Objective To compare the differences and characteristics of the dose distribution of the two optimization methods in the three dimensional brachytherapy,and provide the basis for clinieal treatment.Methods Excel 2007 was used to generate random number.And a total of 21 patients of cervical cancer were selected from those who have completed the treatment.Inverse simulated annealing optimization (IPSA) plans were designed for graphical optimization (GO) plans.The dose volume histogram (DVH) parameters of the targets (V100％,V150％) and the organs (D1 cm3,D2cm3) of the two methods were analyzed.Results The targets dose of both plans could meet the prescription requirements.There was no statistically significant difference in the dose parameters of all targets (P ＞ 0.05).The closes of D1 cm3 and D2cm3 in the bladder of IPSA plan were significantly lower than that of the GO plan (t =3.596,3.490,P ＜ 0.05).There was no statistically significant difference in the dose parameters of rectum (P ＞ 0.05).Conclusions For cervix brachytherapy,the GO and IPSA have no effect on targets dose,but IPSA optimization can reduce the maximum dose of bladder.

Objective To investigate the clinical effects of mucosolvan on the respiratory tract in elderly patients with long-time tracheal intubation for upper abdominal operation.Methods A total of 88 elderly patients to receive upper abdominal surgery were randomly divided into 2 groups:the treatment group (n=41,treated with antibiotics and mucosolvan 90 mg,iv,bid,for 7 consecutive days) and the control group (n=39,with the same antibiotics but without mucosolvan).Patients indwelling endotracheal tube≤3 hours were excluded.Lung function [forced vital capacity (FVC),forced expiratory volume in 1 second (FEV1),FEV1/FVC ratios (FEV1％)],blood gas analysis (pH,PaCO2,PaO2) and lung condition changes were compared between the two groups before and after surgery.Results There was a significant difference in blood gas analysis between the two groups 3 days after surgery (P＜0.05).There were differences in FEV1 and FEV1％ between the two groups 5 days after surgery (P＜0.05),but no differences were found in FVC in the two groups before versus after surgery.There were significant differences in the incidences of pulmonary infection and atelectasis between the treatment group and the control group [4.9 ％ vs.23.1％ (2 cases vs.9 cases),0％ vs.10.3％ (0 cases vs.4 cases),respectively,both P＜0.05].Conclusions Mucosolvan has a better protective effect on the respiratory tract in elderly patients undergoing upper abdominal surgery and the synergies can be achieved in combination with antibiotics.

Objective To design a wearable physiological monitoring system for acquiring and monitor-ing vital signs non-intrusively and concurrently.Methods All bio-sensors were embedded in an elastic shirt for detecting physiological parameters with wearable technology.A patented respiratory inductive plethysmography technology was used to measure respiratory function,two sensors were woven into the jerkin around the patient's chest and abdomen.A three-lead,single channel ECG measures heart rate,and a three-axis accelerometer records posture and activity level.An NTC thermometer embedded in the shirt measures the body temperature.Results An elastic jerkin with embedded sensors that collect and continuously monitor respiration,cardiac,temperature,posture and activity signals was fabricated.Conclusion This wearable physiological monitoring system can record multiple parameters non-intrusively and concurrently.It can act as an useful platform for further researches.

A total of 60 patients with an acute attack of asthma were studied.On presentation,fractional exhaled nitric oxide (FeNO) and the serum concentrations of procalcitonin (PCT) and C-reactive protein (CRP) were measured.And sputum culture was also performed.The patients were re-evaluated while returning to their clinical remission states.They were classified into 2 groups:patients with bacterial infection (group A) and those with nonbacterial infection (group B).The levels of FeNO were significantly higher in patients with acute exacerbation than those in remission.No difference existed between groups A and B ( P ＞ 0.05 ).The levels of PCT and CRP of group A with acute exacerbation were significantly higher than those of group B( all P ＜0.05).While in remission,the levels of PCT and CRP decreased significantly in group A ( P ＜ 0.05 ) ; But compared with exacerbation,the levels of PCT and CRP showed no change in group B (P ＞0.05).And no differences existed between two groups while in remission (P ＞ 0.05 ).An elevation of FeNO indicates the acute exacerbation of asthma.And the increased serum levels of PCT and CRP are associated with bacterial infection.

