OBJECTIVETo evaluate the value of spiral computed tomography in the preoperative assessment of the degree of tumor infiltration in mesorectum and circumferential resection margin status of rectal cancer compared with large tissue slice technique.

METHODSFifty-seven patients with rectal cancer diagnosed by fiber colonoscopy and pathology from March 2007 to December 2007 underwent preoperative 64-layers spiral CT examination. The degree of tumor infiltration in mesorectum and circumferential resection margin status were evaluated. Large tissue slice technique was applied in the pathologic study after the total mesorectal excision of the rectum to determine the degree of tumor infiltration in mesorectum and the circumferential resection margin status. The spiral CT findings were compared with pathologic results. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the CT results were assessed respectively.

RESULTSThe overall spiral CT accuracy was 93.0% (53/57) for the degree of tumor infiltration in mesorectum, and it was 94.7%, 94.7% and 96.5% for degree I, II, III infiltration, respectively. Fifty-three cases (93.0%) were accurately predicated with the circumferential resection margin status. The sensitivity, specificity, PPV and NPV of spiral CT measurement was 80.0%, 97.6%, 92.3% and 93.2%, respectively, and was consistent well with the histopathological diagnosis.

CONCLUSIONSSpiral CT provides accurate preoperative assessment for the degree of tumor infiltration in mesorectum and circumferential resection margin status of rectal cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Mesentery ; diagnostic imaging ; pathology ; Middle Aged ; Neoplasm Invasiveness ; diagnostic imaging ; Neoplasm Staging ; Predictive Value of Tests ; Rectal Neoplasms ; diagnostic imaging ; pathology ; Rectum ; diagnostic imaging ; pathology ; Sensitivity and Specificity ; Tomography, Spiral Computed

OBJECTIVETo summarize experience of using screws and cement to rebuild tibial bone defect in primary total knee arthroplasty (TKA) and to discuss the relationship between the number of required screws and the severity of tibial bone defects.

METHODSFrom July 2009 to May 2015, 34 patients (40 knees) with varus knees underwent TKA, and the screw and cement technique was used to rebuild medial tibia plateau during operation. There were 8 males (8 knees) and 26 females (32 knees), and the average age was (65.00 +/- 7.25) years old (ranged,55 to 82 years old). One to 6 screws were used in each case. Extension stems were used in 2 cases (4 and 5 screws was used respectively). The area percentages of the bone defects measured as defect area/tibia plateau area, depth of each defect, the number of screws needed in each case, were all used to determine the relationship between the number of screws and the area percentage in certain depth of bone defect by statistic methods, as well as the relationship between screw number and defect depth.

RESULTSAll the patients were followed up and the average duration was 24 months (ranged, 1 to 72 months). The average preoperative HSS score was 43.33 +/- 6.11 (ranged, 32 to 51 scores). Whereas the average postoperative HSS score was 92.15 +/- 4.64 (ranged,83 to 96 scores). The preoperative individual scores including pain, function, activity, nuscle strength, flexion deformity and stability were all improved compared with preoperation,and the differences were statistically significant. All the patients received normal alignment postoperatively, femoraltibial angle was improved from (167.00 +/- 6.39) degrees preoperatively to (175.00 +/- 2.69) degrees postoperatively, the tibial angle was improved from (78.09 +/- 4.51) degrees preoperatively to (88.75 +/- 1.24) degrees postoperatively. Both area percentage and depth of bone defect in a fitting Ologistic model had a significant statistical relationship with the screw number, and a rectangular coordinate system could be formed according to the relationship.

CONCLUSIONScrews and cement technique is a simple, safe and convenient method to rebuild tibial bone defects in primary TKA and its short-term and midterm effect are both reliable. During opera- tion, according to the rectangular coordinate system, the screw number needed in the operation can be inferred form th area and depth of tibia defect, which could have a guiding function in surgery.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; instrumentation ; methods ; Bone Screws ; utilization ; Female ; Fracture Fixation, Internal ; Humans ; Knee Injuries ; surgery ; Knee Joint ; surgery ; Male ; Middle Aged ; Tibia ; surgery

UNLABELLEDTo study the method for dose calculation and beam weight optimization of intensity-modulated radiation therapy (IMRT).

METHODSThe IMRT dose calculation model based on two-dimensional convolution was constructed, the program of dose calculation and beam weight optimization with genetic algorithm was written with Visual c#.Net, and the optimization results were analyzed.

RESULTSGenetic algorithm optimization of beam weights can produce highly conformal dose distributions within a clinically acceptable computation time.

CONCLUSIONGenetic algorithm is valid and efficient in IMRT beam weight optimization, which may facilitate IMRT treatment planning.

Algorithms ; Humans ; Models, Statistical ; Models, Theoretical ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; standards

OBJECTIVETo observe the expression of receptor activator of NF-κB ligand (RANKL) and its decoy receptor osteoprotegerin (OPG) during unloading period of dental implants.

METHODSAn animal model of dental implants was established in Beagle dogs. Bone remodeling was tested at 3, 7, 15, 30, 60 and 90 days after the placement of implants. RANKL and OPG mRNA expression were quantified by real-time PCR. Then mandibular bones were resected and some sections were observed.

RESULTSThe most prominent period of bone remodeling occurred at 7 day after the placement of implants (OPG/RANKL mRNA, 2.15 ± 0.1). The expression of RANKL and OPG increased in a time-dependent manner in both soft and hard tissue. After 7 days they gradually decreased.

CONCLUSIONSBoth OPG and RANKL were expressed in peri-implant tissues, and the changing tendency of RANKL and OPGmRNA was consistent with the change of bone remodeling. The active stage for bone remodelling in peri-implant tissues during unloading period is about 7 days after implantation.

