Objective To quantitatively evaluate the image quality, stability and volume precision in kilovoltage cone beam CT (CBCT) on Varian linear accelerator. Methods The Catphan (R) 600 phantom was repeatedly scanned in the full-fan and half-fan CBCT scanning modes. A simulation fan-beam CT (FBCT) was used as a benchmark and results related to the low contrast resolution, spatial resolution,uniformity and image noise were compared with the CBCT using the treatment planning system. The comparison of image quality and long-term stability and volume precision was analyzed. Results Spatial resolution was no differences observed between FBCT and CBCT ( 6 lp/cm: 6 lp/cm , T = 18. 00 , P＞ 0. 05 ) .Low contrast resolution was, on average, 1. 65％ and 1. 74％ for both CBCTFull-Fan and CBCTHalf-Fan , and 1. 03％ for the FBCT ( T =6. 00, P ＜ 0. 05). Uniformity was, on average, 0. 005 and 0. 033 for both, and 0. 003 for the FBCT ( T=6. 00 , P ＜0. 05). In terms of image noise, the FBCT images were superior to the CBCT (T=30. 00, P＜O. 05). In valid scan range of the CBCT, reconstructed precision was high. There was no significant time trend in the image quality. Conclusions The image quality of kilovoltage CBCT is inferior to the conventional CT. However, tumor and soft tissues are visible in the CBCT images. The image stability and reconstructed precision is satisfying.

Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

Objective To develop a practical image acquisition strategy using intermittent breath?hold cone beam computed tomography (CBCT). Methods A breathing phantom was used to simulate the movement of tumor near the diaphragm during free breathing and breath hold and scanned by conventional breath?hold CBCT and type Ⅰ/Ⅱ intermittent breath?hold CBCT. In the conventional breath?hold CBCT, scan paused and free breathing occurred at the break of breath hold and free breathing was not included in the scan. In the intermittent breath?hold CBCT, one scan covered several breath holds separated by free breathing in a ratio of 3 vs1. Image quality and three?dimensional registration accuracy were quantitatively compared between conventional breath?hold CBCT and type Ⅰ/Ⅱ intermittent breath?hold CBCT. Comparison of image quality parameters between conventional breath?hold CBCT and intermittent breath?hold CBCT was made by paired t test. Results Motion artifacts arose in type I and Ⅱ intermittent breath?hold CBCT scans. There were no significant differences in the reconstructed pixel value or uniformity between intermittent breath?hold CBCT and conventional breath?hold CBCT ( P>0. 05, and P= 0. 02, 0. 53 ) . Compared with conventional breath?hold CBCT images, the signal?to?noise ratios of type I andⅡintermittent breath?hold CBCT images were reduced by 30% and 60%, respectively ( P<0. 05 ) . The registration error was up to 0 . 4 cm in the anterior?posterior direction and less than 0 . 1 cm in other directions . Conclusions The phantom study shows that intermittent breath?hold CBCT does not significantly reduce image quality or registration accuracy compared with conventional breath?hold CBCT. The feasibility of intermittent breath?hold CBCT in clinical application needs to be further validated among a large number of patients.

Objective To explore detection value of vacuum sealing drainage in osteomyelitis of sternum after cardio-thoracic surgery operation.Methods 132 cases of osteomyelitis of sternum after cardio-thoracic surgery operation were randomly divided into two groups(research group and control group).The research group had 72 cases)and the control group had 60 cases.The control group was treated with conventional treatment.The research group was treated with vacuum sealing drainage.The average healing time and clinical therapeutic effect of the two groups were observed.Results The patients'age and the sternum of osteomyelitis was significantly related,with OR=1.153 and P＜0.05.After treatment,the average healing time of the research group was(3.1±0.8)months.The average healing time of the control group was(7.2±1.5)months.The average healing time of the two groups had significant difference(P＜0.05).Conclusion Vacuum sealing drainage in osteomyelitis of sternum after cardio-thoracic surgery operation has sure curative effect.It can change chronic wounds for acute tissue effectively,shorten the healing time.It has high application value in the first phase of treatment and the second phase of repair.

