Digital X-ray photography has been applied to clinical medicine in recent 3years.This paper introduces the development situation of the flat detectors for digital X-ray photography.The technical indexes and structure differences of the detectors are presented in this paper.

Objective To compare the clinical outcomes of urethral resectoscopy and retroperitoneal laparoscopic nephroureterectomy with open surgical nephroureterectomy. Methods A total of 44 patients with renal pelvic and ureteral neoplasms were included.Urethral resectoscopy and retroperitoneal laparoscopic nephroureterectomy were performed in 15 cases (Group A) and open surgical nephroureterectomy in 29 cases (Group B).The therapeutic effectiveness,postoperative recovery,relevant cost and complications were compared between Group A and Group B. Results The analysis showed that the intra-operative bleeding volum [(75.1?29.5)ml],the postoperative intesinal function recovery [(24.1?12.6)h],time to ambulation [(24.3?10.5)h],use of antalgesic [(3.0?0.8)d],intravenous antibiotic [(7.2?3.1)d],hospital stay [(6.3?1.2)d],convalescene of normal activities [(28.0?7.8)d] and incidence of complications with Group A were significantly superior to those with Group B(P

Objective To study the effect of rehabilitation in stroke patients with dysphagia. Methods 31 cases with dysphagia were randomly divided into rehabilitation group (17 cases) and control group (14 cases). Two groups were given same basic therapy on the whole, while the early rehabilitation was performed on the patients in rehabilitation group three times a day for 3 weeks. We compared assessment score of dysphagia by VFSS (videofluoroscopic swallowing study), and observed serum potassium, sodium, albumin levels and the incidence of inhalation-pneumonia in two groups before and after treatment. Results VFSS score (7.2?2.1) of rehabilitation group was markedly higher than before treatment (4.0?1.9) and control group (4.7?2.1)(all P0.05).Conclusions Rehabilitation has a remarkable effect on stroke patients with dysphagia.

Bioeleotrical activities of human cerebral cortex which control and regalate movements get to increase during voluntary movements, the metabolic level of the cells of motor areas change at the same time,and consequently regiond cerebrd blood flow (rCBF)changes. Different changes of rCBF indicate the range of motor areas with which the relavant movemats are involved.And studies of this take great significance in finding out the basic active regalarity and features of human brain. In this artide motheds of the determination of rCBF an introduced briefly, and changes and distribution of rCBF of rCBF of each cortical moter area during different types of volantary movements are discribed. Keywords：regional cerebral blood flow; voluntary movements; cerebral corrical motor areas

Influenced by the intensity, volume of exercise, the basic metabolic features of skeletal muscle are changed to such structural and functional adaptations as there are increases in the amount of contractile components, muscle glycogen and myoglobin, in the volume and quantity of mitochondria and in the density of capillary in skeletal muscle, which result in enhanced aerobic metabolism, contraction efficiency and prolonged time defore failure. It is also pointed out that the structural changes and decrease of function of sarcoplasmic reticula during acute exercise are important reasons for skeletal muscle fatigue , whereas, high- intensity training can improve sarcoplasmic reticulum function and its Ca2＋ -intake rate, so that to improve the physiological efficacy of excitation- contraltion coupling. So it is put forward that anti- resistance training, as a means of exercise therapy, can efficiently increase muscle strength and prevent muscle atrophy. Keywords：exercise;muscle metabolism;contractile protein;sarcoplasmic reticulum;mitochondria;oxygen restore;exercise therapy

