Objective To investigate the advantage of the intensity-modulated radiotherapy treatment (IMRT) by allowing dose heterogeneity in the target volume in esophageal cancer treatment planning.Methods Two sets of 5-field IMRT planning were designed for 10 esophageal cancer patients upon the condition of appropriate clinical tolerance level with the prescription dose of 60 Gy to 95% of the planned target volume (PTV) and the maximum dose of 45 Gy to the spinal cord:the IMRT with rigid restriction of the maximum homogeneous dose to the PTV within 63 Gy prescribing a homogeneous dose ( IMRThom ) and the IMRT allowing dose heterogeneity by loosening the constraints on maximum dose in the PTV to 69 Gy ( IMRTinhom ).Dosimetric comparison was conducted by using dose-volume histograms.Results Compared to IMRThom, the minimum dose (t = -3.37,P =0.012), maximum dose (t = - 23.58,P = 0.000), mean dose ( t = - 4.95, P = 0.002 ), and heterogeneity index ( t = - 11.06, P =0.000) in PTV of the IMRTinhom were all significantly increased, and the values of V5 (t = 6.96, P =0.000), V10(t=5.24,P=0.001) , V15(t=4.73,P=0.002) , V20(t=8.08,P=0.000) , V25(t=8.58,P = 0.000), and mean dose (t = 7.28,P = 0.000) of the normal lungs were all significantly lower.There were no significant differences in all the indexes for the mean dose to the heart and maximum dose to the spinal cord between these 2 set of planning.Conclusions The IMRT plan allowing dose heterogeneity in the PTV escalates the prescription dose and decreases the doses to the lungs.

Objective To compare the therapeutic differences between stent-thrombectomy combined with urokinase thrombolysis and simple arterial urokinase thrombolysis in treating patients with acute cerebral infarction.Methods Arterial urokinase thrombolysis was carried out in 28 selected patients with acute cerebral infarction,admitted to our hospital in 2011 (urokinase group),while Solitaire AB stent-thrombectomy combined with arterial urokinase thrombolysis was carried out in 29 patients with acute cerebral infarction,admitted to our hospital in 2012 (combination group).Postoperative indices,including National Institutes of Health Stroke Scale (NIHSS),recanalization rate and intracranial hemorrhage incidence,were analyzed between the two groups.Results Recanaliztion rate of combination group was detailed as:middle cerebral artery in 20 patients,internal carotid artery in 3 patients,and vertebral-basilar artery in 4 patients,with a total recanalization rate of 93.1％.No postoperative hemorrhage was confirmed; two patients diagnosed as having internal carotid artery occlusion died.Recanaliztion rate of urokinase group was detailed as:middle cerebral artery in 15 patients,internal carotid artery in 3 patients,and vertebral-basilar artery in 0 patients,with a total recanalization rate of 64.2％; postopertive intracranial hemorrhage was noted in 5 patients and death in 8.For combination group,postoperative fourteen-day NIHSS scores decreased by 11.40±4.57 as compared with preoperative NIHSS scores; for urokinase group,postoperative fourteen-day NIHSS scores decreased by 11.40±4.57 as compared with preoperative NIHSS scores; significant differece was noted between the two groups (P＜0.05).Postoperative satisfactory rehabilitation (modified Rankin scale scores＜2) in combination group and urokinase group appeared in 20 and 17 patients,respectively,after 3 months of follow up.Conclusion The efficacy of stent-thrombectomy combined with arterial urokinase thrombolysis is superior to that of simple arterial urokinase thrombolysis in patients with acute cerebral infarction.

Objective To investigate the status and molecular epidemiology of hepatitis D virus (HDV) infection in the gathering area of Mongolian population in Inner Mongolia Autonomous Region of China. Methods A total of 230 patients with positive hepatitis B surface antigen (HBsAg) who attended Inner Mongolia International Mongolian Hospital from April 2019 to October 2020 were enrolled, and according to related information, they were divided into hepatitis B+liver cirrhosis group( n =18) and hepatitis B group( n =212). According to HBsAg quantification with a cut-off value of 250 IU/mL, the patients were divided into HBsAg < 250 IU/mL group( n =104) and HBsAg ≥250 IU/mL group( n =126). ELISA was used to detect HDV antibody, and quantitative real-time PCR was used to measure HDV RNA in patients with positive HDV antibody. Genotyping was performed for HDV RNA-positive samples. The chi-square test was used for comparison of categorical data between two groups. Results The positive rate of HDV antibody was 16.09%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 91.89%. Among the 18 patients with hepatitis B and liver cirrhosis, the positive rate of HDV antibody was 44.44%, and among the patients with positive HDV antibody, the positive rate of HDV RNA was 100%. There were 104 patients with HBsAg < 250 IU/mL, among whom only 3 patients (2.88%) were positive for hepatitis D antibody, and there were 126 patients with HBsAg ≥250 IU/mL, with a positive rate of HDV antibody of 26.98%. Genotype 1 was observed in all the samples that could be genotyped. Conclusion There is a relatively high infection rate of HDV in Inner Mongolia Autonomous Region, especially in patients with HBsAg ≥250 IU/mL or those with liver cirrhosis. It is necessary to strengthen the detection of hepatitis D in HBsAg-positive patients and perform early diagnosis and treatment to prevent the further progression of hepatitis.