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 define individualized internal target volume (ITV) for hepatocellular car-cinoma using four-dimensional (4D) CT, and to compare the differences in target volume definition and dose distribution among 3D, 4D and respiratory-gated plans. Methods 4DCT scanning was obtained for 12 pa-tients with hepatoceUular. Gross tumor volume (GTV), clnical target volume (CTV) and normal tissues were contoured on all 10 respiratory phases of 4DCT images. The 3D, 4D and gated treatment plans were prepared for each patient using three different planning target volumes (PTVs): 1) PTV3D was derived from a single CTV plus conventional margins;2) PTV4D was derived from ITV4D, which encompassed all 10 CTVs plus setup margins (SMs);3) PTV_(Gating) was derived from ITV_(Gating), which encompassed 3 CTVs within ga-ting-window at end-expiration plus SMs. The PTV volume and dose distribution were compared among differ-ent plans. Results The PTV3D was the largest in all 12 patients, but still missed partial target volume in 5 patients when comparing with PTV4D. Both the 4D plans and the gated plans spared more normal tissues than the 3D plans, especially the hver. Without increasing normal tissue dose, the 4D plans allowed for increas-ing the calculated dose from (50.8±2.0) Gy (3D plans) to (54.7±3.3) Gy, and the gated plans could further increase the dose to (58.0±3.9) Gy. Conclusions The 4DCT-based plans can ensure optimal tar-get coverage with less irradiation of normal tissues and allow dose escalation when compared with 3D plans.Respiratory gated radiotherapy can further reduce the target volumes to spare more surrounding tissues, espe-cially for patients with large extent of respiratory mobility.

OBJECTIVE: To investigate the risk factor,type and characteristic nystagmus of the otolith abnormal migration during diagnosis and treatment for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV). The therapy and prevention is also discussed. METHOD: Four hundred and seventy-nine patients with PSC-BPPV were treated by Epley's canalith repositioning procedures(CRP) from March 2009 to March 2012. We observed otolith abnormal migration complicating during diagnosis and treatment. According the type of otolith abnormal migration, the additional repositioning maneuver was performed. RESULT: The rate of complication was 8. 1%(39/479), with canal conversion in 5.4%(26/479) and primarily canal reentry in 2.7%(13/479). The rate of incidence of conversion to horizontal canal conversion and anterior canal were 4. 8%(23/479)and 0. 6%(3/479) respectively. All the patient was cured in follow up. The risk factors were unappropriated head movement during or after CRP, including another Dix-Hallpike were performed immediately. CONCLUSION To prevent the complications,the pathognostic positioning sequence and angle of head rotation are commenced during CRP. Appropriate short time postural restrictions post-treatment is necessary. Careful observation of nystagrnus variation is crucial to determine the otolith abnormal migration.
Benign Paroxysmal Positional Vertigo ; therapy ; Head ; Humans ; Incidence ; Nystagmus, Pathologic ; etiology ; Otolithic Membrane ; Patient Positioning ; adverse effects ; Semicircular Canals ; Vertigo

A survey on schistosomiasis conducted in sampled 453 out of 1971 villages in Jingzhou City in the year of 2006. Miracidia hatching test demonstrated that the prevalence in human population was 3.9% (12 006/310 232), with sporadic cases of acute schistosomiasis, and the prevalence in cattle was 10.2%(270/2 651). The mean density of living snails was 0.67/0.11 m2(1 988/1 054 597) with a density of infected snails of 0.001 9/0.11 m2(1 988/713 486). In comparison to those of 2004, prevalence in humans decreased by 40.0%, prevalence in cattle increased by 22.3%; the snail-ridden area increased by 4.0%, but the mean density of living snails increased by 68.5% and the infected snail density increased by 18.8% with a decrease of 36.4% in snail infection rate. Consequently, there is an urgent need in controlling schistosome infection in cattle.

