Objective This study analyzes the effect of the shrinkage of thermoplastic mask on patient positioning. Methods Design of the two test. Test 1:thermoplastic film shrinkage test. Get some thermoplastic film by the size of 10 cm×5 cm, extrude it at a certain rate after heated. Measure the length of thermoplastic film on different time, and calculate the contraction. Test 2:phantom test. Take advantage of head and neck phantom, and simulate the procedure that from making mask for patients to radiation therapy. Measure the off set of isocenter which caused by the contraction of thermoplastic mask. Results The largest shrinkage of thermoplastic had happened in 20 minutes. Different tensile ratio had little effect on the shrinkage. The offset of isocenter which caused by the shrinkage of thermoplastic mask were:LR ( -0?? 1± 0?? 3) mm,SI (-0?? 2±0?? 2) mm, AP (0.6±0?? 4) mm,respectively. There was little change in the course of six weeks ( P= 0.185?0?? 961). Conclusions The cooling time should be more than 20 minutes, when making a mask for the patient. The setup errors which caused by the shrinkage of thermoplastic mask is at an acceptable level on this premise.

Objective To summarize MSCT manifestations of normal small bowel with oral water and colon water enema double-filling. Methods Small bowel parameters of 44 healthy volunteers were measured with oral water and colon water enema double-filling. The parameters included bowel wall thickness, diameter of filling bowel, bowel wall delamination, bowel wall CT attenuation, the number of the plica, the attenuation of mesenteric fat, mesenteric vessels, the appearance rate of lymph node in mesentery, retroperitoneum, and so on. Results The average bowel thickness was (1.72±0.20) mm; the average diameter of filling bowel was (21.24±3.05) mm; the average CT attenuation of plain scan, artery phase and portal phase was (28.13±0.38) HU, (55.42±0.88) HU and (67.86±0.94) HU. Jejunum plica of normal small intestine was 2.29/cm; the number of the mesenteric artery bowel was 2.59/cm; the average attenuation of mesenteric fat was-98.57 HU; the single layer of bowel changed mostly. Conclusion Proper knowledge of normal manifestations of small bowel on MSCT is helpful for the diagnosis of small bowel diseases.

Cold-heat problem is one core of traditional Chinese medicine theory. This paper summarizes the experimental research related to the biological basis of cold-heat essence in cold-heat syndrome, cold-heat body constitution and cold-heat property of Chinese herbs. In view of the classical physiological and biochemical indices, gene expression, protein expression and metabolic differences, differences in cold-heat syndrome or cold-heat constitution are mainly based on neurotransmitter, thyroid function, sex hormone, cyclic nucleotide system, and energy metabolism relating to the corresponding gene and protein expression. Furthermore, this paper analyses the change of correlation indices that accompany with a dynamic development process of "constitution-syndrome-herbal intervention", implying that the research of biological basis of cold-heat essence has turned from single index to multiple indices, and from dispersion research to system research.

Objective To evaluate the accuracy of ultrasonography and magnetic resonance imaging detection on preoperatively predicting axillary lymph node in breast cancer patients.Methods From August 2010 to February 2011,the clinical data of 293 breast cancer patients underwent preoperative breast ultrasound exam and MRI detection in Ruijin Hospital were analyzed retrospectively.Results In 293 breast cancer patients,3 suffered from bilateral breast cancer.The sensitivity,specificity,negative predictive value and positive predictive value of ultrasound were 60.0％,90.6％,78.0％ and 80.2％,respectively.The sensitivity,specificity,negative predictive value and positive predictive value of MRI test were 50.5％,90.8％,74.0％ and 77.9％,respectively.There was no significant difference between ultrasound and MRI test in these four indices (P ＞ 0.05).No significant difference on accuracy and predictive value was seen in subgroup analysis according to tumor size,tumor grade,hormone receptor and HER2 status between the two examinations.The sensitivity and specificity of ultrasound associated with MRI test were 70.6％ and 97.2％.Conclusions The accuracy and predictive value between preoperative ultrasound exam and MRI is comparable.Ultrasound associated with MRI examination can achieve high specificity,which may spare a portion of patients free from sentinel lymph nodes biopsy.

