Objective To investigate the correlation between setup error and couch position error in radiotherapy.Methods A total of 25 patients with thoracic and abdominal tumors who recently finished image-guided radiotherapy were randomly selected.The data on couch position during treatment were obtained through the record validation system, and then the couch position error was calculated.The Pearson correlation analysis was used to investigate the correlation between setup error and couch position error during treatment.Results In the ≥5 setup errors among the 25 patients, the correlation coefficient between random setup error and random couch position error was 0.83(P=0.00), and the correlation coefficient between systematic setup error and systematic couch position error was 0.36(P=0.11).Conclusions In radiotherapy, the random setup error is highly correlated with the random couch position error, while a moderate or low correlation exists between the systematic setup error and the systematic couch position error.

Objective To establish a loop-mediated isothermal amplification method for detection of Campylobacter jejuni.Methods Six sets of primers were designed to recognize Campylobacter jejuni specific gene hipO.One was selected as the optimal primer and its specificity and sensitivity to Campylobacter jejuni were evaluated by LAMP reaction in 60 minutes at 62℃.Results The results recorded by the turbidity meter showed that the sensitivity of LAMP with a detection limit of 6.97×102 copies/μl was ten times that of PCR.Conclusion LAMP is a potential and valuable method of detection of Campylobacter jejuni due to its rapidity,simplicity,low cost and accuracy.It is especially suitable for grass-roots medical units.

Objective To evaluate the effect of setup errors upon the target area and the organs at risk (OAR) during radiotherapy for prostate cancer.Methods Twelve prostate cancer patients receiving treatment in the recent 1 year were randomly recruited in this study.The position of each patient was verified by using cone beam CT (CBCT) for 6-10 times during the treatment.In treatment planning system (TPS),the isocenter position was moved along the setup errors with averaging error value (Plan_A) and each CBCT value (Plan_F).The dose distribution was recalculated without changing the beam setting,weight factors and monitor units (MUs).The dose difference was statistically compared between the simulation and original plans (Plan_O).Results For clinical target volume (CTV) D95,there was a significant difference between Plan_A and Plan_O (P =0.008),whereas no significant difference was observed between Plan_F and Plan_O.There were significant differences between Plan_F and Plan_O,Plan_A and Plan_O (P=0.004,and 0.041) for the planned target volume (PTV) D95.For OAR,rectal V60,Dmax,left femoral V20,Dmax and right femoral Dmax significantly differed between Plan_F and Plan_O (P=0.026,0.015,0.041,0.049,0.003).However,only left femoral Dmax significantly differed between Plan_A and Plan_O (P=0.045).The movement in the superior-inferior (SI) direction was significantly correlated with the changes in the rectal V40,V50 and V60 and PTV D95 (r=-0.785,-0.887,-0.833,0.682).The movement in the anterior-posterior (AP) direction was significantly associated with the variations in the bladder V20,V30,V40,V50 and V60(r=-0.945,-0.823,-0.853,-0.818,-0.774).The evaluation indexes of all normal tissues in the re-plan could meet the clinical requirements.However,the volume of target prescription volume had different levels of deficit,and the deficit of Plan_F was greater than that of Plan_A.Conclusions The simulation results of averaging into the TPS underestimates the effect of daily setup errors on the dose distribution.The effect of setup errors on the dose distribution in target area is greater than that of normal tissues.Y-direction errors are more likely to cause the variations of the rectal and PTV dose,and the errors in the z-direction are inclined to cause the changes in the bladder dose.

Empathy is one of the basic qualities that modern clinicians need to possess.Although traditional Chinese medicine has no definition for empathy,it does have practical applications.TCM clinical empathy,nurtured by Chinese excellent traditional culture,can be seen in TCM classics and clinical practice of famous doctors of previous generations,and has been inherited in the spiritual thinking of modern colleges and universities of Chinese medicine.However,at present,there is a relative lack of special training courses for"empathy"in Chinese medicine higher education.This paper first briefly describes the connotation,history,and neuroscience mechanism of the concept of"empathy".Secondly,the manifestations and characteristics of"empathy"in the clinical practice of traditional Chinese medicine were sorted out.Finally,we use modern medicine and psychology for reference,and combine the characteristics of traditional Chinese medicine to make suggestions for the cultivation of the ability of"empathy"in clinical Chinese medicine.