Objective To explore the factors imfluencing the prognosis of patients with renal cell carcinoma after laparoscopic partial nephrectomy.Methods Clinical data from 593 renal cell carcinoma patients underwent laparoscopic partial nephrectomy in our institution from December 2010 to December 2015 were retrospectively collected..Tbere were 396 males and 197 females,aged 35 to 72 years old(mean 55.4 years).There were 181 cases of smoking history,206 cases of hypertension and 105 cases of diabetes.Before operation,98 cases of liver function were damaged and 122 cases were anemia.There were 521 cases with PLT ＜ 450 × 109/L,72 cases PLT≥ 450 × 109/L.Thc tumor of 292 cases on the left and 301 cases on the right.The Kaplan-Meier method log-rank test was used for survival analysis.Univariate analysis and factors which were significantly associated with survival in the univariate analysis were conducted into the multivariate analysis with Cox proportional hazards model.Results The operative time was 88.0-120.6 min,mean 104.3 min,the blood loss during operation was 47.2-157.8 ml,mean 102.5 ml. Pathological tumor stage revealed that 398 cases were T1 and 195 cases were T2 . Fuhrman classification revealed that 29 cases were grade Ⅰ,411 cases were grade Ⅱ,150 cases grade Ⅲ,3 cases grade Ⅳ . The median follow-up time was 36 months(ranged 6 to 99 months) . Five cases (1.3％) in the T1 patients relapsed,recurrencefree survival (RFS) rate was 98.7％;In the T2 patients,7 cases (3.6％) relapsed,1 of them had local recurrence and died of lung metastasis,and the RFS rate was 96.4％.Univariate analysis revealed that T stage,Fuhrman grade,tunor necrosis,tumor pseudocapsule,lymphovascular invasion,collection system violation,anemia,and high platelet were significantly associated with RFS of patients.Multivariate analysis found that T stage (HR =1.524,95 ％ CI 1.326-1.926,P =0.001),Fuhrman grade (HR =1.600,95 ％ CI 1.035-2.364,P =0.022),tumor necrosis (HR =2.315,95％ CI 1.523-3.624,P =0.001) were independent risk factors for the RFS of patients with renal cell carcinoma after retroperitoneal laparoscopic partial nephrectomy.Conclusion High T stage,high Fuhrman grade and tumor necrosis were independent risk factors for the RFS of patients with renal cell carcinoma after retroperitoneal laparoscopic partial nephrectomy.

Objective To investigate the feasibility of dose verification of helical tomotherapy (HT) using the PTW Seven29 2D-ARRAY with Octavius phantom.Methods The 12 patients HT plan were verified with the PTW Seven29 2D-ARRAY combining Octavius phantom.The detector array was guided and registered by MVCT imaging,and measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system (TPS).Based on several different Gamma criteria,the Gamma analysis method was utilized to evaluate the dose verification.Results According to the different acceptance criteria combination of dose difference/distance to agreement at different threshold level including 3％/2 mm,3％/3 mm,3％/4 mm,3％/5 mm at TH5,TH10,TH20,TH30,the mean passing rates with γparameter ≤ 1 were all above 91.7％ and 93.9％ when PTW Seven29 2D-ARRAY was horizontal and vertical.The dose distribution measured by the 2D-ARRAY combining Octavius phantom was well consistent with that calculated by the TPS.Conclusions 2D-ARRAY with Octavius phantom can get satisfying results when used in HT plan dose verification and is a viable tool to replace traditional film dosimetry system in clinical quality assurance work.

Objective To use helical tomotherapy ( HT ) for determining the difference between actual doses and planning doses to the target volume and organs at risk ( OARs ) in patients with nasopharyngeal carcinoma receiving radiotherapy, and to provide guidance for the clinical treatment. Methods Localization and delineation of the target volume and OARs were performed by computed tomography ( CT) in 21 patients with nasopharyngeal carcinoma receiving radical radiotherapy using HT. All patients underwent megavoltage CT ( MVCT) scan prior to treatment. The obtained MVCT images were used for dose reconstruction in the adaptive module of HT, in which the actual dose was obtained and the non?image?guided dose was simulated. Each single dose distribution and the corresponding CT image were sent to software MIM6. 0 for superimposition, and the overall dose was obtained. The initial plan, image?guided plan, and non?image?guided plan were named Plan?1, 2, and 3, respectively. The dose distribution in the target volume and OARs was compared between the three plans with t ? test or wilcoxon test . Results Compared with those in Plan?1, the D98 values for the planning gross tumor volume ( PGTV) and planning target volume ( PTV) in Plan?2 were significantly reduced by 1. 16% and 2. 3%, respectively ( P=0. 025;P=0. 043);the volumes of the left and right parotids in Plan?2 were significantly reduced by 46. 0% and 46. 5% on average, respectively ( P=0. 000);the distances between the midline and the center?of?mass for left and right parotids were significantly reduced by 6. 9% and 6. 5%, respectively ( P=0. 000);the V26 and Dmean for both parotid glands were significantly elevated by 32. 8% and 25. 2%, respectively ( P=0. 000) . Compared with those in Plan?1, the D98 values for PGTV, PTV?1, and PTV?2 in Plan?3 were significantly reduced by 2. 0%, 1. 9%, and 2. 4%, respectively ( P=0. 001;P=0. 007;P=0. 036);the V26 and Dmean for both parotid glands in Plan?3 were significantly elevated by 33. 6% and 25. 3%, respectively ( P=0. 000);Dmax to the spinal cord was significantly increased by 6. 9%( P=0. 005) . There was no significant difference in D2 to the spinal cord between Plan?2 and Plan?1( P=0. 392) . Conclusions The doses to both parotid glands increase during HT for nasopharyngeal carcinoma, which is closely associated with the shift of the parotid glands toward the midline. Image?guided radiotherapy does not enhance the dose to the target volume, but reduces the dose to the spinal cord.

