Primary mediastinal large B-cell lymphoma (PMBCL) has specific phenotypical features, pathological features and clinical presentation.PMBCL patients are predominantly female and typically present early stage disease and mediastinal involvement.Due to the lack of randomized studies, most patients with PMBCL usually receive combination chemotherapy with consolidation IF-RT.Considering IF-RT can improve the complete remission rates and recurrence-free survival, the combined therapy achieved good results.The different chemotherapeutic regimens were used in clinical practice of different institutions and clinicians, including CHOP or CHOP-like, intensive chemotherapy or the third-generation regimens.Recent studies have showed promising outcomes when rituximab is added to doxorubicin-containing chemotherapy.Patients treated with R-CHOP with radiotherapy had significantly better local control rates compared with R-CHOP without radiotherapy, especially for bulky diseases.Intensity-modulated radiation therapy offers excellent target coverage, favorable outcome and minimal toxicity in PMBCL.Although the majority of patients with PMBCL receive radiotherapy following chemotherapy, few studies have specifically addressed the role of consolidation radiotherapy for the treatment of PMBCL.The prognostic importance of rituximab and radiotherapy has not been clearly defined in patients with PMBCL.Heterogeneous treatment options and small number of patients have made it difficult to draw definitive conclusions about the potential advantages of rituximab and radiotherapy in patients with PMBCL.

There has been great interest in NiTi alloy in medical domain si nc e Buehler found its memory effect in 1963. In the recent 30 years, a lot of basi c and clinical researches of the alloy have been reported in the world. From the biomechanical viewpoint, the ossification and resorption of bone are related to the stress. Different stresses are required in the different kinds of fracture healing. Many measurements have been used to test the biomechanical properties o f the Nitinol orthopedic instruments. The clinical applications of the instrumen ts in hand surgery started in China in 1980's and resulted in satisfactory outco mes. This article summarizes the progress made in the basic researches of the ni tinol orthopedic instruments and their clinical applications in hand surgery.

Objective The goal of this work is to evaluate the dosimetric characteristics of a new 2D diode array (Mapcheck from Sun Nuclear Corporation,Melbourne,Florida) and assess the role it can play in routine IMRT QA. Methods Fundamental properties of the Mapcheck such as reproducibility and linearity were studied for high-energy photon beams. Clinical performance of the MapCheck for relative and absolute dosimetry was demonstrated with head and neck IMRT plans,and compared with plan dose distribution. Absolute dose measured by Ion chamber and Mapcheck are compared with the one given in TPS. Results The Mapcheck offers the dosimetric characteristics required for performing both relative and absolute dose measurements. Conclusion Mapcheck can provide the verification of absolute dose and relative dose. Its use in the clinic can simplify and reduce the IMRT QA workload.

In this paper, industry development and market tendency, supervision and standardization of nanomaterial-contained medical devices are overviewed comprehensively based on a large number of reference data including national and international information. Furthermore, the consideration about standardization of biological evaluation for nanomaterial-contained medical devices is discussed by combined some works performed in our laboratory.
Device Approval ; Equipment and Supplies ; standards ; Nanostructures ; standards

Objective To explore influencing factors of the individual entrepreneurship from as-pects of entrepreneurial intention, entrepreneurial cognition and entrepreneurship education. Methods Questionnaire of entrepreneurial cognition was conducted for 1860 students in Southern Medical Universi-ty. SPSS was used to analyze the data. Results ①Entrepreneurship intention among university students were strong.②There was a lack of awareness of college students entrepreneurship policy among college students. ③Students never receiving entrepreneurship education accounted for 65%, but 89%students held that entrepreneurial education courses was necessary. Conclusions Due to arduous professional tasks, medical students have compelling and demanding need for personalized entrepreneurship educa-tion. Initiative participation of library in integrating of entrepreneurship education information by using advantageous resources plays a important role in entrepreneurship education.

