OBJECTIVE:To evaluate the long-term toxicity of Ginkgolide B injection on Beagle dogs,and to provide safety evidences for clinical experiment.METHODS: A total of 24 Beagle dogs were equally assigned to receive placebo(control group,n=6) or Ginkgolide B injection at high,medium,and low doses(80,20,and 5 mg?kg-1) by iv gtt for 6 consecutive days per week for up to 90 days.There were 6 Beagle dogs(male: female =1∶1) in each group.All the laboratory indicators were monitored and the recovery of the Beagle dogs was observed.RESULTS: During medication,vomiting was noted in one dog in high dose group,and the clotting time in high and medium dose groups was prolonged obviously.During the recovery stage,one dog in high dose group was strong positive in urinary protein test.No significant drug-associated toxic reactions were noted judging from Beagle dogs' body weight,appetite,temperature,ECG,hematology,blood biochemical analysis,ophthalmology test,marrow test,urine routine test,histopathologic examination etc.CONCLUSION: The non-toxic dose of Ginkgolide B injection for Beagle dogs was 20 mg?kg-1.

Objective To study the reproductive outcome of infertile women suffered from hydrosalpinx treated by laparoscopic salpingostomy or salpingectomy.Methods There were 77 infertile women diagnosed hydrosalpinx by HSG or B ultrasonography and excepted for other infertile factors. Unilateral or bilateral salpingostomy or salpingectomy was performed after hydrosalpinx conifrmed by laparoscopy. Seventy seven patients were followed up for 1 ~ 4 years postoperatively.Results Among 77 cases 39 cases (50.65%) got pregnancy. Thirteen cases (16.88%) conceived spontaneously and 26 cases (33.77%) conceived by IVF-ETin. Thirty ifve cases delivered health babies and 3 cases of pregnancy, 1 cases of early abortion.Conclusion Both laparoscopic surgeries were effective treatment of hydrosalpinx results in infertility. After operation the pregnant rate of those conceived by IVF-ET is higher than spontaneously.

Objective To evaluate clinical effects of combined use of hysteroscopy and laparoscopy in the diagnosis and treatment of infertility with uterine septum,and to analyze the relationship between infertility and uterine septum. Methods Surgery using hysteroscopy combined with laparoscopy was performed in 110 patients with infertility accompanying uterine septum,including primary infertility in 78 patients and secondary infertility in 32 patients.The relative infertility factors and post-operative pregnancy prognoses were analyzed. Results Unexplained infertility accounted for 40% of patients(44/110).As of March 2006,a total of 82 patients were successfully followed.The total post-operative pregnancy rate was 45.1%(37/82),consisting of 46.6% in patients with primary infertility(27/58) and 41.7% in patients with secondary infertility(10/24),without significant difference between the two groups(?~2=0.164,P=0.686).The post-operative pregnancy rates in patients with unexplained infertility and etiologically-clarified infertility were 51.2%(22/43) and 38.5%(15/39),respectively,without significant difference(?~2=1.332,P=0.248).In patients with unexplained infertility,the post-operative pregnancy rate for primary infertility was 56.7%(17/30) and for secondary infertility,38.5%(5/13). Conclusions Combined use of hysteroscopy and laparoscopy for infertility with uterine septum can improve the post-operative pregnancy rate.The presence of uterine septum bears some relationship to the incidence of infertility.

Objective In order to explore the ways of reflecting the dose distribution in the implementation of the of IMRT (intensity modulated radiation therapy),a 2D diode array (2D-DA) was used in verifying the composite dose distribution of IMRT plans in the way of multi-gantry-angle composite (MGAC).Methods IMRT quality assure (QA) plans of 27 patients,based on the 2D-DA and solid water phantom,were designed and verified in two ways of single-gantry-angle composite (SGAC) and MGAC verifications.The comparison and analyzation of the dose distributions of the TPS calculation and the measurement of the 2D-DA were done.Results (1) When the beam central axes were not superposed with the detectors'plane of the 2D-DA,the verification passrate of SGAC and MGAC planar dose distribution of 27 patients'IMRT plan were 94.56%±4.28% and 94.81%±3.80% (the criteria:rvalue,3 ram/3%),respectively.There was no statistical difference between the results of two sets (t =-0.213,P＞0.05).(2) When one of the beam central axes was superposed with the detectors'plane of the 2D-DA,the verification passrate of MGAC planar dose distribution were 79.72%±12.77%.Conclusions Using the 2D-DA with a proper phantom,there was no statistical difference in the SGAC and MGAC verifications of IMRT plans when the beam central axes were not superposed with the detectors'plane.However,the MGAC dose distribution can provide more about the clinical dosimetry,and the errors in the implementation of the of IMRT were easier located.