0.05).Compared to cultivation whose positive rate was 33.33%,the rates were obvious higher(P

Objective To survey the urinary iodine (UI) status of school children aged from 8 to 10 in Nanchang City, and to provide a scientific basis for preventing and controlling the iodine deficiency disorders (IDD). Methods From 2009 to 2012, Donghu, Xihu, Qingshanhu, Qingyunpu, Wanli, Nanchang, Xinjian, Jinxian and Anyi 9 counties (areas) were chosen in Nanchang City as monitoring areas, and five townships were selected according to the five directions as east, west, south, north and centre in each county (area), one school was selected in each township, 20 school children aged from 8 to 10 (10 males and 10 females) were chosen as respondents. Ammonium persulfate digestion-arsenic cerium catalytic spectrophotometry (WS/T 107-2006) was used to detect UI. The monitoring data on UI of 8 to 10 years old school-age children were collected and analyzed. Results From 2009 to 2012, a total of 3 600 urine samples were collected, the median of urinary iodine (MUI) was 257.35 μg/L. In the 4 years, the MUI of school children aged from 8 to 10 was 315.30, 314.80, 262.92 and 112.73 μg/L, respectively, the MUI decreased year by year, the difference was statistically significant (χ2=631.129, P<0.05). Compared with 2009 and 2010, the proportion [15.22% (137/900), 14.67% (132/900), 25.11% (226/900), 30.22%(272/900)] of MUI of 100 -199μg/L (moderate intake) in 2011 and 2012 increased year by year; the difference was statistically significant (χ2=93.977, P< 0.05). The MUIs between different counties (areas) were statistically significant (χ2=36.520, P<0.05). The MUI of children aged 8 (280.10 μg/L), 9 (255.11 μg/L) and 10 (249.20 μg/L) decreased with increasingage (χ2 = 7.813, P < 0.05). The MUI of male students (269.70 μg/L) was higher than that of female students (247.60μg/L), the difference was statistically significant (Z = - 3.704, P < 0.01). Conclusions Iodine nutrition status of 8 to 10 years old school-age children in Nanchang City is good, iodine intake meets the body's need. It is suggested that the monitoring for UI of school-age children should be strengthened in order to prevent the potential harmful effects of inappropriate iodine intake.

OBJECTIVETo evaluate transcervical removal of foreign bodies (TCRF) and to estimate the effectiveness of its monitoring methods.

METHODSOne hundred and thirteen women were identified as having residual intrauterine devices (IUD), residual pregnancy products, unabsorbed strings and broken hooks, which were not removed during routine curettage or IUD removal. All patients were monitored using B ultrasonography while TCRF was performed. Four cases were monitored by laparoscopy simultaneously. One case was monitored by laparoscopic ultrasonography.

RESULTSForeign bodies of one hundred and nine patients were taken out by TCRF. Uterine bleeding, amenorrhoea, discharge, abdominal pain, micturition and hematuria disappeared postoperatively. Fetal bones embedded into intramural uterin in four cases were not removed completely. Of these four, one became pregnant 4 months later after TCRF and term delivered. One case encountered uterine perforation that was sutured by laparoscopy.

CONCLUSIONSTCRF is safe and efficient. Sufficient cervical canal distension, selection of equipment and methods to be used is important for successful TCRF. As a non-invasive and effective monitoring method, B ultrasonography is the first choice to monitor for TCRF. For patients with high risk factors for uterine perforation, laparoscopic monitoring should be done simultaneously. Laparoscopic ultrasonography monitoring has both the advantages of B ultrasonography and laparoscopy monitoring, but is invasive and expensive.

Adult ; Aged ; Female ; Foreign Bodies ; diagnostic imaging ; surgery ; Humans ; Hysteroscopy ; methods ; Intrauterine Devices ; Laparoscopy ; Middle Aged ; Pregnancy ; Ultrasonography

Objective To investigate the methods and internal quality control ( IQC ) leucorrhea routine examinationin clinical laboratories of medical institutions in Guizhou Province.Methods In 2009, 97 clinical laboratories were randomly selected for the first investigation.At the same time, staffs in theinvestigated laboratories were educated on the importance of IQC.The second investigation of the same items was carried out in 2011 inthe same laboratories.The results of the two investigations were analyzed byChi-square test.Results 2009 and 2011 numbers of laboratories thoseonly used normal saline suspension method for leucorrhea examination were 17and 16 (χ2 =0.037, P >0.05 ) respectively, used bothnormal saline and 10%KOH suspension methodswere 16and 2(χ2 =12.003,P<0.01), used staining method were 64and 79(χ2 =5.488,P<0.05), both used suspension and staining methods were 60and 73(χ2 =4.041, P<0.05), used normal salinesuspension method combined with Wright stain and Gram staining methods were3and 28(χ2 =23.996,P<0.01) respectively.Numbers of Laboratoriespracticing IQC were 2and 88in 2009 and 2011 respectivly(χ2 =153.293,P <0.01).Conclusions Currently, the most common used method for leucorrhea routine examination is suspension.Through the investigations and education, the quality ofleucorrhea routine examination was improved in Guizhou Province.

