Objective To study the image quality control system to ensure that equipment meet clinical needs.Methods It was scanning the Catphan504 phantom with models of high quality head,standard dose head and pelvis,we could get the results of CT numbers linearity,uniformity,spatial resolution,contrast resolution.Using T test to compare different scanning technique results.Results The standard dose head scanning technique was better than the pelvis scanning technique in CT numbers linearity test,and gets the best result in uniformity test.The result of CT numbers uniformity was higher in the standard dose head scanning than the high quality head and the pelvis scanning (9.7 ±3.9 vs.17.9 ±5.3,P =0.00 and 9.5 ± 4.0 vs.31.1 ± 5.7,P =0.00).The result of contrast resolution was higher in the pelvis scanning than the high quality head and the pelvis scanning (5.6 ± 0.1 vs.1.3 ± 0.5,P =0.00 and 6.0 ± 1.0 vs.1.3 ± 0.5,P =0.00).The result of spatial linear distance was very accurate,the range was 4.98 -5.06 cm.Conclusions The results of spatial linearity test are stable and accuracy,but CT numbers linearity and uniformity test are affected by the scanning technique significantly for device.To spatial resolution test and contrast resolution test,we need to set the standard and tolerance according to each linear accelerator specialty.

Objective To compare the dose distribution of the three-dimensional conformal radiotherapy(3D-CRT)and 5-field or 7-field intensity modulated radiation therapy(IMRT), and to explore the value of IMRT in preoperative radiotherapy for rectal cancer.Methods Ten rectal cancer patients treated with preoperative combination radiotherapy and chemotherapy were enrolled in this study. 3D-CRT plan and the 5.field or 7-field IMRT plans were performed for each patient.The conformal index (CI),heterogeneity index(HI)of the planning target volume(PTV)and the dose of normal organs of 3D-CRT plan(3D-CRTp)and the 5-field or 7-field IMRT plans(IMRT5fp or IMRT7fp)were analyzed with the dose-volume histogram.Results The CI values of PTV were 0.91,0.87 and 0.78 in IMRT7fpIMRT5fp and 3D- CRT but with IMRT7fp>IMRT5fp>3D-CRTp(t=-5.69、-8.91,P<0.01),respectively.The HI values of PrV were 1.09,1.08 and 1.05 in IMRT5fp,IMRT7fp and 3D- CRTp but with IMRT5fp >IMRT7fp>3D- CRTp(t=3.41、-6.89,P<0.01),respectively.The ratio of dose volume were 0.08,0.10 and 0.19(t=2.79、3.52,P<0.05)in IMRT7fp,IMRT5fp and 3D- CRTp on the small intestine V50,with 0.07,0.10 and 0.19(t=2.58、3.40,P<0.05)in IMRT7fp,IMRT5fp and 3D-CRTp on the bladder V50 and 0.01,0.01 and 0.05(t=3.00、3.17,P<0.01)in IMRT7fp,IMRT5fp and 3D- CRTp on the fomoral head V45.The ratio of dose volume were 0.31 and 0.38(t=3.91,P<0.01)in IMRT7fp and IMRT5fp on the bone marrow V50,with 0.07 and 0.10 in IMRT7fp and IMRT5fp on bladder V45.Conclusions IMRT plan is superior to 3 D- CRT plan in dose conformal degrees of PTV with preoperative radiotherapy of rectal cancer and can significantly protect the normal tissues.The 7-field IMRT plan might be the optimal plan for dose conformal degree and dose uniformity compared with 5-field IMRT.

Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury (ABI) complicated by acute lung injury (ALl)/acute respiratory distress syndrome (ARDS).Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group (n =41) and control group (n =42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol.The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated.Results The results of heart rate (HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different (P ＜ 0.05) from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference (P ＞ 0.05) between the two groups.Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective.Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.

Feasibility Studies ; Humans ; Ligation ; Paranasal Sinuses ; Tomography, X-Ray Computed

Objective To observe the effect of intra-articular injection of sodium hyaluronate (Na-HA) on mRNA expression of inducible nitric oxide synthase (iNOS) in cartilage of osteoarthritis (OA). Methods Sixteen white rabbits were underwent unilateral anterior cruciate ligament transection and were divided into 2 groups randomly 5 weeks after transection. Experimental group rabbits received 0.3 ml of intra-articular 1% Na-HA injection once a week. Animals in control group were treated with the same conditions using normal saline. All animals were sacrificed 10 weeks following surgery. The aritcular cartilage degeneration of medial femoral condyle was evaluated at mascroscopically and microscopically. The mRNA expression of iNOS in cartilages was analyzed by reverse transcription-polymerase chain reaction (RT-PCR). Results Cartilage degradation in experimental group was significantly less severe than that in control group. No significant difference of iNOS mRNA expression in cartilage was found between the experimental group and the control group. Conclusion Na-HA can significantly reduce the severity of cartilage degradation of OA. Na-HA dose not show definite effect on iNOS expression in cartilage during early stage of OA.