[ABSTRACT]AIM:Toestablishatransgenicheterozygousmousemodelofprecancerouslesionsofcolorectal cancer with p110δmutation in the C57BL/6J background for serving the studies on colorectal cancer research mediated by p110δ.METHODS:The transgenic heterozygous mice were generated by crossing in p110δD910A/D910A mouse and ApcMin/+mouse, and the genotype was detected by PCR .Compared with ApcMin/+mice, transgenic heterozygous mice ( ApcMin/+;p110δD910A/D910A)were counted, and the number and size of intestine polyps were analyzed after methylene blue staining . The intestinal tissue structure was assessed by HE staining .RESULTS:The transgenic heterozygous mouse model of pre-cancerous lesions of colorectal cancer with p 110δmutation was established .The number and size of polyps in the transgenic heterozygous mice were declined .CONCLUSION: A transgenic heterozygous mouse model of precancerous lesions of colorectal cancer with p 110δmutation was successfully established .The initial phenotype of intestinal tumors in transgenic mice was observed .This model will greatly contribute to the related research of colorectal cancer in mice .

Objective To retrospectively review the history and development of radiotherapy quality assurance ( QA) in the Affiliated Cancer Hospital of Fudan University, and to report the primary experience and evolvement of an entire QA workflow management. Methods The multidisciplinary QA team has implemented an entire QA workflow management process in the Radiotherapy Center using the failure modes and effects analysis ( FMEA) and plan?do?check?act ( PDCA) tool since April 2015. Treatment data of approximately 6000 patients before and after implementation were compared. Results The error rate was reduced from 17% to 09% after using the entire QA workflow management. Conclusions Entire QA workflow management effectively improves the accuracy and safety of radiotherapy.

Objective To investigate the change in body weight over time in rectal cancer patients receiving radiotherapy and the correlation between setup errors and weight loss,and to establish the image-guided radiotherapy regimens in different periods of treatment.Methods A total of 24 postoperative patients with rectal cancer admitted to our hospital in 2016 were selected.Before each fraction of radiotherapy,the body weight was recorded,and the patients underwent cone-beam computed tomography (CBCT) with different frequencies in every week.The planning CT was matched with CBCT to obtain setup errors.The paired t test was used for difference analysis;the Pearson method was used to analyze the correlation between setup errors and weight loss.Results Body weight was measured 456 times in the 24 patients,and these patients underwent CBCT scans and image registration 456 times.Two patients were excluded because of treatment discontinuance.In the first and second weeks,there was no significant change in body weight.In the third week,the mean weight loss was 1.53 kg.In the fourth week,the mean weight loss was 2.48 kg.In the fifth week,the mean weight loss was 3.24 kg.The setup errors obtained by CBCT image registration in the superior-inferior (SI),anterior-posterior (AP),and left-right (LR) directions were 0.19 cm,0.20 cm,and 0.18 cm,respectively,in the first week,0.18 cm,0.17 cm,and 0.15 cm,respectively,in the second week,0.20 cm,0.22 cm,and 0.21 cm,respectively,in the third week,0.19 cm,0.25 cm,0.24 cm,respectively,in the fourth week,and 0.34 cm,0.33 cm,and 0.31 cm,respectively,in the fifth week.The Pearson correlation analysis showed that weight loss increased the setup errors,with P values of 0.140,0.046,and 0.044 in the SI,AP,and LR directions,respectively.Conclusions For rectal cancer patients receiving radiotherapy,the body weight decreases significantly in the late period (especially in the fifth week),which influences the setup errors.Therefore,in the fourth and fifth weeks of radiotherapy for rectal cancer,the weight loss should be closely monitored,and the number of CBCT scans can be increased before the treatment fraction to ensure the accuracy and optimization of treatment.