ObjectiveBoth kilovolt (KV) cone-beam computed tomography (CBCT) and KV radiography can determine set-up errors for patients with head-and-neck cancer.This study is to compare their performance.Methods16 patients with head and neck cancer were enrolled in this study.There were 160 sets of CBCT and corresponding orthogonal radiography images.Through registration of CBCT images with the planning CT images,and registration of radiography images with the digitally reconstructed radiographs,translational set-up errors were determined along left-right (x),super-inferior (y),and anterior-posterior (z) directions.Pearson correlation analysis was performed to evaluate the correlation of the set up errors determined by the two methods,and Bland-Altman plot analysis was used to assess the coincidence of these two methods.ResultsThe Pearson coefficient of correlation along all three directions was less than 0.01,and R2 was 0.95,0.84,0.81 on x,y,z,respectively.That means high correlation for two methods.The Bland-Altman plot analysis showed that the 95％ agreement limits of agreement were within preset 2 mm tolerance (x[ 1.3mm,- 1.2mm],y[ 1.6mm,- 1.1mm],z[0.8mm,-1.4 mm] ),which indicates an agreement exists for two methods.ConclusionsFor determination of set-up errors for patients with head and neck cancer,KV radiography is equivalent to CBCT.Considering CBCT delivers higher dose than KV radiography,but provides more soft tissue information.We suggest to use these two methods combinative in clinic.

Objective To assess the diagnostic value of CT spectral imaging using quantitative iodine-based material decomposition images in the evaluation of pulmonary embolism. Methods Fifty-three patients underwent CT angiography with spectral imaging mode on a GE Discovery CT750HD scanner. Iodine distribution in the lung parenchyma using the iodine-based material decomposition images was quantitatively measured by post-processing. Monochromatic CT angiographic images were reconstructed from the same data sets and thee images were reviewed for the identification and localization of pulmonary embolism as well as the degree ( partial or complete) of the embolic occlusion. The number and location of perfusion defects were recorded. The iodine content of perfusion defects and normal lung parenchyma on the iodine maps were measured by one reader using an ROI analysis. Comparative analyses were obtained using the Chi-square test for categorical data. Two independent samples rank test and 2 related samples signed-rank test were used to compare iodine densities between different groups. Results CT angiography showed no pulmonary embolism in 33 patients, and iodine distribution was homogeneous. A total of 93 clots with lobar ( n = 26), segmental (n = 54) and sub-segmental (n=13) distribution were detected in 19 patients; Fifty-one clots were occlusive and 42 clots were non-occlusive. The iodine-based material decomposition images of all occlusive clots showed lobar, segmental or sub-segmental iodine distribution defects; whereas eleven of 42 non-occlusive clots had evidence of iodine distribution defects. There was significant difference ( x2 = 39. 94,P＜0. 01 ) in the perfusion defects between occlusive and non-occlusive clots. There was a significant difference in iodine content between normal lung parenchyma [ (1.92 ±0. 54) g/L] and perfusion defects [ (0. 30 ± 0. 20)g/L] (Z= -5.63, P ＜ 0. 01 ). There was a significant difference in the iodine content of peffusion defects before [ (0. 26 ± 0. 23 )g/L] and after anticoagulation [ (0. 94 ± 0. 50 )g/L ] ( Z = -3.93,P ＜ 0. 01 ). Conclusion With the ability of iodine mapping, CT spectral imaging is areliable method in the evaluation of pulmonary embolism both qualitatively and quantitatively, and may be a useful tool in providing information regarding the severity of PE and monitoring therapeutic efficacy.

Objective To study image-guided hypofractionated radiotherapy for thoracic and abdominal tumors,and to determine the margins extended from internal target volume(ITV) to planning target volume(PTV). Methods Twenty-four patients who received image-guided hypofractionated radiotherapy for thoracic and abdominal tumors were included in this study. X-ray cone beam CT was regularly performed before the treatment. The shift and Rotation in right-left ( R-L), superior-inferior(S-I) and anterior-posterior (A-P) directions were recorded and analyzed. The shift margin from ITV to PTV was calculated with the equation,margin =2'mean+0.7'standard deviation. Results Before online correction,the shift errors in R-L,S-I and A-P directions were [2.1±2.0] mm, [3.9±3.2] mm and [2.9±2.8] mm,and the corresponding margins were 5.6 mm, 10.2 mm and 7.7 mm. After the correction the shift errors were [0.8±0.7] mm, [0.9±0.7] mm and [0.9±0.7] mm, and the margins were 2.1 mm,2.3 mm and 2.3 mm. The set-up error was markedly decreased after the correction. There was no change in rotation after the correction. Conclusions The positioning error decreases after the correction in IGRT,and the precision of radiotherapy is improved. Measuring set-up error in radiotherapy can provide institution-specific margins for PTV designing.

