Objective To investigate the effect of antimicrobial-impregnated incise drape on preventing surgical site in-fection(SSI)following neurosurgical operation.Methods Patients undergoing neurosurgical operation from January to De-cember 2012 were divided into two groups:antimicrobial-impregnated incise drape group(group A)and general incise drape group(group B).The occurrence of SSI and risk factors for SSI were analyzed.Results Percentage of drape lifting at the wound edge in group A was lower than group B(38.3%[98/256]vs 96.88% [248/256],χ2 =200.57,P <0.01).Among 512 patients,SSI rate was 3.32%(n=17),SSI rate in group A was lower than group B(1.56%[4/256]vs 5.08%[13/256],χ2 = 7.93,P <0.05 ).Multivariate analysis revealed that body mass index ≥24,perioperative hypothermia,smok-ing,perioperative length of hospital stay ≥5 days,and lack of drape use were independent risk factors for SSI following neurosurgical operation.Conclusion Whether antimicrobial-impregnated incise drape is used in neurosurgical operation is one of the independent risk factors for SSI following neurosurgical operation,it can effectively reduce the drape lifting rate and incidence of SSI,and is recommended to be used in neurosurgical operation.

Objective To summarize the experience on clinical diagnosis and treatment for cervical neurilemmoma. Methods The clinical data of 77 cases of cervical neurilemmoma from 1976 to 2005 were retrospectively analyzed. Results The diagnosis was dependent on the anamnesis, clinical presentations, ultrasonography, CT and cytology of fine needle aspiration. Correct preoperative diagnosis was abtained in 51 cases (66. 2% ) , and the misdiagnosis rate was 33. 8% (26/77). All patients underwent surgical resection. The postoperative diagnosis was benign neurilemmoma by pathological examinations. The postoperative complications included recurrent laryngeal nerve injuries (6 cases) , Horner syndrome (4 cases) , tongue deviation (3 cases), neck pain or numbness (2 cases) and reffered pain in limb (1 case). Sixteen patients were followed up, and these symptomes disappeared after 3-11 months. Nerve dysfunction remained in 2 out of 3 patients in whom the vagus was wrongly amputated during the operation. Intraoperative inadvertent sympathetic nerve amputation caused permanent nerve dysfunction. Conclusion B-mode ultrasonography, CT and fine needle aspiration cytology are useful for the diagnosis of cervical neurilemmoma. Surgical resection is most effective among all available therapies.

OBJECTIVEThe automatic generation of planning targets and auxiliary contours have achieved in Eclipse TPS 11.0.

METHODSThe scripting language autohotkey was used to develop a software for automatically generated contours in Eclipse TPS. This software is named Contour Auto Margin (CAM), which is composed of operational functions of contours, script generated visualization and script file operations. RESULTS Ten cases in different cancers have separately selected, in Eclipse TPS 11.0 scripts generated by the software could not only automatically generate contours but also do contour post-processing. For different cancers, there was no difference between automatically generated contours and manually created contours.

CONCLUSIONThe CAM is a user-friendly and powerful software, and can automatically generated contours fast in Eclipse TPS 11.0. With the help of CAM, it greatly save plan preparation time and improve working efficiency of radiation therapy physicists.

BACKGROUND:At present, a heparin-coated extracorporeal circulation pipe is used widely, but the price is expensive and limits its wide application.
OBJECTIVE:To screen the optimal coating condition of oxidated sodium alginate as a coating material to coat the medical polyvinyl chloride pipe and to evaluate the anticoagulant properties and the stability of the coated pipe.
METHODS:Oxidized sodium alginate was prepared with sodium periodate, and the mole ratio of sodium periodate and sodium alginate was 1:8, 1:10 and 1:12, respectively. Oxidized sodium alginate with different
degree of oxidation was coated on the surface of medical polyvinyl chloride pipes by chemical methods, then to select the best degree of oxidation. The optimal coating condition was screened through an orthogonal
experiment based on concentrations of sulfuric acid, polyethyleneimine and oxidized sodium alginate, and pH
value and temperature of oxidized sodium alginate. Additional y, the anticoagulant properties and expulsion rates of the prepared pipes were evaluated in comparison with the blank control group and heparin-coated group.
RESULTS AND CONCLUSION:The optimal oxidation degree for oxidized sodium alginate was 1:10 for the mole ratio of sodium periodate and sodium alginate. The best coating conditions were 50%concentrated sulfuric acid, 0.05%polyethyleneimine, 40 ℃ of reaction temperature, 2 g/L oxidized sodium alginate, and pH value=3.5. The oxidized sodium alginate coating group had a similar trend compared with heparin-coated group in the expulsion rate. The anticoagulant properties of oxidized sodium alginate coating group were little weaker than those of
heparin-coated group (P<0.05), but significantly better than those of the blank control group. The oxidized sodium alginate-coated extracorporeal circulation pipe has a good anticoagulant property and stability.