This study explored the role of apoptosis of alveolar wall cells of chronic obstructive pulmonary disease (COPD) patients with pulmonary emphysema in the pathogenesis of emphysema. The subjects were divided into three groups: COPD patients with pulmonary emphysema (COPD group), asymptomatic smokers and non-smokers. Lung tissues were harvested and histologically assessed. TUNEL assay was employed to determine the apoptotic cells. The expression of PCNA, Bax and SP-C in the lung alveolar wall cells were immunohistochemically determined. SP-C immunofluorescence staining was used to identify type II alveolar cells in the TUNEL-positive cells. The mean linear interval (MLI), mean alveoli number (MAN) and mean alveoli area (MAA) in COPD group were significantly different as compared with those in asymptomatic smokers and non-smokers, respectively (P<0.01). The proliferation index (PI), apoptosis index (AI) and the percentage of Bax-positive cells in COPD group were significantly greater than those of asymptomatic smokers and non-smokers (P<0.01). However, the percentage of SP-C-positive cells was significantly lower in COPD group than in asymptomatic smokers and non-smokers (P<0.01). Most of the TUNEL-positive cells expressed SP-C. In COPD group, the apoptosis of alveolar wall cells, especially apoptosis of type-II cells, may take part in the pathogenesis of emphysema. Up-regulation of Bax expression may be responsible for the apoptosis of alveolar wall cells in the COPD patients with pulmonary emphysema.

Objective To optimize the cerebral ischemia-reperfusion process for acute ischemic stroke patients,so as to reduce the time of in-hospital delays.Methods A multi-disciplinary management team was established to design the flowchart of the cerebral ischemia-reperfusion process for acute ischemic stroke patients.By applying Healthcare Failure Mode and Effect(HFMEA) management mode,intervention was conducted and its effect was analyzed.Results After implementation of the HFMEA intervention,the door to needle time(DNT)was reduced from 88 (42,140) minutes to 45 (37,59) minutes(P＜0.001);the ratio of patients with the DNT＜60 minutes increased from 20％ to 87.7％(P＜0.001);the door to cerebral ischemia-reperfusion time was shortened from 207(169,227) minutes to 165(155,185) minutes (P＜O.05).There was no significant difference in the incidence and mortality of symptomatic cerebral hemorrhage between before and after intervention (P＞0.05).Conclusion Utilization of HFMEA to optimize the emergency cerebral ischemia-reperfusion process can effectively reduce the in-hospital delays of acute ischemic stroke patients.

Objective To understand the status of the radiation therapy in sichuan province, analysis the development level of radiotherapy in the past five years in sichuan province,provide reference for the rational allocation of radiotherapy resources in the province, promote the healthy development of radiotherapy. Methods With reference to the surveys carried out by other provinces and the survey of sichuan province in 2009,to determine the survey schemes,survey projects. The survey covers all medical units of radiation therapy in the province, adopt the way of combination of questionnaire and on?the?spot visiting. Results There is a big progress in basic condition, treatment equipment, auxiliary equipment, verification equipment,personnel and application of new technologies. Compared with 2009 survey,multiple projects achieve a 50% or even more than 100% growth. Conclusions The rapid development of radiation oncology in sichuan province will ultimately benefit a large number of tumor patients in sichuan province. Patients will be treated with better environment,treatment technology and quality. At the same time,higher requirement of quality control for the entire province is put forward to us.