Objective To retrospectively analyze the setup error in radiotherapy of somal tumors and body metastases using the ExacTrac X-ray portal image,and to evaluate the feasibility and effectiveness of 6D setup error correction in body radiotherapy.Methods The translational and rotational setup errors were calculated by registering the bony structures on the ExacTrac X-setup images to that of the digitally reconstructed setup images,and the corresponding residual errors were calculated together.Results The translational and rotational setup errors in the x (left-right),y (superior-inferior),z (anterior-posterior) and Rx (sagittal),Ry (transverse),Rz (coronal) directions were(2.27±2.02) mm,(4.49±2.52) mm,(2.27± 1.37) mm and (1.02 ± 0.73) °,(0.67 ± 0.68) °,(0.76 ± 0.84) °,respectively.The residual translational and rotational setup errors in the x(r),y(r),z(r) and Rx(r),Ry(r),Rz(r) directions were(0.27±0.48)mm,(0.37±0.45)mm,(0.22±0.30)mm and (0.17±0.33)°,(0.14±0.34)°,(0.16± 0.28) ° respectively.Conclusions Besides the translational setup errors,a certain amount of rotational setup errors exist in radiotherapy of somal tumors and body metastases.By using the 6D setup error correction of the ExacTrac system,a translational less than 0.4 mm and rotational setup errors less than 0.2° could be achieved.

Objective:To summarize the experience of ELEKTA Unity MR-linac in clinical application in our hospital and analyze the positioning accuracy, process time and other related issues.Methods:A total of 14 patients enrolled in the Unity MR-Linac study were reviewed. All treatment time (including positioning, scanning, replanning, and beam discharge) and setup errors in 3directions were statistically analyzed. 11 patients with conventional accelerators using the multifunctional immobilization system (MIS) were randomly selected to make statistical analysis of the setup errors, and the differences between the Unity group and the conventional accelerators using the MIS were compared using t-test. Results:In the Unity group, the setup errors in X, Y and Z directions were (-0.15±0.30) cm, (0.02±0.57) cm and (-0.10±0.28) cm, respectively. The average treatment time was 36.87minutes. The average positioning time was 5.40minutes. The mean scan time was 7.48minutes, the mean adaptive plan time was 7.46minutes, and the mean beam time was 9.48minutes. In the conventional accelerator group, the setup errors were (0.05±0.25) cm, (-0.01±0.25) cm and (-0.03±0.23) cm, respectively. The results of the setup errors of patients fixed with MIS showed that there were significant differences in the left and right directions ( P<0.001), while there were no significant differences in the Y and Z directions ( P=0.061 and 0.374) between two groups. Conclusions:Except in the X direction, there is no significant difference in setup errors between the Unity and conventional accelerator groups in the condition of laser-free system. Under smooth circumstances, the treatment time by using ATP (adapt to position) workflow will also be within the range of tolerance of the patients. Magnetic-guided radiotherapy has a promising application prospect, whereas the procedure needs to be optimized.

Objective:To establish the basic procedures of the application of optical surface monitoring system (OSMS) in the deep inspiration breath hold (DIBH) radiotherapy for patients with left sided breast cancer and compare the performance of OSMS and cone-beam CT (CBCT) in the determination of the set-up errors of DIBH radiotherapy for patients with left sided breast cancer.Methods:Twenty patients with left sided breast cancer received DIBH radiotherapy. Through the registration of CBCT images with the planning CT images, and the registration of OSMS radiography images with the outer contour of the body surface, translational set-up errors and rotational errors were determined along the lateral-medial ( Rx), superior-inferior ( Ry) and anterior-posterior ( Rz) directions. Pearson correlation analysis was performed to evaluate the correlation of the set-up errors determined by two methods, and Bland- Altman plot analysis was used to assess the coincidence of these two methods. Results:Two methods were positively correlated. The Rz volume was 0.84, 0.74 and 0.84 in the x, y and z directions, and 0.65, 0.41 and 0.54 in the Rx, Ry and Rz directions, respectively (all P<0.01). The 95% CI of agreement were within preset 5 mm tolerance (-0.37-0.42cm, -0.39-0.41cm, -0.29-0.49cm ) in x, y and z directions for two methods. The 95% CI of agreement were within preset 3 ° tolerance -2.9°-1.4°, -2.6°-1.4°, -2.4°-2.5°in Rx, Ry and Rz directions for two methods. The system errors of 20 patients with left sided breast cancer receiving DIBH radiotherapy were <0.18cm and the random errors were <0.24cm. Conclusions:OSMS is equivalent to CBCT in the determination and stimulation of set-up errors for patients with left sided breast cancer receiving DIBH radiotherapy. The combination of CBCT and OSMS is a safe and reliable method.