Objective To investigate the impact of planning parameter settings on plan quality and delivery efficiency of VMAT for nasopharyngeal carcinoma with two treatment planning systems (TPS),as references for clinic plan optimization. Methods 25 patients with nasopharyngeal carcinoma were selected and planned for SIB?VMAT treatment. The same planning aims were used in the two kinds of TPS ( TPS?1 and TPS?2). Multiple planning parameters were set for plan optimization. Dose distribution to the target volumes and organs at risk,monitor unit ( MU) and delivery time were compared. Paired t?test or one?way ANOVA was used for the data which was in accordance to normal distribution;otherwise, nonparametric Wilcoxon signed rank test or nonparametric Friedman test was used. Results More segments lead to better plan quality and less MU but longer delivery time ( Minor impact was observed when segment number was larger than 120) in TPS?1,while it had little impact on both plan quality and delivery efficiency in TPS?2. Comparing to single?arc plans,dual?arc VMAT achieved no significant benefit in plan quality but had more MU and longer delivery time in TPS?1 ( P= 0?000 ) . However, dual?arc VMAT plans had better dose distribution in TPS?2, decreased the maximum and mean dose for spinal cord in 3?9% and 13?7%respectively (P=0?000,0?000).Changing the settings of maximum or minimum dose rate did not affect the plan quality in both of the tested TPSs. Increasing the maximum or minimum dose rate reduced the delivery time but the latter increased the number of MU ( P=0?000,0?000) . Conclusions VMAT plan quality and delivery efficiency is affected significantly and differently by planning parameter settings for two TPSs. Trial test should be conducted for different TPS to determine the optimal parameter settings.

Objective To evaluate the respiratory movement of the both lungs with four-dimensional CT(4DCT), and determine the optimal respiratory phase series CT images for radiation dose calculation. Methods From November 2005 to November 2006,thirty patients with lung cancer who received 4DCT scan were enrolled,including 15 left and 15 right lung cancer cases,25 men and 5 women. The media age was 55 (35-78) years old. After 4DCT scanning, the image was treated with Advantage 4D workstation,and then transmitted into Pinnacle station( Adac 7.4). The both lungs were automatically outlined using Pinnacle station with CT recognition value of-900 to-200 Hu. Then-the same physician examined the unreasonable parts and revised them. After the delineation was completed,the volume of 10 respiratory phases of lung was obtained. Results The average respiratory phase in inspiratory and expiratory phases was 78.87%±2.71% and 26.32%±3.17% in the tumor located lung,77.55%±2.81% and 24.73%±2.55% in the healthy lung. The maximum and minimum mean volume was 106.48%±3.00% and 94.23%±2.78% in the tumor located lung,107.47%±2.43% and 93.65%±2.32% in the healthy lung. The volume at the end of inspiratory and expiratory was 106.43%±3.07% and 94.63%±2.71% in the tumor located lung, 107.37%±4.62% and 93.98%±2.34% in the healthy lung. Conclusions The series CT images scan on 20% ,30% and 80% respiratory phases are reasonable for radiation dose calculation. The maximum and minimum average lung volumes are almost equal to those at the end of inspiratory and expiratory.

Objective To evaluate the dosimetry of high-energy electron beams by using GafChromic EBT film. Methods The percent depth doses of electron beams of 4 MeV,6 MeV,8 MeV,10MeV, 12 MeV and 15 MeV were measured with EBT. The results were then compared with the measurements with diode detector in RFA and parallel plate chamber in water tank. Results The percent depth dose curves using EBT film had a good agreement with those using the other two detectors. Furthermore, no differences were found between up-right and tilt setup methods. When film upper edge is higher than water surface, a sharp drop of measurement results using EBT film was observed in comparison with those from diode detector in build-up region. Conclusions EBT film can be applied to measure percent depth doses of high-energy electron beams. During the EBT film measurements, the film should be tilted at the angle of 5degrees to the central axis of the field. When choosing up-right setup method, the edge of the film should be parallel to the water surface.