Objective To investigate the activation, distribution, origin, and expression of hepatic stem cells(HSC)in different histological types of primary liver carcinomas. Methods The histological and immunohistochemical features of 94 cases of hepatocellular carcinoma (HCC), 12 cases of intrahepatic cholangiocarcinoma (ICC) and 10 cases of mixed hepatocarcinoma were examined by HE staining and immunohistochemistry SP method, with 5 cases of sclerotic liver and 4 cases of normal liver tissues as control. Results HSC expression was observed and the transfor mation from HSC to carcinoma cell was also noted in the liver. CK7, CK19, c-kit, Thy-1, and AFP were found expressed in different types of hepatic carcinomas and the greatest intensive expression was found in the mixed hepatocarcinoma (P

Telemedicine technology is a means of deploying medical resources with low cost and high efficiency. A set of remote radiotherapy system based on Citrix was designed in this paper, so that the senior radiation therapists from the developed areas can provide medical services effectively for the patients in the rural areas. This paper focused on the design ideas and the detail of the technical implementation of how to design a remote radiotherapy system based on the existing equipment in the primary hospital. And the technical reliability and security of the remote radiotherapy system were verified by the scientific test method with pairwise comparison. The early practical experience shows that through the remote radiotherapy system the primary radiotherapy personnel and the radiotherapy experts from thirdgrade class-A hospital can form effective alliance in radiotherapy techniques to allow patients in rural areas to receive more professional radiation therapy.
Humans ; Information Systems ; Radiotherapy ; Reproducibility of Results ; Telemedicine

Objective:To study the genetic profile of neonatal hyperbilirubinemia with unknown etiology in Guangdong Province and the clinical significance of jaundice-related genetic screening.Methods:From July to September, 2021, neonates with hyperbilirubinemia of unknown etiology born in different hospitals in Guangdong Province were studied. 24 neonatal jaundice-related exons were sequenced using targeted capture and high-throughput sequencing technology. The pathogenic variants were analyzed.Results:A total of 331 cases, 139 (42.0%) cases showed positive screening results with five diseases, including 65 (19.6%) cases of Gilbert syndrome, 48 (14.5%) cases of glucose-6-phosphate dehydrogenase (G6PD) deficiency,18 (5.4%) cases of sodium taurocholate cotransporting polypeptide deficiency, 4 (1.2%) cases of Citrin deficiency and 4 (1.2%) cases of Dubin-Johnson syndrome. 149 (45.0%) cases carried one or more genetic variants and 43 (13.0%) cases showed no clinically significant variants. The 8 high-frequency mutation loci (carrier rate >1%) are UGT1A1 gene c.211G>A and c.1091C>T, G6PD gene c.1466G>T and c.1478G>A, SLC10A1 gene c.800C>T, SLC25A13 gene c.852_855del TATG, HBB gene c.126_129delCTTT and c.316-197C>T.Conclusions:Genetic factors are important for neonatal hyperbilirubinemia with unknown etiology in Guangdong. The common pathogenic genes are UGT1A1, G6PD, SLC10A1, and SLC25A13 and the population carries high-frequency mutation loci. Therefore, genetic screening in neonates with hyperbilirubinemia of unknown etiology has important clinical significance.

To investigate the γ pass rate limit of plan verification equipment for volumetric modulated arc therapy (VMAT) plan verification and its sensitivity on the opening and closing errors of multi-leaf collimator (MLC), 50 cases of nasopharyngeal carcinoma VMAT plan with clockwise and counterclockwise full arcs were randomly selected. Eight kinds of MLC opening and closing errors were introduced in 10 cases of them, and 80 plans with errors were generated. Firstly, the plan verification was conducted in the form of field-by-field measurement and true composite measurement. The γ analysis with the criteria of 3% dose difference, distance to agreement of 2 mm, 10% dose threshold, and absolute dose global normalized conditions were performed for these fields. Then gradient analysis was used to investigate the sensitivity of field-by-field measurement and true composite measurement on MLC opening and closing errors, and the receiver operating characteristic curve (ROC) was used to investigate the optimal threshold of γ pass rate for identifying errors. Tolerance limits and action limits for γ pass rates were calculated using statistical process control (SPC) method for another 40 cases. The error identification ability using the tolerance limit calculated by SPC method and the universal tolerance limit (95%) were compared with using the optimal threshold of ROC. The results show that for the true composite measurement, the clockwise arc and the counterclockwise arc, the descent gradients of the γ passing rate with per millimeter MLC opening error are 10.61%, 7.62% and 6.66%, respectively, and the descent gradients with per millimeter MLC closing error are 9.75%, 7.36% and 6.37%, respectively. The optimal thresholds obtained by the ROC method are 99.35%, 97.95% and 98.25%, respectively, and the tolerance limits obtained by the SPC method are 98.98%, 97.74% and 98.62%, respectively. The tolerance limit calculated by SPC method is close to the optimal threshold of ROC, both of which could identify all errors of ±2 mm, while the universal tolerance limit can only partially identify them, indicating that the universal tolerance limit is not sensitive on some large errors. Therefore, considering the factors such as ease of use and accuracy, it is suggested to use the true composite measurement in clinical practice, and to formulate tolerance limits and action limits suitable for the actual process of the institution based on the SPC method. In conclusion, it is expected that the results of this study can provide some references for institutions to optimize the radiotherapy plan verification process, set appropriate pass rate limit, and promote the standardization of plan verification.
Humans ; Radiotherapy, Intensity-Modulated ; Immune Tolerance ; Nasopharyngeal Carcinoma ; ROC Curve ; Nasopharyngeal Neoplasms/radiotherapy*