Objective To compare the dose distribution of reserved planned tangential beam IMRT(2-field IMRT) with multifields beams IMRT(6-field IMRT) of the bulk-recurrent chest wall in postmastectomy breast cancer patients.Methods For 8 patients with chest wall in postmastectomy breast cancer bulk-recurrence,2-field IMRT and 6-field IMRT plans were generated on PTV in Pinnacle Planning System.The prescribed dose of PTV was 50 Gy in 25 fractions and GTV was 66-70 Gy which irradiated incrementally by subsequent plan in 8-10 fractions.The conformal index (CI) and homogeneity index (HI) of 95％ of prescribed dose over PTV were compared,while the dose distribution on ipsilateral lung and heart were evaluated.Results The CI of PTV by 6-field IMRT (0.66 ± 0.08) was higher than that of the2-field IMRT (0.53±0.10)(t=7.99,P＜0.05).The HI ofPTV by6-field IMRT (1.36±0.08)waslower than that of 2-field IMRT (2.19 ±0.78) (t =9.04,P ＜0.05).There was no statistical difference in V5,V10,V20 and V35 for ipsilateral lung and in D V35 and D for heart between two plans.Conclusions Compared with 2-field IMRT,6-field IMRT might have a better dose distribution on planning target volume(PTV) for chest wall in postmastectomy breast cancer bulk-recurrence patients,butthere is no significant difference in dose-volume of ipsilateral lung and heart between two plans.

From the standpoint of training mode,the paper makes an effort to analyze the present situation on Sino-Foreign cooperation in nnning schools in mode of nursing personnel training in Hubei Province,find out the existing problems and put forward the corresponding proposals in order to ensure sustainable development of the Sino-Foreign cooperation in running schools in mode of nursing personnel training.

Purpose To evaluate the clinical value of triple-rule-out (TRO) computed tomographic angiography using adaptive prospective ECG triggering for chest pain patients.Materials and Methods Sixty patients with chest pain were prospectively collected and randomly divided into group A and group B:group A (n=30) performed prospectively gated axial scan and group B (n=30) performed retrospectively gated helical scan.The vascular density,noise and muscle density of the vessels including aorta,pulmonary artery,coronary artery between the two groups were measured and analyzed.The vascular density/noise ratio,contrast noise ratio and effective dose (ED) between the two groups were calculated.The image quality and scanning radiation dose were compared between the two groups.Results There was no significant difference in the image quality of aorta,pulmonary artery and coronary artery between group A and group B (P＞0.05).The ED in group A was lower than that in group B [(5.90±2.10) mSv vs (11.31 ± 2.12) mSv,P＜0.01].Conclusion The technique of TRO computed tomographic angiography triggered by adaptive prospective ECG can significantly reduce the radiation dose while ensuring image quality.

Objective:To investigate the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT metabolic parameters for occult lymph node metastasis (OLM) in non-small cell lung cancer (NSCLC). Methods:A total of 183 patients (72 males, 111 females; age (61.5±8.4) years) who underwent 18F-FDG PET/CT and preoperatively diagnosed with clinical N0 stage (cN0) in Third Affiliated Hospital of Soochow University from January 2013 to December 2018 were retrospectively enrolled. All patients underwent anatomical pulmonary resection with systematic lymph node dissections within 3 weeks after 18F-FDG PET/CT examinations. According to the presence or absence of lymph node metastasis, patients were divided into OLM positive (OLM+ ) group and OLM negative (OLM-) group. Parameters of primary lesions, such as the maximum diameter (D max), tumor sites, morphological features, maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), metabolic total volume (MTV), total lesion glycolysis (TLG), tumor SUV max to liver SUV mean (TLR max), tumor TLG to liver SUV mean (TLR TLG) were analyzed. Mann-Whitney U test and χ2 test were used to compare the parameters between groups. Multivariable logistic regression was used to analyze the independent risk factors for OLM. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different parameters. Results:Among 183 patients, 25 (13.7%, 25/183) of them were diagnosed as OLM. In OLM+ group, 46 lymph nodes were pathologically positive for metastasis, including 15 N1 disease and 31 N2 disease. D max (2.9(2.3, 3.7) vs 2.3(1.7, 2.8) cm), lobulation ((76.0%(19/25) vs 37.3%(59/158)), SUV max (11.1(7.9, 17.7) vs 4.7(2.3, 9.2)), TLG (41.5(10.2, 91.1) vs 15.6(6.5, 23.8) ml), TLR max (4.7(3.5, 7.6) vs 2.1(0.9, 4.0)) and TLR TLG (18.1(5.0, 44.3) vs 6.1(3.0, 11.4) ml) of the primary lesions in OLM+ group were significantly higher than those in OLM-group ( z values: from -4.709 to -3.247, χ2=13.190, all P<0.05). Multivariable logistic regression analysis showed that TLR max (odds ratio ( OR)=15.145, 95% CI: 3.381-67.830, P<0.001) and D max ( OR=3.220, 95% CI: 1.192-8.701, P=0.021) were independent risk factors for OLM. TLR max yielded the highest area under curve (AUC; AUC=0.794) with the threshold of 3.12, and the sensitivity, specificity, accuracy, positive predictive value and negative predictive value for predicting OLM were 92.0%(23/25), 63.3%(100/158), 67.2%(123/183), 28.4%(23/81) and 98.0%(100/102), respectively. Conclusions:TLR max of tumor is the independent risk factor for OLM in NSCLC patients. TLR max can sensitively predict OLM preoperatively in patients with NSCLC.