Objective: Through analyzing development statue of integrative coronary heart disease clinical practice guidelines, we aim to provide a reference baseline for the future study. Methods: Databases including CBM, CNKI, WanFang, VIP were searched for published integrative coronary heart disease clinical practices. The website medlive.cn was also used as supplementary. The reporting tool for clinical practice guidelines RIGHT statement was used to evaluate the reporting quality. Results: A total of nine relevant clinical practice guidelines or experts consensuses were included, covering five integrative treatment therapy guidelines of PCI or CABG perioperative period, three myocardial infarction guidelines and one atherosclerosis guideline. Experts consensus methods were adopted in seven guidelines, the remining two guidelines used the evidence-based guidelines development methods. The evaluation of RIGHT statements showed that most guidelines reported complete information in"Basic information"and"Background"domain, however, they usually failed to provide enough description in"Evidence", "Recommendations", "Review and quality assurance", "Funding and declaration and management of interests"and"Other information"parts. Conclusion: Although some achievements have been reached in the development of integrative coronary heart disease clinical practice guidelines, the development methods and quality of reporting still needs further improvements. Researchers should explore more specific Chinese medicine guideline development methods and tools in the future.

Objective To analyze the epidemiological features and trends of glenoid fractures from 2003 through 2012 in the Third Affiliated Hospital to Hebei Medical University.Methods The clinical data were collected of the patients with glenoid fracture who had been treated between January 2003 and December 2012 in our hospital.The patients' gender,age and fracture type of Ideberg classification were documented.The data from January 2003 to December 2007 were assigned into group A and those from January 2008 to December 2012 into group B.The 2 groups were compared to find out the general epidemiological characteristics and trends in the recent 10 years.Results A total of 225 patients with glenoid fracture were collected,including 176 males and 49 females.The total male/female ratio was 3.59∶ 1.The glenoid fractures predominated in an age range of 31 to 40 years (23.56％).According to Ideberg classification,there were 35 cases (15.56％) of type Ⅰ,58 ones (25.78％) of type Ⅱ,64 ones (28.44％) of type Ⅲ,21 ones (9.33％) of type Ⅳ,30 ones(13.33％) of type Ⅴ and 17 ones(7.56％) of type Ⅵ.The male/female ratio was 5.29∶1 in group A of 107 patients and 2.69∶1 in group B of 118 patients.The mean age of group A was 40.2 ± 16.0 years and that of group B 47.5 ± 14.8 years.The differences in male/female ratio,mean age and distribution of age were statistically significant between the 2 groups (P ＜ O.05).The fractures predominated in an age range of 31 to 40 years (28.97％) in group A and in the age group of 51 to 60 years (27.12％) in group B.The most frequent fracture type was type Ⅲ in both groups,accounting for 29.91％ and 27.12％ respectively.There was no significant difference between the 2 groups in distribution of Ideberg classification (P ＞ 0.05).Conclusions The peak age of glenoid fractures was from 31 to 40 years.There was an increasing trend in the mean age.There were more male patients than female ones.The high-frequency type was Ideberg type Ⅲ.

The main clinical features of obsessive-compulsive disorder (OCD) are obsessions and/or compulsions. Due to its symptoms are heterogeneous and have a wide range of influences, OCD usually causes different degrees of damage to patients' social functions. Social cognition is the process of perceiving and judging the psychology and behavior of others or oneself. Its core is to understand the information processing process and the underlying mechanism of social psychological phenomena. Studies have shown that social cognitive deficits can affect an individual's social function. Therefore, many scholars believe that the social cognitive function of OCD patients are impaired. Through collecting and sorting out relevant literature, we find that OCD patients can’t perceive social cues accurately, and they have trouble recognizing their own emotions and those of others. In general, they are not prone to emotional response, that is, their ability of emotional experience is impaired, while because of their own emotional regulation dysfunction, they overreact to special events that can induce the obsession and/or compulsion.The patients have poor insight into the mental states of others.The researches on attributions of life events are dificient, so their characteristics of attribution styles are not yet clear.These findings provide a preliminary theoretical basis and reference for the specificity of social cognitive impairment in patients with OCD and for guiding clinical effective and precise intervention.