Objective To study the dosimetry characteristics of 9 equal spaced fields and 9 fields with beam angle optimization (BAO) process for cervix uteri.Methods 12 cervix uteri cancer patients CT Images were transferred into Eclipse planning system.Each patient,the 9 equal spaced fields and 9 fields by BAO process were IMRT plan designed with the same CT image.Make a evaluation of dose distribution for target volume and OARs,and paired t test for them.Results Comparing to 9 equal spaced fields IMRT plan,the quality of 9 fields IMRT plan with BAO process the the PTV V95％ was 99.31％ vs 99.42％,P =0.020,at the same time V105％,V110％,Dmax,D got 60.54％ vs 47.92％,P =0.013;7.14％ vs 0.37％,P =0.000;56.62 Gy vs 55.47 Gy,P =0.000;53.29 Gy vs 52.72 Gy,P =0.000,the CI and HI was 0.85 vs 0.89,P =0.000 ;0.10 vs 0.13,P =0.000.For organs at risk,bladder V40 was increased by 4.7 ％ (P =0.013) ;the D40 of rectum was 0.5 Gy higher (P =0.004) ; the small bowel's DVH showed that V40 and Dmax increased by 0.6％ (P =0.015) and 1.4 Gy (P =0.000),D of bone marrow were raised separately by 1.3 Gy (P =0.000),the spinal cord's dose D0.1 cm3 was also increased by 2.0 Gy (P =0.000).Conclusion The quality of 9 equal spaced fields IMRT plan will be better than those achieved by BAO process optimized plans.

Objective To investigate bladder anatomical changes and dose variation in patients with cervical cancer.Methods We analyzed 20 patients,undergoing external beam radiotherapy scanning cone beam CT(CBCT)before each fraction.Bladder was contoured on each CBCT,was projected onto the planning CT and assesses anatomical changes and dose variation.Results A total 451 CBCT images,for 20 patients were collected for analysis,show more change in bladder volume and position.In 15 cases bladder volume and V45 had no significant correlation(r=0.225 -0.473,all P>0.05),4 cases shows negative correlation(r=-0.564,P<0.05;r=-0.597,P<0.01;r=-0.942,P<0.01;r=-0.816,P<0.01),1 case shows positive correlation(r=0.662,P<0.01).Have more than the criteria(V45≤50%)number is 64/451(14.2%)in whole treatment.Conclusions For most patients by filling adequacy bladder,bladder dose variation is acceptable:CTV lager for individual patients should be closely observed its regression,implementation of the offline or online calibration.

ObjectiveTo investigate the anatomical changes and dose variation of rectum during radiotherapy in patients with cervical cancer.Methods Ten patients with cervical cancer underwent intensity-modulated radiotherapy using online cone beam computed tomography (CBCT) before each fraction.Rectum was contoured on each CBCT and projected onto the planning CT to analyze the changes of the rectal volume and position.The rectal volume receiving ≥ 45 Gy ( V45 ) was evaluated accordingly.Results227 CBCT images in 10 patients were collected.The rectal volume changed from ( 35.0 ± 7.3)cm3 to (97.7±14.7) cm3.The shift of rectal center was (0.14 ±0.06) cm in left and right direction,(0.24±0.10) cm in anterior and posterior direction,and (0.55±0.28) cm in superior and inferior direction.The V45 of rectum varied from (9.19±2.46)％ to (60.54 ±11.67)％.In7 of the 10 patients,rectal volume and V45 of the rectum had significant positive correlation (r =0.582 - 0.743,all P ＜ 0.01 ).Among the 227 images,the V45 of rectum was ≤50％ in 68 images (30.0％ ).ConclusionsSignificant changes in rectal volume and position occurred during fractionated radiotherapy in patients with cervical cancer,which resuhs in variations in the dose rectum received.For most patients,rectal volume and the V45of rectum had significant positive correlation.

Adenocarcinoma ; metabolism ; pathology ; surgery ; ultrastructure ; Aged ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Neuroendocrine ; metabolism ; pathology ; surgery ; ultrastructure ; Cardia ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Microscopy, Electron, Transmission ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; ultrastructure ; Synaptophysin ; metabolism

Objective To explore the clinical effect of treatment on facial soft tissue depression by autologous fat granule mixed with adipose-derived stem ceils.Methods A lof of 36 patients with facial soft tissue depression from September 2011 to March 2013 in this clinic were as the research objects.The autologous fat granules were harvested from patients' lateral thigh.The autologous fat granules mixed with adipose-derived stem cells (ADSCs) which were harvested by separating and cleaning were injected into facial soft tissue depression.The standard was based on the subjective satisfaction of patients and the physicians' objective assessment;there were two unrelated doctors to reach an objective assessment of the clinical efficacy based on the comparison of preoperative and postoperative photographs.Results A lof of 36 patients were followed up for 5 16 months,low absorption rate of injec ted fat and significant improvement in shape filling areas were observed,and skin texture,pores,spots and wrinkles were significantly improved.Conclusions Autologous fat granule mixed with AD SCs in the treatment of facial soft tissue depression is a minimally injuried,easily-handled,cheap and safe procedure.It is an ideal treatment of facial soft tissue depression.All the patients have no complications such as infection,induration and fat liquefaction.