Objective To assess the short-term efficacy and tolerability of different radiotherapy doses schedules as 46 Gy and 50 Gy for locally advanced rectal cancer patients undergoing neoadjuvant chemoradiotherapy.Methods All patients with locally advanced rectal cancer who had received neoadjuvant chemoradiotherapy between Aug 2010 and May 2015 were enrolled.This retrospective analysis was performed according to the radiotherapy dose grouping of 46 Gy and 50 Gy groups.Concurrent chemotherapy regimen was capecitabine-based and oxaliplatin was added only when young patients (＜ 75 years old) were in a good condition.Total mesorector excision was scheduled 6-8 weeks after concurrent chemoradiotherapy.Results Totally 213 patients were enrolled in our analysis,including 61 cases in 46 Gy group and 152 cases in 50 Gy group.There were 145 male and 68 female patients.There were 22 patients diagnosed clinically with T2,180 with T3,and 11 with T4.Tumor distance from the anal verge was ≤5,＞5 and ＜ 10 cm,or ≥10 cm in 82,115 and 16 patients,respectively.T downstaging was observed in 95 (44.6％) patients,pathologic complete response (PCR) was shown in 48 (22.5％) patients.In the 46 Gy and 50 Gy groups,the rate of PCR was 18.0％ vs.24.3％ (P ＞0.05).In addition,good response rate (TRG 3 + 4) was 67.2％ vs.75.0％ (P ＞ 0.05),and T downstaging rate was 39.3％ vs.46.7％ (P ＞0.05).Subgroup analysis for T3N2/T4 patients,the rate of PCR was 6.3％ vs.23.3％ (P＞0.05),good response rate (TRG 3 +4) was 50.0％ vs.72.1％ (P＞0.05),and T downstaging was 31.3％ vs.46.5％ (P ＞0.05).There was no significant difference in treatment-related toxicity between the two groups.Conclusions The two different radiation dose fractionation (50 Gy vs.46 Gy) had no impact on pathologic tumor regression and T downstaging for locally advanced rectal cancer.Nonetheless,a further long-term follow-up is warranted to confirm the preliminary study.

Objective : To learn the awareness of chronic diseases prevention and control and its influencing factors among high school students in regions inhabited by ethnic groups,so as to strengthen the prevention of chronic diseases among adolescents in these regions. Methods: Totally 1 050 high school students in Tuquan County,Hinggan League,Inner Mongolia were selected by cluster sampling method. The general information,family factors,attitude to learning,psychological factors,behavioral styles and awareness of chronic diseases prevention and control were investigated,and the influencing factors for the awareness were analyzed by multivariate logistic regression model. Results: There were 1 001 valid questionnaires recovered,with a response rate of 95.33%. There were 685 Han students,accounting for 68.43%,241 Mongol students,accounting for 24.08%,and 75 students with other ethnic minorities,accounting for 7.49%. The average awareness rate of chronic diseases prevention and control was 53.25%;the awareness rates of hypertension prevention measures,smoking and drinking hazards,food susceptible to aflatoxin pollution and high cholesterol food were high,all more than 70%;while the awareness rates of long-term high lipid hazards,high blood pressure diagnosis standard and diabetes symptoms was low,all less than 40%. There was no significant difference in the awareness rate of chronic diseases prevention and control among different nationalities（P>0.05）. The results of multivariate logistic regression analysis showed that the students who were female（OR=1.309,95%CI：1.008-1.700）,had high achievement（OR=1.509,95%CI：1.055-2.159）,and thought exams were important（OR=1.570,95%CI：1.204-2.046）were more likely to have high awareness,while the students who spent five to less than eight hours a day on screens（OR=0.514,95%CI：0.335-0.789）were less likely to have high awareness. Conclusions The awareness rate of chronic diseases prevention and control of high school students in Tuquan County is 53.25%,and there is no significant difference between Mongol and Han students. Gender,academic performance,attitude to examination and time spent on screens can affect the awareness rate.