Objective To establish an external quality assessment ( EQA) system of genitourinary tract secretions routine testing in Guizhou Province and improve the overall testing level.Methods From 2009 to 2011, more than 50 clinical laboratories in different grade hospitals from Guizhou Province were enrolled as participating units every year.EQA was carried out twice a year.Each time, five slides of high quality Wright′s or Gram stain smear of the genitourinary tract secretions or photographs obtained from these smears were selected to send to the participating laboratories for testing, and the feedback results from each laboratory were analyzed.The qualification was judged by the coincidence rate equal to or more than 80%. The average coincidence rates of each time and each year were statistically analyzed by Chi-squared test. Results From 2009 to 2011, the number of EQA participating units increased from 55 to 96, with an average return rate of >80%.Coincidence rates <80%of the 6 EQA results in the 3 years were as follow:four times for coccobacteria (73.7%,77.8%,61.1%,77.1%), twice for bacillus (75.6%,79.3%) and coccobacillus (64.3%,52.1%), once for infusorian (79.7%), epithelial cells (76.1%), neutropenia (75.7%) and cleanliness (71.3%).There were six batches of 30 quality assessment controls (accounting for 20.0%) in the six EQAs had the coincidence rate of <80%.Eleven items of 30 quality assessment controls with 1 to 15 batches were unqualified ( average coincidence rate of<80%) respectively.The item with the highest total average coincidence rate was suspected gonococcus (94.2%), and two items with the lowest total average coincidence rates were coccus and coccobacillus ( 77.0%, 75.2%, respectively ) . Conclusions This EQA program carried out within a certain range of clinical laboratories achieved good results:participating units increased significantly;the total score of all the items showed an obviously upward trend;the quality awareness of clinical lab technicians has enhanced to a certain extent.In this study, EQA system of genitourinary tract secretion routine testing were preliminarily established in Guizhou province, which provided a reference model of internal quality control ( IQC ) and EQA for clinical laboratories and higher authorities, and will be bound to have a positive impact on improvement of the overall level of genitourinary tract secretion routine testing.

Objective To investigate the patterns of gait and locomotion in three dimension space using OptiTrack motion capture system in 30 healthy people aged 20-70 years. Methods The 3D OptiTrack motion capture system was applied in young(aged 20-30 years,n=10),middle-aged(aged 40-50 years,n=10)and the elderly (aged 60-70 years,n=10)to capture the gait and the rhythmic oscillations of the trunk,head,hip and kneewhen subjects walked on the treadmill under three different conditions of normal walking,walking under visual interfering and walking under proprioceptive interfering.Several markers were placed on the subject.For each locomotor trial, the preferred walking speed,stride width,stride time,the absolute angular dispersions and the stander deviation of four segments around the roll,pitch and yaw axes,and gait instability(λ)were calculated to assess the equilibrium strategies of head,trunk,pelvis and knee under different experimental conditions. Results With increasing age, there were decreases in preferring walking speed(PWS)and increases in stride width(F=3.23,3.87;P=0.030, 0.020,respectively).The absolute angle of the segment of head in roll axis was significantly smaller in young group than in middle age and elderly group(F=4.01,3.72;P=0.035,0.028,respectively)under the condition of normal walking and proprioceptive interfering.The trunk sway in yaw was significantly decreased while significantly increased in roll plane either in normal walking or walking under proprioception interfering(F=3.19,P=0.015) .The standard deviation(SD)of movement of head,trunk and hip in yaw direction was higher in young group than in middle-age and elderly group(F=2.89,3.14,3.92;P=0.036,0.019,0.034,respectively),but was lower in young group in roll direction than in middle-age and elderly group(F= 3.90,2.56,3.28;P= 0.017,0.021,0.056, respectively),the difference existed only in hip and trunk under proprioception interfering.The SD value of movement of bilateral knee joints was increased in elderly subjects.Using mediolateral-λ(ML-λ)to predict the gait stability,the results showed a significantly increased λ value by our small circle,and the λ value was positively correlated with age(r=0.03,P<0.05). Conclusions With aging,the abnormal adjustment of body posture and the incongruity of gait may cause a high risk for falling,and gait instability begins to increase as early as age 40-50 years.This finding supports that local dynamic stability is likely to be an indicator of falling risk.OptiTrack motion capture system can be used to evaluate a balance for rehabilitation.