Animals ; Bone Remodeling ; genetics ; Dental Implantation ; Dogs ; Male ; Osteoprotegerin ; genetics ; metabolism ; RANK Ligand ; genetics ; metabolism ; RNA, Messenger ; metabolism

Objective To assess the income status of primary care providers and to explore the determinants of income in a county of Dali. Methods In August 2016, the questionnaire was employed to collect the data of income status of 191 rural health workers and 217 village doctors in the county. Results Through the study, we found that the income of rural health workers in the county was 34, 000 (26, 000, 46,000) yuan with a satisfaction rate of 62.3% (95% CI 55.4%～69.2%) and no change (74.7%) was seen in the income among majorities after implementing the Zero Mark-up Policy for essential medicines. For the village doctors, the income was 20,000 (15,000, 24,000) yuan with a satisfaction rate of 40.6% (95% CI 34.0%～47.1%) and a fall of the income was found in more than half of the doctors after the implement of the policy. Conclusion Health care workers in towns are quite satisfied with their income whereas those in health stations of villages are not content, compared with the average income at the national level. We should increase government's investments on grass-root healthcare team, improve the incentive pay plans and promote the integrated management of health facilities in towns and villages.

Objective:Using cancer care as an example,we apply multi-dimensional data for healthcare region division in Beijing,and apply indicators to compare the results of the divisions.Methods:We use two approaches:the hospital catchments division method based on the hospital service range,and the K-Means clustering algorithm based on the population geographic distribution from the residents'healthcare needs,and established two indicators for comparison.Results:Three regions are divided by hospital service range method and eight regions by population geographic distribution method.The indicators of the number of beds per 100 000 population and the need satisfaction rate are more balanced among the different regions than when divided by administrative district.Conclusions:The distribution of healthcare resource in Beijing is significantly imbalanced.The region division based on hospital service range has extended the range of high-quality medical institutions.The division based on population geographical distribution reflects the actual supply and need of healthcare resources in different regions.Beijing can adopt the regional division method based on hospital service range to expand the service coverage of high-quality hospitals and reduce the imbalance in medical resources between central urban areas and suburban areas.The regional division based on population geographical distribution can provide decision support to achieve balanced allocation of healthcare resources.

Objective To compare the differences between Hertel exophthalmometry and CT on exophthalmos measurement,and explore its practical application value in forensic medicine.Methods Fifty-six normal individuals without eye injuries or diseases were selected as the control group.The absolute values of exophthalmos were measured in the standardized CT image workstation.The difference of binocular exophthalmos was compared in normal group.Forty-seven cases with unilateral orbital fracture were divided into injured eye group and normal eye group according to the presence of binocular orbital fractures.The differences of the absolute values of eophthalmos from the same eye and the relative values of eophthalmos between two eyes for same person measured by Hertel exophthalmometry and CT were analyzed.Results There was no statistical difference of exophthalmos between the normal eyes measured by CT method.In the normal eye group,the absolute value of exophthalmos measured by CT method was (16.66±5.41) rm,which was (16.16±4.45)mm when measured by the Hertel exophthalmometry method.There was no statistical difference between two groups (P＞0.05).In the injured eye group,there was statistical difference between the absolute values of exophthalmos measured by two measurement methods (P＜0.05).There was no statistical difference of the relative values of exophthalmos between the injured eyes and the normal eyes by two measurement methods (P＞0.05).Conclusion CT method has a good consistency with Hertel exophthalmometry,which can be applied into the practice of medicolegal expertise.

As a powerful global optimization approach, genetic algorithms (GA) can solve a variety of optimization problems in which the objective function is discontinuous, non-differentiable, or highly non-linear, to produce high convergence speed and vast search space. In this thesis, GA is used to optimize the beam weights of intensity modulated radiation therapy (IMRT) inverse planning, and 2D and 3D isodose contour as well as dose volume histogram (DVH) are used to evaluate the treatment plan. Also presented in this thesis are the results of calculation with discussions.
Algorithms ; Humans ; Models, Theoretical ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Conformal ; methods ; standards

OBJECTIVETo compare two fluorochrome staining methods for the assessment of sperm quality.

METHODSWashed sperm cells were incubated in 0, 0.15, or 15 micromol/L camptothecin (CAM), or 0.37 or 3.7 mmol/L genistein (GEN) at 37 degrees C for 4 hours. The sperm cells were analyzed for cycle-independent apoptosis and necrosis by single-stain compared with dual-stain fluorescence microscopy to contrast the relative effectiveness of these two approaches.

RESULTSThe single-stain procedure could not detect the sperm viability differences. In contrast, the dual-stain procedure identified a dosage-dependent decrease in the viability and increased necrozoospermia after topoisomerase inhibitor CAM and GEN treatments. Apoptosis was 2-fold higher with topoisomerase inhibitor treatment.

CONCLUSIONThe two topoisomerase inhibitors were associated with increased apoptosis and dosage-dependent necrosis. The data suggested that the dual-stain combination Hoechst 33342/PI was more sensitive than the single Hoechst 33342 stain analysis and permitted quantitative analysis of the apoptosis and necrosis in sperm.

Apoptosis ; drug effects ; Benzimidazoles ; Camptothecin ; pharmacology ; Cell Survival ; drug effects ; DNA ; metabolism ; Dose-Response Relationship, Drug ; Enzyme Inhibitors ; pharmacology ; Fluorescent Dyes ; Genistein ; pharmacology ; Humans ; Male ; Propidium ; Sensitivity and Specificity ; Spermatozoa ; drug effects ; physiology ; Staining and Labeling ; methods

genes.