Objective: To analyze the normal value of the iodine content in the left ventricular myocardium of healthy subjects and to observe if there is a segmental differences on iodine distribution by using the second generation dual-source dual-energy computed tomography myocardial first perfusion imaging. Methods: In this retrospective study, 42 healthy subjects, who admitted to our department between January to June 2016, with normal second generation dual-source dual-energy computed tomography and coronary CT angioghphy (CTA), electrocardiogram (ECG) results, normal cardiac, hepatic, renal function, normal myocardial enzymes results were enrolled, data from 38 out of 42 subjects with satisfactory image quality were analyzed using Siemens Dual Energy-Heart PBV image processing software.In accordance with the standards of the American Heart Association myocardial 17 fractionation method, content of iodine was measured at different segmental left ventricular myocardium and aorta (left coronary artery from the opening level). The standardized containing iodine value (nIC) was calculated. Results: The iodine content of left ventricular myocardium in normal subjects was 3.1-7.8 mg/ml.The nIC of myocardium from 1st to 17th segments was 0.28±0.06, 0.31±0.07, 0.30±0.07, 0.30±0.04, 0.28±0.04, 0.29±0.05, 0.29±0.01, 0.30±0.07, 0.31±0.07, 0.27±0.06, 0.28±0.08, 0.28±0.07, 0.29±0.08, 0.31±0.07, 0.27±0.06, 0.29±0.06 and 0.21±0.07, respectively.The nIC of the 17th segment was the lowest and was significantly lower than in other segments (all P<0.05), the nIC was similar among the rest 16 segments (all P>0.05). Conclusion The normal iodine content range in left ventricle myocardium is 3.1-7.8 mg/ml, and the lowest iodine content is detected in the apex and which is significantly lower than the other left ventricular segments.

Standardized training of dental residents is the only way to train qualified dentists. Under the trend of homogenization of resident standardized training and professional degree education, the residents, teachers and departments will face more challenges and opportunities. Since the stomatological hospital of Chongqing Medical University established one of the resident standardized training centers in 2015, in view of the current situation and problems in the teaching of prosthodontics, the department of prosthodontics has been actively exploring new management mechanism and teaching methods to improve the clinical ability and scientific research capability of residents in prosthodontics, on the basis of strengthening the coordination of promoting the training of professional graduate of stomatology and the standardized training of residents.

Objective:To provide a theoretical basis for the clinical application of the posterior route through atlas occipital articular slope screw internal fixation system through the biomechanical study.Methods:Eight cadavers of healthy adults aged 35-60 years and 155-180 cm in height were selected. The specimens with complete anatomical structure and without surgical operation were established as normal models. The model of occipito-atlantoaxial complex was established by breaking the articular capsule, ligament and other connecting structures and cutting the dentate process. The device was established as an internal fixation model through the specimen of atlantooccipital joint slope screw internal fixation system. Given normal model and internal fixation of 1.5 N·m in the moment of flexion, lateral bending and axial rotation and to measure the specimen C 0-C 1 and C 0-C 2 segment of the range (range of motion, ROM), comparative analysis of pillow neck area within the normal model and fixed model changes the range of movement, after the evaluation through the slope between atlas and the occipital screw internal fixation system of mechanical properties. Results:In the normal model, the flexion, flexion and extension, lateral bend and axial rotation ranges of C 0-C 1 segments were 23.85°±2.43°, 4.74°±0.55°, 5.77°±0.75°, respectively; the corresponding activity ranges of C 0-C 2 segments were 30.66°±3.05°, 9.09°±1.37°, 70.97°±9.48°, respectively; in the internal fixation model, the flexion and extension, lateral bend and axial rotation ranges of C 0-C 1 segments were 0.71°±0.24°, 0.24°±0.06°, 0.34°±0.09°, respectively. The corresponding activity range of C 0-C 2 segment was 3.09°±0.82°, 0.74°±0.07°, 1.22°±0.10°, respectively. Compared with the normal model, the range of activity of the internal fixation model in all directions was significantly reduced (<3°), and the reduction ratio of activity was more than 90%. Conclusion:The posterior route through pillow slope screw internal fixation system can effectively reduce the range of motion of the occipital neck in flexion, extension, lateral bending and rotation, and has safe and reliable biomechanical stability.

Obesity is the main risk factor of cardiovascular diseases.As the indexes of obesity evaluation, body mass index(BMI) and waist circumference are the most common methods to predict metabolic risk of cardiovascular system.Recently, neck circumference, a reliable and low-cost parameter of anthropometry, could be considered as a new indicator to evaluate childhood obesity since it is closed correlation with children′s BMI and waist circumference.Moreover, studies had shown that the increase of neck circumference had strong correlation with cardiometabolic risk, such as high blood pressure, hyperlipidemia, hyperglycaemia and hyperuricemia.This indicates that it might be the index to predict metabolic risk of cardiovascular system.Understanding and illuminating the changes of neck circumference and its relationship with obesity and metabolic disorders would have significances for preventing and identifying metabolic risks of cardiovascular system in children and adolescents.