Heart rate variability(HRV)analysis and its circadian rhythm(CR)were determined in 58patients with type 2 diabetes mellitus with lower extremity neuropathy(diabetic neuropathy group), 59 patients with type 2 diabetes mellitus without lower extremity neuropathy(diabetes group), and 50 healthy controls according to 24-hour Holter recording. Frequency domain parameters of HRV were significantly decreased in both diabetes groups. Frequency domain parameter of HRV in healthy controls,and daytime/nighttime difference were statistically significant. CR of HRV was changed in diabetes group and disappeared in diabetic neuropathy group. Impaired and seriously impaired autonomic nervous function developed in type 2 diabetes mellitus without and with lower extremity neuropathy respectively.

Hypofractionated conformal radiotherapy is capable to deliver much higher doses to the cancer than is possible with standard techniques. Recently there is data suggesting that the early stage nonsmall cell lung cancer ( NSCLC) which is not suitable to surgery is likely to benefit from this regimen, with low lung toxicity. Manyphase Ⅰ-Ⅱ studies showed that the patients with locally advanced NSCLC are well-tolerated to hypofractionated conformal radiotherapy. The model of radio-physic and relative clinical studies suggest that hy-pofractionation would not increase the risk of radiation pneumonitis compared to standard therapy.

Objective To investigate reasonable method of deciding internal target volume (ITV) by comparing physical phantom volumes (including moving volume) with reconstruction volumes of spiral CT scanning.Methods The various-volume wax blocks which were labeled No.1-9 were made and put on the respiratory motion simulator.The range of motion was set 2.5 cm and frequency 18 beats/min.All blocks were scanned 10 times continuously and imported into the Eclipse TPS.All blocks volumes were calculated and then compared with the true physical volumes and paired t-test.Results The reconstruction volumes of 1-9 blocks were bigger than their stationary volumes (121.77 cm3 vs.103.14 cm3,P =0.038),but significantly smaller than their moving volumes (121.77 cm3 vs.161.75 cm3,P =0.045).The results can be gotten in different volume block scanning.The relative deviation of reconstruction volumes and the moving volumes tends to increase as the stationary physical volume decreases.Conclusions As to moving targets,conventional spiral CT scanning speed is too fast to collect all volume information of targets.So the one-time-scanning volume does not represent the ITV.

Objective To compare and analyze DMLC(Sliding Window,SW)and SMLC(Step and Shoot,SS)for delivering IMRT.Methods 5 patients with nasopharyngeal carcinoma were treated with radical intensity modulated radiation therapy using Varian 23EX and Helios tool on a Varian Eclipse system.Different modalities to deliver IMRT were considered for Sliding Window(SW) and Step and Shoot(SS) techniques using a different number of intensity levels(e.g.5,10 and 20).The total beam-on-time,total delivery time and a number of dose-volume parameters regarding PTV and OARs were considered.Results Comparing with the DVH,it was found that SW was the best of the four modalities in the dose distribution of PTV,but SS was better when considering the protection of OARs.The total beam-on-time(MUs) requirement for SS was 9～23% less than SW,but the total delivery time(in minutes)was about twice as long.Conclusion With the number of intensity level of 10 or more,no differences between SS and SW can be appreciated in the dose distribution of PTV and OARs sparing.Referring to the quality assurance,only leaf position needed to be checked in SS,whereas both leaf position and leaf speed need to be checked in SW,so it is proposed to use SS10 for delivering IMRT.

Objective To investigate the protective role of two-step decapping technique for superior parathyroid glands in total thyroidectomy surgery.Methods The clinical data of 136 consecutive cases underwenttwo-step decapping technique in total thyroidectomy plus central compartment dissection from April 2013 to January 2016 were retrospectively analyzed.And the incidences of postoperative hypocalcemia were was compared with conventional consecutive decapping surgical methods containing 113 cases from January 2010 to March 2013.All operations were performed by the same treatment group.Results In the two-step decapping group,28 cases(28/136,20.6％) displayed postoperative temporary hypoparathyroidism and a higher incidence were was observed in 37 cases (37/113,32.7％) in the conventional method group,the difference was statistically significant(x2 =4.737,P =0.03).Whereas,2 cases(2/136,1.5％) suffered permanent hypoparathyroidism in the two-step decapping group and 7 cases (7/113,6.2％) of permanent hypoparathyroidism in the conventional method group,the difference was statistically significant (x2 =3.954,P =0.047).Conclusion Two-step decapping technique can more effectively protect the parathyroid gland function.It is worthy of popularization.