ObjectiveTo compare planning quality,treatment efficiency and delivery accuracy for initial treated nasopharyngeal carcinoma (NPC) with step & shoot intensity modulated radiation therapy (ssIMRT) and volumetric modulated arc therapy (VMAT).These results will help make a clinic choice of the therapeutical technique.MethodsTwenty-six NPC cases were planned with the same dose prescription and objective constrains by means of 9-field ss-IMRT and VMAT respectively.Compare:( 1 ) plan dosimetric distribution,conformity index and homogeneity index of the targets,the average dose,maximum dose and interested dose-volume histograms of organs at risk (OAR) et al;(2) delivery times of the therapy plans ;(3) the accuracy of treatment plans dose verification.ResultsBoth therapeutical plans can achieve the clinic dosimetric demands.Compared to ss-IMRT,VMAT had less inferior target coverage.The CI and HI of the PGTV was 0.57 and 0.08 ( ss-IMRT),0.48 and 0.12 (VMAT) respectively ( t =-4.52,- 8.33,P =0.000,0.000).Except of brain stem,VMAT had higher mean dose and maximum dose of OARs than ss-IMRT (t=-9.57 - -3.71,P=0.000 -0.001).The spinal cord D1cc and parotids D50％ were increased by 11.9％ and 6.5％ averagely.The treatment times of ss-IMRT and VMAT were 803.7 s and 389.3 s respectively (t =24.12,P =0.000),while V MAT decreasing by 51.6％.The pass ratios of γ (3mm,3％ ) from the dose verification were 99.4％ (ss-IMRT) and 98.0％ (VMAT) respectively ( t =5.19,P =0.000).ConclusionsThe dose distribution of VMAT for initial treated nasopharyngeal carcinoma can achieve the clinic demands,but slightly worse than 9-field ss-IMRT.VMAT has the advantage of high efficiency and dosimetric accuracy.

Objective To investigate the effects of preventive chemotherapy for hepatocellular carcinoma (HCC) exceeding Milan criteria after liver transplantation. Methods The clinical data of 243 patients who had undergone orthotopic liver transplantation for HCC exceeding Milan criteria from April 2001 to July 2007 were retrospectively analyzed. Of all patients, 162 received preventive chemotherapy after transplantation. Results The 1- and 3-year survival rates and disease-free survival rates were not statistically different between patients who had received chemotherapy (78.5%, 63.7% ; 76.8%, 52.5% ) and those without chemotherapy (56.6%, 39.1%; 69.3%, 64.7% ) (X2 = 3.084, 0.444, P > 0.05). Cox regression analysis demonstrated that postoperative chemotherapy was not an independent factor affecting the survival rates of HCC patients without vascular invasion, but an independent factor affecting the survival rates of HCC patients with vascular invasion. Conclusions Early preventive chemotherapy could obviously increase the survival rate and delay the tumor recurrence of patients with HCC exceeding Milan criteria, especially for HCC patients with vascular invasion.

Objective To study the therapeutic of anastomotic leakage in post-esophagogastrectomy. Meth-ods There were 18 cases of anastomotic leakage in 127 cases with cancer of the thoracic esophagus who underwent esophagectomy were retrospectively studied. There were ten cases had anastomotic leakage of 67 cases of esophagogas-trectomy from 1995 to 2001 (first phase),the intestines nutrition sustain treatment taked rice water,fish soup and broth, there were eight cases had anastomotic leakage of 60 cases of esophagogastrectomy from 2002 to 2007 (second phase) ,the intestines nutrition sustain treatment taked supportan,fresubin. Results There were six cases death of 10 cases of anastomotic leakage at first phase, and there was any not death in the second phase. Conclusion When anastomotic leakage of esophagogastreetomy,it can elevate the cure rate with early diagncsis and treatment and intes-tines nutrition sustain treatment choose by supportan or fresubin.