Objective To evaluate the effect of low-dose colonic CT scanning in image quality and lesion revealing with different noise idex.Methods Model group:in order to find the optimal scanning parameter range,small simulated polyps in pig colon was prepared and mA was modulated by regulating noise index.Images were reprocessed with CT colonography and Raysum reconstructions.Image quality and the lesion revealing situation were evaluated and scored based on both reconstructive and axial images.The study of patient group was prospective and continuous.All positive cases were comfirmed by biopsy or surgery pathology.Two groups of patients were enrolled.First group(39 cases from January 2007 to June 2007):patients were divided into three sub-groups randomly(15 cages with NI=10,13 cases with NI:13,11 cases with NI=16),while NI was not changed with position.Second group(32 cases from Jury 2007 to January 2008):patients were scanned and NI was changed with different position(NI=10,20).The average X-ray radiation values of two patient groups were compared with standard values.All data were processed with rank sum tesL Results First group:when NI=10,the average scores of axial and constructive images were 4.2 and 2.4 respectively,when NI=13,those were 3.2 and 2.5 respectively,When NI=16.those were 2.9 and 2.7 respectively.and the average CTDlw were 17.51,12.90 and 5.94 mGy respectively.When NI increased,the average scores of axial decreased(H=20.01,P＜0.01),the average scores of constructive images did not changed(H=0.81,P＞0.05).Second group:when NI=10,the average scores of axial and constructive images were respectively 3.6 and 2.3,when NI=20,those were 2.2 and 2.3 respectively,and the average CTDIw was 11.63 mGy.When NI increased from 10 to 20,the average scores of axial decreased(H=20.84,P＜0.01),the average scores of constructive images did not decreased(H=0.29,P＞0.05).In the first group,the average CTDIw wag reduced by 35.0%,52.1%and 77.9%respectively when NI was 10,13 and 16.In the second group,the average CTDIw Was reduced by 56.8%.Conclusions Auto-mA low-dose CT scanning could reduce X-ray radiation obviously,while not affecting image quality.

Objectives To investigate the clinical significance of dual energy spectral CT (DESCT) in quantitatively differentiating peripheral lung cancers from pulmonary inflammatory masses.Methods Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT to get arterial phase (AP) images and venous phase (VP) images.Iodine concentrations in the central and peripheral zone of the masses were measured and normalized to the aorta as normalised iodine concentration (NIC).The difference of NIC between central and peripheral zone of the masses (dNIC) was calculated.The spectral attenuation curve was obtained automatically and the slope of curve (λHU) was also calculated in the two groups.The quantitative parameters was presented as M (Q1,Q3),and Wilcoxon signed rank test was used to compare above two independent samples.Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity.Results NICs in the central zone of peripheral lung cancers were significantly lower than that of inflammatory masses:mean NICs were 0.03 (0,0.05) versus 0.12 (0.07,0.20) in AP,and 0.14 (0.12,0.19) versus 0.30 (0.21,0.57) in VP (Z=-4.14,-3.70,respectively,P＜0.01).While the dNIC values of lung cancers were significantly higher than that of inflammatory masses:dNIC values were 0.08 (0.05,0.11) versus 0.04 (-0.02,0.08) in AP,and 0.23 (0.17,0.34)versus 0.07 (-0.04,0.08) in VP(Z=-2.56,-4.00,respectively,P＜0.05).Mean λHU values of lung cancers were also lower than inflammatory masses:1.03 (0.67,1.67)versus 2.75 (1.61,3.19) in AP,and 1.58 (1.30,2.17) versus 3.25 (2.37,4.54) in VP (Z=-3.90,-4.42 respectively,P＜0.01).According to ROC curves,cutoff value of λHU =2.11 in VP had the highest sensitivity (89％) and specificity (91％) in differentiating peripheral lung cancers from inflammatory masses.Conclusions Contrast-enhanced dual energy spectral CT imaging with some quantitative parameters such as normalised iodine concentration,dNIC,and the slope of spectral attenuation curves may be a promising new method for differentiating peripheral lung cancers from inflammatory masses.

ObjectiveTo evaluate the app li cation value of the Dipstick Dye Immuno assay (DDIA) for screening chemotherapy targets of schistosomiasis in a lower endemic area. Methods[ WT5”BZ]In a lower endemic area of schistosomiasis a random sample of 463 individuals from a natural village were examined using miracidium hatching metho d, Kato Katz's method, DDIA, DGS COPT and ELISA. The positive rates of these a ss ays were compared. ResultsThe positive rate of stool examination was 3.9% in 463 individuals. The positive rate of DDIA was 15 8%. The positive rate in 18 stool positive subjects was 94 4% with Youden In dex 0 81. The positive rate of DGS COPT was 8 9% . The positive rate in 18 stool po sitive subjects was 72 2% with Youden Index 0 66. The positive rate of ELISA w as 18 4%. The positive rate in 18 stool positive subjects was 83 3% with Youden In dex 0 68. ConclusionDDIA was more suitable for application in screening target population in lower endemic areas than other im munoassys.