66% and the mean dose to the lungs on the same side of cancer decreased by 7.45%. Conclusions:The model allowing gantry acceleration allows the treatment time to be significantly shortened and the treatment efficiency improved. Although this model had the shortcomings such as affecting the conformity and uniformity of target areas to a certain extent and increasing the doses to some OARs, clinical requirements for dosimetry were still met. Therefore, it is recommended to use the model allowing gantry acceleration in the Pinnacle planning system.

Objective:To explore the radiological damage to cells induced by the delayed particles of 9C-ions for heavy ion therapy, as well as the microdosimetric distribution and biological effects of these particles on a single model of V79 Chinese hamster lung cells. Methods:The Monte Carlo program was employed to simulate the endonuclear absorbed doses of α particles with various energies (3-10 MeV) transported in cells (cell radius RC = 10 μm, nucleus radius RN = 5 μm). Then, the result were compared with the S values ( SN←N, SN←Cy, and SN←CS) derived using the medical internal radiation dose (MIRD) method to demonstrate the feasibility of Monte Carlo simulations. Finally, the energy deposition of the delayed particles of 9C-ions generated at three sites (i.e., on the surface and in the cytoplasm and nucleus of the V79 cell model) during their transport in targets was simulated, and the result ing cell surviving fraction was analyzed. Results:Monte Carlo and MIRD method yielded differences in S values of 1.91%-4.95% for SN←N (nucleus to nucleus), 1.48%-5.11% for SN←Cy (cytoplasm to nucleus), and -1.99% to 0.80% for SN←CS(surface to nucleus), indicating highly consistent S values derived using both method(differences < 6%). When a 9C-ion decayed on the surface of the V79 cell model and the produced secondary particles entered the cell, the average endonuclear absorbed dose was 10 -2 Gy orders of magnitude, with a cell surviving fraction of about 88%. In the case where decay occurred in the cytoplasm, the cell surviving fraction was about 80%. However, when the 9C ion decayed in the nucleus, α particles had short ranges and deposited most of their energy in the cell (mean endonuclear absorbed dose: 0.1 Gy). In this case, severe cell damage was induced, with the cell surviving fraction reducing to about 53%. Conclusions:9C-ions emit secondary charged particles due to decay, among which α particles cause great damage to cells when entering the nucleus and trigger evident biological effects.