Objective To evaluate the effects of silicone pessary treatment on relieving the symptoms and improving the life quality of the pelvic organ prolapse patients.Methods From November 2005 to March 2009,33 pelvic organ prolapse (POP-Q stage Ⅲ～Ⅳ) patients received silicone pessary coneervative treatment were followed up and required to complete the Pelvic Floor Distress Inventory-20 (PFDI-20) before and after initiating pessary treatment.Results 31 of 33(93.94%) patients finished the follow-up completely.23 of 31(74.19%) patients continually used the pessary.The follow up time was 3 to 17 (10.04±2.57) months.27 patients completed the PFDI-20 questionnaires.Before silicone pessary treatment, PFDI20 total score,POPDI6 (Pelvic organ prolapse distress inventory),CARDI8 (colorectal anal distress inventory 8) and UDI6 (urinary distress inventory 6) scores were (54.16±36.12),(27.78±17.30),(0.61±1.01) and (25.77± 24.10),respectively.After the treatment of pessary,the scores decreased to (20.20±25.98), (4.48±5.88), (0.45±0.84) and (15.28± 21.53),respectively.Except for CARDI8,the PFDI scores decreased significantly after the pessary treatment (P＜0.05).Conclusion Silicone pessary is a viable noninvasive treatment for pelvic organ prolapse.It could relieve the symptoms and improve the life quality of protrusion and voiding dysfunction patients.

Objective:To compare the safety of adrenal central vein treated at different times in laparoscopic adrenal pheochromocytoma resection through abdominal approach.Methods:A study was conducted on 43 patients with adrenal pheochromocytoma admitted to Xijing Hospital, Air Force Military Medical University from June 2012 to June 2019. The included patients were divided into two groups according to the surgical method: observation group ( n=22) and control group ( n=21). The patients of observation group were ligated the central advenal vein before the tumor was completely isolated, and the patients of control group were ligated the central advenal vein after the tumor was isolated. The changes of blood catecholamine levels before anesthesia, before central adrenal vein ligation, and after tumor resection were compared between the two groups, as well as the differences in operative time, intraoperative blood loss, hospital stay, number of cases with intraoperative blood pressure fluctuations and frequency. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square. Results:There was no significant difference in the mean operation time, the mean hospital stay, intraoperative blood loss, number of cases with dramatic blood pressure fluctuations between two groups ( P>0.05). The frequency of severe fluctuation of intraoperative blood pressure in observation group and control group was 19 times and 47 times, respectively, the difference was statistically significant ( P<0.05). There was no significant difference in the blood epinephrine and norepinephrine levels between the two groups before anesthesia and after tumor resection ( P>0.05). However, before ligation of the central vein, the epinephrine concentrations in the observation group and the control group were (572.1±282.1) pg/mL and (935.6±417.5) pg/mL, respectively, the noradrenaline concentrations were (8 347.9±4 103.6) pg/mL and (13 695.7 ±3 205.3) pg/mL, respectively, the difference was statistically significant ( P<0.05). Conclusion:Early ligation of the adrenal central vein can improve the safety of the laparoscopic approach to adrenal pheochromocytoma.