Objective To investigate the role and potential mechanism of interleukin-17A (IL-17A) in the inflammatory response to traumatic brain injury (TBI) in rats.Methods The adult male Wistar rats were randomly (random number) divided into seven groups:control group (n =6),sham operation group (n =6),TBI group (n =24),sham operation + normal saline group (n =6),sham operation + Y320 (an immunomodulator acts as an inhibitor of IL-17A) group (n =6),TBI + normal saline group (n =6) and TBI + Y320 group (n =6).The TBI model of rat was established by using free-falling-body impact device.The levels of IL-17A and nuclear transcription factor kappa B p65 (NF-κB p65) in the cerebral cortex were assayed by using Western Blot.The capability of leaming and memory of rats was assessed by Morris water maze.The beam balance test was employed to evaluating the neurological motor performance and the capability of balance.Results Compared with the sham operation group,the levels of IL-17A and NF-κB p65 in the cerebral cortex of TBI,TBI + saline and TBI + Y320 groups increased significantly (P ＜0.05) and peaked at the 3rd day after TBI.Compared with TBI + normal saline group,the level of NF-κB p65 was significantly down regulated by Y-320 (P ＜ 0.05) at the 3rd day after TBI in TBI + Y320 group.The lengths of latency time required for rats to escape to the platform area in TBI + normal saline group were (57.72±3.29) s,(55.63±3.85) s,and (55.02±3.92) sat the3rd,5th and7th days after TBI,respectively;while those in TBI + Y320 group were (35.45 ± 3.04) s,(30.98 ± 2.92) s,and (23.90 ±2.51) s at the 3rd,5th and 7th days after TBI,respectively.Thus,the capability of learning and memory of rats in TBI + Y320 group was improved significantly 3d,5d and 7 days after TBI (all P ＜ 0.01).Conclusions This study shows IL-17A is involved in the process of secondary brain injury after TBI,and associated with inflammation by activating the NF-κB p65 signaling pathway.

Objective To investigate the dosimetric influence of dwell weight standard deviation (DWSD) and applicator displacement in cervical cancer patients treated with three-dimensional brachytherapy.Methods A total of 20 cervical cancer patients who had completed radical treatment were selected in this study.The Fletcher applicator (Nucletron#189.730) was used for these patients.A new plan,based on the former CT images and structures,was designed for each patient.In former and new plans,dwell weight was recorded,and DWSD was calculated.Two groups,low-DWSD (LDWSD,0.141-0.299) and high-DWSD (HDWSD,0.211-0.337),were set according to the DWSD size for the two plans.Dosimetric effects from ± 1 mm displacement of tandem applicator or ovoid applicator were simulated with Oncentra (R) Brachy V4.3 treatment planning system.D100,D90,and V150 for clinical target volume (CTV)and D0.1cc,D1cc,and D2cc for the bladder,rectum,and sigmoid were evaluated.Dosimetric comparisons were made between the LDWSD group and HDWSD group to study the dosimetric effects of DWSD and applicator displacement in cervical cancer patients.Results The dosimetric effects from applicator displacement increased with increasing DWSD.If there was a 1 mm displacement of tandem applicator or ovoid applicator,D100,D90,and V150 of CTV were 3.0％,23.8％,and 4.8％ higher or 0.5％,1.2％,and 5.2％ higher in the HDWSD group than in the LDWSD group;D0.1cc,D1cc,and D2cc of the bladder and rectum were significantly higher in the HDWSD group than in the LDWSD group,particularly for the sigmoid (up 44.0％,22.8％,and 16.8％) and (up 10.3％,14.4％,and 12.4％).Conclusions DWSD should be considered in plan evaluation for cervical cancer patients treated with three-dimensional brachytherapy.The dosimetric influence from applicator displacement can be decreased by reducing DWSD properly.

Objective:To investigate the effects and underlying mechanisms of XRCC3 on esophageal squamous-cell carcinoma (ESCC) radiotherapy response. Methods:Expression levels of XRCC3 were detected by reverse transcription PCR, Western blot, and immunohistochemistry. We knocked down XRCC3 with lentiviral infection in ESCC cells. Cell apoptosis was examined by flow cytom-etry. DNA damage and telomere dysfunction-induced foci were determined by immunofluorescence. Results:The expression levels of XRCC3 in ESCC cells and tissues were higher than those in normal esophageal epithelial cells and corresponding adjacent noncancer-ous esophageal tissues. Knockdown of XRCC3 in ESCC cells substantially increased the therapeutic efficacy of radiation. We demon-strated that the radiation resistance of XRCC3 was attributed to the XRCC3-maintaining telomere stability, which reduced ESCC cell death through radiation-induced apoptosis. Conclusion: Our data suggested that XRCC3 protects ESCC cells from ionizing radia-tion-induced DNA damage and death by enhancing telomere stability. Thus, XRCC3 can be used as a promising therapeutic target for ESCCs.